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Solomon Islands

Solomon
Islands - US Consular Information Sheet
August 13, 2008
COUNTRY DESCRIPTION:
The Solomon Islands form an Archipelago in the southwest Pacific Ocean about 1,200 miles northeast of Australia.
The capital, Honiara, is locate
on the Island of Guadalcanal.
The Solomon Islands are a parliamentary democracy within the British Commonwealth.
Tourism facilities are limited, particularly outside Honiara.
Read the Department of State Background notes on the Solomon Islands for additional information.
ENTRY/EXIT REQUIREMENTS:
U.S. passport holders do not require visas to enter the Solomon Islands.
Passports, onward/return tickets and proof of sufficient funds for the duration of stay are required.
Visitor permits are granted upon arrival at Henderson International Airport in Honiara.
Visitors may enter any number of times provided the total period in the Solomon Islands does not exceed 90 days in a 12-month period.
Persons arriving on one-way airline tickets must have documentation stating their business, for example, a work permit if taking up employment in the Solomon Islands.
The Solomon Islands government strictly enforces immigration laws, and travelers may face fines and other penalties if they remain in the country beyond the authorized period of stay.
Persons arriving on yachts should visit the nearest immigration office to complete arrival forms for issuance of visitors' permits.

Travelers who plan to
arrive in the Solomon Islands by plane or some other conveyance
but who plan to depart on a yacht should apply for a visitor’s permit before their arrival in the Solomon Islands, to the Director of Immigration (via fax to the U.S. Consular Agent in Honiara at 677-27429).
The application should state the traveler’s arrival date, vessel name and registration details, vessel’s arrival date, approximate time traveler will spend in the Solomon Islands, and it should request entry on a one-way (arrival only) airline ticket.
The Director will issue a permit to be presented at airline check-in.
If the traveler does not have this permit, she/he may be denied boarding.
For more information about entry requirements, travelers may contact the Solomon Islands Mission to the United Nations at 800 Second Avenue, Suite 8008, New York, NY 10017-4709; Tel: (212) 599-6192 or 6193.
Travelers who anticipate the possibility of transiting or visiting Australia are advised to obtain an electronic travel authority (ETA) or visa for Australia before leaving the United States.
An ETA may be obtained for a small service fee at http://www.eta.immi.gov.au/.
Airlines and many travel agents in the United States are also able to issue ETAs.
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:
Since July 24, 2003, the Regional Assistance Mission in the Solomon Islands (RAMSI), a coalition of Pacific Island states that includes military and police forces from Australia and several other Pacific Island nations, has helped the Solomon Islands improve law and order.
.
It is generally safe to walk alone during the day; however, walking alone at night is discouraged.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The U.S. Consular Agent in Honiara also has available up-to-date safety and security information at (677) 23426 and (677) 94731, or Fax (677) 27429.
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:
Major crimes against travelers are uncommon, although incidences of theft, mugging, and extortion are increasing.
Some 350 RAMSI Police are working alongside Royal Solomon Islands Police (RSIP) to respond to any situation requiring police.

Lawlessness is increasing in Honiara, mostly in the form of petty crime (theft and harassment for money).
The isolated incidents of harassment of expatriates that have increased in Honiara since April 2006 are generally minor and associated with alcohol and fringe elements of the community. House and vehicle break-ins occur, with expatriates particularly targeted.
Some recent episodes have involved violence and the use or threatened use of knives.
Gang-based criminal activity has increased in and around the Burns Creek area in East Honiara, and in the Borderline area, which is close to the Japanese memorial.
It is not advisable to go alone to the Japanese memorial.

Americans should be aware that the public does not distinguish between Australians and Americans.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and to the nearest U.S. Consular Agent in Honiara, or the U.S. Embassy in Port Moresby, Papua New Guinea.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Consular Agent or the U.S. Embassy for assistance.
The Consular Agent or Embassy staff can, for example, assist you to find appropriate medical care, to contact family members or friends, and explain how funds may be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in the Solomon Islands is: 999.
Other emergency numbers are:
Ambulance, Hospital - 911
National Disaster - 955
Fire - 988

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Hospitals and pharmacies in the Solomon Islands are limited to population centers and missions.
Since 2001, the quality of medical services has deteriorated seriously, although it is expected to improve as the country’s overall economic condition continues to improve.
The nearest reliable medical facilities are in Australia or New Zealand.
There is a hyperbaric recompression chamber in Honiara at the In-the-Zone Medical Centre, phone (677) 23485 or (677) 23482; however, medical conditions resulting from diving accidents may require medical evacuation to Australia or New Zealand.
Serious medical conditions requiring hospitalization and/or medical evacuation to Australia, New Zealand or the United States can cost thousands of dollars.
The incidence of malaria is high.
Doctors and hospitals often expect immediate cash payment for health services. Travelers who anticipate the possible need for medical treatment in Australia should obtain entry permission for Australia in advance.
Entry permission for Australia can be granted by the Australian High Commission in Honiara, but it is easier to obtain it prior to leaving the United States (see section above on Entry/Exit Requirements)
Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Solomon Islands.
Per Solomon Islands Immigration Act Cap 60, Section 4 (1) (d) and section 11, subsection (2), an immigration officer can bar a visitor from entering the country or deport an immigrant if he or she refuses to submit to an examination by a government medical officer after being required to do so.

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 website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.

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

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

Vehicular traffic in the Solomon Islands moves on the left.
Paved roads are found only in and around Honiara, located on Guadalcanal Island.
These two-lane paved roads are poorly marked and have many potholes.
Roads are not well lit at night.
The remaining roads in the Solomon Islands are made of coral or gravel, or are dirt tracks.
Travelers must take care when driving off main roads to avoid trespassing on communal land.
For information concerning the rental and operation of motor vehicles in the Solomon Islands, contact our Consular Agent in Honiara.
Please refer to our Road Safety page for more information.
For specific information concerning Solomon Islands driving permits, vehicle inspection, road tax and mandatory insurance, visit the Solomon Islands Department of Commerce web site at http://www.commerce.gov.sb/.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in the Solomon Islands, the U.S. Federal Aviation Administration (FAA) has not assessed the Solomon Islands’ Civil 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.

SPECIAL CIRCUMSTANCES: Customs Information: The Solomon Islands' customs authorities enforce strict regulations concerning temporary importation into or export from the Solomon Islands of items such as firearms and ammunition, sexually explicit material, and certain prescription drugs.
Other items may be subject to quarantine regulations or import duty.
The Solomon Islands' government prohibits the export of military artifacts from World War II.
It is advisable to contact the Solomon Islands' Mission to the United Nations for specific information regarding customs requirements.
Natural Disasters:
The Solomon Islands lie in the South Pacific cyclonic trajectory, and are vulnerable to earthquakes, volcanic eruptions, and sudden tidal movements.
The Pacific cyclone season extends from November through March.
General information regarding disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.

Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating the Solomon Islands laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in the Solomon Islands are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
There is no U.S. Embassy in the Solomon Islands.
However, there is a U.S. Consular Agent in Honiara.
The Consular Agent has general information and forms, such as passport applications, and can be contacted at the United States Consular Agency, Commonwealth Avenue, Point Cruz, telephone number is (677) 23426 or (677) 98367, cell number is (677) 94731, home number is (677) 22539; fax (677) 27429; e-mail keithieusa@solomon.com.sb or us_consular@solomon.com.sb.
For additional information and to download forms, please visit our Virtual Embassy for the Solomon Islands at http://www.usvpp-solomonislands.org/
The U.S. Embassy in Papua New Guinea provides primary assistance for U.S. citizens in the Solomon Islands.
The Embassy is located on Douglas Street, adjacent to the Bank of Papua New Guinea, in Port Moresby.
Use that address for courier service deliveries.
The mailing address is PO Box 1492, Port Moresby, N.C.D. 121, Papua New Guinea; the telephone number is (675) 321-1455; after hours duty officer telephone number is (675) 683-7943; Fax (675) 321-1593.
American citizens may submit consular inquiries via e-mail to ConsularPortMoresby@state.gov.
The web site for the U.S. Embassy in Port Moresby is http://portmoresby.usembassy.gov/.
Americans living or traveling in the Solomon Islands are encouraged to register with the U.S. Embassy in Port Moresby through the State Department’s travel registration web site, and to visit the Consular Agency in Honiara to obtain updated information on travel and security within the Solomon Islands.
Americans without Internet access may register directly with the Embassy or Consular Agency.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
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This replaces the Country Specific Information for the Solomon Islands dated January 17, 2008, to update sections on Crime, Information for Victims of Crime, Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Mon, 23 Oct 2017 06:02:34 +0200

Wellington, Oct 23, 2017 (AFP) - Residents in the Solomon Islands' southeast were warned to stay indoors Monday to avoid showers of ash from a volcanic eruption.   Officials said a lack of scientific equipment made it difficult to monitor the situation on Tinakula island, which lies just north of Vanuatu where 11,000 people were evacuated last month following an eruption on Ambae island.

While the Vanuatu government decided on Friday that the situation on Ambae had settled and people could return home, Solomon Islands officials said they had no indication how long the eruption on Tinakula would continue.    Although Tinakula is uninhabited, about 10,600 people live on the neighbouring Santa Cruz islands.   "Authorities do not have a scientific way to monitor the situation and determine when it will end," the Solomon Islands Broadcasting Corporation (SIBC) quoted National Disaster Management Office director Loti Yates as saying. 

Yates said ashfall on nearby communities and the impact on air travel were the main concerns. An aviation warning has been issued for the Santa Cruz Islands.    "As much as possible, people need to stay indoors," he said, while downplaying the significance of the eruption.   "From what we know currently, the danger of the volcano's impact on Santa Cruz is very small or very limited," he said.   Tinakula, which is frequently active, once had a population of about 130 until an eruption in 1971 forced their permanent evacuation.
Date: Sun, 19 Mar 2017 18:23:14 +0100

Hong Kong, March 19, 2017 (AFP) - A 6.0-magnitude earthquake hit off the Solomon Islands in the early hours of Monday, the US Geological Survey said.   The quake struck at 02:43 am local time (1543 GMT Sunday) at a depth of 4.0 kilometres (2.5 miles), some 170 kilometres north-northeast of the capital city Honiara, the USGS said.   No tsunami warning was issued.

The Solomon Islands are part of the Pacific "Ring of Fire", a zone of tectonic activity known for frequent quakes and volcanic eruptions.    In 2007 an 8.0-magnitude quake in the Solomon Islands claimed 52 lives and left thousands homeless when it created a 10-metre tsunami.
Date: Fri, 20 Jan 2017 01:16:56 +0100

Sydney, Jan 20, 2017 (AFP) - A 6.8-magnitude earthquake hit off the Solomon Islands on Friday, seismologists said, with officials in the Pacific island nation saying there were no initial reports of damage.   The US Geological Survey said quake struck at 10:04 am local time (2304 GMT Thursday) at a depth of 33 kilometres (20 miles) some 70 kilometres west of Kirakira -- the same region where several large tremors struck last month.   The Hawaii-based Pacific Tsunami Warning Center said there was no tsunami threat from the latest shake.   Three strong tremors were felt off Kirakira in December without causing serious damage.

The Solomons National Disaster Management Office (NDMO) said it had not received any damage reports from the remote area.   "We haven't had any information come through," NDMO director Loti Yates told AFP from the capital Honiara.   "It's in the same area as the tremors last month and there are large cracks in the ground. Combined with heavy rain, that could cause landslips but it's too early to say at this stage and we're not making assumptions."   The Solomon Islands are part of the Pacific "Ring of Fire", a zone of tectonic activity known for frequent quakes and volcanic eruptions.    In 2007 an 8.0-magnitude quake in the Solomon Islands claimed 52 lives and left thousands homeless when it created a 10-metre tsunami.
Date: Tue, 20 Dec 2016 06:28:29 +0100

Sydney, Dec 20, 2016 (AFP) - The Solomon Islands was rattled by a strong 6.7-magnitude earthquake Tuesday, the US Geological Survey said, but no tsunami warning was issued and no immediate damage reported.   The quake struck 164 kilometres (101 miles) from the capital Honiara at a depth of 35 kilometres -- the fourth big tremor is just over a week.

"Based on all available data, a destructive Pacific-wide tsunami is not expected," the Pacific Tsunami Warning Center said, while Geoscience Australia estimated damage would only be likely up to 74 kilometres away.   The Solomon Islands are part of the Pacific "Ring of Fire", a zone of tectonic activity known for frequent quakes and volcanic eruptions.    On December 9, a 7.7-magnitude tremor triggered severe shaking and a tsunami warning in the same area, although there were no reports of serious damage. This was followed by a 6.9-magnitude aftershock a day later and another of 6.0 magnitude on Sunday.
Date: Sun, 18 Dec 2016 07:26:39 +0100

Sydney, Dec 18, 2016 (AFP) - A 6.0-magnitude earthquake struck off the Solomon Islands on Sunday, the US Geological Survey said, the third strong tremor off the Pacific nation in less than two weeks.   The quake hit at 4.46pm (0546 GMT) at a depth of 39 kilometres (24 miles) about 83 kilometres west-northwest of Kirakira, the USGS added.   On December 10 a 6.9-magnitude quake struck off Kirakira. The previous day a 7.7-magnitude tremor triggered severe shaking and a tsunami warning, although there were no reports of serious damage.
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Guinea

Guinea US Consular Information Sheet
August 15, 2008
COUNTRY DESCRIPTION:
Guinea is a developing country in western Africa, with minimal facilities for tourism.
Travelers who plan to stay in Conakry, the capital, should make reservati
ns well in advance. French is the official language; Pular, Malinké, and Soussou are also widely spoken.
Read the Department of State Background Notes on Guinea for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport, visa, international vaccination record (WHO card), and current yellow fever vaccination are required.
Travelers should obtain the latest information and details from the Embassy of the Republic of Guinea, 2112 Leroy Street, NW, Washington, DC
20008, tel. (202) 986-4300, fax (202) 478-3010.
The Guinean embassy does not maintain a current website. Overseas, inquiries should be made to the nearest Guinean embassy or consulate.
Overseas, inquiries should be made at the nearest Guinean embassy or consulate.

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:
Since early 2008, there has been a constant threat of violent strikes and demonstrations in Guinea.
The price of gasoline increased by more than 60 percent in April 2008, squeezing already economically hard-pressed Guineans and increasing tension in the country.
Parliamentary elections scheduled for late 2008 could result in violence.

While U.S. citizens have not been targeted in past outbreaks of violence, being in the wrong place at the wrong time can be very dangerous.
During periods of civil unrest, public services such as transportation and medical care, as well as availability of goods and services, can be affected.
During many demonstrations, crowds of people gather and burn tires, create roadblocks, and damage vehicles by throwing rocks and bricks. The military has also been known to demonstrate and incite unrest due to their grievances with the government.
Because of the potential for violence, U.S. citizens should avoid large crowds, political rallies, and street demonstrations. They should also avoid sensitive government installations, including the Presidential Palace, official government buildings, and military bases.

U.S. citizens should maintain security awareness at all times. There are no known terrorist groups officially operating in the country.

Most border crossings are controlled jointly by Guinean armed forces, gendarmes, police and immigration officials.
A long land frontier and the military’s lack of physical and monetary resources, however, mean that borders are lightly patrolled. U.S. citizens considering travel to the border regions with Liberia, Sierra Leone or Côte d’Ivoire should consult the latest Travel Warnings and Country Specific Information for those countries (available at the Bureau of Consular Affairs' Web site at http://travel.state.gov) and contact the U.S. Embassy in Conakry for the latest travel and security information.
Crossing land borders requires visas and complete paperwork, and can be difficult.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ website at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

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

CRIME:
In Conakry, as in many large cities, crime is a fact of daily life.
Residential and street crime is very common.
Sentiments toward Americans in Guinea are generally positive, but criminals regularly target foreigners, including Americans, because they are perceived as lucrative targets.
Nonviolent and violent crimes are a problem.
The majority of nonviolent crime involves acts of pick pocketing and purse snatching, while armed robbery, muggings, and assaults are the most common violent crimes.
In spite of good intentions, the police have been unable to prevent the rapid escalation of crime.
There have also been cases of direct and indirect requests for bribes from the police and military officials. Criminals particularly target visitors at the airport, in the traditional markets, and near hotels and restaurants frequented by foreigners.
Visitors should avoid unsolicited offers of assistance at the airport and hotels because such offers often mask an intention to steal luggage, purses, or wallets. Travelers should arrange for hotel personnel, family members, or business contacts to meet them at the airport to reduce their vulnerability to these crimes of opportunity.

Commercial scams and disputes with local business partners can create legal difficulties for U.S. citizens because corruption is widespread in Guinea.
Business routinely turns on bribes rather than the law, and enforcement of the law is irregular and inefficient.
The U.S. Embassy has extremely limited recourse in assisting Americans who are victims of illegal business deals.

Business fraud is rampant and the targets are usually foreigners, including Americans.
Schemes previously associated exclusively with Nigeria are now prevalent throughout West Africa, including Guinea, and pose a danger of severe financial loss.
Typically these scams begin with the receipt of an unsolicited communication (usually e-mails) from strangers who promise quick financial gain, often by transferring large sums of money or valuables out of the country, but then require a series of "advance fees" to be paid -- such as fees for legal documents or taxes -- to finalize the release of the transferred funds.
The final payoff does not exist; the purpose of the scam is simply to collect the advance fees. A common variation is the scammer’s claim to be a refugee or émigré of a prominent West African family, or a relative of a present or former political leader who needs assistance in transferring large sums of cash.
Still other variations appear to be legitimate business deals that require advance payments on contracts.
Sometimes victims are convinced to provide bank account and credit card information and financial authorization that drains their accounts, incurs large debts against their credit, and takes their life savings.

The best way to avoid becoming a victim of advance-fee fraud is common sense -- if a proposition looks too good to be true, it probably is.
You should carefully check and research any unsolicited business proposal before committing any funds, providing any goods or services, and undertaking any travel.
A good clue to a scam is the phone number given to the victim; legitimate businesses and offices provide fixed line numbers, while scams typically use only cell phones.
It is virtually impossible to recover money lost through these scams.

There is no “911” type of emergency assistance in Guinea.
For additional information on these types of scams, see the Department of State's publication, International Financial Scams.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends, and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are poorly equipped and extremely limited both in the capital city and throughout Guinea. Medicines are in short supply, sterility of equipment should not be assumed, and treatment is frequently unreliable. Some private medical facilities provide a better range of treatment options than public facilities but are still well below global standards. There are no ambulance or emergency rescue services in Guinea and trauma care is extremely limited. Water in Guinea is presumed contaminated, so you should use only bottled or distilled water for drinking. Malaria is a serious risk to travelers in Guinea. For additional information on malaria, including protective measures, see the CDC travelers’ health web site at http://wwwn.cdc.gov/travel/contentDiseases.aspx#malaria.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Guinea.

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 website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

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

Drivers in Guinea tend to be poorly trained and routinely ignore road safety rules.
Guinea's road network, paved and unpaved, is underdeveloped and unsafe.
Roads and vehicles are poorly maintained, road signs are insufficient, and roads and vehicles are frequently unlit.
Livestock and pedestrians create constant road hazards and make nighttime travel inadvisable.
Guinea has many roadblocks set up by the police or the military, making inter- and intra-city travel difficult from 10:00 p.m. to 6:00 a.m.
During the rainy season (July through September), flash floods make some roads temporarily impassable.
There is also a significant increase in banditry along the roadways between towns and upcountry during the hours of darkness.
Americans and other foreigners are strongly discouraged from traveling after dark outside of populated areas.
Roadside assistance is not available in Guinea.

Guinea has no public transportation. Taxis, including small cars and larger vans, are often poorly maintained and overcrowded.
Taxis frequently stop and start without regard to other vehicles, making driving hazardous.
Rental vehicles, with drivers, are available from agencies at major hotels in Conakry.

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 Guinea, the U.S. Federal Aviation Administration (FAA) has not assessed Guinea’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s Internet web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Guinean customs authorities may enforce strict regulations concerning the temporary import or export of items such as firearms, antiquities, medications, business equipment, and ivory.
You should contact the Embassy of Guinea in Washington (see contact information above in the Entry Requirements section) for specific information regarding customs requirements.

The local currency is the Guinean franc (FG).
Travelers may not have more than 100,000 FG (currently about $23.00 nor more than $5,000 when they depart Guinea.
Guinea has a cash economy.
ATMs are not available, and traveler’s checks are accepted only at some banks and hotels.
Credit cards are accepted at some larger hotels in Conakry, but should be used only at reputable hotels and banks.
Cash advances on Visa credit cards are available at various branches of BICIGUI, a local bank.
Inter-bank fund transfers are possible at BICIGUI branches but can be difficult and expensive.
Money transfers from the U.S. have worked successfully in the past.
Western Union has several offices in Conakry, and Moneygram has an office downtown.

Visitors should restrict photography to private gatherings and should obtain explicit permission from the Guinean government before photographing military and transportation facilities, government buildings, or public works.
Photographing without permission in any public area may provoke a response from security personnel or a dangerous confrontation with people who find being photographed offensive.

Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Guinean laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Guinea are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.

Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Guinea are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within Guinea. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located on the Transversale No. 2, Centre Administratif de Koloma opposite the New Radio Station in Ratoma, Conakry, Guinea; telephone +224-30-42-08-61 through 68 or fax +224-30-42-08-71; web site: http://conakry.usembassy.gov/.
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This replaces the Country Specific Information for Guinea dated August 28, 2007, to update sections on Safety and Security and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Thu, 1 Aug 2019 17:40:25 +0200 (METDST)

Conakry, Aug 1, 2019 (AFP) - Six children aged between four and 10 died after they were struck by lightning while making tea under a mango tree in north-eastern Guinea on Wednesday, a witness said.   The storm began shortly before 7:00 pm (1900 GMT) in the town of Siguiri, close to the border with Mali, witness Mamadi Doumbouya, a local resident, told AFP.   He said eight children in total, accompanied by two of their mothers, were under a mango tree at the back of his house.   "I invited everyone to take shelter in my living room. The ladies rushed under my roof but the children stayed behind to make the last cups of tea," he added.

Lightning then struck the mango tree and when Doumbouya rushed out, all of the children were on the ground and unconscious, he said in a telephone call.   Six of the children -- five girls and a four-year-old boy -- died while being taken to hospital, he added.    A doctor from Siguiri Hospital said the six dead children were brought there in the early evening and two others were placed under observation for the coming days.   West Africa is currently undergoing its rainy season.   On Saturday a landslide hit a gold mine in the same area as Wednesday's storm, killing four people including a two-year-old girl and her mother.   "The victims were working in a former gold mine where mining was banned because of the risk of landslides" in the heavy rains, "but people were hiding to go to the tunnels", a Red Cross official said.
Date: Thu, 7 Feb 2019 18:17:54 +0100

Conakry, Feb 7, 2019 (AFP) - Medical services in Guinea are on alert after a man died from Lassa fever, health officials said on Thursday, with some 80 people being monitored for the deadly disease.   Lassa fever is caused by a haemorrhagic virus which belongs to the same family as Marburg and Ebola.   The virus was found in a 35-year-old man from the southwestern town of Kissidougou. He died on January 29 in Mamou, some 400 kilometres (250 miles) away, according to officials.   Kissidougou is where an outbreak of Ebola began in December 2013, leading to thousands of deaths in Guinea, Liberia and Sierra Leone.   "(We) have set to work to see if there are any hidden cases and to trace all the contacts" of the deceased man, said Sakoba Keita from the National Health Security Agency (ANSS).   Keita said it was not yet clear whether this was "an isolated case or an epidemic". 

Around 80 people -- 30 in Kissidougou and 50 in Mamou -- are being monitored but none have so far shown any symptoms of the disease, Keita said.   Lassa takes its name from the town of that name in northern Nigeria where it was first identified in 1969.   The virus is spread through contact with food or household items contaminated with rats' urine or faeces, or after coming into direct contact with the bodily fluids of an infected person.   It can be prevented by enhanced hygiene and avoidance of all contact with rats.   Nearly four in five peple who become infected with the virus do not have symptoms of the disease, the World Health Organization (WHO) says on its website.   A Lassa outbreak in Nigeria last year left 171 dead, and a resurgence of the disease there last month killed 16, according to official figures.
Date: Mon, 4 Feb 2019 21:26:07 +0100

Conakry, Feb 4, 2019 (AFP) - At least 17 people have been killed in a landslide at a gold mine in northeastern Guinea, local police said Monday.   A local elected official confirmed the death toll, saying he had "seen at least 17 dead" after the accident which took place late Sunday in Norassoba, some 35 kilometres (20 miles) from the town of Siguiri.   "This death toll is clearly provisional as the villagers say there are still many people missing," police lieutenant Marcus Bangoura said.

One local inhabitant said "the landslide apparently took everyone by surprise, there was no sign of danger in this mine where we have been working for several years."  There are many such accidents in mines in mineral-rich Guinea where thousands risk their lives working in illegal pits.   The work becomes even more dangerous in the rainy season.

Guinea has gold, diamonds, bauxite and huge reserves of iron ore but the west African country's population struggle to make ends meet.    The miners include locals and those from nearby countries such as Burkina Faso, Liberia and Ivory Coast.   Authorities say there are more than 20,000 such miners in the Siguiri region.
Date: Sun 3 Feb 2019 9:02 AM GMT+1
Source: Bloomberg [edited]

Guinea's government has reported one case of a 35-year-old man with Lassa fever in the central town of Mamou, some 260-kilometers [162 mi] from the country's capital of Conakry.

An investigative mission will be deployed to the region to support health authorities, the government said on [Sat 2 Feb 2019] in statement posted on the website of the National Health Security Agency. No other Lassa fever cases were reported.

Lassa fever is an acute viral haemorrhagic illness, transmitted to humans through contact with food or household items contaminated by infected rodents.  [Byline: Ougna Camara]
========================
[Although rarely reported in Guinea, this may not be the 1st Lassa fever case that has occurred there. As noted when an earlier case was first posted on Thu 8 Feb 2018, it was the 1st Lassa fever case that ProMED-mail had posted for Guinea (see Lassa fever - West Africa (09): Liberia ex Guinea http://promedmail.org/post/20180210.5620420). That report indicated that the affected individual actually died in Liberia but indicated that the infection was acquired in Guinea. West Africa, including Guinea and Liberia, is endemic for Lassa fever virus.

The situation where the person reported above acquired Lassa fever virus is not indicated in this case. Virus transmission to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (in the genus _Mastomys_) or its excreta, as was likely the situation in this case. Rodent control has to be undertaken at the village level with individual households. This requires an extensive and continuous public education effort. Transmission also occurs in health facilities when personal protective equipment is not employed and barrier-nursing practices are not adequate to protect staff from blood and secretions of infected patients.

Images of the _Mastomys_ mouse, the rodent reservoir of Lassa fever virus, can be seen at
<https://www.inaturalist.org/taxa/45326-Mastomys-natalensis>. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Guinea:
Date: Mon, 29 Oct 2018 14:38:26 +0100

Conakry, Oct 29, 2018 (AFP) - A "dead city" strike call by the opposition in Guinea largely emptied the streets of the capital Conakry on Monday, with no solution in sight to a pay dispute in the education sector.   Streets were deserted in some parts of the West African city, while traffic was jammed in other areas where all drivers were being diverted, an AFP correspondent saw.   Troops and police were placed on alert but few were deployed on the streets. Instead they were gathered in strength in central police stations and gendarmerie barracks, the correspondent said.   Youths burned tyres early in the day along a main Conakry thoroughfare, Le Prince street, but rain soon put out the fires and dampened the ardour of would-be demonstrators.

The political opposition called for the strike in protest against what it considers a violation by the authorities of an agreement reached in August over the appointment of local government officials elected in a hotly disputed vote on February 4.   Rivals of President Alpha Conde have also called for a march and rally in Conakry on Tuesday, a week after a banned demonstration during which opposition leader Cellou Dalein Diallo alleged that police tried to assassinate him.   Also last Tuesday, an 18-year-old was killed in street clashes and his family blamed police, who denied both shooting allegations.

On Monday morning, hundreds of schoolchildren in Siguiri, a town in the far north of the country, took to the streets to call for the return of their teachers, who began "an unlimited strike" on October 3 to press demands for a raise in minimum pay, according to local media.   The teachers decided to take tougher action after the government announced that it would not pay October wages for the strikers, said Aboubabar Soumah, general secretary of the powerful Free Union of Teachers and Researchers of Guinea (SLECG).   "From now on, it's not the worker who gets paid, but the work," Conde warned on state media.   "Teachers will stay at home until the end of the head of state's second mandate in 2020," the SLECG said in response.
More ...

Cambodia

Cambodia US Consular Information Sheet
June 05, 2008
COUNTRY DESCRIPTION:
Cambodia is a developing country with a constitutional monarchy and an elected government. King Norodom Sihamoni is the constitutional monarch and head of state. Ele
tions for Members of the National Assembly were last held in July 2003, and are scheduled to take place again in July 2008. Two political parties, the CPP and FUNCINPEC, have formed a coalition government, which the CPP dominates. The country has a market economy with approximately 80 percent of the population of 13.6 million engaged in subsistence farming. The government has good relations with its neighbors despite strains over residual border disputes and other historic antagonisms. The quality of tourist facilities varies widely in Cambodia with the highest standard found in Phnom Penh, Siem Reap, and Sihanoukville. Read the Department of State Background Notes on Cambodia for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid passport and a Cambodian visa are required.
Cambodia offers on-line visa processing at http://evisa.mfaic.gov.kh.
Tourist and business visas are valid for one month beginning with the date of entry into Cambodia. You may also apply in person at the Cambodian Embassy located at 4530 16th Street NW, Washington, DC
20011, tel. 202-726-7742, fax 202-726-8381. Tourists and business travelers may also obtain a Cambodian visa at the airports in Phnom Penh, Siem Reap, and at all major border crossings.
Both methods of obtaining a Cambodian visa require a passport-sized photograph and a passport that is valid for a minimum of six months beyond the date of entry into Cambodia. A departure tax is charged on all domestic and international flights. This tax must be paid in U.S. dollars.
Overseas inquiries may be made at the nearest embassy or consulate of Cambodia. Travelers should note that Cambodia regularly imposes fines of USD 5.00 per day on charges of overstay on an expired visas. Visit the Embassy of the Kingdom of Cambodia web site http://www.embassyofcambodia.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 State Department is concerned that individuals and groups may be planning terrorist actions against United States citizens and interests, as well as sites frequented by Westerners, in Southeast Asia, including in Cambodia.
Extremist groups present in Southeast Asia have transnational capabilities to carry out attacks against locations where Westerners congregate.
American citizens traveling to Cambodia should therefore exercise caution in clubs, discos, bars, restaurants, hotels, places of worship, schools, outdoor recreation venues, tourist areas, beach resorts, and other places frequented by foreigners.
They should remain vigilant with regard to their personal security and avoid crowds and demonstrations.
From time to time, the U.S. Embassy places local establishments off limits to Embassy personnel due to safety and security incidents.
You can contact the Embassy for notification on the current restrictions in place for Embassy personnel.
Local commune elections in April 2007 were peaceful.
National elections are scheduled for July 27, 2008. Political tensions have eased, and the current situation is relatively stable; however, Cambodian political activities have turned violent in the past, and the possibility for politically motivated violence remains.

In November 2006, police arrested six people for allegedly plotting to conduct bomb attacks in Phnom Penh during the November Water Festival.
On July 29, 2007, three improvised explosive devices (IEDs) were planted at the Vietnam-Cambodia Friendship Monument in Phnom Penh. One of the IEDs partially exploded, but the others failed to detonate and were recovered by Cambodian authorities. No one was injured, primarily because the explosion occurred during the early morning hours. Police subsequently arrested several individuals suspected of constructing the devices and planning the bombings. While there is no indication this attack was directed at U.S. or other Western interests, the possibility remains that further attacks could be carried out, harming innocent bystanders.
The U.S. Embassy advises U.S. citizens to avoid large public gatherings and crowded public areas.
Land mines and unexploded ordnance are found in rural areas throughout Cambodia, and especially in Battambang, Banteay Meanchey, Pursat, Siem Reap, and Kampong Thom provinces. Travelers should never walk in forested areas or even in dry rice paddies without a local guide. Areas around small bridges on secondary roads are particularly dangerous.
Travelers should not touch anything that resembles a mine or unexploded ordnance; they should notify the Cambodia Mine Action Center at 023-368-841/981-083 or 084.

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

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

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

CRIME:
Cambodia has a high crime rate, including street crime. Military weapons and explosives are readily available to criminals despite authorities’ efforts to collect and destroy such weapons. Armed robberies occur frequently in Phnom Penh. Foreign residents and visitors are among the victims.
Victims of armed robberies are reminded not to resist their attackers and to surrender their valuables, since any perceived resistance may be met with physical violence, including lethal force. Local police rarely investigate reports of crime against tourists, and travelers should not expect to recover stolen items.
The U.S. Embassy advises its personnel who travel to the provinces to exercise extreme caution outside the provincial towns at all times. Many rural parts of the country remain without effective policing. Individuals should avoid walking alone after dusk anywhere in Sihanoukville, especially along the waterfront. Some of the beaches are secluded, and post has received reports that women have been attacked along the Sihanoukville waterfront during the evening hours. Take security precautions when visiting the Siem Reap (Angkor Wat) area. Travelers should be particularly vigilant during annual festivals and at tourist sites in Phnom Penh, Siem Reap and Sihanoukville, where there have been marked increases in motorcycle “snatch and grab” thefts of bags and purses. A group of young men sexually assaulted a foreigner in Phnom Penh in November 2006 while she was taking a moto-taxi from a nightclub.
Pickpockets, including some who are beggars, are present in the markets and at the tourist sites. Persons visiting Cambodia should practice sound personal security awareness by varying their routes and routines, maintaining a low profile, not carrying or displaying large amounts of cash, not wearing flashy or expensive jewelry, and not walking the streets alone after dark. In addition, we recommend that Americans travel by automobile and not use local moto-taxis or cyclos (passenger-carrying bicycles) for transportation. These vehicles are more vulnerable to armed robberies and offer no protection against injury when involved in traffic accidents.
To avoid the risk of theft or confiscation of original documents, the U.S. Embassy advises its personnel to carry photocopies of their U.S. passport, driver's license or other important documents.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance. The embassy/consulate staff can assist you to find appropriate medical care, to contact family members or friends and explain how funds can be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities and services in Cambodia do not meet international standards.
Both Phnom Penh and Siem Reap have a limited number of international-run clinics and hospitals that can provide basic medical care and stabilization. Medical care outside these two cities is almost non-existent. Local pharmacies provide a limited supply of prescription and over-the-counter medications, but because the quality of locally obtained medications can vary greatly, travelers should bring adequate supplies of their medications for the duration of their stay in Cambodia.

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

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

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

Driving at night in Cambodia is strongly discouraged. Road maintenance is sporadic in both urban and rural areas. Roads between major areas are adequate; however, roads leading to areas that are more rural are poor. During the rainy season, both urban and rural road conditions deteriorate considerably. Roadside assistance is non-existent. The safety of road travel outside urban areas varies greatly. Cambodian drivers routinely ignore traffic laws, and vehicles are poorly maintained. Intoxicated drivers are commonplace, particularly during the evening hours, and penalties for DWI offenses vary greatly. Banditry occurs even on heavily traveled roads, so all travel should be done in daylight between the hours of 7:00 a.m. and 5.00 p.m.
Serious flooding occurs in both Phnom Penh and the rest of Cambodia starting at the end of July, early August. Heavy flooding continues into November. The unimproved highways to Prey Veng, Battambang, Pailin, Stung Treng and Poipet become more difficult and dangerous during this time of the year, and travel on unpaved or dirt roads is virtually impossible. The National Route highways are the only roads that can be traveled, with caution, this time of the year.
The U.S. Embassy advises Embassy personnel not to travel by train because of low safety standards and the high risk of banditry. Travel by boat should be avoided because boats are often overcrowded and lack adequate safety equipment.
Boat owners accept no liability for accidents.
Travelers also should exercise caution when using intercity buses, including those to popular tourist destinations such as Siem Reap and Sihanoukville.
Moto-taxis and cyclos are widely available; however, the Embassy does not recommend using them due to safety concerns and because personal belongings can be easily stolen. Organized emergency services for victims of traffic accidents are non-existent outside of major urban areas, and those available in major urban areas are inadequate. 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 Cambodia, the U.S. Federal Aviation Administration (FAA) has not assessed Cambodia’s Civil 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 U.S. Embassy strongly discourages its employees from using domestic air carriers due to safety incidents that have occurred in recent years.
A PMT Air flight from Siem Reap to Sihanoukville crashed in bad weather in a coastal mountain range on June 25, 2007.
There were no survivors.
Incidents at the Ratanakiri airport since 2005 have included collapsed landing gear and hard landings.
Embassy employees are permitted to use international carriers Siem Reap Airways and Bangkok Airways between Phnom Penh and Siem Reap.
SPECIAL CIRCUMSTANCES:
Cambodian customs authorities may enforce strict regulations concerning temporary importation into or export from Cambodia of items such as drugs, firearms, antiquities, or ivory. It is advisable to contact the Embassy of Cambodia in Washington for specific information regarding customs requirements. Please see our information on Customs Regulations.

Dual Nationality:
Dual nationality is not prohibited under Cambodia's 1996 nationality law. In addition to being subject to all Cambodian laws affecting U.S. citizens, individuals who possess Cambodian nationality may also be subject to laws that impose special obligations on Cambodian citizens.
Business Transactions: Some U.S. citizens have reported threats of personal injury, extortion, detention or kidnapping related to personal business disputes, in particular those involving real estate.
The Embassy urges any American citizen planning to engage in real estate deals or other significant financial transactions to proceed with caution.
U.S. citizens who do not have confidence in the ability of the local police to protect them may wish to depart the country expeditiously.

Financial Transactions:
The U.S. dollar is widely used, especially for larger transactions, and most prices are quoted in dollars. Ripped or torn U.S. bills are not accepted. The Cambodian riel can also be used, but is less favored and is mostly given to tourists as change for dollar purchases. The riel is commonly used in smaller towns and rural areas.
Credit cards are increasingly accepted within Cambodia, and a number of banks in Phnom Penh accept Visa cards for cash advances. Credit cards are often subject to a service charge. Banks and major hotels accept travelers' checks, but usually charge a service fee.
Several international banks operate ATM machines that allow travelers to obtain U.S. dollar currency in Phnom Penh, Siem Reap and other urban centers.
Personal checks are not generally accepted. Several banks serve as Western Union agents in Phnom Penh, Siem Reap, Sihanoukville and other provincial cities to which funds can be wired. Information on Western Union can be found at http://www.westernunion.com.
Photography: Taking photographs of anything that could be perceived as being of military or security interest — including government buildings, military installations, airfields, bridges — may result in problems with the authorities and confiscation of the camera.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Cambodian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession of, use of, or trafficking in illegal drugs in Cambodia are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Cambodia are encouraged to register with the nearest U.S. embassy or consulate through the State Department's travel registration web site and to obtain updated information on travel and security within Cambodia. Americans without Internet access may register directly with the nearest U.S. embassy or consulate. By registering, American citizens make it easier for the embassy or consulate to contact them in case of emergency. The U.S. Embassy is located at No. 1, Street 96 (near Wat Phnom), Phnom Penh, Cambodia. The telephone number is (855-23) 728-000; fax (855-23) 728-600. Additional information about American Citizen Services can be found at the U.S. Embassy in Phnom Penh at http://cambodia.usembassy.gov/
* * *
This replaces the Country Specific Information for Cambodia dated September 14, 2007, to update sections on Safety and Security, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Aviation Safety Oversight and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Fri, 15 Nov 2019 09:41:09 +0100 (MET)

Phnom Penh, Nov 15, 2019 (AFP) - Cambodia will ban all elephant rides at the country's famed Angkor temple park by early next year, an official said Friday, a rare win for conservationists who have long decried the popular practice as cruel.   The Angkor archaeological complex in northern Siem Reap attracts the bulk of the kingdom's foreign tourists -- which topped six million in 2018 -- and many opt for elephants rides around the ancient temples.

But these rides "will end by the start of 2020", said Long Kosal, a spokesman with the Apsara Authority, which manages the park.   "Using elephants for business is not appropriate anymore," he told AFP, adding that some of the animals were "already old".   So far, five of the 14 working elephants have been transferred to a community forest about 40 kilometres (25 miles) away from the temples.   "They will live out their natural lives there," Kosal said.   The company that owns the elephants will continue to look after them, he added. 

Cambodia has long come under fire from animal rights groups for ubiquitous elephant rides on offer for tourists, also seen in neighbouring Thailand, Vietnam and Laos.    The elephants are broken in during training and rights groups have accused handlers of overworking them.   In 2016, a female elephant died by the roadside after carrying tourists around the Angkor Wat temple complex in severely hot weather.   The animal had been working for around 45 minutes before she collapsed.
Date: Mon, 28 Oct 2019 08:10:36 +0100 (MET)

Phnom Penh, Oct 28, 2019 (AFP) - Cambodia deployed soldiers, police and divers to scour an island popular with backpackers after a British tourist went missing there four days ago, an official told AFP on Monday.

Nearly 200 members of the army, navy and police have fanned out across Koh Rong in southern Cambodia in an attempt to find Amelia Bambridge, who was last seen at a beach party around 3:30 am on October 24.   "Divers are searching in the sea around Koh Rong while the others are scanning the jungle," said Kheang Phearun, a spokesman for the Preah Sihanouk provincial administration.   "We have not yet found the missing British woman."

British media reports said the 21-year-old had befriended other tourists, but the alarm was raised after she failed to check out of her hostel.   The mystery deepened after authorities said they found her bag and phone where she was last seen, a late-night hangout called Police Beach.   Bambridge's family have arrived in Cambodia and headed to the closest city, Sihanoukville, on Sunday night, Phearun added.

Located in the Gulf of Thailand, Koh Rong is a two-hour boat ride from the coast and draws budget travellers with its cheap guesthouses, beachside bars and idyllic beaches.   But it has also undergone development in recent years in keeping with a construction and casino boom in nearby Sihanoukville.   Cambodia has long been a stop for tourists travelling around Southeast Asia.   Though generally safe, crimes involving foreigners have grabbed headlines in the past.

Last week a Cambodian court charged three men with gang-raping a French tourist in the coastal province of Kampot after offering her a ride in their car.   In 2013, Kampot town was rocked by the discovery of a mutilated body of a 25-year-old Frenchwoman floating in a river.    A Belgian was charged with the alleged rape and murder of the woman, but released on bail due to a lack of evidence.
31 Jul 2019

The north eastern province of Si Sa Ket, on the Cambodian border, has declared that the prevention and control of dengue fever required urgent attention throughout its area. Local health officials say they are now especially concerned about what will happen during the last 3 months of the annual wet season. At a Provincial Hall meeting it was announced that 7 people had died from dengue so far in 2019 and that 1664 people were now suffering from the mosquitoborne disease, making Si Sa Ket the country's 12th worst-hit province. They agreed the situation had worsened drastically, saying the monthly figures for those hospitalised had exploded from 81 cases in January to 618 in June and 457 in July [2019].

HealthMap/ProMED-mail map of Cambodia:
Date: Thu, 15 Aug 2019 06:14:20 +0200 (METDST)

Battambang, Cambodia, Aug 15, 2019 (AFP) - As he tears off a leg of a charcoal-grilled rat at a roadside stall in western Cambodia, Yit Sarin hails the simple joy of rodent and rice washed down with beer.   "It's delicious," he says of the snack.   Barbecued field rats are not everybody's idea of a tasty treat, but in Cambodia's rural Battambang province they are popular as a quick -- and cheap -- snack, with small skewered ones going for $0.25 each while larger rodents can cost $1.25.

Rats were commonly eaten in the 1970s, under the ultra-Maoist Khmer Rouge, when frogs, tarantulas and other small creatures were considered fair game as a means to survive.   Now they are simply an inexpensive lunch for workers and farmers -- though there is disagreement over what its meat tastes like.    Sarin tells AFP that rat is like "chicken or beef", whereas others say it's more like pork.

He is one of many customers and Cambodian tourists stopping at a stall outside of Battambang town, where rows of grilled field rats are displayed over burning coals and served with dipping sauces made from lime juice, black peppers or chillies.    Vendor Ma Lis says the snack has grown in popularity since she launched her stall more than a decade ago and sold just a few kilograms a day.   Today, she can net daily sales of around 20 kilograms, making brisk business from van-loads of travelling Cambodians and the occasional curious foreigner. 

The holiday season also spells bad news for the field rodents -- Ma Lis can sell up to 180 large rats a day on the Cambodian New Year or water festival.   Dismissing any health concerns one might have about eating her unconventional treat, Ma Lis says her rodents are caught from rice fields and are good for you.    "These rats are healthier than pork and chicken... they eat lotus roots and rice grains," she says, as she flips the barbecued bodies on the grill.    Despite the snack's enduring appeal, many people remain squeamish.     "They feel it is disgusting," she says, smiling.
Date: Fri 31 May 2019 08:04 ICT
Source: The Phnom Penh Post [edited]

A 50-year-old man from Svay Rieng province died on Tuesday night [28 May 2019], 19 days after being bitten by a dog in Trapaing Trav village in Kampong Ro district's Nhor commune.

The wife of the bitten man told The Post that before the incident, while she was at home, her husband went to a paddy field with their 5-year-old niece and sheltered in a hut where he always rests on sunny days.

When they arrived at the hut, they saw a dog asleep on the ground. The dog woke up and bit [the man's] niece, causing a minor skin injury with no bleeding, [the wife] said.

[The man] went to help her, but the dog suddenly jumped up and bit him on the right forearm, this time inflicting more serious injuries. "The dog bit my niece and he helped her. He said the dog had seemed gentle. "They chased the dog to hit it, but it lunged back from about 5 metres away and bit my husband," [the wife] said.

She said that after being bitten, [her husband] sought treatment from a traditional Khmer physician but did not go to a doctor for an injection.

"After leaving the traditional physician, he didn't get any more treatment. Our children told him to see a doctor for injections, but he didn't go."

"As days went by, he was busy growing rice, spraying rice fertilizer, and pumping water. He kept putting off going to see a doctor until he was in serious danger," she said.

She said her husband became feverish and was unable to drink water, and developed a fear of water, fire, and the wind.

At this point, she sent her husband to the Svay Teap Referral Hospital where he was injected with a serum and sent to the provincial hospital. That hospital, in turn, sent him on to the capital's Pasteur Institute in Cambodia.

Because the gate was not yet open, she finally sent her husband to Calmette Hospital next door. When they arrived at Calmette Hospital, doctors told [the wife] that her husband was in a critical condition and they could not save his life.

She then took her husband back home, arriving there on Tuesday morning
[28 May 2019]. [He] died that same night.

[She] said the dog was probably carrying rabies. She didn't know where it came from and it was sleeping in the paddy fields.

Ly Sowath, a doctor at the Pasteur Institute in Cambodia's Epidemiology and Public Health Unit, could not be reached for comment.

Sowath told The Post in February [2019] that the vaccine against rabies is effective if received before being bitten or in the 1st 24 to 48 hours afterwards [see comment].

Doctors ask people to observe the health of the animal that bites them. If the dog does not get sick or die within 10 days, it is a sign that it was not carrying rabies. But anyone suspecting any irregularity should get vaccinated as soon as possible.

According to the Pasteur Institute of Cambodia, the disease is 100 per cent preventable through post-exposure vaccination if provided in time, but it is [almost] 100 per cent fatal once symptoms develop.  [Byline: Ry Sochan]
=====================
[The last comment by Cambodia's Pasteur Institute deserves to be listened to and memorized. The appearance of clinical rabies signs indicates the termination of the incubation period; at this stage, attempts to save the life of the victim are doomed to fail.

On the other hand, we have reservations concerning the cited Cambodian Pasteur Institute's advice of February 2019, in which it was allegedly stated that "the vaccine against rabies is effective if received before being bitten or in the 1st 24 to 48 hours afterwards." Such information may leave exposed people's life seriously threatened in case they have missed seeking medical help during the 1st 48 hours after being exposed.

In fact, the incubation period for rabies is typically 1 to 3 months but may vary from less than a week to more than 2 years. Due to the potentially long incubation period, there is no time limit for giving post exposure treatment (PET) before the appearance of clinical signs: all potential exposures should be risk-assessed. This and much more useful updated information on PET is available in the recently (April 2019) published "Guidelines on managing rabies post-exposure" (Public Health England, April 2019, 40 pages) at <https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/800017/PHE_guidelines_on_rabies_post-exposure_treatment.pdf>.

Hopefully, the family of the victim's niece, who was exposed to the same dog, has already sought medical advice. - ProMED Mod.AS]

[HealthMap/ProMED-mail map of Cambodia:
More ...

Guadeloupe

French West Indies US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
The French West Indies consists of the islands of Martinique, Guadeloupe, St. Martin (the French side) and St. Barthélemy. These islands are well develop
d. In St. Martin and St. Barthélemy, English is widely spoken, and U.S. currency is accepted. Read the Department of State Background Notes on France for additional information.

ENTRY/EXIT REQUIREMENTS:
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S.
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted.
We expect cards will be available and mailed to applicants in spring 2008.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Visas are generally not required for visitors planning to remain for up to 90 days. For further information, travelers can contact the Embassy of France at 4101 Reservoir Road NW, Washington, DC 20007; telephone 1 202 944-6000; or the nearest French consulate in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New York, New Orleans or San Francisco. Visit the web site for the Embassy of France at http://www.info-france-usa.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 latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings, and Travel Alerts 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:
Petty street crime, including purse snatching, occurs throughout the French West Indies. Visitors should take care whenever traveling to safeguard valuables and always lock hotel rooms and car doors.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Good medical care is available throughout the French West Indies. Not all doctors speak or understand English. Hyperbaric chambers are available in Guadeloupe at the Centre Hospitalier Universitaire in Abymes, http://www.chu-guadeloupe.fr/fr/fw_index.asp, and, in Martinique at the Centre Hospitalier Universitaire in Fort de France, http://www.chu-fortdefrance.fr/pages/sommaire.html.
Cases of dengue fever have been reported in Martinique and Guadeloupe.

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

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning the French West Indies is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in the French West Indies is on the right side of the road. Children under 12 are not legally allowed in the front seat. Seatbelt laws are strictly enforced.

The roads in the French West Indies are the best in the Eastern Caribbean. Roads are well paved and well maintained. Main roads are well marked; secondary roads and tourist sites are adequately marked. Excellent maps are available and local residents are helpful, especially if greeted in a friendly manner. Both Martinique and Guadeloupe have expressways. Traffic safety is enforced by the police. Night driving can be dangerous, especially in the mountains and on winding rural roads. Public transportation in the form of taxis, vans, and buses is relatively safe. For specific information concerning French West Indies driver's permits, vehicle inspection, road tax and mandatory insurance, contact the French National Tourist Organization offices at: http://www.franceguide.com/.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.securite-routiere.gouv.fr/index.html.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the French West Indies fall under the jurisdiction of French authorities.
The U.S. Federal Aviation Administration (FAA) has assessed the Government of France’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of France’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: In addition to being subject to all French laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on French citizens. Although France recognizes dual nationality, dual nationals are considered French citizens and are subject to French laws without regard to the other nationality. For additional information, please see our Dual Nationality flyer.

French customs authorities may enforce strict regulations concerning temporary importation into or export from the French West Indies of items such as firearms, medications, animals, etc. For questions, travelers may wish to contact the Embassy of France or a French Consulate for specific information regarding customs requirements. Please see our information on customs regulations.

The French West Indies can be affected by hurricanes. The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at: http://www.fema.gov/.
Please see 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 French West Indies’ laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the French West Indies are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the French West Indies are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site, and to obtain updated information on travel and security within the French West Indies. Americans without Internet access may register directly with the U.S. Embassy in Barbados, which has jurisdiction over the French West Indies. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in Wildey Business Park in St. Michael, Barbados; web site: http://barbados.usembassy.gov/.

The Consular Section is open for American Citizens Services from 8:30am to 4:00pm, Monday-Friday, except Barbados and U.S. holidays. For after-hours service, American citizens may contact the U.S. Embassy in Bridgetown, Barbados, telephone 1-246-436-4950. The U.S. Consular Agent in Martinique, Henry Ritchie, is located at the Hotel Valmeniere #615, Avenue des Arawaks, 97200 Fort de France, telephone (011) (596) (596) 75-6754, fax (011) (596) (596) 70-8501, mobile (011) (596) (696) 93-8406, email: hritchie@sbcglobal.net. Consular Agent Henry Ritchie is available Monday through Friday from 9:00am to 12:00pm, except French and U.S. holidays.
* * *
This replaces the Country Specific Information for French West Indies dated June 7, 2007, to update sections on Entry/Exit Requirements, Safety and Security, Traffic Safety and Road Conditions, Medical Facilities and Health Information, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu, 24 May 2018 11:39:42 +0200

Paris, May 24, 2018 (AFP) - The French government is preparing a plan to deal with a new invasion of stinky seaweed that is covering the beaches of some its islands in the Caribbean, causing health problems for residents and threatening key fishing and tourism industries.

The brown sargassum algae "is one more disaster for the West Indies, one which we here probably haven't fully taken into account," Environment Minister Nicolas Hulot told lawmakers in Paris late Wednesday.   Tons of the seaweed began arriving on the islands of Martinique and Guadeloupe several weeks ago, where it has piled up knee deep in some areas over large stretches of shoreline.

It soon begins decaying, producing huge amounts of hydrogen sulphide and other noxious gases which reek of ammonia or rotten eggs and can severely irritate the eyes, nose and throat.   The fumes also damage nearby houses and other property by eating away at metal, while also killing fish and fauna, hurting the local fishing industry.   Officials have closed schools near infested zones, while some islands have been cut off since supply boats and ferries cannot get past the thick banks of seaweed.

The French government has already unlocked three million euros ($3.5 million) of credits for supplying tractors, gas masks and other equipment to remove the seaweed -- though it often returns in a matter of weeks.   "Beyond the urgent response, a new national plan for combatting sargassum will be finalised by mid-June," Hulot said in parliament.   Although researchers are not sure why the seaweed suddenly begins proliferating in the region, "climate change is probably aggravating the problem," Hulot said.

Similar outbreaks have occurred in the Caribbean in recent years, often requiring officials to deploy the army to gather up the seaweed.   But officials then need to figure out what to do with it, since the fumes are so toxic that the algae cannot be used for producing biomass fuel, nor can it be turned into fertiliser.

Currently the only option is to spread it out across acres of isolated land until it fully decays and dries out.   This latest invasion comes as Guadeloupe, Martinique and other French islands are still rebuilding from devastating hurricanes that struck the Caribbean last September, causing millions of euros in damages.
Date: Tue, 19 Sep 2017 19:05:52 +0200

Pointe-à-Pitre, Sept 19, 2017 (AFP) - At least one person was killed as Hurricane Maria battered Guadeloupe, officials said Tuesday, in the first confirmed casualty from the huge storm sweeping the eastern Caribbean.     The person was killed by a falling tree, the local administration said, while two more were reported missing after their ship sank off Desirade, the easternmost island in the French territory's archipelago.   The dead person "did not respect orders to stay inside", authorities said in a statement, adding that "several floods have been signalled" around Pointe-a-Pitre, Guadeloupe's largest city.

Coastal areas around the capital Basse-Terre have also been "submerged".   "All of the archipelago's road networks have been affected by falling trees or branches," it said.   Little damage to buildings had been reported so far, though "some roofs have been ripped off".   Authorities said 40 percent of households in the territory of some 400,000 had no electricity, and 25 percent of landlines had been cut.   The US National Hurricane Center described Maria as "potentially catastrophic" as it pushed northwest towards the Virgin Islands and Puerto Rico.
Date: Wed 7 Jun 2017
From: Aubert Lyderic <lyderic.aubert@santepubliquefrance.fr> [edited]

Since May 2015, the French Caribbean territories experience an outbreak of viral conjunctivitis.

According to the general practitioners (GP) sentinel network, the number of medical consultations due to conjunctivitis during the last 2 weeks (W2017-20 and W2017-21) was estimated between 500 and 600 cases per week in Guadeloupe and 150 and 250 cases per week in Martinique.

The beginning of the outbreak in week 2017-20 [week 14 to 20 May 2017] was confirmed by the GP's network on the 2 territories. Their reports showed that the outbreak had spread in Guadeloupe Archipelago from Marie-Galante island and in Martinique, the center and the south of the island are currently the most affected areas. As of today [Wed 7 Jun 2017], around 35 percent of municipalities of the 2 territories do not report any case. The peak does not seem to have been reached.

In order to determine the etiology of this outbreak, biological samples were performed on conjunctiva and naso-pharynx from cases of conjunctivitis who consulted in emergency departments of the main public hospitals of both territories. The 1st analyses confirmed presence of enteroviruses with significant viral loads. Results from biological investigation of adenovirus are not yet known. Among the conjunctivitis specimens testing positive for enteroviruses, samples were sent to the National Reference Centre for Enteroviruses (Lyon, France) for further characterization.

Outbreaks of viral conjunctivitis occur mainly in tropical countries with high population density, hot and humid climate. They are mostly attributed to adenoviruses and enteroviruses (EV). Enteroviruses are ubiquitous pathogens responsible for a large range of infections. There is no specific antiviral treatment.

In the Caribbean and in the American region, several outbreaks of conjunctivitis have also been reported (Haiti, Dominican Republic, Mexico, French Guiana and Surinam) but the pathogen has not yet been identified.

The source of the week epidemiological bulletin (will be update soon at this link):
-----------------------------------
Aubert Lyderic
National Public Health Agency
Regional Office of French Caribbean Territories
lyderic.aubert@santepubliquefrance.fr
====================
[Conjunctivitis, also known as pinkeye, is an inflammation of the conjunctiva. The conjunctiva is the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid.

There are a number of different causes, including infectious agents such as Viruses (Adenoviruses, Enteroviruses), Bacteria (gonorrhea or chlamydia), or Allergies to dust, pollen, contact lenses.

Both viral and bacterial conjunctivitis are highly contagious. Each of these types of germs can spread from person to person in different ways. They are usually spread from an infected person to others through:
- close personal contact, such as touching or shaking hands
- the air by coughing and sneezing
- touching an object or surface with germs on it, then touching your eyes before washing your hands. <https://www.cdc.gov/conjunctivitis/about/transmission.html>.

Infectious conjunctivitis caused by some bacteria and viruses can spread easily from person to person, but is not a serious health risk if diagnosed promptly.

As confirmed by laboratory diagnosis in the above report, the causative agent for most of the tested cases was enteroviruses.

Most cases of viral conjunctivitis are mild. The infection will usually clear up in 7 to 14 days without treatment and without any long-term consequences. But in some cases, viral conjunctivitis can take 2 to 3 weeks or more to clear up. An antiviral medication can be prescribed to treat more serious forms of conjunctivitis for which there is a specific treatment, such as those caused by herpes simplex virus or varicella-zoster virus. Antibiotics will not improve viral conjunctivitis. - ProMED Mod.UBA]

[The HealthMap/ProMED maps can be found at:
Guadeloupe, Guadeloupe: <http://healthmap.org/promed/p/57615> and,
Martinique: <http://healthmap.org/promed/p/43638>. - ProMED Mod.MPP]
Date: Sat 8 Mar 2014
Source: European Centre for Disease Prevention and Control (ECDC), [edited]

Communicable Disease Threats Report (CDTR), week 10 (2-8 Mar 2014)
------------------------------------------------------------------
On 6 Dec 2013, France reported 2 laboratory-confirmed autochthonous cases of chikungunya in the French part of the Caribbean island of St Martin. Since then, local transmission has been confirmed in the Dutch part of Saint Martin [St Maarten], on Martinique, St Barthelemy, Guadeloupe, British Virgin Islands, Dominica, Anguilla, and French Guiana. Aruba only reported imported cases. This is the 1st documented outbreak of chikungunya with autochthonous transmission in the Americas. As of 6 Mar 2014, there have been close to 8000 suspected cases in the region. There have been 3 fatalities reported.

Update of the week
------------------
During the past week the number of new cases reported increased in some of the affected areas. No new affected areas or islands were reported. The islands affected are St Martin/St Maarten, Martinique, St Barthelemy, Guadeloupe, Virgin Islands (UK), Anguilla, Dominica, Aruba, Saint Kitts and Nevis, and French Guiana in mainland South America.
===================
[It is good to learn that there are no new localities reporting chikungunya virus infections, either locally acquired or imported. However, with new cases being reported in localities with previously reported cases, the risk of spread to other islands or mainland countries remains real. There is no further information concerning the suspected cases in Merida, Yucatan, Mexico reported in last week's update (see ProMED-mail archive no 20140302.2309812). It is important to know if these cases were confirmed or discarded.

Maps showing the location of the islands mentioned can be accessed at
Date: 3-9 Feb 2014
Source: Pointe Epidemiologique No. 6. French Caribbean Antilles [in French, trans. ProMed Mod.TY, summarized, edited]

Cases since November 2013:
  • St. Martin (susp.) 1450 cases, (probable and conf.) 653 cases.
  • St. Barthelemy (susp.) 270 cases, (probable and conf.) 104 cases
  • Martinique (susp.) 2040 cases, (probable and conf.) 844 cases; increasing
  • Guadeloupe (susp.) 1120 cases, (probable and conf.) 253 cases.

[Weekly graphs and maps for these case locations are provided in the above URL. ProMed Mod.TY]

Other Caribbean localities:
  • British Virgin Islands 6 locally acquired cases
  • St. Maarten 65 locally acquired cases
  • Anguilla 5 locally acquired cases, 1 imported case
  • Dominica 3 locally acquire cases, 1 imported case
  • Aruba 1 imported case from St. Maarten.
More ...

Virgin Islands

British Virgin Islands US Consular Information Sheet
April 03, 2006
COUNTRY DESCRIPTION: The British Virgin Islands (BVI) are a British overseas territory, part of the British West Indies, lying about 60 miles east of Puerto Rico. There are abo
t 50 islands in the BVI, many of them uninhabited. Tortola is the main island; other islands include Virgin Gorda, Jost Van Dyke, and Anegada. Tourist facilities are widely available.
ENTRY/EXIT REQUIREMENTS: For tourist stays of up to six months, U.S. citizens need a valid U.S. passport or other proof of U.S. citizenship (original or certified birth certificate, Certificate of Naturalization or Certificate of Citizenship as well as photo identification), onward or return tickets, and sufficient funds for their stay. Upon initial entry, no more than 60 days will be granted. At the end of 60 days, visitors must report to the Immigration Department's main office in Road Town for an extension. Extensions of up to 90 days are issued at the discretion of the Immigration Officer subsequent to an interview. For further information on travel to the British Virgin Islands, travelers should contact the BVI Department of Immigration at 1-284-494-3471. Visit the Embassy of the British Government web site at for the most current visa information.
See Entry and Exit Requirements for more information pertaining to dual nationality and the international child abduction . Please refer to our Customs Information to learn more about customs regulations.

SAFETY AND SECURITY For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site, where the current Travel Warnings and Public Announcements , including the Worldwide Caution Public Announcement , 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., 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: Thefts and armed robberies do occur in the BVI. Visitors should take common-sense precautions against petty crime. Avoid carrying large amounts of cash and use hotel safety deposit facilities to safeguard valuables and travel documents. Do not leave valuables unattended on the beach or in cars. Always lock up boats when going ashore.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in the British Virgin Islands consists of a small general hospital with an emergency room staffed 24-hrs/day by physicians, several clinics on Tortola, and one clinic in Virgin Gorda. Ambulances staffed with paramedics serve both islands. There are no medical facilities on the other islands. A volunteer organization, Virgin Islands Search and Rescue (VISAR), responds 24-hrs/day to medical emergencies at sea or on outer islands. VISAR transports casualties to the nearest point for transfer to ambulance. To reach VISAR, dial SOS (767) or call on Marine Channel 16.
There is no hyperbaric chamber in the BVI. Patients requiring treatment for decompression illness are transferred to St. John, U.S. Virgin Islands. Most sensitive medical cases are transferred to San Juan, Puerto Rico.
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 internet site at . For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at . Further health information for travelers is available at .
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the British Virgin Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Vehicles drive on the left (the British side) with most steering wheels on the left (the "American" side). Road signs are limited and seatbelts are required by law. Drivers often fail to yield the right-of-way to pedestrians, even at painted crosswalks. Speeding and reckless driving are fairly common in the BVI. Drivers can encounter nighttime drag racing on main thoroughfares and livestock on roads. Roads in Tortola's interior can be steep and extremely slippery when wet. Travelers planning to drive across the island should consider requesting four-wheel drive vehicles and should ensure that tires and brakes are in good operating condition on any rental vehicle. Please refer to our Road Safety page for more information, as well as the website of the BVI's national tourist office and national authority responsible for road safety at
.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of the British Virgin Islands as being in compliance with ICAO international aviation safety standards for oversight of BVI's air carrier operations. For more information, travelers may visit the FAA's Internet web site at .
CUSTOMS REGULATIONS: BVI customs authorities may enforce strict regulations concerning temporary importation into or export from the British Virgin Islands of items such as drugs and firearms. Visitors to BVI carrying firearms must declare them upon entry into any port in the territory. Firearms must be bonded and are held by the proper authorities until time of departure. Contact BVI Customs & Immigration at 1-284-494-3475, the Embassy of the United Kingdom in Washington, D.C. or one of the UK's consulates in the United States for specific information regarding customs requirements. Please see our 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 British Virgin Island laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the BVI are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties .
DISASTER PREPAREDNESS: All Caribbean countries can be affected by hurricanes. The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA).
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children's Issues website.
REGISTRATION/EMBASSY AND CONSULATE LOCATIONS: Americans living or traveling in the British Virgin Islands are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website , and to obtain updated information on travel and security within the BVI. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The nearest U.S. Embassy to the BVI is located in Bridgetown, Barbados. The Consular Section is located in the American Life Insurance Company (ALICO) Building, Cheapside, telephone 1-246-431-0225 or fax 1-246-431-0179, email ConsularBridge2@state.gov , or . The U.S. Consular Agent in Antigua, located at Jasmine court, St. John's, tel. 1-268-463-6531, is closer to the BVI and can also assist in some limited non-emergency cases, by previous appointment only.
****
This replaces the British Virgin Islands Consular Information Sheet dated April 26, 2005 to update all sections.

Travel News Headlines WORLD NEWS

Date: Thu 19 Sep 2019
Source: Emerg Infect Dis [edited]

Citation:
Guendel I, Ekpo LL, Hinkle MK, Harrison CJ, Blaney DD, et al.: Melioidosis after Hurricanes Irma and Maria, St. Thomas/St. John District, US Virgin Islands, October 2017. Emerg Infect Dis. 2019; 25(10): 1952-1955. doi: 10.3201/eid2510.180959.

Melioidosis is caused by _Burkholderia pseudomallei_, a saprophytic, gram-negative bacillus endemic to tropical regions worldwide (1). Diagnosis is difficult because of wide-ranging clinical manifestations (2), and this bacterium is innately resistant to many antimicrobial drugs, making treatment options limited, complex, and lengthy (3). Infection occurs by percutaneous exposure, inhalation, or ingestion.

Melioidosis is rare in the USA, and cases are usually travel related (4,5). However, regional endemicity has been documented in Puerto Rico (6), and sporadic human cases have been reported in the Caribbean (5,7). In September 2017, the US Virgin Islands were affected by 2 category 5 hurricanes, Irma and Maria; widespread flooding continued for weeks. We describe the clinical manifestations, management, and outcome of post-hurricane melioidosis cases in 2 women in St. Thomas and St. John, US Virgin Islands.

The study
Despite major damage to the 2 hospitals in the territory during the 2 hurricanes, the Virgin Islands Department of Health (VIDOH) maintained surveillance at both emergency departments. Two isolates were recovered from each patient. Local specimen analysis for organism identification was performed by using the MicroScan WalkAway System (Siemens Healthcare Diagnostics, <https://www.siemens-healthineers.com>). All isolates were confirmed as _B. pseudomallei_ at the CDC. Whole-genome sequencing and single-nucleotide polymorphism analysis were performed (National Center for Biotechnology Information, <https://www.ncbi.nlm.nih.gov>. Genomes from a given patient were clonal to each other. However, representative genomes from both patients had differences (greater than 5600 single-nucleotide polymorphisms), indicating the presence of different strains in these infections. Genomic comparison with a reference panel indicated that the isolates were within the previously described Western Hemisphere clade and subclade associated with the Caribbean (8).

Patient 1 was an 80-year-old female resident of St. Thomas who had a history of cardiomyopathy and type II diabetes mellitus. She came to the emergency department (ED) at Schneider Regional Medical Center (St. Thomas, US Virgin Islands) because of shortness of breath (symptom onset 28 days after Hurricane Irma and 9 days after Hurricane Maria). Her symptoms were worsened orthopnea, increased abdominal girth, and edema, consistent with her symptoms at previous admissions. The patient was admitted for management of acute decompensated heart failure.

The patient had a temperature of 98.5 deg F [36.9 deg C]; diffuse pulmonary crackles; jugular venous distension; normal heart sounds; and bilateral, lower extremity pitting edema. Examination showed a focal area on the anterior left thigh that had a central, firm, warm, erythematous, tender, subcutaneous nodule about 2 cm [approximately 0.8 in] in diameter with a central fluctuant area and a small pinhole. Incision and drainage was performed, and a swab specimen of purulent drainage was sent for culture.

The patient was given intravenous clindamycin (600 mg every 8 h for 5 d) and was discharged while receiving oral clindamycin, but the treatment course was not completed. Cultured wound showed growth of _B. pseudomallei_ at 5 days. However, culture growth was not yet positive before patient discharge. The isolate was susceptible to trimethoprim/sulfamethoxazole (Table 1 [for Tables and Figure, see original URL - ProMED Mod.LL]).

Patient 1 returned to the ED 2 weeks later because of manifestations similar to those at the 1st visit. She was afebrile and admitted for diuresis. The left thigh lesion had progressed into a 2 cm [about 0.8 in], tender, shallow ulcer productive of purulent material surrounded by erythema and a focal area of induration (Figure). Laboratory data reflected a leukocyte count within reference ranges and mild renal insufficiency with estimated glomerular filtration rate of 40.47 mL/min (Table 2). A 2nd wound culture was collected, and the patient was given intravenous meropenem (1 g every 8 h). Culture was presumptively positive for _B. pseudomallei_ and _Serratia marcescens_ after 48 hours, confirmed after 8 days. Both isolates showed the same resistance pattern and were susceptible to meropenem and trimethoprim/sulfamethoxazole: the MIC for meropenem was <1 microgram/mL (Table 2). Meropenem was continued for 8 days, and ulcer improvement was observed. The patient was discharged while receiving oral trimethoprim/sulfamethoxazole (800 mg/160 mg 2x/d) to complete maintenance therapy. The patient completed a 3-month course of trimethoprim/sulfamethoxazole and achieved resolution.

Patient 2 was a 60-year-old female who had diabetes and was a resident of St. John. She was referred to the ED at Schneider Regional Medical Center by her primary care physician because of hyperglycemia, productive cough, and malaise for one week (symptom onset 46 days after Hurricane Irma and 33 days after Hurricane Maria). The patient was admitted to the intensive care unit because of community-acquired pneumonia.

The patient was lethargic and had a temperature of 101 deg F [38.3 deg C]; heart rate was 99 beats/min, respiratory rate 22 breaths/min, and blood pressure 142/81 mm Hg. Blood gas testing showed pO2 of 47.6 mm Hg with an oxygen saturation of 87.2% on 2-liter nasal cannula. A chest radiograph showed a left-sided mild infiltrate, and her leukocyte count was markedly increased (28 300 cells/mm3) (Table 2).

The patient was given intravenous ceftriaxone (1 g/d) and azithromycin (500 mg/d) after blood and sputum cultures were prepared. She required bilevel positive airway pressure but eventually required mechanical ventilation. The patient then became hypotensive and required norepinephrine to maintain a main arterial pressure greater than 65 mm Hg. Ceftriaxone was discontinued, and she was given intravenous piperacillin/tazobactam (3.375 g every 6 h). Trimethoprim/sulfamethoxazole- and ceftazidime-sensitive _B. pseudomallei_ were identified from sputum culture after 72 hours (Table 1). Methicillin-sensitive _Staphylococcus aureus_ and _Candida glabrata_ were also identified. One of 2 blood cultures was positive for gram-negative rods. Piperacillin/tazobactam was discontinued, and the patient was given meropenem (1 g every 8 h).

The patient remained critically ill and was transferred to a tertiary-care hospital in the continental USA. She died in a long-term care facility during October 2018 without showing signs of neurologic improvement.

Isolates from both patients showed susceptibility to routinely tested antimicrobial drugs (10,11). Isolates from patient 1 showed resistance to ceftazidime during preliminary analysis (Table 1). However, broth microdilution confirmatory testing performed at CDC indicated ceftazidime susceptibility, highlighting the need for additional antimicrobial resistance confirmation.

Both patients were interviewed to determine travel history and possible exposure sources. Patient 1 traveled occasionally to the southeastern USA; her last travel date was 3 months before her illness. This patient reported flooding and water damage to her home from the hurricanes but did not report contact with flood waters. Patient 2 reported no travel history before the hurricanes.

VIDOH has investigated and confirmed a subsequent case-patient with pulmonary melioidosis in St. Thomas during December 2018 (I. Guendel et al., unpub. data). This case-patient reported no recent travel and might have had occupational exposure as a professional gardener. This person had 2 risk factors (type II diabetes mellitus and heavy use of alcohol).

Conclusions
Given regional occurrence, detection of melioidosis in the US Virgin Islands is not surprising. Furthermore, emergence of melioidosis after extreme weather events has been well documented, and cases were likely acquired locally from storm-related exposure to flooded soil, surface water runoff, or generation of coarse aerosols (12,13). Although detection of _B. pseudomallei_ has yet to be confirmed in the environment, it might be endemic to the US Virgin Islands, as in Puerto Rico.

In January 2018, melioidosis was listed as a reportable disease in the US Virgin Islands. Future actions include disease education efforts for physicians and laboratory staff because misdiagnosis is common (14). Awareness campaigns highlighting preventive measures for the public are necessary because risk factors are prevalent in the local population (e.g., diabetes and other chronic disease) and might be exacerbated under disaster settings (e.g., respiratory effects and open wounds). VIDOH has implemented rapid diagnostic testing by using Active Melioidosis Detect (InBios International, <https://inbios.com>) on suspected specimens for prompt on-island case identification while routine ED diagnostic cultures are performed (5). All confirmatory testing is conducted at CDC.

References
-------
On Request
======================
[This infection is found primarily in southeast Asia and the Northern Territory of Australia. Despite this, cases of melioidosis have been acquired in other parts of the world including the Americas. Flooding from the increasing number of severe tropical storms related to climate change is increasing.

Melioidosis is a disease of the rainy season in its endemic areas. It mainly affects people who have direct contact with soil and water. Many have an underlying predisposing condition such as diabetes (most common risk factor), renal disease, cirrhosis, thalassemia, alcohol dependence, immunosuppressive therapy, chronic obstructive lung disease, cystic fibrosis, and excess kava consumption (kava is an herbal member of the pepper family that can be associated with chronic liver disease).

Melioidosis may present at any age but peaks in the 4th and 5th decades of life, affecting men more than women. In addition, although severe fulminating infection can and does occur in healthy individuals, severe disease and fatalities are much less common in those without risk factors.

The most commonly recognized presentation of melioidosis is pneumonia, associated with high fever, significant muscle aches, and chest pain, and -- although the cough can be nonproductive -- respiratory secretions can be purulent, significant in quantity, and associated with on-and-off bright red blood. The lung infection can be rapidly fatal -- with bacteremia and shock -- or somewhat more indolent.

Acute melioidosis septicaemia is the most severe complication of the infection. It presents as a typical sepsis syndrome with hypotension, high cardiac output, and low systemic vascular resistance. In many cases, a primary focus in the soft tissues or lung can be found. The syndrome, usually in patients with risk factor comorbidities, is characteristically associated with multiple abscesses involving the cutaneous tissues, lung, liver, and spleen, and a very high mortality rate of 80-95%. With prompt optimal therapy, the case fatality rate can be decreased to 40-50%.

The melioidosis bacillus is intrinsically insensitive to many antimicrobials, and in fact, bioterrorism strains may be engineered to be even more resistant. _Burkholderia pseudomallei_ is usually inhibited by tetracyclines, chloramphenicol, trimethoprim-sulfamethoxazole (SXT), antipseudomonal penicillins, carbapenems, ceftazidime, and amoxicillin/clavulanate or ampicillin/sulbactam. Ceftriaxone and cefotaxime have good in vitro activity but poor efficacy, and cefepime did not appear, as well, to be equivalent to ceftazidime in a mouse model. The unusual antimicrobial profile of resistance to colistin and polymyxin B and the aminoglycosides but sensitivity to amoxicillin/clavulanate is a useful tool to consider in treatment of infection with the organism.

The randomized and quasi-randomized trials comparing melioidosis treatment have been reviewed, and it was found that the formerly standard therapy of chloramphenicol, doxycycline, and SXT combination had a higher mortality rate than therapy with ceftazidime, imipenem/cilastatin, or amoxicillin/clavulanate (or ampicillin/sulbactam). The betalactam-betalactamase inhibitor therapy, however, seemed to have a higher failure rate.

Source: Tolaney P, Lutwick LI: Melioidosis. In: Lutwick LI, Lutwick SM (eds). Bioterror: the Weaponization of Infectious Diseases. Totowa NJ: Humana Press, 2008. pp 145-58. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
US Virgin Islands: <http://healthmap.org/promed/p/479>]
Date: Fri 31 Jan 2014
Source NBC News [edited]

The Explorer of the Seas outbreak was caused by norovirus, one of the worst outbreaks in 20 years, the Centers for Disease Control and Prevention (CDC) said. The Explorer of the Seas cruise ship returned to port after hundreds of passengers became ill. Federal health officials confirmed on Friday [31 Jan 2014] that norovirus was the culprit that sickened nearly 700 people on a cruise ship this week, and said it was one of the biggest norovirus outbreaks in 20 years. But the source of the outbreak on the Royal Caribbean ship Explorer of the Seas, which returned early to New Jersey on Wednesday [29 Jan 2014], may never be known, CDC said: "CDC has been investigating the outbreak since last Sunday [26 Jan 2014] but no particular source has been identified and it's quite possible a source won't be identified."

The report comes after passengers streamed off the Caribbean Princess on Friday morning [31 Jan 2014], the 2nd cruise cut short this week amid reports of illness on board. The ship, operated by Princess Cruises, returned to Houston [Texas] a day early with a confirmed outbreak of norovirus. "The ship was forced to return to Houston one day early because we were informed that dense fog was expected to close the port for much of the weekend," the company said in a statement. "The ship did not return early because of the increased incidence of norovirus on board, despite some media reports."

At least 178 people on board became ill during the cruise, according to the cruise line and CDC. Sick patients were quarantined to their rooms, and other passengers said they no longer had access to buffet tongs as crew members handed out hand sanitiser. CDC health officials met the Caribbean Princess at the Bayport Cruise Terminal in Pasadena, Texas. The vessel launched on a 7-day cruise to the western Caribbean on [25 Jan 2014] and had been scheduled to return on Saturday [1 Feb 2014]. Princess Cruises said the outbreak was over by the time the ship returned to Houston. "As a result of our actions, case numbers declined significantly and by the end of the cruise there were no passengers with active symptoms," the company said. "Over the course of the cruise 178 passengers (5.7 per cent) and 11 crew (1 per cent) reported ill to the Medical Center."

CDC officials also helped Royal Caribbean clean up the Explorer of the Seas, and said it had been approved to go back out again with a new batch of passengers Friday afternoon [31 Jan 2014]. Royal Caribbean officials say they cleaned the ship, which carried more than 3000 passengers, 3 times. It's the 3rd cruise ship outbreak to occur this year [2014]. A Norwegian Cruise Line ship, the Norwegian Star, reported that 130 passengers and 12 crew members became ill on 2-week cruise that launched [5 Jan 2014] from Miami.

About 20 million passengers take cruises in the US each year, fuelling a USD 37.8 billion annual industry, according to the American Association of Port Authorities. There were 9 vessel outbreaks in 2013 and 16 in 2012, according to the CDC. Norovirus is a common culprit in outbreaks on cruise ships, in nursing homes, and other confined places. It is a fast-moving gut bug typically spread by infected people or contaminated food or water. Norovirus is the most common cause of acute gastroenteritis in the US, resulting in about 21 million illnesses, between 56 000 and 71 000 hospitalizations and as many as 800 deaths, CDC says.

The virus lingers on surfaces and spreads very easily. Thorough hand washing with hot water and soap and meticulous environmental cleaning can help stop the spread. CDC says it's the season for norovirus. "Norovirus outbreaks wit high attack rates are common during this time of year," the agency said. "Most outbreaks occur between January and April."   [byline: Maggie Fox]
*****
Date: Wed 29 Jan 2014
Source: NBC News [edited]

Beleaguered passengers finally fled a Royal Caribbean cruise ship on Wednesday [29 Jan 2014] after a 10-day vacation cut short by a nasty gut bug that sickened nearly 700 people. One woman aboard the Explorer of the Seas yelled, "We made it!" as the ship docked in Bayonne [New Jersey], 2 days ahead of schedule. Other passengers stood on deck wrapped in blankets to watch the ship pull in. One person was removed from the Explorer of the Seas on a stretcher and taken away by ambulance. Others walked under their own power after the vessel arrived. Several passengers recounted a week full of tension and drama, but also professionalism and care from the cruise line crew.

Still, the ordeal on the 1020-foot ship -- whose relaxing voyage to the US Virgin Islands was thwarted by suspected norovirus -- may linger a little longer for people still showing signs of the fast-moving infection, health officials said. "We have passengers who are still exhibiting active disease," said Burnadette Burden, a spokeswoman for the Centers for Disease Control and Prevention. People who are still sick may be too ill to travel home -- and too contagious to use public transportation like trains and buses, health experts say. Royal Caribbean officials said Wednesday [29 Jan 2014] that they'd pay for hotels or make sure that ill passengers get additional medical care. "Should a guest feel sick enough that they want to go to the hospital, we will arrange for transportation," Royal Caribbean spokeswoman Cynthia Martinez said in an email. "We will work with the small number of guests that still feel ill to make them as comfortable as possible."

At least 630 of the ship's 3071 passengers and at least 54 of the 1166 crew members came down with diarrhea and vomiting -- classic signs of norovirus. Most of the cases occurred early in the cruise, which left New Jersey on [21 Jan 2014], and many passengers had already recovered. It's hard to say that the outbreak was the worst on record because of inconsistencies in record-keeping. But it's a bad one, Burden said. "It would be fair to say this is one of the largest numbers in the last 20 years or so," she said. One of the closest outbreaks to compare occurred in 2006, when a Carnival Cruise ship, the Carnival Liberty, was hit with an outbreak of norovirus that sickened 679 passengers and crew on a November trip to the US Virgin Islands.

CDC officials have not confirmed that norovirus is the culprit on the Explorer of the Seas, though it's a common cause of illness on cruise ships. Officials said testing was delayed by a treacherous winter snowstorm that closed the agency's Atlanta headquarters and results aren't expected until Friday [31 Jan 2014]. But if it is the germ, it's highly contagious for the one to 2 days when people are actively sick -- and for a few days afterward. The virus actually lingers in people's stool for 2 weeks or more, according to the CDC. That means that anyone who fell ill -- and those who were around them -- should pay extra attention to washing their hands and other kinds of cleanliness, said Dr Ruth Lynfield, outgoing head of the public health committee of the Infectious Diseases Society of America.

Cleanliness will be the key for the cruise line, too. Officials said they plan another scrub, a so-called "barrier sanitation" program to ensure that any remaining traces of illness are removed from the ship. Norovirus is a notoriously difficult bug to eradicate, health experts say. "It will be the 3rd aggressive sanitizing procedure the ship has undertaken since we became aware of the issue, and will additionally provide a window of more than 24 hours where there are no persons aboard the ship," officials said in a statement.   [byline: JoNel Aleccia]
******
Date: Fri 31 Jan 2014
Source: CDC, National Center for Environmental Health, Division of
Emergency and Environmental Health Services, Vessel Sanitation Program (VSP) [edited]

Cruise ship: Explorer of the Seas -- voyage dates: 21-31 Jan 2014
-----------------------------------------------------------------
- number of passengers who reported being ill during the voyage out of total number of passengers onboard: 634 of 3071 (20.6 per cent)
- number of crew who reported being ill during the voyage out of total number of crew onboard: 55 of 1166 (4.7 per cent)
- predominant symptoms: vomiting, diarrhea
- Causative agent: Norovirus

Actions: in response to the outbreak, Royal Caribbean Cruise Line and the crew aboard the ship took the following actions:
- increasing cleaning and disinfection procedures according to their outbreak prevention and response plan;
- making announcements to both notify onboard passengers of the outbreak and encourage case reporting;
- collecting stool specimens from ill passengers and crew for submission to the CDC lab;
- making multiple daily reports of gastrointestinal illness cases to the VSP [Vessel Sanitation Program];
- preparing additional crew members to join the ship mid-voyage to assist with case management and intensified sanitation procedures;
- consulting with CDC on plans for: passenger notification procedures and the planned delayed embarkation schedule in Bayonne, NJ on [31 Jan 2014], and disembarkation plans for active cases, terminal, and transport infection control procedures.

One CDC Vessel Sanitation Program epidemiologist, one contract epidemiologist, and one VSP environmental health officer boarded the ship in St Thomas, [US Virgin Islands] and are sailing on the ship as it travels back to port in New Jersey. This team is conducting an epidemiologic investigation, environmental health assessment, and evaluating the outbreak and response activities on board. One additional CDC Vessel Sanitation Program environmental health officer will board the ship upon arrival on [29 Jan 2014] to assist with the evaluation of the disinfection process. The team will continue the investigation and evaluation on the ship thru the boarding of new passengers for the next voyage. 5 clinical specimens were shipped to the CDC lab for testing on [26 Jan 2014].
**************************
Date: Fri 31 Jan 2014
Source: CDC, National Center for Environmental Health, Division of
Emergency and Environmental Health Services, Vessel Sanitation Program (VSP) [edited]

Cruise ship: Caribbean Princess -- voyage dates: 25 Jan-1 Feb 2014
------------------------------------------------------------------
- number of passengers who reported being ill during the voyage out of total number of passengers onboard: 181 of 3102 (5.8 per cent)
- number of crew who reported being ill during the voyage out of total number of crew onboard: 11 of 1148 (0.96 per cent)
- predominant symptoms: vomiting, diarrhea
- causative agent: Norovirus

Actions: in response to the outbreak, Princess Cruise Lines and the crew aboard the ship took the following actions:
- increasing cleaning and disinfection procedures according to their outbreak prevention and response plan;
- making announcements to both notify onboard passengers of the outbreak and encourage case reporting;
- collecting stool specimens from ill passengers and crew for submission to the CDC lab. Samples tested with the vessel's onboard rapid norovirus test were positive for norovirus. The specimens will be sent to the CDC lab for confirmatory analysis;
- making multiple daily reports of gastrointestinal illness cases to the VSP;
- consulting with CDC on plans for: passenger notification procedures and the planned delayed embarkation schedule in Houston, TX on [1 Feb 2014], and disembarkation plans for active cases, and terminal and transport infection control procedures.

Two CDC Vessel Sanitation Program environmental health officers will board the ship in Houston, TX on [31 Jan and 1 Feb 2014] to conduct an epidemiologic investigation, environmental health assessment, and evaluate the outbreak and response activities. Specimens are being collected and will be sent to the CDC lab for testing.
=====================
[ProMED-mail does not normally report outbreaks of norovirus-related gastroenteritis because of their ubiquity during the winter months. (Hence the alternate designation 'winter vomiting bug'). Norovirus infection is very contagious and can be contracted from an infected person, contaminated food or water, or by touching contaminated surfaces. The virus causes acute gastroenteritis with stomach pain, nausea, and diarrhea and vomiting. Anyone can be infected with norovirus and acquire norovirus illness repeatedly throughout life. Norovirus is the commonest cause of acute gastroenteritis in the United States. Each year, it causes 19-21 million cases and contributes to 56 000-71 000 hospitalizations and 570-800 deaths. Norovirus is also the commonest cause of foodborne disease outbreaks in the United States. There's no vaccine to prevent norovirus infection and no drug to treat it.

Norovirus illness is usually not serious. Most people get better in 1 to 3 days. But norovirus illness can be serious in young children, the elderly, and people with other health conditions. It can lead to severe dehydration, hospitalisation but rarely death. Most outbreaks of norovirus illness happen when infected people spread the virus to others. But, norovirus can also spread by consumption of contaminated food or water and by touching contaminated surfaces.

Health care facilities, including nursing homes and hospitals, are the most commonly reported places for norovirus outbreaks in the United States. Over half of all norovirus outbreaks reported in the United States occur in long-term care facilities. Outbreaks of norovirus illness appear to be occurring more frequently in cruise ships and similar environments. - ProMed Mod.CP]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/r/8vcv>.]
Date: Tue 13 Dec 2011
Source: Virgin Islands Daily News [edited]

The Centers for Disease Control and Prevention [CDC] has linked 5 past cases of Legionnaires' disease -- reported between March 2010 and August 2011 -- with stays at Marriott's Frenchman's Reef and Morning Star Beach Resort and Marriott's Frenchman's Cove [in Saint Thomas], prompting remediation work to the resorts' water systems. The VI [Virgin Islands] Health Department has been "working closely" with a team of CDC specialists to monitor the remediation efforts at the resorts, after an investigation into the 5 past cases, according to a statement the Health Department released Monday [12 Dec 2012].

The illness was found in stateside residents who had been guests at the resorts, said Health Department spokeswoman Eunice Bedminster. They required hospitalization but have since recovered, she said. There have been no reports of employees affected at either site, according to the Health Department statement.

The statement indicates that Frenchman's Reef and Morningstar Beach Resort has hired a consultant who led a cleaning project of the affected areas and treated the water system. Test results show no existence of _Legionella_ bacteria, although the Health Department statement said the test results have not yet been evaluated independently by the CDC.

The Health [Department] had asked the resorts to notify those who could potentially be affected by the bacteria: guests and employees, Bedminster said. The properties asked for an extension on a deadline that had been set, and it was granted, but the deadlines passed last week [week of 5 Dec 2011] without the notification to guests and employees going out, Bedminster said. She did not know if, after the deadline, the properties had made the requested notifications, she said.

The hotel provided The Daily News with a written statement that did not address guest notification: "Marriott takes hotel hygiene and cleanliness very seriously. As soon as we were notified of the possibility of the presence of _Legionella_ bacteria we immediately began to work with the USVI Department of Health (DOH) to address the situation. The Frenchman's Reef and Morning Star Beach Resorts hired a consultant who led a cleaning project of affected areas and the treatment of the water system. The latest test results taken after the implementation of these measures show no existence of _Legionella_ bacteria in the samples tested. We have complied with the recommendations provided by the DOH, and we have successfully addressed the issue at the resort. The DOH has allowed the hotel to remain fully open for business and welcome our guests."

The Daily News spoke with Marriott Frenchman's Reef and Morning Star Beach Resort General Manager Jose Gonzalez Espinosa by phone and asked for comment on the Health Department's assertion that the resort did not make the notifications it was supposed to make by the deadline. Gonzalez would not answer the questions unless they were in writing. The Daily News has a policy against submitting questions in writing because written Q and A stifles and slows follow-up and response. The resort underwent a major renovation during the summer, closing 3 May 2011 and reopening on 6 Oct 2011.

Legionnaires' disease is a pneumonia caused by the _Legionella_ bacteria, which live in warm water supplies, said Dr Lauri Hicks, a medical epidemiologist with the CDC. The bacteria that cause the disease do not pass from person to person. "It really requires exposure to water aerosol that contains _Legionella_," she said, Exposure may occur from showering or with time spent in a whirlpool or hot tub where the bacteria that lead to Legionnaires' disease are present, Hicks said.

Only a fraction of people -- typically those with certain risk factors, such as compromised immune systems -- exposed to the bacteria become ill, she said.

According to the Health Department statement, from 2000 through 2009, a total of 22 418 cases of legionellosis were reported to CDC from the 50 states and the District of Columbia. The CDC informed the Health Department in October [2011] of the 5 Legionnaires' disease cases among past guests at the resorts, and the Health Department asked for the agency's help in investigating. From 18 to 22 Oct 2011, CDC specialists conducted testing, and the properties were alerted about the possible _Legionella_ contamination, Bedminster said. On 3 Nov 2011, the Health Department notified each property of the CDC's conclusive findings and ordered them to immediately work on their water systems, including cleansing, superheating, chlorinating, and hiring a private consultant experienced in eliminating _Legionella_ from building water systems, according to the release. More than 6 weeks later, the Health Department notified the public with the statement it released Monday [12 Dec 2011].

Bedminster said that there had been no delay -- and that remediation work began immediately. "We have worked in good faith with both the resorts during what I have said was a monitoring process. We had some agreed-upon deadlines that had not been met, so we had to let the public know," she said.

Bedminster said that Health Department officials had discussed the possibility of enforcement actions with the Department of Labor and the Department of Planning and Natural Resources to get those deadlines met, but she did not know the outcome of the discussions. "Safeguarding the public's health, including that of employees and guests, from exposure and threats are of the utmost importance to the Department of Health," acting Health Commissioner Mercedes Dullum said in the prepared statement. "DOH will continue to monitor this situation with assistance from the CDC. People should not be discouraged from traveling to or within the US Virgin Islands."  [Byline: Joy Blackburn]
---------------------------------------------
Communicated by:
Denis Green
denis@gatesit.com.au
=======================
[The following has been extracted from the US CDC document Travel-Associated Legionnaires' Disease (<http://www.cdc.gov/legionella/faq.htm>):

"About 20-25 percent of all Legionnaires' disease reported to CDC is travel-associated. Legionnaires' disease is important to diagnose and to report because its identification implies the presence of an environmental source to which other susceptible individuals are likely to be exposed. Clusters of Legionnaires' disease associated with travel to hotels or aboard cruise ships are rarely detected by individual clinicians or health departments; travelers typically disperse from the source of infection before developing symptoms. Therefore, a travel history should be actively sought from patients with community-acquired pneumonia and _Legionella_ testing should be performed for those who have traveled in the 2 weeks before onset of symptoms.

"_Because of the multi-state nature of travel in the US, national-level surveillance is necessary to detect outbreaks of travel-associated Legionnaires' disease. CDC relies upon state and local health departments to conduct this surveillance. Surveillance through the National Notifiable Diseases Surveillance System (NNDSS) is still important for monitoring national trends; all cases should be reported through NNDSS."

"Because of the public health importance of timely reporting, inform CDC of travel-associated cases by emailing about the patient's movements in the 2-10 days before onset."

"Environmental sampling/testing should only be conducted after careful consideration of the epidemiologic evidence linking a case(s) to a particular location."

The following article is linked to the CDC document: Barbaree JM, et al: Protocol for Sampling Environmental Sites for Legionellae. Applied Environmental Microbiol 1987; 53(7): 1454-8 (<http://www.cdc.gov/legionella/files/sampling_protocol1987.pdf>): "Since legionellae not related to disease may be found in many of the sites sampled, an epidemiologic association with the probable source should be established before intervention methods, such as disinfection, are undertaken."

"Random sampling without an epidemiologic evaluation and comparing isolates from the environment and from patients could lead to false conclusions about sources of epidemic strains."

Potential environmental sampling sites for _Legionella_ spp that the CDC document suggests include: internal surfaces of faucets, aerators, and shower heads; and water from incoming water main, holding tanks and cisterns, water heater tanks, decorative fountains, irrigation equipment, fire sprinkler system (if recently used), whirlpools, and spas. Because _Legionella_ may be found in water supplies without linkage to any cases, the actual causative source should be demonstrated by matching the genotype of the environmental isolates with that of any clinical isolates to assure frequently costly corrective measures are carried out on the actual source (<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC86783/>; and <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730281/>).

The Virgin Islands are located in the Leeward Islands of the Lesser Antilles, which form the border between the Caribbean Sea and the Atlantic Ocean. Politically, the eastern islands form the British Virgin Islands and the western ones form the United States Virgin Islands. The US Virgin Islands consist of the main islands of Saint Croix, Saint John, and Saint Thomas (<http://en.wikipedia.org/wiki/United_States_Virgin_Islands >). They can be seen on the HealthMap/ProMED-mail interactive map at <http://healthmap.org/r/1xng>. - ProMed Mod.ML]
Date: Sat 18 Sep 2010
Source: Virgin Islands Daily News [edited]
<http://virginislandsdailynews.com/dengue-outbreak-confirmed-in-1.1018284>

After 19 cases of suspected dengue fever -- and at least one death -- reported in the St Thomas-St John District, the VI Health Department issued a statement Friday [17 Sep 2010] saying that the district is experiencing a dengue fever outbreak. According to the Health Department statement released [Fri 17 Sep 2010], 9 of the 19 suspected cases have been laboratory-confirmed as dengue fever in the St Thomas-St John District since June [2010]. On St Croix, there have been 4 suspected cases with no confirmed cases. There is no requirement in the territory that people with suspected dengue fever undergo testing to confirm whether or not they have the mosquito-borne virus, said Health Department epidemiologist Eugene Tull.

His experience with a 2005 outbreak on St Croix leads him to believe that the number of dengue cases this year [2010] is higher than reported, Tull said, adding that he is now receiving anecdotal information about more cases in the community. According to the release, the strain causing the current outbreak is [dengue virus] type 2, which was responsible for the 2005 outbreak on St Croix.
================
[An interactive HealthMap/ProMED-mail map showing the location of the Virgin Islands in the Caribbean can be accessed at
<http://healthmap.org/r/01tp>. - ProMed Mod.TY]
Date: Fri 27 Aug 2010
Source: Virgin Islands Daily News [edited]
<http://virginislandsdailynews.com/news/dengue-fever-possible-cause-of-death-of-st-john-woman-1.977556>

A St John woman who was transferred last week [week of 16 Aug 2010] to a Miami hospital with possible dengue fever symptoms died there 20 Aug [2010] from complications, her husband said. VI [Virgin Islands] Health Department epidemiologist Eugene Tull said earlier this week [week of 23 Aug 2010] that he had no information about a possible death from dengue fever.

Health Department spokeswoman Eunice Bedminster said Thursday [26 Aug 2010] that the department was not aware of any deaths from the territory's dengue fever cases but had been investigating since receiving inquiries from reporters Monday [23 Aug 2010].

Tull said earlier this week that so far this year [2010], there have been 8 confirmed, laboratory positive cases of dengue fever in the territory, 3 probable cases with lab results pending, and 15 suspected cases. All of those were in the St Thomas/St John District, except for 2 of the suspected cases, which were on St Croix, he said. [Byline: Joy Blackburn]
=====================
[The attribution of the woman's death to dengue virus infection is speculative. ProMED-mail awaits confirmation (or not) as further information becomes available. It is clear, however, that locally acquired dengue virus infections are occurring there.

Maps showing the location of the US Virgin Islands can be accessed at <http://www.worldatlas.com/webimage/countrys/carib.htm>. and the HealthMap/ProMED-mail interactive map at <http://healthmap.org/r/01tp> - ProMed Mod.TY]
More ...

World Travel News Headlines

Date: Fri, 17 Jan 2020 17:48:09 +0100 (MET)

Barcelona, Jan 17, 2020 (AFP) - Spain's Balearic Islands passed a bill Friday aimed at clamping down on alcohol-fuelled holidays in the Mediterranean archipelago which bans happy hours when drinks are offered a discount and open bars.   "This is the first law adopted in Europe which restricts the sale and promotion of alcohol in certain touristic areas," the regional government of the Balearic Islands which have long been a magnet for young German and British tourists, who often drink heavily and enjoy rowdy late-night clubbing.

The restrictions will apply to three areas with a reputation for excess: San Antoni on the island of Ibiza and El Arenal and Magaluf -- which has been nicknamed "Shagaluf" because of its reputation for drunken casual sex -- on Mallorca, the largest of the Balearic's four islands.   The law, which was drawn up in consultation with the tourism industry also bans pub crawls and two-for-one drink offers, prohibits the sale of alcohol in shops between 9:30 pm and 8 am and forbids advertising party boats in the designated areas.   Establishments that break the new rules risk fines of up to 600,000 euros ($669,000) and the threat of being closed down for three years.

The new law also takes aim at the so-called "balconing" craze, the term given to holidaymakers who decide to jump into a swimming pool from a hotel or apartment balcony, a stunt which claims several lives every year.   It bans "balconing" across the entire archipelago and requires hotels to evict anyone who does it. Those caught jumping from balconies face fines of up to 60,000 euros ($67,000).   Up until now only some resorts on the Balearics imposed fines for "balconing".

The regional government of the Balearics said the law, which stiffens measures already introduced in 2015, will "fight excesses in certain tourist zones" and "force a real change in the tourism model of those destinations".   Magaluf made global headlines in 2014 after a video showing a young woman performing oral sex on several men on the dance floor of a nightclub went viral.   Local shops sell souvenir T-shirts with the catchphrase "On it 'till we vomit".

The four islands which make up the Balearics -- Palma de Mallorca, Ibiza, Menorca and Formentera, received nearly fourteen million tourists in 2018, drawn by their crystal clear waters, and in many cases by all-inconclusive package holidays.   The archipelago is Spain's second most visited region. Spain is the world's second most visited country after France.
Date: Fri, 17 Jan 2020 12:55:16 +0100 (MET)

Rennes, France, Jan 17, 2020 (AFP) - Several oyster farmers along France's Atlantic and Mediterranean coasts have been forced to halt sales since December after their sites were contaminated by the highly contagious norovirus, which they blame on overflowing sewage treatment plants.   Authorities ordered the suspensions at 23 of the country's 375 designated fields, and recalls of affected oysters as well as mussels and clams, after tests revealed the virus, which can cause severe vomiting and diarrhoea.

The move came just before the year-end holidays, when oysters are a traditional delicacy on millions of French tables.   "The oysters are not sick. They're carrying the virus because it's in the water they are constantly filtering," Philippe Le Gal, president of France's national shellfish council (CNC), told AFP this week.   "They were in the wrong place at the wrong time," he said, adding the ban had prompted many people to stop eating oysters altogether.   Local officials say oyster farmers are paying the price of insufficient spending on wastewater treatment, with facilities strained to the limit even as development of coastal areas has surged in recent years.

Heavy rains before Christmas prompted treatment basins to overflow, they say, spilling tainted water into rivers.   "This was predictable -- they've kept issuing building permits even though treatment sites are already at full capacity," said Joel Labbe, a senator for the Morbihan region in Brittany.   Oyster farmers are demanding compensation, and a delegation met with agriculture ministry officials in Paris last week warning that more than 400 businesses had been impacted by the sales ban.

This week, angry growers dumped trash bins full of oysters and mussels in front of the offices of the regional ARS health authority in Montpellier over the decision to halt sales from a nearby basin on the Mediterranean coast.   "We're the victims, and we shouldn't have to suffer any financial damages," Le Gal said.
Date: Fri, 17 Jan 2020 04:44:41 +0100 (MET)

Suva, Fiji, Jan 17, 2020 (AFP) - Fiji opened evacuation centres and warned of "destructive force winds" Friday as a cyclone bore down on the Pacific island nation for the second time in three weeks.   Two people were missing after attempting to swim across a swollen river late Thursday when heavy rain fell ahead of the advancing Cyclone Tino, police said.   On the outer islands, locals prepared to go to emergency shelters while many tourists fled beach resorts and made their way to the capital Suva before regional flights and inter-island ferry services were suspended.

The Fiji Meteorological Service said Tino was strengthening as it headed for Fiji's second-largest island, Vanua Levu, warning of wind gusts of up to 130 kilometres per hour (80 mph), heavy rain, coastal flooding and flash flooding in low lying areas.    "I'm preparing to go to an evacuation centre soon with my family and wait for the cyclone to pass," Nischal Prasad, who lost his home in northern Vanua Legu when Cyclone Sarai struck just after Christmas, told AFP.   "Sarai destroyed my house and almost left my family homeless. My daughters had to hide under their bed from the strong winds. It was a scary experience," he said.

Russian tourist Inna Kostromina, 35, said she sought safety in Suva after being told her island resort was in the path of the cyclone.   "We didn't want to get stuck in there and with the authorities warning of coastal flooding, anything can happen. So we decided to move to Suva for now. I think we will be much safer here."    Police said a man and his daughter, believed to be aged nine or 10, were attempting to swim across a flooded river when they were caught in the strong currents.    The incident happened on Thursday before the storm developed into a tropical cyclone, but a police spokesman linked the tragedy to "heavy rain brought about by the current weather system (which) raised the river level".   Although the Pacific islands are popular tourist destinations in summer it is also the cyclone season, and Fiji is being targeted for the second time in three weeks.

In late December, Tropical Cyclone Sarai left two people dead and more than 2,500 needing emergency shelter as it damaged houses, crops and trees and cut electricity supplies.    On its present track, Tino would hit Tongatapu, the main island of neighbouring Tonga, on the weekend.    Two years ago, Tongatapu was hit by Cyclone Gina, with two people killed and nearly 200 houses destroyed.
Date: Thu, 16 Jan 2020 16:38:39 +0100 (MET)
By Hiroshi HIYAMA

Tokyo, Jan 16, 2020 (AFP) - Japan has confirmed a case of a mystery virus that first emerged in China and is from the same family as the deadly SARS pathogen, authorities said Thursday.   It appears to be only the second time the novel coronavirus has been detected outside China, after the World Health Organization (WHO) confirmed a case in Thailand.   Japan's health ministry said a man who had visited the central Chinese city of Wuhan, the apparent epicentre of the outbreak, was hospitalised on January 10, four days after his return to Japan. He reported a persistent fever.

Tests on the patient, who was released from hospital on Wednesday, confirmed he was infected with the new virus.   "This is the first domestic discovery of a pneumonia case related to the new coronavirus," the ministry said in a statement.   "We will continue active epidemiological research while also coordinating efforts with the World Health Organization and related agencies to conduct a risk assessment."   The outbreak has killed one person so far, with 41 patients reported in Wuhan.

The outbreak has caused alarm because the new virus is from the same family as the pathogen that causes SARS (Severe Acute Respiratory Syndrome), which killed 349 people in mainland China and 299 in Hong Kong in 2002 and 2003.   Authorities in Wuhan said a seafood market was the centre of the outbreak. It was closed on January 1.   Japanese authorities said the man had not visited the market and that it was possible he had been in contact with a person infected with the virus while in Wuhan.

- Outbreak in Japan 'unlikely' -
Health ministry official Eiji Hinoshita told reporters that the risk of the disease spreading from the patient was considered low, with careful checks done on those who had been in close contact with him.   "At this point, we feel it is unlikely this will lead to a dramatic outbreak," he said, adding that the patient was no longer suffering a fever and was recuperating at home.

Officials declined to give further information on the man, including his nationality, citing privacy concerns.   Local media said the patient was a Chinese national in his 30s living in Kanagawa, just southwest of Tokyo.   Public broadcaster NHK said he had already recovered and was resting at home, as quarantine officials at Tokyo's Narita airport boosted health checks on all travellers.

The health ministry urged people who develop a cough or fever after visiting Wuhan to wear a surgical mask and "swiftly visit a medical institution".   Hinoshita said Japan would need to be on guard ahead of the Lunar New Year, a popular travel period in China.   "It is expected that Japan will see many visitors from China," he said.   It is not yet clear whether the mystery virus can be transmitted between humans, but on Wednesday authorities said it was possible it had spread inside a family.

The woman diagnosed in Thailand, who is in a stable condition, also said she had not visited the Wuhan seafood market.   And WHO doctor Maria Van Kerkhove on Tuesday said she "wouldn't be surprised if there was some limited human-to-human transmission, especially among families who have close contact with one another".   Hong Kong authorities on Tuesday said several dozen people had been hospitalised with fever or respiratory symptoms after travelling to Wuhan, but no cases of the new virus have so far been confirmed.
Date: 20 Jan 2020
Source: News Joins [In Korean, machine trans. edited]
----------------------------
An unexplained pneumonia in China caused the Korean quarantine authorities to strengthen the quarantine, and a fever-sensing camera is installed to monitor the body temperature of Chinese tourists who entered Korea at Incheon Port 1 International Passenger Terminal. 

Pneumonia confirmed by the new coronavirus, which is prevalent in Wuhan, China, was confirmed for the first time on [20 Jan 2020]. According to health officials, a Chinese woman, A, who arrived at Incheon International Airport on a plane from Wuhan last weekend, was confirmed with pneumonia. The patient showed signs of pneumonia, including high fever and cough. The health authorities entered the airport at the same time, confirmed the symptoms of high fever, suspected pneumonia, and went into quarantine and testing. The Centers for Disease Control immediately quarantined A and entered treatment with a nationally designated quarantine bed. The Centers for Disease Control will hold an emergency press conference at 1:30 pm on [20 Jan 2020] and release the reporter A.
 
Meanwhile, Beijing's Daxing District Health and Welfare Committee said 2 fever patients who had been to Wuhan were confirmed as a new pneumonia patient on [19 Jan 2020]. They are currently being treated at a designated hospital and said they are stable. Daxing District is where Beijing New Airport opened last year [2019]. The Guangdong Provincial Health and Welfare Committee said on [19 Jan 2020] that a 66-year-old man who had visited a relative's home in Wuhan showed fever and lethargy and was diagnosed with Wuhan pneumonia. Confirmation patients have also emerged in Shenzhen, a neighbouring Hong Kong province in southern China, raising concerns that the new pneumonia has already spread throughout China.
 
The Chinese government has said that "there is no basis for human-to-human propagation," but domestic experts pointed out that "the nature of coronavirus is less likely to prevent human-to-human propagation."   [Byline: Esther Toile]
========================
[This is now the 4th international identification of the 2019-nCoV (novel coronavirus) associated illness reported outside of China.  To date, all 4 cases have reported being in Wuhan China in the 14 days preceding onset of illness.  Illness in each involved a history of fever and dry cough.  Cases were reported by Thailand (2 cases) and Japan, and now South Korea.  An update following a Ministry of Health Korea press conference mentioned that there were 5 individuals accompanying this woman, none of whom were currently showing symptoms. (<http://news1.kr/articles/?3821049>).

As mentioned in an earlier post (see Novel coronavirus (10): China (HU, GD, BJ) http://promedmail.org/post/20200119.6898567), there have also been cases confirmed in China outside of Wuhan City, with cases reported in Beijing, Guangdong and possibly Shanghai. It is becoming more difficult to conclude that there has been limited person-to-person transmission as the case numbers are climbing both inside of Wuhan City, elsewhere in China, and in individuals travelling from Wuhan China to other countries (Japan, Thailand and South Korea).

A map of South Korea can be found at:
Date: 15 Jan 2020
Source: Fox News [edited]

CDC is facing criticism over its response to a polio-like illness. The Centers for Disease Control and Prevention has confirmed 10 additional cases of acute flaccid myelitis.  An Ohio teen is determined to walk again despite doctors' warnings that she may not after she contracted a rare polio-like illness that's left her paralyzed from the waist down.  IK, a catcher on her middle school's softball team, said it started with what felt like a cramp in her leg on Christmas. "I just thought, 'Oh gosh, it's just growing pains or a Charley horse,'" NK, the 13-year-old's mother, told News 5 Cleveland.  But the next day, IK couldn't stand on her own, and her worried parents rushed her to Akron Children's Hospital, where she was diagnosed with acute flaccid myelitis (AFM). It's a rare but serious condition that affects the nervous system, specifically the grey matter of the spinal cord, which weakens the body's muscles and reflexes.

Health officials have noticed an increase of cases in children occurring every 2 years since 2014, according to the Centers for Disease Control and Prevention (CDC). And while it often is referred to as a "polio-like" illness, tests so far have tested negative for poliovirus.  Symptoms typically begin with sudden onset of arm or leg weakness and loss of muscle tone and reflexes, but can also include facial droop or weakness, difficulty moving eyes, drooping eyelids, difficulty swallowing,  slurred speech, and pain in the arms and legs.  Severe symptoms may include respiratory failure, or serious neurological complications, according to the CDC. Parents are encouraged to seek medical care right away if a child is suspected of developing any symptoms

Since her diagnosis, IK has been working in physical therapy and has received steroid treatments as well as multiple plasma exchange, according to the news outlet. Her mother said it's been like "a bad dream" for the family as they watch her struggle to gain strength.  "It's a lot, but I just try to go with the flow, just to push through," IK, who has received support from her teammates, classmates and members of the community, told News 5 Cleveland.  [Byline: Alexandria Hein]
======================
[Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak.

In 2019, there were 33 total confirmed cases in 16 US states
[<https://www.cdc.gov/acute-flaccid-myelitis/cases-in-us.html>].

The case definition for AFM is based on clinical and lab criteria

Clinical Criteria: An illness with onset of acute flaccid limb weakness.
Laboratory Criteria:
Confirmatory Laboratory Evidence: a magnetic resonance image (MRI) showing spinal cord lesion largely restricted to grey matter and spanning one or more vertebral segments. Supportive Laboratory Evidence: cerebrospinal fluid (CSF) with pleocytosis (white blood cell count over 5 cells/mm3) Case Classification:
- Confirmed: Clinically compatible case AND Confirmatory laboratory evidence: MRI showing spinal cord lesion largely restricted to grey matter and spanning one or more spinal segments.
- Probable: Clinically compatible case AND Supportive laboratory evidence: CSF showing pleocytosis (white blood cell count over 5 cells/mm3)

With the high number of cases reported in 2018 and 2019, CDC enhanced AFM surveillance through collection of data at the national level by encouraging healthcare providers to recognize and report to their health departments all patients whom they suspect may have AFM; health departments are being asked to send this information to CDC to help us understand AFM activity nationwide. - ProMED Mod.UBA]

[HealthMap/ProMED map available at:
Date: Sat 18 Jan 2020
From: Guido Calleri <guidocalleri@aslcittaditorino.it> [edited]

90 persons presented to the Infectious Diseases Hospital Amedeo di Savoia, Torino, North-West Italy between 24 Dec 2019 and 10 Jan 2020 after consuming raw sausages from a wild boar hunted in the area of Susa Valley, 50 km [31.1 mi] away from Torino, in late November 2019.

All of them either were symptomatic (fever, muscle and/or abdominal pain, nausea) or had peripheral blood eosinophilia over 500/cmm, or both. IgG serology for trichinella was performed by immunoblot (Trichinella E/S IgG kit, EFFEGIEMME, Milan, Italy) and resulted positive in 48/90 (53.3%), allowing a diagnosis of confirmed trichinella infection.

Otherwise, a diagnosis of suspected trichinella infection was made with a negative serology, probably due to performing the test too early, before the development of antibodies or possibly a false negative result. In a few cases (under 10 cases) an alternative diagnosis was considered.

All patients were treated with oral albendazole 400 mg twice daily for 10 days and prednisone 50 mg/day.

Most likely, all patients were infected after eating meat from a single animal, given the low prevalence of the infection in this area: no human case has ever been detected in Torino province, and only one wild boar has been found positive for trichinella at microscopy in Susa valley in the last 10 years.
---------------------------------------
Guido Calleri, Filippo Lipani, Giovanna Paltrinieri, Silvia Faraoni,
Valeria Ghisetti
ASL Citta di Torino, Infectious Diseases Unit and Microbiology Lab,
and ASL TO3,
Department of Prevention
Torino, Piedmonte, Italy
======================
[ProMED thanks Guido Calleri, Filippo Lipani, Giovanna Paltrinieri, Silvia Faraoni, and Valeria Ghisetti for sending us this information. The report underlines that _Trichinella_ are found in wild boars in Europe and should be assessed by a certified laboratory for _Trichinella_ before used for human consumption. Sausages made of smoked meat are especially dangerous, because the temperatures seldom reach what is needed to kill the trichinella larvae. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Date: Fri 17 Jan 2020
Source: Outbreak News Today [edited]

Media sources in Bangladesh are reporting a Nipah virus infection in the city of Khulna. The reported case is a 20-year-old female who has been hospitalized since last Saturday [11 Jan 2020] at the Khulna Medical College Hospital (KMCH).

"A medical board has confirmed her infection by Nipah virus. As her infection is a risk to other patients, she is being treated separately at the hospital's Medicine unit 1," said SM Kamal Hossain, chief of KMCH Medicine Department.

According to the World Health Organization (WHO), in the Bangladesh and India outbreaks, consumption of fruits or fruit products (e.g. raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection. Fruit bats of the family Pteropodidae -- particularly species belonging to the _Pteropus_ genus -- are the natural hosts for Nipah virus. There is no apparent disease in fruit bats.

In more recent outbreaks of the disease, person-to-person transmission has been seen in Bangladesh and India.

The disease in humans can range from asymptomatic infection to fatal encephalitis. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for surveillance investigations, according to the WHO.

Those who survive acute encephalitis make a full recovery, but around 20% are left with residual neurological consequences, such as persistent convulsions and personality changes.

There is no treatment or vaccine available for either people or animals.
======================
[Nipah virus infections occur sporadically in Bangladesh in a geographic area termed the Nipah belt and during certain seasons of the year when the reservoir fruit bat is abundant. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and they contaminate date palm sap or fruit. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April.

As noted earlier, it is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur.

Interestingly, a simple skirt constructed out of locally available materials can prevent access of the bats to the palm sap collecting pots, but apparently they are not commonly used. Boiling the palm sap would inactivate the virus, but local consumers indicated that it alters the flavour of the sap.

An image of a _Pteropus_ fruit bat can be found at

[HealthMap/ProMED map available at:
Khulna, Khulna, Bangladesh: <http://healthmap.org/promed/p/14886>]
Date: Wed 15 Jan 2020
Source: Hindustan Times [edited]

Government High School, Tajpur village, has been put under surveillance after 16 students of the school were found to be infected with mumps, a viral infection that swells up the saliva-producing glands of a person.

A rapid response team had been dispatched to the school last week, after the students, all aged between 11 and 14, were found infected. The school currently has 106 students [enrolled], and all are under observation. The team had also surveyed the entire village and collected samples, to be sent to the Integrated Diseases Surveillance Program (IDSP) lab for testing.

Lack of measles, mumps, and rubella [MMR] vaccination is what leaves a person prone to the infection. Mumps virus spreads from person to person through infected saliva. If an individual is not immune, they can contract the viral by breathing in saliva droplets from an infected person.

Dr. Divjot Singh, epidemiologist, district health department, said the situation is now under control. "We have asked the school's principal to relieve all students infected with mumps. The school will remain under surveillance for 15 more days. Medical officers are also carrying out awareness drive at the school and the village against mumps," said Dr. Divjot Singh.

Last year [2019], a mumps outbreak was reported from 2 areas of the district, including Andlu village in Raikot and Red Cross Bhavan, Sarabha Nagar, Ludhiana.  [Byline: Harvinder Kaur]
Date: Wed 15 Jan 2020
Source: Devon Live [abridged, edited]

An outbreak of 19 new cases of mumps has been reported across Devon in the last week. The contagious viral disease particularly affects under 25s. The new mumps figures have been released in the official Government weekly Statutory Notifications of Infectious Diseases report, with the highest number in Exeter.

It follows a warning that mumps is on the rise, particularly in university towns. Traditionally known as the "kissing disease" because it spreads fast between groups of young people, mumps is a contagious viral infection recognisable by the painful swellings in the side of the face under the ears (the parotid glands), giving a person a distinctive "hamster face" appearance.

In severe cases, it can develop into viral meningitis if it moves in the outer layer of the brain. Other complications include swelling of the testicles or ovaries (if the affected person has gone through puberty), which may affect a person's fertility.  [Byline: Colleen Smith]