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Mauritania

Mauritania US Consular Information Sheet
September 23, 2008
COUNTRY DESCRIPTION:
Mauritania is a developing country in northwestern Africa.
Arabic is the official language, but French is widely used and several local languages are als
spoken.
Tourist facilities in the capital, Nouakchott, are adequate, but limited or non-existent elsewhere.
Read the Department of State Background Notes on Mauritania for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required, as is evidence of a yellow fever vaccination.
For the most current visa information, contact the Embassy of the Islamic Republic of Mauritania, 2129 Leroy Place NW, Washington, DC
20008, tel. (202) 232-5700, or the Mauritanian Permanent Mission to the UN, 211 East 43rd Street, Suite 2000, New York, NY 10017, telephone (212) 986-7963 or 8189, or e-mail Mauritania@un.int.
Overseas, inquiries should be made at the nearest Mauritanian embassy or consulate.

See our information on dual nationality, the prevention of international child abduction and Customs regulations.

SAFETY AND SECURITY:
There is increasing activity by the terrorist group Al Qaeda in the Islamic Maghreb (AQIM) in Mauritania.
On December 24, 2007, terrorists shot and killed four French tourists and wounded a fifth near the town of Aleg, in southeastern Mauritania.
On December 26, 2007, terrorists killed four soldiers near the town of El Ghallaouiya in northern Mauritania.
These two attacks were followed by an attack on the Israeli Embassy and an adjoining nightclub frequented by westerners early in the morning of February 1, 2008.
The perpetrators of these attacks are believed to be linked to AQIM.
These are the first attacks that have occurred in Mauritania since June 2005, when members of the terrorist group GSPC (now known as AQIM) attacked a military outpost based at Lemgheity, near the Algerian and Malian borders.
In the attack, they killed or wounded about 35 soldiers.
Travelers should avoid all non-essential travel to the Hodh El Charghi region of southeastern Mauritania due to increased AQIM activities in the border area.
Official Americans continue to travel to the town of Atar, although AQIM has also talked about targeting Westerners there.
Travelers should check http://mauritania.usembassy.gov for current Consular Warden messages concerning Mauritania.

Travelers should exercise prudence and caution when traveling in Mauritania.
They should not venture outside of urban areas unless in a convoy and accompanied by an experienced guide, and even then only if equipped with sturdy vehicles and ample provisions.
The U.S. Embassy in Nouakchott has received reports of banditry and smuggling in the more remote parts of Mauritania.
Landmines also remain a danger along the border with the Western Sahara and travelers should cross only at designated border posts.
The U.S. Embassy recommends that travelers avoid travel in regions north and east of Zouerate, Ouadane, and Tichit unless with a government escort.
Travelers planning overland trips from Mauritania to Morocco, Algeria, Senegal or Mali should check with the U.S. Embassy in Nouakchott before setting out.
For more information about travel in Mauritania, please see the section “Traffic Safety and Road Conditions” below.

The Mauritanian military led a bloodless coup on August 6, 2008.
There has been increased political unrest following the coup, but no violence.
There have also been increased political gatherings and street demonstrations.
The police have been using tear gas to break up some anti-coup demonstrations.
An increased police presence and additional vehicle controls may also be expected.
U.S. citizens should avoid large crowds and maintain security awareness at all times.

In Nouakchott and other major cities in Mauritania, there is an increased security presence and additional checkpoints.
Police routinely conduct road blocks at which they may ask for proof of identity and drivers’ licenses.
These checkpoints should be respected.
Americans visiting Mauritania should be prepared for such inquiries and carry their identification cards at all times.
It is best to drive cautiously and be prepared to stop at short notice.

American citizens should be aware of their surroundings at all times and maintain good personal security practices, including always locking their homes and cars.
They should avoid established patterns and take care not to draw attention to themselves.
When going out, they should avoid being part of large, highly visible groups of Westerners and when in restaurants or cafes, avoid sitting in areas that are easily visible from the street.

Although U.S. citizens are generally welcomed in Mauritania, there were reports of anti-American incidents such as threats and stoning of vehicles, following the 1998 U.S.- and British-led intervention in Iraq, and demonstrations outside the Embassy during the 2003 U.S. intervention in Iraq.
Some Muslim extremists have occasionally perceived Christian non-governmental organizations as a threat.
However, local authorities closely monitor political violence and religious extremist groups.

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

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

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

CRIME:
Crime in Mauritania is moderate but steadily increasing.
Most incidents occur in the cities and larger towns, and are petty crimes such as pick pocketing and the theft of improperly secured and openly visible valuables left in vehicles.
Most criminal activity occurs at night and walking alone at night is not advisable.
Residential burglaries and robberies, particularly at the beaches in Nouakchott, are not uncommon.
In Nouakchott, travelers should avoid the beach at night.
During the day, beach-goers should travel in large groups or stay in popular areas because of the increase in the number of thefts and robberies, some involving injury to victims, reported there in the past several years.
Violent crimes and crimes involving the use of weapons are rare, but increasing.
Rapes and assaults have occurred and, in some instances, involved the American community.
Foreign tourists, including Americans, might be targeted for kidnapping in Mauritania.

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 in finding appropriate medical care, contact family members or friends, and explain how funds can be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Mauritania are limited.
There are few modern clinics or hospitals beyond the capital and a few major towns.
At local pharmacies, some medicines are difficult to obtain; travelers are advised to bring their own supplies.

Malaria is a serious and sometimes fatal disease.
Chloroquine-resistant P. falciparum malaria is a severe form of the disease that is found in many parts of western Africa, including Mauritania.
Because travelers to Mauritania are at high risk for contracting malaria, they should take one of the following anti-malarial drugs:
mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™).
The Centers for Disease Control and Prevention (CDC) have determined that a traveler who is on an appropriate anti-malarial drug has a greatly reduced chance of contracting the disease.
In addition, other personal protective measures, such as the use of insect repellents, may help to reduce malaria risk.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarial drugs they have been taking.
For additional information on malaria, protection from insect bites, and anti-malarial drugs, please visit the CDC travelers’ health web site at http://www.cdc.gov/malaria/.

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.

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

Public transportation is not safe and road conditions in Mauritania are generally poor, particularly in the interior.
Overland travel is difficult and roadside assistance is almost nonexistent.
The country’s size and harsh climate make road maintenance and repair especially problematic.
Mauritania has only about 2,070 km (1,286 miles) of surfaced roads, 710 km (441 miles) of unsurfaced roads, and 5,140 km (3,194 miles) of unimproved tracks.
Drivers should not offer rides to hitchhikers, nor should visitors to Mauritania accept rides offered by strangers.


The traditional route to Nouadhibou, prior to the completion of a paved road, was along the beach during low tide.
Some travelers continue to use this route, as do visitors to coastal fishing villages and other points of interest, and smugglers and others who try to avoid the security checkpoints that are often established along the asphalt roads.
Pedestrian visitors to the beach should exercise caution because of the beach’s use as a route for motorized vehicles.

U.S. citizens traveling overland for long distances in Mauritania should travel in convoys and be sure to have suitable four-wheel drive vehicles, a local guide, an adequate supply of water and food, and a second fuel reservoir.
Multiple vehicles are recommended in case of breakdown.
A Global Position Satellite (GPS) receiver and satellite phone are essential when traveling in remote areas.
Visitors are urged not to travel alone into the desert.

Driving in Mauritania is treacherous, and we encourage travelers to hire a trained local driver.
Traffic patterns differ considerably from American-style “rules of the road,” and many Mauritanians drive without regard to traffic signs or rules.
Roadway obstructions and hazards caused by drifting sand, animals, and poor roads often plague motorists; when combined with the number of untrained drivers and poorly maintained vehicles, heightened caution is imperative at all times.
Drivers should be alert to conditions and always wear their seat belts.
Motorcycle and bicycle riders should wear helmets and protective clothing.
Nighttime driving is discouraged.

The telecommunications infrastructure is limited and cellular telephone coverage is not wide spread.
For those traveling outside the major urban areas, it is recommended to have a satellite telephone readily available.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Mauritania, the U.S. Federal Aviation Administration (FAA) has not assessed Mauritania’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 website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Mauritanian customs authorities may enforce strict regulations concerning the temporary import or export of items such as firearms, narcotics, alcoholic drinks and pork products.
Contact the Embassy of Mauritania in Washington, DC for specific information regarding customs regulations.

The local currency is the ouguiya, and it may not be imported or exported.
Credit cards can be used only at a few hotels in the capital, Nouakchott, and the northwestern city of Nouadhibou.
ATM machines are available only in Nouakchott.
Major foreign currencies are changeable in banks and numerous currency exchanges; however, this service is not always available without advanced notice or prior arrangement.
There is a risk of getting fraudulent bank notes even from banks which often do not have the security means to detect fake bank notes.
Furthermore, credit card fraud is a problem, so it is strongly advisable to pay hotel bills in cash.

Islamic ideals and beliefs in the country encourage conservative dress.
Sleeved garments and below-the-knee skirts are recommended, and people should avoid wearing shorts.
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 Mauritania’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Mauritania are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Mauritania are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Mauritania. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located between the Presidency building and the Spanish Embassy on Rue Abdallaye.
The postal address is B.P. 222, Nouakchott, telephone (222) 525-2660/2663, 525-1141/45, or 525-3038 (ext. 5441), and fax (222) 525-1592.
The Consular Section may be contacted by e-mail at ConsularNKC@state.gov
* * *
This replaces the Consular Information Sheet dated April 29, 2008, to update the section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Tue, 31 Mar 2020 15:32:42 +0200 (METDST)

Nouakchott, March 31, 2020 (AFP) - Mauritania has declared its first fatality from coronavirus, state media reported on Tuesday, adding to the growing death toll on the African continent.    The victim is a 48-year-old French-Mauritanian dual national who tested positive for the virus after she died, according to the Mauritanian Information Agency.    The woman had been quarantined alongside 16 other French nationals who landed in the West African state in mid-March, in one of the last flights to reach Mauritania before it banned international arrivals.

N'Diaye Mamadou, an official in charge of the isolation centre in the capital Nouakchott, told state TV that the woman's case was unusual because she did not initially present symptoms.   She began to feel ill on Sunday evening, before her condition worsened on Monday morning. She then died en route to hospital on Monday, Mamadou said.    France's embassy in Nouakchott said on Tuesday that it had been in contact with the woman, but that it had been unaware of her worsening health.

Mauritania has recorded six coronavirus cases in total, two of which have recovered.    The government has also ordered a night-time curfew and stopped travel between its 13 regions in a bird to curb the spread of the virus.     The African continent has recorded over 5,300 coronavirus cases to date, according to an AFP tally, of whom 171 have died.
Date: Sat, 14 Mar 2020 01:44:10 +0100 (MET)

Nouakchott, March 14, 2020 (AFP) - Mauritania has confirmed its first case of novel coronavirus, the country's health minister said on Friday, adding to the growing number of cases in West Africa.   In a televised statement, Health Minister Mohamed Nedhirou Ould Hamed said the case involved a foreigner who tested positive on Friday.   "He was immediately isolated and the state has all the means at its disposal to take care of those suffering from the virus," the minister said.   A statement from the health ministry, also released on Friday, said the man was an expatriate who had flown into Mauritania from Europe on Monday.   He isolated himself after a friend in Europe tested positive for the virus, the statement added.    Health officials discovered he was feverish on Friday morning and he was confirmed positive for coronavirus later in the evening.

The health minister also promised, in his televised address, that the government would stop charter flights coming to Mauritania from France.   The West African state of Guinea registered its first coronavirus case on Friday too.    And Senegal, which shares a border with Mauritania, registered 11 new coronavirus infections on Friday, bringing its total number to 19.    Ivory Coast, Ghana, Burkina Faso and Nigeria have all also recently registered coronavirus cases.    Gabon, which announced its first case earlier this week, said Friday it would close schools for two weeks and stop issuing tourist visas to areas hit by the pandemic.
Date: Mon 30 Apr 2018
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/crimean-congo-hemorrhagic-fever-case-reported-mauritania-28755/>

The Mauritania Ministry of Health has reported a confirmed case of Crimean-Congo haemorrhagic fever [CCHF] in Ould Yengé commune, Guidimaka region located in the southern-most part of the country. The case-patient is a 58-year-old male herder from Elghabra locality who became ill on [16 Apr 2018] (reportedly) after tending to a sick cow days earlier. He presented to a private clinic the same day [16 Apr 2018] with high fever, arthralgia and headache. He was admitted, managed for an unspecified medical condition and discharged on [18 Apr 2018].

The following day [19 Apr 2018], he developed bleeding from the gums and nose, and was admitted to the regional hospital where he was transfused and subsequently discharged on [20 Apr 2018], following an apparent clinical improvement. On [21 Apr 2018], the case-patient's health deteriorated and he was taken to Guerou health centre, from where he was immediately referred to Cheikh Zayed hospital in Nouakchott on [22 Apr 2018].

A blood specimen was obtained and shipped to the national public health laboratory. The test result released on [24 Apr 2018] was IgM positive for Crimean-Congo haemorrhagic fever. A total of 32 close contacts, including 10 health workers and 4 family members, have been listed and are being followed up. Efforts to identify other close contacts are ongoing.

The case-patient used public transportation and a taxi at various stages of his movement during the course of illness. Preliminary investigations also established that all the 4 healthcare facilities that managed the case-patient did not apply appropriate infection prevention and control measures, potentially indicating a higher number of contacts.

According to the WHO, Crimean-Congo haemorrhagic fever is a widespread disease caused by a tick-borne virus (_Nairovirus_) of the _Bunyaviridae_ family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 percent. CCHF is endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north - the geographical limit of the principal tick vector.

The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats. Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites.

Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vector. The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission is possible.
=======================
[There is need to emphasize inter-sectoral collaboration involving health, veterinary and entomology/environmental services to map the areas of vector distribution. Furthermore, awareness messages among the high exposure groups should be widespread as CCHF vector propagates from May onwards leading to higher transmission rates in summer. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map:
Guidimaka Region, Mauritania: <http://healthmap.org/promed/p/25044>]
Date: Mon 27 Nov 2017
Source: Outbreak News Today [edited]

Following cases of Crimean-Congo haemorrhagic fever (CCHF) reported this spring and summer [2017], the Mauritania Ministry of Health has reported an addition CCHF case last week [week ending Sun 26 Nov 2017] in a 48-year-old male farmer from Haye Sakin community in Dar Nairn, at the outskirt of the capital city, Nouakchott. He fell sick on the [11 Nov 2017] and was later treated and discharged last week.  The frequency of these events affirms the relative prevalence of the pathogen and the reservoir and vector for CCHF virus (Hyalomma ticks) in the country.

According to the WHO, Crimean-Congo hemorrhagic fever is a widespread disease caused by a tick-borne virus (Nairovirus) of the _Bunyaviridae_ family. The CCHF virus causes severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 percent.  CCHF is endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north - the geographical limit of the principal tick vector. The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats.

Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vector.

The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission is possible.
=========================
[Crimean-Congo hemorrhagic fever (CCHF), an acute viral disease in humans, is characterized by extensive ecchymoses, bleeding, and hepatic dysfunction and is associated with a 30 percent case-fatality ratio (World Health Organization Crimean-Congo haemorrhagic fever. Fact sheet no. 208. Geneva: the Organization; 1998). It is caused by CCHF virus (genus _Nairovirus_, family _Bunyaviridae_).

CCHF is a zoonosis transmitted to large and small mammals and birds by ticks. Although the virus has been isolated from several genera and species of ixodid ticks, the main group of vectors involved in CCHF virus transmission appears to be ticks of the genus _Hyalomma_ (Hoogstraal H. The epidemiology of tick-borne Crimean-Congo haemorrhagic fever in Asia, Europe, and Africa. J Med Entomol. 1979;15(4):307-417.). Immature ticks acquire the virus by feeding on infected small vertebrates. Once infected, they remain infected throughout their development and, when they are mature, transmit the infection to large animals, such as livestock. Transovarian transmission has also been demonstrated.

The circulation of CCHF virus and the high prevalence of infected animals and ticks have been well documented in Mauritanian farming areas since 1983 (Gonzalez JP, LeGuenno B, Guillaud M, Wilson ML. A fatal case of Crimean-Congo haemorrhagic fever in Mauritania: virological and serological evidence suggesting epidemic transmission. Trans R Soc Trop Med Hyg. 1990;84(4):573-6).

Mauritania experienced a fairly large CCHF outbreak in 2003, involving 38 cases with a case fatality rate of 28.6 percent. Over 90 percent of the cases (35/38) were resident in Nouakchott. In 2017, the WHO reported confirmation of a 3rd CCHF case in Boutilimit as well as in 2 patients referred from Mauritania to Dakar, Senegal who tested positive between May and June 2017. These cases had also originated from the capital city Nouakchott. This may be indicative of the relative prevalence of the reservoir and vector for the CCHF virus (Hyalomma ticks) in the country.

Even though the country has established adequate diagnostic capacity, which facilitated rapid confirmation of cases; the national authorities and partners need to carry out extensive outbreak investigations, including seroprevalence studies, to determine the potential risk for continued CCHF outbreaks in humans and institute effective prevention and control measures, with a strong animal health component  (<http://apps.who.int/iris/bitstream/10665/258794/1/OEW34-192582017.pdf>).

The case reported in this report is a farmer admitted in early
November [2017], however no exposure history is mentioned. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map Nouakchott, Nouakchott, Mauritania:
Date: 28 Aug 2017
Source: Outbreak News Today [edited]

On 24 Aug 2017, the Mauritania Ministry of Health notified WHO of a confirmed case of Crimean-Congo hemorrhagic fever (CCHF) in a 47-year-old shepherd, from Arafat Village in Mohammedia, Boutilimit Prefecture, located about 150 km southeast of the capital, Nouakchott.

In May 2017, health officials reported 2 imported cases of Crimean-Congo hemorrhagic fever (CCHF) in Senegal imported from Mauritania. A 3rd imported case was reported in June 2017.

He developed headache, muscle and joints pains and diarrhea on 20 Aug 2017 and sought medical attention. He was treated with anti-malarial medicines and analgesics.

After 2 days, he returned for medical care as his condition worsened. He was tested for CCHF because of bleeding manifestations and was IgM positive for Crimean-Congo haemorrhagic fever by enzyme-linked immunosorbent assay (ELISA). The patient is still hospitalized and in stable clinical condition.

Mauritania experienced a fairly large CCHF outbreak in 2003, involving 38 cases with a case fatality rate of 28.6 percent. According to the WHO, Crimean-Congo hemorrhagic fever is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 percent.

CCHF is endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north, the geographical limit of the principal tick vector. The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats.

Animals become infected by the bite of infected ticks, and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vectors.

The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission is possible.  [Byline:  Robert Herriman]
==================
[An outbreak of Crimean-Congo hemorrhagic fever was documented in Nouakchott, the capital of Mauritania in 2003. The index case was detected on 18 Feb 2003. By 21 Mar 2003, the Ministry of Health of Mauritania had reported a total of 35 cases (18 laboratory confirmed) of Crimean-Congo haemorrhagic fever (CCHF), including 6 deaths [Crimean-Congo hemorrhagic fever - Mauritania (04) http://promedmail.org/post/20030324.0732].

In the period from February to August 2003, 38 persons were infected with Crimean-Congo hemorrhagic fever (CCHF) virus; 35 of these persons were residents of Nouakchott. The 1st patient was a young woman who became ill shortly after butchering a goat. She transmitted the infection to 15 persons in the hospital where she was admitted and 4 members of her family. In Nouakchott, 2 disease clusters and 11 isolated cases were identified. Of the patients not infected by the 1st case-patient, almost half were butchers, which suggests that the primary mode of animal-to-human transmission was direct contact with blood of infected animals.

Cattle heavily infested with ticks were more likely to be CCHFV seropositive, and vector control to reduce the tick burden can result in reduced seroprevalence. Cattle are noted as the most sensitive indicator of low-level CCHFV circulation because they tend to be highly infested with _Hyalomma_ spp. ticks, which are the most common vectors of CCHF  [<http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004210>].

The circulation of CCHF virus and the high prevalence of infected animals and ticks have been well documented in Mauritanian farming areas since 1983 [Crimean-Congo haemorrhagic fever and Rift Valley fever in south-eastern Mauritania. Saluzzo JF, Digoutte JP, Camicas JL, Chauvancy G Lancet. 1985 Jan 12; 1(8420):116].

Since then, this is the latest case reported from that country, with history of exposure to livestock. - ProMed Mod.UBA]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/13859>.]
More ...

World Travel News Headlines

Date: Thu, 9 Apr 2020 07:30:18 +0200 (METDST)
By Mary Lyn Fonua

Nuku'alofa, Tonga, April 9, 2020 (AFP) - A resurgent Tropical Cyclone Harold flattened tourist resorts in Tonga Thursday, extending a week-long trail of destruction across four South Pacific island nations that has claimed more than two dozen lives.   The cyclone gathered pace as it bore down on the tiny island kingdom, which declared a state of emergency, warning residents to seek shelter from destructive winds and massive sea surges.

By early Thursday it had again become a scale-topping Category Five superstorm -- surprising meteorologists after signs earlier in the week that its intensity was dropping.   Packing winds of up to 260 kilometres per hour (160 miles per hour), it cut power in parts of the country and police said at least three tourist resorts north of the capital Nuku'alofa had been reduced to rubble.

The cyclone killed 27 people in the Solomons late last week before barrelling southeast to directly hit Vanuatu as a Category Five, obliterating entire towns in the northern provinces.   There have been no reports of deaths in Vanuatu, Fiji or Tonga, with emergency workers saying residents in the hardest hit areas took shelter early.   "It appears that many buildings and crops have been destroyed and some people in the most affected areas have lost everything," Red Cross Vanuatu secretary general Jacqueline de Gaillande said.

Harold weakened slightly to a still-formidable Category Four as it lashed Fiji on Wednesday but hopes the storm was dissipating were dashed as it regathered momentum heading towards Tonga.   "It's been a tricky one to predict," meteorologist Bill Singh from New Zealand's Metservice told AFP.   "We knew the track it was going to take but initially everyone thought it was just going to be Cat 3 or 4, but as it progressed over open warm waters it deepened."

- Closed borders -
The storm is expected to head away from Tonga onto the open ocean late Thursday but WeatherWatch.co.nz head forecaster Philip Duncan said there were no certainties.   "It's almost unheard of to see a cyclone tracking south away from the equator, weakening, then suddenly returning back to Cat 5 so far south," he said.

The COVID-19 pandemic has complicated disaster relief efforts, with Vanuatu reluctant to open its international borders as it seeks to remain one of the few countries without any confirmed virus cases.   "No foreign personnel are being brought to Vanuatu for response efforts at the present time, this will be an internally run operation," Vanuatu's National Disaster Management Office said.

Fiji has 15 virus cases and Prime Minister Frank Bainimarama said the virus and cyclone meant "our economy and our people have been dealt two body blows to start the year".   "This storm must not compromise our coronavirus containment efforts, lest we risk damage far more painful than the aftermath of any cyclone," he said.

Australian Foreign Minister Marise Payne said an air force plane carrying essential supplies such as tents and water containers was on its way to Vanuatu, while assistance had also been offered to other impacted nations.   "We are acutely conscious that this comes on top of the impact and difficulties created by COVID-19 for those countries," she said.   Vanuatu said any supplies that came into the country would be handled with protective equipment and the air crews delivering them would be isolated in transit areas.
Date: Wed, 8 Apr 2020 18:07:06 +0200 (METDST)

London, April 8, 2020 (AFP) - Britain on Wednesday reported a record 938 new COVID-19 deaths in its daily update, 152 more than its previous highest toll, as the total number of deaths passed 7,000.    "As of 5pm on 7 April, of those hospitalised in the UK who tested positive for coronavirus, 7,097 have sadly died," the health ministry tweeted, up from 6,159 on Tuesday.
Date: Wed, 8 Apr 2020 16:50:53 +0200 (METDST)
By Sofia CHRISTENSEN

Johannesburg, April 8, 2020 (AFP) - A pride of lions flops lazily across a track at a South African game reserve, enjoying newfound tranquility since last month's closure of all national parks to support an anti-coronavirus lockdown.   Rather than the usual Land Rover, a lone elephant rumbles down the road, causing the felines to scatter into the surrounding bush.   A vehicle stands in the background, live streaming the scene for thousands of people watching the animals from the comfort of their homes.   "Since the lockdown occurred we have seen an amazing explosion in our audience," said Graham Wallington, head of a live safari broadcaster called WildEarth.

As the number of viewers tripled over the last days of March, Wallington noted that the audience -- typically American -- was increasingly from South Africa.   "It just happened overnight because all these kids at home with their families are watching these live safaris," he told AFP.   South Africa is almost two weeks into a 21-day lockdown meant to halt the spread of COVID-19.   The country is the worst-affected in Africa, with more than 1,700 infections recorded so far, including 13 deaths.

WildEarth operates from two vehicles in two private game reserves bordering the internationally famous Kruger National Park.   Guides take viewers along for a virtual game drive, finding wildlife and sharing facts about animals encountered along the way.   The cameras are positioned at the back of the vehicles, where passengers would usually be seated, in order to create a real-life experience.   "There it is," guide James Hendry whispered excitedly to the camera after stumbling across a mother hyena and her newborn cubs.   "Tell me, have you ever seen anything that cute in your life before?"   Participants can also send questions to the guides as they go along.

- Rare species emerge -
"You want to know how much water an elephant drinks in a day?" asked ranger Trishala Naidoo, as she drove along a bumpy bush track.   "Around 100 litres if not more," she answered, before pulling over to show viewers a leopard tortoise crossing the road.   Aside from providing entertainment, Wallington believes virtual safaris are an opportunity to observe how wildlife behave in the absence of tourists.   "It's kind of an interesting time where the animals are being left alone," Wallington said, adding that rare species such as the endangered African wild dogs had started venturing into his areas.   "Wild dogs coming in and hunting almost every day... is unheard of," he exclaimed.    "It's because there is no one else there and they've got the run of the place for themselves."
Date: Wed, 8 Apr 2020 16:44:56 +0200 (METDST)

Monrovia, April 8, 2020 (AFP) - Liberian President George Weah declared a state of emergency in the West African country on Wednesday, with the capital Monrovia set to go into lockdown in a bid to curb coronavirus.    In a televised statement, the president said that all movement between Liberia's 15 counties would be banned from 11:59 pm on Friday, and that all non-essential businesses and government offices would close.

Residents of four counties -- including Monrovia's, which is home to about 1 million people -- must also stay at home for two weeks, he said.    Authorities in those counties will allow people to leave their homes only to buy food or for health reasons.     "We have to ask ourselves why we should abide by these measures. The answer is simple: to save lives," Weah said.

Wednesday's announcement escalates earlier health measures which banned large gatherings as well as flights to and from virus-stricken countries.   As with other poor countries in the region, there are fears that Liberia is ill prepared to handle a large outbreak.

The nation of some 4.8 million has recorded 13 coronavirus cases to date, with three deaths.  But Liberia was badly hit during the West Africa's 2014-16 Ebola crisis, which killed more than 4,800 people in the country.    Weah warned that the coronavirus was the greatest threat facing Liberia since Ebola.    "The horrific scenarios that are beginning to emerge should serve as sufficient warning for every one of us to spring into action," he said.   Coronavirus "has already arrived in Liberia, and confirmed cases are now on the rise," Weah added.   Decimated after back-to-back civil wars from 1989 to 2003, Liberia also suffers economic woes including rampant inflation and fuel shortages.
Date: Wed, 8 Apr 2020 16:42:52 +0200 (METDST)

Cairo, April 8, 2020 (AFP) - Egypt will extend a nationwide night-time curfew by a further two weeks in a bid to slow the spread of the coronavirus, Prime Minister Mostafa Madbouli said on Wednesday.   He told a news conference the measure would be enforced from 8:00 pm (1800 GMT) to 6:00 am and run until April 23.   The curfew would start an hour later, he said, to avoid overcrowding in public transport.   Schools and universities, as well as restaurants and cafes would also remain closed until then, while food outlets would be allowed to offer delivery services only.   To stem the spread of the coronavirus, authorities have also halted air traffic until the end of the month and closed tourist and religious sites.

Penalties against violators including fines of up to 4,000 Egyptian pounds (just over $250) and even prison, the prime minister said.  Madbouli also announced that cabinet members will take a 20 percent salary cut for three months, and allocate that sum to underprivileged Egyptians.   Egypt's health ministry has so far declared 94 fatalities out of 1,450 confirmed cases of COVID-19.   Authorities have in recent weeks carried out sweeping disinfection operations at archaeological sites, museums and other sites across the country.   In tandem, strict social distancing measures were imposed to reduce the risk of contagion among the country's 100 million inhabitants.
Date: Wed, 8 Apr 2020 15:46:57 +0200 (METDST)

Beirut, April 8, 2020 (AFP) - Millions in Lebanon risk food insecurity due to a coronavirus lockdown unless the government provides urgent assistance, Human Rights Watch warned Wednesday.   Lebanon in mid-March ordered residents to stay at home and all non-essential businesses to close to halt the spread of COVID-19, which has officially infected 575 people and killed 19 nationwide.   Before the pandemic erupted, Lebanon was struggling with its worst economic crisis in decades, with 45 percent of the population facing poverty according to official estimates.   Lockdown measures to slow the spread of the virus have made matters worse with "millions of Lebanon's residents... at risk of going hungry", HRW said in a statement.

Lebanon is home to 4.5 million people, and also hosts around 1.5 million Syrians who have fled the nine-year war next door, most of whom rely on aid to survive.   "The lockdown... has compounded the poverty and economic hardship rampant in Lebanon before the virus arrived," said HRW senior researcher Lena Simet.    "Many people who had an income have lost it, and if the government does not step in, more than half the population may not be able to afford food and basic necessities."

The economic crisis since last year had already caused many people to lose their jobs or take salary cuts, and stay-at-home measures to counter the virus have now prevented even more from earning a wage.   Media has carried reports of a taxi driver who set his car on fire after security forces fined him for breaking the lockdown rules.   And an unemployed Lebanese construction worker unable to afford rent offered to sell his kidney, in an image widely shared online.   HRW Lebanon researcher Aya Majzoub said many families are struggling due to a lack of savings.

The government has said it will pay out 400,000 Lebanese pounds (less than $150 at the market rate) to the most vulnerable.   HRW said the government should also consider suspending rent and mortgage payments throughout the lockdown.   Majzoub said Syrian refugees were also affected.   "Many of them were seasonal workers -- they worked in agriculture, they worked in the service industry -- and they're not able to do that anymore," she said.   But their ability to cope will depend largely on international aid, as before the pandemic.

The World Bank last week said it had re-allocated $40 million from its support to Lebanon's health sector to fight the virus, including for tests and ventilators.   And it has also been discussing "assistance to help mitigate the impact of the economic and financial crisis on the poor through emergency social safety nets", World Bank spokeswoman Zeina El-Khalil told AFP in March.    On Monday, Lebanon's President Michel Aoun urged the international community to provide financial assistance to back economic reforms.
Date: Wed, 8 Apr 2020 15:13:03 +0200 (METDST)

Dublin, April 8, 2020 (AFP) - Irish police set up nationwide traffic checkpoints on Wednesday, armed with new powers to enforce a lockdown designed to stem the spread of the coronavirus.   Emergency legislation passed in the Irish parliament two weeks ago allows the government to curb non-essential travel during the crisis.

People violating the ban risk a fine of up to 2,500 euros ($2,700) and/or six months in prison.   "The regulations now are in effect," Garda -- Irish police -- commissioner Drew Harris said at a press conference.   "People only should be moving if they have an essential reason to move throughout country. What we'll be doing is making sure that movement is essential."

Over 2,500 officers will be involved in the operation at any one time as it runs from noon Wednesday until midnight on Sunday, with an extension possible.   "It will involve thousands of checkpoints every day," police said in a statement. The roadblocks have been put in place ahead of Easter holidays, traditionally used as an occasion for travel in Ireland.

Harris said nationwide compliance with the ban on movement -- which allows for exercise within two kilometres of home -- had been strong.   But there is a "small minority and perhaps... an increasing number" in breach of the government order.   There have been 210 COVID-19 related deaths and 5,709 confirmed cases of the virus in Ireland according to health department figures released Tuesday.
Date: Wed, 8 Apr 2020 13:24:23 +0200 (METDST)

Tehran, April 8, 2020 (AFP) - Iran on Wednesday reported 121 new deaths from the novel coronavirus, bringing its overall number of fatalities to 3,993.   In the past 24 hours, 1,997 new cases of COVID-19 infection were detected in Iran, state news agency IRNA quoted health ministry spokesman Kianoush Jahanpour as saying.   That put the number of confirmed cases at 64,586, he added.

Iran, which announced its first COVID-19 cases on February 19, is by far the worst hit by the pandemic in the Middle East, according to official tolls.   But there has been speculation abroad that the real number of deaths and infections in the country could be higher.   Jahanpour said that while 3,956 patients were in critical condition, those who recovered had reached 29,812.   The spokesman added that Iran had carried out 220,975 COVID-19 tests to date, according to IRNA.   In a bid to halt COVID-19, Iran has ordered the closure of non-essential businesses and imposed inter-city travel bans, while refraining from a lockdown.

Iran's President Hassan Rouhani said a "second wave" of the fight against the coronavirus would start from Saturday, and that it would be more difficult.   "Low-risk" businesses would be allowed to reopen from Saturday, he said, because "we want to continue economic activities as much as possible while fighting coronavirus at the same time".   The decision to reopen businesses has drawn criticism from health experts and even some government officials.   But Rouhani said "there is no other way".
Date: Wed, 8 Apr 2020 13:14:26 +0200 (METDST)
By Robbie COREY-BOULET

Addis Ababa, April 8, 2020 (AFP) - Ethiopia on Wednesday declared a state of emergency to fight the coronavirus pandemic, which has so far infected 55 people and resulted in two deaths there.    It is the first state of emergency announced under Prime Minister Abiy Ahmed, who came to power in 2018 and won last year's Nobel Peace Prize in part for expanding political freedoms in the authoritarian nation.    "Because the coronavirus pandemic is getting worse, the Ethiopian government has decided to declare a state of emergency under Article 93 of the constitution," Abiy said in a statement.     "I call upon everybody to stand in line with government bodies and others that are trying to overcome this problem," he added, warning of "grave legal measures" against anyone who undermines the fight against the pandemic.

It was not immediately clear how the state of emergency would affect day-to-day life in Ethiopia.   The government has so far refrained from imposing a lockdown similar to those in effect elsewhere in the region, including in Rwanda, Uganda and Mauritius.

According to the country's constitution, under a state of emergency the Council of Ministers has "all necessary power to protect the country's peace and sovereignty" and can suspend some "political and democratic rights".    The constitution also says lawmakers need to approve a state of emergency, which can last for six months and be extended every four months after that.

Wednesday's decree is likely to "beef up security operations with a greater role for the ederal government, including the military," said William Davison, Ethiopia analyst for the International Crisis Group, a conflict-prevention organisation.    "While this approach is understandable given the situation, it is critical that there is transparency over the government's extra powers and that there is adequate monitoring of implementation," Davison said.

-Opposition challenges move-
Since reporting its first COVID-19 case on March 13, Ethiopia has closed land borders and schools, freed thousands of prisoners to ease overcrowding, sprayed main streets in the capital with disinfectant, and discouraged large gatherings.    But Abiy said over the weekend that a harsher lockdown would be unrealistic given that there are "many citizens who don't have homes" and "even those who have homes have to make ends meet daily."    Jawar Mohammed, a leading opposition politician, said Wednesday this called into question why a state of emergency was necessary.   "Officials have been saying the country is too poor to stop population movement. So why do you need a state of emergency if you are not planning to impose stricter rules?" Jawar told AFP.

During consultations with Abiy earlier this week, the opposition Oromo Liberation Front (OLF) voiced worries that a state of emergency would lead to human rights abuses -- a well-documented problem under previous states of emergency imposed during several years of anti-government protests that swept Abiy to power.    "We explained our concern that the state of emergency has been initiated several times and it has been abused to violate the rights of citizens and other political activists," OLF chairman Dawud Ibsa told AFP.   It's also unclear how the state of emergency might affect planning for hotly-anticipated general elections in Ethiopia.

The country's electoral board announced last week that voting planned for August would need to be postponed because of the pandemic.    It did not provide a timeline for when the elections would ultimately be held, and lawmakers' constitutional mandates expire in October.   Davison, with the International Crisis Group, said the state of emergency could be used "to formally postpone elections" past that deadline, though such a move risks sparking opposition backlash.    "It is therefore essential that the government works with opposition parties on managing this constitutionally sensitive period and making new electoral arrangements," Davison said.
Date: Wed, 8 Apr 2020 13:08:25 +0200 (METDST)

Madrid, April 8, 2020 (AFP) - Spain recorded Wednesday a second successive daily rise in coronavirus-related deaths with 757 fatalities, lifting the total toll in Europe's second-hardest-hit country after Italy by 5.5 percent to 14,555.   The number of new infections rose by 4.4 percent to 146,690, the health ministry said, as Spain has ramped up its testing for the disease.   The number of daily deaths, which peaked on Thursday at 950, rose for the first time on Tuesday after falling for four straight days.

But the rate of increase in both deaths and new infections on Wednesday was largely in line with that recorded the previous day, and half of what was recorded just a week ago.   "We have consolidated the slowdown in the spread of the virus," Health Minister Salvador Illa tweeted after the latest figures were published.   The Spanish government on March 14 imposed one of the toughest lockdowns in Europe to curb the spread of the virus, with people allowed out of their homes only to work, buy food and seek medical care.

The pandemic has stretched the country's public healthcare system close to breaking point, with a shortage of intensive care beds and equipments, but in recent days hospitals have said the situation has improved.   "We have observed a de-escalation at this hospital in particular, and I believe at all hospitals," the spokesman for the Hospital Severo Ochoa in Leganes near Madrid, Jorge Rivera, told AFP.   "We can't let down our guard, emergency services are now working below their full capacity and are working well, they are not saturated and overcrowded but it does not mean that we can relax and go to the emergency ward because you have an ailment."