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Nigeria

Nigeria US Consular Information Sheet
June 02, 2008
COUNTRY DESCRIPTION:
Nigeria is a developing country in western Africa that has experienced periods of political instability. It has the largest population on the continent, estimated at
44 million people, and its infrastructure is not fully functional or well maintained. Read the Department of State’s Background Notes on Nigeria for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and visa are required. The visa must be obtained in advance from a Nigerian Embassy or Consulate. Visas cannot be obtained on arrival at the airport. Promises of entry into Nigeria without a visa are credible indicators of fraudulent commercial schemes in which the perpetrators seek to exploit the foreign traveler's illegal presence in Nigeria through threats of extortion or bodily harm. U.S. citizens cannot legally depart Nigeria unless they can prove, by presenting their entry visas, that they entered Nigeria legally. Entry information may be obtained at the Embassy of the Federal Republic of Nigeria, 3519 International Court NW, Washington, DC 20008, telephone (202) 822-1500, or at the Nigerian Consulate General in New York, telephone (212) 808-0301. Overseas, inquiries may be made at the nearest Nigerian embassy or consulate.

Visit the Embassy of Nigeria web site at http://www.nigeriaembassyusa.org/ for the most current visa information.

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

SAFETY AND SECURITY:
The Department of State continues to caution U.S. citizens about the possible dangers of travel to some parts of Nigeria. [Please also see the Crime Section below.] In light of the risk of kidnapping, crime, militant activity, or armed attacks, the U.S. Mission restricts the travel of U.S. government personnel to the following states to official travel only: Delta, Bayelsa, Rivers and Akwa Ibom in the Niger Delta, and Edo and Imo in the south. Only essential travel by non-official Americans is recommended to these areas. In addition, the military's Joint Task Force patrols the creeks in the Niger Delta because of ongoing militant and piracy incidents, especially against oil-related facilities or infrastructure, so individuals may be questioned, detained or arrested when traveling in these sensitive areas without evidence of permission from the Nigerian government or for carrying electronic equipment such as cameras, recorders, etc. Periodically, travel by U.S. mission personnel is restricted in certain parts of Nigeria based on changing security conditions, often due to crime, general strikes, or student/political demonstrations or disturbances. See the Department of State’s Travel Warning for Nigeria for more information.

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 current Travel Warnings, Travel Alerts, and 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: Violent crime committed by individual criminals and gangs, as well as by some persons wearing police and military uniforms, is a problem, especially in Lagos, Abuja and other large cities, although it can occur anywhere. Some visitors and resident Americans have experienced armed muggings, assaults, burglary, carjacking, kidnappings and extortion, often involving violence. Home invasions are on the rise in Lagos, with armed robbers accessing even guarded compounds by following, or tailgating, residents or visitors arriving by car into the compound, subduing guards and gaining entry into homes or apartments. Armed robbers in Lagos also access waterfront compounds by boat. U.S. citizens, as well as Nigerians and other expatriates, have been victims of armed robbery on roads to airports during both daylight and evening hours. Law enforcement authorities usually respond to crimes slowly or not at all, and provide little or no investigative support to victims. U.S. citizens and other expatriates have experienced harassment and shakedowns at checkpoints and during encounters with Nigerian officials.

Nigerian-operated fraud scams, known as 419s, are noted for their cleverness and ingenuity. These scams target foreigners worldwide, posing risks of both financial loss and personal danger to their victims. Scams are often initiated through internet postings or from internet cafes, by unsolicited emails, faxes, and letters, or can involve credit card use. As anywhere else, no one should provide personal or financial information to unknown parties or via Nigerian telephone lines. The expansion of bilateral law enforcement cooperation, which has resulted in numerous raids on commercial fraud premises, has reduced the overall level of overt fraud activity, but new types of sophisticated scams are introduced daily.

American citizens are very frequently the victims of Nigerian confidence artists offering companionship through internet dating websites. These confidence artists almost always pose as American citizens visiting or living in Nigeria who unexpectedly experience a medical, legal, financial or other type of “emergency” that requires the immediate financial assistance of the American citizen in the United States. In these cases, we strongly urge the American citizen in the United States to be very cautious about sending money to any unknown person purportedly acting on their behalf, or traveling to Nigeria to meet someone with whom their sole communications have been via the internet. Other common scams involve a promise of an inheritance windfall, work contracts in Nigeria, or an overpayment for goods purchased on-line. For additional information on these types of scams, see the Department of State's publication, International Financial Scams.

Commercial scams or stings that targets foreigners, including many U.S. citizens, continue to be a problem. One needs to be alert to scams that may involve U.S. citizens in illegal activity, resulting in arrest, extortion or bodily harm. These scams generally involve phony offers of either outright money transfers or lucrative sales or contracts with promises of large commissions or up-front payments, or improperly invoke the authority of one or more ministries or offices of the Nigerian government and may cite, by name, the involvement of a Nigerian government official. In some scams, government stationery and seals are also improperly used to advance the scam. The ability of U.S. consular officers to extricate U.S. citizens from unlawful business deals or scams and their subsequent consequences is extremely limited. U.S. citizens have been arrested by police officials and held for varying periods on charges of involvement in illegal business activity or scams. Nigerian police or other law enforcement officials do not always inform the U.S. Embassy or Consulate immediately of the arrest or detention of a U.S. citizen. The U.S. Department of Commerce has advisories to the U.S. business community on a variety of issues that should be seriously reviewed with respect to doing business in Nigeria. To check on a business’s legitimacy while in the United States, contact the Nigeria Desk Officer at the International Trade Administration, Room 3317, Dept. of Commerce, Washington, D.C. 20230, telephone 1-800-USA-TRADE or (202) 482-5149, fax (202) 482-5198. If you are abroad, contact the nearest U.S. Embassy or Consulate.

The Department of State encourages all travelers abroad to register their travel. The most convenient way to do so would be through the online travel registration page. Travelers may also register in person at the U.S. Embassy in Abuja or the U.S. Consulate General in Lagos. See the section on Registration / Embassy Location below.

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, for example, can provide you with a list for appropriate medical care, or contact family members or friends and explain how funds could be transferred to you to cover unexpected costs. 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 the Department of State’s information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: While Nigeria has many well-trained doctors, medical facilities in Nigeria are in poor condition, with inadequately trained nursing staff. Diagnostic and treatment equipment is most often poorly maintained, and many medicines are unavailable. Caution should be taken as counterfeit pharmaceuticals are a common problem and may be difficult to distinguish from genuine medications. This is particularly true of generics purchased at local pharmacies or street markets. Hospitals often expect immediate cash payment for health services.

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 health insurance policy applies overseas and whether it will cover emergency expenses such as a medical evacuation from a foreign country to the United States or another location. Please see the our brochure 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 Nigeria is provided for general reference only and may not be totally accurate in a particular location or circumstance.

Roads in many areas are generally in poor condition, causing damage to vehicles and contributing to hazardous traffic conditions. There are few working traffic lights or stop signs. The rainy season from May to October is especially dangerous because of flooded roads and water-concealed potholes.

Excessive speed, unpredictable driving habits, and the lack of basic maintenance and safety equipment on many vehicles are additional hazards. Motorists seldom yield the right-of-way and give little consideration to pedestrians and cyclists. Gridlock is common in urban areas. Chronic fuel shortages have led to long lines at service stations, which disrupt or block traffic for extended periods.

Public transportation vehicles are unsafe due to poor maintenance, high speeds and overcrowding. Motorbikes, known in Nigeria as "okadas," are a common form of public transportation in many cities and pose particular danger to motorists, their own passengers and pedestrians. Motorbike drivers frequently weave in and out of traffic at high speeds and observe no traffic rules. Motorbikes are banned within Abuja's city limits. Passengers in local taxis have been driven to secluded locations where they were attacked and robbed. Several of the victims required hospitalization. The U.S. Mission advises that public transportation throughout Nigeria be avoided.

It is recommended that short-term visitors not drive in Nigeria. A Nigerian driver's license can take months to obtain, and to date an international driving permit is not recognized. Major hotels offer reliable car-hire services complete with drivers. Reliable car-hire services can also be obtained at the customer service centers at the airports in Lagos, Abuja, and Kano. Inter-city travelers must also consider that roadside assistance is extremely scarce, and as noted above medical facilities and emergency care are poor, meaning that being involved in a traffic incident might result in a lack of available medical facilities to treat either minor or life-threatening injuries.

All drivers and passengers are reminded to wear seat belts, lock doors, and raise windows. It is important to secure appropriate automobile insurance. It is also important to be aware that drivers and passengers of vehicles involved in accidents resulting in injury or death have experienced extra-judicial actions, i.e., mob attacks, official consequences such as fines and incarceration or involvement with the victim's family. Night driving should be done with extreme caution, but it is recommended to avoid driving between 6:00 p.m. and 6:00 a.m. as bandits and police roadblocks are more numerous at night. Streets are very poorly lit, and many vehicles are missing one or both headlights, tail lights, and reflectors.

The Government of Nigeria charges the Federal Road Safety Commission with providing maps and public information on specific road conditions. The Federal Road Safety Commission may be contacted by mail at: Ojodu-Isherri Road, PMB 21510, Ikeja, Lagos; telephone [243] (1) 802-850-5961 or [234] (1) 805-684-6911.
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 Nigeria, the U.S. Federal Aviation Administration (FAA) has not assessed Nigeria’sCivil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

The Port Harcourt International Airport, which was closed in mid-2006 for rehabilitation, resumed operations in December 2007 for domestic daylight flights. Installations and improvements needed for international flights and night operations are expected to be completed in 2008.

For additional information on aviation safety concerns, see the Department of State’s Travel Warning for Nigeria.
SPECIAL CIRCUMSTANCES:
Permission is required to take photographs or videotape any government buildings, airports, bridges, and in areas where the military is operating throughout the country. These sites include, but are not limited to, Federal buildings in the Three Arms Zone (Presidential palace area, National Assembly, Supreme Court/Judiciary) of the capital of Abuja, other government buildings around the country and foreign Embassies and Consulates. Many restricted sites are not clearly marked, and application of these restrictions is subject to interpretation by the Nigerian security services and can result in detention. Permission may be obtained from Nigeria's State Security Services, but even permission may not prevent the imposition of penalties or detention. Penalties for unauthorized photography or videography may include confiscation of the still or video camera, exposure of the film or deletion of film footage, a demand for payment of a fine or bribe, and/or detention, arrest, or physical assault. For these reasons, visitors to Nigeria should avoid taking still photos or videotaping in and around areas that are potentially restricted sites, including any government sites.

The Nigerian currency, the naira, is non-convertible. U.S. dollars are widely accepted. Nigeria is a cash economy, and it is usually necessary to carry sufficient currency to cover the expenses of a planned visit, which makes travelers an attractive target for criminals. Credit cards are rarely accepted beyond a few upscale hotels. Due to credit card fraud in Nigeria and by cohorts in the United States, credit card use should be considered carefully. While Citibank cashes some traveler’s checks, most other banks do not. American Express does not have offices in Nigeria; however, Thomas Cook does. Inter-bank transfers are often difficult to accomplish, though money transfer services such as Western Union are available. For further information, visitors may contact the U.S. Embassy or Consulate.

Please see the Department of State’s information on Customs Information.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Nigerian laws, even unknowingly, may be expelled, detained, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Nigeria 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 the Department of State’s information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Nigeria are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Nigeria and other general information.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 at 1075 Diplomatic Drive, Central Area, Abuja. American citizens can call [234] (9) 461-4176 during office hours (Monday through Thursday, 7:30 a.m. to 4:30 p.m.; Friday, 7:30 a.m. to 1:30 p.m.). For after-hours emergencies, call [234] (9) 461-4000. The email address for the Consular Section in Abuja is ConsularAbuja@state.gov.

The U.S. Consulate General is located at 2 Walter Carrington Crescent, Victoria Island, Lagos. American citizens can call [234] (1) 261-1215 during office hours (7:30 a.m. to 4:00 p.m.). For after-hours emergencies, call [234] (1) 261-1414, 261-0050, 261-0078, 261-0139, or 261-6477. The e-mail address for the Consular Section in Lagos is Lagoscons2@state.gov.

The Embassy and Consulate website is http://nigeria.usembassy.gov/.
* * *
This replaces the Consular Information Sheet dated April 16, 2007, to update sections on Country Description, Safety and Security, Crime, Traffic Safety and Road Conditions, Aviation Safety Oversight, Special Circumstances and Registration / Embassy Location.

Travel News Headlines WORLD NEWS

Date: Sun 3 Mar 2019
Source: Nigeria CDC Yellow fever situation report in Nigeria [edited]

Highlights
----------
In this reporting week, 25 Feb to 3 Mar 2019:
- 88 suspected cases were recorded.
- 2 new presumptive positive cases were recorded: NCDC Central Public Health Laboratory (CPHL) reported 2 new presumptive positive cases from Edo State - 2 (Uhunmwode local government area [LGA]).
- No new confirmed case from the Institute Pasteur (IP) Dakar.
- Last IP Dakar confirmed cases were 20 Feb 2019.
- 18 states have recorded at least one confirmed case from IP Dakar since the onset of the outbreak in 2017.
- Yellow fever response activities are being coordinated by the Yellow Fever Technical Working Group (YF TWG).

From 1 Jan to 3 Mar 2019:
- 364 suspected cases have been reported in 177 (22.9%) LGAs.
- All suspected cases had blood samples collected.
- 14 presumptive positive and one inconclusive cases from 4 states in 10 LGAs: Edo (8), Ondo (4), Kebbi (1), Imo (1), and the inconclusive case from Imo (1).
- 5 confirmed cases were reported from 2019 samples sent to IP Dakar: Edo (2), Ondo (2), and Imo (1).
- No death has been recorded.

Summary of outbreak
-------------------
A yellow fever outbreak has been active in Nigeria since September 2017:
- From 2017 to 2018, 139 cases were confirmed in 17 states: Kwara (8), Kogi (10), Kano (1), Zamfara (19), Kebbi (7), Nasarawa (3), Niger (1), Katsina (2), Edo (69), Ekiti (2), Rivers (1), Anambra (1), FCT [Federal Capital Territory] (10), Benue (1), Delta (1), Ondo (2), and Abia (1) in 46 LGAs.
- From September 2017 to December 2018, 276 samples (presumptive positive, 239; inconclusive, 37) were sent to IP Dakar for reconfirmation.
- All Nigerian states (36 plus FCT) reported 4100 suspected cases in 604 (78%) LGAs.
- Of all suspected, probable, and confirmed cases, 80 deaths were recorded with 29 deaths among confirmed cases.
- The case fatality rate (CFR) for all cases (suspected, probable, and confirmed) is 2%, and 21% for confirmed cases.
- Yellow fever preventive mass vaccination campaign (PMVC) has been completed in 12 states, led by NPHCDA:
-- 2013 PMVC phase 1: Nasarawa, Cross River, Akwa Ibom.
-- 2018 phase 2a: Kogi, Kwara, and Zamfara and in 58 political wards in 25 LGAs in Borno State.
-- 2018 phase 2b PMVC: Sokoto, Kebbi, Niger, FCT, Plateau, and Borno (3 LGAs: Askira/Uba, Chibok, Konduga) states.
-- Yellow fever reactive vaccination campaigns were implemented in Katsina (Danja LGA), Edo (13 LGAs), and Benue (Vandekeiya).
-- 2019 phase 3 PMVC will be implemented in all LGAs where no yellow fever campaigns have been implemented in Edo, Ekiti, Katsina, and Rivers states.

EPI - summary [table, graphs, and maps]

Table 1: Showing all affected states and cases with yellow fever as of week 9, 25 Feb to 3 Mar 2019 [with data for categories that interested readers can see at the source URL]:
- Total number of cases in the line list
- Attack rate per 100 000 population
- Number of LGAs with suspected cases
- Number of LGAs with presumptive/inconclusive cases
- Number of LGAs with confirmed cases from IP Dakar
- Number suspected cases with blood sample collected in Nigeria
- Number of presumptive positives in Nigeria
- Number with inconclusive results in Nigeria
- Total number of samples sent to IP Dakar
- Number positive cases from IP Dakar
- Total number negative in IP Dakar
- Number awaiting result from IP Dakar
- Number of deaths from all cases
- Number of deaths among presumptive positives
- Number of deaths from IP Dakar confirmed

Figure 1 [graph]: Epidemic curve of suspected/presumptive cases of yellow fever in Nigeria as of week 8, 18-24 Feb, 2019
Figure 2 [graph]: Trend of confirmed cases of yellow fever in Nigeria 2017-2019
Figure 3 [graph]: Epicurve of yellow fever cases in Edo state (Sep 2018 to Feb 2019)
Figure 4: Map of Nigeria showing states with suspected/presumptive cases as of week 9, 25 Feb to 3 Mar 2019
Figure 5 [graph]: 2018 Phase 2 Nov to Dec 2018 preventive mass vaccination campaigns admin vaccination coverage by state
=====================
[The yellow fever (YF) outbreak peaked in weeks 48-51 of 2018. Numbers of confirmed cases fell abruptly on 1 Jan 2019, and confirmed cases have remained a low level to date but suspected cases have continued between weeks 1 and 6. The ongoing mass vaccination campaign in affected states in 2019 has reached or exceeded 90% in 5 cases and nearly so in Plateau state. That coverage has undoubtedly contributed to the decline in case numbers, and its continuation is prudent, as YF virus will not disappear from the country. - ProMED Mod.TY]

[Maps of Nigeria:
Date: Tue 5 Mar 2019
Source: Nigeria Center for Disease Control, situation report [edited]

2018-2019 Cerebrospinal meningitis outbreak in Nigeria/Epi Week 10: highlights
----------
- This is the 12th situation report for 2018/2019 season.
- The National Cerebrospinal Meningitis Emergency Operations Centre has been monitoring cases and ensuring preparedness and coordination of response across the states.
- States in the meningitis belt were formally placed on alert on 8 Nov 2018.
- As at epi week 9 [ending Sat 2 Mar 2019] 9 new suspected cases were reported.
- Beginning from 1 Oct 2018 to 5 Mar 2019, a total of 285 suspected cases have been reported from 14 states.
- 25 samples were positive for bacterial meningitis. - _Neisseria meningitidis_ serogroup C (NmC) accounted for 32.0% (8) of the positive cases.
- So far, 22 deaths (CFR=7.7%) have been recorded among all suspected cases.
- In the last 4 weeks (Epi Week 6 [ending 9 Feb 2019] to Epi Week 9, 2019), no LGA [local government area] is in the alert threshold.
- Media messages have been developed and disseminated via conventional and social media.
- The multi-agency CSM Emergency Operation Centre (EOC) has been activated.
- Monitoring of the situation continues across the high-risk states.

[The epidemic curve and a map of Nigeria showing the distribution of cerebrospinal meningitis cases by Nigerian states as at 5 Mar 2019 is available at the source URL. - ProMED Mod.ML]
===================
[Northern Nigeria lies within the African meningitis belt, the semi-arid areas of sub-Saharan Africa, where epidemics of meningococcal meningitis recur each year during the hot, dry season, between December and June. _Neisseria meningitidis_ serogroup A had been the main cause of epidemic meningococcal disease in this region (<http://www.who.int/csr/resources/publications/meningitis/whoemcbac983.pdf>).

Since
the introduction of the meningococcal A conjugate vaccine in countries of the African meningitis belt beginning in 2010, however, WHO has noted a decrease in the number of cases of meningitis; in fact, the number of cases in 2013 was the lowest recorded during the epidemic season in the prior 10 years (<http://www.who.int/csr/don/2013_06_06_menin/en/>), and _N. meningitidis_ serogroup A was noted to be no longer the predominant pathogen, having been replaced by other serogroups, notably serogroup C. - ProMED Mod.ML]

[HealthMap/ProMED map available at:
Date: Thu 28 Feb 2019
Source: Concise [edited]

Between January and February [2019], 15 people died of Lassa fever in Ondo state, south west Nigeria, while 102 persons are infected, the Nigerian Medical Association (NMA) said. "As at Thursday [21 Feb 2019], 102 people have tested positive for Lassa fever this year [2019]," chairman of the medical association in Ondo, Dr Wale Oke, told NAN in Akure.

"82 people in January [2019], and 20 people so far in February [2019] [have tested positive], apart from 15 deaths recorded in January [2019] as a result of the fever; no death has been recorded so far in February [2019]. Most people that died either reported late or were already subjected to alternative treatment and doing self-medication before they eventually came to the hospital. Their kidneys and livers were affected as a result of the delay."

Oke, who is also a staff member at the Federal Medical Centre, Owo, urged residents of the state to report early to the medical centre if they experience an upsurge of temperature in their bodies. "We have a contact tracing mechanism whereby we can place on surveillance for 21 days those who may have had contact with the infected persons," Oke said. "We continue to monitor their temperature; if it is above 37.8 deg C [100 deg F], we direct them for quick treatment."  [byline: John Andah]
=======================
[Lassa fever virus transmission is continuing as Nigeria, including Ondo state, is now in the period of the year when more Lassa fever cases usually occur. The situations under which the Ondo state patients acquired their infection is not stated. Transmission of Lassa fever virus (LFV) occurs when individuals are in contact with rodent reservoir hosts' excreta or are within healthcare facilities. As of 17 Feb 2019, 3 healthcare workers were infected with LFV, so presumably most of the other 99 infected individuals acquired their infection from contact with the excreta of infected rodent reservoirs.

Images of the rodent reservoirs of Lassa fever virus:
_Mastomys natalensis_:
_Mastomys erythroleucus_ and _Hylomyscus pamfi_:

[Map of Nigeria:

HealthMap/ProMED-mail maps:
Ondo State, Nigeria: <http://healthmap.org/promed/p/24841>]
Date: Sun 17 Feb 2019
Source: Nigeria CDC Situation Report in Nigeria [edited]

In this reporting week, 11-17 Feb 2019:
- 103 suspected cases were recorded.
- 3 new presumptive positive cases were recorded:
 - NCDC Central Public Health Laboratory (CPHL) reported the 3 new presumptive cases from Edo State - 2 (Ovia South West and Esan North East local government areas [LGAs]) and Ondo State - 1 (Ose LGA).
 - 2 confirmed cases and one inconclusive case were reported on 15 Feb [2019] from Institut Pasteur Dakar: Kwara - 1 (Ifelodun LGA), Federal Capital Territory - 1 (Gwagwalada Area Council) and inconclusive Edo State (Esan West LGA) (note: pending samples from 2018).

- Edo State yellow fever outbreak has been declared over:
 - Reactive vaccination campaign was carried out in 13 (72.2%) LGAs.
 - Total number of 1 734 423 were vaccinated with (120.1%) coverage.
- The national Yellow Fever Level 2 Emergency Operation Centre (EOC) has been de-activated.
- Response activities coordinated by the Yellow Fever Technical Working Group (YF TWG).

>From 1 Jan-17 Feb 2019:
- 254 suspected cases have been reported in 134 (17.3%) LGAs.
- All suspected cases had blood samples collected.
- 11 presumptive positive and one inconclusive cases from 4 states in 9 LGAs: Edo (6), Ondo (3), Kebbi (1) and Imo (1), inconclusive case from Imo (1).
- No IP Dakar confirmed case from 2019 data.
- No death has been recorded.

Summary of outbreak:

A yellow fever outbreak has been active in Nigeria since September 2017:
- From 2017 to 2018, 139 cases have been confirmed in 17 States: Kwara (8), Kogi (12), Kano (1), Zamfara (19), Kebbi (7), Nasarawa (3), Niger (1), Katsina (2), Edo (69), Ekiti (2), Rivers (1), Anambra (1), FCT (11), Benue (1), Delta (1), Ondo (2) and Abia (1) in 46 LGAs.
- From September 2017 to December 2018, 274 samples (presumptive positive - 237 and inconclusive - 37) in 238 LGAs have been sent to IP Dakar for re-confirmation.
- All Nigerian states (36 plus FCT) have reported 4100 suspected cases in 604 (78.0%) LGAs.
- Of all suspected, probable and confirmed cases, 80 deaths were recorded with 29 deaths among confirmed cases only.
- The case fatality ratio (CFR) for all cases (suspected, probable and confirmed) is 2.0%, and 21.0% for confirmed cases.
- Yellow fever preventive mass vaccination campaigns (PMVC) have been successfully completed in 12 states:
 - 2013 PMVC phase 1 Nasarawa, Cross River, Akwa Ibom.
 - 2018 Phase 2a: Kogi, Kwara and Zamfara and in 58 political wards in 25 LGAs in Borno State.
 - 2018 phase 2b PMVC: Sokoto, Kebbi, Niger, FCT, Plateau and Borno (3 LGAs (Askira/Uba, Chibok, Konduga) States.

EPI - summary [table, graphs and maps]

Table 1: Showing All Affected States and Cases with Yellow Fever as at Week 7, 11-17 Feb 2019

Figure 1 [graph]: Epidemic Curve of Suspected/Presumptive Cases of Yellow Fever in Nigeria as at Week 7; 11-17 Feb 2019
Figure 2 [graph]: Trend of Confirmed Cases of Yellow Fever in Nigeria 2017 and 2018
Figure 3 [graph]: Epicurve of Yellow Fever Cases in Edo State (September 2018 - February 2019)
Figure 4: Map of Nigeria Showing States with Suspected/Presumptive Cases as at Week 7, 11-17 Feb 2019
Figure 6: Map Showing States that Implemented PMVC
===================
[The above report indicates that there are 254 suspected yellow fever (YF) cases and 11 presumptive cases, and 2 cases have been confirmed. The YF virus is endemic in Nigeria, and cases occur there sporadically. Because the 2019 outbreak that began in Edo Stat e mayhave started as sylvatic (forest) yellow fever spread by various _Aedes_ species with subsequent rapid development suggesting urban yellow fever transmission spread by _Ae. aegypti_, it is reassuring to learn that the Edo state outbreak has been declared over with a reported vaccination coverage of 120% [This startling level of coverage may have occurred as a result of individuals vaccinated outside the state being vaccinated in the state as well, and/or by individuals being vaccinated twice within the state.]. Coverage in the 3 other states reporting suspected, presumptive or confirmed cases is not mentioned. Continued surveillance for new cases will be important. If coverage in these 3 states is less than 80-90%, one hopes that the vaccination campaign there will continue.

Maps of Nigeria:

[HealthMap/ProMED map of Kwara State, Nigeria available at
Date: Thu 21 Feb 2019
Source: Niaja News [edited]

A popular and deadly disease caused by [a virus in] rodents, Lassa fever, has killed 10 persons and infected 28 others in Plateau state, Nigeria.  Naija News reports that Plateau State commissioner for health Dr Kunden Deyin, while confirming the cases of the fever, said that 64 cases were taken to the laboratory for confirmation; of these, 28 were confirmed to be Lassa fever. According to Deyin, the state has recorded 28 new cases of Lassa fever with 10 deaths.

Deyin's remarks came on [Thu 21 Feb 2019], when he confirmed that the cases were imported from Kaduna state, adding that some patients of the fever are already responding to treatment.  "Lassa fever presents like any other fever, with symptoms such as headache, body pain, and a general feeling of being unwell. Therefore, anyone who is feeling feverish should visit the hospital immediately. Prompt presentation is the key to reducing the mortality rate associated with the disease, but most times, patients do come to the hospitals late.

"However, all health workers should make referrals to other health facilities such as the tertiary health facilities, when they cannot handle cases like Lassa fever that require prompt medical attention," he added.

Deyin also advised that people should learn to keep their environment clean and ensure that it is not rodent-friendly so as to avoid further reoccurrence of the fever; he also advised residents to store all grains in rodent-proof containers.  [Byline: Akoh Godday]
===========================
[There have been several reported Lassa fever cases in Plateau state so far this year (2019):

Date reported in 2019 / Number of cases
6 Jan / 1
27 Jan / 5
3 Feb / 4
10 Feb / 4
17 Feb / 2
Total / 16

That total has now increased to 38 (10 dead and 28 others) per the above report. Lassa fever virus transmission is currently very active in the state. This is well into the usual active virus transmission season (December-June).

Transmission of Lassa fever virus occurs when individuals are in contact with rodent reservoir hosts' excreta or are within healthcare facilities. Community involvement to reduce exposure to the rodent host is a challenge. A proactive public education effort is required to encourage use of containers that prevent rodent access to food materials and blocking of entry points of the rodents into houses.

Images of the rodent reservoirs of Lassa fever virus:
_Mastomys natalensis_:
_Mastomys erythroleucus_ and _Hylomyscus pamfi_:

These rodents can live near or in people's houses. - ProMED Mod.TY]

[Map of Nigeria:
HealthMap/ProMED-mail maps:
Plateau state, Nigeria: <http://healthmap.org/promed/p/616>]
More ...

World Travel News Headlines

Date: Mon, 25 Mar 2019 11:52:43 +0100

Sanaa, March 25, 2019 (AFP) - Nearly 110,000 suspected cases of cholera have been reported in war-hit Yemen since the beginning of January, including 190 related deaths, the UN said on Monday.   The UN office for humanitarian affairs (OCHA) said children under the age of five make up nearly a third of 108,889 cases which were reported between January 1 and March 17.

OCHA said the spike, which comes two years after Yemen suffered its worst cholera outbreak, was concentrated in six governorates including in the Red Sea port of Hodeida and the Sanaa province home to the capital.   Early rains could be blamed for the recent increase in suspected cholera cases, it said.   "The situation is exacerbated by poor maintenance of sewage disposal systems in many of the affected districts, the use of contaminated water for irrigation, and population movements," OCHA added.   The waterborne disease is endemic to Yemen, which witnessed the worst cholera outbreak in its modern history in 2017.

More than one million suspected cases were reported within an eight-month period that year. More than 2,500 people died of the infection between April and December 2017.    Yemen's brutal conflict, which pits Iran-linked rebels against a regional pro-government alliance led by Saudi Arabia, has left some 10,000 people dead since 2015 and pushed millions to the brink of famine.    The war has created the perfect environment for cholera to thrive, as civilians across the country lack access to clean water and health care.
Date: Wed 20 Mar 2019
Source: Outbreak News Today [edited]

Swedish public health authorities, Folkhalsomyndigheten, is reporting an outbreak of psittacosis, or parrot disease, since November 2018. According to officials, some 60 cases have been reported from the regions of Vastra Gotaland, Kalmar, Jonkoping, and Skane. This is the highest number of cases reported in one winter in 2 decades.

Those who have now fallen ill have mainly come into contact with bird droppings from wild birds, for example through the handling of bird tables and other outdoor activities. A smaller number are believed to have been infected by domestic birds (parrots) in cages. The most common way someone gets infected with the bacteria that cause psittacosis (_Chlamydia psittaci_) is by breathing in dust containing dried secretions (e.g., droppings, respiratory) from infected birds. It is rare for psittacosis to spread from person to person.

In general, psittacosis causes mild illness in people. The most common symptoms include fever and chills, headache, muscle aches, and dry cough. Psittacosis can also cause pneumonia (a lung infection) that may require treatment or care in a hospital. Rarely, psittacosis can result in death. Most people begin developing signs and symptoms of psittacosis within 5-14 days after exposure to the bacteria (_C. psittaci_). Occasionally, people report the start of symptoms after more than 14 days.
=================
[The news report above attributes the increase in number of human cases of psittacosis in Sweden since Nov 2018 mainly to contact with wild bird droppings, for example through the handling of bird tables and other outdoor activities. Outbreaks of avian chlamydiosis, due to _Chlamydia psittaci_ or the other Chlamydia species, have been reported occasionally in wild birds including shorebirds, waterfowl, and migratory birds, especially in birds under stress (<http://www.cfsph.iastate.edu/Factsheets/pdfs/psittacosis.pdf>).

An outbreak in Australia was probably caused by organisms carried in wild birds and spread when organisms in bird droppings became aerosolized during activities such as lawn mowing (<https://www.ncbi.nlm.nih.gov/pubmed/15757553>). An increase in psittacosis cases in Sweden in the winter of 2013 was also linked to wild birds, apparently through exposure to wild bird droppings; most cases were associated with tending bird feeders (<https://www.ncbi.nlm.nih.gov/pubmed/23725809>; also see ProMED-mail post Psittacosis - Sweden (02): wild bird http://promedmail.org/post/20130509.1701695).

Vastra Gotaland, Kalmar, Jonkoping, and Skane are counties located in southern Sweden. A map of Swedish counties can be found at <https://fotw.info/flags/se(.html>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: PNA [edited]

A public elementary school in Tubungan town, Iloilo has recorded a total of 36 chickenpox cases from 15 Jan to 3 Mar [2019], the Provincial Health Office (PHO) said. In an interview on Wednesday [20 Mar 2019], Dr. Patricia Grace Trabado, PHO head, said the cases were observed as patients who sought treatment at the rural health units (RHU) and private clinics in Tubungan.

All the cases were recorded in Cadabdab Elementary School, with 21 male and 15 female students affected. Trabado said affected pupils might still be attending school even though they were infected, which resulted in its transmission.

She emphasized that the spread of the infection might have been prevented if the children were advised not to attend school with the onset of infection. "If a child is showing chickenpox symptoms, especially when he or she was previously exposed to an affected person, then the pupil will be advised to stay at home," she said.

Trabado said the source of the infection came from the 1st patient working in Iloilo City but lives in Tubungan town. "The patient might have a family member that attends school in Cadabdab. From there, we see where the infection originated," she said. Trabado, however, did not give figures of the disease other than that from the school.

The RHUs and private clinics were able to monitor and manage the cases, Trabado said. All the student patients were discharged, given medication, and let the viral infection take its course. "And eventually, the patients recovered," she said. However, Trabado warns that a child with chickenpox can get secondary infection when he or she scratches the blisters, creating skin lesions.

She added that cases of chickenpox and mumps are mostly observed during the summer season. Trabado said patients with chickenpox experience fever and headache in the first 1 or 2 days before the itchy blister rash appears.  [Byline: Gail Momblan]
======================
[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: USDA Animal and Plant Health Inspection Services [edited]
<https://content.govdelivery.com/accounts/USDAAPHIS/bulletins/23806a5>

The US Department of Agriculture's (USDA) under secretary for marketing and regulatory programs, Greg Ibach, is alerting international travellers of a deadly swine disease they could unknowingly bring back into the United States on their clothes, shoes, or hands.

African swine fever (ASF) is a highly contagious and deadly disease affecting both domestic and feral (wild) pigs. It does not affect human health and cannot be transmitted from pigs to humans. Recent spread of the disease to new countries in Asia and Europe has triggered a series of actions by USDA, state agriculture departments, and the pork industry to bolster protections against ASF in the United States and keep ASF out of North America.

"ASF has never been detected in the United States," said Ibach, "but an outbreak here would not only affect the pork industry, but also have major impacts on trade and raise food prices for consumers. We are asking international travellers to help prevent the spread of ASF to the United States by understanding what products can be brought back into the United States and declaring any agricultural items in their baggage."

The USDA's Animal Plant and Health Inspection Service's (APHIS) new traveller website provides updated information about potentially harmful pests and diseases that can hitchhike on food or other agricultural products. When returning to the United States, travellers are reminded to declare food items and animal products in their luggage. Failure to declare items may result in serious penalties.

"USDA and US Customs and Border Protection (CBP) recognize the crucial work of detector dog teams at US ports of entry." said Ibach. "While travellers' declarations of any food products brought with them to the United States is a critical step to protecting US agriculture, the dogs and secondary agricultural inspections provide another line of defence to keep ASF out of the country."

Travellers will also see some changes at airports as USDA works with CBP to increase screenings of passenger baggage. This includes training and adding 60 additional beagle teams for a total of 179 teams working at key US commercial, sea, and air ports and ensuring travellers who pose an ASF risk receive secondary agricultural inspection. USDA is also coordinating with CBP to expand arrival screenings, including checking cargo for illegal pork and pork products.

Anyone who visits a farm in an ASF-affected country should take specific precautions before returning to the United States. Follow the farm's biosecurity protocols and wear site specific footwear and coveralls or clothing. Thoroughly clean and disinfect or dispose of clothes and footwear worn on the farm before returning, and declare the farm visit to CBP when re-entering the United States. Travelers should not visit farms or any other locations with pigs -- including livestock markets, zoos, circuses, and pet stores with pot-bellied pigs -- for at least 5 days after returning.

More information on ASF, partner resources, and additional resources for travellers are available on the APHIS ASF webpage
and in this infographic
======================
[This disease would be extremely serious for the US, and likely for all of North America. The warning is appropriate for travellers to be more alert to situations that could ultimately have horrible outcomes. - ProMED Mod.TG]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: ReliefWeb [edited]

The Federal Ministry of Health, in collaboration with the World Health Organization (WHO), Gavi, the Vaccine Alliance, and UNICEF, has launched a large-scale mass vaccination campaign in Sudan to vaccinate more than 8.3 million people 9 months to 60 years of age against yellow fever in the states of Blue Nile, Gezira and Sennar during 10-29 Mar 2019.

The campaign represents a crucial step in protecting a large portion of the population and reducing the risk of severe and deadly yellow fever outbreaks in the country. It is the 3rd and final drive thatSudan is undertaking to protect populations at risk and prevent yellow fever epidemics, pending the implementation of infant immunization as routine practice.

The campaign forms a critical part of Sudan's ongoing work to protect all populations against yellow fever epidemics, in alignment with the global Eliminate Yellow fever Epidemics (EYE) Strategy. The country plans to complement these yellow fever mass campaigns and ensure long-term protection through the introduction of yellow fever vaccination into routine immunization in the coming months.

"We acknowledge the commitment of the health authorities in Sudan to avail cash and fuel during this economic crisis to ensure that their people, especially children, are protected with a quality vaccine which will contribute to health security and making the world safer," said Dr. Naeema Al-Gasseer, WHO Representative in Sudan.

"Yellow fever vaccination is the most important tool we have to prevent yellow fever outbreaks. The vaccine will be freely available to any eligible person and will provide life-long protection against the disease. While protecting yourself against mosquito bites is important to reduce the risk of many diseases, only vaccination can eliminate the risk of yellow fever outbreaks," she added.

Yellow fever is a viral disease that is transmitted by certain types of mosquito. Infection can cause fatal illness, including jaundice, and death, and can spread rapidly, locally and internationally, especially in urban areas. However, the disease can be prevented by a single dose of a highly effective and safe vaccine. This campaign aims to boost protection in the general population and will target all eligible people.

Sudan is at high risk for the spread of yellow fever due to a combination of climate and ecological factors, and because there are still areas of low population immunity. Recent years have seen global changes in the epidemiology of yellow fever, with outbreaks occurring in areas that were not previously assessed as being at high risk.

"We are observing a changing nature in yellow fever disease dynamics. It is very important that every eligible person in this campaign receives the vaccine to protect themselves, their families and their communities," said Professor Dr. Babkir Kabaloo, Undersecretary of the Federal Ministry of Health.

"The current campaign represents one of the final phases in the Ministry's efforts to protect the entire nation against yellow fever outbreaks. This campaign will cover Blue Nile, Gezira, and Sennar states. In the coming months, the remaining states of Khartoum, Northern and River Nile will also be covered, completing the protection of the entire Sudanese population," he added.

Sudan's health authorities and partners are working to introduce yellow fever vaccine in the national immunization schedule in the near future. This will help ensure the protection of the whole population and generations to come against this fatal but preventable disease.
=====================
[It is good to see this ambitious yellow fever (YF) vaccination campaign drawing to a close. Incorporating YF vaccine into routine childhood vaccination schedules is prudent and if successful will eliminate the need for intensive, country-wide campaigns to deal with outbreaks. YF is no stranger to Sudan. Between 3 Oct and 24 Nov 2013, a total of 44 confirmed cases of YF were reported, including 14 deaths. A total of 12 localities in West and South Kordofan were affected by that outbreak. There was a large YF outbreak in the Darfur state in 2012-2013. In 2012, the World Health Organisation (WHO) said that more than 840 people were infected with YF in Darfur and that the epidemic affected 35 of 64 localities in the region since September 2012. The total recorded cases of YF in Greater Darfur hit 849 with a 20% death toll during an epidemic in 2012 (see WHO Disease Outbreak News <http://who.int/csr/don/2012_12_03/en> as reported by ProMED post http://promedmail.org/post/20130125.1513849, as noted at the time by Mod.JW). Mounting campaigns in the face of these types of outbreaks is inefficient, logistically difficult, and costly -- financially and in terms of human lives. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Thu 21 Mar 2019
Source: SBS News, Australian Associated Press (AAP) report [edited]

An egg recall has been announced following the discovery of a _Salmonella_ outbreak at a Victorian egg farm. The scare has prompted a recall of some brands of eggs from outlets in 4 states.

To date, 5 cases of _Salmonella [enterica_ serotype] Enteritidis have been linked to eggs produced by Victoria's Bridgewater Poultry, the state's health department said on [Thu 21 Mar 2019]. The company's free-range and barn-laid eggs are packaged as Woolworths brand, Victorian Fresh, and Loddon Valley, with best-before dates ranging from [20 Mar to 29 Apr 2019]. They are on shelves in Victoria, New South Wales, Tasmania, and South Australia. All other eggs are safe to eat, Chief Health Officer Brett Sutton said.

"It is important to know that not all eggs are affected, but any eggs carrying the listed brands should return them to the point of sale for a full refund. Alternatively, they can be discarded by throwing them into the garbage, not the garden or compost. "These eggs should not be given to pets or livestock."

Vulnerable people, including the elderly, are urged to avoid eating raw egg products.

Eggs of concern:
- Woolworths 12 Cage Free Eggs 700 g
- Victorian Fresh Barn Laid Eggs 600 g
- Victorian Fresh Barn Laid Eggs 700 g
- Victorian Fresh Barn Laid Eggs 800 g
- Loddon Valley Barn Laid 600 g (Victoria and South Australia only)
========================
[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with faecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the egg shell was formed. To avoid this, uncooked eggs should only be used as an ingredient, if pasteurized. - ProMED Mod.LL]

[Maps of Australia:
Date: Wed 20 Mar 2019 3:50 PM EDT
Source: The Day [edited]

Groton [New London county] public health officials are reminding residents to refrain from feeding or approaching wild or stray animals after a dog found in the area of Midway Oval tested positive for rabies [Wed 20 Mar 2019].

Rabies is a deadly disease caused by a virus that can infect all warm-blooded animals, including people, the Ledge Light Health District said in an alert sent to media outlets.

The disease mostly is spread by wild animals, but stray cats and dogs may also become infected and spread the virus, the district's alert said. The rabies virus lives in the saliva and brain tissue of infected animals, and the disease can be spread by scratches from infected animals or when infected saliva comes into contact with open wounds, breaks in the skin or mucous membranes, including the eyes, nose and mouth.

For more information, contact Ledge Light Health District at (860) 448-4882, extension 1311, or the animal control officer at (860) 441-6709.
======================
[HealthMap/ProMED-mail map of Connecticut, United States:
Connecticut county map:

Please keep your animals up-to-date on their rabies vaccine. It is for their protection and for your protection.

Regarding the 1st article, it sounds like South Carolina could consider using some oral rabies vaccine bait for some of their wild animals.

Unfortunately, wild animals may attack even when you are unaware of their presence.

Animals may be either unusually friendly and timid (dumb rabies) or aggressive and vicious (furious rabies). These are 2 presentations of the same disease but we should be aware of both forms and teach both forms to our children. - ProMED Mod.TG]
Date: Wed 20 Mar 2019
Source: Aiken Standard [edited]

[One person] in Aiken county may have been exposed to rabies following an unfriendly encounter with a wild raccoon, according to the South Carolina Department of Health and Environmental Control [DHEC].

According to a DHEC press release, the victim was on the North Augusta Greeneway Walking Trail on 16 Mar 2019 when they were bitten by a raccoon. The raccoon was later submitted to DHEC and tested positive for rabies. [Apparently the DHEC knows there is a victim so their earlier statement of "may have been exposed" seems a bit odd. - ProMED Mod.TG]

The victim who was bitten has since been referred to their health care provider. The raccoon on the Greeneway trail was the 3rd animal diagnosed with rabies in Aiken county this year [2019]. Statewide, there have been 32 confirmed cases of rabies in 2019. Coyotes, foxes, and skunks are also common carriers of the virus. Although it is extremely rare in people, rabies can be spread to humans and can also claim the lives of pets. The virus causes hallucinations, hydrophobia (fear of water), aggression, and death in its final stages.

Rabies is normally spread through bites but can also be spread when open wounds or areas like the eyes, nose, or mouth come into contact with saliva or blood of an infected animal. Infected areas should be washed with soap and water and medical attention should be sought immediately.  If a wild animal is foaming at the mouth and shows a lack of motor control (stumbling, staggering, or bumping into things) it may have rabies. Rabid animals are often very aggressive and do not fear people or other animals. [This behaviour may describe raccoons with distemper, but although they are not usually aggressive with distemper, they can be. The point is, when an animal is not acting normally it is time to move on and leave it alone and report it to the authorities in your area. - ProMED Mod.TG]

"To reduce the risk of getting rabies, always give wild and stray animals their space," said David Vaughan, Director of DHEC's Onsite Wastewater, Rabies Prevention, and Enforcement Division. "If you see an animal in need, avoid touching it and contact someone trained in handling animals, such as your local animal control officer or wildlife rehabilitator."

DHEC also stresses the importance of keeping pets up to date on their rabies shots to prevent the spread of the disease. For more information, call DHEC's Environmental Affairs Aiken office at 803-642-1637 during normal business hours on weekdays.  [Byline: Kristina Rackley]
========================
[HealthMap/ProMED-mail map of South Carolina, United States:
South Carolina county map:
Date: Thu, 21 Mar 2019 16:10:28 +0100

Kinshasa, March 21, 2019 (AFP) - A six-month-old baby in the eastern DR Congo city of Bunia has died of Ebola, becoming the first fatality of the disease in a provincial capital, the heath ministry said Thursday.   Bunia, which has a population of 300,000, is the capital of Ituri province, which along with neighbouring North Kivu province has been battling an epidemic of Ebola since last August.

The baby is among 610 fatalities out of 980 recorded cases, the ministry said in a statement.   "The parents are apparently in good health," it said.   "Extensive investigations are underway and will include, among other things, analysis of the maternal milk to identify the source of contamination."   The ministry added that it had also registered 97 new cases in the previous three weeks.   This increase "was expected" given the impact of an attack on two Ebola treatment centres by armed groups in the troubled region, it said.
Date: Thu, 21 Mar 2019 22:32:17 +0100

Blantyre, Malawi, March 21, 2019 (AFP) - Heavy rains could cause a dam in southern Malawi to give way if there is no let-up, authorities said Thursday, urging local residents to take shelter.   The warning came after cyclone Idai battered neighbouring Mozambique last Friday killing 242 people    Hurricane-force winds and rains have also ravaged hit eastern Zimbabwe where over 100 have died.

In Malawi, the storm has affected nearly a million people with over 80,000 displaced, according to the WHO.   The Chagwa dam "has had one of its major embankments eroded due to heavy rains," the interior security ministry said in a statement. "(It) is likely to burst in the event of heavy and incessant rains."   The statement advised local residents in the southern African country to evacuate "in case of an emergency".