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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 ...

El Salvador

El Salvador - US Consular Information Sheet
May 01, 2008
COUNTRY DESCRIPTION: El Salvador is a democratic country with a developing economy. Tourism facilities are not fully developed. The capital is San Salvador, accessible by El Salvador's In
ernational Airport at Comalapa. Both the U.S. Dollar and the Salvadoran Colon are legal tender in El Salvador. While Colones are still accepted, the primary currency of El Salvador is the U.S. Dollar. Americans traveling with U.S. Dollars should not exchange them for Colones. Read the Department of State Background Notes on El Salvador for additional information.

ENTRY/EXIT REQUIREMENTS:
To enter the country, U.S. citizens must present a current U.S. passport and either a Salvadoran visa or a one-entry tourist card.
The tourist card may be obtained from immigration officials for a ten-dollar fee upon arrival in country.
U.S. travelers who plan to remain in El Salvador for more than thirty days can apply in advance for a multiple-entry visa, issued free of charge, from the Embassy of El Salvador in Washington, DC or from a Salvadoran consulate in Boston, Chicago, Dallas, Houston, Las Vegas, Long Island, Los Angeles, Miami, New York City, or San Francisco.
Travelers may contact the Embassy of El Salvador at 1400 16th Street NW, Washington, DC
20036, tel. (202) 265-9671, 265-9672; fax (202) 232-3763; e-mail: correo@elsalvador.org or visit the Embassy's web site at http://www.elsalvador.org.
When applying for a visa, travelers may be asked to present evidence of U.S. employment and adequate finances for their visit at the time of visa application or upon arrival in El Salvador.
For passengers departing by air, El Salvador has an exit tax of $32.00 which is usually included in the price of the airline ticket.

Travelers should be aware that El Salvador's entry requirements vary in accordance with agreements the country has with foreign governments.
Citizens of several countries in addition to the United States may enter El Salvador with a current passport and either a visa or tourist card.
Citizens of many other countries, including many Latin American and western European nations, may enter with only a current passport.
However, citizens of most nations are required to present both a current passport and a visa to enter El Salvador.
Non-U.S. citizen travelers are advised to contact a Salvadoran embassy or consulate to determine the entry requirements applicable to them.

In June 2006, El Salvador entered into the “Central America-4 (CA-4) Border Control Agreement” with Guatemala, Honduras, and Nicaragua.
Under the terms of the agreement, citizens of the four countries may travel freely across land borders from one of the countries to any of the others without completing entry and exit formalities at immigration checkpoints.
U.S. citizens and other eligible foreign nationals, who legally enter any of the four countries, may similarly travel among the four without obtaining additional visas or tourist entry permits for the other three countries.
Immigration officials at the first port of entry determine the length of stay, up to a maximum period of 90 days.
Foreign tourists who wish to remain in the four-country region beyond the period initially granted for their visit must request a one-time extension of stay from local immigration authorities in the country where the traveler is physically present, or they must leave the CA-4 countries and reapply for admission to the region.
Foreigners “expelled” from any of the four countries are excluded from the entire CA-4 region.
In isolated cases, the lack of clarity in the implementing details of the CA-4 Border Control Agreement has caused temporary inconvenience to some travelers and has resulted in others being fined more than one hundred dollars or detained in custody for 72 hours or longer.

Airlines operating out of El Salvador International Airport require all U.S. citizen passengers boarding flights for the United States (including U.S.-Salvadoran dual nationals) to have a current U.S. passport.
U.S. citizens applying for passports at the U.S. Embassy in San Salvador are reminded that proof of citizenship and identity are required before a passport can be issued.
Photographic proof of identity is especially important for young children because of the high incidence of fraud involving children.
Since non-emergency passports are printed in the United States, and not at the U.S. Embassy in El Salvador, citizens submitting applications in El Salvador should be prepared to wait approximately one week for receipt of their new passports.

The U.S. Embassy in El Salvador reminds U.S. citizen travelers that their activities in El Salvador are governed by Salvadoran law and the type of visa they are issued.
Under Salvadoran law, all foreigners who participate directly or indirectly in the internal political affairs of the country (i.e. political rallies, protests) lose the right to remain in El Salvador, regardless of visa status or residency in El Salvador.

Visit the Embassy of El Salvador’s web site at http://www.elsalvador.org
for the most current visa information.

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

In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points.
These often include requiring documentary evidence of relationship and permission for the child's travel from the parent(s) or legal guardian if not present.
Having such documentation on hand, even if not required, may facilitate entry/departure.
Minors traveling on Salvadoran passports and who are traveling alone, with one parent or with a third party must have the written permission of the absent parent(s) or legal guardian to depart El Salvador.
A Salvadoran notary must notarize this document.
If the absent parent(s) or legal guardian is (are) outside of El Salvador, the document must be notarized by a Salvadoran consul.
If a court decree gives custody of the child traveling on a Salvadoran passport to one parent, the decree and a passport will allow the custodial parent to depart El Salvador with the child.
Although Salvadoran officials generally do not require written permission for non-Salvadoran minors traveling on U.S. or other non-Salvadoran passports, it would be prudent for the parents of minor children traveling on U.S. passports to provide similar documentation if both parents are not traveling with their children.

SAFETY AND SECURITY: Most travelers to El Salvador experience no safety or security problems, but the criminal threat in El Salvador is critical.
Random and organized violent crime is endemic throughout El Salvador.
U.S. citizens have not been singled out by reason of their nationality, but are subject to the same threat as all other persons in El Salvador.
See the section below on Crime for additional related information.
Political or economic issues in the country may give rise to demonstrations, sit-ins or protests at any time or place, but these activities occur most frequently in the capital or on its main access roads.
U.S. citizens are cautioned to avoid areas where demonstrations are being held and to follow local news media reports or call the U.S. Embassy for up-to-date information.
Information about demonstrations also is available as “Security Alerts” on the U.S. Embassy home page at http://elsalvador.usembassy.gov.
Many Salvadorans are armed, and shootouts are not uncommon.
Foreigners, however, may not carry guns even for their own protection without first obtaining a firearms license from the Salvadoran government.
Failure to do so will result in the detention of the bearer and confiscation of the firearm, even if it is licensed in the United States.
Armed holdups of vehicles traveling on El Salvador's roads are increasing, and U.S. citizens have been victims in various incidents.
In one robbery, an American family was stopped by gunmen while driving during the day on the Pan American highway in the Santa Ana Department.
In another incident, an American citizen passenger was robbed after the van in which she was riding was carjacked by armed men.
The van was stopped at a traffic light on the busy road between Comalapa International Airport and San Salvador shortly after dark.
Strong undertows and currents can make swimming at El Salvador's Pacific Coastal beaches extremely dangerous for even strong and experienced swimmers.
As an example of this hazard, during a single seven-day holiday period, nine Salvadoran citizens drowned while swimming at Pacific beaches.
In one month alone, three U.S. citizens drowned while swimming at Pacific beaches in La Libertad and La Paz Departments.

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, including the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: The U.S. Embassy considers El Salvador a critical crime-threat country.
The homicide rate in the country increased 25 percent from 2004 to 2007, and El Salvador has one of the highest homicide rates in the world.
Violent crimes, as well as petty crimes are prevalent throughout El Salvador, and U.S. citizens have been among the victims. The Embassy is also aware that there has been at least one rape of an American minor and one attempted rape of an American adult in the past year.
Travelers should avoid displaying or carrying valuables in public places.
Passports and other important documents should not be left in private vehicles.
Armed assaults and carjacking take place both in San Salvador and in the interior of the country, but are especially frequent on roads outside the capital where police patrols are scarce.
Criminals have been known to follow travelers from the international airport to private residences or secluded stretches of road where they carry out assaults and robberies.
Armed robbers are known to shoot if the vehicle does not come to a stop.
Criminals often become violent quickly, especially when victims fail to cooperate immediately in surrendering valuables.
Frequently, victims who argue with assailants or refuse to give up their valuables are shot.
Kidnapping for ransom continues to occur, but has decreased in frequency since 2001.
U.S. citizens in El Salvador should exercise caution at all times and practice good personal security procedures throughout their stay.
The U.S. Embassy warns its personnel to drive with their doors locked and windows raised, to avoid travel outside of major metropolitan areas after dark, and to avoid travel on unpaved roads at all times because of criminal assaults and lack of police and road service facilities.
Travelers with conspicuous amounts of luggage, late-model cars or foreign license plates are particularly vulnerable to crime, even in the capital.
Travel on public transportation, especially buses, both within and outside the capital, is risky and not recommended.
The Embassy advises official visitors to use radio-dispatched taxis or those stationed in front of major hotels.
U.S. citizens using banking services should be vigilant while conducting their financial exchanges either inside local banks or at automated teller machines.
There have been several reports of armed robberies in which victims appear to have been followed from the bank after completing their transactions.
Visitors to El Salvador should use caution when climbing volcanoes or hiking in other remote locations.
Armed robberies of climbers and hikers are common.
Mine-removal efforts ceased several years ago, but land mines and unexploded ordnance in backcountry regions still pose a threat to off-road tourists, backpackers, and campers.
The Embassy strongly recommends engaging the services of a local guide certified by the national or local tourist authority when hiking in backcountry areas, even when within the national parks.
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 U.S. Embassy.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy for assistance.
The Embassy 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 crime is solely the responsibility of local authorities, consular officers can help you understand the local criminal justice process and find an attorney if needed.

Victims of crime should bear in mind that law enforcement resources are limited and judicial processes are uneven in El Salvador.
Many crimes in the country go unsolved and the likelihood for redress through the judicial system is limited.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: There are few private hospitals with an environment that would be acceptable to visiting Americans.
The Embassy recommends that these hospitals be used only for emergency care, to stabilize a condition prior to returning to the U.S. for definitive evaluation and treatment.
Private hospitals and physicians expect upfront payment (cash or, for hospitals, credit card) for all bills.
Priority Ambulance (503-2264-7911) is the only ambulance service in San Salvador that has trained personnel and medical equipment to manage most emergencies.
Not all medicines found in the U.S. are available in El Salvador.
Medicines often have a different brand name and are frequently more expensive than in the U.S.
No specific vaccinations are required for entry into El Salvador from the United States. Travelers coming from countries where yellow fever is endemic must have had a yellow fever vaccination in order to enter the country.
For more information visit El Salvador’s Immigration web site at http://www.seguridad.gob.sv/Web-Seguridad/Migracion/migracion.htm.

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

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
It may be possible to purchase supplemental coverage for travel.
U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States.
Separate insurance should be obtained for medical evacuation, as it may cost in excess of $50,000.
Many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas, including emergency medical services and even transportation of remains, in the event of death.
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 El Salvador is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road conditions throughout El Salvador are not up to U.S. standards.
However, the rebuilding of major roads following the earthquakes in 2001 is nearly completed.
Mini-buses, buses, and taxis are often poorly maintained.
Drivers are often not trained, and generally do not adhere to traffic rules and regulations.
The U.S. Embassy recommends that its personnel avoid using mini-buses and buses, and use only taxis that are radio-dispatched or those stationed in front of major hotels.
Robberies and assaults on buses are commonplace.
Because of inconsistent enforcement of traffic laws in El Salvador, drivers must make an extraordinary effort to drive defensively.
Passing on blind corners is commonplace.
Salvadoran law requires that the driver of a vehicle that injures or kills another person must be arrested and detained until a judge can determine responsibility for the accident.
This law is uniformly enforced.
Visitors to El Salvador may drive on their U.S. license for up to thirty days.
After that time, a visitor is required to obtain a Salvadoran license.
Please refer to our Road Safety page for more information.
Visit the web site of El Salvador’s national tourist office and national authority responsible for road safety at http://www.elsalvadorturismo.gob.sv/.
Further information on traffic and road conditions is available in Spanish from Automovil Club de El Salvador, at telephone number 011-503-2221-0557.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of El Salvador’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of El Salvador’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:
Travelers intending to carry cell phones from the United States should check with their service provider to determine if the service will be available in El Salvador.
Credit cards are acceptable for payment in many-but not all-retail stores and restaurants in major cities.
Automatic teller machines with access to major U.S. bank networks are widely available in San Salvador, but less prevalent elsewhere in the country.
Please see our information on Customs Information.
DISASTER PREPAREDNESS:
El Salvador is an earthquake-prone country.
Flooding and landslides during the rainy season (June to November) also pose a risk.
On October 4, 2005, the Government of El Salvador declared a nation-wide state of emergency following major flooding caused by a series of storms.
More than 50 deaths were confirmed as attributed to landslides and flooding at that time and over 34,000 residents were evacuated to temporary shelter.
The Llamatepec Volcano, located approximately 50 kilometers west of San Salvador, erupted briefly on October 1, 2005, casting rocks and volcanic ash onto neighboring regions and producing two confirmed deaths.
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/.
An earthquake measuring 7.6 on the Richter scale devastated much of El Salvador on January 13, 2001.
A second earthquake on February 13, 2001, measured 6.6 on the Richter scale, and caused significant additional damage and loss of life.
Reconstruction efforts are largely complete and the country has returned to normal.
Additional information in Spanish about earthquakes (sismos) in El Salvador can be found on the Government of El Salvador’s web page at http://www.snet.gob.sv/.
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 offences.
Persons violating El Salvador’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in El Salvador 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.

Guns:
El Salvador has strict laws requiring a locally obtained license to possess or carry a firearm in the country.
The Embassy strongly advises persons without a Salvadoran firearms license not to bring guns into the country or use a firearm while in El Salvador.
During a three-month period in 2006, three U.S. citizens were arrested in separate incidents for firearms violations.
In each instance, the individuals complied with airline procedures, declared the firearm on a Customs form upon arrival at El Salvador's Comalapa International Airport, and were allowed to depart the airport without hindrance.
However, when the individuals returned to the airport and declared the weapons to airline employees, they were arrested by Salvadoran police, not for violating aviation regulations but for having carried an unlicensed firearm while in El Salvador.
The Embassy cannot intervene in the judicial process when a U.S. citizen is charged with a firearms violation.
Conviction for possessing an unlicensed firearm can carry a prison sentence of three to five years.

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 El Salvador are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, and to obtain updated information on travel and security within El Salvador.
Americans without Internet access may register directly with the Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The Consular Section of the U.S. Embassy in San Salvador is located at Final Boulevard Santa Elena Sur, Urbanizacion Santa Elena, Antiguo Cuscatlan, La Libertad, telephone 011-503-2501-2999, fax 011-503-2278-5522, e-mail: CongenSansal@state.gov.
The Embassy's web site can be accessed at http://sansalvador.usembassy.gov/.
The Consular Section is open for U.S. citizens’ services from 8:15 a.m. to 11:30 a.m. weekdays, excluding U.S. and Salvadoran holidays.
After business hours, the Embassy can be contacted by telephone at 011-503-2501-2316 or 011-503-2501-2253.
For any questions concerning U.S. visas for either temporary travel to or permanent residence in the U.S., please contact our regional U.S. Visa Information Center.
From El Salvador, the Visa Information Center may be reached by calling 900-6011 from any landline operated by Telecomm, or by purchasing a VISAS-USA calling card from any location that sells Telefonica phone cards.
Calling instructions are on the back of the card.
Calls using the 900 number cost approximately $2.15 per minute and will be charged to the caller's telephone bill.
The Telefonica phone card costs $15.00 and permits a seven-minute call.
From the U.S., the Visa Information Center can be contacted by dialing 866-730-2089 and charging the call to a Visa or MasterCard credit card.
*

*

*
This replaces the Country Specific Information for El Salvador dated October 2007, to update the format and sections on Entry/Exit Requirements, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Disaster Preparedness, and Registration and Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu, 30 May 2019 14:19:59 +0200

San Salvador, May 30, 2019 (AFP) - A 6.6 magnitude earthquake struck off the coast of El Salvador on Thursday near the capital but authorities said there were no initial reports of casualties or damage.   The quake was so strong it was likely felt throughout Central America, officials said.   The quake struck in the Pacific Ocean around 25 miles (40 kilometres) south of San Salvador at a depth of 40 miles (65 km), according to the US Geological Survey.

The Salvadoran environment ministry said the quake was even stronger, with a magnitude of 6.8.   The Pacific Tsunami Warning Center did not issue an alert for the quake. But the Environment Ministry issued one of its own, predicting sea level variations of up to 12 inches (30 centimetres).   However, Environment Minister Lina Pohl said the alert was sent "as a protocol."   Coastal residents should avoid entering the water for four hours after the quake, the ministry said on Twitter.

President-elect Nayib Bukele, who takes office on Saturday, said on Twitter that the earthquake was felt "throughout 100 percent of the country."   Police and firemen fanned out across the country to evaluate the situation and reported "no serious or generalized damage," the Civil Protection department said on Twitter.   The Education Ministry cancelled classes in coastal areas.   In the coastal town of Puerto de la Libertad, authorities evacuated families who live near the water.   Rattled residents stood outside their homes Thursday morning digesting the quake.   "The quake was very strong. Thank God, nothing happened to me. But we are taking precautions," one of them, Maria Valencia, told Canal 21 television.

The Environment Ministry reported as many as 12 aftershocks ranging from 3.3 to 4.9 in magnitude.   In San Salvador, police and soldiers patrolled streets but people largely stayed indoors despite the scare from the quake.   The government gave slightly different figures for its location.   It placed it more shallow than the USGS at 48 kilometres, and said the epicentre was a bit further out to sea, some 66 kilometres from Puerto de La Libertad.
Date: Mon 1 Apr 2019
Source: La Prensa Grafica, El Salvador [in Spanish, trans., edited]

According to MINSAL [El Salvador's Ministry of Public Health] figures for week 12 (updated till 23 Mar) 2019, the number of cases of typhoid fever remains high. They have reported 517 cases in 2019, compared to 313 cases in 2018, which is equivalent to an increase of 65%.

The head of health surveillance of the ISSS [El Salvador's Social Security Institute], Jose Adan Martinez, said that the figures themselves reflect an increase of 44%. It is worth mentioning that the MINSAL presents the data at the national level, which include those of the ISSS, FOSALUD [El Salvador Solidarity Fund for Health], and other institutions.

"We have been experiencing this upward trend in the disease since the beginning of 2019, and it has increased in the last week," Martinez said.

He also recalled that this is a disease transmitted by water or food contamination. "Given the scarcity of water that has been in some sectors of San Salvador, which is the most affected department, [the increase] could be due to the lack of hygiene measures that the population is taking, both for the preparation of food and for water consumption," he added.  [Byline: Edwin Teos]
========================
[Vaccine intervention is an important step, as increasing antimicrobial resistance in the typhoid bacillus in Asia has made treatment more difficult.

Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the more common kinds of salmonellosis. Epidemiologically, usually spread by contaminated food or water, typhoid is not a zoonosis like the more commonly seen types of salmonellosis. Clinically, vomiting and diarrhoea are typically absent; indeed, constipation is frequently reported. As it is a systemic illness, blood cultures are at least as likely to be positive as stool in enteric fever, particularly early in the course of the infection, and bone marrow cultures may be the most sensitive.

The symptoms of classical typhoid fever typically include fever; anorexia; lethargy; malaise; dull, continuous headache; non-productive cough; vague abdominal pain; and constipation. Despite the (often high) fever, the pulse is often only slightly elevated. During the 2nd week of the illness, there is protracted fever and mental dullness, classically called coma vigil. Diarrhoea may develop but usually does not. Many patients develop hepatosplenomegaly (both liver and spleen enlarged). After the 1st week or so, many cases develop a maculopapular rash on the upper abdomen. These lesions ("rose spots") are about 2 cm (0.78 inch) in diameter and blanch on pressure. They persist for 2-4 days and may come and go. Mild and atypical infections are common. The word typhoid (as in typhus-like) reflects the similarity of the louse-borne rickettsial disease epidemic typhus and that of typhoid fever; in fact, in some areas, typhoid fever is still referred to as abdominal typhus. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Sun 29 Jul 2018
Source: La Prensa Grafica, El Salvador [in Spanish, machine trans. edited]
<https://www.laprensagrafica.com/elsalvador/Casos-de-tifoidea-se-duplicaron-y-triplicaron-20180728-0055.html>

All the departments of the country experienced significant rises in typhoid fever in the 1st 6 months of 2018, with the exception of Cabanas, in comparison with the figures for the 1st 6 months of 2017. The statistics were provided by the Information and Response Office of the Ministry of Health (MINSAL), at the request of The Graphic Press. According to the data, the departments that registered the highest increases were San Miguel, San Salvador, La Paz and Sonsonate. Throughout 2017, San Miguel, for example, reported 9 cases of typhoid fever; while only between January and June 2018, cases rose to 17.

In San Salvador, cases for 2017 totalled 427, but during the 1st months of 2018 only, they totalled 653. Although the increase was noticed by the Salvadoran Social Security Institute (ISSS), through a press release issued on 8 Feb 2018, the Ministry of Health (MINSAL) spent several weeks without issuing any report with official data and did not speak of the outbreak until several months later, a few days after the end of June 2018. After the ISSS report, some physicians and infectious disease experts also reported an increase in cases of infection caused by the _Salmonella_ Typhi bacterium in private clinics and hospitals.

By mid-February 2018, MINSAL confirmed that there was a 30% increase in cases, compared to the same period in 2017: from 56 to 73. However, it did not include the statistics in its weekly epidemiological surveillance bulletins, for which the medical association denounced the lack of transparency with respect to the preventive management of the disease, which if not treated in time can be fatal. The Minister of Health, Violeta Menja­var, even admitted at that time that there was no vaccine against typhoid fever in the public health network. "In the vaccination scheme, there is not one; so that we can produce a vaccine against typhoid, we have to wait for the one being prepared by the Pan American Health Organization (PAHO), since there is not one that meets the conditions; we have incorporated it into the vaccination scheme," he explained.

The abysmal difference between 622 confirmed cases in the ISSS network, which serves only 17% of the population, and zero confirmed cases in the national public network, which serves more than 80% of the population, generated even more doubts than certainties about the management of the disease by the MINSAL. Finally, in the 2nd half of June 2018, Minister Menja­var acknowledged that there was an outbreak of typhoid fever that affected mainly 28 municipalities in the country, although she suggested that the effect was moderate and not high. "This year [2018], we have almost double that of 2017; it has happened that in 28 municipalities we have an epidemic outbreak; it is not epidemic because that would have to be in the entire country," she said.

The total numbers of cases of 2017 were 675, while the total between January and June of 2018 rose to 937. The authorities have reiterated on several occasions that this disease is directly related to the hygiene habits of people, so they have emphasized, to the point of exhaustion, that the population should take necessary precautions to avoid contagion, especially with surveillance of water quality in water used to cook food or for consumption. Drinking water, however, is the product that has been most scarce in recent months. At the end of March 2018, there was chaos due to lack of drinking water at the start of Holy Week, as the Water and Sewerage Administration (ANDA) reported one of its 48-inch main pipes damaged, which affected the San Pedro Metropolitan Area, Salvador (AMSS).

Less than a month ago, ANDA again left a million inhabitants of the AMSS without water, also due to another fault in the same 48-inch pipeline. The municipalities with the highest figures of typhoid fever between January and June 2018 were San Salvador, (205), Mejicanos (70), Soyapango (59) and Apopa (54), in the capital of the country. After San Salvador, which totaled 653 cases in that period, is La Libertad, with 85 cases. [Byline: Evelyn Machuca]
===========================
[Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the commoner kinds of salmonellosis. Epidemiologically, usually spread by contaminated food or water, typhoid is not a zoonosis like the more commonly seen types of salmonellosis. Clinically, vomiting and diarrhoea are typically absent; indeed, constipation is frequently reported.

As it is a systemic illness, blood cultures are at least as likely to be positive as stool in enteric fever, particularly early in the course of the infection, and bone marrow cultures may be the most sensitive. The symptoms of classical typhoid fever typically include fever, anorexia, lethargy, malaise, dull continuous headache, non-productive cough, vague abdominal pain, and constipation. Despite the (often high) fever, the pulse is often only slightly elevated.

During the 2nd week of the illness, there is protracted fever and mental dullness, classically called coma vigil. Diarrhoea may develop but usually does not. Many patients develop hepatosplenomegaly (both liver and spleen enlarged). After the 1st week or so, many cases develop a maculopapular rash on the upper abdomen. These lesions ("rose spots") are about 2 cm (0.78 in) in diameter and blanch on pressure. They persist for 2-4 days and may come and go.

Mild and atypical infections are common. The word typhoid (as in typhus-like) reflects the similarity of the louse-borne rickettsial disease epidemic typhus and that of typhoid fever; in fact, in some areas, typhoid fever is still referred to as abdominal typhus. -  ProMED Mod.LL]

[HealthMap/ProMED map available at: El Salvador:
<http://healthmap.org/promed/p/21>]
Date: Fri 15 Jun 2018 12:02 AM CST
El Mundo, El Salvador [in Spanish, trans., edited]
<http://elmundo.sv/ministerio-de-salud-dice-hay-un-brote-epidemico-de-fiebre-tifoidea/>

The Minister of Public Health, Violeta Menja­var, said that there is an epidemic outbreak of typhoid fever in some 26 municipalities, not in the entire country. "We have salmonellosis and within it some typhoid cases, an increase of cases in 26 municipalities, which have a mild to moderate affectation ... What does that mean? We are talking about an epidemic outbreak because it is localized; it is not a national epidemic, "Menja­var said on [14 Jun 2018].

The head of the health surveillance unit, Hector Ramos, said that they had 644 cases suspected of typhoid but that it is too early to speak of a decrease. "We have to wait but it seems that it is starting to level off and we hope that it will continue to decrease," said Minister Menja­var. The minister explained that the increase was a surprise because the winter was early as a result of the La Nina phenomenon.

The municipalities moderately affected are:
San Antonio Pajonal in the department of Santa Ana;
Santa Tecla in La Libertad;
and Apopa, Cuscatancingo, San Salvador, Mejicanos, Panchimalco, Ilopango,
and Soyapango in the department of San Salvador.
**************************************
Date: Tue 12 Jun 2018 12:00 AM CST
Source:  El Mundo, El Salvador [in Spanish, trans. ProMED Sr.Tech.Ed.MJ, summ., edited]
<http://elmundo.sv/tifoidea-ha-afectado-nueve-municipios-moderadamente/>

The epidemiological bulletin of the Salvador Ministry of Public Health and Social Assistance (MINSAL) reported moderate activity of typhoid fever in 9 of the country's 262 municipalities. From January 2018 to date, 469 suspected cases of typhoid fever have been hospitalized, of which 346 have been confirmed by blood culture.

In addition to the 9 municipalities moderately affected, there are 19 municipalities mildly affected and none severely affected. During the week of 4 Jun 2018, the epidemiological bulletin reported 644 suspected cases between January and May 2018. 376 cases were reported during the same period in 2017. One person has died in 2018 and one person died in 2017.
========================= 
[Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the commoner kinds of salmonellosis. Epidemiologically, usually spread by contaminated food or water, typhoid is not a zoonosis like the more commonly seen types of salmonellosis. Clinically, vomiting and diarrhoea are typically absent; indeed, constipation is frequently reported.

As it is a systemic illness, blood cultures are at least as likely to be positive as stool in enteric fever, particularly early in the course of the infection, and bone marrow cultures may be the most sensitive. The symptoms of classical typhoid fever typically include fever, anorexia, lethargy, malaise, dull continuous headache, non-productive cough, vague abdominal pain, and constipation.

Despite the often high fever, the pulse is often only slightly elevated. During the 2nd week of the illness, there is protracted fever and mental dullness, classically called coma vigil. Diarrhoea may develop but usually does not. Many patients develop hepatosplenomegaly (both liver and spleen enlarged). After the 1st week or so, many cases develop a maculopapular rash on the upper abdomen.

These lesions ("rose spots") are about 2 cm (0.78 in) in diameter and blanch on pressure. They persist for 2-4 days and may come and go. Mild and atypical infections are common. The word typhoid (as in typhus-like) reflects the similarity of the louse-borne rickettsial disease epidemic typhus and that of typhoid fever; in fact, in some areas, typhoid fever is still referred to as abdominal typhus. - ProMED Mod.LL]

[Maps of El Salvador: <http://www.lib.utexas.edu/maps/americas/elsalvador.jpg>
and <http://healthmap.org/promed/p/21>.]
Date: Sat 12 May 2918
Source: The New England Journal of Medicine (NEJM) [edited]

ref: Gomez CA, Banaei N. _Trypanosoma cruzi_ reactivation in the brain. N Engl J Med. 2018; 378(19):1824. doi: 10.1056/NEJMicm1703763.
----------------------------------------------------------------------
A 31-year-old man who had recently received a diagnosis of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome [AIDS] presented to the emergency department with headache, confusion, and gait instability.

He had immigrated to the United States from El Salvador 6 years earlier. Fever (temperature, 38.9 deg C [102 deg F]) and an ataxic gait were noted on physical examination.

Laboratory test results were notable for a CD4 positive cell count of 60 per cubic millimeter, an HIV viral load of 409 000 copies per milliliter, a positive result for IgG antibodies to _Toxoplasma gondii_, and a negative result for IgM antibodies to _T. gondii_.

Magnetic resonance images of the brain showed a mass measuring 8 by 7 by 6 cm in the corpus callosum and the white matter of the right parietal and occipital subcortical lobes.

Cytologic examination of a brain aspirate revealed intracellular organisms, with prominent kinetoplasts (masses of mitochondrial DNA) visible within macrophages and astrocytes.

The organisms were identified as _Trypanosoma cruzi_ on the basis of partial protozoal 28S ribosomal RNA sequencing. After vector-borne transmission, which occurs mainly in Central America, South America, and some rural areas in Mexico, _T. cruzi_ infection can persist asymptomatically. Immunosuppression predisposes patients to _T. cruzi_ reactivation in the brain, which can manifest as a brain abscess or meningoencephalitis.

The patient received benznidazole, followed by the initiation of antiretroviral therapy. After 2 weeks of treatment, clinical improvement was noted in his mentation and gait.
======================
[The case underlines that one has to expect the unusual in immunocompromised patients and underlines that biopsy is needed also from the brain in order to reach the correct diagnosis. The guide to the suspicion of a _T. cruzi_ infection is the history of immigration from an endemic area. We do not know if the patient was seropositive for _T. cruzi_ antibodies. - ProMED Mod.EP]

[HealthMap/ProMED-mail map
More ...

World Travel News Headlines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Available at:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[HealthMap/ProMED-mail map of Yemen:
Date: Tue 3 Dec 2019
Source: Cordoba Epidemiology Report and Los Tiempos news article [in Spanish, trans., edited]
<http://www.reporteepidemiologico.com/wp-content/uploads/2019/12/REC-2264.pdf>

Los Tiempos, Bolivia, 2 Dec 2019 Confirmation of the 1st case of the year (2019) of human rabies in Cochabamba After confirming the death of rabies of a 7-year-old girl in the southern area of Cochabamba, the Departmental Health Service (SEDES) and the Zoonosis Unit of the Mayor's Office intensified prevention actions to prevent the proliferation of the virus. This would be the 1st case confirmed so far this year [2019].

The head of the Epidemiology Unit of SEDES, Arturo Fernando Quiaones Lapez, reported that in the last rabies vaccination campaign for dogs more 1000 doses were given. "We suspected rabies in the case of this minor. She tested positive by laboratory both in cerebrospinal fluid as well as in brain tissue," according to lab results obtained on 2 Dec 2019. The victim died on 26 Nov 2019 after being hospitalized in intensive care of the Children's Hospital for 2 days with signs of rabies," said Dr Manuel Ascencio Villarroel.

The patient's relatives reported the girl had contact with a puppy which died a month ago. The dog did not receive rabies vaccines and belonged to someone the family knows. Quiñones mentioned the family members of the girl and the owners of the animal are receiving preventive treatment. Meanwhile, the head of Zoonosis of the Mayor's Office, Javier Humberto Rodraguez Herrera, stated on 2 Dec 2019 a "massive focus blockade" will be held with the participation of 8 health centers to prevent the circulation of the virus in the area.

He commented that, to date, 11 cases of canine rabies have been recorded in the municipality. In more than 11 months of 2019, SEDES identified 25 positive cases of canine rabies, the majority in the metropolitan region. Quiaones asked the population to report the death of their pets with signs of rabies at health centers for follow-up to fight the disease. Meanwhile, from the City Hall, the owners of dogs were urged to have their dogs vaccinated. Javier Rodra­guez added another risk factor is when animals are collected from the street and they are not vaccinated.
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[The rabies virus attacks the nervous system in animals.  When a rabid animal bites a human being, it can transfer the virus, contained in saliva, to that individual. "After inoculation, rabies virus may enter the peripheral nervous system directly and migrates to the brain or may replicate in muscle tissue, remaining sequestered at or near the entry site during incubation, prior to central nervous system invasion and replication. It then spreads centrifugally to numerous other organs. The case-fatality ratio approaches unity [100%], but exact pathogenic mechanisms are not fully understood. "Susceptibility to lethal infection is related to the animal species, viral variant, inoculum concentration, location and severity of exposure, and host immune status.

Both virus-neutralizing antibodies and cell-mediated immunity are important in host defense. "Early diagnosis is difficult. Rabies should be suspected in human cases of unexplained viral encephalitis with a history of animal bite. Unvaccinated persons are often negative for virus-neutralizing antibodies until late in the course of disease. Virus isolation from saliva, positive immunofluorescent skin biopsies or virus neutralizing antibody (from cerebrospinal fluid, or serum of a non-vaccinated patient), establish a diagnosis. "Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery).

No specific anti-rabies agents are useful once clinical signs or symptoms develop. The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Incubation periods may be somewhat shorter in children and in individuals bitten close to the central nervous system (such as the head).

Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnoea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhoea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness).

More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paraesthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies. "The acute neurologic period begins with objective signs of central nervous system dysfunction.

The disease may be classified as furious rabies if hyperactivity (that is, hydrophobia) predominates and as dumb rabies if paralysis dominates the clinical picture. Fever, paraesthesia, nuchal rigidity, muscle fasciculations, focal and generalized convulsions, hyperventilation, and hypersalivation may occur in both forms of the disease. "At the end of the acute neurologic phase, periods of rapid, irregular breathing may begin; paralysis and coma soon follow. Respiratory arrest may occur thereafter, unless the patient is receiving ventilatory assistance, which may prolong survival for days, weeks, or longer, with death due to other complications.

"Although life support measures can prolong the clinical course of rabies, rarely will they affect the outcome of disease. The possibility of recovery, however, must be recognized, and when resources permit, every effort should be made to support the patient. At least 7 cases of human "recovery" have been documented." (<https://www.ncbi.nlm.nih.gov/books/NBK8618/>)

A very sad situation which could have been prevented if the animal had been vaccinated. Responsible owners vaccinate their animals. Condolences to the family. - ProMED Mod.TG]

[HealthMap/ProMED-mail map of Bolivia: <http://healthmap.org/promed/p/55162>]