text:
Africa (2 of 54)
Algeria Angola Benin Botswana British Indian Ocean Territory Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Congo, DRC Cote d'Ivoire Djibouti X Egypt Equatorial Guinea Eritrea Ethiopia Gabon Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Libya Madagascar Malawi Mali Mauritania Mauritius Mayotte Morocco Mozambique Namibia Niger Nigeria Rwanda Sao Tome & Principe Senegal Seychelles Sierra Leone Somalia South Africa St. Helena Sudan X Swaziland Togo Tunisia Uganda Zambia Zimbabwe
Antarctica (1 of 4)
Antarctica X Bouvet I. French Southern & Antarctic Lands Heard I. & McDonald Is.
Asia (1 of 48)
Afghanistan Armenia Azerbaijan Bahrain Bangladesh Bhutan Brunei Cambodia China Christmas I. Cocos Is. Gaza Strip Georgia India Indonesia Iran Iraq Israel Japan X Jordan Kazakhstan Kuwait Kyrgyzstan Laos Lebanon Malaysia Maldives Mongolia Myanmar Nepal North Korea Oman Pakistan Philippines Qatar Saudi Arabia Singapore South Korea Sri Lanka Syria Tajikistan Thailand Turkey Turkmenistan United Arab Emirates Uzbekistan Vietnam Yemen
Europe (1 of 48)
Albania Andorra Austria Belarus Belgium X Bosnia & Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Faroe Is. Finland France Germany Gibraltar Greece Hungary Iceland Ireland Italy Jan Mayen Latvia Liechtenstein Lithuania Luxembourg Macedonia Malta Moldova Monaco Montenegro Netherlands Norway Poland Portugal Reunion Romania Russia San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Ukraine United Kingdom
North America (1 of 36)
Anguilla Antigua & Barbuda Aruba Barbados Belize Bermuda British Virgin Is. Canada Cayman Is. X Costa Rica Cuba Dominica Dominican Republic El Salvador Greenland Grenada Guadeloupe Guatemala Haiti Honduras Jamaica Martinique Mexico Montserrat Netherlands Antilles Nicaragua Puerto Rico St. Kitts & Nevis St. Lucia St. Pierre & Miquelon St. Vincent & the Grenadines The Bahamas Trinidad & Tobago Turks & Caicos Is. United States Virgin Is.
Oceania (1 of 26)
American Samoa Australia Cook Is. Fiji French Polynesia Guam Jarvis I. Kiribati Marshall Is. Micronesia Nauru New Caledonia New Zealand Niue Norfolk I. Northern Mariana Is. Palau Papua New Guinea Pitcairn Is. Samoa Solomon Is. X Timor-Leste Tokelau Tonga Vanuatu Wallis & Futuna
South America (2 of 14)
Argentina Bolivia Brazil Chile Colombia Ecuador Falkland Is. French Guiana Guyana Paraguay Peru South Georgia & the South Sandwich Is. Uruguay X Venezuela X
Cuba is an independent island country situated in the Caribbean. It is the largest of the islands and covers 42,000sq miles. The climate is sub tropical throughout the year with most of the rainfall in Read More Show Less
the northern parts of the country. Temperatures of between 20C to 35C are fairly standard throughout the year. Generally the winter effects of the American continent only last for short periods.
The majority of tourists visiting Cuba will have no difficulty but bag snatching and other street crime appears to be increasing. The old Havana area and other major tourist resorts may be particular areas of concern in this regard. On arrival be careful to only use your recognised tour operator. If you are taking a taxi at any stage make sure it is a registered one and not a private vehicle. It is unwise to carry large quantities of money or jewellery away from your hotel and try not to flaunt wealth with your belongings. Pickpockets are too common an occurrence on buses and trains and at train stations so be careful with your essential documents and credit cards. Valuables should not be stored in suitcases when arriving in or departing from Havana as there have been a number of thefts from cases during the time the cases are coming through baggage handling. There is an airport shrink-wrap facility for those departing Havana which reduces the risk of tampering. Remember to carry a photocopy of your main documents (passport, flight tickets etc).
Road Safety:
Following a number of serious road accidents involving tourists, you are advised not to use mopeds for travelling around Cuba or in Havana. Also, if you are involved in any accident a police investigation will be required to clear you and this may significantly delay your travel plans. On unlit roads at night there have been a number of accidents associated with roaming cattle (sounds like Ireland!). The traffic moves on the right side of the roads. There is a main highway running the length of the country but many of the country roads are in poor repair.
Local Laws & Customs:
When arriving into Cuba make sure you are not carrying any items which could be considered offensive. Any illicit drug offense is treated very seriously and Cuban law allows for the death penalty to be used under these circumstances. If you require personal medication for your health, make sure it is in original packing and carry a letter from your doctor describing the medication. Never agree to carry any item for another individual and always secure your cases once they are packed. Taking photographs of military or police installations or around harbours, rail and airport facilities is strictly forbidden.
Since 1993 it is now possible to use US dollars for all transactions within Cuba. Remember, there is a 20$ airport departure tax. Certain travellers cheques and credit cards may not be acceptable within Cuba. This is particularly true of American Express cheques and cards but check your situation with the travel operator before departure.
Health Facilities:
Generally healthcare facilities outside of Havana are limited and many standard medications may not be available. It is important to carry sufficient quantities of any medications which may be required for the duration of your time in Cuba.
Food & Water:
The level of food and water hygiene varies throughout the country and between resorts. On arrival check the hotel cold water supply for the smell of chlorine. If it is not present then use sealed bottled water for both drinking and brushing your teeth throughout your stay. Cans and bottles of drinks are safe but take care to avoid pre-cut fruit. Peel it yourself to make sure it is not contaminated. Food from street vendors should be avoided in most cases. Bivalve shellfish are also a high risk food in many countries and Cuba is no exception in this regard. (Eg Mussels, Oysters, Clams etc)
Malaria & Mosquito Borne Diseases:
Malaria transmission does not occur within Cuba and so prophylaxis is not required. However, a different mosquito borne disease called Dengue has begun to reoccur in the country over the past few years. This viral disease can be very sickening and even progress to death. It is rare for tourists to become infected but avoiding mosquito bites is a wise precaution.
Swimming, Sun & Dehydration:
The extent of the Cuban sun (particular during the summer months (April to October) can be very excessive so make sure your head and shoulders are covered at all times when exposed. Watch children carefully as they will be a significant risk. Drink plenty of fluids to replace what will be lost through perspiration and, unless there is a reason not to,
take extra salt either on your food or in crisps, peanuts etc. Take care if swimming in the Caribbean to stay with others and to listen to local advice. Never swim after a heavy meal or alcohol.
Rabies Risk in Cuba:
This viral disease does occur throughout Cuba and it is essential that you avoid any contact with all warm blooded animals. Dogs, cats and monkeys are the most commonly involved in spreading the disease to humans. Don't pick up a monkey for a photograph! If bitten, wash out the wound, apply an antiseptic and seek urgent medical attention.
Vaccinations for Cuba:
There are no essential vaccines for entry / exit if coming from Ireland. However, for your own personal protection travellers are advised to have cover against the following;
Tetanus (childhood booster)
Typhoid (food & water borne disease)
Hepatitis A (food & water borne disease)
For those planning a longer or more rural trip vaccine cover against conditions like Hepatitis B and Rabies may also need to be considered.
Cuba is becoming a popular destination for tourists and generally most will stay very healthy. However commonsense care against food and water borne disease is essential at all times. Also take care with regard to sun exposure, dehydration and mosquito bites.
Antarctica tourism: the quest for Earth's vulnerable extremes
Tourism Antartica - 1 month ago
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."
Antarctica tourism regulation urgent for environment
Tourism Antartica - 2 years ago
Buenos Aires, May 17, 2018 (AFP) - Tourism regulation in Antarctica has become an urgent matter due to environmental threats, officials from the 53 member countries of the Antarctic Treaty warned at their annual meeting, held this week in Buenos Aires.
In the absence of rules, travel agencies offer trips to the region on boats sometimes equipped with helicopters or submarines, according to Segolene Royal, French ambassador for the Arctic and Antarctic poles. "This activity creates considerable disturbance ... we are witnessing a race toward large-scale tourism that is dangerous for ecosystems," she said at the assembly on Wednesday.
During the austral summer of 2016/2017, around 44,000 tourists set off for Antarctica, compared with just 9,000 in 1995/1996, according to French authorities. However, the push for regulation is not about banning tourism, former environmental minister Royal said, but rather about ensuring it is managed in compliance with the treaty and its environmental protection protocol.
In Buenos Aires, the Antarctic Treaty Consultative Meeting -- whose mission is to regulate human activity on the continent -- also sought to encourage scientific cooperation between countries that have collectively set up around 100 research bases across the ice. Also up for analysis is China's proposed fifth permanent scientific station in Antarctica, which would be located in the Ross Sea area south of New Zealand.
Huge Antarctic ice block poised to snap off
Natural Disaster Antartica - 3 years ago
Date: Wed, 5 Jul 2017 13:01:49 +0200
By Marlowe HOOD
Paris, July 5, 2017 (AFP) - A chunk of ice bigger than the US state of Delaware is hanging by a thread from the West Antarctic ice shelf, satellite images revealed Wednesday. When it finally calves from the Larsen C ice shelf, one of the biggest icebergs in recorded history will be set adrift -- some 6,600 square kilometres (2,550 square miles) in total, according to the European Space Agency (ESA).
The iceberg's depth below sea level could be as much as 210 metres (almost 700 feet), or about 60 storeys, it said. "The crack in the ice is now around 200 kilometres (125 miles) long, leaving just five kilometres between the end of the fissure and the ocean," the ESA said in a statement. "Icebergs calve from Antarctica all the time, but because this one is particularly large its path across the ocean needs to be monitored as it could pose a hazard to maritime traffic."
Scientists tracking the berg's progression expect it to break of within months. The Larsen C shelf will lose more than 10 percent of its total surface area. The massive ice cube will float in water and by itself will not add to sea levels when it melts. The real danger is from inland glaciers. Ice shelves float on the sea, extending from the coast, and are fed by slow-flowing glaciers from the land. They act as giant brakes, preventing glaciers from flowing directly into the ocean. If the glaciers held in check by Larsen C spilt into the Antarctic Ocean, it would lift the global water mark by about 10 centimetres (four inches), researchers have said.
The calving of ice shelves occurs naturally, though global warming is believed to have accelerated the process. Warming ocean water erodes the underbelly of the ice shelves, while rising air temperatures weaken them from above. The nearby Larsen A ice shelf collapsed in 1995, and Larsen B dramatically broke up seven years later. The ESA is keeping an eye on Larsen C with its Copernicus and CryoSat Earth orbiters.
Man-made global warming has already lifted average global air temperatures by about one degree Celsius (1.8 degrees Fahrenheit) since pre-industrial levels. Antarctica is one of the world's fastest-warming regions. The world's nations undertook in the Paris Agreement, inked in 2015, to cap average global warming at "well under" 2 C.
Sick workers evacuated in daring South Pole rescue
Disturbances Antartica - 4 years ago
By Jean-Louis SANTINI
Washington, June 22, 2016 (AFP) - Two sick workers were evacuated from a remote US research station near the South Pole on Wednesday in a risky rescue mission carried out in the dead of Antarctica's winter, a US official said. A Twin Otter turboprop plane flew in dark and cold conditions to pick up the workers from the Amundsen-Scott station, about 250 meters from the geographic South Pole, a spokesman for the US National Science Foundation (NSF), Peter West told AFP.
The plane's crew and a medical team had made the 10-hour journey to the South Pole in the middle of Antarctica's 24-hour winter on Tuesday night to reach the unidentified patients, who could not be treated on site. The NSF -- the US research agency that operates the Amundsen-Scott Station -- organized the rescue mission last week given the condition of the first patient, which was not disclosed for privacy reasons. "It was really an emergency," West said. It later became apparent that the second worker also needed to be evacuated.
The sick workers -- employees of the US company Lockheed Martin who worked on base logistics -- were then taken to the Rothera base, a British research station some 2,200 kilometers (about 1,365 miles) away, the spokesman said. The pair, who were not identified, were then to be transferred to a hospital in South America, West said, without giving further details. The Amundsen-Scott base was home to 48 people -- 39 men and nine women -- who work on-site throughout the austral winter, which spans February through October.
- Rare rescue mission -
Near the world's southernmost point, workers spend this period withstanding nearly complete darkness and dramatically low temperatures -- on Tuesday, the thermometer dropped to -60 degrees Celsius (-76 degrees Fahrenheit). It was only the third time that an emergency rescue operation has been launched in the middle of winter. In 2001, the only doctor at the Amundsen-Scott station was suffering from a life-threatening pancreatic condition and required urgent evacuation. A second medical evacuation was carried out that year.
In 1999, the US station's doctor Jerri Nielsen, who was self-treating her own breast cancer, required medical evacuation but weather conditions were more favorable, as the mission took place in the spring. The Twin Otter plane, operated by the Canadian company Kenn Borek Air, is specially designed to operate in extremely cold temperatures.
Research projects at the Amundsen-Scott station include monitoring long-term levels of carbon dioxide (CO2) in the atmosphere. The station also operates two telescopes that observe "cosmic microwave background" radiation -- the faint light signature left by the Big Bang -- to study the origins of the universe, dark energy and dark matter.
Scientists warn of tourism threat to Antarctica
Date: Wed, 18 Jun 2014 09:04:56 +0200 (METDST)
by Martin PARRY
SYDNEY, June 18, 2014 (AFP) - Antarctic scientists warned Wednesday that a surge in tourists visiting the frozen continent and new roads and runways built to service research facilities were threatening its fragile environment. Tourist numbers have exploded from less than 5,000 in 1990 to about 40,000 a year, according to industry figures, and most people go to the fragmented ice-free areas that make up less than one percent of Antarctica. A growing number of research facilities are also being built, along with associated infrastructure such as fuel depots and runways, in the tiny ice-free zones.
It is these areas which contain most of the continent's wildlife and plants, yet they are among the planet's least-protected, said a study led by the Australian government-funded National Environmental Research Programme (NERP) and the Australian Antarctic Division. "Many people think that Antarctica is well protected from threats to its biodiversity because it's isolated and no one lives there," said Justine Shaw from the NERP of the study published in the journal PLoS Biology. "However, we show that there are threats to Antarctic biodiversity. "Most of Antarctica is covered in ice, with less than one percent permanently ice-free," she added. "Only 1.5 percent of this ice-free area belongs to Antarctic Specially Protected Areas under the Antarctic Treaty System, yet ice-free land is where the majority of biodiversity occurs." Five of the distinct ice-free areas have no protection at all while all 55 of the continent's protected zones are close to sites of human activity.
- Fragile ecosystems -
Steven Chown of Monash University, another collaborator in the study, said the ice-free areas contain very simple ecosystems due to Antarctica's low species diversity. This makes its native wildlife and plants extremely vulnerable to invasion by outside species, which can be introduced by human activity. "Antarctica has been invaded by plants and animals, mostly grasses and insects, from other continents," he said. "The very real current and future threats from invasions are typically located close to protected areas. "Such threats to protected areas from invasive species have been demonstrated elsewhere in the world, and we find that Antarctica is, unfortunately, no exception."
The study said the current level of protection was "inadequate by any measure" with Shaw saying more was needed to guard against the threat posed by the booming tourism industry. "(We need) to protect a diverse suite of native insects, plants and seabirds, many of which occur nowhere else in the world," she said. "We also need to ensure that Antarctic protected areas are not going to be impacted by human activities, such as pollution, trampling or invasive species." Antarctica is considered one of the last frontiers for adventurous travellers. Most travel by sea, some paying in excess of US$20,000 for a luxury cabin in the peak period from November to March. There is also a healthy market for sightseeing flights.
Approximately 30 nations operate permanent research stations on the continent including the US, China, Russia, Australia, Britain, France and Argentina, and more are on the way. China's state media said in December that the country was building its fourth base and a fifth was being planned. Fellow study author Hugh Possingham, from NERP, said that without better protection "this unique and fragile ecosystem could be lost". "Although we show that the risks to biodiversity from increasing human activity are high, they are even worse when considered together with climate change," he added. "This combined effect provides even more incentive for a better system of area protection in Antarctica."
Sudan US Consular Information Sheet
Sudan is a diverse, developing country in northeastern Africa. The capital city is Khartoum. The civil war between the northern and southern regions, which began in 1 Read More Show Less
83, ended in 2005. A multi-party conflict continues in the west in Darfur, and the armed Ugandan group known as The Lord's Resistance Army is present in the south. Security conditions are adverse in these and some other regions. Transportation networks and other forms of infrastructure are poor and do not meet western standards. Even where available, water and electric services suffer frequent outages. Read the Department of State Background Notes on Sudan for additional information.
ENTRY/EXIT REQUIREMENTS: The Government of Sudan requires all travelers to present a passport and an entry visa. Most travelers must obtain the entry visa before arrival; only American citizens who also possess a Sudanese national identification document (such as a Sudanese passport or national identification card) may apply for an entry visa at Khartoum International Airport. The Government of Sudan routinely denies visas to travelers whose passports contain visas issued by the Government of Israel or other evidence of travel to Israel such as exit or entry stamps.
Travelers must obtain an exit visa before departure from Sudan as well as pay any airport departure tax not included in the traveler's airline ticket. Visitors may obtain the latest information and further details from the Embassy of Sudan, 2210 Massachusetts Avenue NW, Washington, DC 20008, tel.: 202-338-8565.
Travel permits issued by the semi-autonomous Government of Southern Sudan (GOSS) or by the South Sudan Relief and Rehabilitation Commission (SSRRC) are not adequate for entry to the country, although travelers may find these documents useful to present to local authorities when in the south. Personal baggage, including computers, is routinely searched upon arrival to and departure from Sudan. The authorities will seize material deemed objectionable, such as alcohol or pornography, and may detain or arrest the traveler. Travelers intending to bring electronic items should inquire about entry requirements when they apply for a visa; restrictions apply to many devices, including video cameras, satellite phones, facsimile machines, televisions, and telephones. Travelers are not allowed to depart Sudan with ivory, some other animal products, or large quantities of gold.
All visitors must register with the authorities within three days of arrival. Travelers must register within 72 hours of arrival in Sudan at the Ministry of Interior. All foreigners traveling more than 25 kilometers outside of Khartoum must obtain a travel permit from the Ministry of Humanitarian Affairs in Khartoum. This applies to all travel, including private, commercial, and humanitarian activities. Americans risk detention by Sudanese authorities when traveling more than 25 kilometers outside of Khartoum without a travel permit issued by the Ministry of Humanitarian Affairs. Travelers must register again with the police within 24 hours of arrival. The government requires a separate travel permit for travel to Darfur. These regulations are strictly enforced and even travelers with proper documentation may expect delay or temporary detention from the security forces, especially outside the capital. Authorities expect travelers to strictly respect roadblocks and other checkpoints.
Travelers who wish to take any photographs must obtain a photography permit from the Government of Sudan, Ministry of Interior, Department of Aliens.
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.
On January 1, 2008, unknown assailants shot and killed two U.S. Embassy employees - an American USAID officer and a Sudanese national driver. Terrorists are known to operate in Sudan and continue to seek opportunities to carry out attacks against U.S. interests. Terrorist actions may include suicide operations, bombings, or kidnappings. U.S. citizens should be aware of the risk of indiscriminate attacks on civilian targets in public places, which include tourist sites and locations where westerners are known to congregate, and commercial operations associated with U.S. or Western interests. Terrorists are known to have targeted both official facilities and residential compounds. Anti-American sentiment is prevalent and Americans should exercise utmost caution at all times.
The U.S. Embassy's ability to provide consular services in Sudan, including emergency assistance, is severely limited. Many areas outside the capital of Khartoum are extremely difficult to access.
Travel in many parts of Sudan is hazardous. Outside the major cities infrastructure is extremely poor, medical care is limited, and very few facilities for tourists exist.
Conflict among various armed groups and government forces continues in western Sudan, in the states of North Darfur, South Darfur, and West Darfur. Banditry and lawlessness are also common in the west. Many local residents are in camps for internally-displaced persons, and receive humanitarian assistance for basic needs such as food, water, and shelter. Expatriate humanitarian workers have been the targets of carjackings and burglaries.
Land mines remain a major hazard in southern Sudan, especially south of the city of Juba. Visitors should travel only on main roads unless a competent de-mining authority such as the UN has marked an area as clear of mines. The armed Ugandan group known as The Lord's Resistance Army is present along the southern border and reportedly has announced it will target Americans.
Occasional clashes between armed groups representing communal interests continue to occur in the centrally-located states of Upper Nile, Blue Nile, and Bahr al Ghazal. Banditry also occurs.
Sudan shares porous land borders with nine other countries, including Chad, the Central African Republic, Uganda, Democratic Republic of Congo, Ethiopia, and Eritrea. Conflict in these countries occasionally spills over into Sudan.
Americans considering sea travel in Sudan's coastal waters should exercise caution as there have been incidents of armed attacks and robberies by unknown groups in recent years, including one involving two American vessels. Exercise extreme caution, as these groups are considered armed and dangerous. When transiting in and around the Horn of Africa and/or in the Red Sea near Yemen, it is strongly recommended that vessels convoy in groups and maintain good communications contact at all times. Marine channels 13 and 16 VHF-FM are international call-up and emergency channels, and are commonly monitored by ships at sea. 2182 Mhz is the HF international call-up and emergency channel. Wherever possible, travel in trafficked sea-lanes. Avoid loitering in or transiting isolated or remote areas. In case of emergency, contact the nearest U.S. Embassy or Consulate. In the event of an attack, consider activating Emergency Position Indicating Radio Beacons.
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: Crime is on the increase throughout Sudan. Additional security measures should be taken at places of residence to protect life and property. Anti-American sentiments can be found throughout the country. Americans should exercise caution by avoiding crowded public areas and public gatherings. Americans should avoid traveling alone. Report all instances of anti-American acts and crime targeting westerners to the American Embassy, and report incidents of crime to the Sudanese Police.
Americans should guard their backpacks or hand luggage. When traveling by air, travelers should maintain constant contact with their baggage and assure that they do not contain illicit items, such as alcohol or military ordinance. Americans have been removed from international airlines and detained when suspect items have been detected in checked baggage.
Carjacking and armed robbery continue to occur in western and southern Sudan. Sexual assault is more prevalent in the areas of armed conflict. Travelers who do not use the services of reputable travel firms or knowledgeable guides or drivers are especially at risk. Travel outside of Khartoum should be undertaken with a minimum of two vehicles so that there is a backup in case of mechanical failure or other emergency. Solo camping is always risky.
The Sudanese mail system can be unreliable. International couriers provide the safest means of shipping envelopes and packages, although anything of value should be insured.
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: Individuals with medical conditions which may require treatment are discouraged from traveling to Sudan. Medical facilities in Khartoum fall short of U.S. standards; outside the capital, very few facilities exist and hospitals and clinics are poorly equipped. Travelers must pay cash in advance for any medical treatment. Ambulance services are not available. Medicines are available only intermittently; travelers should bring sufficient supplies of needed medicines in clearly-marked containers.
Malaria is prevalent in all areas of Sudan. The strain is resistant to chloroquine and can be fatal. Consult a health practitioner before traveling, obtain suitable anti-malarial drugs, and use protective measures, such as insect repellent, protective clothing, and mosquito nets. Travelers who become ill with a fever or a flu-like illness while in Sudan, or within a year after departure, should promptly seek medical care and inform their physician of their travel history and the kind of anti-malarial drugs used. For additional information about malaria and anti-malarial drugs please see the Center for Disease Control travelers' health web site, http://www.cdc.gov/malaria/index.htm.
Officially, people with HIV are not granted a visa and are not permitted to enter Sudan. A negative HIV test result must be presented at a Sudanese embassy or at Khartoum airport in order to obtain a visa. However, anecdotal reports indicate this requirement is not enforced in practice. Please confirm this requirement with the Embassy of Sudan at www.sudanembassy.org.
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 Sudan is provided for general reference only, and may not be accurate in a particular location or circumstance.
Road conditions throughout Sudan are hazardous due to erratic driver behavior, pedestrians and animals in the roadways, and the lack of basic safety equipment on many vehicles. Only major highways and some streets in the cities are paved; many roads are narrow, rutted, and poorly maintained. Local drivers do not observe conventions for the right-of-way, stop in the road without warning, and frequently exceed safe speeds for road, traffic, and weather conditions. Driving at night is dangerous and should be avoided if possible; many vehicles operate without lights.
In the north and west, dust storms and sand storms, known locally as haboobs, greatly reduce visibility when they occur. Roads in these areas can be quickly covered with shifting sand at any season of the year. Roads in southern Sudan often are impassable during the rainy season, from March to October.
U.S. citizens are subject to the laws of the country in which they are traveling, including traffic laws. In Sudan vehicles have the steering wheel on the left side and drivers use the right side of the road.
Traffic from side streets on the right has the right-of-way when entering a cross street, including fast-moving main streets. Traffic on the right has the right-of-way at stops. Right turns on a red light are prohibited. Speed limits are not posted, but the legal speed limit for passenger cars on inter-city highways is 120 kph (about 70 mph), while in most urban areas the limit is 60 kph (about 35 mph.) The speed limit in congested areas and school zones is 40 kph (about 25 mph).
Many local drivers carry no insurance despite the legal requirement that all motor vehicle operators purchase third-party liability insurance from the government. Persons involved in an accident resulting in death or injury must report the incident to the nearest police station or police officer as soon as possible. Persons found at fault can expect fines, revocation of driving privileges, and jail sentences, depending on the nature and extent of the accident. Persons convicted of driving under the influence of alcohol face fines, jail sentences, and corporal punishment.
Americans may use their U.S. driver's licenses for up to 90 days after arrival in Sudan, and then must carry either an International Driving Permit (IDP) or a Sudanese driver's license. There are no restrictions on vehicle types, including motorcycles and motorized tricycles.
Public transportation is limited to within and between major urban areas. Passenger facilities are basic and crowded, especially during rush hours and periods of seasonal travel. Schedules are unpublished and subject to change without notice. Vehicle maintenance does not meet U.S. standards. There is routine passenger train service on the route from Khartoum to Wadi Halfa (on the border with Egypt) and to Port Sudan (on the Red Sea.) Bus service between major cities is regular and inexpensive. Intra-city bus service in the major urban areas is regular, but most buses and bus stops are privately-operated and unmarked. Taxis are available in the major cities at hotels, tourist sites, and government offices. The motorized rickshaws in common use in Khartoum are unsafe. Travelers are encouraged to hire cars and drivers from reputable sources with qualified drivers and safe vehicles. Irregularly-scheduled mini-buses provide some public transit to rural communities; many areas lack any public transportation.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Sudan, the U.S. Federal Aviation Administration (FAA) has not assessed Sudan'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.
Enforcement of aviation safety standards in Sudan is uneven; civil aviation in Sudan continues to experience air incidents and accidents, including 5 crashes with at least 64 fatalities between November 8, 2007, and June 30, 2008. Incidents included engine failures, collapsed landing gear, and planes veering off the runway. Whenever possible, Americans traveling to Sudan despite the ongoing travel warning are advised to travel directly to their destinations on international carriers from countries whose civil aviation authorities meet international aviation safety standards for the oversight of their air carrier operations under the FAA's International Aviation Safety Assessment (IASA) program. Adverse seasonal weather conditions, such as dust or sand storms in the north between April and June and severe rain storms in the south between March and October, cause frequent flight cancellations.
Two hijackings originated in Sudan in 2007; no passengers were harmed.
SPECIAL CIRCUMSTANCES: In November 1997, the U.S. imposed comprehensive financial and commercial sanctions against Sudan, prohibiting U.S. transactions with Sudan. Travelers intending to visit Sudan despite the Travel Warning should contact the Department of the Treasury, Office of Foreign Assets Control (OFAC), Office of Compliance, telephone 1-800-540-6322 or 202-622-2490, regarding the effect of these sanctions.
Travelers must be prepared to pay cash for all purchases, including hotel bills, airfares purchased locally, and all other travel expenses. Major credit cards, including Visa, MasterCard, or American Express, cannot be used in Sudan due to U.S. sanctions. Sudan has no international ATMs. Local ATMs draw on local banks only.
Travelers, including journalists, must obtain a photography permit before taking any photographs. Even with a photography permit, photographing military areas, bridges, drainage stations, broadcast stations, public utilities, slum areas, and beggars is prohibited.
Sudan is a conservative society, particularly in the capital and other areas where the Muslim population is the majority. Alcohol is prohibited by law and modest dress is expected. Loose, long-sleeved shirts and full-length skirts or slacks are recommended attire for women visitors. Women who are not Muslim are not expected or required to cover their heads. Men may wear short-sleeved shirts but short pants are not acceptable in public.
Please see our information on Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Sudanese laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in alcohol or illegal drugs in Sudan 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 as well in Sudan.
Sudan's Public Order Courts have continued to serve as the state mechanism for morality enforcement since the early 1980's. Today the court still issues punishments ranging from fines, to lashings, to lengthy prison sentences for offences such as drinking alcohol, wearing inappropriate clothing, or associating with unmarried women.
CHILDREN'S ISSUES: For information see our Office of Children's Issues web pages on intercountry adoption and international parental child abduction.
Americans living or traveling in Sudan are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site so that they can obtain updated information on travel and security within Sudan. 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 Sharia Ali Abdel Latif, Khartoum, Sudan; tel: 249 1 83 774-701, http://sudan.usembassy.gov/.
This replaces the Country Specific Information dated March 12, 2008, to update sections on Entry/Exit Requirements, Medical Facilities and Health Information, Aviation Safety Oversight, and Criminal Penalties.
80 confirmed cases of Diphtheria in South Darfur State of Sudan
Disease Diphtheria Sudan - 8 days ago
Date: Sun 5 Jan 2020
<http://outbreaknewstoday.com/diphtheria-update-in-south-darfur-sudan-51296/>
In a follow-up on the diphtheria outbreak in Alsunta locality in South Darfur State, Sudan, the Ministry of Health in South Darfur State is now reporting 80 cases of confirmed diphtheria, including 10 deaths in Alsunta locality, according to [a] 3 Ayin report (computer translated).
Health authorities [attribute] this recent resurgence of diphtheria cases in this locality to the prolonged absence of primary healthcare services, which manifested in the closure of some health facilities and inadequate vaccination services provided to the local population [83% of the cases were not vaccinated against the disease (<https://translate.google.com/translate?hl=en&sl=es&u=https://fundacionio.com/tag/al-sunta/&prev=search>)].
The director general of the state's Ministry of Health, Dr. Muhammad Idris Abd al-Rahman, told local media, "Immediately after the appearance of the disease, the ministry spent several days and took samples and sent 6 of them to the reference laboratory that proved a positive condition."
He pointed to sending another more specialized delegation from the capital Khartoum and taking additional samples to ensure that it is clinically proven to be diphtheria cases that led the ministry to a health and treatment mission to the centre of the administrative unit as the largest affected area, indicating that work continues to contain the disease [so that] it does not spread to other [regions]. The best way to prevent diphtheria is to get vaccinated.
[South Darfur State (2006, estimated population of 2.89 million) is one of the 5 states that comprise the Darfur region in western Sudan; Nyala is the state capital
(<https://en.wikipedia.org/wiki/South_Darfur>).
A map showing the location of South Darfur can be found at
<https://www.google.com/maps/place/Janub+Darfur,+Sudan>.
Diphtheria is a vaccine-preventable disease. In 2013, WHO reported that more than 90% of Sudan's children were vaccinated against diseases that include diphtheria, tetanus, pertussis, polio, and tuberculosis with the support of WHO, UNICEF, GAVI and other partners (<https://www.who.int/features/2013/sudan_immunization/en/>). However, this report noted that vaccination of children was especially difficult in the Darfur region because armed conflict in these areas made access difficult for vaccination teams. A study in the Nyala locality, South Darfur, published in 2014, that included urban, rural and internal displaced people in proportion to their representation in the population, confirmed that vaccine coverage was low -- only 63.4% of children were found to be fully vaccinated (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340504/>). - ProMED
[HealthMap/ProMED-mail map:
Sudan: <http://healthmap.org/promed/p/96>]
Severe floods could provoke famine in South Sudan
Famine Sudan - 1 month ago
Date: Thu, 12 Dec 2019 15:59:23 +0100 (MET)
Juba, Dec 12, 2019 (AFP) - Devastating flooding in South Sudan following a fierce drought could tip parts of the country into famine in the next few months, the World Food Programme (WFP) warned on Thursday. According to the UN refugee agency nearly one million people were affected by floodwaters that submerged entire towns, compounding an already dire humanitarian situation after six years of war.
The WFP said that 5.5 million people are expected to be going hungry in early 2020 -- the time at which the population is generally benefiting from their harvest in October and November of the previous year. An earlier harvest failed due to drought. This time crops have been washed away. "The number of people in need is likely to increase because of the catastrophic level of destruction caused by floods since October following a drought that hammered parts of the country earlier in the year," the agency said in a statement.
The floods wiped out 73,000 metric tons of potential harvests as well as tens of thousands of cattle and goats, said the WFP. "We know the problems that we've been having in South Sudan, but the rains and the floods have led to a national disaster and are much worse than anyone could have anticipated," said WFP Executive Director David Beasley. "In fact, if we don't get funding in the next few weeks and months, we are literally talking about famine. We need support, we need help and we need it now." The agency estimated its needs at $270 million (242 million euros) for the first half of 2020. South Sudan declared a "man-made" famine affecting around 100,000 people in 2017.
The term "famine" is used according to a scientific system agreed upon by global agencies, when at least 20 percent of the population in a specific area has extremely limited access to basic food; acute malnutrition exceeds 30 percent; and the death rate exceeds two per 10,000 people per day for the entire population. "Famine in South Sudan was defeated after four months in 2017 by a concerted large-scale humanitarian response," said the WFP. "Experts now say the country's food security outlook has never been so dire." Political instability is also high as President Salva Kiir and his rival Riek Machar have again delayed their formation of a power-sharing government, this time by 100 days until February 2020.
HIV campaign tackles sex taboos in South Sudan
Disease AIDS Sudan - 2 months ago
Date: Sat, 30 Nov 2019 18:41:31 +0100 (MET)
By Waakhe Simon Wudu
Juba, Nov 30, 2019 (AFP) - In Andrew Makech's home village near Rumbek in central South Sudan, few have ever heard of a condom, and broaching the topic of its use would be considered taboo. However the 35-year-old on Saturday joined hundreds in the capital Juba to get tested for HIV/Aids and learn about the use of condoms to combat the disease, in a rare public sex education campaign in the country wracked by six years of war. The campaign, launched by the Okay Africa Foundation NGO in partnership with government, comes ahead of World Aids Day on Sunday, and highlights that despite great strides made in raising awareness about the disease around the globe, many are still at risk.
In South Sudan, HIV rates are currently believed to be low, at around 200,000 people infected in a population of around 12 million, however few protect themselves or get themselves tested, and only 10 percent of those infected are receiving anti-retroviral treatment, according to the World Health Organisation. Makech told AFP that in his village anyone using a condom would be considered a prostitute and that asking someone to use one would probably insult them. At the campaign launch at the Kampala University College in Juba, demonstrations were carried out on how to use both male and female condoms -- as students listened attentively and took photos with their phones -- and around 5,000 condoms were distributed. Data Emmanuel Gordon from the Okay Africa Foundation said the campaign was motivated by a lack of awareness on how to stop the spread of HIV/Aids.
In South Sudan "the use of condoms is attributed to immorality. When you use condoms you are immoral. People think the use of condoms is for... going outside your marriage to have sex with someone," said Gordon. Chris Isa, who works on HIV prevention at the South Sudan Aids Commission said there was a perception that educating young people about sex exposed them to immorality. "The fact that we don't talk about sex in this country doesn't mean it is not happening so we really need to accept that we need to condomise and not compromise," said Isa.
South Sudan plunged into war in 2013, two years after achieving independence, and the conflict has devastated health infrastructure in the country. A peace deal was signed in September 2018 which largely stemmed fighting, but a power-sharing government has yet to be formed. Isa said HIV prevalence was particularly high in the military, with five in every 100 soldiers testing positive. He said that if testing was more widely carried out, many more than the almost 200,000 currently recorded could be infected because "all the ingredients and the factors for the spread of the virus are evident in our society."
47 cases of suspected Rift Valley Fever reported in Red Sea State of Sudan
Disease Rift Valley Fever Sudan - 2 months ago
Date: Thu 14 Nov 2019
Source: WHO Emergencies preparedness, response, Disease Outbreak News (DONs) [edited]
<https://www.who.int/csr/don/14-november-2019-rift-valley-fever-republic-of-the-sudan/en/>
On 10 Oct 2019, the National IHR Focal Point for Sudan notified WHO of 47 suspected [human] cases of Rift Valley fever (RVF), including 2 deaths in Arb'aat Area, Towashan Village, in El Qaneb locality, Red Sea State. The suspected cases presented with high-grade fever, headaches, joint pain, vomiting. There were no hemorrhagic signs or symptoms observed. The 1st case presented to the health facility on 19 Sep 2019.
On 28 Sep 2019, a total of 14 samples were sent to the National Public Health Laboratory in Khartoum, and 5 tested positive for RVF by immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) and reverse-transcriptase polymerase chain reaction (RT-PCR). These samples were also tested for malaria and were found negative.
On 13 Oct 2019, a total of 10 suspected RVF cases were recorded in Barbar and Abu Hamed localities, of River Nile State. Of the 10 suspected RVF cases, 5 samples were tested and 4 were found positive for RVF. From 19 Sep 2019 until 11 Nov 2019, a total of 293 suspected human RVF cases, including 11 associated deaths have been reported from 6 states; including the Red Sea (120), River Nile (168), Kassala (2), White Nile (1), Khartoum (1), and Al Qadarif (1) States. The most affected age group is 15-45 years old, which accounts for 83% of the total suspected cases. The male to female ratio is 2.6, with a high proportion of the cases being farmers (37.5%).
These human RVF cases are concomitant with abortions and deaths among goats in the areas where the human suspected and confirmed cases have been reported. From 25 Sep through 3 Nov 2019, 21 goats in Red Sea State were reported as positive for RVF, including 4 deaths; and in River Nile State 16 goats, with 3 deaths, and 37 sheep, with 5 deaths, were confirmed positive for RVF by ELISA test at the Central Veterinary Research Laboratory in Khartoum.
Public health response
Red Sea State
- Activation of RVF task force committee;
- printing and distribution of RVF guidelines;
- deployment of surveillance teams for daily reporting and active case finding in the affected areas;
- establishment of 2 health centers and one dispensary with a capacity of 11 beds, laboratory items, drugs, and supplies to provide health services in the affected villages;
- conducting household inspections and fogging: In Arb'aat area, a total of 452 households were inspected, out of which 30 were found positive for the presence of a competent vector; in Port Sudan, out of 1225 households inspected, 29 were found positive for the competent vector, and fogging was provided to 1949 households;
- the Veterinary Epidemiology Department of the Ministry of Animal Resources conducted vector control in 4 animal enclosures in the affected villages.
River Nile State
- A joint investigation conducted by the State Ministry of Health (SMoH) and WHO on 12 Oct 2019;
- initiation of an RVF Action plan by the SMoH and WHO;
- initiation of Integrated Vector Management (IVM), surveillance, case management, and Rapid Response Team (RRT) activities.
WHO risk assessment
RVF is endemic in Sudan. There have been 3 outbreaks affecting humans previously documented in 1973, 1976, and 2008. During the outbreak in 2008, a total of 747 laboratory-confirmed cases were reported, including 230 deaths.
The recent floods, following heavy rains on 13 Aug 2019, caused flash floods in 17 of the 18 states, including Abyei area in West Kordofan State. These floods have favored vector abundance, distribution, and longevity. The current RVF outbreak started on 19 Sep 2019 and has affected states impacted by the floods.
The uncontrolled movements of animal populations within and outside the country borders may increase the spread of the disease to new areas.
RVF can cause significant economic losses due to livestock travel and trade restrictions, as well as high mortality and abortion rates among infected animals.
In a country where the export of livestock is one of the major sources of the national income, the current RVF outbreak, in the context of political unrest and a debilitated health system requires an urgent need for external assistance.
WHO advice
Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that primarily affects animals but also has the capacity to infect humans. The majority of human infections result from direct or indirect contact with the blood or organs of infected animals. Herders, farmers, slaughterhouse workers, and veterinarians have an increased risk of infection.
Awareness of the risk factors of RVF infection and measures to prevent mosquito bites is the only way to reduce human infection and deaths. Public health messages for risk reduction should focus on:
- reducing the risk of animal-to-human transmission resulting from unsafe animal husbandry and slaughtering practices;
- practicing hand hygiene as well as wearing gloves or other personal protective equipment when handling sick animals or their tissues and when slaughtering animals;
- reducing the risk of animal-to-human transmission arising from the unsafe consumption of raw or unpasteurized milk or animal tissue. in endemic regions, all animal products should be thoroughly cooked before eating;
- reducing the risk of mosquito bites through the implementation of vector control activities (e.g. insecticide spraying and use of larvicidal to reduce mosquito breeding sites), use of insecticide-impregnated mosquito nets and repellents, light-coloured clothing (long-sleeved shirts and trousers);
- restricting or banning the movement of livestock to reduce the spread of the virus from infected to uninfected areas;
- routine animal vaccination is recommended to prevent RVF outbreaks. Vaccination campaigns are not recommended during an outbreak as they may intensify transmission among the herd through needle propagation of the virus;
- outbreaks of RVF in animals precede human cases, thus the establishment of an active animal health surveillance system is essential in providing early warning for veterinary and public health authorities.
WHO advises against the application of any travel or trade restrictions with the affected country based on the current information available on this event.
[The report above provides a good overview of the development of the current Rift Valley fever outbreak. Surveillance and responses require a One Health approach since both humans and animals are affected and environmental change, in this situation extensive flooding, has promoted vector abundance. Effective vector control over extensive geographical areas is difficult to achieve and is expensive. Maintenance of herd immunity through vaccination of animals can be a successful preventive measure prior to the occurrence of cases. - ProMED Mod.TY]
[Neighbouring Egypt, which suffered introductions of RVF from Sudan in the past, has undertaken preventive measures. This relates initially to the 2 governorates bordering Sudan, namely the Red Sea and the New Valley governorates. In the Red Sea governorate, vaccination has already started. Reportedly, as of 18 Nov 2019, a total of 12 801 animals have been vaccinated, including 11 568 sheep and goats, 712 camels, and 421 cows and buffalo. The vaccination, which is free of charge, is being continued. In the New Valley governorate, 62 guidance seminars about RVF for animal breeders in the 5 provincial centers have been undertaken; the implementation of a "magnified immunization campaign for a month" is said to commence "next Saturday" (23 Nov 2019), "aimed at immunizing 120 000 cattle, goats, and sheep." Intensified surveillance in animals has, reportedly, been applied in both governorates; no suspected cases detected. - ProMED Mod.AS]
[Maps of Sudan: <https://en.wikipedia.org/wiki/States_of_Sudan> and
<http://healthmap.org/promed/p/96>]
WHO scales up Cholera vigilance in Khartoum (Sudan)
Disease Cholera Sudan - 2 months ago
http://www.emro.who.int/sdn/sudan-news/who-scales-up-cholera-vigilance-in-khartoum-sudan.html
5 November 2019, Khartoum, Sudan -- To prevent a potential spread of the current cholera outbreak to Khartoum State – including to the country's capital Khartoum City – and at the request of the Federal Minister of Health Dr Akram Eltoum, WHO is working closely with health partners, nongovernmental organizations, and at-risk communities to ensure that suspected cases are quickly identified and responded to, and that people can effectively protect themselves from infection. "The risk of cholera spreading is very real. If not properly managed, this could have potentially serious consequences. More than eight million people live in Khartoum State, where the public health system is impacted by the economic crisis, recent flooding, and ongoing outbreaks of infectious diseases," said Dr Naeema Al Gasseer, WHO Representative in Sudan.
As of 3 November, Sudan's Ministry of Health reported 332 suspected cases of cholera, concentrated in Blue Nile and Sennar States. Two cases were confirmed in Khartoum State on 19 October. Together with the Ministry of Health, WHO has conducted initial risk mapping in Khartoum State to identify which areas are more likely to be at increased risk of an outbreak. This will allow for more informed planning to ensure high-risk areas, including Sharq Elnil and Ombada localities, are better prepared to respond as needed. Scaling up health capacities to detect and respond to cholera
To ensure that health facilities and cholera treatment centres in Khartoum State are equipped to diagnose and treat suspected patients, WHO has delivered cholera medicines and supplies sufficient for 400 severely dehydrated patients, and 500 Rapid Diagnostic Tests used for immediate detection and screening of cholera patients in health facilities. WHO is also supporting the establishing of two cholera treatment centres in Ombada and Bahri localities by providing additional cholera medicines, medical supplies, and Rapid Diagnostic Tests.
To strengthen disease surveillance in Khartoum State, WHO, with support MSF, is providing refresher training for 271 health staff and paramedics from all 7 localities on cholera detection and management. An additional 35 health staff are being trained to form Rapid Response Teams who will be the first to respond to suspected cases at locality level. Ensuring communities are aware of prevention and treatment actions. "A key aspect of preventing and controlling cholera is how well at-risk communities are able to protect themselves by drinking safe water, properly handling food, avoiding defecation in open areas, handwashing, and knowing what to do when they see the first signs of infection," said Dr Al Gasseer.
WHO and the Khartoum State Ministry of Health are working with more than 1700 male and female health promoters and volunteers who will play a critical role in raising awareness among communities on cholera, hygiene practices, and environmental health, as well as linking communities with available health services and involving them more in health planning activities.
WHO's work to protect people from cholera in Sudan is made possible through the Sudan Humanitarian Fund.
Inas Hamam
WHO Regional Office
hamami@who.int
Djibouti - US Consular Information Sheet
COUNTRY DESCRIPTION: Djibouti is a developing African country located on the Gulf of Aden. It is a multi-party democracy with a legal system based on French civil law (Djibouti was a Fr Read More Show Less
nch colony until 1977), though modified by traditional practices and Islamic (Sharia) law. Although exact statistics are unavailable, unemployment is estimated in excess of 50% of the working-age population. About two-thirds of the country's 650,000 residents live in the capital, also called Djibouti. Modern tourist facilities and communications links are limited in the city of Djibouti and are virtually non-existent outside the capital. Read the Department of State Background Notes on Djibouti for additional information.
ENTRY/EXIT REQUIREMENTS: A passport, visa, and evidence of yellow fever vaccination are required. Travelers may obtain the latest information on entry requirements from the Embassy of the Republic of Djibouti, 1156 15th Street, N.W., Washington, D.C. 20005, telephone (202) 331-0270, or at the Djibouti Mission to the United Nations, 866 United Nations Plaza, Suite 4011, New York, N.Y. 10017, telephone (212) 753-3163. Overseas, inquiries may be made at the nearest Djiboutian embassy or consulate. In countries where there is no Djiboutian diplomatic representation, travelers may sometimes obtain visas at the French Embassy. See our Foreign Entry Requirements brochure for more information on Djibouti and other countries. Visit the Embassy of Djibouti web site at www.embassy.org/embassies/dj.html for the most current visa information.
American journalists or any American connected with the media must contact the U.S. Embassy's Public Affairs section prior to travel to facilitate entry into Djibouti. If you are unclear whether this applies to you, please contact the U.S. Embassy for more information.
See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction . Please refer to our Customs Information to learn more about customs regulations
SAFETY AND SECURITY: Djibouti enjoys a stable political climate. However, its international borders are porous and lightly patrolled. In particular, Somalia, Djibouti's neighbor to the south, is considered by many to be a haven for terrorists and other insurgent elements. In addition, tensions exist between neighboring Ethiopia and Eritrea due to the unsettled nature of their long-running border dispute. Civil unrest or armed conflict in neighboring countries could disrupt air travel to and from Djibouti or otherwise negatively affect its security situation.
Terrorism continues to pose a threat in East Africa. U.S. citizens should be aware of the potential for indiscriminate attacks on civilian targets in public places, including tourist sites and other sites where Westerners are known to congregate.
Travelers should exercise caution when traveling to any remote area of the country, including the borders with Eritrea, Ethiopia, and Somalia. Djiboutian security forces do not have a widespread presence in those regions. In recent years, acts of sabotage have occurred along the Djibouti-Ethiopia railway. Although Americans were not specifically targeted in any of these attacks, U.S. citizens should exercise caution.
Demonstrations have become more frequent due to the recent increase in energy prices. Americans are advised to avoid all demonstrations as they may become violent.
Americans considering seaborne travel around Djibouti's coastal waters should exercise extreme caution, as there have been several recent incidents of armed attacks and robberies at sea by unknown groups. These groups are considered armed and dangerous. When transiting in and around the Horn of Africa and/or the Red Sea near Yemen, it is strongly recommended that vessels convoy in groups and maintain good communications contact at all times. Marine channels 13 and 16 VHF-FM are international call-up and emergency channels and are commonly monitored by ships at sea. 2182 Mhz is the HF international call-up and emergency channel. In the Gulf of Aden, transit routes farther offshore reduce, but do not eliminate, the risk of contact with suspected assailants. Wherever possible, travel in trafficked sea-lanes. Avoid loitering in or transiting isolated or remote areas. In the event of an attack, consider activating the Emergency Position Indicating Radio Beacons. Due to distances involved, there may be a considerable delay before assistance arrives. Vessels may also contact the Yemeni Coast Guard 24-hour Operations Center at 967 1 562-402. Operations Center staff members speak English.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times for readily available proof of identity and U.S. citizenship if questioned by local officials. Police occasionally stop travelers on the main roads leading out of the capital to check identity documents.
For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site where the current Worldwide Caution Public Announcement , Travel Warnings and Public Announcements 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: Accurate crime statistics are not available, but crime appears to be on the rise. Petty thefts and pickpockets are common, and a few home invasions have been reported. Major crimes involving foreigners are rare, but are increasing in frequency. In the past year the number of murders has increased in Djibouti, involving mainly Djiboutian and third country nationals (TCNs). This increase in crime is possibly linked to declining economic conditions and a deepening resentment toward the increasing number of TCN workers brought in to assist with major construction projects in Djibouti.
See our information on Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Adequate medical facilities in the capital of Djibouti are limited and medicines are often unavailable. Medicines that are available are extremely expensive. Medical services in some outlying areas may be completely nonexistent. Motorists especially should be aware that in case of an accident outside the capital, emergency medical treatment would depend almost exclusively on passersby. In addition, cell phone coverage in outlying areas is often unavailable, making it impossible to summon help.
Malaria and dengue fever are prevalent in Djibouti. Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarial drugs they have been taking.
In 2005, polio was found in all of Djibouti's neighbors (Somalia, Ethiopia, Eritrea and Yemen) and health professionals strongly suspect it is present in Djibouti. The Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children in the United States should receive four doses of inactivated poliovirus vaccine (IPV) at 2, 4, and 6-18 months and 4-6 years of age. Adults who are traveling to polio-endemic and epidemic areas and who have received a primary series with either IPV or oral polio vaccine should receive another dose of IPV. For adults, available data does not indicate the need for more than a single lifetime booster dose with IPV.
In May 2006, avian influenza was confirmed in three chickens and one human in Djibouti. For more information about this illness, see the Department of State's Avian Flu Fact Sheet .
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's internet site at . For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at . Further health information for travelers is available at .
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas .
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Djibouti is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
The Djiboutian Ministry of Defense and the national police force share responsibility for road safety in Djibouti. While Djibouti has been declared a "mine-safe" country, this indicates landmines have been identified and marked, not that they have been removed. Landmines are known to be present in the northern districts of Tadjoureh and Obock. In addition, there may be mines in the Ali Sabieh district in the south. Travelers should stay on paved roads and should check with local authorities before using unpaved roads.
The two main international routes to the capital city via Dire Dawa, Ethiopia, and Yoboki, Djibouti, are both in poor condition due to heavy truck traffic, whose presence demands that drivers remain vigilant. Major roads outside the capital are paved but lack guardrails. Railroad crossings are often not clearly marked.
Roads are often narrow, poorly maintained, and poorly lit. Drivers and pedestrians should exercise extreme caution. Excessive speed, unpredictable local driving habits, pedestrians and livestock in the roadway, and the lack of basic safety equipment on many vehicles are daily hazards. Speed limits are posted occasionally but are not enforced. The leafy narcotic khat is widely used, particularly in the afternoons, creating another traffic hazard. Travelers should be aware that police set up wire coils as roadblocks on some of the major roads, and these may be difficult to see at night.
The only means of public inter-city travel is by bus. Buses are poorly maintained and their operators often drive erratically with little regard for passenger safety.
Please refer to our Road Safety page for more information. Visit the web site of Djibouti's national tourist office and national authority responsible for road safety at .
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Djibouti, the U.S. Federal Aviation Administration (FAA) has not assessed Djibouti's Civil Aviation Authority for compliance with ICAO international aviation safety standards. For more information, travelers may visit the FAA's Internet website at .
SPECIAL CIRCUMSTANCES: Although the narcotic khat is legal and widely chewed in Djibouti, it is considered an illegal substance in many countries, including the United States.
Djiboutians are generally conservative in dress and manner, especially in rural areas.
Photography of public infrastructure (including, but not limited to, public buildings, seaports, the airport, bridges, military facilities or personnel) is not allowed in Djibouti. Use extreme caution when photographing anyone or anything near prohibited areas. Photographic equipment will be confiscated, and the photographer may be arrested.
Djibouti is a cash-based economy and credit cards are not widely accepted. Reliable automated teller machines (ATMs) are not available. Changing money on the street is legal, but be aware of possible scams as well as personal safety considerations if people observe you carrying large amounts of cash. The exchange rate on the street will be similar to that at a bank or hotel. It is important that the U.S. banknotes that you carry have a date of 2003 or newer because some currency exchanges will not accept U.S. paper money older than 2003.
Djiboutian customs authorities may enforce strict regulations concerning temporary importation into or export from Djibouti of firearms. It is advisable to contact the Embassy of Djibouti in Washington, D.C., for specific information regarding customs requirements.
Please see our information on Customs Information .
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Djiboutian law, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Djibouti 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 on international adoption of children and international parental child abduction, see the Office of Children's Issues website.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Djibouti are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website and to obtain updated information on travel and security within Djibouti. Americans withoutInternet 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 Plateau du Serpent, Boulevard Marechal Joffre, Djibouti City. The mailing address is Ambassade Americaine, B.P. 185, Djibouti, Republique de Djibouti. The telephone number is (253) 35-39-95. The fax number is (253) 35-39-40. Normal working hours are Sunday through Thursday, 7:30 a.m. to 4:00 p.m.
This replaces the Consular Information Sheet dated November 2, 2005, to update sections on Safety and Security, Crime, Medical Facilities and Health Information, Special Circumstances, and Registration/Embassy Location.
Djibouti ruling party claims landslide parliamentary win
Miscellaneous Djibouti - 2 years ago
Djibouti, Feb 26, 2018 (AFP) - President Ismael Omar Guelleh's ruling party claimed a resounding victory in Friday's parliamentary elections in Djibouti, taking nearly 90 percent of seats after the opposition largely boycotted the poll. Mohamed Abdallah Mahyoub, a senior member of Guelleh's UMP party and campaign spokesman, told AFP late Sunday the party had won 58 out of 65 parliamentary seats, an increase of three since the last vote in 2013. There was no immediate figure for turnout among the tiny Horn of Africa nation's 194,000 registered voters. Guelleh has ruled Djibouti since 1999 and was last re-elected in 2016 with 87 percent of the vote.
The UMP's victory has helped by the badly-divided opposition with two parties -- MRD and RADDE and a faction of a third party, ARD -- refusing to put forward any candidates, saying the elections would neither be fair nor transparent while others accused the election commission of bias. The UMP claimed every seat outside of the capital and all but seven seats in Djibouti city with the remainder going to the UDJ party. The law stipulates that 25 percent of seats must go to women, an increase from just 10 percent in the outgoing parliament. According to Mahyoub, this threshold was nearly met as 15 women won parliamentary seats, 14 of them from the UMP.
Drought and malnourishment across Djibouti
Famine Djibouti - 6 years ago
Date: Thu, 12 Jun 2014 16:56:37 +0200 (METDST)
GENEVA, June 12, 2014 (AFP) - Nearly a quarter of the population in drought-hit Djibouti is in desperate need of aid, with malnutrition and a dramatic lack of water causing a mass exodus from rural areas, the UN said on Thursday. "Persistent and recurring droughts have resulted in a general lack of water for both people and livestock," said the UN's Djibouti coordinator Robert Watkins. The crisis, which has dragged on since 2010, has left a full 190,000 of the country's 850,000 residents in need of humanitarian assistance. They include 27,500 refugees, mainly from neighbouring Somalia, Watkins told reporters in Geneva.
Yet the crisis in Djibouti has received little international attention, with a UN appeal for aid last year reaching only a third of its target -- the lowest level of funding for any such appeal worldwide. The appeal comes amid warnings from Britain on Thursday that Somalia's Al-Qaeda-linked Shebab insurgents were planning further attacks in the tiny and traditionally tranquil Horn of Africa country. Shebab suicide bombers hit a crowded restaurant in Djibouti last month, killing at least one, in an attack apparently linked to the country's participation in the African Union force in Somalia. Djibouti's port also serves as a key base for international anti-piracy operations off the Somali coast.
Watkins also said on Thursday that some 60,000 migrants -- most of them Ethiopians trying to reach the Gulf for work -- were also in need of aid inside Djibouti. Last year alone, 100,000 passed through the country, he said. Most migrants come on foot, staggering alongside the roads in the extreme heat. "Many die from dehydration," he said. Foreigners are not the only ones on the move in the country, where most people still live off livestock which have been hard-hit by the drought. "There has been a huge exodus of people living in rural areas," Watkins said, adding that the population in the capital Djibouti City had more than doubled since 2010, now home to 85 percent of the population.
Nationwide, a full 18 percent of the population is considered acutely malnourished, rising to 26 percent in some areas -- well above the 15-percent emergency threshold, Watkins said. Sixty percent of the country's population was also suffering from diarrhoeal diseases, he said. Watkins said he hoped the lack of interest from funders would change, pointing out that a new appeal last month for $74 million (55 million euros) was already 13 percent funded, with contributions from the United States, the EU and Japan among others.
Nearly half a million Arabs said to be infected with HIV
Disease AIDS Djibouti - 7 years ago
Date: Mon, 26 Nov 2012 18:20:54 +0100 (MET)
RIYADH, Nov 26, 2012 (AFP) - The United Nations said on Monday that the number of people in Arab countries infected with HIV more than doubled to 470,000 in the eight years to 2009. "The number of adults and children living with HIV has more than doubled between 2001 and 2009 from 180,000 to 470,000," according to data from UNAIDS, the UN programme on HIV and AIDS. New HIV infections increased from 43,000 in 2001 to 59,000 in 2009, it said at a meeting in Riyadh on combatting AIDS, organised by the Arab League and the Saudi government. The number of deaths from AIDS also surged from about 8,000 in 2001 to 24,000 in 2009.
In Djibouti and Somalia, the percentage of infected people represents 2.5 percent and 0.7 percent of the countries' respective populations. "These figures are very worrying and need an immediate response," it said in an Arabic-language statement. The figures appear in contrast with the global trend. UNAIDS said last week that 25 low- and middle-income countries had managed to at least halve their rate of new HIV infections since 2001, representing a reduction of 700,000 new HIV infections. Globally, new HIV infections fell to 2.5 million last year from 2.6 million in 2010 and represented a 20-percent drop from 2001, it said.
Update on Cholera in Djibouti with 127 new cases in November
Disease Cholera Djibouti - 8 years ago
Date: Wed 23 Nov 2011
Source: IC Publications [edited]
<http://www.africasia.com/services/news_africa/article.php?ID=CNG.9bdd1d5b82f023fa74048f611ee23327.701>
Authorities in Djibouti have reported a serious outbreak of a potentially fatal diarrhea infection in the capital [Djibouti], with 2 deaths since October 2011 and 127 new cases this month [November 2011], the WHO said on Tuesday [22 Nov 2011]. WHO said 5000 cases of acute watery diarrhea (AWD) have already been reported this year [2011] compared to 2000 in the Red Sea port in 2010.
Poor hygiene and sanitation along with recent rainfall in some areas had led to the contamination of already limited and unsafe water supplies, according to the UN health agency, which said the drought in the Horn of Africa had exacerbated the situation.
"The effects of the recurring drought on several parts of Djibouti and neighbouring countries have resulted in a malnourished, poorer and more vulnerable population," a WHO statement said. [WHO] is working with the Djibouti ministry of health to train health workers and set up treatment centres.
Thousands hit by diarrhoea outbreak in Djibouti
Disease Diarrhoea Djibouti - 8 years ago
Date: Tue, 22 Nov 2011 12:16:01 +0100 (MET)
GENEVA, Nov 22, 2011 (AFP) - Authorities in Djibouti have reported a serious outbreak of a potentially fatal diarrhoea infection in the capital, with two deaths since October and 127 new cases this month, the WHO said on Tuesday. The World Health Organization said 5,000 cases of Acute Watery Diarrhoea (AWD) have already been reported this year compared to 2,000 in the Red Sea port in 2010.
Poor hygiene and sanitation along with recent rainfall in some areas had led to the contamination of already limited and unsafe water supplies, according to the UN health agency, which said the drought in the Horn of Africa had exacerbated the situation. "The effects of the recurring drought on several parts of Djibouti and neighbouring countries have resulted in a malnourished, poorer and more vulnerable population," a WHO statement said. The body is working with the Djibouti ministry of health to train health workers and set up treatment centres.
Last week the UN rights agency reported an outbreak of cholera among Somali refugees in Kenya's huge Dadaab refugee camp, with one death. The WHO said on Tuesday that all five camps were affected by AWD but no cases had been reported in Kenya outside the camps. AWD is rife in south central Somalia where more than 53,000 cases were reported this year, resulting in 795 deaths, the agency said.
Uruguay - US Consular Information Sheet
Uruguay is a constitutional democracy with a large, educated middle class and a robust developing economy.
The capital city is Montevideo .
Tourist facilit Read More Show Less
es are generally good with many 5-star accommodations at resort destinations such as Punta del Este and Colonia de Sacramento.
The quality of tourist facilities varies according to price and location.
Travelers are encouraged to seek travel agency assistance in making plans to visit Uruguay .
Read the Department of State Background Notes on Uruguay for additional information.
All United States citizens entering Uruguay for business or pleasure must have a valid passport.
U.S. citizens traveling on a regular passport do not need a visa for a visit of less than three months.
U.S. citizens traveling on diplomatic or official passports require a visa.
Air travelers are required to pay an airport tax upon departure.
This fee may be paid in U.S. dollars or in Uruguayan pesos.
For further information on entry requirements, contact the Embassy of Uruguay at 1913 "Eye" Street NW, Washington, DC 20006, tel. (202) 331-4219; e-mail: conuruwashi@uruwashi.org.
Travelers may also contact the Consulate of Uruguay in New York, Miami, Chicago, Los Angeles, and Puerto Rico.
Visit the Embassy of Uruguay web site at http://www.uruwashi.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.
Regular protests, some with an anti-American flavor, take place outside Congress, City Hall and the "University of the Republic."
U.S. citizens visiting or residing in Uruguay are advised to take common-sense precautions and avoid any large gatherings or any other event where crowds have congregated to demonstrate or protest.
If travelers encounter a protest they should walk the other way or enter a commercial establishment until the protest passes.
Taking pictures of protesters is not a good idea.
Although there have been no past instances of violence directed at U.S. citizens from cross-border extremist groups, U.S. citizens traveling or residing in the more remote areas of Uruguay near the border with Argentina and Brazil are urged to exercise caution.
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.)
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.
Petty street crime is prevalent in Montevideo .
The criminals tend to be non-violent.
However, criminals often resort to violence if the victims resist.
Travelers should exercise reasonable caution to minimize their exposure to crime.
Criminals prey on the unaware, particularly those carrying cameras, pocketbooks, laptops, or backpacks.
Travelers are advised to lock most valuables in secure hotel safes and to download their wallets of excess credit cards and cash.
If dining at an outdoor restaurant take extra care with pocketbooks or bags.
There are no "off limits" areas of the city and parts of "Ciudad Vieja" are popular tourist attractions.
However the only sections of Ciudad Vieja with continual police patrols are Plaza Independencia, the pedestrian street Sarandi, and the Mercado del Puerto.
Mugging is common in other parts of Ciudad Vieja - particularly for travelers walking alone, or couples walking at night.
A smart alternative is to call for a taxi for evening travel between restaurants, bars, and hotels.
Victims are usually foreign tourists, individuals openly carrying valuable items, and motorists in unlocked vehicles stopped at busy intersections, particularly on Montevideo 's riverfront road known as the Rambla. Drivers should keep all car doors locked, the driver's window open only one inch, and purses, bags, briefcases and other valuables out of sight on the floor or in the trunk. Parked cars, particularly in the Carrasco neighborhood, are also increasingly targeted for break-ins. During the summer months (December-March), beach resort areas such as Punta del Este attract tourists, and petty street crimes and residential burglaries--similar to those that occur in Montevideo --rise significantly. Visitors are advised to exercise common sense in the conduct of their activities around Montevideo and in Uruguayan resort areas. They should be very attentive to personal security and their surroundings in the aforementioned areas.
Those planning to live in Montevideo should note that burglaries and attempted burglaries seem to be on the rise in upscale neighborhoods.
The perpetrators are mostly non-confrontational but determined teenagers.
A combination of preventive measures including rigorous use of locks and alarms, strong grillwork on all windows, guard dogs, keeping a residence occupied as much as possible, and using a security service is highly recommended.
Montevideo continues to experience armed robberies of patrons at crowded restaurants in the Pocitos neighborhood.
Most of these crimes have occurred very late at night.
Restaurant patrons should exercise extreme caution for late night dining.
Uruguayan law enforcement authorities have increased the number of uniformed policemen on foot in areas where criminal activity is concentrated and the number of patrol cars in residential areas. The clearly marked patrol cars are equipped with cellular phones and the phone numbers are conspicuously painted on the vehicles.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy or Consulate for assistance.
Facilities for medical care are considered adequate. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost tens of thousands of dollars.
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.
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 Uruguay is provided for general reference only, and may not be totally accurate in particular location or circumstance.
The Uruguayan Ministry of Transportation is responsible for maintaining safe road conditions countrywide. The Uruguayan Ministry of Interior highway police (tel. 1954) are responsible for traffic safety on highways and other roads beyond city limits. In urban and suburban areas, transit police and municipal employees share road safety responsibilities.
Driving is on the right-hand side of the road. Wearing seat belts and using headlights on highways and other inter-city roads 24 hours a day are mandatory. Children under 12 must ride in the back seat. Motorcyclists must wear helmets. The use of cellular phones while driving is prohibited. Right turns on red lights and left turns at most intersections marked with a stoplight are not permitted. Drivers approaching an intersection from the right or already in traffic circles have the right of way.
Flashing high beams indicate intent to pass or continue through unmarked intersections.
Many drivers ignore speed limits and traffic signs.
If you plan to drive, use extreme caution and drive defensively.
For driving under the influence, violators are fined and confiscated licenses may be retained for up to six months. In accidents causing injury or death, drivers are brought before a judge who decides if incarceration is warranted.
Inter-city travel is via bus, taxi, car service (remise), car, and motorcycle. Speed limits are posted on highways and some main roads. Most taxis have no seat belts in the back seat. Cycling outside the capital or small towns is hazardous due to a scarcity of bike paths, narrow road shoulders and unsafe driving practices.
Illumination, pavement markings, and road surfaces are sometimes poor. Route 1, which runs between Montevideo and Colonia or Punta del Este, and Route 2, between Rosario and Fray Bentos, are particularly accident-ridden because of heavy tourist traffic. Road accidents rise during the austral summer beach season (December to March), Carnaval (mid-to-late February), and Easter Week.
Within Montevideo , the emergency number to contact the police, fire department, rescue squad, or ambulance service is 911. In the rest of the country, dial 02-911 to connect with the Montevideo central emergency authority, which will then contact the local emergency service. The Automobile Club of Uruguay responds to emergency calls for roadside assistance at 1707, "Car Up" at 0800-1501 and the Automobile Center of Uruguay at 2-408-6131/2091. SEMM (tel. 159) and UCM (tel. 147), Montevideo-based ambulance services manned by doctors, have agreements with emergency medical units in other cities.
You may also telephone Uruguay 's national tourist office and national authority responsible for road safety in Miami at (305) 443-7431.
The U.S. Federal Aviation Administration (FAA) has assessed Uruguay 's Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Uruguay '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.
Uruguay 's customs authorities may enforce strict regulations concerning temporary importation into or export from Uruguay of items such as precious jewels, gold, firearms, pornography, subversive literature, inflammable articles, acids, prohibited drugs (medications), plants, seeds, and foodstuffs as well as some antiquities and business equipment. It is advisable to contact the Embassy of Uruguay in Washington, D.C., or one of Uruguay 's consulates in the U.S. for specific information regarding customs requirements. Note: Travelers entering Uruguay with precious jewels or gold worth more than $500.00 ( U.S. ) must declare them to customs officers at the port of entry or face possible detention or seizure of the goods and charges of contraband or evasion of customs controls. Visitors are expected to comply with local law and regulations by approaching a customs officer before routine inspection of all incoming baggage, conducted on standard security equipment.
Please see our Customs Information.
Persons violating Uruguay 's laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Uruguay 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 .
The Uruguayan Ministry of Agriculture and Fishing strictly enforces all regulations regarding hunting permits, as well as seasonal and numerical limits on game. Visitors who contravene local law have been detained by the authorities and had valuable personal property (weapons) seized. Under Uruguayan law, seized weapons can only be returned after payment of a sum equivalent to the value of the property seized. Hunters are also subject to stiff fines for practicing the sport without all appropriate permits.
For information see our Office of Children's Issues web pages onintercountry adoption and international parental child abduction.
Americans living or traveling in Uruguay are encouraged to register with the U.S. Embassy through the State Department's travel registration web site so that they can obtain updated information on travel and security within Uruguay .
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at Lauro Muller 1776; telephone (598) (2) 418-7777; fax (598) (2) 418-4110 or -8611. Internet: http://uruguay.usembassy.gov/, email: MontevideoACS@state.gov. Consular Section hours for American Citizen Services are Monday to Thursday, 9:00 a.m. to 11:00 p.m. and 2:00 p.m. to 4:00 p.m., except U.S. and Uruguayan holidays.
This replaces the Consular Information Sheet dated August 28, 2007 to update Sections on Entry/Exit Requirements, Safety and Security, Crime, Aviation Safety Oversight, Children's issues, and Registration/Embassy Location.
Torrential rains in Uruguay forces 7.400 to abandon their homes
Climate Changes Uruguay - 7 months ago
https://en.mercopress.com/2019/06/20/torrential-rains-in-uruguay-forces-7.400-to-abandon-their-homes
Torrential rains in central and southern Uruguay in the past several days have caused massive floods and forced some 7,400 people to leave their homes, according to the latest update by the country's National Emergency System. The central city of Durazno is the most affected, with 5,299 evacuees, according to official reports.
Defense Minister Jose Bayardi visited one of the camp sites managed by the military to help the displaced. "We have established a high level of experience (in the face of these catastrophes) which we have succeeded in institutionalizing," he told the media. Troops will continue monitoring the situation because "there are many people who do not want to leave their homes due to fear of being robbed and looted" Bayardi said.
The National Highway Police also said that 12 national highways remain cut-off in different directions. Uruguay's National Meteorological Institute said that between June 11 and 16, some southern regions of the country received around 270 mm of rain. On Wednesday morning, the Yi River, which had been 11.8 meters higher than its normal water level in the Durazno area, was falling at a rate of 11 cm per hour, according to local media reports.
17yo dies from Hantaviral infection in Colonia region of Uruguay
Disease Hantavirus Uruguay - 10 months ago
Date: Tue 12 Mar 2019
Source: Carmelo Portal [in Spanish, trans. Mod. TY, edited]
<http://carmeloportal.com/42015-fallecio-joven-de-17-anos-por-hantavirus>
The departmental health director, Dr Jorge Mota, confirmed for Carmelo Portal the death in our city of a young 17 year old girl from [a] hantavirus [infection]. "In Colonia department, there are on average 3 cases per year. The evolution of the disease is in thirds. One-third of the [infected] people do not have notable symptoms; another third have serious symptoms, especially respiratory symptoms and ones in all the systems, but with adequate treatment, [the infected people] survive, sometimes with sequelae. There is another third that die. It is those few with the virus that die with an evolution so drastic, such as is the case of this girl, sadly," Dr Mota stated.
The department health director said that hantaviruses are not contagious person-to-person. "It is transmitted from an intermediate animal, the field mouse. Only 3% of these mice have [a] hantavirus. To become infected, one must be in contact with an [infected] mouse's secretions that have dried, are mixed with dust, and are in a closed space, away from sunlight and ventilation. A spa, a shed, or a wood pile [are examples of such a space]. The person had to have been moving around there and inhaled the dust," he explained.
Dr Mota spoke about the epidemiological surveillance that is carried out. "We tracked places where the person was, even those that could be identified 2 months before contracting the virus; sometimes we found the place, but sometimes not." As a preventive measure, Mota stated that in these cases, ventilate these closed spaces for at least half an hour. Wet down floors and shelves with water [with 10% bleach]. Use masks [and gloves].
[The report above does not mention the circumstances under which the infection might have been acquired nor which hantavirus was responsible for this or earlier cases in Uruguay. Hantaviruses that cause hantavirus pulmonary syndrome (with rodent hosts found in Uruguay) include Laguna Negra virus (_Calomys laucha_), Maciel virus (_Necromys benefactus_), Central Plata virus, Lechiguanas virus (_Oligoryzomys flavescens_, complex of rodents), and Anajatuba virus and Juquitiba virus (_Ologoryzomys fornesi_).
The rodent reservoir hosts shed the virus in its saliva, urine, and faeces, contaminating the environment in which they live and breed.
A HealthMap/ProMED-mail map showing the location of Uruguay in South America can be accessed at
<http://healthmap.org/promed/p/28995>.
A map of Colonia department in southern Uruguay is available at
<https://en.wikipedia.org/wiki/Colonia_del_Sacramento>
and <http://healthmap.org/promed/p/27367>. - ProMED Mod.TY]
Population in Uruguay mark a year of pot pharmacies - 'it's like selling aspirin'
Drug Trade Uruguay - 1 year ago
Date: Thu, 19 Jul 2018 03:23:55 +0200
By Lucia LACURCIA
Montevideo, July 19, 2018 (AFP) - Enrique Curbelo is delighted. Selling cannabis has allowed the affable 76-year-old to keep his privately owned pharmacy in Montevideo open in a market dominated by big chains. "I had to sell what they didn't sell," he told AFP. "For me it's like selling aspirin." It's been this way for a year now. Every Wednesday, Ismael Fernandez receives a WhatsApp message from his local pharmacist telling him a new stock of cannabis has arrived. After leaving work, he heads there and buys the 10 grams that Uruguayan law permits, costing 400 pesos, around $13.
Fernandez then heads home and rolls a joint "to relax" with his partner Stefania Fabricio. No longer do they need to surreptitiously contact a dealer and pay more for Paraguayan or Brazilian marijuana that's been "pressed, mixed (and is) sometimes very bad and full of chemicals." "Now it's much easier than when it started," Fernandez, a 31-year-old who works for a cleaning company, told AFP. It has been four and a half years since marijuana use became legal in Uruguay and a year since it has been sold in pharmacies -- up to 40 grams a month per person.
Initially, there was insufficient supply, leaving people standing in long queues as stocks sometimes ran out. Pharmacies are better prepared now. "They send you a message with a number which you use later to go and collect it, and in my pharmacy you can order it online," added Fernandez, the father of a three-year-old. Hairdresser Fabricio, also 31, says "it's good quality," but not too strong. "It doesn't send your head spinning, but it's not meant to. You get a hit but you can still do things perfectly." - 'Privileged' - She says she feels "privileged" to live in a country that enacted a law to "get tons of people out of the black market." As a result, she said, the stigma attached to those who smoke pot is changing, "albeit slowly."
The system is simple: to buy cannabis in a pharmacy you must be at least 18, live in Uruguay and sign up as a "buyer" at the post office. An initial stumbling block arose when banks refused to work with establishments selling cannabis due to international rules against drug-trafficking. But the country plowed on, and last year it became the first in the world to fully legalize its sale. But Enrique Curbelo had to get over his own prejudices before deciding to join the select band of pharmacies selling the plant. There are 14, half of them in the capital, serving the 24,812 registered buyers.
- 'Normal people' -
Users can choose between two brands and two types of cannabis -- sativa and indica -- both provided by an official distributor. Customers are generally not the stereotypical grubby-looking student or idle waster. On this day in Curbelo's store they include two young women, a man in his 50s and an older lady -- "normal people," says the pharmacist. Official statistics say 70 percent of buyers are male and 49 percent are between the ages of 18 and 29.
To keep anyone from exceeding their monthly allowance, a fingerprint machine is used to register every sale. Along with the ability to purchase cannabis in a pharmacy, Uruguayans have the right to grow their own -- up to a six-plant maximum -- or to join a cannabis club, which can have up to 45 members and 99 plants. Federico Corbo, a 41-year-old gardener, grows cannabis in his garden on the outskirts of Montevideo. He experiments by crossing species in an attempt to improve quality and optimize the flowering period. Corbo is not impressed with the quality on offer in pharmacies. "It's not the worst, but it's low," he said, insisting quality control needs to be improved. "Marijuana that doesn't reach the minimum standards -- with crushed flowers, no aroma, low quality -- shouldn't be sold in the pharmacy. "Maybe, as I'm a grower, I'm very demanding, but there is a cost associated to the product and it must be offered to the public in the best way possible."
According to the Institute of Cannabis Regulation and Control (Ircca), an average cultivator or club member supplies cannabis to two other people, while those who buy it in a pharmacy share it with one other. "Approximately half of marijuana users have access to regulated cannabis," says Ircca. The rest prefer to continue buying the drug on the black market, put off by the need to register as a user. "It's wrong -- if they legalize it they have to do so in a way in which the state doesn't keep a paternalistic role in overseeing how much you smoke or stop smoking," one clandestine user, who wished to remain anonymous, told AFP. This 48-year-old lawyer simply doesn't trust the authorities. He pointed to the danger a change of government could bring, or even the return of dictatorship. "Right now that seems impossible," he said, "but you can never discount it."
Seafood warning issued in Uruguay after recent deaths
Disease Vibrio vulnificans Uruguay - 2 years ago
Date: Thu 1 Feb 2018 23:02hs UYT
Source: LaRed 21 [in Spanish, machine trans. edited]
<http://www.lr21.com.uy/comunidad/1358685-salud-publica-bacteria-playas-alerta>
The Ministry of Public Health (MSP) issued a statement through which it reports that it has detected cases of infection by the bacterium _Vibrio vulnificus_ in Montevideo, Canelones, and Maldonado [departments]. The State Secretariat assured that every year there are cases of this bacterium, but so far in 2018, 4 serious cases have been reported, of which 3 died. All of them had underlying illnesses.
"90 percent of these cases, in the world, are associated with the consumption of undercooked or raw seafood. Infrequently, the infection can be acquired when entering the sea with open wounds, especially in elderly people or people with diseases that affect the immune system," explained the MSP. It is an event "extremely rare in our country," said the State Secretariat. It also indicated that fewer than 10 cases per year are registered per year for this bacterium.
It is an infection that "can be serious and in some cases fatal, so it is recommended to avoid the consumption of undercooked or raw sea products (as well as their handling without protection measures) and in the same way, avoid entering the sea with wounds or cuts on the skin." The bacteria can be found in coastal marine waters and estuaries in areas of tropical and subtropical climates that have a moderate degree of salinity and temperatures that usually exceed 18 C [64.4 F].
[The following is extracted from the previous edition of the "Bad Bug Book," Center for Safety and Applied Nutrition, US FDA (Food and Drug Administration). The newest version is available at: <https://www.fda.gov/downloads/Food/FoodborneIllnessContaminants/UCM297627.pdf>:
"_Vibrio vulnificus_, a lactose-fermenting, halophilic, Gram-negative, opportunistic pathogen, is found in estuarine environments and associated with various marine species such as plankton, shellfish (oysters, clams, and crabs), and finfish. Environmental factors responsible for controlling numbers of _V. vulnificus_ in seafood and in the environment include temperature, pH, salinity, and amounts of dissolved organics. It may be normal flora in salt water, and acquiring this organism from shellfish or water exposure does not imply that the water is contaminated by sewage.
"Wound infections result either from contaminating an open wound with sea water harbouring the organism, or by lacerating part of the body on coral, fish, etc., followed by contamination with the organism. The ingestion of _V. vulnificus_ by healthy individuals can result in gastroenteritis."
The "primary septicaemia" form of the disease follows consumption of raw seafood containing the organism by individuals with underlying chronic disease, particularly liver disease. The organism can also enter through damaged skin. In these individuals, the microorganism enters the blood stream, resulting in septic shock, rapidly followed by death in many cases (about 50 percent). Over 70 percent of infected individuals have distinctive bullous skin lesions (shown at <http://safeoysters.org/medical/diagnosis.html>).
There are 2 points to be emphasized: that vibrios are normal flora in warm saltwater (not indicative of any sewage contamination) and that most of the life-threatening illnesses occur in individuals with underlying medical illnesses, including immunocompromised states, chronic liver disease, and diabetes. So-called normal individuals often just develop gastroenteritis. The range of disease due to _V. vulnificus_ can involve more northern geographical areas as overall global warming takes effect. - ProMED Mod.LL]
[Maps of Uruguay: <http://geology.com/world/uruguay-map.gif> and
28yo dies from Hantavirus in Canelones in Uruguay
Disease Hantavirus Uruguay - 2 years ago
Source: Monte Carlo [in Spanish, trans. ProMED Mod.TY, edited]
<https://www.radiomontecarlo.com.uy/2018/01/29/nacionales/sospechan-hantavirus-como-causa-de-la-muerte-de-una-joven/>
Personnel of the Ministry of Public Health are investigating the death of a young --28-years old -- agronomist caused by [a] hantavirus [infection]. After completion of the specific studies, which could take 48 hours, they will be able to determine if the young woman died as a consequence of the virus [infection].
The disease is contracted by the inhalation of excretions or secretions of rodents infected by the hantavirus.
As a preventive measure, personnel of the Department of Epidemiology of the Ministry of Health will go to the rural area in Canelones, where the young woman resided. [Byline: Enrique Puig]
[No information is given about the symptoms that the young woman experienced prior to her death, nor the date of her illness and death. Presumably, the diagnosis of a suspected hantavirus infection leading to death was hantavirus cardiopulmonary syndrome (HPS).
The report above does not mention which hantavirus was responsible for this or earlier cases in Uruguay. Central Plata hantavirus could be the etiological agent responsible (for this and previous HPS cases). Its rodent host is the yellow pygmy rice rat, _Oligoryzomys flavescens_, complex of rodents. This rodent reservoir host sheds the virus in its saliva, urine and faeces, contaminating the environment in which it lives and breeds.
An image of this rodent can be accessed at
<http://www.reservacostanera.com.ar/wp-content/uploads/2010/05/colillargo.jpg>.
A HealthMap/ProMED-mail map showing the location of Uruguay in South
America can be accessed at: <http://healthmap.org/promed/p/28995> and
Canelones department in southern Uruguay at
<https://en.wikipedia.org/wiki/Canelones,_Uruguay>. - ProMED Mod.TY]
Islands - US Consular Information Sheet
The Solomon Islands form an Archipelago in the southwest Pacific Ocean about 1,200 miles northeast of Australia.
The capital, Honiara, is locate Read More Show Less
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.
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.
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.
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.
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.
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.
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.
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
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.
Further health information for travelers is available at http://www.who.int/ith/en.
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.
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/.
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.
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.
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.
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.
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.
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.
Volcanic eruption showers Solomons' villages with ash
Natural Disaster Solomon Islands - 2 years ago
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.
6.0-magnitude quake hits off Solomon Islands
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.
Strong quake hits off Solomon Islands 70 kilometres west of Kirakira
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.
Further strong quake rattles Solomons
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.
Third strong quake in two weeks hits off Solomon Islands
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.
Venezuela US Consular Information Sheet
Venezuela is a medium income country whose economy is dominated by a substantial oil industry.
The political climate in Venezuela is highly polarized and Read More Show Less
olatile.
Violent crime is a continuing problem.
Assaults, robberies, and kidnappings occur throughout the country.
Scheduled air service and all-weather roads connect major cities and most regions of the country.
Venezuela's tourism infrastructure varies in quality according to location and price.
For an in depth country description of Venezuela, please read the Department of State Background Notes on Venezuela.
A valid passport and a visa or tourist card are required.
Tourist cards are issued on flights from the U.S. to Venezuela for persons staying less than ninety days.
Persons traveling for reasons other than tourism, however, should consult the Venezuelan Embassy or nearest Venezuelan consulate regarding possible visa requirements for their specific purpose of travel.
Venezuelan immigration authorities may require that U.S. passports have at least six months validity remaining from the date of arrival in Venezuela.
Some U.S. citizens have been turned back to the United States if their passports will expire in less than six months. Passports should also be in good condition, as some U.S. citizens have been delayed or detained overnight for having otherwise valid passports in poor condition.
U.S. citizens residing in Venezuela should be careful to obtain legitimate Venezuelan documentation appropriate to their status.
There have been numerous cases in the last several months of U.S. citizens who, having employed intermediaries, received what they believed to be valid Venezuelan resident visas and work permits.
They were subsequently arrested and charged with possessing fraudulent Venezuelan documentation.
ONIDEX, the Venezuelan government agency responsible for immigration documents, has informed the Embassy that the only valid resident visas are those for which the bearer has personally signed at ONIDEX headquarters in Caracas.
Venezuelan law requires Venezuelan citizens to enter and depart Venezuela using Venezuelan passports and Venezuelan immigration authorities are increasingly enforcing this requirement.
In order to comply with U.S. and Venezuelan law, persons who hold dual American-Venezuelan nationality must plan to travel between Venezuela and the United States with valid U.S. and Venezuelan passports.
Please see our information on dual nationality for entry and exit requirements pertaining to dual nationals.
Venezuela's child protection law mandates that minors (under 18) who are citizens or non-citizen residents of Venezuela and who are traveling alone, with only one parent, or with a third party, must present a copy of their birth certificate and written, notarized authorization from the absent parent(s) or legal guardian, specifically granting permission to travel alone, with one parent, or with a third party.
This authorization must reflect the precise date and time of the travel, including flight and/or other pertinent information.
Without this authorization, immigration authorities will prevent the child's departure from Venezuela.
The Venezuelan Government no longer recognizes blanket or non-specific travel authorizations.
When a parent is deceased, a notarized copy of the death certificate is required in lieu of the written authorization.
If documents are prepared in the United States, the authorization and the birth certificate must be translated into Spanish, notarized, and authenticated by the Venezuela Embassy or a Venezuelan consulate in the United States.
If documents are prepared in Venezuela, only notarization by a Venezuelan notary is required.
A permission letter prepared outside Venezuela is valid for 90 days.
A permission letter prepared in Venezuela is valid for 60 days.
Travelers entering Venezuela from certain countries are required to have a current yellow fever vaccination certificate.
The Venezuelan government recommends that all travelers, regardless of their country of departure, be vaccinated for yellow fever before entering Venezuela.
Mosquito-borne diseases such as malaria and dengue fever are also common in some areas and travelers should take precautions to prevent infection.
An exit tax and airport fee must be paid when departing Venezuela by airline.
The exit tax is currently 46 Bolívares Fuertes, and the airport fee is currently 115 Bolívares Fuertes (a total of approximately 75 USD calculated at the official exchange rate). In many instances, especially with non-U.S. airlines, the exit tax and airport fee are not included in the airline ticket price and must be paid separately at the airport upon departure.
Authorities usually require that payment be made in local currency.
Both the departure tax and the airport fee are subject to change with little notice.
Travelers should check with their airlines for the latest information.
For current information concerning entry, tax, and customs requirements for Venezuela, travelers may contact the Venezuelan Embassy at 1099 30th Street, NW, Washington DC
20007, tel: (202) 342-2214, or visit the Embassy of Venezuela web site at http://www.embavenez-us.org/.
Travelers may also contact the Venezuelan consulates in New York, Miami, Chicago, New Orleans, Boston, Houston, San Francisco, or San Juan.
Additional information about vaccination requirements for travel to Venezuela, as well as to other international destinations, 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); fax 1-888-CDC-FAXX (1-888-232-3299), or via CDC's Internet site at http://wwwn.cdc.gov/travel/default.aspx.
Violent crime in Venezuela is pervasive, both in the capital, Caracas, and in the interior.
The country has one of the highest per-capita murder rates in the world.
Armed robberies take place in broad daylight throughout the city, including areas generally presumed safe and frequented by tourists.
A common technique is to choke the victim into unconsciousness and then rob them of all they are carrying.
Well-armed criminal gangs operate with impunity, often setting up fake police checkpoints.
Kidnapping is a particularly serious problem, with more than 1,000 reported during the past year alone.
Investigation of all crime is haphazard and ineffective.
In the case of high-profile killings, the authorities quickly round up suspects, but rarely produce evidence linking these individuals to the crime.
Only a very small percentage of criminals are tried and convicted.
Travel to and from Maiquetía Airport, the international airport serving Caracas, can be dangerous and corruption at the airport itself is rampant.
Travelers at the airport have been victims of personal property theft, as well as mugging and "express kidnapping" in which individuals are taken to make purchases or to withdraw as much money as possible from ATMs, often at gunpoint.
The Embassy has received multiple, credible reports that individuals with what appear to be official uniforms or other credentials are involved in facilitating or perpetrating these crimes.
For this reason, American citizen travelers should be wary of all strangers, even those in official uniform or carrying official identification.
There are also known drug trafficking groups working from the airport.
Travelers should not accept packages from anyone and should keep their luggage with them at all times.
Because of the frequency of robberies at gunpoint, travelers are encouraged to arrive during daylight hours.
If not, travelers should use extra care both within and outside the airport.
The Embassy strongly advises that all arriving passengers make advance plans for transportation from the airport to their place of lodging.
If possible, travelers should arrange to be picked up at the airport by someone who is known to them.
The Embassy has received frequent reports of armed robberies in taxicabs going to and from the airport at Maiquetía.
There is no foolproof method of knowing whether a taxi driver at the airport is reliable.
The fact that a taxi driver presents a credential or drives an automobile with official taxi license plates marked "libre" is no longer an indication of reliability.
Incidents of taxi drivers in Caracas overcharging, robbing, and injuring passengers are common.
Travelers should take care to use radio-dispatched taxis or those from reputable hotels.
Travelers should call a 24-hour radio-dispatched taxi service from a public phone lobby or ask hotel, restaurant, or airline representatives to contact a licensed cab company for them.
A list of transportation services used by members of the U.S. Embassy community is available on the U.S. Embassy web site at http://venezuela.usembassy.gov/.
The Embassy does not vouch for the professional ability or integrity of any specific provider.
The list is not meant to be an endorsement by the Department of State or the Embassy.
Likewise, the absence of any individual or company does not imply lack of competence.
While visiting Venezuela, Americans are encouraged to carry as little U.S. currency on them as possible and to avoid wearing expensive or flashy watches and jewelry.
Due to the poor security situation, the Embassy does not recommend changing money at the international airport.
Visitors should bring a major credit card, but should be aware of widespread pilfering of credit card data to make unauthorized transactions.
Travelers' checks are not recommended as they are honored in only a few locations.
It is possible to exchange U.S. currency at approved exchange offices near major hotel chains in Caracas (personal checks are not accepted) and at commercial banks with some restrictions.
Due to currency regulations, hotels cannot provide currency exchange.
There are ATM machines throughout Venezuela.
Malfunctions are common, however, and travelers should be careful to use only those in well-lit public places.
ATM data has also been hacked and used to make unauthorized withdrawals from user's accounts.
Popular tourist attractions, such as the Avila National Park, are increasingly associated with violent crime.
Americans planning to participate in outdoor activities in potentially isolated areas are strongly urged to travel in groups of five or more and to provide family or friends with their itineraries prior to departure.
Cross-border violence, kidnapping, drug trafficking, smuggling, and cattle-rustling occur frequently in areas along the 1,000-mile long border between Venezuela and Colombia.
Some kidnap victims have been released after ransom payments, while others have been murdered.
In many cases, Colombian terrorists are believed to be the perpetrators.
Colombia's National Liberation Army (ELN) has had a long history of kidnapping for ransom, and the Revolutionary Armed Forces of Colombia (FARC) are active in the kidnapping trade.
Common criminals are also increasingly involved in kidnappings, either dealing with victim's families directly or selling the victim to terrorist groups.
In-country travel by U.S. Embassy employees, both official and private, within a 50-mile area along the entire Venezuela/Colombia border, is prohibited.
The State Department warns American citizens not to travel within a 50-mile area along the entire Venezuela/Colombia border.
U.S. citizens who elect to visit areas along the border region with Colombia despite this warning, apart from the Colombian terrorist threat, could encounter Venezuelan military-controlled areas and may be subject to search and arrest.
The U.S. Embassy must approve in advance the official travel to Venezuela of all U.S. Government personnel.
Private travel by U.S. military personnel to Venezuela requires advance approval by the U.S. Embassy.
Please consult the Department of Defense Foreign Clearance Guide at https://www.fcg.pentagon.mil/ for further information.
Non-military employees of the U.S. Government do not need Embassy approval for private travel.
Political marches and demonstrations are frequent in Caracas and often pass without incident.
Nevertheless, travelers should be aware that violence, including exchanges of gunfire, has occurred at political demonstrations in the past.
Demonstrations tend to occur at or near university campuses, business centers, and gathering places such as public squares and plazas.
Marches generally occur on busy thoroughfares, significantly impacting traffic.
Most major tourist destinations, including coastal beach resorts and Margarita Island, have not in the past been generally affected by protest actions.
The city of Merida, however, a major tourist destination in the Andes, has been the scene of frequent student demonstrations, some of them violent, including the use of firearms.
Travelers should keep informed of local developments by following the local press, radio and television.
Visitors should also consult their local hosts, including U.S. and Venezuelan business contacts, hotels, tour guides, and travel organizers.
As circumstances warrant, the Embassy sends out messages to U.S. citizens who have registered on-line.
These messages are also posted on the U.S. Citizens page of the Embassy's web site at http://venezuela.usembassy.gov/.
U.S. citizens traveling or residing in Venezuela are advised to take common-sense precautions and avoid large gatherings and demonstrations, no matter where they occur.
Harassment of U.S. citizens by pro-government groups, Venezuelan airport authorities, and some segments of the police occurs but is quite limited. Venezuela's most senior leaders, including President Chavez, regularly express anti-American sentiment.
The Venezuelan government's rhetoric against the U.S. government, its American culture and institutions, has affected attitudes in what used to be one of the most pro-American countries in the hemisphere.
Venezuela is an earthquake-prone country and is occasionally subject to torrential rains, which can cause major disasters such as the one in Vargas State in 1999.
Travelers who intend to rent or purchase long-term housing in Venezuela should choose structures designed for earthquake resistance.
Such individuals may wish to seek professional assistance from an architect or civil/structural engineer, as does the Embassy, when renting or purchasing a house or apartment in Venezuela.
Americans already housed in such premises are also encouraged to seek a professional structural assessment of their housing.
For further information on seismic activity, you may wish to visit:
1. The Multidisciplinary Center for Earthquake Engineering Research (MCEER) web site at http://mceer.buffalo.edu/infoservice/Quakeline_Database/default.asp
2. The Global Seismic Hazard Assessment Program web site at www.seismo.ethz.ch/GSHAP
3. The Caribbean Disaster Mitigation Project web site at www.oas.org/CDMP
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs' web site, where the current Travel Warnings and Travel Alerts including the Worldwide Caution can be found.
CRIME: Venezuela and its capital, Caracas, have one of the highest per capita murder rates in the world.
Virtually all murders go unsolved.
The poor neighborhoods that cover the hills around Caracas are extremely dangerous.
These areas are seldom patrolled by police and should be avoided.
Armed robberies are common in urban and tourist areas throughout Venezuela, even areas presumed safe and visited by tourists.
Crimes committed against travelers are usually money-oriented crimes, such as theft and armed robbery.
Incidents occur during daylight hours as well as at night.
Many criminals are armed with guns or knives and will use force.
Jewelry attracts the attention of thieves.
Travelers are advised to leave jewelry items, especially expensive-looking wristwatches, at home.
Gangs of thieves will often surround their victims and use a chokehold to disable them, even in crowded market areas where there is little or no police presence.
Theft from hotel rooms and safe deposit boxes is a problem, and theft of unattended valuables on the beach and from rental cars parked near isolated areas or on city streets is a common occurrence.
A guarded garage or locked trunk is not a guarantee against theft.
Pickpockets concentrate in and around crowded bus and subway stations in downtown Caracas.
Subway escalators are favored sites for "bump and rob" petty thefts by roving bands of young criminals.
Many of these criminals are well dressed to allay suspicion and to blend in with crowds using the subways during rush hour.
Travelers should not display money or valuables.
"Express kidnappings," in which victims are seized in an attempt to get quick cash in exchange for their release, are a problem.
Kidnapping of U.S. citizens and other foreign nationals, from homes, hotels, unauthorized taxis and the airport terminal has occurred.
U.S. citizens should be alert to their surroundings and take necessary precautions.
The Department has received reports of robberies during nighttime and early morning hours on the highways around and leading to Caracas.
Reports have specifically involved cars being forced off the La Guaira highway leading from Caracas to the Maquetía International Airport, and the "Regional del Centro" highway leading from Caracas to Maracay/Valencia, at which point the victims are robbed.
The Department recommends avoiding driving at night and in the early morning where possible.
Drivers traveling on highways during nighttime and early morning hours should exercise caution.
Police responsiveness and effectiveness in Venezuela vary drastically but generally do not meet U.S. expectations.
U.S. travelers have reported robberies and other crimes committed against them by individuals wearing uniforms and purporting to be police officers or National Guard members.
Incidents of piracy off the coast of Venezuela remain a concern.
Some of these incidents have been especially violent, including the severe beating of a U.S. citizen in 2002, the fatal shooting of an Italian citizen in January 2004, and a machete attack on a U.S. citizen in 2005.
U.S. citizen yachters should exercise a heightened level of caution in Venezuelan waters.
Please consult the U.S. Coast Guard web site at http://www.uscg.mil/hq/g-o/g-opr/g-opr.htm for additional information on sailing in Venezuela.
Rules governing the sale of fuel to foreign sailors in Venezuela vary by state.
U.S. citizen yachters should inquire about specific state procedures prior to attempting to purchase fuel in any given location.
Failure to comply with a state's particular requirements can result in arrest and criminal charges.
The Embassy is aware of several instances where women lured American men to Venezuela after establishing "relationships" with them over the Internet.
Some of these men were robbed shortly after they arrived in Venezuela.
Others were recruited to act as narcotics couriers or "drug mules."
In three instances, the Americans were arrested at the airport with narcotics in their possession and served extended jail terms in Venezuela.
In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.
Although the investigation and prosecution of the crime are 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.
Medical care at private hospitals and clinics in Caracas and other major cities is generally good.
Public hospitals and clinics generally provide a lower level of care and basic supplies at public facilities may be in short supply or unavailable.
Cash payment is usually required in advance of the provision of medical services at private facilities, although some facilities will accept credit cards.
Patients who cannot provide advance payment may be referred to a public hospital for treatment.
Private companies that require the patient to be a subscriber to the service or provide cash payment in advance generally provide the most effective ambulance services.
Public ambulance service is unreliable.
U.S. citizens should be aware that due to the currency restrictions in effect in Venezuela they might find it difficult to receive wire transfers from abroad, whether through a bank or Western Union.
Such wire transfers cannot be used reliably as a source of emergency funds.
U.S. citizens traveling to Venezuela may also find it difficult to obtain certain prescription drugs, particularly name brands, and should ensure that they have sufficient quantities of all medications for the duration of their stay.
The information below concerning Venezuela is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving regulations in Venezuela are similar to those in the United States, although many drivers do not obey them.
Defensive driving is a necessity.
Child car seats and seatbelts are not required and are seldom available in rental cars and taxis.
Outside the major cities, night driving can be dangerous because of unmarked road damage or repairs in progress, unlighted vehicles, and livestock.
Even in urban areas, road damage is often marked by a pile of rocks or sticks left by passersby near or in the pothole or crevice, without flares or other devices to highlight the danger.
Traffic jams are common within Caracas during most of the day and are frequently exploited by criminals. Stops at National Guard and local police checkpoints are mandatory.
Drivers should follow all National Guard instructions and be prepared to show vehicle and insurance papers and passports.
Vehicles may be searched.
Inexpensive bus service is available to most destinations throughout the country, but the high incidence of criminal activity on public transportation makes bus travel inadvisable.
Peak holiday travel occurs during summer and winter school breaks and major civil and religious holidays, including Carnival, Easter, Christmas and New Year's holidays.
Lengthy delays due to road congestion are common during these peak periods.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Venezuela's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Venezuela's air carrier operations.
For more information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa/.
SPECIAL CIRCUMSTANCES: In February 2007, the National Assembly granted President Chavez the authority to rule by decree in 11 general areas for 18 months.
Laws issued by President Chavez under this authority become effective immediately after their publication in the government legislative gazette.
As a result, laws directly impacting U.S. Citizens or their interests in Venezuela may come into force with little or no warning.
U.S. Citizens are advised to carefully monitor changes in Venezuelan law. Venezuela is also slated to hold gubernatorial and mayoral elections nation-wide in late 2008.
These electoral races are expected to generate extensive political campaigning from pro-government and opposition parties.
The government of Venezuela implemented rigid foreign exchange controls in 2003, including a fixed official rate of exchange.
Foreign exchange transactions must take place through exchange houses or commercial banks at the official rate.
As of October 2005 it is no longer possible to exchange money at hotels.
Currency exchange for tourists can be arranged at "casas de cambio" (exchange houses).
There are exchange houses located near most major hotels.
It is also possible to exchange money at commercial banks; however, visitors should be aware that the exchange would not be immediate.
Exchanges through commercial banks must first be approved by the Commission for Administration of Foreign Currencies (CADIVI).
This requires a registration process, which delays the exchange.
The exchange control mechanisms also require the exchange houses and commercial banks to obtain authorization from CADIVI to trade Bolívares Fuertes (the local currency) into U.S. dollars.
Outside the major cities, a good supply of Venezuelan currency is necessary, as it may be difficult to find exchange houses.
The Embassy cannot provide currency exchange services.
Travelers will likely encounter individuals in Venezuela who are willing to exchange Bolívares Fuertes for U.S. dollars at a rate significantly higher than the official rate of exchange.
These "parallel market" currency exchanges are prohibited under the Venezuelan foreign exchange controls.
Travelers engaging in such activity may be detained by the Venezuelan authorities.
Additionally, in accordance with an October 2005 law, any person who exchanges more than 10,000 U.S. dollars in the course of a year through unofficial means is subject to a fine of double the amount exchanged.
If the amount exceeds 20,000 U.S. dollars the penalty is two to six years imprisonment.
Any person who transports more than 10,000 U.S. dollars into or out of Venezuela by any means must declare this amount to customs officials.
Credit cards are generally accepted at most upscale tourist establishments, but foreign exchange controls have made credit card acceptance less common than in the past.
Visa, MasterCard, and American Express have representatives in Venezuela.
Due to the prevalence of credit card fraud in Venezuela, travelers should exercise caution in using their credit cards and should check statements regularly to ensure that no unauthorized charges have been made.
Most major cities have ATMs with 24-hour service where users may withdraw local currency, but many of these ATMs will not accept U.S.-issued debit cards.
Venezuelan customs authorities may enforce strict regulations concerning temporary importation into or export from Venezuela of items such as plant and animal products, firearms, medications, archaeological or "cultural heritage" items, and pirated copies of copyrighted articles.
It is advisable to contact the Embassy of Venezuela in Washington or one of Venezuela's consulates in the United States for specific information regarding customs requirements.
Persons violating Venezuela's laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Venezuela are severe, and convicted offenders can expect long jail sentences and heavy fines.
Americans living or traveling in Venezuela are encouraged to register with the U.S. Embassy in Caracas through the State Department's travel registration web site so that they can obtain updated information on travel and security within Venezuela.
The Consular Section is open for American Citizen Services from 8:00 a.m. to 10:30 a.m. Monday through Friday, excluding U.S. and Venezuelan holidays.
The U.S. Embassy is located at Calle Suapure and Calle F, Colinas de Valle Arriba, Caracas.
The telephone number during regular business hours (8:00 a.m. to 5:00 p.m.) is (58) (212) 975-6411.
In case of an after-hours emergency, callers should dial (58) (212) 907-8400.
The Embassy's web site, http://venezuela.usembassy.gov/ , contains complete information about services provided and hours of operation.
A part-time consular agent in Maracaibo provides services for U.S. citizens in western Venezuela.
The agent is available to the public every Monday from 8:15 am to 12:15 pm, at the Centro Venezolano Americano del Zulia (CEVAZ), Calle 63 No. 3E-60, Maracaibo; telephone 58)(0261) 793-2101 or 793-3488.
This replaces the Consular Information Sheet dated November 1, 2007, and updates all sections.
WHO update on Yellow Fever in Bolivar State of Venezuela
Disease Yellow Fever Venezuela - 2 months ago
Source: WHO Emergencies preparedness [edited]
<https://www.who.int/csr/don/21-november-2019-yellow-fever-venezuela/en/>
On 13 Nov 2019, the Venezuela International Health Regulations (IHR) National Focal Point (NFP) and the Venezuela PAHO/WHO Country Office shared information about a confirmed case of yellow fever in Bolivar State. The case-patient is a 46-year-old male resident of the municipality of Gran Sabana, Bolivar State. He was in the locality of Uriman municipality of Gran Sabana within the 19 days prior to the onset of symptoms. Symptom onset was on 14 Sep 2019, and included fever, chills, nausea, vomiting, epistaxis, petechiae, and diarrhoea. On 26 Sep 2019, he visited a public hospital in the municipality of Heres where his condition deteriorated, with moderate dehydration, bleeding from the gums, jaundice, choluria, abdominal pain, and hepatomegaly. As of 13 Nov 2019, the patient remains hospitalized with chronic renal failure and moderate anaemia.
On 26 Sep 2019, the 1st serum sample was sent to the National Reference Laboratory, the National Institute of Hygiene "Rafael Rangel" per its acronym in Spanish, IHRR, in Caracas. On 13 Nov 2019, the sample tested positive for yellow fever by reverse-transcriptase polymerase chain reaction (RT-PCR), and negative for dengue on 14 Nov 2019 by RT-PCR. On 10 Oct 2019, a 2nd serum sample was taken and sent to the IHRR, for which the results are still pending.
Most of the territory of Venezuela is considered as at risk for sylvatic yellow fever, and this case marks the 1st confirmed autochthonous case of yellow fever diagnosed in Venezuela since 2005.
A joint investigation team (WHO Country Office and the Venezuela Ministry of Health) was deployed on 12 Nov [2019] to characterize the risk and develop the response plan. PAHO Immunizations (IM) Unit along with the Revolving Fund have secured a donation of 571 000 doses of yellow fever vaccine from UNICEF that arrived in the country at the end of October [2019].
The local public health authorities have strengthened the active and passive epidemiological surveillance activities in humans and non-human primates. Additionally, strategic vaccination activities have been planned.
Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life. Supportive care is required to treat dehydration, respiratory failure, and fever; antibiotics are recommended to treat associated bacterial infections.
The origin of the infection of this case is likely to be sylvatic, in an area determined as at risk for yellow fever. Venezuela is considered at risk for yellow fever transmission.
This yellow fever case report illustrates the importance of maintaining awareness and strong surveillance systems (including laboratory capacity) and high coverage of yellow fever vaccination, especially in areas with a favourable ecosystem for yellow fever transmission and indigenous groups.
Advice to travelers planning to visit, or reside in, areas at risk for yellow fever transmission includes:
- Vaccination against yellow fever at least 10 days prior to the travel is recommended for all travelers aged 9 months or above traveling to Venezuela, except for travelers whose itineraries are limited to the following areas:
-- the entire states of Aragua, Carabobo, Miranda, Vargas and Yaracuy, and the Distrito Federal.
- It is not recommended for travelers whose itineraries are limited to the following areas:
-- all areas above 2300 m in the states of Merida, Trujillo and Tachira;
-- the states of Falcon and Lara; Margarita Island;
-- the capital city of Caracas and the city of Valencia (please see the map here:
<https://www.who.int/ith/yf-vaccination-30April2018.png?ua=1&ua=1>).
- The vaccine is contraindicated in children aged under 6 months and is not recommended for those aged between 6 and 8 months, except during epidemics when the risk of infection with yellow fever virus may be very high.
- Caution is recommended before vaccinating people aged 60 years or more against yellow fever, and a risk-benefit assessment should be performed for any person 60 years or more of age who has not been vaccinated and for whom the vaccine is normally recommended.
- A single dose of WHO-approved yellow fever vaccine is sufficient to confer life-long protection against yellow fever disease. A booster dose of the vaccine is not needed.
- Yellow fever virus may be transmitted not only in areas of high endemicity but also in areas of low endemicity if a traveller's itinerary results in heavy exposure to mosquitoes (e.g., during prolonged travel in rural areas). WHO recommends as a general precaution to avoid mosquito bites; the highest risk for transmission of yellow fever virus is during the day and early evening.
- A yellow fever vaccination certificate is required for travellers aged one year of age or older, arriving from Brazil, and for travellers having transited for more than 12 hours through an airport in Brazil. Travelers should be aware that the absence of a requirement for vaccination does not imply that there is no risk of exposure to yellow fever in the country. Vaccination coverage in some populations might be suboptimal, particularly among indigenous communities.
- International certificates of vaccination against yellow fever become valid 10 days after primary vaccination and remain valid for the duration of the life of the person vaccinated. A booster dose after 10 years is not necessary for protection and can no longer be required for international travelers as a condition of entry into a country.
- Awareness of symptoms and signs of yellow fever.
- Promotion of healthcare-seeking advice while traveling and upon return from an area at risk for yellow fever transmission, especially to a country where the establishment of a local cycle of transmission is possible (i.e., where the competent vector is present).
WHO encourages Member States to take all actions necessary to keep travelers well informed of risks and of preventive measures including vaccination. Travelers should also be made aware of yellow fever signs and symptoms and be instructed to seek rapid medical advice when presenting signs after possible exposure.
WHO reminds Members States to strengthen the control checks of immunization status of travelers to all potentially endemic areas. Viraemic returning travelers infected in endemic areas may pose a risk for the establishment of local cycles of yellow fever transmission in areas where a competent vector is present. If there are medical grounds for not getting vaccinated, this must be certified by the appropriate authorities.
WHO does not recommend any general travel or trade restrictions be applied to Venezuela based on the information available for this event.
For more information on yellow fever, please see:
PAHO/WHO Yellow Fever Fact Sheet
(<https://www.who.int/en/news-room/fact-sheets/detail/yellow-fever>)
WHO Yellow Fever Health Topics
(<https://www.who.int/csr/disease/yellowfev/en/>)
WHO Yellow Fever Risk Mapping and Recommended Vaccination for Travellers
(<https://www.who.int/ith/yellow-fever-risk-mapping/state_request/en/>)
PAHO/WHO Guidance on Laboratory Diagnosis of Yellow Fever Virus Infection
(<https://www.paho.org/hq/index.php?option=com_docman&view=download&alias=46877-laboratory-diagnosis-of-yellow-fever-virus-infection&category_slug=guidelines-5053&Itemid=270&lang=en>)
Country list - Vaccination requirements and recommendations for international travellers; and malaria situation per country - 2019 edition
(<https://www.who.int/ith/ith-country-list-new.pdf?ua=1&ua=1>)
Global Strategy to Eliminate Yellow Fever Epidemics (EYE) 2017-2026
WHO International Travel and Health Website
(<https://www.who.int/ith/en/>)
[This report provides additional information that was unavailable in the initial report. The case is now confirmed as yellow fever (YF), and the locality in Bolivar state where the man was infected is now identified as the municipality of Gran Sabana. The likelihood that this is a case of sylvan (forest) transmission is stated. The arrival of a substantial lot of YF vaccine is reported. One hopes that the plans for a vaccination campaign are completed and put into action quickly to prevent ongoing transmission in an urban cycle involving _Aedes aegypti_ that are doubtless abundant in this locality. - ProMED Mod.TY]
Venezuela: <http://healthmap.org/promed/p/55916>]
Health alert issued as case of Yellow Fever confirmed in Bolivar State of Venezuela
Date: Tue 19 Nov 2019
Source: Caracas Chronicles [edited]
<https://www.caracaschronicles.com/2019/11/19/yellow-fever-is-back/>
The Venezuelan Public Health Society and the Let's Defend The National Epidemiology Network issued an alert after a case of yellow fever was confirmed in the state of Bolivar, after 14 years without the disease. The Health Ministry hasn't published information about the case or issued an alert, but Venezuela must formally report it to international institutions, due to the risk to a population that isn't vaccinated, having the vector (mosquitoes) in all of the territory (increasing the odds of an epidemic), and the poor access to an epidemiologic report [about the case]. Doctor Julio Castro wrote about the case for Prodavinci. [Byline: Naky Soto]
[There is little information about this case: where and when it occurred in Bolivar state, tests used to diagnose the case, condition of the patient, and any follow-up measures taken by public health authorities. Yellow fever (YF) virus is endemic in Venezuela as it is in many South American countries.
The most recent ProMED-mail report of YF in Venezuela was in 2010, in Anzoategui state, where there were 3 probable YF cases in monkeys. This outbreak was enzootic, as determined by the Ministry of Health (see Yellow fever - South America: Venezuela (AN) monkey, susp http://promedmail.org/post/20101112.4114).
Presumably, this current case is one of spill-over from the sylvan (forest) transmission cycle. Maintenance of a high level (80-90%) of coverage is essential to prevent cases and avoid outbreaks involving the urban cycle with _Aedes aegypti_ transmission. - ProMED Mod.TY]
[HealthMap/ProMED-mail map of Venezuela:
<http://healthmap.org/promed/p/55916>]
Venezuelans turn to alternative medicine amid shortages
Drug Trade Venezuela - 3 months ago
Date: Tue, 8 Oct 2019 04:13:25 +0200 (METDST)
By Margioni BERMÚDEZ
Caracas, Oct 8, 2019 (AFP) - The small waiting room at the home of self-styled healer "Brother Guayanes" in Caracas' rundown Petare district fills up quickly with patients -- business has never been better. With Venezuela's chronic medicine shortages and hyperinflation, more and more people are turning to alternative medicine to treat common ailments in the crisis-wracked South American country. "We go to the hospital and there's nothing there. They don't have medicines, or they're too expensive, what are we to do?" said Rosa Saez, 77, who has come to get treatment for a painful arm. Carlos Rosales -- he uses the more ceremonious "Brother Guayanes" for his business -- is finishing up a "spiritual intervention" on a patient in what passes for his surgery. The patient lies, eyes closed, on a cot as, in a series of swishes and clicks, the healer waves five pairs of scissors one after another over his prone body. The healer says he performs 200 such interventions a week in a dim, candle-lit room that features two camp beds and an array of plaster statues that Rosales says represent "spiritual entities". A regular visitor to the spiritual center, Saez says she has faith in Rosales' methods: "He healed my kidneys."
- Natural healing -
All across Venezuela, but particularly in poor areas like Petare, patients cannot hope to afford the price of medicines that due to the economic crisis, have become exceedingly rare. Venezuela's pharmacists' federation say pharmacies and hospitals have on average only about 20 percent of the medicine stock needed. Rosales' clinic is muggy with the smell of tobacco. A crucifix suspended from a chain around his neck, he practices a seeming mixture of smoke-blowing shamanism, plant-based medicine and mainstream religion. Posters hung near the entrance remind clients to arrive with a candle and tobacco and "Don't forget that payment is in cash". Much like a general practitioner, Rosales spends time consulting with his patients, examining them with a stethoscope, before offering a diagnosis. Often he prescribes potions based on plants and fruit, such as pineapple and a type of local squash known as chayote. "We know medicines are necessary," he says. "I'm not against medicine, but my medicine is botany."
- Plants replace drugs -
At her stall in a downtown Caracas market, 72-year-old Lilia Reyes says she has seen her trade in medicinal plants flourish. "I can't keep up with the demand," she said at her stall, bathed in the aroma of camomile, one of the 150 plants she sells. Careless consumption of some herbs can be deadly, warns Grismery Morillo. A doctor at a Caracas public hospital, she says she has seen many cases of acute liver failure in people who have eaten certain roots. According to Venezuela's opposition parties, some 300,000 chronically ill people are in danger of dying from the shortages of medicines.
But despite the risks, people like Carmen Teresa say they have no alternative. In the kitchen of her restaurant which closed down three years ago as the economic crisis took hold, the 58-year-old Colombian prepares an infusion of fig leaves to treat "diabetic neuropathy". The painkillers needed for the condition are "too expensive" and prices are going up due to hyperinflation, so she is cutting back on the pills and supplementing her treatment with herbal infusions. She needs at least four tablets a day to keep her diabetes at bay. Her mother, bedridden since breaking a leg a year ago, suffers from Alzheimer's disease and needs five pills a day for hypertension. "I'm still taking my pills, but I reduced the dose," says Teresa, who is also replacing cholesterol pills with lemon juice.
Concern over increasing reports of Malaria in regions of Venezuela
Disease Malaria Venezuela - 6 months ago
Date: Sat 20 Jul 2019
Source: El Pitazo [in Spanish, trans. ProMED KS, edited]
<https://elpitazo.net/oriente/enfermera-denuncia-brote-de-paludismo-en-sector-boyaca-iii-de-barcelona/>
More than 10 cases of malaria have been reported in the Boyaca III sector of Barcelona (Anzoategui, Venezuela) in the past 2 weeks. Of these cases, 2 are young children aged 1 and 2 years old, infected after the bite of the _Aedes aegypti_ mosquito.
Maria Febres, a nurse and resident of the community, states that the malaria outbreak is due to the lack of weeding and cleaning in the channel that crosses the Boyaca III sector, where more than 500 families reside. "We have 12 cases of malaria in the sector. We need them to come clean the canal, which has not received adequate maintenance for 2 years, putting many families at risk of contracting malaria due to the proliferation of mosquitoes," she said.
The nurse told the infociudadano [city correspondent] of El Pitazo [local media company], Eduardo Mora, that the sector has not been fumigated since 2018, and called on Public Health and Malariology officials to visit the area and verify what is happening. "The most affected area is Boyaca III sector II, because we have a Simoncito [children's centre -- so-called in honour of Simon Bolivar] there and the children who go every day are the ones most at risk of being bitten by an infected mosquito and, thus, getting malaria," said Maria. [Byline: Giovanna Pellicani]
[Over the past 5 years, the malaria control programme in Venezuela has not be functioning, and malaria has resurged in most of the country, which is well illustrated by this report. - ProMED Mod.EP]
[HealthMap/ProMED-mail maps:
Venezuela: <http://healthmap.org/promed/p/29>
Anzoategui, Venezuela: <http://healthmap.org/promed/p/40477>]
Malaria surges back in crisis-hit Venezuela
Date: Sun, 7 Jul 2019 14:05:22 +0200
By Guillaume DECAMME
El Tucuco, Venezuela, July 7, 2019 (AFP) - The sweltering heat of the Venezuelan forest makes no difference to Jose Gregorio, who trembles with a cold chill. "I have pain everywhere, fever," he stammers. Gregorio has the classic symptoms of malaria, a disease eradicated years ago among his Yukpa indigenous people, but it's back with a vengeance all across crisis-struck Venezuela. "He had sore joints and then started vomiting, and it's been four or five days since he's eaten anything," says his worried wife Marisol. Their four-month-old baby babbles beside his father on the bed. "The baby and I also had malaria," says Marisol. "Before, that was not the case here, there was only chikungunya and dengue, malaria came back here last year."
She doesn't bat an eyelid at the mention of either of the other mosquito-borne viruses, whose spread has been fueled by the collapse of Venezuela's health system. "Here" is El Tucuco, a small village at the foot of the mountains that form the border with Colombia, a three-hour drive from Maracaibo in Venezuela's western Zulia state. With 3,700 people, El Tucuco is the Yukpas' "capital" and malaria is rapidly making its presence felt here as in the rest of Venezuela -- a country that could once boast of being the first to have eradicated the disease in 1961.
- 'Pandemic' -
There are no official statistics on malaria's reach into El Tucuco, nor on the number of deaths it causes. But from his consulting room at the Catholic Mission, Dr Carlos Polanco is seeing a developing crisis. "Out of 10 people who are tested for malaria in the village laboratory, four to five come out with a positive test. This is an alarming figure." Brother Nelson Sandoval, a Capuchin friar who presides over the mission, adds: "Before entering the order, I already knew this community and I had never seen a case of malaria. Today we are in the middle of a pandemic." El Tucuco is affected by Plasmodium vivax, the most geographically widespread malarial species. The more lethal Plasmodium falciparum strain is prevalent in the Amazonian regions of southeastern Venezuela.
According to Sandoval and Polanco, the reason for malaria's sudden virulence in El Tucuco is simple: once-regular fumigation missions by the Venezuelan government stopped. "And as the population of mosquitos increased, cases exploded," said Polanco. Added to this is the malnutrition that weakens resistance to the disease, a new phenomenon since the economic crisis took hold at the end of 2015. "Before, it was possible to vary one's diet, but with inflation the Yukpa cannot afford it," instead making do with what they can grow, like cassava and plantain, according to Polanco. Rosa, 67, knows all about malnutrition. Lying on the floor of her house, she is battling malaria for the third time. "The doctor weighed me yesterday -- 37 kilograms. I was 83 kilos before."
A report published in British medical journal The Lancet in February warned of an epidemic of malaria and dengue fever as a result of the continuing crisis in Venezuela. Between 2016 and 2017 alone, the number of malaria cases in the nation jumped 70 per cent. "The situation is catastrophic," said Dr Huniades Urbina, secretary of the national Academy of Medicine. In 2018, "there were 600,000 cases of malaria and we, the scientific organizations, estimate that in 2019 we could reach a million cases" -- one in every 30 people. But these figures are only estimates, "because the government conceals the statistics."
-'Nobody answers us'-
The malaria explosion has gone hand in hand with the worsening economic crisis. According to Nicolas Maduro's government, inflation reached a staggering 130,000 percent in 2018 and GDP halved between 2013 and 2018. In the oil-rich state of Zulia, service stations have been dry for more than a month. Electricity blackouts are commonplace and residents flee abroad in their thousands. Despite a poster of late president Hugo Chavez at the entry to the clinic, there is little sign of government presence in El Tucuco. Dr Luisana Hernandez despairs of ever seeing any state help. "Every day, everything is deteriorating a bit more," she says, exasperated. Refrigerators intended to keep vaccines cold do not work "because we have no gasoline to run the generator," and both the clinic's broken-down ambulances are gathering rust in the garden. "We've knocked on every door. But nobody answers us," said Hernandez.
Without fuel to bring drugs from the city, without resources to prevent illnesses, eradicating malaria in an almost impossible task. Brother Nelson does what he can, with help from the Catholic charity Caritas and the Pan American Health Organization. His mission distributes the antimalarial drugs chloroquine and primaquine to sick Yukpa people. Maria Jose Romero, 22, was able to benefit from treatment. "Repeated seizures are due to the fact that many people cannot follow the treatment," for lack of drugs, she said. Romero now lives across the border in Colombia, having fled Venezuela. She is visiting El Tucuco to see her family. Soon she will return to the other side of the mountain, on foot. "It's three days' walk," she says.
Belgium - US Consular Information Sheet
Belgium is a highly developed and stable democracy with a modern economy. Tourist facilities are widely available.
Read the Department of State Background N Read More Show Less
tes on Belgium for additional information.
ENTRY/EXIT REQUIREMENTS: Belgium is a party to the Schengen agreement. As such, U.S. citizens may enter Belgium for up to 90 days for tourist or business purposes without a visa. The passport should be valid for at least three months beyond the period of stay. Sufficient funds and a return airline ticket are required. For further details about travel into and within Schengen countries, please see our fact sheet. For further information concerning entry requirements, contact the Embassy of Belgium at 3330 Garfield Street NW, Washington, DC 20008, telephone (202) 333-6900; or one of the Belgian Consulates General in Atlanta, Los Angeles, or New York.Visit the Belgian Embassy web site at http://www.diplobel.org/usa for the most current visa information.
Belgian law requires that everyone carry some form of official identification at all times, which must be displayed upon request to any Belgian police official. A U.S. passport suffices for these purposes.
See the section on Special Circumstances for information on new business visitor and employee registration requirements.
SAFETY AND SECURITY: Belgium remains largely free of terrorist incidents. Belgian law enforcement and security officials, in close cooperation with neighboring countries, maintain a solid anti-terrorism effort and a peaceful environment for tourists and business. However, like other countries that are members of the Schengen Agreement on free cross-border movement, Belgium's open borders with its European neighbors allow the possibility for terrorist groups to enter/exit the country with anonymity.
Prior police approval is required for public demonstrations in Belgium, and police oversight is routinely provided to ensure adequate security for participants and passers-by. Nonetheless, situations may develop that could pose a threat to public safety. U.S. citizens are advised to avoid areas where public demonstrations are taking place.
CRIME: Belgium remains relatively free of violent crime, but low-level street crime is common. Visitors should always be watchful and aware of their surroundings, however, because muggings, purse snatchings, and pickpocketing occur frequently, particularly in the major cities. Transportation hubs like the Metro (subway) and train stations are also frequented by thieves who take advantage of disoriented travelers. In Brussels, pickpocketing, purse snatching, and theft of light luggage and laptops are common at the three major train stations -- the North Station (Noordstation or Gare du Nord), the Central Station (Centraal Station or Gare Central) and especially at the South Station (Zuidstation or Gare du Midi). The latter is a primary international train hub, and travelers are advised to pay very close attention to their personal belongings when in the station. Common ploys are to distract the victim by spraying shaving cream or another substance on his or her back or asking for directions while an accomplice steals the luggage. It is a good idea to remain in physical contact with hand luggage at all times, and not to place carry-on luggage on overhead racks in trains.
Another growing problem, especially in Brussels, is theft from vehicles, both moving and parked. Do not leave valuables in plain sight where a thief may spot them. Thieves will sometimes position themselves at stop lights to scan for valuables in stopped cars. If they see a purse or other valuable item they break the window and steal the item before the victim can even react. Expensive car stereos and GPS navigational devices left in plain sight are often stolen from parked cars. Always drive with windows up and doors locked.
Travelers to Brussels should be aware that small groups of young men sometimes prey on unwary tourists, usually at night and often in Metro stations. Items such as expensive mobile phones and MP3 players are often the target. Travelers should carry only a minimum amount of cash, credit cards, and personal identification. Wearing expensive jewelry and watches is discouraged.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Good medical facilities are widely available in Belgium. The large university hospitals can handle almost every medical problem. Hospitals in Brussels and Flemish-speaking Flanders will probably have English-speaking staff. Hospitals in French-speaking Wallonia may not have staff members who are fluent in English, however. The Embassy Consular Section maintains a list of English-speaking doctors, which can be found on the Embassy web site at http://brussels.usembassy.gov/medical_facilities.html.
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 Belgium is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Belgian urban highways are generally well built and maintained with extensive lighting systems, but rain and fog often reduce visibility. Rural roads are less likely to be illuminated at night. Belgian rules for right-of-way differ from those in the U.S., and new drivers should thoroughly understand these rules before driving in Belgium. For instance, traffic coming from the right generally has priority at uncontrolled intersections and roundabouts, even if coming from a smaller street. The maximum speed limit on Belgian highways is 120 kilometers (72 miles) per hour, but is not always posted except at Belgium's borders and on roads leaving major airports. The maximum speed in urban areas is normally 50 km (30 miles) per hour. While Belgian authorities strictly enforce speed limits, many Belgians still drive significantly faster than the posted limit. Claims of ignorance may not prevent a significant fine for speeding, which can also lead to the vehicle's being impounded if the driver is unable to pay the fine on the spot. Belgian police also conduct breath analysis checks for alcohol use, particularly at night and during major holidays.
Roadside assistance and information on road conditions are available in English from Touring Mobilis, tel: 0900 10280. Belgian police will also provide information on road conditions, tel: 02-642-6666. Emergency services are efficient and responsive. By phone within Belgium, for police emergencies dial 101 and for all other emergencies,112.
Please refer to our Road Safety page for more information. Visit the website of Belgium's national tourist office at http://www.visitbelgium.com/.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Belgium's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Belgium'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: While most forms of monetary transactions are available (cash, credit cards), U.S. money orders cannot be negotiated in Belgium. Personal checks may only be cleared through a bank at which a person holds an account and clearance can take from two to four weeks. Banks and exchange facilities may refuse U.S. dollar denominations of $50 and $100 if they are not equipped with devices to identify counterfeit currency. Automated Teller Machines (ATMs) are widespread in Belgium and accept most U.S. ATM cards to withdraw funds. Travelers seeking to purchase Euros are more likely to find a more favorable exchange rate at banks than at money exchange facilities located at tourist locations, train stations, and airports. Please see our Customs Information.
Non-EU citizens visiting Belgium and staying in a private residence are required by Belgian law to register with local Commune authorities within three days of their arrival. Any change in visa or resident status must also be requested through Commune authorities and must be completed prior to the expiration of the current status. Given the requirements to change status in Belgium, it is nearly impossible to do so within the 90 days permitted to remain in Belgium without a visa under the Visa Waiver Program.
BUSINESS VISITOR AND EMPLOYEE REGISTRATION REQUIREMENT: Since April 1, 2007 non-Belgian employers and self-employed persons or their employees who carry out short term assignments in Belgium must declare these activities in advance.
This mandatory "Limosa" declaration applies to: (1) Employees and apprentices, who come to Belgium to execute certain temporary work and who, because of the nature of their short term assignment, are not subject to the Belgian social security system; (2) Self-employed people and self-employed apprentices who come to work in Belgium temporarily, irrespective of whether they are subject to the Belgian social security system.
Some exceptions to this general obligation exist. Certain persons may be exempted, especially for short-term assignments. For more information about the Limosa declaration, visit http://www.limosa.be.
For more information about working in Belgium, please see http://www.employment.belgium.be/home.aspx.
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 Belgian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Belgium 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.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Belgium are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site so that they can obtain updated information on travel and security within Belgium. 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 in Brussels is located at 25 Boulevard du Regent. The telephone number from the U.S. is 011-32-2-508-2111. Within Belgium, the telephone number is 02-508-2111. The Embassy's fax number is 02-511-2725. The Consular Section's fax number is 02-513-0409. The American Citizen Services Unit of the Consular Section is open from 1:30 to 3:30 p.m. Monday through Friday, except for American and Belgian holidays. Further information can be obtained at the Embassy's web site at http://belgium.usembassy.gov/
This replaces the Country Specific Information for Belgium dated March 13, 2008, to update sections on Entry/Exit Requirements.
Mumps warning issued for campus of Sint-Lambrechts-Woluwe (Belgium)
Disease Mumps Belgium - 2 months ago
Date: Tue 22 Oct 2019
Source: The Brussels Times [abridged, edited]
<https://www.brusselstimes.com/all-news/belgium-all-news/74870/major-mumps-outbreak-on-the-uclouvain-brussels-campus/>
Students from the UCLouvain [Catholic University of Leuven] have received an email warning of increased cases of mumps on the campus of Sint-Lambrechts-Woluwe and in the colleges in the municipality [of Brussels-Capital Region].
This information -- widely reported in Belgium -- was confirmed by the spokesperson for the University Isabelle Decoster to Belga.
The total number of infected is currently not known as students can go to doctors across the city. Sick students are asked to stay at home. [Byline: Jules Johnston]
[HealthMap/ProMED-mail map of Belgium:
Two cases of Listeriosis in Belgium
Disease Listeriosis Belgium - 3 months ago
Date: Thu 24 Oct 2019
Source: Brussels Times [edited]
<https://www.brusselstimes.com/belgium/75139/two-listeria-cases-detected-in-belgium-after-deadly-dutch-outbreak/>
Two people in Belgium have been infected with _Listeria_ bacteria that lead to the death of 3 people and a miscarriage over a 2-year period in the Netherlands, a sampling by a federal health centre showed. [See ProMED-mail post Listeriosis - Europe (15): (Netherlands) fatal, WGS, cold cuts http://promedmail.org/post/20191005.6711608, which described a listeriosis outbreak that affected 20 people, 3 of whom died and one woman had a miscarriage, over the past 2 years after eating cold cuts produced by Offerman, a Netherland-based producer. - ProMED Mod.ML]
The cases in Belgium affected a 97-year-old woman and a Dutch national who recently gave birth in Antwerp [Belgium], a study by federal health research centre Sciensano confirmed. Both women were infected with the bacteria in 2018, according to the study, which compared samples of bacteria in the Netherlands with those of Belgian patients infected, HLN reports.
The centre's study comes after three people died and one woman had suffered a miscarriage in the Netherlands after eating meat contaminated with _Listeria_ over a 2-year period, which was reportedly linked to Dutch meat producer Offerman.
In Germany, 2 _Listeria_-related deaths were also reported in the central state of Hesse. [See ProMED-mail post Listeriosis - Europe (16): (Germany) fatal, WGS, meat, healthcare facilities http://promedmail.org/post/20191019.6736570, which described a listeriosis outbreak that affected 40 people, 3 of whom have died, in 12 German states between 2014 and 2019, due to _Listeria_-contaminated meat products manufactured at a processing facility in the German state of Hesse and widely distributed to more than 20 European countries. This German outbreak associated with the Hesse-based meat processing facility is unrelated to the Netherlands/Belgium outbreak associated with the Netherlands-based meat processing facility. - ProMED Mod.ML]
News of the deaths led supermarkets in Belgium to issue recalls for pre-packaged meat, a move they said at the time was precautionary. Offerman, a subsidiary of Belgian food group Ter Beke, has since been shut down in the Netherlands.
The Sciensano study could not identify the cause of the infections in Belgium, since isolated cases, unlike outbreaks, are not subject to follow-ups, Het Nieuwsblad reports. [Byline: Gabriela Galindo]
[The incriminated meat is refrigerated cold cuts that are not cooked before eating (i.e., ready-to-eat). Cold cuts are well-recognized sources for listeriosis. Even if initial contamination adds only a few _Listeria_ organisms to the food, the contamination can be significant for refrigerated foods because _L. monocytogenes_ can subsequently multiply at refrigerator temperatures to a sufficient number to cause disease. People at increased risk for disseminated listeriosis, which include pregnant women (and their new-borns), adults aged 65 years or older, and people with weakened immune systems, should avoid eating food potentially contaminated with _Listeria_. - ProMED Mod.ML]
[HealthMap/ProMED maps available at:
Belgium: <http://healthmap.org/promed/p/99>
Netherlands: <http://healthmap.org/promed/p/104>]
Eggs used to make tartar sauce linked to 200 cases of Salmonella in Belgium
Disease Salmonella Belgium - 4 months ago
Date: Wed 25 Sep 2019
Source: Food Safety News (FSN) [edited]
<https://www.foodsafetynews.com/2019/09/belgian-salmonella-outbreak-traced-to-tartare-sauce/>
A _Salmonella_ outbreak that sickened almost 200 people at a Belgian school was likely caused by eggs used to make a tartar sauce, according to authorities. The Agency for Care and Health (Zorg en Gezondheid) and Federal Agency for the Safety of the Food Chain (FASFC) investigation detected _Salmonella_ in the freshly prepared tartar sauce. Findings from an online survey of students and teachers also reached the same conclusion on the source.
The Agency for Care and Health had previously received information about a number of students from the school complaining of gastrointestinal illness. Since 14 Sep 2019, no new cases of illness have been reported so the Spermalie Hotel and Tourism School in Bruges [West Flanders] has been allowed to resume normal operation. About 200 students and teachers from the school became ill from 6 Sep 2019 onward. Laboratory analyses of stool samples revealed students and teachers had been affected by _Salmonella_.
The Agency for Care and Health handled the online survey part of the investigation, FASFC took samples of meals served on Tuesdays, Wednesdays, and Thursdays at the school restaurant. The samples were sent to the lab of Sciensano, the Belgian Institute for Health. The online survey showed the tartar sauce was the most likely source of the outbreak.
A total of 65 samples were sent to Sciensano and after analysis of the different dishes, _Salmonella_ was detected in the freshly prepared tartar sauce. Bacteria present in the food appeared to be the same as in the stool samples from patients.
Staff and students were asked to pay particular attention to hand hygiene and those sick were encouraged to stay at home. The kitchen of the school restaurant and all kitchens and related equipment have been cleaned and disinfected. The sale of any raw food was also suspended. Control measures have been verified by environmental sampling and no _Salmonella_ has been detected in lab analysis of these samples.
Belgium reported 2698 confirmed salmonellosis cases in 2016 compared to 3050 the year before.
[Tartar sauce (<https://en.m.wikipedia.org/wiki/Tartar_sauce>) is based on either mayonnaise (egg yolk, mustard or vinegar, bitartrate, oil) or aioli (olive oil, garlic), with certain other ingredients added. In the UK, recipes typically add to the base capers, gherkins, lemon juice, and dill. US recipes may include chopped pickles or prepared green sweet relish, capers, onions (or chives), and fresh parsley. Chopped hard-boiled eggs or olives are sometimes added, as may be Dijon mustard and cocktail onions.
Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with fecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the eggshell was formed. To avoid this, uncooked eggs should only be used as an ingredient, if pasteurized. - ProMED Mod.LL]
New all-time high temperature of 40.6 Celsius reported in Belgium
Climate Changes Belgium - 6 months ago
Brussels, July 25, 2019 (AFP) - Belgian meteorologists registered record high temperatures on Thursday as western Europe sweltered under a multi-day heatwave that has disrupted transport and triggered safety warnings. David Dehenauw, chief forecaster at the Royal Meteorological Institute, said a high of 40.6 degrees Celsius (105 Fahrenheit) had been recorded on the Kleine-Brogel military base, in northeastern Belgium.
"New Belgian national record: 40.6 in Kleine Brogel now and it's not finished yet! Unbelievable!" Dehenauw said on Twitter. The temperature in Belgium exceeded 40 degrees for the second day in a row after it reached 40.2 degrees in Liege, the previous record, on Wednesday. Thursday's new record is likely to be temporary as temperatures continued to rise in the middle of the afternoon.
In Brussels, the country's reference station, it was a record 38.8 degrees at 15:00 (1300 GMT), compared to 36.8 degrees an hour earlier in Europe's unofficial capital. Since the beginning of official temperature records in 1833, it has never been so hot. The previous record of 36.6 was set on in June, 1947.
Another case of Legionnaires Disease identified in Belgium
Disease Legionnaires Disease Belgium - 8 months ago
Date: Fri 17 May 2019
Source: [in French, trans. Corr.SB, edited]
<https://www.sudinfo.be/id119412/article/2019-05-17/un-nouveau-cas-de-legionellose-en-flandre-cest-le-19e-cas>
An additional patient, the 19th, was admitted to the hospital in Flanders, [East Flanders province] suffering from legionellosis.
This case comes in addition to the 18 others who have been exposed to _Legionella_ bacteria in the Evergem area [East Flanders], right next to Ghent, and who developed legionnaires' disease, a lung disease that is not transmitted from human to human.
Of the total of 19 patients, 2 men died: one Monday night [20 May 2019] and the other [Wed 22 May 2019], in 2 different Ghent hospitals.
The exact source of _Legionella_ causing the [legionellosis] outbreak in the region has not yet been located. The bacterium normally contaminates people via inhalation of water vapor or micro-droplets, but many exposed individuals do not develop disease.
[This news report above adds 3 cases since the last report posted by ProMED-mail (Legionellosis - Europe (01): Belgium (OV) http://promedmail.org/post/20190514.6468996) for a total now of 19 cases. At the time of the initial report, cooling towers in the vicinity of the Ghent Canal were suspected to be the source of this outbreak. The Ghent Canal separates the town of Evergem, where 7 cases occurred, from the town of Oostakker, where 2 cases occurred. The Ghent-Terneuzen Canal, links Ghent in Belgium to the port of Terneuzen in the Netherlands, thereby providing Ghent with access to the sea (<https://en.wikipedia.org/wiki/Ghent-Terneuzen_Canal>).
A map showing the location of Evergem and this area can be found at
<https://goo.gl/maps/y9Z1tQzbKJa1NkSm7>.
The news report above fails to state where the new cases reside, if _Legionella_ genotypes of the clinical isolates match each other, which would indicate a common source outbreak, and the results of environmental testing for _Legionella_. We await the results of the ongoing investigation. - ProMED Mod.ML]
CAYMAN ISLANDS US Consular Information Sheet
The Cayman Islands are a British dependent territory consisting of three main islands with a total area of approximately 100 square miles and located a Read More Show Less
out 500 miles west of Jamaica. There is an international airport located in Grand Cayman, and facilities for tourists are widely available. The U.S. Embassy in Kingston, Jamaica, has consular responsibility for the Cayman Islands. Read the Department of State Background Notes on the Cayman Islands for additional information.
ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside of the United States are required to present a passport or other valid travel document to enter or re-enter the United States. This requirement will be extended to sea travel (except closed-loop cruises), including ferry service, by the summer of 2009. Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other Western Hemisphere Travel Initiative (WHTI) compliant document such as a passport card for entry or re-entry to the U.S. Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.
Applications for the new U.S. Passport Card are now being accepted and have been in full production since July 2008.The card may not be used to travel by air and is available only to U.S. citizens. Further information on passport cards is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.
Visas are not required for U.S. citizens traveling to the Cayman Islands for short-term visits. U.S. citizens traveling to the Cayman Islands for work must obtain a temporary work permit from the Department of Immigration of the Cayman Islands, telephone (345) 949-8344. There is a departure tax for travelers age 12 and older, which is regularly included in airfare. For further information travelers may contact Cayman Islands Department of Tourism offices in Miami at (305) 599-9033, New York (212) 889-9009, Houston (713) 461-1317 and Chicago (630) 705-0650; or via the Internet at http://www.caymanislands.ky.
The Cayman Islands are considered politically stable and enjoy a high standard of living. There have been no reported incidences of terrorism or threats made against Americans or American interests in the Cayman Islands.
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 Public Announcements, 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. and Canada, or for other callers, 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 pamphletA Safe Trip Abroad.
CRIME: The crime threat in Cayman Islands is generally considered low, although travelers should always take normal precautions when in unfamiliar surroundings. Petty theft, pick-pocketing and purse snatchings occur. A few cases involving sexual assault have been reported to the Embassy. Police in the Cayman Islands rigorously enforce laws against illegal drugs. The majority of arrests of American citizens in the Cayman Islands over the past two years have been for possession, consumption, or intent to sell marijuana, cocaine or other illicit drugs. American citizens should avoid buying, selling, holding or taking illegal drugs under any circumstances.
The local equivalent to the "911" emergency line in the Cayman Islands is "911."
MEDICAL FACILITIES AND HEALTH INFORMATION: The quality of medical care in the Cayman Islands is generally comparable to that available in the United States; however, some procedures and cases requiring critical care may require medical evacuation to the United States. Several American citizens each year drown or suffer cardiac arrest while snorkeling or scuba diving in the Cayman Islands. These deaths may be attributed in part to tourists attempting to do more than they are trained to do or to poor physical conditioning or preexisting medical conditions that are exacerbated when snorkeling or diving. A hyperbaric chamber is available for treatment of decompression illness. Doctors and hospitals often expect immediate payment for health services.
Although there are no express HIV/AIDS entry restrictions exist for visitors to the Cayman Islands, persons suffering from HIV/AIDS can be denied permission to land if a Health Officer certifies that their entry to the Islands would be dangerous to the community pursuant to Section 82 (c) of the Cayman Immigration Law (2007 Revision), which states:
"The following persons, not being Caymanian or permanent residents, are prohibited immigrants – a person certified by a Health Officer to be suffering from a communicable disease that makes his entry into the Islands dangerous to the community."
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 Cayman Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
As in Great Britain and its other colonies, vehicles in the Cayman Islands travel on the left-hand side of the road (the opposite side compared with driving in the United States). Due to their size, the Caymans have little highway infrastructure to maintain. Local driving standards, the risk of accidents, the availability of emergency roadside service, quality and frequency of signage, and enforcement of traffic laws, generally meet the standards of the United States. Visitors must obtain a temporary driver's license, easily granted upon presentation of a valid state driver's license and payment of a small fee, at a car rental agency or a police station. Laws against driving while intoxicated are strictly enforced, with a legal maximum blood alcohol level set at 100 milligrams per 100 milliliters of blood. Seatbelt laws are also enforced and require the driver and all passengers to wear seatbelts while in motion. Please refer to our Road Safety page for more information. Visit the website of the country's national tourist office at www.caymanislands.ky
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of the Cayman Islands' Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the Cayman Islands' air carrier operations. For more information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
Cayman Islands customs authorities may enforce strict regulations concerning temporary importation into or export from the Cayman Islands of items such as firearms of any kind, spear guns (or pole spears or Hawaiian slings), live plants and plant cuttings. Raw fruits and vegetables are also restricted. Visitors from the United States should be aware that products made from farmed green sea turtles at the Cayman Turtle Farm Ltd. are offered for local consumption; however, the importation of genuine sea turtle products is strictly prohibited by the United States, as well as other countries that have signed the Convention on International Trade in Endangered Species. In addition, U.S. Customs prohibits the transshipment of turtle products through the United States and any products discovered will be confiscated. It is advisable to contact the Collector of Customs (345) 949-2473 for specific information regarding customs requirements. Please see our Customs Information.
The Cayman Islands, like all Caribbean countries, can be affected by hurricanes. Hurricane season runs from June 1 to November 30 each year. The Office of Disaster Preparedness and Emergency Management (ODPEM) has put measures in place in the event of an emergency or disaster. General information is available on the subject via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.
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 Cayman Islands' laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the Cayman 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.
Americans living or traveling in the Cayman Islands are encouraged to register with the U.S. Embassy in Kingston, Jamaica through the State Department's travel registration web site, and to obtain updated information on travel and security within the Cayman Islands. Americans without Internet access may register directly with the U.S. Consular Agency in George Town, Grand Cayman or the U.S. Embassy in Kingston, Jamaica. By registering, American citizens make it easier for the Embassy or Consular Agency to contact them in case of emergency. The U.S. Consular Agency in the Cayman Islands is located at 222 Mirco Center, North Sound Road, Georgetown, Grand Cayman. Its phone number is (345) 945-8173. Office hours are Monday, Wednesday, and Friday from 08:00 a.m. to 2:00 p.m.
American citizens requiring assistance in Cayman may also contact the American Citizen Services Unit of the U.S. Embassy in Kingston, Jamaica at (876) 702-6000. The Consular Section of the U.S. Embassy is located at 142 Old Hope Road,, Kingston 6. Office hours are Monday through Friday (except Jamaican and U.S. holidays), 7:15 a.m. to 4:00 p.m., with window services 8:30 to 11:30 a.m. Both the Consular Agency and Embassy may provide updated information on travel and security within the Cayman Islands. The Embassy web site is http://kingston.usembassy.gov/
This replaces the Country Specific Information for the Cayman Islands dated December 3, 2007, to update sections on entry/exit requirements, crime, and medical facilities.
Outbreak of hand foot mouth disease in Grand Caymen
Disease Enterovirus Cayman Islands - 2 years ago
Date: Mon 19 Feb 2018
Source: Cayman Compass [edited]
<https://www.caymancompass.com/2018/02/19/grand-cayman-schools-hit-by-disease-outbreak/>
An outbreak of hand-foot-mouth disease that surfaced a few weeks ago is still affecting some schools on Grand Cayman.
The disease is not uncommon on the island and typically affects children under 10 and especially those aged 5 and younger. Children with the virus typically have a fever, sore throat, a red rash on the palms of the hands and soles of the feet, mouth sores, and loss of appetite. There is no specific treatment other than to let the illness run its course. The best prevention is practicing good sanitation and hygiene.
Tim McLaughlin, an epidemiologist with the Public Health department, said the 14 cases reported from 4-10 Feb 2018 were the most he has seen in a single week. Figures for last week [week of 12 Feb 2018] are not yet available, but Mr McLaughlin said it looked as though the spread of the disease had slowed down. Most children were out of school last week and that may be a factor, he said
"14 in a week is a lot," Mr. McLaughlin said. "It also tells me there are more cases out there."
As a consequence, he said, he is more closely monitoring the spread of the disease, which is not uncommon this time of year. If need be, he said, "We'll sound the alarm."
At the Department of Education Services, director Lyneth Monteith said she was unaware of any public schools currently being affected by the disease. But preschools are seeing the problem.
Bri Bergstrom, the owner of the Montessori School of Cayman, said 3 of her students came down with the illness 3.5 weeks ago. It was the 1st such outbreak at the school, she said, adding that no other students have since been affected.
"It seems to be going around," Ms Bergstrom said. "It's almost impossible to avoid sometimes, things coming into the school."
She and others operating schools and preschools said that they have increased their efforts to keep classrooms and play areas sanitary by cleaning more often and doing thorough deep cleaning.
"Even when the flu is going around, we always amp up the sanitation," Ms Bergstrom said.
At the Treasure Garden, a preschool with 35 students, teacher Tonie-Ann Broomfield said 6 pupils have contracted the disease over the past 2-3 weeks. Some of the students, she said, showed no outward symptoms, such as a fever, before breaking out in a rash. She said the staff is being more vigilant.
"As soon as we check their temperature and it's above 100 deg F [37.8 deg F], we call the parents and ask them to take them to the doctor," Ms Broomfield said, adding that the child is kept isolated from other children until they are picked up. [Byline: Mark Muckenfuss]
[Hand-foot-mouth disease is caused by viruses that belong to the _Enterovirus_ genus (group), which includes polioviruses, coxsackieviruses, echoviruses, and other enteroviruses. - Coxsackievirus A16 is typically the most common cause of hand-foot-mouth disease in the United States, but other coxsackieviruses can also cause the illness. - Enterovirus 71 has also been associated with cases and outbreaks (<https://www.cdc.gov/hand-foot-mouth/outbreaks.html>) of hand-foot-mouth disease, mostly in children in East and Southeast Asia. Less often, enterovirus 71 has been associated with severe disease, such as encephalitis. - Several types of enteroviruses may be identified in outbreaks of hand-foot-mouth disease, but most of the time, only 1 or 2 enteroviruses are identified.
Generally, a person with hand-foot-mouth disease is most contagious during the 1st week of illness. People can sometimes be contagious for days or weeks after symptoms go away. Some people, especially adults, may become infected and not develop any symptoms, but they can still spread the virus to others. This is why people should always try to maintain good hygiene, such as frequent handwashing, so they can minimize their chance of spreading or getting infections. (Excerpted and edited from <https://www.cdc.gov/hand-foot-mouth/about/transmission.html>). - ProMED Mod.LK]
[HealthMap/ProMED-mail map
Grand Cayman, Cayman Islands: <http://healthmap.org/promed/p/7955>]
Authorities in Cayman Islands report Measles alert
Disease Measles Cayman Islands - 2 years ago
Date: Fri 2 Feb 2018
Source: Cayman News Service [edited]
<https://caymannewsservice.com/2018/02/measles-outbreak-in-region-believed-to-be-from-europe/>
The [Cayman Islands] Public Health Department is issuing an alert for travellers after at least 2 cases of measles were confirmed in the Caribbean and Central America that appear to have been imported from Europe. There have been no cases of measles in the Cayman Islands since 1990. Local immunisation coverage against the disease is around 90% among 15-month-old children and about 97% by the time they reach school age. But officials are urging anyone who becomes unwell after returning from the UK and Europe as well as parts of the US to visit a doctor.
People who are experiencing a sudden high fever accompanied by a rash should seek medical attention immediately and provide their travel history to the doctor for necessary investigation.
"If you are travelling to any of the affected areas where measles has been confirmed, safeguard yourself and your family by ensuring that your and your children's immunisations against measles are up to date," advised Nurse Angela Graham, manager of the Health Services Authority's Expanded Programme on Immunisation. "Unprotected children are at the greatest risk of contracting this virus, should a case be imported to the Cayman Islands. It is the responsibility of parents and guardians, alike, to ensure that their children are protected."
Dr Samuel Williams-Rodriguez, Acting Medical Officer of Health, said that while there has been great progress in the fight against measles regionally, there is a risk of spread and sustained transmission in areas with susceptible populations.
"Vaccination with at least 2 doses remains the most effective measure," he said. "I emphasise that measles can be reintroduced as we have many residents and visitors travelling to and from the Americas and European countries. We should therefore remain vigilant."
He added, "The 1st sign of measles is usually a high fever which begins about 10-12 days after exposure to the virus. A runny nose, cough, along with red and watery eyes and small white spots inside the cheeks, can develop in the initial stage followed by a rash on the face and upper neck, eventually reaching the hands and feet."
Measles is caused by a virus which grows in the cells that line the back of the throat and lungs. It is a human disease and is not known to occur in animals. Close contact with other people following the onset of rash must be avoided 7 for days.
For complete protection, children older than 12 months should have 2 doses of MMR (measles mumps and rubella) vaccine. Children between 6 and 11-months, who are travelling abroad, are recommended to have one dose of MMR vaccine.
[Maps of the Caribbean and Central America can be found at
<https://goo.gl/maps/yMRFiDoaLDB2>and
<http://healthmap.org/promed/p/449>]
400 chickens in Bodden Town (Caymen Islands) die of Botulism
Disease Botulism Cayman Islands - 6 years ago
Date: Thu 17 Apr 2014
Source: cayCompass.com [edited]
<http://www.compasscayman.com/caycompass/2014/04/17/Hundreds-of-chickens-die-of-botulism/>
More than 400 feral chickens in Bodden Town have died of botulism, according to a post-mortem examination carried out by the Department of Agriculture. The birds began dying more than 2 weeks ago, residents in the area said. Brian Crichlow of the Department of Agriculture said a post-mortem exam on one of the birds revealed botulism. The bird was also tested for avian flu, with negative results. Mr Crichlow said botulism is not spread by direct contact with affected chickens, but there is a "low potential for spreading to humans and other animals through consumption of dead chickens" contaminated with the botulism toxin.
Botulism is a micro-organism that occurs naturally in the soil and in decaying flesh. Since chickens are scavengers, they likely ate a dead animal and got sick, said Mr. Crichlow.
The Department of Environmental Health was expected to begin removing the birds from the site, near the Bodden Town Mission House, on Wednesday afternoon [16 Apr 2014], according to the department's director, Roydell Carter. "We are aware of the situation. We were notified by the Department of Agriculture about it. We went on site today [Wed 16 Apr 2014] and we will be assisting them in getting the birds removed and disinfecting the area," he said. "We're putting together the resources we need -- there are so many [dead chickens] all over the place ... We will go in and help. There could probably be public health implications as well [if the carcasses are not removed]. We don't want all these dead birds lying around ... where other animals might feed on their carcasses," he added.
On Wednesday [16 Apr 2014], many of the dead chickens could be seen around the Mission House and Harry McCoy Park, and under the home of an elderly couple nearby. Mr Crichlow advised that if the dead or dying birds are not removed and disposed of properly, other chickens will feed on the carcasses and the maggots from the dead chickens, leading to more chickens contracting botulism. Botulism is also known as "limberneck," he said, reflecting the neck paralysis typically seen in affected birds. [The son] of the couple under whose home many of the decaying carcasses were seen, said he had picked up as many as he could, but those under the house would have to stay there until he had help removing them.
"The chickens just get crippled, lie down and die," said [the man], who often fed the chickens. For the past 2 weeks, the chickens have been "dropping off like flies," he said.
The feral chickens roam the neighborhood and are considered pests by many in the area. Mr Crichlow said there had been no reports of domestic flocks of chickens owned by local farmers being affected by botulism. However, he said the department had seen similar episodes before of local wild chickens dying, adding that botulism is common in feral chickens in Cayman and elsewhere. Over the past 2 years, his department has responded to deaths of feral chickens in George Town, West Bay and Bodden Town districts, he said.
Karen Rosenthal, a St. Matthews Veterinary School veterinarian who studies birds, said, "It is not so easy for people to get botulism the same way chickens do. But you would never eat the eggs or meat from a chicken with botulism," she said. "What we should worry about is if the people are using the same water source as the dead birds."
Kiran Kumar, medical officer of health at the public health department, said botulism from dead chickens does not spread to human beings through the air, and there is also no evidence of it spreading to humans by consumption of chickens with botulism. However, he advised against eating infected chickens to "prevent any rarest possibility of such occurrence." [Byline: Jewel Levy]
[Avian botulism is much more often seen in wild ducks and other water birds. But we do have a prior report of an Australian incident which is very similar to this Cayman report. The Australians ascribed it to a buildup of the causative organism, _Clostridium botulinum_, in the soil. - ProMed Mod.MHJ]
Chikungunya warning across Caribbean
Disease Chikungunya Virus Cayman Islands - 6 years ago
Date: Fri 17 Jan 2014
Source: Businessweek [summ., edited]
<http://www.businessweek.com/news/2014-01-17/african-virus-outbreak-in-caribbean-prompts-government-warnings>
The 1st known outbreak of the chikungunya virus in the western hemisphere has Caribbean governments working to prevent the disease from spreading and damaging the region's tourism-dependent economies.
About 280 cases of chikungunya [virus infection; many more cases than this, see other reports - ProMed Mod.TY], which can cause severe joint pain, fever and headaches, have been reported since early December [2013] in Dutch and French Saint Martin, Saint Barthelemy, Martinique, Guadeloupe, Dominica, the British Virgin Islands, and French Guiana. Officials from Venezuela to the Cayman Islands have warned of the potential for the mosquitoborne virus, 1st identified from a patient in Tanzania in 1953, to spread. There is no treatment, and the illness is rarely fatal.
"The worst case scenario would be that the impact would be significant and slow down the whole economy in the Caribbean," James Hospedales, the executive director of the Caribbean Public Health Agency, said by telephone. "The Caribbean is the most tourism-dependent region in the world, so if it spreads like wildfire you could scare away tourists." [byline: Isabella Cota and Elizabeth Lopatto]
[This report is a good illustration of potential adverse economic effects when a new disease appears in a major tourist destination. Although dengue fever poses greater health risks, the addition of a 2nd virus disease to the area increases concern on the part of the traveling public. - ProMed Mod. TY]
Mosquito reduction in Caymen Islands
Disease Dengue Fever Cayman Islands - 7 years ago
Date: Mon 17 Sep 2012.
Source: Cay Compass [edited]
<http://www.compasscayman.com/caycompass/2012/09/17/Dengue-carrying-mossies-hit-hard/>
The Cayman Islands Mosquito Research and Control Unit and Oxitec have cited an 80 per cent reduction in the numbers of _Aedes aegypti_ mosquitoes in Grand Cayman after introducing genetically modified mosquitoes into the environment as a control measure. This finding, which was officially published in a report in Nature Biotechnology, was previously reported in the 17 Jan 2012 edition of the Caymanian Compass.
One of the main reasons the report said led to the Cayman Islands "having a need the need for alternative measures of control" was the high level of resistance to insecticide shown by _Aedes aegypti_ mosquitoes in Grand Cayman. The report references research done by MRCU Entomologist Angela Harris and Hilary Ranson of the Liverpool School of Tropical Medicine, who in their findings, "Pyrethroid Resistance in Aedes Aegypti," stated: "The Grand Cayman population of _Aedes aegypti_ is highly resistant to DDT and pyrethroid insecticides."
In an interview with the Caymanian Compass, Dr. Harris said, "For our experiments regarding the issue of resistance to insecticides we used mosquitoes that have been in a secure environment for over 30 years in a colony that was bred repeatedly over time and then compared those with the mosquitoes from the Grand Cayman. The results indicated that those found here are much more resistant and could be exposed to DDT for up to 8 hours."
Ms Harris added that the _Aedes aegypti_ mosquito has only been in the Cayman Islands since 2002 and could have likely acquired its resistance from its places of origin, which have not been determined. She also surmised that their resistance level could be as a result of cross-resistance from a pyrethroid resistance. In any event, much of Dr. Harris' research going forward will be to substantiate the theory that the mosquitoes came to the Cayman Islands with the resistance as opposed to developing it here. The Cayman Islands has never used DDT in its mosquito control efforts.
However, the Mosquito Research and Control Unit of the Cayman Islands was scrutinised in the foreign press for using genetically modified _Aedes aegypti_ mosquitoes to combat the spread of dengue fever. It was the 1st time the method was being used in a real world test area.
At the time, Bill Petrie, director of MRCU, said the initiative was essentially a new spin on an old technique in which males that were made sterile were released. He added that the difference here is that the male mosquitoes' genes were altered, as opposed to their sterility being chemically induced by radiation.
"MRCU along with Oxitec of Oxford University ran the trial for 6 months," Mr. Petrie said. "We chose a small isolated area in East End. This was done in 3 blocks; one block was where the method was introduced, while nothing was done in another block and the 3rd block was used to monitor the natural population of the _Aedes aegypti_ mosquito.
"Once the team perfected the technique, monitoring was done by traps. The final statistical analysis has shown a significant reduction in the population of this potential dengue carrier," he added.
Mr. Petrie said the male _Aedes aegypti_ mosquito cannot bite and lives a short life-span and since their eggs will not survive using this new method of control, the population of the species has decreased, as did the probability of dengue fever transmission. Since the Cayman Islands' success using the genetic modification technique, several other jurisdictions are following suit.
"Dengue is a dangerous and debilitating disease, which affects up to 100 million people each year. The incidence of dengue has grown very rapidly in recent years: it is now a serious threat to global health, and the only means of prevention is to target the mosquitoes which carry it. We need new tools in the fight against these dangerous pests, and today's publication shows that Oxitec's approach can provide that," Mr. Petrie said. [Byline: Stuart Wilson]
Harris AF, Nimmo D., McKemey AR, Kelly N, Scaife S, Donnelly CA, Beech C, Petrie WD, Alphey L. Field performance of engineered male mosquitoes. Nat Biotechnol 2011 Oct 30;29(11):1034-7.
[This is an interesting field experiment that produced an 80 per cent reduction in the _Aedes aegypti_ population through release of genetically modified mosquitoes into a population of native mosquitoes resistant to 2 common pesticides. The release of genetically modified mosquitoes will be considered controversial and opposed by some, but alternatives such as increasing use of pesticidal chemicals have been of limited success in medium- to long-term vector population reduction efforts. It will be interesting to see how successful the release of these genetically modified mosquitoes will be in other locations. An effective, commercially available dengue virus vaccine is still several years away. Meanwhile, vector control is the only way to prevent dengue virus transmission. - ProMed Mod.TY]
[A HealthMap/ProMED-mail map showing the location of the Cayman Islands in the Caribbean can be accessed at: http://healthmap.org/r/1IG3.]
Japan is a highly developed country with excellent tourist facilities. The country covers a number of islands and the population is estimated at over 125 million. English is widely spoken in the main tourist a Read More Show Less
d urbanised centres.
Weather Profile
Due to the strong influence from the sea, Japan tends to have a high rainfall but milder winters than the adjacent mainland of China. This is similar to the climate experienced in Ireland by comparison to the rest of Europe. Spring and Autumn are usually the most pleasant months but during the Summer the climate can be significantly humid and tiring. During this time it will be essential that fluid intake is increased and that salt (lost through perspiration) is replaced - usually by increasing the amount eaten on your food providing this is not contraindicated by any personal medical condition such as blood pressure etc.
The Japanese authorities have limited patience with those arrested while under the influence of alcohol. For some travellers visiting the country this may mean a prolonged stay in the local jail and the subsequent missing of important appointments.
Japan is situated in a region of the world which regularly experiences earthquakes and other climatic changes including typhoons. A number of relatively small earthquakes are reported each year but, to date, this has seldom affected any tourist itinerary. However, further information is available at http://www.tokyoacs.com
The risk to personal security for tourists while travelling throughout Japan is small though commonsense care of personal belongings is always essential. Where available, use the hotel safety boxes to store valuables and your passport, return air tickets. During the mid 1990's a number of terrorist incidents occurred but no recent serious problems are being reported.
Many countries now include the cost of their 'departure tax' within the ticket. In Japan this will depend on which airport you leave from. The fee is collected in Yen at Kansai - Osaka International Airport but usually included in the ticket cost if flying via Narita - Tokyo International Airport.
Japan is not a cheap country for tourists. The cost of living is one of the highest throughout the world. Credit cards may be used in main cities but the ATM's machines may not be available at all hours. Before taking a taxi from the airport it would be wise to check the costs and then assess whether or not it might be more prudent to use the local bus transport!
The level of medical care throughout most tourist regions in Japan is excellent. However, there may be limited English-speaking doctors in some more rural areas and even where this facility is available in the main cities the cost of healthcare can be very expensive. It is wise to carefully check your travel health insurance premium before you leave home.
Local Medications
Some commonly used European over-the-counter medications
may not be available in Japan. Also, there are strict laws governing the importation of certain medications which can be strictly enforced. Certain inhalers, sinus preparations etc may be confiscated on arrival. If you are taking any personal medications it may be wise to check before you leave. Obviously never carry packages for anybody else while travelling unless you are certain of the contents.
Avoiding Prickly Heat
The term prickly heat is used in a variety of ways but the cause is generally the same. In a hot climate the body perspires to maintain the internal temperature at a correct level. In the perspiration there will be fluid and your personal salts. The fluid evaporates but the salt dries against the skin. It is your individual reaction to this salt that leads to the 'prickly heat rash'. The reaction to these salts can be minimised by removing the salts from the skin surface as soon as possible. Change your clothes regularly, use plenty of talcum powder to absorb the perspiration and dry off well after showering.
Food & Water Care in Japan
Any international traveller should recognise the risks of a ruined trip from unwise indulgence in local food and beverages. In Japan the level of food hygiene is high but the consumption of Sushi (uncooked raw fish) is unwise. Bivalve shellfish also carry a significant risk due to the limited level of sterilisation during the cooking process.
Malaria & Mosquitoes
No malaria transmission occurs throughout Japan although avoiding mosquito bites during the humid months is wise.
Airborne Disease
In any situation where you will be crowded together with many others the risk of a variety of airborne diseases will be higher. This will include serious diseases such as Meningococcal Meningitis but also others such as Influenza and the common cold. The risk of Meningococcal Meningitis in Japan is regarded as small and vaccine is not routinely recommended. However, having the Flu vaccine may be a wise precaution. It is also sensible to carry a small supply of lozenges to treat the inevitable sore throat which may occur.
Driving in Japan
The road system throughout Japan is excellent but unfortunately the road signs may prove too much of a hurdle for those unfamiliar with the language! The congestion within the cities tends to be high and tolls on some of the major roads may be quite expensive. The traffic moves on the left side of the road but for many tourists it will be wiser to consider using local transportation rather than risking a ruined holiday.
English Help Lines
Tourists can obtain important information and assistance in English while visiting Japan through the following numbers;
In Tokyo - 03-3968 4099
Rest of Japan - 0120-461 997
Vaccines for Japan
For the majority of short-term travellers visiting Japan no particular vaccines will be recommended. Those planning to live for longer periods within the country will need to discuss this through in greater detail.
Update report on Rubella situation in Japan
Disease Rubella Japan - 4 days ago
Date: Tue 7 Jan 2020
Source: National Institute of Infectious Diseases Epidemiology Center for Infectious Diseases [in Japanese, trans. & summ. Rapp. KI, edited]
<https://www.niid.go.jp/niid/images/epi/rubella/2019/rubella191225.pdf>
Urgent Information on Rubella Outbreak in Japan: as of 25 Dec 2019
Rubella reports in week 51 of 2019 [16 Dec - 22 Dec 2019], 6 cases were diagnosed with rubella and reported.
Rubella in weeks 1-51
The cumulative number of reported cases was 2294, an increase of 6288 from 2288 in week 50 (Figures 1, 2-1, and 2-2). Even if diagnosed in the 51st week, reports reported late on or after [26 Dec 2019] are not included, so care must be taken in interpreting the number of reports.
Number of reported cases of congenital rubella syndrome
The number of cases of rubella and congenital rubella syndrome reported since the start of notification of all cases in 2008 (Figure 3), 2014 report. Since then, there have been no reports of congenital rubella syndrome
(<http://www.niid.go.jp/niid/ja/rubella-m-111/rubella-top/700-idsc/5072-rubella-crs-20141008.html>)
A total of 4 people were reported, 1 each in weeks 4, 17, 24, and 44 in 2019
Presumed infected area: Saitama Prefecture 1 person, Tokyo 2 people, Osaka Prefecture 1 person.
Gender: 3 males, 1 female
Kuching vaccination history: Yes (1 time, vaccination year unknown, type unknown) 1 person, 3 unknown, maternal rubella history during pregnancy: Yes 1 person, unknown 2 people, none 1).
Rubella reports since 2013
Since the epidemic of 2013 (14,344), there were 319 in 2014, 163 in 2015, 126 in 2016 and 91 in 2017.
Despite a downward trend (Figures 2-1, 2-2, 3), 2946 people were reported in 2018, and 2294 in week 51 in 2019.
Number of reports by region
By region, Tokyo (854: no increase from week 50), Kanagawa (293: one increase from week 50), Yo-ken (200: no increase from week 50), Saitama (197: no increase from week 50), Osaka (130: no increase)
(No increase from 49 weeks), with more than 100 reports (Figures 4 and 7). Week 51 is for Aichi prefecture (3 people) (Figure 5).
The largest number was 250 from the Kinki region (11%), 168 from the Kyushu region (7%), 125 from the Chubu region (5%), 96 people (4%) from the Chugoku / Shikoku region and 72 (3%) from the Hokkaido / Tohoku region were reported. No report is high. Only in Chichi Prefecture (Figures 4 and 7).
Symptoms (with duplication)
In the descending order, rash 2262 (99%), fever 2035 (89%), lymphadenopathy 1324 (58%), conjunctival congestion 1066 (46%), cough 567 (25%), arthralgia / arthritis 542 (24%), nasal discharge 499 (22%), thrombocytopenic purple 7 (0.3%) had plaque disease and 1 (0.04%) had encephalitis. In addition; sore throat 41; headache 42; malaise 24; 11 people, diarrhea / watery / soft stools; 11 people, papular hemorrhage of hard palate / palate mucosa; 8 people, thrombocytopenia; 7 people, leukopenia; 3 people, hepatitis / hepatic dysfunction; meningitis in 1 person, and pneumonia in 1 person. Fever, rash, lymphadenopathy
All reported were 1182 (52%).
Laboratory diagnosis method (with duplication)
Virus isolation was 26 (1%), 4 in 1E, and 2 in 2B. Detection of viral genes by PCR 1326. Of these (58%), of which 625 had been genotyped, 548 in 1E and 35 in 2B. 1207 (53%) of serum IgM antibodies were detected, of which both viral genes and serum IgM antibodies were detected; were 413 (34%). Rubella antibody seroconversion or significant increase with paired sera was found in 54 (2%) patients. In addition, after being accepted by the public health center as measles (clinical diagnosis example), the result of the test diagnosis is reported to rubella (test diagnosis example): there were 136 cases in which this was changed.
Putative source of infection
In the occupation statement column added to the notification slip from January 2019, 837 (36%) were listed as company employees. The most common was 33 healthcare professionals (10 nurses, 5 medical clerks, 4 pharmacies, 3 doctors, 2 occupational therapists, 2 nursing assistants, 1 dentist, 1 pharmacist, 1 dental assistant, working at a dental clinic 1 person, 1 laboratory technician, 2 medical professionals), 12 childcare workers, 16 teachers, 11 police officers and police officers, 7 firefighters were reported, and 7 SDF personnel were reported.
94% (2166) of the reported cases are adults, with 3.6 times more men than women (1795 men, 499 women) (Figure 8, 9, 10). The median age of male patients is 40 years (0-76 years), especially for men in their 30s and 40s (59% of all men) (Figure 8). The median age of female patients is 30 (0-76), especially in their 20s and 30s (64% of all women). Figure 9).
Vaccination history
None (479: 21%) or unknown (1594: 69%) account for 90% of vaccination histories (Figures 8 and 9). Of those who had been inoculated (221 persons: 10%), both the date of inoculation and the lot number were reported... Estimated infected area
The estimated number of infected areas was 1774 (77%) in Japan, 460 (20%) unknown in Japan and abroad, 48 (2%) outside Japan, 12 people (0.5%) in Japan or abroad have low outbreaks overseas (Figure 11). ...[continued]
IDWR Surveillance Data Table 2019 week 51 [16 Dec-22 Dec 2019], Japan
Source: National Institute of Infectious Diseases, Japan [edited]
<https://www.niid.go.jp/niid/en/survaillance-data-table-english.html>
Notifiable diseases, number of cases of the week and total number of cases by prefecture.
Total number of cases was updated with delayed reported and discarded cases.
- 2019, week 51:
<https://www.niid.go.jp/niid/images/idwr/data-e/idwr-e2019/201951/zensu51.csv>
Week 51; 2019/2018/2017
Rubella (FN, FO), current week 6/84/4; cum 2294/2806/91 (data of 2017 was checked. - Rapp.KI)
[Rubella, also called German measles, is a disease spread by the coughs and sneezes of infected people. Symptoms include rash and fever for 2-3 days. Rubella on its own is not a high-risk infection. But rubella is very dangerous for a pregnant woman and her developing baby. If a pregnant woman gets rubella virus, her baby could have birth defects such as deafness, cataracts (blurred vision), heart defects, mental disabilities, and organ damage. Pregnant women who are not protected against rubella through either vaccination with the MMR vaccine or previous rubella infection should not travel to Japan during this outbreak. (from <https://wwwnc.cdc.gov/travel/notices/alert/rubella-japan>). - ProMED Mod.LK]
Japan: <http://healthmap.org/promed/p/156>]
Tick borne "Severe Fever with Thrombocytopenia Syndrome" (SFTS) alert in Japan
Disease Haemorrhagic Disease Japan - 12 days ago
Date: Tue 10 Dec 2019
Source: The Telegraph [edited]
<https://www.telegraph.co.uk/global-health/science-and-disease/pet-owners-increased-risk-deadly-tick-borne-disease-spreads/>
A tick-borne virus that is rapidly spreading throughout Asia has such a high death rate that it should be treated on par with diseases such as Ebola, a Japanese virologist has warned.
The new virus -- severe fever with thrombocytopenia syndrome (SFTS) -- is spread by tick bites and was 1st identified by Chinese researchers 8 years ago.
It has a death rate of 30 percent, similar to diseases such as Crimean-Congo haemorrhagic fever, classified by the World Health Organization as having "epidemic potential."
Owners of pet cats and dogs have been warned to be especially vigilant, as they carry ticks.
SFTS was 1st identified in Japan in 2013, when 40 patients were identified. The number of cases has risen sharply since then, with 96 in the 1st 11 months of this year [2019], and experts are anticipating that the total will surpass 100 for the whole of 2019.
"SFTS is a tick-borne infection with a fatality rate around 30 percent, and it should be classified as a viral haemorraghic fever," said Dr Masayuki Saijo, director of Japan's National Institute of Infectious Diseases.
"The route of the virus infection is very similar to Ebola [Ebola virus is not tick-borne. - ProMED Mod.TY] and the fact that the fatality rate is so high means that SFTS should be treated as a biosafety level 3 pathogen," he added.
With a high mortality rate and no effective treatment available, experts are warning people to take precautions against ticks while they are in rural areas. Pets are also susceptible to carrier insects, such as the Asian longhorned tick, and owners are being cautioned to be vigilant.
"We have recently found that domestic cats and dogs show similar symptoms of the virus as humans when they are infected, and the fatality rate in cats exceeds 50 percent," Dr Saijo told the Telegraph.
"We have identified several cases in Japan in which pet owners have been infected by their pets and at least one case in which a vet died after being bitten by an infected cat," he said.
As well as being found in China and Japan, SFTS has now been confirmed on the Korean Peninsula, Taiwan and, last year [2018], in Viet Nam. The disease is believed to have evolved between 50 and 150 years ago, and previous deaths, particularly in developing parts of east Asia, were blamed on other illnesses or were simply recorded as being from unknown causes.
The primary clinical symptoms in humans are fever, vomiting, diarrhoea, low platelet count, a low white blood cell count, elevated liver enzyme levels, and, ultimately, multiple organ failure.
Most cases are reported in rural areas between March and November, with the virus believed to lie dormant in the host for between 6 days and 2 weeks before the symptoms become apparent. Anyone who finds a tick embedded in their body is being advised not to try to remove it themselves but to seek medical attention.
As of the end of October [2019], a total of 491 people had been treated in Japan for SFTS, with 70 patients dying. It appears that the illness is particularly dangerous to older people, with 90 percent of the recorded cases among people aged 60 or older.
The virus is carried by wild animals, primarily deer and boars in Japan, but also by hedgehogs, cattle, goats and sheep.
The institute is working on a treatment, with early indications suggesting that it can reduce fatalities by about 10 percent, Dr Saijo said.
"Viral zoonoses such as SFTS have become more prominent worldwide," he said. "With approximately 1/4th of the world's population and a vast diversity of wild and domestic animals living in close proximity to humans, it is very likely that China has the greatest potential for the emergence of infectious diseases worldwide.
"The frontline defense against such emerging infectious diseases continues to be careful clinical observation, heightened surveillance and rapid detection," said Dr Perlin.
While SFTS has not been recorded outside east Asia, tick-borne viruses are on the rise worldwide because of a combination of climate change and increased travel. Earlier this year [2019] a potentially deadly brain disease, tick-borne encephalitis virus, was found for the 1st time in the UK.
Japanese authorities have been conducting education programmes in areas that have reported a high number of cases, although there have been criticisms that the authorities are not taking adequate precautions.
In 2017, a press conference at the offices of the Miyazaki Prefectural Government descended into chaos when a live tick that had been brought in to show to journalists disappeared during the proceedings. A local government official placed the insect on a piece of paper to allow photographers to take close-up images, but it disappeared.
Officials searched for the tick but were unable to locate it. After the room was evacuated, 2 types of insecticide were sprayed on the carpet and the prefectural governor issued an apology the next day. [Byline: Julian Ryall]
[The above report indicates that SFTS virus has become established in Japan. There were cases every year from 2013 to present. Cases were widely disbursed geographically in 2018, with 24 prefectures reporting infected individuals. There were 96 cases in the 1st 11 months of 2019. Since there is no vaccine, the best way to avoid infection is to avoid tick bites and contact with infected pets, especially cats.
SFTS is a serious disease and of significant public health concern. Although SFTS virus infections may be serious, there is evidence for subclinical or mild infections as well, so the previous numbers may be an underestimate of the total number of infections. There is also some evidence for person-to-person direct transmission of the virus, but that appears to be a rare event. The virus is doubtless endemic in several countries in Asia, and cases have occurred previously in Japan. Apparently, there are 2 previously reported affected individuals who acquired their infections directly from an SFTS virus-infected cat. No mention was made of tick transmission in that instance. The possible route of transmission from the cat to the veterinarian and veterinary nurse via exposure to blood or other bodily fluids is not mentioned (see Severe fever w/ thrombocytopenia synd. - East Asia (02): Japan (MZ) http://promedmail.org/post/20181211.6204927).
SFTS virus is a tick-transmitted phlebovirus in the Bunyavirus family. Images of a longhorn tick, _Haemaphysalis longicornis_, the SFTS vector, can be seen at
<http://www.lowchensaustralia.com/pests/paralysis-tick/haemaphysalis-longicornis-description.htm>. - ProMED Mod.TY]
Cases of Herpes B virus in Kagoshima City in Japan
Disease Herpes Japan - 2 months ago
Source: Mainichi Newspaper [in Japanese, machine trans, edited]
<https://mainichi.jp/articles/20191128/k00/00m/040/224000c>
An announcement has been received that an employee of Kagoshima City and the drug development company Shin Nippon Kagaku (Shin Nippon Biomedical Laboratories (SNBL) in Tokyo) was infected with monkey-derived "B virus". The case concerns a technician, who was conducting animal experiments on monkeys at the research institute in Kagoshima City on the [28 Feb 2019]. The condition [of the infected individual] is not disclosed. This is the 1st time that infection has been confirmed in Japan, with about 50 cases overseas.
Most cases of past infections have come into contact with monkeys at animal testing facilities, and the National Institute of Infectious Diseases says that "normally there is no risk of spreading infection because it does not move from person to person."
B virus is a type of herpes virus, and most macaque monkeys such as rhesus monkeys and Japanese [cynomolgus macaque] monkeys have viruses. It does not cause airborne infection, but if one is bitten by a monkey with the virus, fever and sensory abnormalities [may] occur at the contact area. Severe infections may cause sequelae of neuropathy.
According to the city, a technician was infected at the Safety Laboratory, which uses monkeys to investigate safety during drug development. In February of this year [2019], she complained of headache and fever, and this month [November 2019], the National Institute of Infectious Diseases determined that it was a B virus. Technicians have never been bitten or scratched and are likely to have touched excrement and saliva. [byline: Ran Kanno]
[The timeline of the infection in the above patient is uncertain. The 2nd report above indicates that the patient initially became ill in February 2019 but was diagnosed as a herpes B virus infection this month (November 2019). The 1st report above indicates that the patient is currently in a critical condition, but not for how long in that condition. The incubation period for human herpes B virus infections is 3-30 days, although CDC notes that it may be months or even years after infection is initiated for symptoms to appear.
Herpes B virus is an alpha herpes virus. Although herpes B virus is relatively common among the 3 species of macaques affected, human cases over the years have been sporadic and few -- 50 confirmed cases (now 51 with the case above) with 21 deaths. For those humans infected CDC notes that "vesicular skin lesions sometimes occur at the exposure site. The patient may also have lymphadenitis (inflamed lymph nodes), lymphangitis (infection of lymph vessels), nausea and vomiting, abdominal pain, and hiccups.
"The virus can spread to the central nervous system (CNS) and cause the following symptoms:
- hyperesthesias (increase in sensitivity to stimuli);
- ataxia (lack of voluntary control of muscle movements);
- diplopia (double vision);
- agitation;
- ascending flaccid paralysis (extreme weakness due to reduced muscle tone).
Most patients with CNS complications will die, even with antiviral therapy and supportive care, and those who survive usually suffer serious long-term neurologic problems. Respiratory failure associated with ascending paralysis is the most common cause of death. Respiratory involvement and death can occur 1 day to 3 weeks after symptom onset." The CDC website for this virus can be found at <https://www.cdc.gov/herpesbvirus/healthcare-providers.html>. - ProMED Mod.TY]
Kagoshima City, Kagoshima, Japan:
Cases of Syphilis said to be 'surging' in Japan
Disease Syphilis Japan - 2 months ago
Date: Mon 25 Nov 2019
<http://outbreaknewstoday.com/japan-syphilis-5700-cases-to-date-in-2019-pregnant-women-with-the-std-15273/>
In recent years, the number of syphilis cases has surged in Japan. In 2015, we reported on a big increase in syphilis cases in Japan where well over 2000 cases were recorded, a 4-fold increase from just 5 years earlier. In the past 2 years, more than 5500 cases were reported in 2017 and more than 6000 last year [2018]. Through [13 Nov 2019], the National Institute of Infectious Diseases (NIID) reported 5703 syphilis cases, including 1464 cases in Tokyo and 921 cases in Osaka.
Another issue the NIID has been looking at is syphilis in pregnant women in Japan. According to a report in The Mainichi [<https://mainichi.jp/english/articles/20191125/p2a/00m/0na/015000c>]: The NIID analyzed cases of syphilis reported from the 1st to the 26th week of 2019 [1-30 Jun 2019], a 6-month period from January, and found that a reported 106 of 1117 women with syphilis were pregnant. Of the 61 patients who gave their answers to a section on whether they had worked in the adult entertainment industry in the preceding 6 months, 56 said they had not done so. "It is possible that most of the expectant mothers suffering from syphilis were infected by their male partners," said Takuya Yamagishi, a doctor at the NIID. Through mid-October [2019], Japan has reported 17 congenital syphilis cases, the same as in all of 2018.
[Japan, as the United States and other countries, has experienced a rising incidence of primary and secondary syphilis that initially involved mainly men who have sex with men, but more recently has involved women in their 20s and 30s. See ProMED-mail: Syphilis - Japan (02): rising incidence, heterosexual women & men, urban http://promedmail.org/post/20181202.6175741.
In the US and elsewhere, this increase in the incidence of syphilis in women of childbearing age has been associated with a rising incidence of congenital syphilis. However, we were not told in that prior ProMED-mail post if rates of congenital syphilis are similarly rising in Japan. Now, according to data compiled by Japan's National Institute of Infectious Diseases (NIID), the incidence of congenital syphilis in Japan is rising, with 17 cases reported by the 42nd week of 2019 (week ending 19 Oct 2019), which is as many as were reported in the whole of 2018 (<https://mainichi.jp/english/articles/20191125/p2a/00m/0na/015000c>). - ProMED Mod.ML]
[HealthMap/ProMED-mail map of Japan:
<http://healthmap.org/promed/p/156>.]
cases of severe tick-borne Huaiyangshan banyangvirus in Japan causing concern
Disease Miscellaneous Japan - 2 months ago
Source: The Mainichi [edited]
<https://mainichi.jp/english/articles/20191120/p2a/00m/0na/006000c>
Cases of a lethal tick-borne virus in Japan are reportedly set to start passing the 100-people-per-year mark for the 1st time since record keeping on the condition began in 2013.
The National Institute of Infectious Diseases announced on [19 Nov 2019] that the 2019 total of 96 people affected with Huaiyangshan banyangvirus [severe fever with thrombocytopenia syndrome], also known as the SFTS virus, had surpassed the previous high of 90 in 2017. Additionally, the mortality rate is high, and due to the risk of infection being passed on by pets, the institute is warning people to be cautious. [There is a unique case of a cat transmitting SFTS virus to a veterinarian and veterinary nurse in Japan (see Severe fever w/ thrombocytopenia synd. - East Asia (02): Japan (MZ) http://promedmail.org/post/20181211.6204927). The usual transmission is via ticks. - ProMED Mod.TY]
The virus that causes SFTS was discovered by a group of Chinese researchers in 2011. It lies dormant in the body for around 6 days to 2 weeks, when it then shows symptoms including a fever, diarrhoea and bloody bowel discharges. Mortality rates of 30% have been reported. Only symptomatic treatment is available for those suffering from the virus, and there is no vaccine.
The institute has been seeking reports from medical institutions across the country regarding all patients since 2013, and an upward trend has been visible since the 1st set of reports showed 40 patients in the initiative's 1st year.
It is believed that there has not been an increase in infections, but rather that as a newly understood disease it has gradually become more easily recognized by medical professionals.
As of the end of October [2019], an overall total of 491 patients had been diagnosed with the condition [since 1st diagnosed in the country in 2013], and at the time those reports were filed 70 of [the patients] had died. It is possible that the number of the deceased has increased since that time. SFTS is particularly dangerous for elderly people, with 90% of recorded cases among those aged 60 and over.
The virus is carried by wild animals including deer and boars; if a tick (such as the Asian longhorned tick) sucks the blood of an infected animal and then later bites into another one, it passes on the virus. While it is important to be vigilant when out in hills and fields, there is also a danger of pets transmitting the disease to their owners at home after going outside.
Masayuki Saijo, head of the institute's Department of Virology 1, said, "When your pet is feeling unwell, wear protective items including thick gloves, and try not let them bite you." [Byline: Go Kumagai]
[SFTS virus apparently has become established in Japan. There were cases every year from 2013 to present, but more cases occurred in 2017 and 2018. Cases were widely disbursed geographically in 2018, with 24 prefectures reporting infected individuals. The best way to avoid infection would be to avoid tick bites.
SFTS virus is a tick-transmitted phlebovirus in the Bunyavirus family.
Images of a _Haemaphysalis longicornis_ tick, the SFTS vector, can be seen at