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Saudi Arabia

Travelling to the Hajj
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Background
Every devout Muslim seeks to perform the Hajj on at least one occasion during their life. This pilgrimage, which is a central duty of Islam, brings Muslims from all over the wor
d together as they visit the holy cities of Mecca and Medina in Saudi Arabia. Each year over two million gather to celebrate the five 'pillars' of Islam.
Coping with the Climate
The dates for this festival vary from year to year but this year it is in December. In the evenings it can be significantly cold in 'tent city' and so travellers should bear this in mind when packing.
Travel Restrictions
With this massive influx of people travel in and out of Saudi can be difficult and, where possible, plans should be made well in advance.
Care for the pilgrims
The Saudi government seek to provide the highest level of health care possible for those visiting their Kingdom. This has involved the setting up of a series of rules and regulations which need to be observed. Nevertheless every pilgrim should ensure that their own personal health is sufficient before agreeing to travel. This may involve a consultation with their GP - especially if they have any underlying medical conditions.
Food Restrictions
No food is allowed into Saudi during this time and will be confiscated on arrival.
Vaccine Requirements
In order to reduce the risk of certain diseases the Saudi authorities insist on all travellers providing correctly certified evidence of vaccination against some diseases.
Meningitis
All travellers are required to provide evidence of vaccination against Meningococcal Meningitis (ACYW-135). This vaccine has to have been given to every traveller within the previous three years and at least 10 days before arrival into Saudi Arabia. (Other vaccinations against Meningitis C or Meningococcal A&C are not acceptable.)
Compulsory Medications
Some travellers arriving from what are regarded as 'higher risk' countries will also be given prophylactic antibiotics to lessen the possibility of their carrying Meningococcal Meningitis into the country. This is a compulsory requirement - though the medication given varies depending on the age of the individual and whether or not the female traveller is pregnant.
Yellow Fever
It is also essential for some travellers to have evidence of Yellow Fever vaccination certification. Generally this is only required for those arriving from the countries of Africa and South America. This vaccine needs to have been given within the previous 10 years and at least 10 days before arrival.
Other Recommended Vaccines
Even though it is not a requirement of entry to perform the Hajj or visit Saudi Arabia, travellers are strongly advised to consider the following vaccinations;
Influenza / Pneumococci
These are air-borne diseases and the close proximity of so many pilgrims will make the risk of contracting either or both of these highly infectious diseases much higher. Influenza vaccine needs to be given each year where as Pneumococcal vaccine is often only given on one occasion in a lifetime.
Poliomyelitis
This viral disease is disappearing from much of the world and may be eradicated within a few years. However during 2005 a significant number of outbreaks occurred in various African countries and India. The Hajj was linked to outbreaks in Yemen and Saudi Arabia itself. Vaccination is recommended for all unprotected travellers.
Hepatitis A / Typhoid
With such a massive number of people to be catered for it is hardly surprising that the level of food and water borne disease is high. These vaccines are strongly recommended for all travellers. They provide excellent protection but all travellers will still need to exercise extra care to lessen their personal exposure.
Hepatitis B
The main specific risk of contracting Hepatitis B probably relates to the ritual head shaving which is performed as part of the celebrations. Professional barbers are used and long lines of men wait for their turn. In some cases the blade is not changed between shaves and this potentially presents a serious risk of contamination with Hepatitis B infection.
Ritual sacrifice
It should also be noted that during the celebrations a ritual sacrifice of a small animal is performed. Pilgrims are strongly advised not to undertake the actual act of sacrifice themselves - unless they are very experienced - as otherwise they could seriously injury themselves.
Avoiding Accidents and Dehydration
The desire to perform the Hajj is strong and it is an emotional time for any Muslim. Unfortunately the presence of so many other pilgrims in a very confined space at the same time does increase the risk of various diseases and accidents. This includes the risk of being crushed, as has occurred with disastrous consequences in the past. The degree of dehydration can also be high as there is a significant amount of exercise and walking involved. A good pair of comfortable walking shoes is certainly worth the investment. It will also be important to bring some plasters to treat minor injuries and blisters.
Being Separated from Companions
Due to the numbers involved it is very easy to become separated from travelling companions. It is wise to have a plan in place before arriving so that each member of the party knows where to meet.
Overview
It is extremely important that all those undertaking this pilgrimage recognise the necessity to stay constantly alert to the personal health and accident risks which are present and do everything within their power to avoid them. The Tropical Medical Bureau centres throughout Ireland usually carry both the required and the recommended vaccines for travellers to the Hajj. Appointments should be made well in advance of visa application to ensure that these are given in sufficient time.

Travel News Headlines WORLD NEWS

Date: 1 Dec 2019
Source: Saudi MOH (14 Nov 2019 to 1 Dec 2019) [edited]

In the period since the last update (13 Nov 2019, MERS-CoV (69): Saudi Arabia (RI, AS, MK) http://promedmail.org/post/20191113.6776647), there have been a total of 3 newly confirmed cases of MERS-CoV infection reported by Saudi Arabia and 11 newly reported outcomes (2 deaths and 9 recoveries).
Date: Mon, 28 Oct 2019 12:42:34 +0100 (MET)

Riyadh, Oct 28, 2019 (AFP) - Seven people have been killed and 11 injured in floods after heavy rain lashed northeastern parts of Saudi Arabia, Al-Ekhbariya state television reported Monday.   Rescue services in the northeastern city of Hafer al-Batin, about 100 kilometres southwest of Kuwait, said that 16 people were forced to evacuate their homes.   Seven affected by the rain were provided with shelter, it added.  Schools in Hafer al-Batin suspended classes on Monday due to the weather.   In January, 12 people were killed in floods in Saudi Arabia.  Ten died in the northwestern city of Tabuk, one in the Islamic holy city of Medina and another in a northern border area.
Date: Sun, 6 Oct 2019 12:04:37 +0200 (METDST)

Riyadh, Oct 6, 2019 (AFP) - Saudi Arabia announced Sunday it would allow unmarried foreign couples to rent hotel rooms together as the ultraconservative kingdom begins offering up tourist visas for the first time.   The tourism authority said in a statement published on Twitter that Saudi women travelling alone would also be able to check into a hotel by presenting valid ID.

In the past, couples wanting to stay in a hotel had to prove they were married.    "This is no longer required for tourists," the statement said.   Saudi Arabia announced on September 27 it was opening its doors to holidaymakers with the goal of diversifying its oil-dependent economy.   The kingdom had previously only issued visas to Muslim pilgrims, foreign workers, and recently to spectators at sporting or cultural events.

Kickstarting tourism is one of the centrepieces of Crown Prince Mohammed bin Salman's Vision 2030 reform programme to prepare the biggest Arab economy for a post-oil era.   Citizens from 49 countries are now eligible for online e-visas or visas on arrival, including the United States, Australia and several European nations.   On September 28, Saudi authorities warned that tourists who violated "public decency", including with immodest clothing and public displays of affection, would be subject to fines.
Date: Sun, 29 Sep 2019 17:39:45 +0200 (METDST)

Riyadh, Sept 29, 2019 (AFP) - Five people were injured in a fire that broke out at a new high-speed train station in Saudi Arabia's western city of Jeddah on Sunday, state television reported, with huge palls of smoke seen rising into the air.    The station serves the main Haramain High Speed Rail system. The route opened to the public in October last year, transporting passengers between Mecca and Medina, Islam's holiest sites.

"Five people who sustained minor injuries because of the fire were transported to hospital," Al-Ekhbariya state television reported.   The General Directorate of Saudi Civil Defence said in an earlier tweet that it was working to extinguish the fire.   A video uploaded on Twitter by the Mecca provincial government showed plumes of grey smoke rising from what looked like the inside of the complex.   An AFP correspondent said security forces closed the main road linking Mecca and Jeddah and cordoned off the site.   The blaze erupted at 12:35 pm local time (0935 GMT), according to the Haramain High Speed Rail's Twitter account.

The railway runs 450 kilometres (280 miles) via the Red Sea port of Jeddah, transporting passengers at speeds of up to 300 kilometres per hour.   Saudi King Salman inaugurated the railway in September 2018. Officials described it as the biggest transportation project in the region.   In 2011, the kingdom signed a deal for a Spanish consortium to build the rail track, supply 35 high-speed trains and handle a 12-year maintenance contract.   Saudi is boosting its infrastructure spending and expanding its railways -- including a $22.5 billion metro system under construction in the capital Riyadh -- as it seeks to diversify its oil-dependent economy.
Date: Sat, 28 Sep 2019 19:56:29 +0200 (METDST)

Riyadh, Sept 28, 2019 (AFP) - Saudi Arabia on Saturday said it would impose fines for violations of "public decency", including immodest clothing and public displays of affection, a day after the austere kingdom opened up to foreign tourists.   The interior ministry said it had identified 19 such "offences" but did not specify the penalties, as the ultra-conservative Islamic country begins issuing tourist visas for the first time as part of a push to diversify its oil-reliant economy.   "The new regulations require men and women to dress modestly and to refrain from public displays of affection. Women are free to choose modest clothing," a statement said.   "The regulations are meant to ensure that visitors and tourists in the kingdom are aware of the law relating to public behaviour so that they comply with it."

Saudi Arabia on Friday said citizens from 49 countries are now eligible for online e-visas or visas on arrival, including the United States, Australia and several European nations.   Kickstarting tourism is one of the centrepieces of Crown Prince Mohammed bin Salman's Vision 2030 reform programme to prepare the biggest Arab economy for a post-oil era.   But the conservative country, which forbids alcohol and is notorious for sex segregation, is seen as an unlikely destination for global tourists aside from Muslim pilgrims visiting holy sites in Mecca and Medina.   Men and women must avoid "tight fitting clothing" or clothes with "profane language or images", read an instruction on an English language website launched by the tourism authority.   "Women should cover shoulders and knees in public," it added.

But tourism chief Ahmed al-Khateeb said foreign women were not obligated to wear the body-shrouding abaya robe that is still mandatory public wear for Saudi women.   Prince Mohammed has sought to shake off his country's ultra-conservative image -- lifting a ban on cinemas and women drivers while allowing gender-mixed concerts and sporting extravaganzas.   The relaxed social norms in a kingdom have been welcomed by many Saudis, two-thirds of whom are under 30.   But new public decency guidelines, first approved by cabinet in April, are widely perceived to be vague and have sparked public concern that they would be open to interpretation.   They have also stoked fears of a revival of morality policing.   Saudi Arabia's religious police once elicited widespread fear, chasing men and women out of malls to pray and berating anyone seen mingling with the opposite sex.   But the bearded enforcers of public morality, whose powers have been clipped in recent years, are now largely out of sight.
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World Travel News Headlines

Date: Fri, 24 Jan 2020 12:26:57 +0100 (MET)

Beijing, Jan 24, 2020 (AFP) - China has quarantined cities and shut major tourist attractions from Disneyland to the Forbidden City and a section of the Great Wall as it scrambles to stop a deadly SARS-like virus from spreading further.   The drastic moves come as hundreds of millions of people criss-crossed the country in recent days to celebrate the Lunar New Year holiday, which officially started Friday and is typically a joyous time of gatherings and public celebration.   Here is a rundown of the measures taken so far in an unprecedented quarantine effort:

- Cities under lockdown -
Public transport has been stopped in 13 cities in central Hubei province, with train stations shut, events cancelled and theatres, libraries and karaoke bars closed in some locations.   The epicentre of the outbreak is provincial capital Wuhan, the biggest city on lockdown, where the government has halted all travel out of the Yangtze River metropolis of 11 million.   Wuhan residents have been told to stay home and authorities are limiting the number of taxis allowed on roads. There are few flights available to the city, deepening the isolation.   Similar quarantine measures are being taken in the other, smaller cities. These include strict controls on weddings and funerals, temperature screening of people as they arrive and the suspension of online taxi services.   More than 41 million people in total are affected by the city shutdowns.

- Festivities cancelled -
Wuhan and Beijing have cancelled public events that usually attract hundreds of thousands of people to temples during the New Year holiday.   Gao Fu, head of the Chinese Center for Disease Control and Prevention, has asked China's 1.4 billion citizens to forego New Year gatherings and confine themselves at home until all is clear.   To discourage nationwide travel, the government also said all tickets for rail, air, road, or water transport could be refunded.

- Attractions closed -
The historic Forbidden City, a sprawling imperial palace in Beijing that is one of the country's most revered cultural sites, will temporarily close from Saturday.   Other famous landmarks including a section of the Great Wall, the Ming Tombs and Yinshan Pagoda are also not open to visitors.   Shanghai Disneyland said it would shut for an indefinite period "to ensure the health and safety of our guests and cast".   Women's Olympics football qualifiers scheduled for February 3-9 in Wuhan have been moved to the eastern city of Nanjing.

- Temperature checks -
Staff in full body protective suits were seen checking the temperatures of people entering a subway station in Beijing on Friday.   The country has ordered sterilisation and ventilation at airports and bus stations, as well as inside planes and trains, while travellers are being screened for fever.   Health authorities are urging people to wash their hands regularly, avoid crowded places, get plenty of fresh air and wear a mask if they have a cough.   In Wuhan, city authorities have made it mandatory to wear a mask in public places.   In response to skyrocketing demand for masks -- starting to sell out at pharmacies and on some popular websites -- China's industry and information technology ministry said it would "spare no effort in increasing supply".

- A new hospital -
In Wuhan, authorities are rushing to build a new hospital in a staggering 10 days as a rising number of patients are infected by the new coronavirus.   The facility is expected to be in use by February 3 and will have a capacity of 1,000 beds spread over 25,000 square metres, according to state media.   Dozens of excavators and trucks were filmed working on the site by state broadcaster CCTV.   Its construction began after reports surfaced of bed shortages in hospitals designated as dealing with the outbreak, which has now infected 830 people across China.
Date: Fri, 24 Jan 2020 11:22:00 +0100 (MET)

Beijing, Jan 24, 2020 (AFP) - China announced Friday it will close a section of the Great Wall and other famous Beijing landmarks to control the spread of a deadly virus that has infected hundreds of people across the country.   A range of Lunar New Year festivities have been cancelled to try to contain the virus, and Beijing's Forbidden City and Shanghai's Disneyland have also been closed temporarily.

The Ming Tombs and Yinshan Pagoda will also be closed from Saturday, the authority that oversees the sites said, while the Bird's Nest stadium -- the site of the 2008 Olympic Games -- was shuttered from Friday.   The Great Wall attracts around 10 million tourists a year and is a popular destination for visitors during the New Year holiday.   The Juyongguan section will close, while the Great Wall temple fair was cancelled at the Simatai section of the famous landmark.

Tourists at the Gubei water town by the Simatai section will have their temperature tested, the authority said in a statement on the WeChat social media app.   The Bird's Nest will be closed until January 30 in order to "prevent and control" the spread of the virus, authorities said. An ice and snow show taking place on the pitch will be closed.   The measures in the capital are the latest to try and control the outbreak of the new coronavirus, after authorities rapidly expanded a mammoth
quarantine effort that affected 41 million people in central Hubei province.

The previously unknown virus has caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed hundreds across mainland China and Hong Kong in 2002-2003.   Although there have only been 29 confirmed cases in Beijing, city authorities have cancelled large-scaled Lunar New Year events this week.   The city government said it would call off events including two popular temple fairs, which have attracted massive crowds of tourists in past years.   Beijing's Forbidden City -- which saw 19 million visitors last year -- is usually packed with tourists during the Lunar New Year festival, when hundreds of millions of people travel across China.
Date: Fri, 24 Jan 2020 10:40:12 +0100 (MET)
By Sébastien RICCI

Wuhan, China, Jan 24, 2020 (AFP) - Chinese authorities rapidly expanded a mammoth quarantine effort aimed at containing a deadly contagion on Friday to 13 cities and a staggering 41 million people, as nervous residents were checked for fevers and the death toll climbed to 26.

While the World Health Organization (WHO) held off on declaring a global emergency despite confirmed cases in half a dozen other countries, China expanded its lockdown to cover an area with a total population greater than Canada's.   A range of Lunar New Year festivities have been cancelled, while temporary closures of Beijing's Forbidden City, Shanghai's Disneyland and a section of the Great Wall were announced to prevent the disease from spreading further.   The previously unknown virus habeis caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed hundreds across mainland China and Hong Kong in 2002-2003.

The WHO said China faced a national emergency but stopped short of making a declaration that would have prompted greater global cooperation, including possible trade and travel restrictions.   The outbreak emerged in late December in Wuhan, an industrial and transport hub of 11 million people in China's centre, spreading to several other countries including the United States.   China is in the midst of its Lunar New Year holiday, a typically joyous time of family gatherings and public festivities.   But on Friday Wuhan was a ghost town, its streets deserted and stores shuttered.

- Worried patients -
Hospitals visited by AFP journalists bustled with worried patients being screened by staff wearing full-body protective suits.   At a temperature-check station, a medical staffer in bodysuit, face mask and goggles took a thermometer from a middle-aged woman, pausing to examine the reading before quickly turning back to the patient.   "Have you registered? Then go and see the doctor," the staffer said.   One 35-year-old man surnamed Li voiced the fears of many.   "I have a fever and cough, so I'm worried that I'm infected," he said.   "I don't know the results yet."

With hundreds of millions of people on the move across China for the holiday, the government has halted all travel out of Wuhan, shut down its public transport and told residents to stay home. Deepening the isolation, there were few flights available to the city.   "This year we have a very scary Chinese New Year. People are not going outside because of the virus," said a taxi driver in the city, who asked not to be named.   But said a prolonged shutdown should not pose food-shortage problems because many Chinese had stocked up for the holiday.

Besides Wuhan, 12 other smaller cities nearby have battened down the hatches, with most of them going public on Friday with various measures ranging from closing public venues and restricting large gatherings to halting public transportation and asking citizens not to leave their cities.   Several of the cities have populations numbering several million, led by Huanggang, which has 7.5 million.    The pathogen -- 2019 Novel Coronavirus (2019-nCoV) -- has caused many outlets in Shanghai, Beijing and other cities to sell out their stocks of face masks.   As reports surfaced of bed shortages in Wuhan hospitals, state media said authorities were rushing to build a new facility devoted to the outbreak in a mind-blowing 10 days.

The Wuhan hospital is targeted to be ready by February 3. Dozens of excavators and trucks were filmed working on the site by state television.   To discourage nationwide travel, the government has said all tickets for rail, air, road, or water transport could be exchanged for a refund.   On Friday, staff in full body protective suits were seen checking the temperatures of people entering a subway station in Beijing.   Thermal cameras scanned passengers arriving at Beijing's West Railway Station.

- 'Work as one' -
Chinese authorities said the number of cases leapt overnight to more than 800, with 177 in serious condition. There were another 1,072 suspected cases.   Officials also said that a virus patient died in Heilongjiang province in China's far northeast, the second death outside the Wuhan epicentre.   Beijing has been praised for its response in contrast to SARS, when it took months to report the disease and initially denied WHO experts any access.

Gao Fu, head of the Chinese Center for Disease Control and Prevention, asked China's people to forego New Year gatherings this year and confine themselves at home until the all-clear.    "If we all work as one, we can contain the virus in Wuhan and add no more cases exported from Wuhan, so as to stem the virus nationwide," Gao told state TV.   Beijing has cancelled popular New Year public events at temples in the capital, the historic Forbidden City will close from Saturday, and Shanghai Disneyland said it also will shut down for an indefinite period from Saturday to protect visitors and staff.
Date: Fri, 24 Jan 2020 07:46:42 +0100 (MET)

Shanghai, Jan 24, 2020 (AFP) - Shanghai Disneyland will close until further notice this weekend due to a deadly virus outbreak that has infected hundreds of people in China, the amusement park said Friday.   The closure comes as China entered its nearly week-long Lunar New Year holiday, and the home of Mickey Mouse had prepared special "Year of the Mouse" celebrations for its guests.

But the park and resort said on its website it would temporarily close from Saturday "in response to the prevention and control of the disease outbreak and in order to ensure the health and safety" of its guests and staff.   "We will continue to carefully monitor the situation and be in close contact with the local government, and we will announce the reopening date upon confirmation," it said, adding that guests who had purchased tickets or booked a resort hotel would be reimbursed.   The entertainment conglomerate opened its $5.5 billion theme park in Shanghai in June 2016, Disney's sixth amusement park and third in Asia.
Date: Fri, 24 Jan 2020 03:33:13 +0100 (MET)
By Rusmir SMAJILHODZIC with Emmy VARLEY in Belgrade

Sarajevo, Jan 24, 2020 (AFP) - As winter grips the Balkans, the poor are caught in a cruel bind, being forced to light fires at home for heating while fuelling a pollution crisis smothering the region.   In recent weeks, Balkan capitals from Belgrade and Sarajevo to Skopje and Pristina have been ranked among the world's top 10 most polluted major cities, according to the monitoring application AirVisual.

While these are small cities compared to leading Asian polluters like New Delhi and Dhaka, a combination of coal-fired power plants, old cars and fires to heat homes are pumping the air with toxins.   "I know it is polluting. I am not an idiot but my only other choice would be to heat this home with electricity and that is damn expensive," said Trajan Nestorovski, who like many in his working-class Skopje neighbourhood burns wood to stay warm in winter.   His wife Vera added: "There are a couple of factories near our neighbourhood that are burning God knows what in the evenings".

Thanks to the rise of mobile phone apps that measure air quality, like the local Moj Vozduh (My Air) created by a Macedonian developer, citizens are finally grasping the full extent of the crisis.    "Serbia is suffocating, has anyone seen the minister of the environment?", said a recent headline in Belgrade's local Blic newspaper, speaking of the fog and dirty air enveloping the city.   Protests have been erupting around the region in recent days.

In Skopje, the capital of North Macedonia, young people have taken inspiration from Swedish activist Greta Thunberg by holding a spate of protests on Fridays.    "Greta inspired all of us," said 17-year-old Iskra Ilieska.   "In winter, half of my school class is absent because of lung problems. That is not normal," she said.

In neighbouring Bosnia, several hundred people wearing face masks gathered in the city of Tuzla to demand a plan from authorities to tackle pollution and phase out coal-fired plants in the next five years.   "The only recommended measures are that we stay shut up at home... when you go out on the streets, in the playgrounds, you won't see children anywhere," said Alisa Kasumovic, a mother in her forties.

- Silent killer -
According to a recent UN environment report, air pollution causes nearly 20 percent of premature deaths in 19 Western Balkan cities.   The main sources of the dust, soot and smoke are low-grade coal plants and household heating, the report said.    More than 60 percent of people in the region rely on coal and firewood to heat their homes, the report said. Only 12 percent of buildings are connected to district heating systems.

Governments need to make "clean energy more accessible", ban old polluting vehicles and tighten regulations on industry emissions and power plants, the UN urged.    Many people cannot afford cleaner heating options at home in countries where average wages are around 500 euros or less.   Sali Ademi, a 78-year-old in Kosovo's capital Pristina, uses coal.     "There's no worse thing, but what can you do?" he said in a city whose air is already poisoned by two nearby coal-fired power plants running on outdated technology.

- Cable car escape -
Those who warm their homes with fires also bear the brunt of health risks, according to experts.   "Some of the emissions from these stoves stay in the house and poison them," warned Anes Podic, president of an environmental group in Bosnia who has called on the government to replace inefficient wood stoves in the country.

In cities like Sarajevo and Skopje, a circle of mountains helps trap the hazardous air in the valleys where residents live.   Sakiba Sahman, 60, is a Sarajevan taking advantage of a recent reduction on ticket prices for a cable car that rides to the top of the 1,160-metre-high (3,800-foot-high) Mount Trebevic, which peaks above the smog over the Bosnian capital.   "We've come to spend a few hours to ventilate the lungs," she told AFP.   Down below, "the pollution is enormous, there are a lot of cars, everything is dirty, grey and depressing."
Date: Fri, 24 Jan 2020 00:46:15 +0100 (MET)

Lima, Jan 23, 2020 (AFP) - Peru's government promised on Thursday to protect the Machu Picchu sanctuary and other Inca ruins when building a new airport to serve the ancient civilization's capital of Cusco.   Machu Picchu and the Inca road system are UNESCO World Heritage sites, and the UN agency has previously expressed concerns over the proposed airport at Chinchero, less than 60 kilometers from the Inca sanctuary that was built in the 15th century.   "We have made a commitment that before work begins on constructing the Chinchero airport, in June of this year, we will present the heritage impact study that UNESCO demands," Transport Minister Edmer Trujillo, who is responsible for the project, told journalists.

UNESCO has told Peru that even though the airport will be built outside of the archeological areas, it is necessary to study how a potential increase in tourists would affect them.   The new airport will be able to receive six million passengers per year -- 60 percent more than the current Cusco airport, which has a capacity for 3,000 passengers a day but receives 5,000.

The existing airport cannot grow because it is inside Cusco, a major Andean city in southeast Peru.   Machu Picchu -- the most iconic site from the Inca empire that ruled a large swathe of western South America for 100 years before the Spanish conquest in the 16th century -- is Peru's most popular tourist attraction, located about 100 kilometers (60 miles) from Cusco.   Trujillo said construction of the new airport would be constantly monitored
by culture ministry experts in case archeological ruins are found.

The airport will be built at 3,780 meters above sea level in the old Inca Sacred Valley.   Many have criticized the impact it could have not only on the country's national treasures but on rural communities.   "Building an airport in the Sacred Valley will have irreparable effects in terms of noise, increase in traffic and uncontrolled urbanization," historian Natalia Majluf said in August.   But local Cusco authorities say it will bring in vital tourism revenue, which the region depends on.
Date: Tue 21 Jan 2020
Source: Channels TV [edited]

In Ondo state, 16 people have been confirmed killed as a result of a Lassa fever outbreak. The state chief epidemiologist, Dr Steven Fagbemi, disclosed this on Tuesday [21 Jan 2020] at the governor's office in the Government House in Akure, the state capital.

Dr Fagbemi made the disclosure while briefing Governor Oluwarotimi Akeredolu as well as the local government chairmen from Ondo North and Central senatorial districts of the state. He also revealed that 84 cases have been reported so far in the state since 1 Jan 2020.

According to the epidemiologist, 16 of the patients have passed on, as their cases had reached the advanced stage before they were taken to the hospital. He added that 47 patients on admission were responding to treatment, while 21 others had already been treated and discharged.

The outbreak is said to have affected Owo, Akoko South-West, Akure South, and Ondo West LGAs of the state.

Also confirming the outbreak, the commissioner for health, Dr Wahab Adegbenro, noted that the disease has been occurring in the state for some years, especially during the dry season. He therefore advised Nigerians to visit hospitals when they noticed symptoms of fever.

Earlier, Governor Akeredolu advised the local government chairmen in the state to deploy cleaners to markets and public places to prevent the outbreak of diseases. He also called on residents to maintain a high level of hygiene to curtail further spread of the Lassa virus in the state.
====================
[The 81 new confirmed and 159 suspected cases in week 3 of 2020 indicate that Lassa fever (LF) virus transmission is continuing to accelerate. The 1st report above confirms that Ondo state has the majority of cases, tied with Edo state. Nigeria is now entering the period of the year when fewer cases usually occur, as illustrated in the graph in Figure 6 (at the source URL above). There has been a peak in case numbers between weeks 1 and 11 (January-March) over the past 3 years and probably will be the case again this year (2020).

Transmission of LF virus occurs when individuals are in contact with rodent reservoir host excreta or are within healthcare facilities. It would be interesting to know whether the prevalence of Lassa fever virus has been increasing in populations of rodent hosts in areas where human cases are occurring.

Images of the rodent reservoirs of Lassa fever virus:
_Mastomys natalensis_: <https://www.inaturalist.org/taxa/45326-Mastomys-natalensis>
_Mastomys erythroleucus_ and _Hylomyscus pamfi_: <http://punchng.com/nigerias-large-rat-population-threatens-lassa-fever-war/>

The pygmy mouse (_Mus baoulei_) has recently been implicated as a reservoir species in West Africa but not in Nigeria.

There is no specific mention in the plans above of public education for avoidance of contact with these rodents and their excreta. - ProMED Mod.TY]

[Maps of Nigeria:
Date: Tue 21 Jan 2020
Source: Ahora Noticias, Costa Rica [in Spanish, machine trans., edited]
<https://www.ahoranoticiascr.com/2020/01/21/autoridades-cerraron-pizzeria-debido-a-casos-de-hepatitis-a-en-san-ramon/>

As many as 22 people suffered from hepatitis A infection in San Ramon de Alajuela, and consequently the Health authorities closed a pizzeria in the area. A source close to this media confirmed the existence of the cases which were detected since 13 Jan 2020.

The cases were thought to be related to food consumption in that establishment 4 of patients were employees of the pizzeria. In statements to the media La Nación, Azalea Espinoza of the Directorate of Surveillance of the Ministry of Health, said they intervened in the business, issued a closing health order, and proceeded to cleaning and disinfecting it. [Byline: Carlos Miranda]
========================
[Although the eating establishment was identified as a pizzeria, pizza itself is not likely to be the vehicle of transmission as it is cooked before serving unless ingredients are added after the cooking process. It is unclear if the pizzeria employees were the source of, or just part of, the outbreak.

With an incubation period averaging 28 but up to 45 days, more cases may occur. The cases are not broken down in regard to age. In children, most cases of HAV infection are subclinical so it is likely that the cases reported were in adults. In the developing world, HAV is not reported much in adults as most children have been infected, and therefore immune to subsequent infection, by the age of 10. That outbreaks are occurring in the area suggests improvement in potable water so fewer children are infected and therefore still susceptible to HAV as adults. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Costa Rica:
<http://healthmap.org/promed/p/17>]
Date: Thu, 23 Jan 2020 17:57:34 +0100 (MET)
By Eva XIAO

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

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

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

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

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

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

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

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

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