22nd July 2017

- Palau. 13 Jul 2017. 290 cases confirmed, with 106 cases in June [2017]; in April and May [2017], 3 people with pre-existing medical conditions died.

[Maps of Palau can be seen at
<http://www.worldatlas.com/img/areamap/nonav/pwnewz.gif> and
<http://healthmap.org/promed/p/519>. - ProMED Sr.Tech.Ed.MJ]
Date: Wed, 4 May 2016 07:15:30 +0200

Koror, Palau, May 4, 2016 (AFP) - A severe drought in Palau is killing marine life at the island nation's popular Jellyfish Lake, researchers say, forcing tourism operators to cancel trips to the unique Pacific destination.   The lake near the capital Koror normally provides a tranquil, otherworldly experience for tourists, mostly from China, who snorkel and float among throngs of non-stinging, golden jellyfish.   But with the tiny nation of 18,000 in the grip of its worst drought on record, scientists last month estimated the jellyfish population had plummeted from eight million to under 600,000.

Boat operators such as Sam's Tours say even that figure is optimistic, putting the numbers at 300,000 and falling.   Sam's no longer runs tours to the lake, normally one of Palau's main attractions, and four out of five operators contacted by AFP last week had adopted a similar policy.   "Many tour companies including ours that have been taking guests to the lake have not seen any jellyfish," Sam's said in a statement to customers.

"We at Sam's Tours have therefore decided to suspend our tours to Jellyfish Lake with immediate effect until further notice."   Palau had 160,000 foreign visitors last year, more than half of them from mainland China, and tourism is the economy's largest earner.   The drought, fuelled by an El Nino weather pattern, has depleted rivers and dams, forcing the government to declare a state of emergency and appeal for overseas aid.

The Coral Reef Research Foundation said the lack of rainwater had increased salinity in the lake, killing off the plankton that sustain the jellyfish.   "The golden jelly population could be on the verge of crashing, to the point where there are no more medusae (adults) swimming around the lake," the foundation said.   It said juvenile polyps could usually go dormant and repopulate when conditions improved but current conditions on the lake were unprecedented.

"This time around the situation is uncertain, as no one knows how this El Nino/La Nina scenario is going to play out," it added.   The Koror state government said it was confident that eventually Jellyfish Lake would once again live up to its name.   "This is a phase in the natural cycle of events in the overall realm of the ecosystem," it said.   "Similar events in the past show evidence of the resilience of our natural environment to recover to normal conditions."
Date: Mon, 4 Apr 2016 08:30:54 +0200

Koror, Palau, April 4, 2016 (AFP) - Drought-stricken Palau could dry up completely this month, officials warned Monday as the Pacific island appealed for urgent aid from Japan and Taiwan, including shipments of water.    The tiny country of about 18,000 people declared a state of emergency last month, the latest Pacific island nation to do so as one of the worst ever El Nino-induced droughts in the region worsens.    "We're still in the state of emergency, there's a sense of urgency to address the crisis," a government spokesman told AFP as the National Emergency Committee (NEC) met to discuss strategy.

An NEC report prepared for President Tommy Remengesau offered a bleak outlook for the already-parched country.     "Based on the current water level and usage rates, and assuming conditions persist unabated, a total water outage is likely to occur in the next two to three weeks," it said.   Access to tap water is already rationed to three hours a day or less in the capital Koror and schools are only open half days because they cannot give students enough to drink.   "The NEC has been in contact with the governments of Japan and Taiwan regarding support of materials and equipment, as well as direct shipments of water as necessary," it said.

The Japanese embassy in Palau confirmed it had received a request for assistance and discussions were ongoing about what form it would take.   "The nature of what type of assistance and in what volume is expected to be finalised as soon as possible," it said in a statement.   Palau also expects help from Taiwan, one of the few countries to maintain diplomatic relations with Taipei in the face of opposition from China.   The NEC report added that the US military had been asked to supply portable water filtration systems to alleviate the increasingly desperate situation.   The US National Oceanic and Atmospheric Administration (NOAA) said last month the El Nino weather pattern -- associated with a sustained period of warming in the central Pacific which can spark climate extremes -- was
unlikely to ease before the second half of the year.

The Marshall Islands and the Federated States of Micronesia have also declared states of emergency, while Guam and the Northern Marianas are experiencing low rainfall.   In Koror, bottled water has become scarce as people stockpile dwindling supplies.   Resident Rolynda Jonathan said she constantly worried about her two children.   "There are no words to describe the level of stress, worry and burden of hauling water from one place to another," she told AFP.    "Every morning we struggle to shower, clean up and prepare for the day with the limited amount of water we have."
Date: Wed, 23 Mar 2016 05:38:32 +0100

Koror, Palau, March 23, 2016 (AFP) - Palau became the latest Pacific island nation to declare a state of emergency Wednesday, as the region struggles with an extreme drought that forecasters warn will not ease for months.   President Tommy Remengesau said rainfall in the capital Koror over the past four months was the lowest recorded in 65 years and the city's only dam had dried up.

He said Koror's only other source of drinking water, the Ngerikiil River, was down to 19 percent capacity.   "According to the... weather report, drought conditions exist and will continue to exist for all islands and atolls of Palau, with below average rainfall projected for the next two to three months," he said in a statement.

Water rationing was introduced in Koror earlier this month, with residents only able to use taps for six hours a day.   The US National Oceanic and Atmospheric Administration (NOAA), which provided the forecast, last week said an El Nino weather system was behind the drought.    "One of the strongest El Nino events in recorded history remains entrenched across the equatorial Pacific Ocean," it said.

The Marshall Islands and the Federated States of Micronesia have already declared states of emergency, while Guam and the Northern Marianas are also experiencing low rainfall.   Remengesau said basic government services such as hospitals, the fire department, prisons and power utilities could fail if the drought worsened.

The emergency declaration will give the president extra power to allocate funds to measures that will alleviate the problem, such as desalination units.   El Nino is the name given to a weather pattern associated with a sustained period of warming in the central Pacific which can spark climate extremes.
Date: Wed 12 Nov 2014
From: Takashi Matono <sincedec2012@gmail.com> [edited]

A 32 year old Japanese male presented with fever and headache; he had participated in a waterfall and hiking tour of Ngardmau Falls, which is located in the state of Ngardmau, Babeldaob Island, Palau. They swam in the waterfall and a river swollen after typhoon flooding [Phanfone-fed] during the rainy season.

At the time of admission, his physical examination showed that his temperature was 40.0 C [104 F], [and he had an erythematous rash on his trunk and muscle pain in both legs]. The serum and urine polymerase chain reaction (PCR) for _Leptospira_ were negative on admission. His IgM antibody was negative at the initial visit; however, the diagnosis of leptospirosis was confirmed by an increased antibody titer after one week.

His girlfriend, a 28 year old Japanese female, also presented with fever, headache, conjunctival hyperemia, and muscle pain in both legs at the same time. She had bimodal fever, including an afebrile period of 24 hours. She was diagnosed with leptospirosis by PCR of her serum and urine at the initial visit.
Takashi Matono, MD
Disease Control and Prevention Center
National Center for Global Health and Medicine, Tokyo, Japan
Satoshi Kutsuna, MD, PhD;
Sunao Takeuchi MD;
Kei Yamamoto MD;
Yoshihiro Fujiya, MD;
Momoko Mawatari, MD;
Nozomi Takeshita, MD, PhD;
Kayoko Hayakawa, MD, PhD;
Yasuyuki Kato, MD, MPH;
Shuzo Kanagawa, MD; Norio Ohmagari, MD, MSc
[Leptospirosis is a zoonotic spirochetal infection that is distributed widely throughout the world. Although leptospirosis is commoner in tropical areas, it is also found in temperate areas. It is transmitted to humans by direct contact of abraded skin or mucous membranes with the urine of infected animals or by contact with wet soil, vegetation, or water that has been contaminated with infected animal urine. These animals are mostly asymptomatic but chronically infected with one of the several hundred serovars of the spirochete leptospira. Many species of wild and domestic animals (including rodents, dogs, cattle, and swine) are susceptible to chronic urinary infection with leptospira. In carrier animals with chronic renal infections, leptospiruria persists for long periods or for life, and leptospira bacteria shed in urine may survive in water or moist soil for weeks to months.

Outbreaks frequently follow heavy rainfalls, flooding with fresh water, and increasing rodent numbers. Leptospirosis is an occupational hazard for people who work outdoors or with animals, for example, farmers, sewer workers, veterinarians, dairy farmers, and rice and sugarcane field workers. It is a recreational hazard for those who participate in outdoor water sports such as swimming, rowing, or white-water rafting in contaminated lakes and rivers, as happened in the 2 Japanese tourists described above. Although vaccines are available for immunizing other animals against leptospirosis, no vaccine against leptospirosis is available for use in humans.

For a discussion of leptospirosis, see ProMED-mail post Leptospirosis - Philippines (03) 20111018.3118.

Palau is an island country that is part of the larger island group of Micronesia in the western Pacific Ocean. Palau's population of around 21 000 is spread across 250 islands forming the western chain of the Caroline Islands. The Imperial Japanese Navy conquered Palau during World War I, and the islands were later made a part of the Japanese-ruled South Pacific Mandate by the League of Nations. Palau was made a part of the United States-governed Trust Territory of the Pacific Islands after WW II in 1947 and gained full sovereignty in 1994 under a Compact of Free Association with the United States, which provides defense, funding, and access to social services (<http://en.wikipedia.org/wiki/Palau>).

Babeldaob is the largest island and contains 10 of Palau's 16 states (<http://en.wikipedia.org/wiki/Babeldaob>). Ngardmau, with a population of 221 persons, is one of Palau's 16 states and is located on the west side of Babeldaob between the states of Ngaraard and Ngeremlengui. The capital Ngerulmud is located in Melekeok State on Babeldaob.

Palau's economy is based mainly on tourism, with the majority of its tourists coming from Japan and Taiwan (<http://en.wikipedia.org/wiki/Japan-Palau_relations>). As a former Japanese colony, Palau was influenced by Japanese culture. Babeldaob is mountainous with many rivers and waterfalls connected to each other (<http://en.wikipedia.org/wiki/Ngardmau>). A scenic waterfall (Taki Falls) is the main tourist attraction of Ngardmau, where there are also historical remains of the Japanese colonial times (<http://www.ngardmau.com/index.php?section=nature>). - ProMed Mod.ML]

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