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North Korea

Democratic People's Republic of Korea US Consular Information Sheet
April 29, 2008
Prior to departing the United States, U.S. citizens planning to transit China on their visit to North Korea are encouraged to register on line with the U.S. Emba
sy in Beijing; U. S. citizens transiting South Korea to take the Mount Kumgang or Kaesong City tours should register with the U.S. Embassy in Seoul.
U. S. citizens visiting North Korea should also register with the Swedish Embassy in Pyongyang (U.S. Protective Power).
Please see the Registration/Embassy Location section below.

COUNTRY DESCRIPTION: The Democratic People’s Republic of Korea (North Korea or the DPRK) is a highly militaristic Communist state located on the Korean Peninsula between northeast China and the Republic of Korea (South Korea or ROK), with land borders with China, Russia and South Korea.
The DPRK is one of the world’s most isolated countries.
The continuing dispute over North Korea’s development of nuclear programs and nuclear weapons has resulted in tensions in the region and between the United States and the DPRK.
North Korea limits trade and transportation links with other countries and tightly restricts the circumstances under which foreigners may enter the country and interact with local citizens.
Telephone and fax communications are unavailable in many areas of the country and foreigners can expect their communications to be monitored by DPRK officials.
In the past few years, North Korea has experienced famine, flooding, fuel and electricity shortages, and outbreaks of disease.
Many countries, including the United States, have contributed to international relief efforts to assist the people of North Korea.

Foreign tourists are a means for North Korea to earn much needed foreign currency, but an underdeveloped service sector, inadequate infrastructure, and political tensions with surrounding countries have stymied any significant tourist flow.
North Korean efforts to expand tourism have focused primarily on group tours from China, as well as from South Korea primarily to the Mount Kumgang tourist area and the city of Kaesong.

The United States does not maintain diplomatic or consular relations with the DPRK.
The Swedish Embassy located in Pyongyang acts as the United States’ interim consular protective power and provides basic consular services to U.S. citizens traveling in North Korea.
Please refer to Special Circumstances for additional information.

Read the Department of State Background Notes on North Korea for additional information.

ENTRY/EXIT REQUIREMENTS: North Korean visas are required for entry.
The U.S. Government does not issue letters to private Americans seeking North Korean visas, even though in the past such letters have sometimes been requested by DPRK embassies.
Prospective travelers entering and departing North Korea through China must also obtain a two-entry visa for China, as a valid Chinese visa is essential for departing North Korea at the conclusion of a visit or in an emergency.
While the ROK government is attempting to open direct travel routes to the DPRK, routine travel from the ROK to the DPRK is currently prohibited.
Travel across the demilitarized zone (DMZ) is allowed only infrequently for official and government-authorized cultural and economic exchanges, or aid shipments, and for tours limited to Mt. Kumgang and Kaesong City.
There are no regularly operating direct commercial flights from South Korea to North Korea.
U.S. citizens who arrive in North Korea without a valid U.S. passport and North Korean visa may be detained, arrested, fined or denied entry.
Travelers to North Korea report that fees for local travel costs (taxi, tolls, permits and the cost for security personnel assigned to escort foreigner visitors) can be high and arbitrary.

Where to obtain a North Korean visa: There is no DPRK embassy in the United States.
U.S. citizens and residents planning travel to North Korea must obtain DPRK visas in third countries, for example in Beijing, China.
For information about entry requirements and restricted areas, contact the DPRK Mission to the United Nations in New York.
Address inquiries to:

The Permanent Representative of the Democratic
People’s Republic of Korea to the United Nations
820 Second Avenue
New York, NY
10017
Tel: (212) 972-3105
Fax: (212) 972-3154

Americans living abroad can contact the DPRK embassy, if any, in their country of residence.
U.S. citizens traveling to North Korea may obtain their visas at the DPRK Embassy in Beijing, China, which will issue visas only after receiving authorization from the DPRK Foreign Ministry in Pyongyang.
Prior to traveling to the region, travelers may wish to confirm that authorization to issue their visa has been received from Pyongyang.
Americans can call the North Korean Embassy in Beijing prior to their travel by telephone at (86-10) 6532-1186 or (86-10) 6532-1189 (fax: (86-10) 6532-6056).

Information on dual nationality or the prevention of international child abduction can be found on our website.
For further information about customs regulations, please read our Customs Information sheet.
Please see those sections below under Special Circumstances.

SAFETY AND SECURITY: DPRK government security personnel closely monitor the activities and conversations of foreigners in North Korea.
Hotel rooms, telephones and fax machines may be monitored, and personal possessions in hotel rooms may be searched.
Photographing roads, bridges, airports, rail stations, or anything other than designated public tourist sites can be perceived as espionage and may result in confiscation of cameras and film or even detention.
DPRK border officials routinely confiscate visitors’ cell phones upon arrival, returning the phone only upon departure.
Foreign visitors to North Korea may be arrested, detained or expelled for activities that would not be considered criminal outside the DPRK, including involvement in unsanctioned religious and political activities, engaging in unauthorized travel, or interaction with the local population.
For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site
at where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on worldwide 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: The North Korean government does not release statistics on crime.
Violent crime is rare and street crime is uncommon in Pyongyang.
Petty thefts have been reported, especially at the airport in Pyongyang.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and to the Swedish Embassy.
If you are a victim of any crime while in North Korea, in addition to reporting to local police, please contact the Swedish Embassy for assistance (address and phone number below).

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Persons with medical problems should not travel to North Korea.
For decades, medical facilities in the DPRK have suffered from a lack of resources and electricity, as well as inadequate and often outdated skills among the medical staff.
Hospitals in Pyongyang can perform basic examinations and lifesaving measures but functioning x-ray facilities are not generally available.
Surgery should be avoided.
For accidents outside Pyongyang, transport back to the capital can be a lengthy trip without medical assistance.
Persons requiring regular medication are encouraged to bring sufficient stocks of drugs for personal use since most drugs are impossible to obtain locally.
Hospitals will expect immediate U.S. dollar cash payment for medical treatment.
Credit cards and checks have not been honored in the past, according to diplomatic personnel stationed in the DPRK.
Local DPRK hosts are often not aware of available evacuation options and might claim that no such options exist.
In case of serious medical problems, it is important to insist on immediate contact with the Swedish Embassy.
The Swedish Embassy can arrange a medical evacuation to Beijing within approximately 5-10 hours.

Vaccinations.
All necessary vaccinations should be received prior to traveling to North Korea.
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 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.
Travelers with special dietary requirements are advised to bring food with them to North Korea, as the restaurants available to foreigners may have limited menus that lack variety and nutritional adequacy.

Medical Vaccinations. In the case of a critical illness or accident, the Swedish Embassy will attempt to arrange flight clearances for air ambulances performing emergency medical evacuations.
Medical air evacuation costs vary, but average approximately $40,000 to $50,000 for medical, personnel, aircraft and clearance costs.
Clearances can usually be arranged within one day.
Medical evacuation by regularly scheduled airlines can be arranged, but is limited to the very few flights that operate from Pyongyang to Beijing, Dalian, Shenyang and Macau.
Chinese visas for injured foreigners and any escorts must be obtained prior to the evacuation from North Korea in order to transit China.
Even in the case of a medical emergency, transit visas may take several days to arrange.
Evacuation across the DMZ to South Korea is not allowed.

If an American citizen falls ill or is injured while traveling in the DPRK, accompanying travelers or family members should immediately contact the Swedish Embassy using the phone numbers listed below.

The Embassy of Sweden,
Munsu-Dong District,
Pyongyang, DPRK

Telephone and fax numbers for the Swedish Embassy (U.S. Protective Power) are:
Tel:
(850-2) 3817 485 (Reception)


(850-2) 3817 904, 907(First Secretary)


(850-2) 3817 908, 905 (Ambassador)
Fax:
(850-2) 3817 663
Email:
ambassaden.pyongyang@foreign.ministry.se
Notification also should be made to the U.S. Embassy’s American Citizen Services (ACS) Unit in Beijing, China, using the phone numbers listed below:

U.S. Embassy, Beijing
American Citizen Services
2 Xiushui Dong Jie
Beijing, China 100600
Telephone: (86-10) 6532-3431
Fax: (86-10) 6532-4153.

After hours, please call (86-10) 6532-3431 and ask for the Embassy duty officer.
Americans who wish to contact U.S. consular officials in China can e-mail amcitbeijing@state.gov
Companies that may be able to arrange evacuation services include, but are not limited to those listed below.
Travelers may wish to contact these or other emergency medical assistance providers for information about their ability to provide medical evacuation insurance and/or assistance for travelers to North Korea.

SOS International (www.intsos.com)
U.S. telephone:
(1-800) 468-5232
China telephone:
(86-10) 6462-9111/9118

Medex Assistance Corporation (www.medexassist.com)
U.S. telephone:
(410) 453-6300 / 6301
Toll free:
108888-800-527-0218 (call from China)
China telephone:
(86-10) 6595-8510)

Global Doctor (www.globaldoctor.com.au/default.php)
China telephone: (86-10) 83151914).









(86-24) 24330678 in Shenyang, Liaoning Province

Useful information on medical emergencies abroad, including overseas insurance programs, is provided in the Department of State’s Bureau of Consular Affairs brochure Medical Information for Americans Traveling Abroad , available via the Bureau of Consular Affairs home page.

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 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 North Korea is provided for general reference only, and may not be totally accurate in a particular location or situation.

Foreigners not holding a valid DPRK driver’s license are not allowed to drive in North Korea.
Foreigners generally are not allowed to use public buses or the subway.
North Korea has a functioning rail transport system; however delays occur often, sometimes for days.
On occasion, service may cease altogether before a traveler reaches his/her final destination.
Bicycles are unavailable for rental or purchase.
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 North Korea, the U.S. Federal Aviation Administration (FAA) has not assessed North Korea’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:

Interim Consular Protecting Power: The United States does not maintain diplomatic or consular relations with the DPRK.
The U.S. Government therefore cannot provide normal consular protective services to U.S. citizens in North Korea.
On September 20, 1995, a consular protecting power arrangement was implemented, allowing the Swedish Embassy in the DPRK capital of Pyongyang to provide basic consular protective services to U.S. citizens traveling in North Korea who are ill, injured, arrested or who have died while there.

Consular Access:
There is no United States diplomatic or consular presence in the DPRK.
Americans traveling in the DPRK may receive limited consular services from the Swedish Embassy in Pyongyang.
Please see section above on “Medical Insurance” for address and contact information for the Swedish Embassy in Pyongyang.
U.S. citizens are encouraged to carry photocopies of their passport data and photo pages with them at all times so that, if questioned by DPRK officials, evidence of their U.S. citizenship is readily available. The U.S.- DPRK Interim Consular Agreement provides that North Korea will notify the Swedish Embassy within four days of an arrest or detention of an American citizen and will allow consular visits within two days after a request is made by the Swedish Embassy.
However, consular access has not been readily granted in cases where American citizens have been reported as being detained or held against their will by DPRK officials.
Moreover, delegations with ethnic Korean individuals, or delegations representing Korean-affiliated organizations in the U.S., are handled by DPRK structures that are well beyond the reach of diplomatic missions in Pyongyang.
Hence, in case of a situation requiring consular assistance, the Embassy’s access is even more limited.

Customs Regulations:
DPRK authorities may seize documents, literature, audio and videotapes, compact discs and letters deemed by North Korean officials to be pornographic, political or intended for religious proselytizing.
Persons seeking to enter North Korea with religious materials in a quantity deemed to be greater than that needed for personal use can be detained, fined and expelled.
It is advisable to contact the DPRK Mission to the United Nations or a DPRK embassy or a DPRK consulate in a third country for specific information regarding customs requirements.
Please see our information on customs regulations.

Dual Nationality:
The DPRK does not recognize dual nationality.
U.S. citizens of Korean heritage may be subject to military obligations and taxes on foreign source income.
For further information see our dual nationality flyer.
Additional questions on dual nationality may be directed to Overseas Citizens Services, SA-29, 4th Floor, 2201 C Street NW, Washington, DC
20520 or by telephone at 1-888-407-4747.

U.S. Government Economic Sanctions Against North Korea:
At this time, goods of North Korean origin may not be imported into the United States either directly or indirectly without prior notification to and approval of the U.S. Treasury Department’s Office of Foreign Assets Control (OFAC).
Exports to North Korea may be subject to licensing requirements.
Check with the Commerce Department’s Bureau of Industry and Security.
Most financial transactions between U.S. and North Korean citizens are authorized, provided they meet the criteria outlined in the June 19, 2000, and subsequent amendments to OFAC regulations.
All transactions ordinarily incident to travel to, from and within North Korea and to maintenance within North Korea are authorized, and U.S. travel service providers are allowed to organize group travel to North Korea.
Commercial U.S. ships and aircraft carrying U.S. goods are allowed to call at North Korean ports with prior clearance.
In May 2006, OFAC began prohibiting U.S. persons from “owning, leasing, operating or insuring any vessel flagged by North Korea.”
Full text of the regulation can be found in the Federal Register at http://www.fas.usda.gov/info/fr/2000/061900-a.txt.

The U.S. maintains various export controls and other sanctions on North Korea for counter- terrorism, nonproliferation and other reasons.
Exports of military and sensitive dual-use items are prohibited, as are most types of U.S. economic assistance.
The U.S. also abides by multilateral restrictions and sanctions with respect to North Korea, including those contained in recent United Nations Security Council Resolutions in response to the North Korean missile launches and nuclear test in July and October 2006.

For additional information, consult the U.S. Department of the Treasury, Office of Foreign Assets Control (OFAC) home page on the Internet at http://www.treasury.gov/offices/enforcement/ofac/.

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.
Local laws also may not afford the protections available to U.S. citizens under U.S. law.
Penalties for breaking local laws can be more severe than those in the United States for similar offenses.
Persons violating the law, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession of, use of, or trafficking in illegal drugs are strict, and convicted offenders often face long jail sentences and heavy fines.
North Korean security personnel may view unescorted travel inside North Korea by Americans who do not have explicit official authorization as espionage, especially when the U.S. citizens are originally from South Korea or are thought to understand the Korean language.
Security personnel may also view any attempt to engage in unauthorized conversations with a North Korean citizen as espionage.
Foreigners are subject to fines or arrest for unauthorized currency transactions or for shopping at stores not designated for foreigners.
It is a criminal act in North Korea to show disrespect to the country's current and former leaders, Kim Jong-Il and Kim Il-Sung, respectively.
Foreign journalists have been threatened when questioning the policies or public statements of the DPRK or the actions of the current leadership.

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 additional 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: There is no U.S. embassy or consulate in North Korea.

U.S. citizens planning to visit North Korea are encouraged to register prior to departing the United States with the U.S. Embassy in Beijing if entering North Korea from China.
U.S. citizens planning to visit the Mount Kumgang tourism area or Kaesong from South Korea should register with the U.S. Embassy in Seoul.
Registration can be done on line through the State Department's travel registration web site
or in person, by telephone or fax, at the U.S. Embassy.

The Embassy of Sweden (U.S. Protective Power).
Americans who have a medical or consular emergency and who wish to contact the Swedish Embassy are reminded first to communicate this need to their North Korean escorts or guides.
Do not attempt to travel to the Swedish Embassy unescorted.
The Swedish Embassy (U.S. Protective Power) is located at Munsu-Dong District, Pyongyang.
The telephone and fax numbers for the Swedish Embassy (U.S. Protective Power) are:

Tel:
(850-2) 3817 485 (reception)
Tel:
(850-2) 3817 904, (850-2) 3817 907 (First Secretary)
Tel:
(850-2) 3817 908, (850-2) 3817 905 (Ambassador)
Fax:
(850-2) 3817 663

U.S. Embassy Beijing.
The American Citizen Services Unit of the U.S. Embassy in Beijing, China, is located at:
2 Xiushui Dong Jie, Beijing.
The Embassy is located near Ritan Park.
Telephone: (86-10) 6532-3431.
Fax: (86-10) 6532-4153.
Email: amcitbeijing@state.gov.
The Embassy Beijing web site is http://beijing.usembassy-china.org.cn/.

For after-hours emergencies please call (86-10)6532-3431 and ask for the Embassy duty officer.
U.S. Embassy Seoul.
The American Citizen Services Unit of the U.S. Embassy in Seoul, South Korea, is located at:
32 Sejong-no, Jongno-gu, Seoul.
The Embassy is located across the street from Sejong Cultural Center and next to the Ministry of Information and Communication/KT Building.

Telephone: (82-2) 397-4114.
Fax: (82-2) 2-397-4101.
E-mail: seoul_acs@state.gov.
The Embassy Seoul web site is http://seoul.usembassy.gov/.

For after-hours emergencies please call (82-2) 721-4114 and ask for the Embassy duty officer.
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This replaces the Consular Information Sheet dated October 15, 2007, to update the sections on Country Description, Medical Insurance, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Mon 23 Sep 2019
Source: Chosun [edited]

A paratyphoid fever epidemic has broken out recently in North Korea in the aftermath of Typhoon Lingling. The illness, which causes high fever and diarrhoea, has been spreading in South Hamgyong and South Pyongan provinces since typhoon Lingling hit the North, a source said Sunday [22 Sep 2019]. It is mainly transmitted by dirty water and human feces in the superannuated sewage systems and contaminated water supply.

The regime is reportedly restricting the movement of trains and vehicles to and from the 2 provinces. Meanwhile, the flooding of paddy and other grain fields in Hwanghae and Pyongan provinces is expected to devastate this year's [2019's] harvest.  [Byline: Kim Myong-song]
====================
[Paratyphoid fever is similar to typhoid fever in that both are enteric fever types of disease, although the former can be, but is not necessarily, less severe. The paratyphoid salmonellas are divided into A, B, and, rarely now, C. _Salmonella_ Paratyphi, also referred to as _S. enterica_ serotype Paratyphi, types B and C also have species, now serotypes, Schottmuelleri and Hirschfeldii, respectively. Like typhoid, paratyphoid is generally considered not to be a zoonosis, with [only] humans as the reservoir, but the paratyphoid bacillus has been isolated from domestic animals and fish.

In India, paratyphoid A has become an increasing problem, accounting for up to 45% of cases of enteric fever in 1998 (1). Although initially quite sensitive to antimicrobials, strains have become more resistant to quinolones; in contrast, _S._ Typhi has manifested resistance for some time.

In a report regarding differential risk factors for typhoid and paratyphoid in Indonesia, the authors found that the infections seemed to have distinct routes of transmission (2). Typhoid was associated with factors within a household (recent case in the house, no soap for handwashing, sharing of food from the same plate, no toilet in the house), whereas paratyphoid was associated with sources outside the household such as food from street vendors and flooding.

References
-------
1. Sood S, Kapil A, Dash N, et al.: Paratyphoid fever in India: an emerging problem. Emerg Infect Dis. 1999; 5: 483-4.
2. Vollaard AM, Ali S, van Asten Hagh, et al.: Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia. JAMA. 2004; 291: 2607-15.

A map of North Korea showing the location of these 2 adjacent provinces in the central part of the country can be seen at <http://annamap.com/north-korea/>. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
South Hamgyeong Province, North Korea:
South Pyongan Province, North Korea:
Date: Sun, 8 Sep 2019 14:18:07 +0200 (METDST)

Seoul, Sept 8, 2019 (AFP) - North Korean state media said Sunday five people had been killed in a powerful typhoon that destroyed farmland and damaged hundreds of buildings.   Typhoon Lingling, called Typhoon-13 in North Korea, hit the reclusive nuclear-armed state on Saturday afternoon, reported the official KCNA news service.

The impoverished and isolated country is vulnerable to natural disasters, especially floods, due in part to deforestation and poor infrastructure.   "According to data available from the State Emergency Disaster Committee, five persons were dead and three persons injured. The injured persons are now under treatment at hospitals," KCNA said.   More than 460 houses and at least a dozen public buildings were "completely or partly destroyed or inundated" by the typhoon, it said.

Crops were wiped out or damaged in 46,000 hectares (110,000 acres) of farmland -- roughly the area of the small European country of Andorra -- the report said, adding that recovery efforts were underway.   It came after South Korea's disaster agency reported three deaths caused by the same typhoon, according to Yonhap news agency.   On Saturday, KCNA reported that North Korean leader Kim Jong Un had berated officials for their "easygoing" attitude to the approaching storm.   According to that dispatch, Kim had convened an emergency meeting on Friday and said "dangerous circumstances" caused by the typhoon were "imminent", but that many in positions of authority were ill-prepared.
Date: Tue, 18 Jun 2019 06:40:09 +0200
By Sebastien BERGER

Pyongyang, June 18, 2019 (AFP) - On a grey stone column in Pyongyang, a mural shows Chinese and North Korean soldiers rushing into battle against US-led forces in the Korean War. Decades later, the monument is a regular stop for new waves of Chinese going to the North, this time as tourists.   Hundreds of soldiers and workers have been sprucing up the obelisk and its grounds in recent days ahead of a state visit to Pyongyang by Chinese President Xi Jinping this week.   An inscription on it lauds "the Chinese People's Volunteer Army, who fought with us on this land and smashed down the common enemy".   Their "immortal exploits" will "last forever", it proclaims, as will "the friendship forged in blood between the peoples of the People's Republic of China and the Democratic People's Republic of Korea".   Nearly 70 years after Mao Zedong sent millions of soldiers to save Kim Il Sung's troops from defeat as General Douglas MacArthur's men marched up the peninsula, China remains the isolated, nuclear-armed North's key diplomatic backer and main provider of trade and aid.

Now the Friendship Tower, as the monument is known, attracts growing hordes of Chinese tourists -- and the renovations suggest it may also be on Xi's itinerary.   Ordinary Chinese pay travel companies around 2,500 yuan ($360) for a standard three-day trip, arriving overland by train in Pyongyang to tour the capital's highlights, from the Arch of Triumph to Kim Il Sung Square.   The following day they head south to the Demilitarized Zone that has divided the peninsula since the two sides fought each other to a stalemate in 1953, before returning home.   "I'm very interested in North Korea and wanted to come to see what North Korea looks like," said Yu Zhi, a retiree from Anhui province visiting Pyongyang, telling AFP that she had a "special feeling" for the country.   "China is very friendly with North Korea," added her fellow traveller, a woman surnamed Jin. "We have been friends for generations."

- Lips and teeth -
It was not always so. Mao -- whose eldest son Mao Anying was among those killed in what China still calls the "War to Resist US Aggression and Aid the DPRK" -- described the neighbours as "as close as lips and teeth".   Ties then waxed and waned during the Cold War, when founder Kim Il Sung was adept at playing his Soviet and Chinese allies off against each other, and his grandson, the current leader Kim Jong Un, did not visit Beijing to pay his respects for more than six years after inheriting power.   But as he embarked on a flurry of diplomacy last year he made sure that Chinese President Xi Jinping was the first foreign head of state he met, and he has since done so three more times -- more often than Kim has seen any other leader.    Now Xi is going to reciprocate.

At the same time Chinese tourism to the North has reached record highs, according to travel industry sources -- so much so that Pyongyang has imposed a limit on arrivals.   No official figures are available from authorities on either side, but Simon Cockerell, general manager of Koryo Tours, the market leader for Western visitors, said there had been "a huge increase in Chinese tourists".   At peak times 2,000 people a day had been arriving in Pyongyang, he said. "That's far too many because there is no infrastructure to accommodate that many tourists, so problems with train tickets, with plane tickets, hotel space."   As a result North Korean authorities had themselves set a 1,000-a-day cap, he added, although it was unclear whether this applied across the industry or solely to Chinese, who make up the vast majority of arrivals.   "There are issues with just hundreds of people showing up at the same time."

- 'Choices being made' -
China has a proven willingness to use tourism as a geopolitical negotiating weapon -- it banned group tours to South Korea after it deployed a US anti-missile system, THAAD.   With nuclear negotiations at a stalemate the North remains subject to multiple UN Security Council sanctions, and the US imposed a travel ban on its own citizens visiting following the death of student Otto Warmbier, who had been jailed after trying to steal a propaganda poster.   But tourism is not among the sectors targeted by the UN, potentially enabling Beijing to use it as an incentive for its sometimes wayward ally.

The Chinese travel phenomenon is market-driven, rather than prompted by state order -- as well as the market offered by China's huge population, the two countries' border enables cheap overland journeys.   But simply enabling it to take place, said John Delury of Yonsei University in Seoul, meant "We can infer some choices are being made" by Beijing.   "We know it's a lever they can turn on and off," he said.   Even with the diplomatic process at a standstill, he added, "The Chinese think you have to use this window of opportunity to move things forward. There has to be a path on both sides and so something like opening up tourism is a good way to enable that."   At the Monument to the Three Charters for Reunification on the edge of Pyongyang, where two giant stone women form an arch over a road, a secondary school teacher from Shanghai called Peng said: "We are both socialist countries. I feel there are more Chinese coming to visit."
Date: Sun, 7 Apr 2019 11:11:12 +0200

Pyongyang, April 7, 2019 (AFP) - Twice as many foreigners as last year gathered in Pyongyang Sunday for the city's annual marathon, tour firms said, as reduced tensions see visitor numbers rise in isolated North Korea.    The event -- part of the celebrations for the anniversary of founder Kim Il Sung's birth in 1912 -- is the highlight of the North's tourism calendar and offers the chance to run or jog through the streets of the tightly controlled city.

Around 950 Westerners entered the event, according to market leader Koryo Tours, compared to some 450 last year when numbers slumped.   That brought participation almost back to the levels of 2017, before tensions soared as the North carried out a series of missile launches and leader Kim Jong Un traded threats and personal insults with US President Donald Trump.   The same year, Washington also banned its citizens from visiting the North following the death of Otto Warmbier, a US student jailed for trying to steal a propaganda poster who died in a mysterious coma days after his release.

Several other countries subsequently raised their travel warnings, a combination of events that dealt a significant blow to the North's tourism industry.   The US ban remains in place but more Western tourists signed up for the marathon this time, tour operators said, following a year of high-level diplomacy between Trump and Kim.   "As political tensions have subsided, tourism demand has increased," said Elliott Davies, director at Uri Tours, another operator, adding: "You could plot a graph in this direct relationship."

- 'Marathon chasers' -
The vast majority of tourists to the North are Chinese and some 5,000 Westerners a year used to visit the North -- with about 20 percent of those from the US -- seeking unique adventures in one of the most closed countries in the world.   The annual race also attracts so-called "Marathon Chasers" who tick off runs around the world, said Matt Kulesza, a senior tour guide at Young Pioneer Tours.   Angel Arnaudov, a 34-year-old engineer from Macedonia, said Pyongyang came onto his "radar" after finishing more than 30 marathons in cities ranging from Tokyo, New York and Copenhagen.   "I want to experience the life in North Korea myself and see if it is like they say on TV or different," he said, adding he would be posting videos on his YouTube channel.

For third-time participant Jasmine Barrett, the Pyongyang Marathon was an opportunity to interact with ordinary North Koreans who line the streets to cheer on the runners, offering high-fives and posing for selfies.   "I keep coming back because I love to see the smiles on the children's faces," the Australian entrepreneur told AFP.   "I'd definitely recommend it to others because it's a great way to see the city and the people who live there," she added.   Tour operators advise visitors to take extra precautions about "what to do and what not to do" when travelling in the North.   Simon Cockerell, Koryo Tours' general manager, said: "This is vital when visiting North Korea and anyone wanting to travel shouldn't go without a briefing."
Date: Thu, 17 Jan 2019 07:33:49 +0100

Seoul, Jan 17, 2019 (AFP) - A giant beach resort in North Korea is nearing completion, a US monitor said Thursday, with satellite pictures showing rapid progress on the sprawling development, now equipped with a water slide and cinema.   The seaside strip known as the Wonsan-Kalma Coastal Tourist Area is squeezed between a new airport and the country's east coast, in an area that has previously been used for artillery drills and ballistic missile launches.

It is intended as a centrepiece of the isolated country's nascent tourism industry as Pyongyang seeks to develop its economy despite international sanctions imposed over its nuclear weapons programmes.   North Korea receives an estimated 100,000 foreign tourists a year, the vast majority of them Chinese, according to industry sources, but Pyongyang issues no official figures itself.   The site's construction has been closely overseen by leader Kim Jong Un and plans have been announced for a grand opening in October, when the country marks the 74th anniversary of the founding of the ruling Workers' Party of Korea.

The respected 38 North website released satellite images taken as recently as December showing that most buildings previously under construction were "nearing external completion and several new or redesigned buildings were in advanced stages".   Kim, who reportedly spent his childhood summers in the area, visited the site at least three times last year according to state media, sometimes berating officials in charge of the works and issuing detailed orders.

Kim "found that the whole street was not perfect in the artistic aspect", the official KCNA news agency reported after his October inspection.   "He instructed officials to envisage the construction of more hotels and inns with over 30 floors," it added, along with more games arcades, movie theatres and an "all-event stadium", plus a "large water park and funfair".   Satellite photos from December 28 indicated the resort was growing into a "vast beach complex", 38 North said.

- 'Great beaches' -
US President Donald Trump, a former real estate developer turned billionaire, applauded North Korea's tourism potential last year following his landmark summit with Kim in Singapore.   After a four-minute screening of a bizarre Hollywood-style trailer -- apparently part of an overall pitch that the US could help the North advance technologically and economically -- Trump pointed to potential property projects in the cash-strapped nation.   "As an example, they have great beaches," he told reporters.    "You see that whenever they are exploding their cannons into the ocean. I said, 'Boy, look at that view. Wouldn't that make a great condo?'"

Kim mentioned the Wonsan-Kalma project in his key New Year speech and 38 North said the push on the development showed "a desire to demonstrate that North Korea, despite the economic sanctions in place, has an economy that is moving forward and showing signs of prosperity.   "It may also reflect an expectation that as the country improves its external political relations, tourism will follow," it added.

At present the US bans its own citizens from tourism in the North.   Hundreds of thousands of South Koreans used to visit Mount Kumgang near the inter-Korean border every year, travelling to a Seoul-funded tourist resort that was the first major cooperation project between the neighbours.   The trips came to an abrupt end in 2008 when a North Korean soldier shot dead a South Korean tourist who strayed off the approved path and Seoul suspended travel.
More ...

Belize

Belize US Consular Information Sheet
November 05, 2008
COUNTRY DESCRIPTION:
Belize is a developing country.
Tourism facilities vary in quality, from a limited number of business class hotels in Belize City and resorts on the cayes to
range of ecotourism lodges and very basic accommodations in the countryside.
Crime is a growing concern. Read the Department of State Background Notes on Belize for additional information.

ENTRY/EXIT REQUIREMENTS :
All U.S. citizens must have a U.S. passport valid for the duration of their visit to Belize.
U.S. citizens do not need visas for tourist visits of up to thirty days, but they must have onward or return air tickets and proof of sufficient funds to maintain themselves while in Belize.
Visitors for purposes other than tourism, or who wish to stay longer than 30 days, must obtain visas from the government of Belize.
All tourists and non-Belizean nationalities are required to pay an exit fee of U.S. $35 (payable in U.S. dollars only) when leaving Belize. Additional information on entry and customs requirements may be obtained from the Embassy of Belize at 2535 Massachusetts Avenue NW, Washington, DC
20008, Tel. (202) 332-9636 or at their web site:
http://www.embassyofbelize.org.

Information is also available at the Belizean Consular offices in Miami, and Los Angeles, or at the Belizean Mission to the UN in New York.
Visit the Embassy of Belize web site at http://belize.usembassy.gov 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:
Visitors should exercise caution and good judgment when visiting Belize.
Crime can be a serious problem (see Crime), particularly in Belize City and remote areas.
Road accidents are common (see Traffic Safety and Road Conditions) and traffic fatalities have included Americans.
Public buses and taxis are frequently in poor condition and lack safety equipment.
Medical care is limited and emergency response services such as ambulances or paramedics may be either unavailable or limited in capability or equipment (See Medical Facilities and Health Information).

Boats serving the public, especially water taxis, often do not carry sufficient safety equipment, may carry an excess number of passengers and may sail in inclement weather.
Rental diving equipment may not always be properly maintained or inspected, and some local dive masters fail to consider the skill levels of individual tourists when organizing dives to some of Belize’s more challenging sites. Deaths and serious mishaps have occurred as a result of negligent diving tour operators and the lack of strict enforcement of tour regulations. The Embassy strongly recommends that anyone interested in scuba diving and snorkeling while in Belize check the references, licenses and equipment of tour operators before agreeing to or paying for a tour.
Both tour guides and boat captains are now required to be licensed by the Government of Belize. Safety precautions and emergency response capabilities may not be up to U.S. standards.

Following a fatal accident at the Cave Branch Archeological Park in September 2008, the Belize Tourism Board (BTB) is implementing new regulations, effective and legally enforced beginning October 15, 2008, to improve safety at cave tubing attractions.
Those policies will include an enhanced, mandatory guest-to-guide ratio of eight-to-one for all operating cave tubing tour companies in Belize.
Additional signage will be posted in each cave tubing excursion site, informing participants of park rules and current water conditions and/or warnings.
Mandatory specialty training for each cave tubing guide will continue and include education on new regulations.

Helmets will also be required for each cave tubing participant starting January 1, 2009.
Furthermore, the National Institute of Culture and History (NICH), which manages the Cave Branch Archeological Park, will be installing additional monitoring equipment for cave tubing excursions which measure currents and other factors needing to be taken into considerations to ensure participant safety,

Cave tubing participants are urged to exercise due caution and their own best judgment regarding safety and river conditions at the time of their tour, particularly during the rainy/hurricane season from June 1 through November 30.
Rainfall upstream from tour sites, sometimes miles away, can cause rapid changes in current strength and water level conditions without notice.

The border between Belize and Guatemala is in dispute, but the dispute thus far has not affected travel between the two countries.
There have not been any terrorist activities in Belize.

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:
The incidence of crime, including violent crimes such as armed robbery, shooting, stabbing, murder, and rape, is on the rise.
The Embassy has noted an increase in recent years in reports of crimes against tourists at resorts and on the roadways and river ways.
The incidence of crimes such as theft, burglary, purse snatching and pick pocketing rises around the winter holidays and spring break.
Several victims who resisted when confronted by criminals have received serious personal injuries, including gunshot wounds.
Although the majority of reported incidents are in Belize City, crime occurs in all districts including tourist spots such as San Pedro, Caye Caulker, and Placencia.

Sexual harassment and/or assault of females traveling alone or in small groups have occurred this past year.
Several American travelers have been the victims of sexual assaults in recent years. One of these occurred after the victim accepted a lift from an acquaintance, while others have occurred during armed robberies in resort areas.
One of these assaults has resulted in the death of the victim.

The Embassy recommends that visitors travel in groups and only in daylight hours, stay off the streets after dark, in urban and rural areas, and avoid wearing jewelry, or carrying valuable or expensive items.
As a general rule, valuables should not be left unattended, including in hotel rooms and on the beach.
Care should be taken when carrying high value items such as cameras, or when wearing expensive jewelry on the street.
Women’s handbags should be zipped and held close to the body.
Men should carry wallets in their front pants pocket.
Large amounts of cash should always be handled discreetly.

If traveling by taxi, use only vehicles with green license plates, do not get in a taxi that is occupied by more than the driver, and do not let the driver pick up additional fares.

Armed robberies of American tourist groups occurred during the summer of 2006 in the Mountain Pine Ridge and Caracol regions of the western district of Belize.
Due to increased police patrols, coordinated tours among resort security managers, and the arrest of two of the "highway bandits," there have not been any additional robberies since June, 2006. In the past, criminals have targeted popular Mayan archeological sites in that region.
Visitors should travel in groups and should stick to the main plazas and tourist sites.
Although there are armed guards posted at some of the archeological sites, armed criminals have been known to prey on persons walking from one site to another.
Victims who resist when confronted by these armed assailants frequently suffer personal injury.

Travel on rural roads, especially at night, increases the risk of encountering criminal activities.
Widespread narcotics and alien smuggling activities can make remote areas especially dangerous.
Though there is no evidence that Americans in particular are targeted, criminals look for every opportunity to attack, so all travelers should be vigilant.

Rather than traveling alone, use a reputable tour organization.
It is best to stay in groups, travel in a caravan consisting of two or more vehicles, and stay on the main roads.
Ensure that someone not traveling with you is aware of your itinerary.
Travelers should resist the temptation to stay in budget hotels, which are generally more susceptible to crime, and stay in the main tourist destinations.
Do not explore back roads or isolated paths near tourist sites.
And remember always to pay close attention to your surroundings.

Americans visiting the Belize-Guatemala border area should consider carefully their security situation and should travel only during daylight hours. Vehicles should be in good operating condition, adequately fueled, and carry communications equipment.
Persons traveling into Guatemala from Belize should check the Country Specific Information for Guatemala and the U.S. Embassy web site at http://guatemala.usembassy.gov for the latest information about crime and security in Guatemala.

A lack of resources and training impedes the ability of the police to investigate crimes effectively and to apprehend serious offenders. As a result, a number of crimes against Americans in Belize remain unresolved.
Nonetheless, victims of crime should report immediately to the police all incidents of assault, robbery, theft or other crimes as well as notifying the U.S. Embassy in Belmopan, telephone 822-4011(after hours and weekends 610-5030).
Tourists may contact the Belizean tourist police unit in addition to the main police office for assistance.

In addition to reporting crimes to local police, American citizens should report all criminal incidents to the U.S. Embassy in Belmopan, telephone 822-4011 (after hours and weekends 610-5030).
The embassy staff can assist an American with finding appropriate medical care, contacting family members or friends, and having funds transferred, as well as in determining whether any assistance is available from the victim’s home state.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help explain the local criminal justice process and assist in finding an attorney if needed.

Drug use is common in some tourist areas.
American citizens should avoid buying, selling, holding, or taking illegal drugs under any circumstances.
Penalties for possession of drugs or drug paraphernalia are generally more severe than in the U.S.

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.

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 care for minor conditions is generally available in urban areas.
Trauma or advanced medical care is limited even in Belize City; it is extremely limited or unavailable in rural areas.
Serious injuries or illnesses often necessitate evacuation to another country.
The Government of Belize reported an outbreak of dengue fever in April, May and June of 2005.

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 Belize is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Valid U.S. driver's licenses and international driving permits are accepted in Belize for a period of three months after entry.
Driving is on the right-hand side of the road.
Buses and private vehicles are the main mode of transportation in Belize; no trains operate in the country.
Roadside assistance can be difficult to summon, as there are very few public telephones along the road and emergency telephone numbers do not always function properly.
The Belizean Department of Transportation is responsible for road safety.

Roads in Belize vary from two-lane paved roads to dirt tracks.
The few paved roads are high-crowned roads, which can contribute to cars overturning, and have few markings or reflectors.
Even in urban areas, few streets have lane markings, leading many motorists to create as many lanes as possible in any given stretch of street or road.
Bridges on the major highways are often only single lanes.
The Manatee Road, leading from the Western Highway to Dangriga, is unpaved, easily flooded after storms and without services.
The Southern Highway from Dangriga to Punta Gorda is mostly completed and in good condition, except for a short portion that is under construction.
Service stations are plentiful along the major roads, although there are some significant gaps in the rural areas.

During Tropical Storm Alma/Arthur in May-June 2008, the Southern Highway bridge over the Sittee River, north of Kendall, Stann Creek District, was destroyed.
In the interim, a temporary causeway has been constructed pending permanent replacement of the Kendall bridge but at times the causeway may not be passable due to conditions on the Sittee River.
The causeway itself has had to be replaced several times following major rainfall and flooding.

Poor road and/or vehicle maintenance causes many fatal accidents on Belizean roads.
Speed limits are 55 miles per hour on most highways and 25 miles per hour on most other roads, but they are seldom obeyed or even posted.
Many vehicles on the road do not have functioning safety equipment such as turn signals, flashers, or brake lights.
Seatbelts for drivers and front-seat passengers are mandatory, but child car seats are not required.
Driving while intoxicated is punishable by a fine; if an alcohol-related accident results in a fatality, the driver may face manslaughter charges. Moreover, Americans can and have been imprisoned in Belize for accidents, even where alcohol is not involved.

Unusual local traffic customs include: pulling to the right before making a left turn; passing on the right of someone who is signaling a right-hand turn; stopping in the middle of the road to talk to someone while blocking traffic; carrying passengers, including small children, in the open beds of trucks; and tailgating at high speeds.

Bicycles are numerous and constitute a traffic hazard at all times.
Bicyclists often ride against traffic and do not obey even basic traffic laws such as red lights or stop signs.
Few bicycles have lights at night. It is common to see bicyclists carrying heavy loads or passengers, including balancing small children on their laps or across the handlebars.
The driver of a vehicle that strikes a bicyclist or pedestrian is almost always considered to be at fault, regardless of circumstances.
Americans who have struck cyclists in Belize have faced significant financial penalty or even prison time.

Driving at night is not recommended, due to poor signage and road markings, a tendency not to dim the lights when approaching other vehicles, and drunk driving.
Pedestrians, motorcyclists and bicyclists without lights, reflectors, or reflective clothing also constitute a very serious after-dark hazard.
Local wildlife and cattle also are road hazards in rural areas.
For safety reasons, travelers should not stop to offer assistance to others whose vehicles apparently have broken down.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Belize’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Belize’s 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:
Belize is vulnerable to tropical storms, especially from June 1 until November 30 of each year. General information on weather conditions may be obtained from the National Hurricane Center at http://www.nhc.noaa.gov.

It is not possible to access most U.S. bank accounts through automated teller machines (ATMs) in Belize.
However, travelers can usually obtain cash advances from local banks, Monday through Friday, using major international credit cards.

Special Notice for Dual Nationals:
A person who is a citizen of both the U.S. and Belize is able to enter Belize with only a Belizean passport; such a dual national should be aware, however, that he/she must have a U.S. passport in order to board a flight to the U.S. from Belize, and that average processing time for a passport at the U.S. Embassy in Belize is approximately 10 working days.

Belize customs authorities may enforce strict regulations concerning temporary importation into or export from Belize of firearms.
It is advisable to contact the Embassy of Belize in Washington or one of Belize’s Consulates in the U.S. for specific information regarding customs requirements.
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 Belize laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Belize 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.
Belize has strict laws making possession of a firearm or ammunition illegal unless a valid permit is obtained.
Penalties for firearms violations are severe.
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 Belize are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site in order to obtain updated information on travel and security within Belize.
Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located in the capital city of Belmopan, approximately 50 miles west of Belize City.
The U.S. Embassy is on Floral Park Road, Belmopan, Cayo District, and the telephone number is 822-4011.
The American Citizen Services section fax number is 822-4050.
In the event of an after hours emergency, the embassy duty officer may be reached at 610-5030. The Embassy is open from 8:00 a.m. to 5:00 p.m., Monday through Friday, except for the 12:00 noon to 1:00 p.m. lunch hour, and on U.S. and Belizean holidays.
The Embassy web site is http://belize.usembassy.gov/; the e-mail address is embbelize@state.gov

Travel News Headlines WORLD NEWS

Date: Wed 2 May 2018, 3:30 PM CST.
Source: Breaking Belize News [edited]

Ministry of Health staff from the Western Health Region are currently in Benque Viejo and surrounding areas monitoring a developing situation due to confirmed cases of hepatitis A in Arenal and Benque. According to a statement from the Ministry, there have been 3 confirmed cases in Benque Viejo and 11 suspected cases in Arenal.

Part of the plan includes sensitization of school staff and students about hepatitis A, its transmission and risk factors. Food handlers in Benque and Arenal will also be visited and informed of the risks of hepatitis A and the importance of following established protocols.

The relevant departments in health have been made aware and are working closely with the region to minimize ongoing cases including a sensitization session on the local radio station in Benque.
===================
[No information is given about the age of those affected. In much of the developing world where hepatitis A is quite endemic, the population is almost all seropositive for HAV by the age of 10. I would wonder if the infection was confirmed by a specific IgM anti-HAV antibody. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Cayo District, Belize: <http://healthmap.org/promed/p/6149>]
Date: Mon 8 Oct 2017
Source: Outbreak News Today [edited]

The summer of 2017 appears to be "pink eye", or conjunctivitis season in the Americas with a number of countries in Central and South America and the Caribbean reporting increases of the eye infection.

Now joining the Bahamas, Brazil, Costa Rica, Dominica, the Dominican Republic, Guadeloupe, Martinique, Mexico, Panama, Saint Lucia, Saint Martin, Suriname, and the Turks and Caicos Islands is Belize where health officials report an increase in the number of reported conjunctivitis cases, particularly in the northern and central health regions.

The Belize Health Ministry says the symptoms of pink eye include:
- redness in the white of the eye or inner eyelid;
- watery eyes;
- thick yellow discharge that crusts over the eyelashes, especially after sleep; and
- itchy eyes, blurred vision and increased sensitivity to light

They offer the following measures to prevent the spread of this contagious infection:
- wash your hands often with soap and warm water. Wash them especially before and after cleaning, or applying eye drops or ointment to your infected eye;
- avoid touching or rubbing your eyes. This can worsen the condition or spread the infection;
- with clean hands, wash any discharge from around your eye(s) several times a day using a clean wet washcloth. Wash the used washcloth with hot water and soap, and then wash your hands again with soap and warm water;
- wash pillowcases, sheets, washcloths, and towels often with hot water and soap; wash your hands after handling such items;
- do not wear contact lenses until your eye doctor says it's okay to start wearing them again;
- do not share personal items such as pillows, washcloths, towels, eye drops, eye and face makeup, makeup brushes, contact lenses and contact lens containers, or eyeglasses;
- avoid shaking hands with others;
- persons suffering pink eye should stay away from work, school and public places until the infection clears.  [Byline: Robert Herriman]
==================
[Viral conjunctivitis, also called pinkeye, is a common, self-limiting condition that is typically caused by adenovirus. Other viruses that can be responsible for conjunctival infection include herpes simplex virus (HSV), varicella-zoster virus (VZV), picornavirus (enterovirus 70, Coxsackie A24), poxvirus (molluscum contagiosum, vaccinia), and human immunodeficiency virus (HIV) (<http://emedicine.medscape.com/article/1191370-overview>). But bacteria and allergens also can cause conjunctivitis.

There is no known specific treatment for this disease, and containment includes increased attention to hygiene.

According to <https://www.garda.com/crisis24/news-alerts/73151/belize-conjunctivitis-outbreak>, in the [3 weeks leading up to 26 Sep 2017], 1108 cases have been reported [in Belize] in what government officials are calling the worst such outbreak since 2005. Cases have been reported in Belize City, Corozal, Cayo, Chetumal, and Orange Walk, among other places.

See ProMED Conjunctivitis - Americas (10): Panama, Grenada, Mexico http://promedmail.org/post/20170929.5348507 for further discussion regarding the conjunctivitis outbreak in the Americas.

A HealthMap/ProMED-mail map of Belize can be found at
Date: Sat 26 Aug 2017
Source: Amandala [edited]
<http://amandala.com.bz/news/ciguatera-poisoning-linked-turneffe-barracudas/>

Each year, between 10,000 and 50,000 people who live in or visit tropical and subtropical areas suffer from Ciguatera Fish Poisoning (CFP), which is said to be one of the most frequently reported seafood-toxin illness in the world. Ciguatera poisoning, which causes symptoms such as tingling and numbness in fingers and toes, around lips, tongue, mouth and throat; nausea, vomiting, diarrhoea and/or abdominal cramps; joint pains and headache; and breathing difficulty, has also been reported in Belize, and over the past 4 days, 2 alerts have been issued by the Ministry of Health in Belize, following reports of cases cropping up, which have been linked to the consumption of barracuda fish. In the 1st alert, issued on [Fri 18 Aug 2017], the Ministry of Health reported that "suspected fish poisoning (Ciguatera poisoning) was detected in people that had eaten fish bought from a fish vendor in Ladyville, Belize District."

In the 2nd alert, issued on [Tue 23 Aug 2017], the Ministry said that 2 further cases of suspected Ciguatera poisoning, linked to the consumption of the large predatory fish, had been identified. "Investigations conducted so far reveal that the barracuda fish from the Turneffe Islands area has been the sole carrier of the ciguaxtoin or poison," the alert said. It warned that toxic fish does not have any odor or taste and cooking and freezing does not eliminate the toxin. According to the US Center for Disease Control and Prevention (CDC), ciguatera fish poisoning (or ciguatera) is an illness caused by eating fish that contain toxins produced by a marine microalgae called _Gambierdiscus toxicus_, associated with corals.

Whereas the barracuda is believed to be the culprit for the most recent bouts of illness caused by the toxin, other fish may also carry the toxin, including coral trout, red snapper, donu, parrot fish, grouper, Spanish mackerel, red emperor, wrasse, reef cod, sturgeon fish, trevally and moray eel. The CDC also lists blackfin snapper, cubera snapper, dog snapper, greater amberjack, hogfish, horse-eye jack, and king mackerel among the fish which have been known to carry ciguatoxins. "Anyone who consumes fish contaminated with the ciguatera toxin will become ill," the Ministry's alert said, adding that, "The gastrointestinal or stomach symptoms normally appear within 24 hours of exposure and those of the nervous system can appear 1 to 2 days later."

Although some symptoms may last only a few days, in some cases, the toxin can continue to affect those who ingest it for months. The CDC says people who have ciguatera may find that cold things feel hot and hot things feel cold. The Belize Ministry of Health has shared some guidelines for reducing the risk of CFP.

It advises the following:
- Avoid eating larger reef fish that have a greater likelihood of carrying ciguatoxins, especially the barracuda.
- Limit the weight of a fish to less than 11 pounds, as ciguatera fish poisoning occurs more frequently in larger fish.
- Eat other types of fish not listed above.
- Avoid eating the head, roe or fish egg, liver, or other organs of the fish, as it is where the highest level of toxin is present. [Byline: Adele Ramos]
=========================
[A recent open access review of ciguatera fish poisoning (CFP) has been published in Marine Drugs: Friedman MA , Fernandez M, Backer LC, et al: An updated review of Ciguatera Fish Poisoning: Clinical, epidemiological, environmental, and public health management. Mar Drugs 2017, 15(3): pii: E72; doi:10.3390/md15030072; available at: <http://www.mdpi.com/1660-3397/15/3/72/htm.

The publication does not say that the intoxication occurs related to fish from European waters. The description of the acute illness with the citations intact (the citations can be found at the original URL) has been extracted below: "CFP is characterized by gastrointestinal, neurological, and cardiovascular symptoms. In addition, after the initial or acute illness, neuropsychological symptoms may be reported.

Clinical features can vary depending on elapsed time since eating the toxic meal, and whether the geographic source of the implicated fish was the Caribbean Sea, Pacific, or Indian Ocean [17,36,52-58]. Gastrointestinal symptoms and signs usually begin within 6-12 hours of fish consumption and resolve spontaneously within 1-4 days.

Gastrointestinal symptoms may include nausea, vomiting, abdominal pain, and diarrhoea. The neurologic symptoms usually present within the 1st 2 days of illness. They often become prominent after the gastrointestinal symptoms (particularly in CFP events from Caribbean fish), although they may present concurrently with gastrointestinal symptoms (K Schrank, written communication, April 2016) [59].

The neurologic symptoms vary among patients and include paresthesias (that is, numbness or tingling) in the hands and feet or oral region, metallic taste, sensation of loose teeth, generalized pruritus (itching), myalgia (muscle pain), arthralgia (joint pain), headache, and dizziness. A distinctive neurologic symptom is cold allodynia, sometimes referred to as "hot-cold reversal," an alteration of temperature perception in which touching cold surfaces produces a burning sensation or a dysesthesia (that is, unpleasant, abnormal sensation) [60]. One study revealed that intra-cutaneous injection of CTX in humans elicited this sensation [61].

Cold allodynia is considered pathognomonic of CFP, although not all patients report experiencing it and it can be seen with other human seafood poisoning syndromes (such as neurotoxic shellfish poisoning). Less commonly, severe central nervous system symptoms, such as coma or hallucinations, have been reported [54,62,63].

Neuropsychological symptoms, which often become apparent in the days or weeks after the initial or acute illness, include subjectively reported cognitive complaints such as confusion, reduced memory, and difficulty concentrating [64-67], depression or irritability [64,65,68], and anxiety [65]. Fatigue or malaise have been reported and may be debilitating [6,62,69,70].

Cardiac symptoms and signs may manifest, generally in the early stage of the illness. When present, they usually occur in combination with gastrointestinal and/or neurologic signs and symptoms [71,72]. Cardiac signs often include hypotension and bradycardia which may necessitate emergency medical care." - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/19>.]
Date: Thu 2 Feb 2017 10:41 AM CST
Source: Breaking Belize News [edited]

Yesterday [1 Feb 2017] the Belize Agricultural Health Authority (BAHA) announced that bovine rabies has been confirmed in 3 districts in Belize: Orange Walk, Cayo, and Toledo.

Bovine rabies is a specific type of rabies that affects cattle; however, it can be transmitted to humans and as a result, farmers are advised by BAHA to vaccinate their livestock as well as sheep, cattle and horses.

Bovine rabies is a fatal disease that can be prevented through vaccination of animals.

Affected animals will show aggressive behavior and may salivate more than normal.

If [bovine] rabies is suspected in your district, please contact BAHA immediately at phone number 822-0818.
===================
[Rabies is a viral infection caused by viruses belonging to the Lyssavirus genus. It is a zoonosis -- an animal disease that can spread to humans -- transmitted through saliva from bites, and even scratches of infected animals.

In Belize, as urban rabies is well controlled, most cases of rabies occur as bovine paralytic rabies transmitted by the vampire bat. Rabies in cattle has been reported in all 6 districts. According to the OIE vaccinating 70 percent of dogs allows rabies to be eradicated from a given endemic area.

Generally in Belize the rabies is of vampire bat origin. Cases of human rabies, including deaths, have been reported in Belize. There, several strains of the rabid virus circulate in the vampire bat, _Desmodus rotundus_.

The hairy-legged vampire bat, _Diphylla ecaudata_, is naturally infected by rabies virus (same variant as one infecting _D. rotundus_), so this vampire species is definitely a source for rabies cases in humans.

This vampire species ranges from Southern Tamaulipas (Mexico) to Colombia, Venezuela, Ecuador, Peru, Bolivia, Belize, and Brazil (except the central Amazon basin); a single vagrant individual has also been reported from Southern Texas, USA. (For a picture go to  <https://naturalhistory.si.edu/mna/images/images/831032911523015.jpg>).

Predators and parasites can be plastic when it comes to selecting their preys/hosts, and this confers to them the ability to adapt to environmental changes, and a phenomenon of special interest for public health, as it is associated with the link between human-driven change and emerging diseases.

Notifications of suspect rabies cases are investigated by BAHA, the MoH and the Ministry of Agriculture (MNRA) at no cost to the animal owner. A history of the animal determines the steps to be taken, I.e., whether it is isolated and kept for observation or euthanatized and the brain sent to the veterinary services laboratory in Panama. The MoH will determine human exposure to the virus. If warranted (bite, scratch, saliva) a post exposure regimen will be initiated which consists of 5 vaccines. Laboratory-confirmed cases in cattle trigger control response which includes vaccination of herd, vaccination of susceptible animals in protection zone and vampire bat control at farm and roosts (caves).

If you believe your animal, regardless of whether it is bovine, dog or other animal has rabies or is acting differently than normal, please call your veterinarian. Remember that thinking a bovine is choking and putting your hand in the mouth to remove the blockage may expose you to rabies.

Portions of this comment were extracted from

[Maps of Belize can be seen at
<http://healthmap.org/promed/p/19>. - ProMED Sr.Tech.Ed.MJ]
Date: Thu, 4 Aug 2016 08:41:33 +0200
By Henry MORALES

Puerto Barrios, Guatemala, Aug 4, 2016 (AFP) - A hurricane packing 130 kilometre (80 mile) per hour winds and heavy rain made landfall in Central America near Belize's capital, where officials warned of likely flooding and damage to homes Thursday.   Hurricane Earl swept in from the Caribbean to strike just south of Belize City, population 60,000, around midnight Wednesday (0600 GMT Thursday), according to the US National Hurricane Center (NHC).

Along the way, it had gathered strength and dumped rain on northern Honduras as it brushed past at sea.     The hurricane's heavy rains "could cause flash floods and mudslides especially over higher terrain," Belize's National Emergency Management Organization said in a bulletin just before it arrived.   "For coastal areas, there is also a risk for flooding, especially in low-lying areas."   Nearby Guatemala, Honduras and southern Mexico also issued alerts. Airports in the area were closed.

- Evacuations -
Earl was expected to weaken as it continued west from Belize City, farther inland, toward northern Guatemala and southeastern Mexico.   The Mexican authorities took no chances, evacuating 300 families living close to a river along the border with Belize in the southeastern state of Quinta Roo for fear of flooding.   More than 750 shelters were readied in the state in preparation for expected high winds and fierce gusts.

Other southern Mexican states likely to be affected were Campeche, Tabasco and Yucatan.   In the northern Guatemala town of Puerto Barrios, a military commander, Colonel Nelson Tun, told AFP that "patrols in vulnerable areas" were being carried out.   "We have identified high areas to where the population can evacuate before possible flooding," he said.

Guatemala in particular is prone to rainy season flooding and mudslides that often prove fatal.   Guatemala's population, at 16 million, is much bigger than the 330,000 in Belize, Central America's only English speaking country.   Guatemala's president, Jimmy Morales, late Wednesday offered Belize humanitarian aid and shelters along the border if needed.   That gesture was significant after months of tensions between the two countries following a shooting death of a Guatemalan boy by a Belizean border patrol in April.

- Category 1 hurricane -
The fifth named tropical storm of the 2016 season, Earl strengthened to a Category 1 hurricane on Wednesday, according to the NHC. Winds initially measured at 120 kilometers per hour picked up just before landfall.   Category 1, the lowest of five grades on the hurricane scale, is described as having dangerous winds of between 119 and 153 kilometers per hour that can rip off roofs, bring down trees and cause extensive damage to power lines.   Belizean public and private sector workers were permitted to go to their homes Wednesday to secure property.   Officials warned that people living on the ground floor "will experience flooding" and some older wooden buildings would likely be destroyed.   The authorities have opened 29 shelters.
More ...

World Travel News Headlines

Date: Fri, 6 Dec 2019 10:30:54 +0100 (MET)

Moscow, Dec 6, 2019 (AFP) - More than 50 polar bears have gathered on the edge of a village in Russia's far north, environmentalists and residents said, as weak Arctic ice leaves them unable to roam.   The Russian branch of the World Wildlife Fund said climate change was to blame, as unusually warm temperatures prevented coastal ice from forming.   The WWF said 56 polar bears had gathered in a one-square-kilometre (0.4-square-mile) area near the village of Ryrkaipy in Chukotka on the north-eastern tip of Russia.

There were concerns they could enter the village, home to fewer than 1,000 people, and patrols had been set up to monitor their movements.   "The number of human and predator encounters in the Arctic is increasing," the WWF said in statement.    "The main reason is the decline of sea ice area due to the changing climate. In the absence of ice cover, animals are forced to go ashore in search of food."

Residents had gathered walrus carcasses in the area to try to keep the bears from wandering into the village.   "We have created a feeding point with walrus carcasses that we gathered along the coast," Tatyana Minenko of the local "Bear Patrol" told news agency RIA Novosti.   "As long as there is no big freeze, the sea ice will not form and the bears will stay on the coast," she said.

Russia's weather service said temperatures in the region should fall from Saturday and that coastal ice should freeze by December 11.    Polar bears regularly visit areas inhabited by humans in Arctic Russia to search for food, often in rubbish tips.   But the number of visits has been growing as the melting of Arctic ice from climate change forces the bears to spend more time on land where they compete for food.
Date: Fri, 6 Dec 2019 10:28:26 +0100 (MET)
By Joseph Schmid

Paris, Dec 6, 2019 (AFP) - Travellers across France endured a second day of chaos on Friday as unions vowed to keep up their strike until President Emmanuel Macron backs down on controversial pension overhauls.   Rail operator SNCF said 90 percent of high-speed TGV trains were again cancelled, and several airlines dropped flights including Air France, EasyJet and Ryanair.

Nine of the capital's 16 metro lines were shut and most others severely disrupted, sparking some 350 kilometres (220 miles) of traffic jams in the Paris region, well above the usual 200 km, the traffic website Sytadin reported.   Many employees were unable to get to work and several schools again provided only daycare, though fewer teachers were on strike compared with Thursday when some 800,000 people demonstrated across the country according to the interior ministry.   Bike paths were crowded with bikes and electric scooters, with metro operator RATP sponsoring special deals for commuters with a range of ride-hailing companies and other transportation alternatives.

The walkout is the latest test for Macron after months of protests from teachers, hospital workers, police and firefighters as well as the "yellow vest" movement demanding improved living standards.   Unions say his "universal" pension system, which would eliminate dozens of separate plans for public workers, forces millions of people in both public and private sectors to work well beyond the legal retirement age of 62.   Health Minister Agnes Buzyn said Friday that the government had "heard" the protesters' anger and would meet with union leaders to discuss the reform on Monday.   The government has yet to lay out the details of its plan, and Buzyn told Europe 1 radio that "there is indeed a discussion going on about who will be affected, what age it kicks in, which generations will be concerned -- all that is still on the table".

- Macron 'determined' -
Yves Veyrier, head of the hardline FO union, warned Thursday the strike could last at least until Monday if the government did not take the right action.   But it remains to be seen if the protests will match the magnitude of the 1995 strikes against pension overhauls, when France was paralysed for three weeks from November to December in an action that forced the government to back down.

Macron, a former investment banker, has largely succeeded in pushing through a series of controversial reforms, including loosening labour laws and tightening access to unemployment benefits.   But this is the first time the various disgruntled groups have come together in protest.   So far Macron has not spoken publicly on the stoppages though a presidential official, who asked not to be named, said Thursday that the president was "calm" and "determined to carry out this reform" in a mood of "listening and consultation".

While most of Thursday's rallies were peaceful, police fired tear gas to disperse dozens of black-clad protesters smashing windows and throwing stones during the Paris march, with one construction trailer set on fire. Sporadic clashes were also reported in some other cities.   Many people were bracing for further disruptions over the weekend, including the prospect of fuel shortages as unions blocked most of the country's eight oil refineries.

The minimum pension age in France is 62, one of the lowest among developed countries, but there are 42 "special regimes" for railway workers, lawyers, opera employees and others offering earlier retirements and other benefits.   The government says a single system will be fairer for everyone while ensuring its financial viability while acknowledging that people will gradually have to work longer.
Date: Fri, 6 Dec 2019 04:23:51 +0100 (MET)

Sydney, Dec 6, 2019 (AFP) - Three hundred animals have been evacuated from a wildlife park north of Sydney as massive bushfires encircled Australia's largest city and foreign firefighters arrived to relieve beleaguered local forces.   Walkabout Wildlife Park said it had shipped out lizards, dingoes, peacocks and marsupials, as firefighters battled more than 100 fires up and down the eastern seaboard.   "This fire has been doing some crazy things, so we have to be prepared," general manager Tassin Barnard told AFP.

Prolonged drought has left much of eastern Australia tinder dry and spot fires have raged every day for the past three months, leaving firefighters struggling to cope.   New South Wales rural fire chief Shane Fitzsimmons said Friday that some US and Canadian firefighters had arrived to help out, easing the strain on the exhausted largely volunteer Australian force.

The incident-management and aviation specialists will help ease "fatigue and crew rotations" he said.   "We are not only appreciative of their presence here today, but of their sacrifice," said Fitzsimmons -- who has become a fixture on Australian television screens for weeks, updating the public on blazes in towns, national parks and backwaters.    "They are volunteering to sacrifice time from loved ones, from families, to give up that special time of the year around Christmas and New Year to come down here and lend us a hand," he said.

More than 600 homes have been destroyed and six people have died since the crisis began in September. That is many fewer than Australia's deadliest recent fire season in 2009 when almost 200 people died, but 2019's toll belies the scale of devastation.    Millions of hectares have burned -- the size of some small countries -- across a region spanning hundreds of kilometres (miles).   Bushfires are common in Australia but scientists say this year's season has come earlier and with more intensity due to a prolonged drought and climatic conditions fuelled by global warming.

The fires have taken a toll in Sydney and other major cities, which have been blanketed in toxic smoke for weeks and occasionally sprinkled with snow-like embers.   Fitzsimmons said he could not "overstate the effect that this profound drought is having" as he warned of a long, painful summer ahead.   "There is an absolute lack of moisture in the soil, a lack of moisture in the vegetation... you are seeing fires started very easily and they are spreading extremely quickly, and they are burning ridiculously intensely."
Date: Fri, 6 Dec 2019 03:03:18 +0100 (MET)
By Pierre-Henry DESHAYES

Half Moon Island, Antarctica, Dec 6, 2019 (AFP) - The swimsuit-clad tourists leap into the icy water, gasping at the shock, and startling a gaggle of penguins.   They are spectators at the end of the world, luxury visitors experiencing a vulnerable ecosystem close-up.   And their very presence might accelerate its demise.   Antarctica, a vast territory belonging to no one nation, is a continent of extremes: the coldest place on Earth, the windiest, the driest, the most desolate and the most inhospitable.   Now, it's also a choice destination for tourists.

All around Half Moon Island, off the Antarctic Peninsula, blocks of ice of all sizes float by on a calm sea, their varying forms resembling weightless origami shapes.    On this strip of land, that juts out of the Antarctic Polar and towards South America, visitors can see wildlife normally only viewed in zoos or nature documentaries along with spectacular icy landscapes.   The ethereal shades of white that play across the pillowy peaks change with the light, acquiring pastel hues at dawn and dusk.   "Purity, grandeur, a scale that's out of this world," says Helene Brunet, an awestruck 63-year-old French pensioner, enjoying the scene.    "It's unbelievable, totally unbelievable. It's amazing just to be here, like a small speck of dust."

AFP joined the 430 passengers on board the Roald Amundsen, the world's first hybrid electric cruise ship, on its maiden voyage in the Southern Ocean.    "It's not your typical beach, but it's awesome to do it," says a numb Even Carlsen, 58, from Norway, emerging from his polar plunge in the three-degree C (37.4 F) water.   When tourists go ashore, bundled up in neon-coloured windbreakers and slathered in SPF50 sunscreen, they have to follow strict rules: clean your personal effects so you don't introduce invasive species, keep a respectful distance from wildlife to avoid distressing them, don't stray from the marked paths and don't pick up anything.   "We mucked up the rest of the world. We don't want to muck up Antarctica too," says an English tourist, as she vacuums cat hair off her clothes before going ashore.

- 'Heart of the Earth' -
The Antarctic peninsula is one of the regions on Earth that is warming the fastest, by almost three degrees Celsius in the past 50 years, according to the World Meteorological Organization -- three times faster than the global average.    In March 2015, an Argentinian research station registered a balmy 17.5 degrees Celsius, a record.    "Every year you can observe and record the melting of glaciers, the disappearance of sea ice... (and) in areas without ice, the recolonisation of plants and other organisms that were not present in Antarctica before," said Marcelo Leppe, director of the Chilean Antarctic Institute.

Antarctica is "like the heart of the Earth," he added, saying that it expands and contracts like a heart beating, while the mighty current which revolves around the continent is like a circulatory system as it absorbs warm currents from other oceans and redistributes cold water.   The Antarctic Treaty, signed 60 years ago by 12 countries -- it now has 54 signatories -- declared the area a continent dedicated to peace and science, but tourism has gradually increased, with a sharp rise in the past few years.   Tourism is the only commercial activity allowed, apart from fishing -- the subject of international disputes over marine sanctuaries -- and is concentrated mainly around the peninsula, which has a milder climate than the rest of the continent and is easier to access.

Cruise ships have roamed the region for around 50 years, but their numbers only started to increase from 1990, as Soviet ice-breakers found new purposes in the post-Cold War era.   Some 78,500 people are expected to visit the region between November and March, according to the International Association of Antarctica Tour Operators (IAATO).   That's a 40-percent increase from last year, due in part to short visits by a few new cruise ships carrying more than 500 passengers, too many to disembark under IAATO regulations.     "Some might say 'Well, 80,000 people, that doesn't even fill a national stadium'... (and that it) is nothing like Galapagos which welcomes 275,000 a year," says IAATO spokeswoman Amanda Lynnes.    "But Antarctica is a special place and you need to manage it accordingly."

- 'Leave Antarctica to the penguins' -
It is Antarctica's very vulnerability that is attracting more and more visitors.   "We want to see this fantastic nature in Antarctica before it's gone," Guido Hofken, a 52-year-old IT sales director travelling with his wife Martina, says.    They said they had paid a supplement to climate compensate for their flight from Germany.

But some question whether tourists should be going to the region at all.   "The continent probably would be better off being left to penguins and researchers, but the reality is, that is probably never going to happen," said Michael Hall, professor and expert on polar regions at the University of Canterbury in New Zealand.   "Vicarious appreciation never seems to be enough for humans. So with that being the case, it needs to be made as low risk to the Antarctic environment and as low carbon as possible," said Hall.    "However, when the average tourist trip to Antarctica is over five tonnes of CO2 emissions per passenger (including flights), that is a serious ask."

Soot or black carbon in the exhaust gases of the scientific and cruise ships going to the region is also of concern, said Soenke Diesener, transport policy officer at German conservation NGO Nabu.   "These particles will deposit on snow and ice surfaces and accelerate the melting of the ice because the ice gets darker and will absorb the heat from the sun and will melt much faster," he told AFP.   "So the people who go there to observe or preserve the landscape are bringing danger to the area, and leave it less pristine than it was," he added.

- Responsible tourism -
Antarctic tour operators insist they are promoting responsible tourism.   The trend is for more intimate, so-called expedition cruises, in contrast to popular giant cruise liners elsewhere which are criticised for being invasive and polluting.   With greener ships -- heavy fuel, the most commonly used for marine vessels, has been banned in Antarctica since 2011 -- cruise companies have sought to make environmental awareness a selling point, occasionally earning them accusations of greenwashing.

Global warming, pollution and microplastics are the result of human activities on other, faraway continents, say tour operators.   Here, their motto is "Take nothing but photographs, leave nothing but footprints, keep nothing but memories".   But before they've even set foot on the cruise ships departing from South America -- the most common itinerary -- visitors to Antarctica will already have flown across the world, causing emissions that harm the very nature they have come so far to admire.

Most visitors hail from the Northern Hemisphere, and almost half are from the United States and China, IAATO says.   "I'm a tourist who feels a little guilty about taking a flight to come here," admits Francoise Lapeyre, a 58-year-old globetrotter om France.   "But then again, there are priorities. There are some trips I just won't take, because they leave a big footprint and they're not worth it.   "Crisscrossing the planet to go to a beach for example," she says.

- Don't mention climate change -
Like other expedition cruises where accessible science is part of their trademark, the Roald Amundsen, owned by the Hurtigruten company, has no dance floor or casino.  Instead, there are microscopes, science events and lectures about whales and explorers like Charles Darwin.   But they steer clear of climate change, which is only mentioned indirectly.   That's a deliberate decision as the subject has proven "quite controversial", said Verena Meraldi, Hurtigruten's science coordinator.   "We held several lectures dedicated specifically to climate change but it leads to conflicts. There are people who accept it as a fact, others who don't," she said.   Onboard, "passengers" are referred to as "guests" and "explorers" rather than "cruisers".   "Explorers" are typically older, well-heeled, often highly travelled pensioners who are handed walking sticks as they step ashore.   "My 107th country," says a Dane, stepping ashore onto Antarctica.

The Roald Amundsen "guests" choose between three restaurants, from street food to fine dining -- a far cry from the conditions endured by the Norwegian adventurer for whom the ship is named, who had to eat his sled dogs to survive his quest to reach the South Pole in 1911.   They have paid at least 7,000 euros ($7,700) each for an 18-day cruise in a standard cabin, and up to 25,000 euros ($27,500) for a suite with a balcony and private jacuzzi.   Other cruises are banking on ultra-luxury, with James Bond-like ships equipped with helicopters and submarines, suites of more than 200 square metres (2,153 square feet) and butler services.   With a seaplane to boot, the mega-yacht SeaDream Innovation will offer 88-day cruises "from Pole to Pole" starting in 2021. The two most expensive suites, with a price tag of 135,000 euros per person, are already booked.
 
- Worlds collide -
Outside, in the deafening silence, wildlife abounds.   All around are penguins, as awkward on land as they are agile in water. Massive and majestic whales slip through the waves, and sea lions and seals laze in the sun.   On Half Moon Island, chinstrap penguins -- so called because of a black stripe on their chin -- strut about in this spring breeding season, raising their beaks and screeching from their rocky nests.   "This is to tell other males 'This is my space' and also, maybe, 'This is my female'," ornithologist Rebecca Hodgkiss, a member of the Hurtigruten's scientific team, explains, as a group of tourists stroll around ashore.   The colony of 2,500 penguins has been gradually declining over the years, but it's not known if that is man's fault or they have just moved away, according to Karin Strand, Hurtigruten's vice president for expeditions.   Invisible to the naked eye, traces of humankind are however to be found in the pristine landscape.   Not a single piece of rubbish is in sight but microplastics are everywhere, swept in on ocean currents.   "We've detected them in the eggs of penguins for example," Leppe told AFP.

- Venice under water -
The Antarctic, which holds the world's largest reserve of freshwater, is a ticking time bomb, warn experts and studies.   They say that the future of millions of people and species in coastal areas around the world depends on what is happening here.   As a result of global warming, the melting ice sheet -- especially in the western part of the continent -- will increasingly contribute to rising sea levels, radically re-drawing the map of the world, says climate scientist Anders Levermann, of the Potsdam Institute for Climate Impact Research.   This meltwater will contribute 50 centimetres (almost 20 inches) to the global sea level rise by 2100, and much more after that, he said.   "For every degree of warming, we get 2.5 metres of sea level rise. Not in this century, but in the long run," he said.

Even if the international community meets its obligations under the Paris Agreement to limit global warming to under two degrees Celsius, sea levels will still rise by at least five metres.   "Which means that Venice is under water, Hamburg is under water, New York, Shanghai, Calcutta," he said.   It's impossible to predict when, but the scenario appears unavoidable, says Levermann.   In the same way that a cruise ship powering ahead at full speed can't immediately stop, sea levels will continue to rise even if all greenhouse gas emissions were to cease immediately, a study has said.

- Changing the world? -
The tourism industry says it hopes to make "ambassadors" out of Antarctica visitors.   "It's good for the animal life and for the protection of Antarctica that people see how beautiful this area is, because you cherish what you know and understand," said Hurtigruten chief executive Daniel Skjeldam.   Texan tourist Mark Halvorson, 72, says he is convinced.   "Having seen it, I am that much more committed to having a very high priority in my politics, in my own inner core convictions to being as environmentally friendly in my life as I can," he said.   So, do Guido and Martina Hofken see themselves as future "ambassadors of Antarctica"?    "Just a little bit, probably. But I don't think I will change the world," Guido Hofken concedes.    "The best thing would be for nobody to travel to Antarctica."
Date: Thu, 5 Dec 2019 16:37:37 +0100 (MET)

Paris, Dec 5, 2019 (AFP) - French rail operator SNCF said Thursday that it had cancelled 90 percent of all high-speed TGV trains and 70 percent of regional trains for Friday due to a strike over the government's pension reforms.   SNCF said that services would "still be very disrupted" on the second day of the biggest transport strike in the country in years, with the Eurostar service to Britain and the Thalys service to northern Europe set to be "very heavily disrupted".   In Paris, where only two of 16 metro lines were operating normally Thursday, public transport workers voted to remain on strike until Monday.

France's civil aviation authority meanwhile told airlines to cut 20 percent of their flights in and out of airports in Paris, Beauvais, Lyon, Marseille, Toulouse and Bordeaux on Friday, the same proportion as on Thursday.   Striking transport workers, air traffic controllers, teachers, fire fighters, lawyers and other groups all fear they will have to work longer or receive reduced pensions under the government's proposal to scrap 42 special pension schemes and replace them with a single plan.   Anticipating the worst travel chaos in years, many employees opted to work from home on Thursday. Those who did venture out travelled mainly by car, bicycle, electric scooter or on foot.
Date: Thu, 5 Dec 2019 12:19:45 +0100 (MET)
By Sofia CHRISTENSEN

Johannesburg, Dec 5, 2019 (AFP) - South African Airways was placed under a state-approved rescue plan on Thursday to avoid the embattled airline's collapse following a costly week-long strike last month.   Thousands of South African Airways (SAA) staff walked out on November 15 after the flag carrier failed to meet a string of demands, including higher wages and job in-sourcing.   The strike was called off the following week after SAA management and unions eventually clinched a deal.

But the walkout dealt a severe blow to the debt-ridden airline, which has failed to make a profit since 2011 and survives on government bailouts.   "The Board of SAA has adopted a resolution to place the company into business rescue," said a statement by South Africa's Public Enterprises Minister Pravin Gordhan, adding that the decision was also supported by the government.   "It must be clear that this is not a bailout," said Gordhan. "This is the provision of financial assistance in order to facilitate a radical restructure of the airline."   The business rescue process will be directed by an independent practitioner. It is meant to prevent a "disorderly collapse of the airline", he added.   Gordhan said the government would provide 2 billion rand ($136 million) to SAA in "a fiscally neutral manner".   Existing lenders will also provide a 2 billion rand loan guaranteed by the government.

- 'Financial challenges' -
South Africa is struggling to get state-owned companies back on track after nine years of corruption and mismanagement under former president Jacob Zuma.   Its national airline -- which employs more than 5,000 workers and is Africa's second largest airline after Ethiopian Airlines -- had been losing 52 million rand ($3.5 million) a day during the strike.   SAA's board said the business rescue, scheduled to start immediately, was decided after consultations with shareholders and the public enterprises department "to find a solution to our company's well-documented financial challenges".

"The considered and unanimous conclusion has been to place the company into business rescue in order to create a better return for the company's creditors and shareholders," said the SAA board of directors in a statement.   The rescue plan will include a "new provisional timetable" and ensure "selected activities... continue operating successfully".   With a fleet of more than 50 aircraft, SAA flies to over 35 domestic and international destinations.   "SAA understand that this decision presents many challenges and uncertainties for its staff," said the board.   "The company will engage in targeted communication and support for all its employee groups at this difficult time.

- 'Lesser evil' -
Unions told AFP they would comment later on Thursday.   They have agreed to a 5.9-percent wage increase backdated to April, but which would only start to be paid out next March depending on funding.   SAA had initially refused any pay rise.    The cash-strapped airline needs two billion rand ($136 million) to fund operations through the end of March. But it was unable to cover all of its staff salaries last month.    "Business rescue allows for the airline to continue to operate while it is being restructured, as opposed to liquidation," analyst Daniel Silke told AFP.   He said the rescue was a "lesser evil for SAA" and would save more jobs than a "shutdown".

But Silke still expected jobs to be cut as SAA attempted to reduce costs.   "Various divisions that make of SAA could be privatised," he said. "There will be a review of SAA aircraft and routes covered by SAA."   Unions had already demanded a three-year guarantee of job security following an announcement last month that almost 1,000 SAA employees could lose their jobs as part of another restructuring plan.   SAA pledged to defer that process to the end of January as part of the deal that ended the strike.
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Out of the 7 patients who were admitted to the hospital suspecting Nipah virus infection, one has been tested positive while the other 6 have been tested negative.

Kerala health minister K K Shailaja said at a press briefing in Kochi on Thursday [28 Nov 2019] that of "7 patients admitted to the hospital, one patient's result is positive for Nipah virus, while 6 patients' results are negative. No one has been discharged from the isolation ward. The source of the virus is not confirmed yet."

On the other hand, 2 persons suffering from high fever were put under observation at Trivandrum Medical College on Thursday [28 Nov 2019]. Their samples have been sent for examination.

On 4 Jun [2019], a 23-year-old-man had tested positive for Nipah virus infection, which killed 17 people in Kerala last year [2018].

As of now, a total of 15 people are under observation in the state.

Union minister for health and family welfare Dr Harsh Vardhan had said on 4 Jun [2019] that the centre had rushed a team of doctors to Kerala for investigation in the wake of the scare of Nipah virus. Vardhan had asserted that he was "very vigorously" following the situation.

Nipah virus is transmitted from animals [bats] to humans and then spreads through people to people, causing respiratory illness. Its symptoms include fever, muscle pain, headache, fever, dizziness, and nausea.

The Health Department in Karnataka issued a circular asking administration in Chamarajanagar, Mysuru, Kodagu, Dakshina Kannada, Uttara Kannada, Udupi, Shivamogga, and Chikkamagaluru districts to immediately convene interdepartmental coordination committee meetings, including the veterinary department, the Indian Medical Association, and the Indian Academy of Pediatrics.

Authorities in these 8 districts have been directed to identify 2 isolation beds to quarantine suspected human cases. They have been asked to keep all the logistics available at all levels, read the circular. The department has also asked district authorities to direct government and private hospitals to keep an eye on suspected cases.

Once a patient shows symptoms of Nipah, the hospitals have to monitor for acute encephalitis syndrome, check all vital parameters, and take a travel history of the patients.

The district hospitals should have an ICU with ventilator facilities and capacity to receive emergency cases, the circular read.

The department asked the districts to furnish a daily outbreak report regarding Nipah virus. It also directed authorities to sensitise health assistants and ASHA workers.
==================
[This is the 3rd case of Nipah virus infection [NVI] in Kerala state this year (2019). It is prudent that surveillance and patient-care capacity have been increased. Last year (2018), as of 17 Jul 2018, a total of 19 Nipah virus (NiV) cases, including 17 deaths, were reported from Kerala state: 18 of the cases were laboratory confirmed, and the deceased index case was suspected to have NVI but could not be tested. The 2018 outbreak was localized to 2 districts in Kerala state: Kozhikode and Malappuram.

The exact circumstances under which this or the previous confirmed Nipah virus cases this year (2019) acquired their infections are not stated in the above or in previous reports, nor is it stated whether these individuals had contact with flying fox fruit bats (_Pteropus giganteus_), the reservoir hosts of Nipah virus, or fruit that the bats may have contaminated. It is interesting to note that 12 of 36 fruit bats tested at the National Institute of Virology were positive for Nipah virus. Although Kerala health minister KK Shailaja officially had declared Ernakulam district Nipah-free, it may have been free of human cases but is unlikely to have been free of the virus in _Pteropus giganteus_ fruit bats. - ProMED Mod.TY]

[Maps of India:
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Bihar Health Minister Mangal Pandey on [Sat 30 Nov 2019] said the state government is doing its best to save children, as the death toll due to acute encephalitis syndrome [AES] in Muzaffarpur mounted to 73.

Pandey said doctors and nurses are being called in from Patna for additional help. "We are trying everything and anything that can save children's lives. Everything is being made available from medicines to doctors. We have even called doctors and nurses from AIIMS in Patna," he said. "There is a protocol regarding what kind of medicines and facilities should be given and we are doing the same. We are monitoring things regularly and trying to save our children."

Recalling the situation that prevailed 5 years ago, Pandey said a team that was formed to ascertain the cause of this disease concluded that sleeping empty stomach at night, dehydration due to humidity and eating lychee on empty stomach were some of the causes of encephalitis.

"Our government has tried to spread awareness which will be beneficial as well. Advertisement in newspapers, radio jingles, pamphlets and mic [microphone] announcements are going to spread awareness regarding the disease. Health ministry is also working on it," he said.

On being asked about spread of ASE in Gorakhpur last year [2018], he said, "From Gorakhpur to Muzaffarpur region, this disease had spread last year and the Union government had worked on this and we will continue to fight it now."

"This incident in Muzaffarpur is very saddening and we also feel bad when children of our nation die like this. Not the whole district is affected but a large part is suffering from it," he added.

From [1 Jan 2019], until now [5 Dec 2019], 220 children were admitted in Sri Krishna Medical College and Hospital in Muzaffarpur due to AES, out of which 62 lost their lives.

As per the data of SKMCH hospital, 235 children were admitted, of which 89 died; in 2013 - 90 children were admitted, of which 35 died; in 2014 - 334 children were admitted, of which 117 died; in 2015 - 37 children were admitted, of which 15 died; in 2016 - 31 children were admitted, of which 6 died; in 2017 - 44 children were admitted, of which 18 died; and in 2018 - 43 children were admitted, of which 12 died.

Meanwhile, Minister of State for Union ministry for home affairs, Nityanand Rai, visited Sri Krishna Medical College and Hospital to review the situation after the outbreak of AES.

Encephalitis is a viral disease, which causes mild flu-like symptoms such as high fever, convulsions and headaches and has been claiming lives in the district for the past few weeks.
======================
[The dates within which these AES cases have occurred is not stated. The urgency that has prompted Behar health officials to request the aid of physicians and nurses from adjoining Patna suggests that the AES outbreak is going on currently. The uncertainty about the etiology of AES continues. It is curious that the above report makes no mention of negative or positive tests for Japanese encephalitis among the AES patients, although that virus is endemic in northeastern India, including Bihar state. Neighboring Uttar Pradesh state has had JE cases as well this summer (2019) but has intensified its JE vaccination program.

The issue of the aetiology of AES has been under discussion for a long time. Lychee fruit contain toxins. Encephalopathy and hypoglycaemia have been associated with consumption of lychee fruit contains phytotoxins, specifically alpha-(methylenecyclopropyl)glycine (see ProMED-mail archive no. http://promedmail.org/post/20150201.3132842). However, the current cases cannot be due to lychee consumption, since the season for that fruit has passed.

AES has continued to be attributed to a variety of aetiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption, and scrub typhus (_Orientia tsutsugamushi_). A recent publication (reference below) states that dengue virus is one of the 3 most common agents identified in AES, but existing surveillance for AES does not include routine testing for dengue. Until the etiology (or etiologies) of these AES cases is determined, effective and efficient prevention of these cases will not be possible.

Reference:
Ravi V, Hameed SKS, Desai A, et al. Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): results from a 4-year AES surveillance study of Japanese encephalitis in selected states of India. Int J Infect Dis 2019;84 Suppl:19-24. <https://doi.org/10.1016/j.ijid.2019.01.008>.

Available at:

[Maps of India:
HealthMap/ProMED maps available
at:<http://healthmap.org/promed/p/364>, and Bihar, India:
Date: Thu 5 Dec 2019 6:11 PM EET
Source: Enab Baladi [edited]

[Leishmaniasis] is spreading widely among residents of Deir ez-Zor, and especially children. Some of the areas affected are controlled by the Kurdish self-administration while others are under the control of the Syrian regime. Medical sources counted hundreds of infected civilians and confirmed the disease's rapid spread.

According to Atef al-Tawil, a manager of the Leishmania & Environmental Health Programme at the Syrian regime's Ministry of Health, most infections in eastern Deir ez-Zor are spread among school children.

In a Facebook comment on a post by Twasol agency, al-Tawil claimed that cases of leishmaniasis were detected, at the end of November [2019], in primary schools in eastern Deir ez-Zor and its surrounding villages (al-Jalaa, al-Salihiyah, al-Tawtha, al-Abbas, al-Mujawdeh, al-Hasarat, al-Saial, al-Ghabrah).

According to al-Tawil, 455 infections of children were detected. A treatment team of 10 members was formed in the affected locations, to help control the disease to aid in early detection.

The Syrian Ministry of Health acted after several appeals by civilians residing in the area as they noticed the disease spreading among their children. Al-Tawil said that this rapid spread was due to the fact that all the infected people have lately returned to their original areas which lack medical centers.

Autonomous administration areas
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According to Euphrates Post network, leishmaniasis is also widely spread in areas controlled by the Syrian Democratic Forces (SDF). In its post on [Sun 1 Dec 2019], the network claimed that the spread of leishmaniasis is mostly concentrated in the eastern countryside of Deir ez-Zor.

According to the network, unofficial statistics by the SDF-affiliated local council shows more than 7000 leishmaniasis infections among children in al-Baghouz, Hajin, Diban, al-Sha'afa, al-Kishkiye, Abu Hamam, and Gharanij. The local councils' attempts of controlling the disease are still substandard, according to the Euphrates Post.

The network also quoted doctors and nurses calling for international organizations to interfere and provide hospitals and clinics with the required vaccine [there is no vaccine for leishmaniasis; ed.], and to train specialized medical staff in each clinic to deal with the disease.

The autonomous-administration-affiliated media center in Deir ez-Zor also confirmed the spread of leishmaniasis and pointed out that the authorities took actions, by the end of November [2019], to provide treatments.

According to the media center, special medical teams and cadres were distributed among the clinics to provide 12,000 ampoules of the required [medicine] to treat leishmaniasis with the support of the World Health Organization.

Leishmaniasis is a parasitic disease transmitted by the bite of infected female phlebotomine sandflies -- a very small yellow fly that is active at night and makes no sound when it bites -- and the main cause for its spread is dirt and lack of hygiene.  [Byline: Enab Baladi]
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[Deir ez-Zor is east and south of the locations in the previous ProMED reports (see below), indicating further increase in cases of cutaneous leishmaniasis beyond its historical concentration in western Syria (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861536/>) and beyond the area of the MENTOR initiative in northern Syria (<https://wwwnc.cdc.gov/eid/article/24/11/17-2146_article>).

Cutaneous leishmaniasis is endemic in Syria with its reservoir in rodents. It has been a problem throughout the Syrian civil war and in ISIS controlled areas during the war due to a breakdown in rodent and vector control. - ProMED Mod.EP]

[Maps of Syria:
Date: Tue 3 Dec 2019
Source: Twitter feed in Arabic [machine trans., edited]

Taiz health official: 24 laboratory-confirmed cases of West Nile virus and more than 300 suspected cases. #Republic_Yemen
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[Any information on the actual number of WNV cases, their lab confirmation, and public health response activities in this regard will be highly appreciated. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Yemen: