WORLD NEWS

Getting countries ...
Select countries and read reports below or

Timor-Leste

General Information:

The People’s Republic of China is the world’s third largest nation in land mass and shares borders with 16 other countries. It is the worlds most populated country. Nowadays many Irish travellers will b

going to China for business or holiday trips. Much of the country is mountainous or semidesert and the country lies almost entirely in the temperate zone. Only portions of the southern-most area - the provinces of Yunnan and Guangdong, and the Zhuang autonomous region of Guangxi - lie within the tropics. The monsoon climate is a major influence in the south, but the north and west have a typical continental climate.

Weather Profile: 

During the summer, warm moist maritime air masses bring heavy rains to eastern China, and hot humid summer weather is typical. Winter offers a sharp contrast when Siberian air masses dominate. In late winter and spring strong north winds sweep across north China and hazy days caused by dust storms are common. Beijing’s spring is mostly dry. In July and August the weather turns hot and humid. Autumn is the nicest time of the year with many warm, clear days and little wind usually. Chest Complaints  Because of the prevailing dust, increased transportation and the burning of soft coal during the winter, Beijing and other major cities in China have a high rate of pollution. This may exacerbate bronchial and/or sinus complaints. The dust level in Lhasa is also very high and this may lead to respiratory problems.

Safety & Security:

The risk of crime against tourists is low but care of personal belonging should be observed at all times. Maintenance of buildings and general safety precautions may not always be in place and so checking for fire exits (and that they are unblocked) is wise. Use the hotel safety boxes and carry photocopies of any important documents rather than the originals where possible.

Local Medications:

Western brand-name drugs or non-prescription medicines are seldom available locally although some Chinese equivalents are to be found at reasonable prices. Always carry your own medication (well marked) on your person and bring enough for your trip.

Rabies:

Rabies is a serious problem throughout China. Reports indicate that as many as five million people are bitten each year by rabid dogs and that approximately 5,000 of these patients die. Travellers should stay well clear of any warm blooded animals, especially dogs. Any contact (lick, bite or scratch) should be treated seriously and immediately by washing out the wound, applying an antiseptic and then seeking urgent medical attention.

River Boat Travel:

Many of the older river boats in China use untreated river water for washing dishes and in the bathrooms. This increases the risk of illnesses such as traveller’s diarrhoea and a parasitic disease called schistosomiasis (Bilharzia). Also be careful that the ferry is not overcrowded and be aware of any sharp corners or rusty edges due to lack of maintenance.

Altitude Sickness in Tibet:

Virtually all of the Tibetan Autonomous region, much of Quinghai and Xinjiang, parts of Sichuan, Yannan and Gansu are above 13,000 feet in altitude. Some main roads in Tibet, Qinghai and Xinjiand go above 17,000 feet. At these levels the available oxygen is very low and altitude sickness may occur. Travellers may experience severe headaches, nausea, dizziness, shortness of breath or a dry cough. These symptoms usually settle over a few days with rest, but if not travellers should seek medical assistance and, if possible, descend to a lower altitude. Travellers with a history of cardiac problems or respiratory difficulties should avoid such high altitudes where possible.

Insect Bites and Malaria:

During the summer months, carry a supply of insect repellent ointments for your trip and use sensible, light coloured clothing to cover yourself when there are mosquitoes or sandflies about. The risk of malaria in most of China is limited but prophylactic tablets may be prescribed depending on your actual itinerary. Other serious mosquito borne diseases do occur so these will need to be considered.

Sunlight:

The sunlight during the summer months and in Tibet at high elevations can be intense so travellers should bring sun screen and sun-glasses and a sensible wide-brimmed hat.

Acupuncture:

Many tourists are tempted to experience this oriental art in its homeland while visiting China. It is essential to ensure that sterile needles are used at all times as otherwise there may be a risk of transmission of a blood borne disease such as the HIV virus or Hepatitis B.

AIDS risk in China:

Official figures suggest that AIDS is a very limited risk in China. Only 707 cases were reported up to October 2000. These very low figures are very difficult to verify and so all travellers should take care not to place themselves at risk where possible.

Customs Regulations: 

Never carry any medication for another individual unless they are part of your family. The Chinese authorities have strict drug regulations which may be enforced.

Vaccination Requirements: 

 There are no vaccination requirements for entry / exit purposes but travellers on short trips should consider the following ... * Poliomyelitis (childhood booster) * Typhoid (food & water disease) * Tetanus (childhood booster) * Hepatitis A (food & water disease) Those planning to spend a longer time in China should consider additional vaccination against conditions like Rabies, Hepatitis B, Japanese B Encephalitis, Meningococcal Meningitis, Diphtheria and Mantoux Test / BCG vaccination.

Summary: 

China is teeming with people and a culture very different to ours. It is a land of many contrasts. Travellers generally stay healthy if they follow standard commonsense healthcare advice.

Travel News Headlines WORLD NEWS

Date: Thu, 5 Mar 2015 13:53:47 +0100 (MET)

Dili, East Timor, March 5, 2015 (AFP) - An American tourist has returned to the United States after six months trapped in East Timor over the discovery of drugs in a taxi that she was sharing.    Stacey Addison arrived back in Portland, Oregon, on Wednesday, embracing her mother tightly during an emotional reunion at the city's airport, TV reports showed.    "It's a great feeling, it's a relief to finally be back home, be out of there," she told a local station, adding her experience in East Timor, a tiny half-island nation bordering Indonesia, had been an "emotional rollercoaster".   A Facebook group set up to advocate for her release carried a celebratory message on Tuesday announcing that she had left East Timor: "IT'S FINALLY HAPPENED! STACEY IS ON HER WAY HOME!!!!"   Addision was arrested on September 5 after methamphetamine was found in the shared taxi that was en route to the capital Dili, but denied any wrongdoing.

The veterinarian, who had just crossed from Indonesia when she was arrested, wrote on Facebook that another passenger -- who was a stranger -- picked up a package containing the drugs, and police later detained everyone in the car.   She was initially released from jail after several days but was later re-arrested, although no charges were laid against her.    Addison was released again in December, but East Timor authorities hung on to her passport while they continued to investigate her case.    Her lawyer had warned that the probe could take two years but last week the East Timor government announced that prosecutors had decided not to pursue her case and "Ms. Addison is now free to leave".   The State Department had supported Addison and pressed for her release.   East Timor, a poor half-island nation that was occupied by Indonesia for over two decades, imposes tough punishments for drugs cases, including the death penalty for traffickers.
Date: Tue, 4 Feb 2014 00:59:28 +0100 (MET)

JAKARTA, Feb 03, 2014 (AFP) - A strong 6.1-magnitude earthquake hit eastern Indonesia Tuesday but there was no tsunami alert, seismologists said.   The quake struck at 7:36 am local time (2236 GMT Monday), 318 kilometres (197 miles) east-northeast of the East Timor capital Dili in the Banda Sea at a depth of 18 kilometres, the US Geological Survey said.

The Pacific Tsunami Warning Center did not issue any alerts following the tremor in the remote region at the eastern end of the Indonesian archipelago between East Timor and the Maluku islands.   In an initial assessment, the USGS said there was a low likelihood of damage or casualties.

Indonesia sits on the Pacific "Ring of Fire", where tectonic plates collide, causing frequent seismic and volcanic activity.   A 6.1-magnitude quake struck Indonesia's main island of Java in January, damaging dozens of buildings.   Another 6.1 quake that hit Aceh province on Sumatra island in July 2013 killed at least 35 people and left thousands homeless.
Date: Sun, 1 Dec 2013 04:07:58 +0100 (MET)

AMBON, Indonesia, Dec 01, 2013 (AFP) - A 6.3-magnitude quake hit off eastern Indonesia and East Timor Sunday, seismologists said, but there was no tsunami alert or reports of damage or casualties.   The quake struck at 10:24 am local time (0124 GMT), 351 kilometres (217 miles) east-northeast of the East Timor capital Dili at a relatively shallow depth of 10 km, the US Geological Survey said.

The Pacific Tsunami Warning Center did not issue any alerts following the tremor in the remote region at the eastern end of the Indonesian archipelago between the islands of Timor and New Guinea.   In an initial assessment, the USGS said there was a low likelihood of damage or casualties.   Indonesian officials said they had not received any reports of casualties or damage so far.   "From data, the epicentre is quite a distance from the nearest cities and the intensity of shaking is not destructive," Suharjono, the technical head of Indonesia's geophysics and meteorology agency, told AFP.

An AFP correspondent in Dili said no tremor was felt.   Johanes Huwae, a police official in the Maluku provincial capital Ambon, one of the cities closest to the epicentre, said "there was no shaking, everything's safe", while the national disaster management agency reported "slight shaking for three to five seconds" in Southwest Maluku.   Indonesia sits on the Pacific "Ring of Fire", where tectonic plates collide, causing frequent seismic and volcanic activity.   A 6.1-magnitude quake that struck Aceh province on Sumatra island in July killed at least 35 people and left thousands homeless.
Date: Tue 20 Mar 2012
From: Helen Hanson <helenjhanson@gmail.com> [edited]

Re: Meng Ling Moi's post from Japan re: DENV-3 in 3 Japanese travelers returning from East Timor in March [see ProMED-mail archives 20120319.1074013 and 20120306.1060914]

I am the Australian Embassy's doctor in Dili, East Timor. Our clinic sees expatriates and some locals.

It is likely that I saw one or more of the travellers concerned prior to their return to Japan.

Our small one-doctor clinic saw 45 test-confirmed cases of dengue in February [2012] alone, mostly expatriates. These are not included in the 161 test confirmed cases for East Timor quoted in the previous post. Serotyping is not available in Dili, however reports from my colleagues at the ASPEN military medical facility, where blood samples have been sent to Australia for analysis, have also shown DEN-3 to be the circulating serotype.
-------------------------------------------------
Dr Helen Hanson
Australian Embassy Clinic
Dili, East Timor
helenjhanson@gmail.com
=========================
[ProMED-mail thanks Dr Helen Hanson for this 1st hand report. These types of reports from health professionals in the field who are dealing with outbreaks are especially valuable sources of reliable, current information. Her report confirms the circulation of dengue virus 3 in East Timor.

A HealthMap/ProMED-mail interactive map of East Timor can be accessed at
<http://healthmap.org/r/1KlU>. - ProMed Mod.TY]
Tuesday 6th March 2012
A ProMED-mail post
<http://www.promedmail.org>

- East Timor (national). 2 Mar 2012. As of 24 Feb [2012], the Ministry of Health had received 563 reports of dengue (161 confirmed by laboratory tests) in every district except one, including 192 reports of DHF that causes severe abdominal pain, vomiting, and in worst cases, death. This is a 36 per cent increase over reports for the 1st 2 months of 2011. As of 1 Mar [2012], 10 people had died from dengue, according to the government.
=====================
[A HealthMap/ProMED-mail interactive map of East Timor can be accessed at <http://healthmap.org/r/1KlU>. - ProMed Mod.TY]
More ...

World Travel News Headlines

Date: Mon, 16 Sep 2019 08:19:07 +0200 (METDST)

Tokyo, Sept 16, 2019 (AFP) - Almost 80,000 homes are still without power a week after a powerful typhoon battered eastern Japan, authorities said Monday, with sustained heavy rain prompting evacuation orders and hampering recovery efforts.    Typhoon Faxai powered into the Tokyo region in the early hours of Monday last week, packing record winds that brought down power lines, disrupted Rugby World Cup preparations and prompted the government to order tens of thousands of people to leave their homes.

The storm killed two people, with at least three elderly later confirmed dead due to heatstroke as temperatures soared to above 35 degrees Celsius (95 degrees Fahrenheit) in areas affected by a post-typhoon blackout.   Some 78,700 households were still without power in Chiba, southeast of the capital, Tokyo Electric Co. (TEPCO) spokesman Naoya Kondo told AFP.   "A complete recovery is still unlikely until September 27 as we have difficulties in mountain areas," he added.   Some 16,700 households were also without water because several water purification plants had no power, a local official said.   With help from the military, officials were dispatching water tanker trucks to the affected areas.

The national weather agency Monday issued new warnings for heavy rain in Chiba, while local authorities issued non-compulsory evacuation orders to 46,300 people due to the risk of landslides.   "A delay in recovery work is expected due to heavy rain," said Kenta Hirano, a disaster management official in Futtsu in Chiba, where more than 1,000 houses were damaged by the typhoon.   Local media showed residents in Chiba hurriedly covering broken roofs with blue tarps.   "We are at a loss as we can't live there again," a 66-year-old man told public broadcaster NHK after the typhoon ripped off the roof of his house.
Date: Sun, 15 Sep 2019 15:38:29 +0200 (METDST)

Athens, Sept 15, 2019 (AFP) - More than 160 firefighters on Sunday battled to contain a large fire near Athens blazing for a second day amid gale force winds, officials said.   And in another emergency, authorities evacuated dozens of people from two villages and a hotel on the island of Zakynthos after a new fire broke out on Sunday.

The fire department said the blaze near Athens burned in the mountains above Loutraki, a coastal resort some 60 kilometres (35 miles) west of Athens.   "The fire is burning near the top of the mountain," Stefanos Kolokouris, the fire department's deputy chief of operations, told state TV ERT.   "We are trying to create a perimeter but the terrain is very difficult, with ravines," he said.   Four water bombers and six helicopters were participating in operations. Given a lack of roads in the area, two squads of firefighters had to be carried to the mountaintop by Super Puma helicopter, state agency ANA said.   Officials had already evacuated 50 people from a local monastery when the fire broke out on Saturday, but stressed that other inhabited areas were not in danger.

On Zakynthos, officials ordered the evacuation of the villages of Agalas and Keri in the south of the island. Some 120 tourists were also relocated to a safe area.   The Greek fire department on Sunday said it had been called to nearly 80 fires over the past 24 hours.   It has already faced more than 9,600 rural and urban fires this year.
Date: Sat, 14 Sep 2019 16:08:47 +0200 (METDST)

Singapore, Sept 14, 2019 (AFP) - Pollution from forest fires in Indonesia pushed Singapore's air quality to unhealthy levels for the first time in three years on Saturday, the government said, a week ahead of the Formula One night race in the city.   The toxic smoke caused by burning to clear land for plantations is an annual problem for Indonesia's neighbours, but has been worsened this year by particularly dry weather.   "There has been a deterioration in the haze conditions in Singapore this afternoon," the National Environment Agency (NEA) said in a statement.   "This was due to a confluence of winds over the nearby region that led to more smoke haze from Sumatra being blown toward Singapore," it said, referring to one of the Indonesian islands where fires are raging.

The NEA said the pollutant standards index (PSI) worsened to 112 in parts of the island Saturday night.   An index reading between 101-200 is considered unhealthy, with residents advised against doing prolonged strenuous exercises outdoors.   Singapore may continue to experience hazy conditions over the next few days, the agency warned.   The city-state of 5.6 million people was shrouded in a thin white haze, with a few residents seen wearing face masks, but there was no major disruption to daily activities.   The F1 race is scheduled from Friday to Sunday on a street circuit in the Marina Bay financial district.

Singapore GP, the Formula One organisers, said the possibility of haze is one of the potential issues covered in their contingency plan for this year's grand prix.   "The plan was formulated and refined with stake holders, government bodies and the Formula One community," Singapore GP said in an emailed statement.   "In the event that the haze causes visibility, public health or operational issues, Singapore GP would work closely with the relevant agencies before making any collective decisions regarding the event."

Neighbouring Malaysia has also been affected by the smoke, with air quality in parts of the country including the capital Kuala Lumpur reaching unhealthy levels over the past few days and triggering a diplomatic row with Jakarta.   In 2015, the index reached "hazardous" levels of more than 300 in Singapore, forcing the closure of schools. Indonesian forest fires were the worst in two decades that year, firing up smog that blanketed large parts of Southeast Asia for weeks.
Date: Sat, 14 Sep 2019 11:16:53 +0200 (METDST)

Bangkok, Sept 14, 2019 (AFP) - Floods in northeastern Thailand have submerged homes, roads and bridges, leaving more than 23,000 people in evacuation shelters as anger grows over the government's "slow" emergency response.   Torrential rain has lashed the country for the last two weeks, causing flash floods and mudslides in almost half its provinces, with families evacuated from their homes in boats or makeshift rafts.   Since August 29, 32 people have been killed in the deluge, said a statement from the disaster department on Saturday that also gave the number of people staying in emergency shelters.   Two weather events are behind the widespread floods, the department said -- Storm Podul and a tropical depression that formed over the South China Sea called Kajiki.

Local media reports from the worst-hit province of Ubon Ratchathani showed people wading through chest-deep water and rescuers in boats trying to steer buffalo to higher ground.   Flooding in the province, which borders Laos and Cambodia, has been exacerbated by rising water levels in the Moon and Chi rivers.   "It will take three weeks to drain the floodwater" from up to 90 percent of inundated households, said provincial governor Sarit Witoon.   "The water has slightly receded about four centimetres today and I think it will keep going down," he added.

But the situation is already "unlivable" for families in one-storey homes, said Pongsak Saiwan, local director of opposition party Future Forward.   Access to an entire district is currently cut off due to flood waters, which are about two metres (6.5 foot) deep in the main town, while three major bridges are "impassable", he said.   "The government has been very slow in responding to the situation since the floods started in the beginning of September," Pongsak told AFP.   Ubon Ratchathani's plight started trending on Twitter this week with the hashtag #SaveUbon.   Aerial shots of the flood-hit plains blanketed with muddy river water were widely shared, as well as photos of stray dogs being rescued by passing boats.

One Twitter user compared the flood response to how quickly the government had mobilised and saved 12 young boys and their football coach from a waterlogged cave last year -- an incident that catapulted Thailand to international attention.   "Only 13 lives stuck in the cave and it was still very high-profile, but this is hundreds of thousands of lives," tweeted Yosita8051. "It's not okay."   Thailand's junta leader-turned-premier Prayut Chan O-Cha tweeted on Saturday that he has told agencies to "expedite assistance" to those in the affected areas.
Date: Fri, 13 Sep 2019 16:44:33 +0200 (METDST)

Niamey, Sept 13, 2019 (AFP) - Niger launched a campaign on Friday to vaccinate more than four million children against measles, one of the biggest causes of child mortality in the country, the health ministry said.

The one-week nationwide vaccination programme aims to "eliminate measles by the end of 2020", Health Minister Illiassou Mainassara said, adding, it "will reach 4.254 million children" aged from 9 months up to the age of five.   "Despite all the efforts made in the fight against communicable diseases, we still note the persistence of localised measles epidemics (in Niger)," Mainassara said on his way to the capital Niamey to launch the campaign.    But some experts say the vaccination programme should have kicked in sooner    "The delay of this campaign which should have happened in 2018 has resulted in ...the emergence of epidemics in several health districts," said Niger's UNICEF representative, Felicite Tchibindat.

Since January this year, 9,741 suspected cases have been documented in Niger resulting in 53 deaths, she said.   "Measles is a serious and extremely contagious viral disease and remains one of the leading causes of early childhood death, while it can be prevented by vaccination," TchibiNdat said.    She believes the children of migrants, refugees and displaced people will especially benefit from the campaign.    Niger's vaccination programme is supported by the World Health Organization (WHO), UNICEF (United Nations Children's Fund) and the Gavi vaccine Alliance.
Date: Fri, 13 Sep 2019 16:08:16 +0200 (METDST)

Nairobi, Sept 13, 2019 (AFP) - Kenya on Friday became the third country to start routinely innoculating infants against malaria, using the world's first vaccine to combat a disease that kills 800 children globally every day.   The vaccine -- lab name RTS,S -- targets the deadliest and most common form of malaria parasite in Africa, where children under five account for two-thirds of all global deaths from the mosquito-born illness.

Kenya joins Malawi and Ghana, which commenced their own pilot programs for the vaccine supported by the World Health Organization (WHO) earlier this year.   The vaccine will be introduced in phases across malaria-endemic parts of western Kenya near Lake Victoria, starting with Homa Bay, the country's health ministry said.   "It's an exciting time for Kenya as we roll out this vaccine in parts of the country where the burden of malaria is the highest," Health Minister Sicily Kariuki said in a statement.   RTS,S will be added to the national immunisation schedule in these areas, given alongside other routine shots for children under two.

The health ministry said 120,000 Kenyan children were expected to be vaccinated under the pilot programme.   The country has distributed insecticide-treated mosquito nets, fumigated homes and improved diagnostics in its fight against malaria.   But the disease remains stubborn. The health ministry says malaria claimed more than 10,000 lives in 2016, and infected millions more.   As in the rest of the world, children in Kenya bear the brunt of the disease.    Up to 27 percent of Kenyan children under five have been infected with the disease, the health ministry said.   "This vaccine represents an additional tool that will boost Kenya's efforts in reducing malaria infections and deaths among children," Kariuki said.   WHO says a child dies roughly every two minutes from malaria somewhere in the world.

- 30 years in making -
Known under its commercial name as Mosquirix, the vaccine was developed over 30 years by British pharmaceutical giant GlaxoSmithKline in partnership with nonprofit PATH and African research institutes.   It is the only vaccine to date to show a protective effect against malaria in young children, WHO says.   It acts against Plasmodium falciparum, the deadliest malarial parasite and the most prevalent in Africa, where illness and death from the disease remain high despite some gains.   The shots, administered over four doses, have been shown in clinical trials to significantly reduce cases of malaria, and malaria-related complications, in young children.   The vaccine prevented about four in 10 cases of malaria and three in 10 cases of the most severe, life-threatening form of the disease, within the trial group, WHO says.

Evidence gained from the vaccine pilot schemes could guide decisions about whether RTS,S is rolled out more widely in future, WHO says.   "This is the most advanced malaria vaccine that we have today. It has been in the making for the last almost three decades," Dr Richard Mihigo, WHO's co-ordinator of immunisation and vaccine development programme, told AFP before the Kenyan launch.   "Children are the most vulnerable group to this severe disease that is malaria, so protecting children can make a big impact in preventing malaria."   The disease kills more than 400,000 people around the world every year. Of these about 290,000 are under five.    Most are in Africa, where more than 90 percent of the world's malaria cases -- and fatalities -- occur.
Date: Fri, 13 Sep 2019 11:40:02 +0200 (METDST)

London, Sept 13, 2019 (AFP) - British Airways has cancelled all its scheduled UK flights for September 27, when company pilots will again strike in a long-running row over pay.   It comes after the carrier cancelled all flights departing and arriving in the UK on Monday and Tuesday owing to BA's first strike by pilots in the company's 100-year history.

In a statement released late Thursday, BA called on the British Airline Pilots Association (BALPA) union "to call off their strike and return to negotiations".    The airline added: "We are very sorry that BALPA's actions will affect thousands more travel plans."   This week's strike sparked travel chaos for about 200,000 passengers, mostly using London's Gatwick and Heathrow airports.   BALPA estimates that the 48-hour strike cost the airline £80 million ($99 million, 89 million euros), but BA has yet to provide a figure.
Date: Tue, 10 Sep 2019 13:02:19 +0200 (METDST)

Khartoum, Sept 10, 2019 (AFP) - Sudan reported four confirmed cases of cholera in Blue Nile Tuesday and said three people had also died of acute diarrhoea in the war-torn state.   Health Minister Akram al-Toum has asked the World Health Organization to send supplies of cholera vaccine immediately, the ministry said.

Ministry and WHO officials have been sent to the affected area.   "There are 37 cases of acute diarrhoea in Blue Nile... There have been three deaths," the ministry said in a statement.   Dozens of people died from acute diarrhoea in Sudan in 2016 after thousands of cases were reported nationwide.   Blue Nile state, which has a large ethnic minority population, has been the focus of a rebellion by the Sudan People's Liberation Army-North since 2011.   The army declared a ceasefire after the  overthrow of veteran president Omar al-Bashir earlier this year.
Date: Sat 14 Sep 2019
Source: Vax Before Travel [edited]

A new report from Japan's National Institute of Infectious Disease (NIID) indicates the Rubella virus outbreak continues to spread. As of [4 Sep 2019], there have been 2156 Rubella cases reported by the NIID during 2019.

This is an increase of about 260 rubella cases in Japan since July 2019. On a local basis, the city of Tokyo has reported 37% of Japan's 2019 Rubella cases.

Since Rubella is very dangerous for a pregnant woman and her developing baby, the US Centers for Disease Control and Prevention (CDC) said on [7 Aug 2019], "pregnant women who are not protected against rubella through either vaccination or previous rubella infection, should not travel to Japan during this outbreak."

But, pregnant women should not get a Rubella vaccination with the measles-mumps-rubella (MMR) says the CDC. This is because the MMR vaccine is an attenuated "live virus" vaccine.

The CDC says "pregnant women who are not vaccinated should wait to get [the] MMR vaccine until after they have given birth. And, women of childbearing age should avoid getting pregnant for at least 4 weeks after receiving the MMR vaccine."

Additionally, the CDC says "if a pregnant woman contracts the rubella virus, her baby could have birth defects such as deafness, cataracts, heart defects, mental disabilities, and organ damage."

And, when a rubella infection occurs during early pregnancy, serious consequences, such as miscarriages, stillbirths, and severe birth defects in infants, which are known as Congenital Rubella Syndrome (CRS), [may result].

This new NIID report indicates there have been 3 CRS cases in Japan during 2019. As a comparison, during 2005-2015 in the USA, only 8 babies with CRS were reported.

Moreover, [fewer] than 10 people in the USA are reported as having rubella each year. Since 2012, all rubella cases had evidence that they were infected when they were living or traveling outside the USA.

To alert international travellers, the CDC issued a Level 2 Travel Alert regarding Japan's ongoing Rubella virus outbreak in August 2019. This "Practice Enhanced Precautions" Travel Alert says "travellers to Japan should make sure they are vaccinated against rubella with the MMR vaccine before visiting Japan." This CDC Travel Alert is important since approximately 4.5 million US citizens visit Japan annually.

Additionally, the Public Health Agency of Canada and the UK Foreign Travel Advice recommend "pregnant women who are not protected against rubella avoid traveling to Japan."

In the USA, there are 2 approved rubella vaccines: MMR II-Rubella and ProQuad. Both rubella vaccines are available at most pharmacies. Travelers to Japan can request a rubella vaccine counselling appointment with a local pharmacist.

Rubella vaccines, like any medicine, can produce side effects. [People] are encouraged to report vaccine side effects to a healthcare provider or the CDC.  [Byline: Dani Reiter]
========================
[See discussion of rubella in ProMED-mail Rubella - Japan (02)

[HealthMap/ProMED-mail map:
Date: Tue 10 Sept 2019
Source: Focus Taiwan [edited]

Taiwan's enterovirus cases continued to increase last week, bringing the total number to nearly 20 000 between [1 and 7 Sep 2019], the Centers for Disease Control (CDC) said Tuesday [10 Sep 2019].

A total of 19 254 patients sought outpatient or emergency treatment at hospitals for enterovirus infection around the country, up 4% from the figure recorded the previous week [25-31 Aug 2019] and the highest over the same period in nearly 5 years, according to CDC data.

CDC physician Lin Yung-ching said there were 2 severe cases recorded last week, one of which involved an 8-month-old girl and the other a 4-year-old boy, both in central Taiwan. The 2 children were reported in stable condition after treatment.

Some of the 2 patients' family members or classmates with whom they had had contact have also been confirmed as enterovirus cases, and the CDC judged that the infection might have been spread through contact, Lin said.

A total of 303 cases of enterovirus-71 (EV-71), the most severe enterovirus strain, have been reported so far this year [2019], the highest in the same period from 2016 to 2018.

Meanwhile, a total of 36 cases with severe complications have been recorded nationwide, including 27 EV-71 cases, according to CDC statistics.

EV-71 is a neurological disease that attacks the nervous system, and infants under the age of 5 are at highest risk of developing severe complications from this type of infection.

In extreme cases, EV-71 can cause polio-like permanent paralysis, according to the CDC. As Taiwan is still in the peak season for enterovirus infection, CDC Deputy Director-General Philip Lo urged the public to take precautions against the spread of the illness, especially among children.

Children infected with enterovirus should be kept away from school so as to prevent the spread of the disease, as enterovirus is highly contagious, Lo advised.  [Byline: Chen Wei-ting and Evelyn Kao]
=====================
[The enteroviruses are spread from person to person by coughs, sneezes, or touching objects or surfaces that have the virus on them. Therefore, practicing good personal hygiene -- washing hands regularly and thoroughly with soap and water -- is the best way to prevent from getting and spreading the infectious disease.

However, most people infected with non-polio enteroviruses do not get sick, or present with mild illness, like the common cold. Infants, children, and teenagers are more likely than adults to get infected and become sick because they do not yet have immunity (protection) from previous exposures to the viruses. Adults can get infected too, but they are less likely to have symptoms, or their symptoms may be milder. Symptoms of mild illness may include fever; runny nose, sneezing, and cough; skin rash; mouth blisters; and body and muscle aches.

Some non-polio enterovirus infections can lead to:
- Viral conjunctivitis;
- Hand-foot-mouth disease;
- Viral meningitis (infection of the covering of the spinal cord and/or brain);
- Viral encephalitis (infection of the brain);
- Myocarditis (infection of the heart);
- Pericarditis (infection of the sac around the heart);
- Acute flaccid paralysis (a sudden onset of weakness in one or more arms or legs);
- Inflammatory muscle disease (slow, progressive muscle weakness).

Infants and people with weakened immune systems have a greater chance of having these complications. People who develop myocarditis may have heart failure and require long-term care. Some people who develop encephalitis or paralysis may not fully recover.

Enterovirus cases were reported from Taipei, Taiwan in 2017 (Human enterovirus - Taiwan: alert http://promedmail.org/post/20170418.4978387), and health alerts like the one mentioned in report above were issued to the general public to observe proper hygiene to reduce disease transmission. Also the case number for EV-71 associated severe disease has also increased, which is a cause for public health concern. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map: