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Afghanistal US Consular Information Sheet March 03, 2009
COUNTRY DESCRIPTION:
Afghanistan has made significant progress since the Taliban were deposed in 2001, but still faces daunting challenges, including de Read More Show Less
eating terrorists and insurgents, recovering from over three decades of civil strife, dealing with years of severe drought and rebuilding a shattered physical, economic and political infrastructure. Coalition and NATO forces under ISAF work in partnership with Afghan security forces to combat Taliban and al-Qa'ida elements who seek to terrorize the population and challenge the government. Violence in 2008 reached unprecedented levels, as both ISAF/Afghan forces and the Taliban initiated more battles than ever before. President Hamid Karzai was sworn in as President of the Islamic Republic of Afghanistan on December 7, 2004 and the Afghan Parliament was subsequently convened in late 2005. The government is working to develop a more effective police force, a more robust legal system, and sub-national institutions that work in partnership with traditional and local leaders to meet the needs of the population. The U.S. works closely with the international community to provide coordinated support for these efforts. An Afghanistan-hosted Peace Jirga with Pakistan resulted in a commitment to cooperate in combating terrorism, facilitate the return of Afghan refugees, and support regional economic activity. Read the Department of State Background Notes on Afghanistan for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and valid visa are required to enter and exit Afghanistan. Afghan entry visas are not available at Kabul International Airport or any other ports of entry in Afghanistan. American citizens who arrive without a visa are subject to confiscation of their passport and face heavy fines and difficulties in retrieving their passport and obtaining a visa, as well as possible deportation from the country. Americans arriving in the country via military air usually have considerable difficulties if they choose to depart Afghanistan on commercial air, because their passports are not stamped to show that they entered the country legally. Those coming on military air should move quickly after arrival to legalize their status if there is any chance they will depart the country on anything other than military air. Visit the Embassy of Afghanistan web site at http://www.embassyofafghanistan.org for the most current visa information. The Consular office of the Embassy of Afghanistan is located at 2233 Wisconsin Avenue NW, Suite 216, Washington, DC 20007, phone number 202-298-9125. Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
The latest Travel Warning for Afghanistan emphasizes that the security situation remains critical for American citizens. The Taliban and associated insurgent groups, al-Qaida network terrorist organizations, and narco-traffickers oppose the strengthening of a democratic government. These groups aim to weaken or bring down the Government of Afghanistan and to drive Westerners out of the country. They do not hesitate to use violence, including targeting civilians. Terrorist activities may include, but are not limited to bombings -- including improvised explosive devices and car bombs -- assassinations, carjackings, rocket attacks, assaults and kidnappings. There were over 120 suicide attacks in 2008. There is an ongoing threat to attack and kidnap U.S. citizens and Non-Governmental Organization (NGO) workers throughout the country. In 2008,, more than 30 NGO workers were killed (six foreigners) and at least 78 NGO staff members (seven foreigners) were abducted. Over 25 other foreign civilians, including journalists, were kidnapped. Kabul continues to experience suicide bombings against Afghan government personnel and installations, Afghan and coalition military assets, and international civilians. Riots -- sometimes violent -- have occurred in response to various political or other issues. Crime, including violent crime, remains a significant problem. Official Americans' use of the Kabul-Jalalabad, Kabul-Kandahar highways and other roads throughout the country is often restricted or completely curtailed because of security concerns. Insurgents continue to use roadside and car bombs to conduct attacks and abductions along major highways. Millions of unexploded land mines and other ordinance present a constant danger. The country faces a difficult period in the near term, and American citizens could be targeted or placed at risk by unpredictable local events. Americans should not come to Afghanistan unless they have made arrangements in advance to address security concerns. The absence of records for ownership of property, differing laws from various regimes and the chaos that comes from decades of civil strife have left property issues in great disorder. Afghan-Americans returning to Afghanistan to recover property, or Americans coming to the country to engage in business, have become involved in complicated real estate disputes and have faced threats of retaliatory action, including kidnapping for ransom and death. Large parts of Afghanistan are extremely isolated, with few roads, mostly in poor condition, irregular cell phone signals, and none of the basic physical infrastructure found in Kabul or the larger cities. Americans traveling in these areas who find themselves in trouble may not even have a way to communicate their difficulties to the outside world. 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, 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:
A large portion of the Afghan population is unemployed, and many among the unemployed have moved to urban areas. Basic services are rudimentary or non-existent. These factors may directly contribute to crime and lawlessness. Diplomats and international relief workers have reported incidents of robberies and household burglaries as well as kidnappings and assault. Any American citizen who enters Afghanistan should remain vigilant for possible banditry, including violent attacks.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and to the U.S. Embassy in Kabul. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy in Kabul for assistance. The Embassy staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to provide a list of attorneys if needed. The local equivalent to the "911" emergency line in Afghanistan is: 119 Please see our information on Victims of Crime, including possible victim compensation programs in the United States.
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 Afghanistan's laws, even unknowingly, may be expelled, arrested or imprisoned. During the last several years, there have been incidents involving the arrest and/or detention of U.S. citizens. Arrested Americans have faced periods of detention—sometimes in difficult conditions—while awaiting trial. Penalties for possession or use of, or trafficking in illegal drugs in Afghanistan are severe, and convicted offenders can expect long jail sentences and heavy fines. Another sensitive activity is proselytizing. Although the Afghan Constitution allows the free exercise of religion, proselytizing is often viewed as contrary to the beliefs of Islam and considered harmful to society. Proselytizing may lead to arrest and/or deportation. 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.
SPECIAL CIRCUMSTANCES:
Because of the poor infrastructure in Afghanistan, access to banking facilities is limited and unreliable. Afghanistan's economy operates on a "cash-only" basis for most transactions. Credit card transactions are not available. International bank transfers are limited. Some ATM machines exist at Standard Charter Bank and Afghan International Bank (AIB) in the Wazir Akbar Khan neighborhood of Kabul, but some travelers have complained of difficulties using them. International communications are difficult. Local telephone networks do not operate reliably. Most people rely on satellite or cellular telephone communications even to make local calls. Cellular phone service is available locally in Kabul and some other cities, but can be unreliable. Injured or distressed foreigners could face long delays before being able to communicate their needs to family or colleagues outside of Afghanistan. Internet access through local service providers is limited. In addition to being subject to all Afghan laws, U.S. citizens who are also citizens of Afghanistan may also be subject to other laws that impose special obligations on Afghan citizens. U.S. citizens who are also Afghan nationals do not require visas for entry into Afghanistan. The Embassy of Afghanistan issues a letter confirming your nationality for entry into Afghanistan. However, you may wish to obtain a visa as some Afghan-Americans have experienced difficulties at land border crossings because they do not have a visa in their passport. For additional information on dual nationality in general, see the Consular Affairs home page for our dual nationality flyer. U.S. citizens are encouraged to carry a copy of their U.S. passport with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available. As stated in the Travel Warning, consular assistance for American citizens in Afghanistan is limited. Islam provides the foundation of Afghanistan's customs, laws and practices. Foreign visitors -- men and women -- are expected to remain sensitive to the Islamic culture and not dress in a revealing or provocative manner, including the wearing of sleeveless shirts and blouses, halter-tops and shorts. Women in particular, especially when traveling outside of Kabul, may want to ensure that their tops have long sleeves and cover their collarbone and waistband, and that their pants/skirts cover their ankles. Almost all women in Afghanistan cover their hair in public; American women visitors should carry scarves for this purpose. Afghan customs authorities may enforce strict regulations concerning temporary importation into or export from Afghanistan of items such as firearms, alcoholic beverages, religious materials, antiquities, medications, and printed materials. American travelers have faced fines and/or confiscation of items considered antiquities upon exiting Afghanistan. It is advisable to contact the Embassy of Afghanistan in Washington for specific information regarding customs requirements. Travelers en route to Afghanistan may transit countries that have restrictions on firearms, including antique or display models. If you plan to take firearms or ammunition to another country, you should contact officials at that country's embassy and those that you will be transiting to learn about their regulations and fully comply with those regulations before traveling. Please consult http://www.customs.gov for information on importing firearms into the United States. Please see our Customs Information sheet.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Well-equipped medical facilities are few and far between throughout Afghanistan. European and American medicines are available in limited quantities and may be expensive or difficult to locate. There is a shortage of basic medical supplies. Basic medicines manufactured in Iran, Pakistan, and India are available, but their reliability can be questionable. Several western-style private clinics have opened in Kabul: the DK-German Medical Diagnostic Center (www.medical-kabul.com), Acomet Family Hospital (www.afghancomet.com), and CURE International Hospital (ph. 079-883-830) offer a variety of basic and routine-type care; Americans seeking treatment should request American or Western health practitioners. Afghan public hospitals should be avoided. Individuals without government licenses or even medical degrees often operate private clinics; there is no public agency that monitors their operations. Travelers will not be able to find Western-trained medical personnel in most parts of the country outside of Kabul, although there are some international aid groups temporarily providing basic medical assistance in various cities and villages. For any medical treatment, payment is required in advance. Commercial medical evacuation capability from Afghanistan is limited and could take days to arrange. Even medevac companies that claim to service the world may not agree to come to Afghanistan. Those with medevac insurance should confirm with the insurance provider that it will be able to provide medevac assistance to this country. There have been outbreaks of Avian Influenza in poultry in Afghanistan, to include the areas of Nangahar, Laghman, and Wardak provinces, and in the city of Kabul, however, there have been no reported cases of the H5N1 virus in humans. Updates on the Avian Influenza situation in Afghanistan are published on the Embassy's web site at http://kabul.usembassy.gov/information_for_travelers.html. For additional information on Avian Influenza, please refer to the Department of State's Avian Influenza Fact Sheet available at http://travel.state.gov/travel/tips/health/health_1181.html Tuberculosis is an increasingly serious health concern in Afghanistan. For further information, please consult the CDC's Travel Notice on TB. http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx| The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Afghanistan. However, if one has questions, please inquire directly with the Embassy of Afghanistan at http://www.embassyofafghanistan.org before you travel. 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. For information about outbreaks of infectious diseases abroad, consult the World Health Organization's (WHO) web site. Further health information for travelers is available from the WHO.
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 Afghanistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance. All drivers face the potential danger of encountering improvised-explosive devices and land mines that may have been planted on or near roadways. An estimated 5-7 million landmines and large quantities of unexploded ordinance exist throughout the countryside and alongside roads, posing a danger to travelers. Robbery and kidnappings are also prevalent on highways outside of Kabul. The transportation system in Afghanistan is marginal, although the international community is constructing modern highways and provincial roads. Vehicles are poorly maintained, often overloaded, and traffic laws are not enforced. Vehicular traffic is chaotic and must contend with numerous pedestrians, bicyclists and animals. Many urban streets have large potholes and are not well lit. Rural roads are not paved. Please refer to our Road Safety page for more information.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Afghanistan, the U.S. Federal Aviation Administration (FAA) has not assessed Afghanistan's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA's internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa. U.S. Government personnel are not authorized to travel on Ariana Afghan Airlines or any other airline falling under the oversight of the Government of Afghanistan's Civil Aviation Authority, owing to safety concerns; however, U.S. Government personnel are permitted to travel on international flights operated by airlines 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.
CHILDREN'S ISSUES:
For information see our Office of Children's Issues web pages on intercountry adoption and international parental child abduction. R
EGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Afghanistan are encouraged to register with the U.S. Embassy through the State Department's travel registration web site and to obtain updated information on travel and security within Afghanistan. Americans without internet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in Kabul on Great Massoud (Airport) Road, local phone number 0700-108-001 or 0700-108-002, and for emergencies after hours 0700-201-908. The web site is http://kabul.usembassy.gov/ * * * * * This replaces the Country Specific Information dated June 16, 2008 to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Criminal Penalties, Special Circumstances, and Medical Facilities and Health Information.
Travel News Headlines WORLD NEWS
2 recent cases of Polio reported in Afghanistan
Disease Poliomyelitis Afghanistan - 1 month ago
Date: Wed 11 Dec 2019
Source: MENA FN [edited]
<https://menafn.com/1099408014/Afghanistan-Two-polio-positive-cases-registered-in-Uruzgan-Baghlan>
Officials in the Ministry of Public Health has said that 2 fresh positive cases of polio have been registered in southern Uruzgan [Oruzgan] and northern Baghlan provinces.
According to health officials, the families of the polio-affected children live in Dand-e-Ghori [Dahana-i-Ghori] and Khas Uruzgan districts, [respectively], and the areas were out of the government's control and deprived of medical facilities.
Dr. Abdul Qayum Khplwak, head of the medical institute for the southern part of Afghanistan, said that one of the 2 children has been deprived of polio vaccination in Khas Uruzgan district of the province. He said that despite tremendous efforts towards fighting polio, there are great obstacles against the implementation of the process.
"Until every child receives polio vaccination, our efforts would not reach a complete goal," he said, adding that "the fresh case in Uruzgan shows that southern provinces are facing serious polio threats."
Meanwhile, a local medical in charge for polio affairs in Baghlan, Marjan Rasikh, has put the age of the polio-affected child at 4 years old, saying that the case has marked the initial positive polio in the province.
Over 24 positive polio cases have been recorded from the beginning of 2019: more than 8 cases in Uruzgan, 5 in Helmand, 4 in Kandahar, 2 in Paktia, and 3 other cases in Badghis, Nangarhar, and Kunar provinces.
To prevent the positive cases of polio, the health officials said that anti-polio vaccination should be implemented across the country.
[The addition of these 2 newly confirmed cases will increase the total number of cases reported from Afghanistan with dates of onset during 2019 to 24. There was a newly confirmed case from Kandahar reported in last week's GPEI (Global Polio Eradication Initiative) report with date of onset 10 Nov 2019.
Again, the common denominator in the occurrence of WPV1 (wild poliovirus type 1)-associated AFP (acute flaccid paralysis) cases (presumed to be WPV cases) and in cVDPV (circulating vaccine-derived poliovirus)-associated cases is the presence of a significant susceptible population, or, in other words, areas with suboptimal vaccination coverages.
A map of Afghanistan showing provinces can be found at
<https://www.mapsofworld.com/afghanistan/afghanistan-political-map.html>.
The HealthMap/ProMED-mail map of Afghanistan can be found at
<http://healthmap.org/promed/p/137>. - ProMED Mod.MPP]
Another case of Polio reported in Afghanistan's southern Kandahar province
Disease Poliomyelitis Afghanistan - 2 months ago
Date: Mon 2 Dec 2019
Source: China.org.cn, Xinhua News Agency report [edited]
<http://www.china.org.cn/world/Off_the_Wire/2019-12/02/content_75469848.htm>
One fresh polio case had been detected in Afghanistan's southern Kandahar province, a local newspaper reported on [Mon 2 Dec 2019].
"With this new case, the total number of polio cases in 2019 reaches 22 in the country. The latest polio case has been reported from Kandahar city, capital of Kandahar province which permanently paralyzed an 18-month-old child," Daily Afghanistan-e-Ma reported.
The paper added that polio is a crippling and potentially fatal infectious disease.
"Most of the Afghan children affected by poliovirus this year [2019] are living in areas where kids do not have access to health facilities and regular anti-polio vaccination campaign. However, this time a child has been affected in a large city where anti-polio vaccination had been conducted repeatedly this year," the report said.
There is no cure for polio and the polio vaccine is the only safe and effective way to protect children.
The ongoing conflicts have been hindering the efforts to stamp out the infectious disease in the mountainous country.
[The addition of 3 newly confirmed cases of polio (all 3 due to WPV1, as per End Polio Pakistan <https://www.endpolio.com.pk/polioin-pakistan/polio-cases-in-provinces>) in Pakistan and one newly confirmed case of polio in Afghanistan brings the total number of WPV1 associated cases with date of onset in 2019 to 116 (94 in Pakistan and 22 in Afghanistan). The key question here is whether Afghanistan and Pakistan, with all the challenges in vaccinating the susceptible populations due to a variety of anti-vaccination impediments, will be able to interrupt transmission of the WPV1 in both countries simultaneously.
Maps of Afghanistan:
<https://www.mapsofworld.com/afghanistan/afghanistan-political-map.html>
and <http://healthmap.org/promed/p/137>. - ProMED Mod.MPP]
Two new cases of Polio reported in southern Uruzgan province of Afghanistan
Date: Sun 1 Sep 2019
Source: MENAFN - Afghanistan Times [edited]
<https://menafn.com/1098951355/Afghanistan-Two-new-polio-cases-detected-in-Uruzgan>
Two new polio cases have surfaced separately in capital city of Tirinkot and Chora district of southern Uruzgan [Oruzgan] province, a statement from the relevant ministry said [Sun 1 Sep 2019].
A 30-month-old child and another 6-month-old infant were permanently paralyzed as a result of the polio virus.
According to a statement issued by the Ministry of Public Health (MoPH), the total number of polio cases in 2019 reached 15 with the 2 new cases, saying all of these cases had been reported from inaccessible areas.
"Of the 15 polio cases this year [2019], 14 have been reported from the southern region of Afghanistan,' the statement said, adding "7 positive cases came from [Oruzgan], 5 from Helmand, and 2 other from Kandahar."
Only 1 out of 12 polio cases was reported from eastern Kunar province while the rest happened in the southern zone.
"Access to health services is the right of every citizen of the country," said Dr Ferozuddin Feroz, the Minister of Public Health. "We are deeply concerned about the increasing polio cases and the number of children who still don't have consistent and proper access to vaccination," he added.
He said the virus could spread further in the country and more children would be affected and paralyzed by polio virus.
He called upon people to 'work together and protect innocent children against polio and facilitate a safe and secure environment for our frontline workers in order to enable them administer vaccine drops to children in every nook and cranny of the country."
Polio is a crippling and potentially fatal infectious disease. There is no cure and the vaccine is the only safe and effective way to protect children.
The polio vaccine is safe and harmless for new-born children whether they are sick or not. It is very important that new-borns and sick children get the vaccine because they may have lower immunity which makes them more susceptible to the virus.
Polio vaccination has also been strongly endorsed by national and global Islamic scholars.
[As I mentioned in the moderator comment of the last post (Poliomyelitis update (71): global (Pakistan, Congo DR) http://promedmail.org/post/20190901.6651501), "While there have been no newly confirmed cases reported from Afghanistan this week nor have there been positive environmental samples reported from either Pakistan or Afghanistan, it doesn't mean the virus is not still circulating, just that there aren't new confirmations." Unfortunately there were cases under investigation.
As correctly stated in the media report above, the addition of these 2 newly confirmed cases brings the number of confirmed WPV1 cases reported by Afghanistan during 2019 to date to 15.
Oruzgan is located in the central part of Afghanistan, sharing southern and southwestern borders with Kandahar and Helmand provinces where other polio cases have been reported this year (2019) as well (<http://www.lib.utexas.edu/maps/middle_east_and_asia/afghanistan_admin-2009.jpg>).
HealthMap/ProMED-mail map of Afghanistan:
<http://healthmap.org/promed/p/1257>. - ProMED Mod.MPP]
Scores wounded as series of blasts rock eastern Afghan city of Jalalabad
Disturbances Afghanistan - 5 months ago
Date: Mon, 19 Aug 2019 13:26:06 +0200 (METDST)
Jalalabad, Afghanistan, Aug 19, 2019 (AFP) - Scores of people including children were wounded Monday after a series of explosions shook the eastern Afghan city of Jalalabad, as the country's independence day was marred by bloodshed.
As many as 10 blasts were reported in and around the city in Nangarhar province, authorities said, and casualty numbers rose as the day wore on. "The explosions were caused by IEDs in different parts of the city and as groups of people were celebrating independence day," the Nangarhar governor's spokesman Attaullah Khogyani said, referring to improvised explosive devices. Jalalabad is the scene of frequent bomb attacks, and the surrounding terrain is home to both Taliban fighters and the Islamic State group's local affiliate.
At least 52 people were wounded, Khogyani said. Zaher Adel, a spokesman for a local hospital, said 66 wounded people had been brought in. An AFP correspondent saw children among the victims. This year's August 19 celebrations mark 100 years of Afghan independence from British influence. The day was supposed to be one of national pride and unity, but was overshadowed by an IS suicide attack Saturday on a crowded Kabul wedding hall that killed at least 63 people.
In Kabul, locals took to the streets to wave the black-red-and-green Afghan flag, but several public events to commemorate the date were scrapped as Kabul mourns and due to fears of a fresh attack. "We postponed the celebrations to honour the victims, but we will definitely take revenge for our people," Afghan President Ahraf Ghani said. "We will avenge the blood of our people, every drop of it."
Mayhem from Afghanistan's war continues to wreak havoc on Afghans every day, even though the US and the Taliban are in final negotiations for a deal that would see US troops begin to quit Afghanistan and could potentially lead to a reduction in violence.
Suicide bomber kills 63 at Kabul wedding
Date: Sun, 18 Aug 2019 11:47:26 +0200 (METDST)
By By Emal Haidary and Mushtaq Mojaddidi
Kabul, Aug 18, 2019 (AFP) - Joy and celebration turned into horror and carnage when a suicide bomber targeted a packed Afghan wedding hall, killing at least 63 people in the deadliest attack to rock Kabul in months, officials and witnesses said Sunday. The massive blast, which took place late Saturday in west Kabul, came as Washington and the Taliban finalise a deal to reduce the US military presence in Afghanistan and hopefully build a roadmap to a ceasefire. The groom recalled greeting smiling guests in the afternoon, before seeing their bodies being carried out hours later.
The attack "changed my happiness to sorrow", the young man, who gave his name as Mirwais, told local TV station Tolo News. "My family, my bride are in shock, they cannot even speak. My bride keeps fainting," he said. "I lost my brother, I lost my friends, I lost my relatives. I will never see happiness in my life again." Interior ministry spokesman Nasrat Rahimi said at least 63 people had been killed and 182 injured. "Among the wounded are women and children," Rahimi said. Earlier he stated a suicide bomber carried out the attack.
Afghan weddings are epic and vibrant affairs, with hundreds or often thousands of guests celebrating for hours inside industrial-scale wedding halls where the men are usually segregated from the women and children. "The wedding guests were dancing and celebrating the party when the blast happened," recounted Munir Ahmad, 23, who was seriously injured and whose cousin was among the dead. "Following the explosion, there was total chaos. Everyone was screaming and crying for their loved ones," he told AFP from his bed in a local hospital, where he is being treated for shrapnel wounds.
Images from inside the hall showed blood-stained bodies on the ground along with pieces of flesh and torn clothes, hats, sandals and bottles of mineral water. The huge blast ripped parts of the ceiling off. The wedding was believed to be a Shia gathering. Shia Muslims are frequently targeted in Sunni-majority Afghanistan, particularly by the so-called Islamic State group, which is also active in Kabul but did not immediately issue any claim of responsibility.
Wedding guest Hameed Quresh told AFP the young couple were saying their vows when the bomb went off. "We fainted following the blast, and we don't know who brought us to the hospital," sobbed Quresh, who lost one brother and was himself wounded. Another guest told Tolo that some 1,200 people had been invited. With low security, weddings are seen as easy targets. The attack sent a wave of grief through a city grimly accustomed to atrocities. President Ashraf Ghani called it "barbaric", while Afghanistan's chief executive Abdullah Abdullah described it as a "crime against humanity".
- Withdrawal deal expected -
The attack underscores both the inadequacy of Afghanistan's security forces and the scale of the problem they face. While the police and army claim they prevent most bombings from ever happening, the fact remains that insurgents pull off horrific attacks with chilling regularity. On July 28, at least 20 people were killed when attackers targeted Ghani's running mate Amrullah Saleh as he campaigned in presidential elections. The incident showed how even amid tight security and known threats, insurgents can conduct brazen attacks. The issue also goes to the heart of a prospective deal between the US and the Taliban that would see Washington begin to withdraw its approximately 14,000 soldiers from Afghanistan.
The deal relies on the Taliban providing guarantees they will stop jihadist groups such as Al-Qaeda and IS from using Afghanistan as a safe haven. Saturday's attack suggests any such promise would be tough to keep. The "Taliban cannot absolve themselves of blame, for they provide platform for terrorists," Ghani said. Few believe such a deal will bring quick peace.
Many Afghans fear the Taliban could return, eroding hard-won rights for women in particular and leading to a spiralling civil war. Meanwhile, in the northern province of Balkh, 11 members of the same family were killed when their car hit a roadside bomb, officials said. The provincial governor blamed the Taliban for planting the device.
Comoros US Consular Information Sheet
The Union of the Comoros is a developing nation located in the Indian Ocean off the east coast of Africa.
Comoros consists of three islands, Ngazidja (also known Read More Show Less
s Grand Comore), Moheli, and Anjouan, that cover about 900 square miles.
A fourth island, Mayotte, is claimed by Comoros but remains a territory of France.
Ngazidja is home to the capital city, Moroni, and is the most developed of the three islands.
Facilities for tourism are limited and telecommunication links are unreliable.
French, Arabic, Swahili, and Comorian Creole are spoken.
Read the Department of State Background Notes on the Union of Comoros for additional information.
A passport and onward/return ticket are required.
Visas are available from the Comoran Mission to the United Nations in New York; American citizens visiting Comoros can obtain a free, 24-hour transit visa upon entry.
The following day, visitors are required to go to the immigration office in Moroni to change their visa status.
A fee is charged, depending on length of stay.
Travelers should obtain the latest details from the Mission of the Union of Comoros, 420 East 50th Street, New York, NY 10022; telephone number (212) 972-8010, fax (212) 983-4712.
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.
Comoros has experienced frequent strikes and civil unrest, resulting in violent clashes between police and demonstrators.
The most recent unrest involved the de facto separation of Anjouan from the Union government.
In March 2008, Union forces re-took Anjouan and are preparing the island for elections.
The former leader of Anjouan, Mohamed Bacar, has applied for asylum with France and is being held on the French Island of Reunion while his asylum claims is adjudicated.
As the government completes the transition to constitutional federalism and as Bacar's asylum claim is pending, periodic strikes and protests will likely continue to occur.
U.S. citizens should avoid political rallies and street demonstrations as even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.
Conditions are subject to rapid change on each of the three islands of the Comoros due to weak political institutions and a lack of economic development.
In a rare, apparently religious-based attack, a clinic run by a foreign Christian organization was firebombed on the island of Grande Comore in August 2007.
Religious intolerance and religious-based violence remain very unusual in Comoros.
Although foreign residents and visitors have not been targeted, the potential for further outbreaks of civil disorder remains high, and Americans should exercise caution and good judgment, keep a low profile, and remain vigilant with regard to their personal security.
U.S. citizens are encouraged to register with the U.S. Embassy in Antananarivo, Madagascar, if visiting or residing in Comoros.
Embassy contact information is provided below.
For the latest security information, Americans traveling abroad should regularly monitor the Department's web site, 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 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.
U.S. travelers are advised to be vigilant against pick-pocketing and other forms of petty crime when visiting crowded market areas, parks, and at the beaches.
Violent crime is uncommon.
The most commonly reported crime is breaking into homes.
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, help you find appropriate medical care, to 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 in Comoros are poorly equipped.
Travelers should bring their own supplies of prescription drugs and preventive medicines. Malaria is prevalent in Comoros.
Travelers to Comoros should take malaria prophylaxis.
The serious and sometimes fatal strain of malaria, P. falciparum, is resistant to the anti-malarial drug chloroquine.
Because travelers to Comoros are at high risk for contracting malaria, the Center for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™).
The CDC has determined that a traveler who is on an appropriate antimalarial drug has a greatly reduced chance of contracting the disease.
In addition, other personal protective measures, such as the use of insect repellents, help to reduce malaria risk.
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 antimalarials they have been taking.
For additional information on malaria, protection from insect bites, and anitmalarial drugs, please visit the CDC Travelers' Health web pages.
The East African Indian Ocean islands have seen a rise in the cases of chikungunya, a viral dengue-like ailment, and dengue itself.
As with malaria, chikungunya and dengue are transmitted by mosquitoes.
Every effort should be made to use repellants, proper clothing and barriers that discourage/prevent mosquito bites.
The CDC web site contains further information on chikungunya at http://www.cdc.gov/ncidod/dvbid/chikungunya/ and dengue at http://wwwn.cdc.gov/travel/yellowBookCh4-DengueFever.aspx.
There have been occurrences of measles in Comoros, with outbreaks of greater severity on the islands of Anjouan and Moheli.
Travelers are advised to ensure that their measles vaccinations are up to date.
Further, 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.
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 if 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 Comoros is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
In Comoros, one drives on the right side of the street.
Roads are ill-maintained, congested, very narrow and poorly lit at night.
Travelers should exercise extreme caution when driving after dark.
Most urban roads are paved, but many rural roads are not.
Many roads are full of potholes and dangerous curves.
Most roads have no posted speed limits, but road conditions limit speeds to below 30 miles an hour.
Drivers and front seat passengers are required to wear seat belts.
There are no laws regarding child safety seats.
There are no organizations in Comoros that provide emergency or roadside assistance.
Individuals involved in accidents rely on passersby for assistance.
Taxis or a rental car with driver are preferable to public transportation.
Please refer to our Road Safety page for more information.
As there is no direct commercial air service to the United States by carriers registered in Comoros, the U.S. Federal Aviation Administration (FAA) has not assessed Comoros' Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: While religions other than Islam are permitted in Comoros, evangelization is illegal.
Violators of this law can be fined or imprisoned.
Few establishments accept credit cards in the Comoros and most prefer Comoran Francs or Euros to dollars.
Please see our Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating the laws of Comoros, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use or trafficking in illegal drugs in Comoros are strict, with convicted offenders receiving a mandatory minimum five-year jail sentence and heavy fines.
Engaging in sex 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.
For information see our Office of Children's Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
The United States has no Embassy in Comoros.
Americans living or traveling in Comoros are encouraged to register with the U.S. Embassy in Antananarivo, Madagascar through the State Department's travel registration web site, and to obtain updated information on travel and security within Comoros.
Americans without Internet access may register in person at the U.S. Embassy in Antananarivo.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at 14-16 Rue Rainitovo, Antsahavola, Antananarivo.
The mailing address is B.P. 620, Antsahavola, Antananarivo, Madagascar; telephone [261] (20) 22-212-57; fax [261] (20) 22-345-39.
The Embassy web site is http://www.usmission.mg/.
This replaces the Country Specific Information dated October 26, 2007 to update the section on Safety and Security.
Update on Rift Valley Fever situation in Mayotte
Disease Rift Valley Fever Comoros - 8 months ago
Date: Sat 11 May 2019
Source: Revue Francophone des Laboratoires May 2019, no. 512, p. 18 [in French, transl., abridged, edited]
<https://www.sciencedirect.com/science/article/pii/S1773035X19302515?via%3Dihub> (subscription)
In February 2019, 63 cases of Rift Valley fever were diagnosed by PCR at the Mayotte hospital laboratory. The first 5 cases were detected in November 2018 by the hospital laboratory and confirmed by the Reunion Reference Center. The vector control center and the health emergency unit of the ARS OI [The Indian Ocean Health Agency] were able to analyze the epidemiology of 36 cases: 21 subjects had been in direct contact with animals and 5 others lived nearby; the last 5 declared no direct or indirect contact with animals. In addition, in 15 cases, patients had consumed raw or curdled milk. Finally, it is interesting to note that 21 patients resided in the communes of west-central Mayotte. With regard to the 63 confirmed cases, the average age of the patients was 38 years (range, 10 to 74 years), of which 16% were under 20 years, with a male/female sex ratio of 4. In addition, 29 patients lived in rural or semi-urban dwellings, 9 of whom lived in traditional huts. In terms of symptoms, 24 patients had headache, 19 arthralgia, 17 myalgia, 14 asthenia, 6 retro-orbital pain, and 6 nausea and vomiting. An entomological survey found several mosquito species, especially _Culex_, _Aedes_, _Anopheles_ and _Mansonia_.
At the same time, samples taken from farms in which abortions were reported identified 33 outbreaks of 1 to 6 animals, including 25 cattle and 8 small ruminants [the figures have increased since; see in comments].
Rift Valley fever, which has been present in Mayotte for a long time, had disappeared in the past decade, with 10 patients detected in 2008 following an epidemic in Kenya. Then there was a steady regression of verified seroprevalence on ruminants. But this seroprevalence rose to 3.6% in 2017 and then to 10.1% in 2018, indicating a new circulation of the virus. This is probably due to illegal and continuous importation of contaminated livestock. [By: Dr. Patrice Bouree]
[Mayotte's health authorities published on Sat 11 May 2019 the following update.
"Epidemiological situation as of May 10, 2019. In total, since the beginning of the epidemic (end of November 2018):
1. Animals.
Samples taken by veterinarians on sick animals or during abortions have identified 119 foci of sick animals (of which 95 are cattle and 24 small ruminants). Animal foci are mainly located in the center and northwest of the island. Additional outbreaks have appeared since the end of March [2019] in the communes of Dembeni, as well as on Petite Terre.
2. Humans.
The CHM laboratory reported 130 human cases of RVF [Rift Valley fever] at the monitoring and health emergencies platform of the ARS OI (CVAGS) of Mayotte.
The number of reported cases has remained stable since the beginning of April [2019] (on average, 4 to 5 reported cases per week). Since the beginning of the health alert, human cases have remained mainly in the center and northwest of the island." (<https://lejournaldemayotte.yt/2019/05/11/fievre-de-la-vallee-du-rift-a-mayotte-stabilite-du-nombre-de-nouveaux-cas/>).
Application of the following measures will contribute to the prevention of future RVF events in animals and humans in Mayotte:
1. Preventing illegal introduction of ruminants;
2. Preventive vaccination of cattle, sheep and goats (preferably, with an inactivated RVF vaccine; see http://promedmail.org/post/20190422.6434655). - ProMED Mod.AS]
[It would be of interest to know what role, if any, mosquito vectors are playing in transmission of RVF virus during the current outbreak. If _Aedes_ mosquitoes are involved, there is a risk of transovarial transmission of the virus that can persist for months in mosquito eggs with resumption of transmission when those eggs hatch and infected adult female mosquitoes emerge. - ProMED Mod.TY]
[HealthMap/ProMED-mail map:
Region d'outre-mer de Mayotte, France:
<http://healthmap.org/promed/p/576>]
Cutting-edge hospital in Comoros faces collapse
Disturbances Comoros - 10 months ago
Date: Mon, 25 Mar 2019 15:42:31 +0100
By Philippe ALFROY
Bambao, Comoros, March 25, 2019 (AFP) - The Bambao hospital, nestled in a tropical forest on Anjouan island in the Comoros, was meant to bring state-of-the-art medical care to the poor Indian Ocean nation. Just two years later, the hospital is deep in debt and shunned by potential patients who find it too costly. "A poisoned chalice", "a colossus with feet of clay", "a sinking ship" are among the cliches that chief paediatrician Ahmed Rakibou used to describe the facility funded and built under a Chinese aid scheme. "If they had consulted us while building it, this could have been a jewel," the doctor said, regretting that "today it's all going straight to hell". The hospital is some 30 kilometres (about 20 miles) east of Mutsamudu, the capital of Anjouan, the poorest of the three islands comprising the Union of the Comoros.
The aim was to make the hospital a flagship of Comoran healthcare, with 120 beds in a brand-new building, a team of 167 staff, many recruited locally, and modern equipment including a digital radio scanner. China's ambassador to the Comoros, Xiao Ming, hailed a "new page in the annals of cooperation" at the opening ceremony, saying "public health has always had a priority place in Sino-Comoran cooperation". But a project that cost four billion Comoran francs (8.1 million euros, $9.2 billion) today looks more like a ghost ship, with a handful of patients wandering its corridors in stifling heat. For lack of funds, about 100 staff jobs have not been filled.
- 'Not many patients' -
In the emergency ward, a doctor silently examines a child's injured arm. The lethargic mood is broken only by the arrival of an ambulance carrying the victim of a motorcycle accident. "Our activity is very varied," nurse Ali Mosthadoi says cautiously before going further. "In fact, we don't have many patients."
Deputy director Sidi Chaanbane was more forthcoming. Since the hospital was opened by President Azali Assoumani in 2017, it has faced mounting difficulties, he said. "At the start, the road from Mutsamudu was in a very bad state and patients had trouble getting here," the administrator said. "It's been repaired since, but our real problem is that we sorely lack equipment and staff." In addition to staff salaries, the Comoran state provides just five million francs (10,000 euros) a month, but the hospital needs three times as much to pay its bills. "We can't balance the budget," Chaanbane said.
Day-to-day management is a nightmare. The scanner broke down soon after it was first used. Repairs were not covered by the Chinese cooperation agreement, so the hospital took out a loan to get the machine working again. The main problem is the cost of treatment, which is not free in the former French colony, independent since 1975. Much of the funding comes from the French Development Agency (AFD) in its aid budget. France still rules over the fourth major island in the archipelago, Mayotte. The three islands forming Comoros lack the standard of living on Mayotte and are far from able to make up the remaining health budget.
- 'Expensive' -
Rakibou said the hospital charges 125,000 Comoran francs for a Caesarean birth. "What Comoran can pay that?" he asks. "No -- this hospital is not made for the population." Kanissa Adbou, 27, brought her eight-year-old daughter who trod on a nail to the hospital. "The treatment is expensive. If I could afford it, I would go to Mayotte because there, hospital is free." Those who believed that providing a modern hospital on Anjouan would dissuade Comorans from trying their luck on Mayotte have been disappointed, although the trip is illegal. "People here prefer to pay 1,000 euros to go to Mayotte by kwassa kwassa (human traffickers' dugouts) than to come to us," a nurse said. "They trust only white doctors."
The failure to put the sophisticated equipment at Bambao to regular good use enrages Ahmed Abdallah, secretary general of the Hombo public hospital in Mutsamudu. "The money spent there would have been enough to repair our buildings, replace our equipment and build roads so that sick people could come from nearby villages," he said. "We don't have even a single ambulance, yet the government has I don't know how many four-wheel drives." Health Minister Fatma Mbaraka declined to respond to requests for comment from AFP. But Rakibou refuses to throw in the towel. He hopes that the winner of Sunday's presidential election and the international community will come up with increased funding. "It wouldn't take much to change our lives!" he said.
latest update on Rift Valler Virus situation in Mayotte
Disease Rift Valley Fever Comoros - 10 months ago
Date: Fri 15 Mar 2019
Source: Le Journal de Mayotte [in French, trans. ProMED B, edited]
<https://lejournaldemayotte.yt/2019/03/15/fievre-de-la-vallee-du-rift-101-cas-humains-et-60-cas-danimaux/>
The circulation of Rift Valley fever (RVF) continues in Mayotte. An animal disease of viral origin, Rift Valley fever mainly affects domestic ruminants (cattle, sheep, goats), causing abortions and high mortality in young animals. It can be transmitted from the infected animal to humans.
In total, since the beginning of the epidemic (end of November [2018]),
- samples taken by veterinarians from sick animals or during abortions led to the identification of 8 new outbreaks this week [week of Mon 11 Mar 2019], for a total of 60 cases in animals (including 49 cattle). Animal foci are located mainly in the centre and north west of the island;
- a total of 101 human cases of RVF have been reported to the platform/cell watch and health emergencies of the ARS OI (CVAGS) of Mayotte by the CHM laboratory. Of those who could be interviewed, almost 80% report having been in contact with animals;
- since the beginning of the health alert, human cases have been located mainly in the centre and north west of the island, with nearly 60% of cases in Chiconi and Tsingoni.
Since 25 Feb 2019, the weekly number of new human cases has been on the decrease. [byline: Anne Perzo]
[This Rift Valley fever (RVF) outbreak has been going on since November 2018. The number of human cases of RVF has increased from 82 to 101 in about 2 weeks. However, it is good to learn that the number of new human cases is decreasing. The above report implies that the human infections are the result of contact with infected animals or their products, with fewer from virus transmission by mosquito vectors. The cattle cases certainly are the result of mosquito transmission.
Because RVF virus can be transovarially transmitted in populations of aedes mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch, and infected adult females emerge from them. There is a risk that RVF will reappear on the island after the current outbreak has ended.
Recent studies have shown that RVF virus may severely injure human foetuses if contracted by mothers during pregnancy. There is no indication of whether any of the 101 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock. There is no mention of whether the livestock populations in the area have been vaccinated.
The clinical findings related to the above human cases are not mentioned. In an earlier comment, ProMED noted that: "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease." - ProMED
[ealthMap/ProMED-mail map of Region d'outre-mer de Mayotte, France:
<http://healthmap.org/promed/p/576>.]
Cases of Rift Valley Fever continue to rise in Mayotte among animals and humans
Date: Fri 22 Feb 2019
Source: Le Journal de Mayotte [in French, trans. ProMED Corr. SB, edited]
<https://lejournaldemayotte.yt/2019/02/22/fievre-de-la-vallee-du-rift-63-cas-humains-depuis-le-debut-de-lepidemie/>
Rift Valley fever (RVF) continues to circulate in Mayotte among the herds of ruminants, and the number of human cases is increasing.
The prefecture of Mayotte, in collaboration with the ARS Indian Ocean and the Directorate of Food, Agriculture and Forestry of Mayotte (DAAF) reminds the population of the importance of implementing recommendations and preventive actions to avoid being ill.
Epidemiological situation as of 22 Feb 2019:
- Samples taken by veterinarians from sick animals or during abortions have identified 33 animal FVR outbreaks.
- Since late November [2018], 63 human cases of RVF have been reported to the monitoring and health emergencies platform of the ARS OI (CVAGS) of Mayotte by the CHM laboratory.
Rift Valley fever (RVF) is a zoonosis (infectious disease that can be transmitted from animals to humans) of viral origin, which mainly affects domestic ruminants (cattle, sheep, goats), causing abortions and high mortality in young animals.
Transmission to humans can occur in different ways:
- By contact with blood, body fluids, or tissues of a sick animal (during slaughter, cutting of meat, calving, care, etc.). The most exposed people are therefore professionals such as breeders, slaughterhouse employees, and veterinarians.
- By mosquito bite, vectors of the disease near infected flocks, often in the rainy seasons.
- When eating unboiled milk or unpasteurized curd from an infected animal.
There is no [direct] person-to-person transmission of RVF [virus].
The disease in humans is usually manifested by an influenza-like illness that clears in a few days and includes symptoms such as high fever (39 deg C [102 deg F]), muscle and / or joint pain, intense headaches, and fatigue. However, in 5% of cases, more serious forms may occur: ocular meningitis / meningoencephalitis, haemorrhagic fever.
Recommendations for protection against the disease-causing virus:
For farmers and people in contact with animals:
- Wash hands with soap after contact with domestic ruminants (cattle, sheep, goats).
- Do not handle unprotected or diseased animals or abortion products without protection.
- Do not handle animal carcasses without protection.
- Wear gloves, goggles, and especially a mask for the slaughter of any animal. Infected animals may have no signs, although they can transmit the virus.
For food consumption:
Transmission by ruminants
- Boil the milk
- Do not consume curd unless it has been boiled and curdled with lactic fermentation.
- Wash hands after cutting meat.
- Do not eat uncooked meat.
- Do not consume the meat of a sick animal.
To protect yourself from mosquito bites:
- Eliminate breeding sites; empty all containers that may contain water.
- Use mosquito nets and repellents.
In case of appearance of symptoms, consult your doctor immediately.
Management measures:
By the Directorate of Food, Agriculture, and Forestry: The monitoring of Rift Valley fever involves the monitoring of abortions. Farmers are asked to report to veterinarians without delay any abortions occurring in their animals in order to take samples for the disease. The prevalence of RVF in the exchange zone with Mayotte being important, the risk of spread of the disease is not negligible in case of uncontrolled import of animals.
By the Indian Ocean Health Agency: Since the1st report, each ill person is interviewed by the ARS Indian Ocean to identify the risk factors for the disease.
A treatment of larval breeding and a mosquito control are done by the service of the Anti-vector Fight [unit] to the homes of the sick persons and around the houses. Information to health professionals was made to strengthen surveillance and identification of human cases. [Byline: Anne]
[This Rift Valley fever (RVF) outbreak has been going on since November 2018. The numbers of human cases of RVF have increased from 31 to 63 in about 2 weeks. The above report does not indicate whether the human infections are the result of virus transmission by mosquito vectors, but the cattle cases certainly are. Because RVF virus can be transovarially transmitted in populations of _Aedes_ mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch and infected adult females emerge from them. Recent studies have shown that RVF virus may severely injure human fetuses if contracted by mothers during pregnancy. There is no indication of whether any of the 63 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock. There is no mention of whether the livestock populations in the area have been vaccinated.
The clinical findings related to the above human cases are not mentioned, but the symptoms associated with RVF infections in general are listed. In an earlier comment, Mod.CP noted that, "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease." - ProMED Mod.TY]
Report on cases of Rift Valley infections in western Mayotte
Date: Fri 1 Feb 2019
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/mayotte-reports-increase-rift-valley-fever-cases-48735/>
In the Indian Ocean, between Madagascar and the coast of Mozambique, sits the archipelago of Mayotte, a Department of France. Health officials have reported an increase in autochthonous Rift Valley fever (RVF) cases in the past 6 weeks. Since the 1st human case was detected on [Tue 11 Dec 2018], health officials have reported 19 human cases. Most of the cases were located in the western part of the island. Samples made on ruminants present around human cases were analyzed at CIRAD in Reunion for the search for the RVF virus. The results identified several positive animals in different villages located in west and center of the island.
In addition, an IgM-positive cattle has been reported in Mamoudzou. This 2-year-old cattle belongs to a breeding herd of 8 cattle, including 4 adults and 4 2-month-old calves. Biological control and investigations are underway. ECDC reports that the detection of autochthonous Rift Valley fever cases on Mayotte is not unexpected, but the occurrence of 19 cases within a short time period is of concern, as current weather conditions (rainy season from November to March) are favorable for the vectors.
Rift Valley fever (RVF) is an illness that is primarily spread by direct contact with blood, fluids, or tissues of infected animals such as cattle, buffalo, sheep, goats, and camels. Less commonly, it can also be spread through mosquito bites. Most people with RVF do not feel sick or have only mild illness. Symptoms of RVF include fever, weakness, back pain, dizziness, and weight loss. However, a small percentage (8-10%) of people may have more serious illness, such as severe bleeding, swelling of the brain, or eye disease. Approximately 1% of people who get RVF die from the disease. [Byline: Robert Herriman]
Source: ECDC Communicable Diseases Threats Report Week 5, 27 Jan - 2
Feb 2019 [edited]
<https://www.ecdc.europa.eu/sites/portal/files/documents/communicable-disease-threats-report-27-january-2-february-2019.pdf>
According to Institut de Veille Sanitaire (InVS), from 11 Dec 2018 - 28 Jan 2019, 19 Rift Valley fever cases were confirmed on Mayotte. All cases were locally acquired. Among these cases, 14 are male and 5 are female, with an age range of 27-64 years.
Most of the cases were located in the western part of the island. Further investigations identified several positive ruminants in the western and central parts of the island.
According to CIRAD, Rift Valley fever seroprevalence among ruminants has decreased from 2008 to 2017, but significantly increased in 2017 and 2018 (3.6%, CI 95% [2.3-5.6%]) and 2018 and 2019 (10.1% CI 95% [6.5-15.3%]). In addition, according to InVS, one case imported from Comoros was reported by authorities on Mayotte in 2011.
The detection of autochthonous Rift Valley fever cases on Mayotte is not unexpected, but the occurrence of 19 cases within a short time period is of concern, as current weather conditions (rainy season from November to March) are favourable for the vectors.
ECDC will continue monitoring this event through epidemic intelligence activities and report again if there is a relevant epidemiological update.
[Map] Distribution of RVF human cases and ruminants, Mayotte, 11 Dec 2018 to 28 Jan 2019
[Graph] Distribution of RVF confirmed human cases, Mayotte, 11 Dec 2018 to 28 Jan 2019
Year-Week / Number of cases
2018-50 / 1
[It is not surprising to have both human and cattle Rift Valley fever (RVF) cases occur simultaneously. The above report does not indicate if the human infections are the result of virus transmission by mosquito vectors, but the cattle cases certainly are. Because RVF virus can be transovarially transmitted in populations of _Aedes_ mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch and infected adult females emerge from them. Recent studies have shown that RVF virus may severely injure human fetuses if contracted by mothers during pregnancy. There is no indication if any of the 19 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock.
The clinical findings related to the above human cases are not mentioned. In an earlier comment, ProMED Mod.CP noted that, "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease. - ProMED Mod.TY]
Equatorial Guinea US Consular Information Sheet
Equatorial Guinea is an oil-rich, developing country on the western coast of central Africa.
Its capital and main port, Malabo, is located on the isla Read More Show Less
d of Bioko, off the coast of Cameroon.
A secondary port, Luba, is also on Bioko.
The mainland territory of Equatorial Guinea is bordered by Cameroon and Gabon.
The principal city on the mainland is Bata.
Facilities for tourism are limited but growing.
Official languages are Spanish, which is widely spoken, and French, which is not widely understood, but sometimes used in business dealings.
Read the Department of State Background Notes on Equatorial Guinea for additional information.
A passport and evidence of a yellow fever vaccination are required to enter Equatorial Guinea.
Visas are not required for U.S. citizens unless the traveler will be there for an extended stay or is intending to work there.
U.S. citizens entering without a visa but staying longer than 90 days should register with the local police station.
Private vessels landing in an Equato-Guinean port must get clearance prior to approaching the shore.
Travelers should obtain the latest information and details from the Embassy of the Republic of Equatorial Guinea, 2020 16th Street NW, Washington, DC
20009, telephone (202) 518-5700, fax (202) 518-5252.
Although large public demonstrations are uncommon, U.S. citizens should avoid large crowds, political rallies, and street demonstrations.
In February 2009, approximately 50 gunmen arriving by speedboats attacked government buildings in Malabo but were repelled by Equato Guinean military and police.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, Bureau of Consular Affairs' web site, 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.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's A Safe Trip Abroad.
Violent crime is rare and the overall level of criminal activity is low in comparison to other countries in the region.
However, there has been a rise in non-violent street crime and residential burglaries.
Travelers should exercise prudence and normal caution, including avoiding dark alleys, remote locations, and traveling alone.
The loss or theft abroad of a U.S. passport should be reported immediately to the U.S. Embassy in Malabo at (240) 098895; Embassy personnel will assist in contacting the local police.
If you are the victim of a crime while in Equatorial Guinea, please remember to report the incident to local police, and contact the U.S. Embassy in Malabo for assistance.
The Embassy staff can, for example, assist you in finding 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, the consular officer can help you understand the local criminal justice process and to find an attorney if needed.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.
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.
Persons violating Equato-Guinean laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Equatorial Guinea are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
It is not uncommon for a uniformed member of the security forces to stop motorists on the pretext of minor or nonexistent violations of the local motor vehicle regulations in order to extort small bribes.
Visitors are advised not to pay bribes, and to request that the officer provide a citation to be paid at the local court.
If visitors encounter any of these problems they should contact the Embassy Consular Officer at 516008 and inform him/her of the situation.
Equatorial Guinea has a strictly cash economy.
Credit cards and checks are not accepted; credit card cash advances are not available and there are no ATMs.
In addition, most local businesses do not accept travelers' checks, dollars or euros.
However, dollars can be changed at local banks for CFA.
Cash in CFA is usually the only form of payment accepted throughout the country.
Special permits from the Ministry of Information and Tourism (or from the local delegation if outside Malabo) are required for virtually all types of photography.
Police or security officials may charge a fine, attempt to take a violator into custody, or seize the camera and film of persons photographing the Presidential Palace and its environs, military installations, airports, harbors, government buildings, and other areas.
Travelers are advised that the possession of camouflage-patterned clothing, large knives, binoculars, firearms, or a variety of other items may be deemed suspicious by the security forces and grounds for confiscation of the item and detention of the carrier.
Please see our Customs Information sheet.
Medical facilities are extremely limited. Pharmacies in Malabo and Bata stock basic medicines including antibiotics, but cannot be counted on to supply advanced medications. Outside of these cities, many medicines are unavailable. Travelers are advised to carry any special medication that they require. The sanitation levels in even the best hospitals are very low though the new Israeli-built and staffed La Paz Hospital in Bata approaches European standards of sanitation and is reported by Red Cross officials to be the best in the region. Doctors and hospitals often require immediate payment for health services, and patients are often expected to supply their own bandages, linen and toiletries.
The Malabo hospital is likewise undergoing a complete update, with expected completion in late 2009.
Malaria is a serious and sometimes fatal disease. The national government, along with U.S. oil companies in the country, has taken aggressive steps to control the mosquito population and limit the impact of malaria on the population centers in Malabo and Bata.
Plasmodium falciparum malaria, the type that predominates in Equatorial Guinea, is resistant to the anti-malarial drug chloroquine. Because travelers to the country are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following anti-malarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™). 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-malarials they have been taking.
Visit the CDC travelers' health page for additional information on malaria, including protective measures.
There are periodic outbreaks of cholera in Equatorial Guinea. Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Equatorial Guinea.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's web site.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization's (WHO) web site.
Further health information for travelers is available from the WHO.
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.
Hospitals, clinics, and other businesses and hotels do not accept credit cards.
If there are any concerns that travelers may need medical care or assistance while in Equatorial Guinea, they should make arrangements to have access to enough cash to cover possible expenses.
There are companies such as Western Union where international money orders can be arranged and cash obtained.
There are no ATM machines in the country (See SPECIAL CIRCUMSTANCES Section above).
You can see more information on medical insurance overseas.
The information below concerning Equatorial Guinea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Generally, Equatorial Guinea's road networks are underdeveloped.
There are few road and traffic signs, though more signs are becoming evident.
Livestock and pedestrians create constant road hazards.
During the rainy season, many roads are passable only with four-wheel-drive vehicles.
However, new road construction and repair is taking place all over the country and road conditions have improved markedly over the course of the past year.
If you plan on staying and driving around the country for any length of time you should attempt to purchase a cell phone for assistance in case of an emergency.
Travelers outside the limits of Malabo and Bata may expect to encounter occasional military roadblocks.
Travelers should be prepared to show proper identification (for example, a U.S. passport) and to explain their reason for being at that particular location.
The personnel staffing these checkpoints normally do not speak or understand English or French; travelers who do not speak Spanish would do well to have their reason for being in the country and their itinerary written down in Spanish before venturing into the countryside.
As there is no direct commercial air service to the United States by carriers registered in Equatorial Guinea, the U.S. Federal Aviation Administration (FAA) has not assessed Equatorial Guinea's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA web site.
Commercial air travel to and from Equatorial Guinea can be difficult.
Malabo is served by European airlines a few times per week.
The island of Bioko and the African mainland are connected by several small local airlines offering daily service.
Schedules are subject to change or cancellation without notice; flights are often overbooked and reservations may not guarantee seats.
Malabo Airport has navigational aids and can accommodate night landings.
There are no navigational aids at Bata Airport.
Special clearances are required to land in or overfly Equatorial Guinea territory.
Americans living or traveling in Equatorial Guinea are encouraged to register with the U.S. Embassy in Malabo through the State Department's travel registration web site so that they can obtain updated information on travel and security within Equatorial Guinea.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy in Malabo to contact them in case of emergency.
The United States reopened its Embassy in Malabo in October 2003.
However, due to reduced staffing, it can offer only limited services to U.S. citizens in distress.
The U.S. Embassy in Malabo can be contacted at (240) 098-895.
Additional services are provided through the U.S. Embassy in Yaoundé, Cameroon, located on Avenue Rosa Parks in the Mbankolo Quartier, adjacent to the Mount Febe Golf Club; mailing address P.O. Box 817; embassy tel. (237) 2220-1500, fax: (237) 2220-1572.
The Embassy Branch Office in Douala, Cameroon, is located on Rue Flatters, in the Citibank Building, tel.: (237) 3342-53-31, fax: (237) 3342-77-90.
This replaces the Country Specific Information for Equatorial Guinea, dated November 15, 2007, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Special Circumstances, Medical Facilities and Health Information, Medical Insurance, Traffic Safety and Road Conditions, and Registration/Embassy Location.
Blaze engulfs historic Equatorial Guinea cathedral in Malabo
Disturbances Equatorial Guinea - 5 days ago
Date: Wed, 15 Jan 2020 23:16:11 +0100 (MET)
Malabo, Equatorial Guinea, Jan 15, 2020 (AFP) - Firefighters battled to bring a blaze at Malabo's cathedral under control on Wednesday, as flames engulfed parts of the historic building, considered the most important Christian church in Equatorial Guinea. Dozens of people gathered in silence near the cathedral in the early evening as the fire service sprayed water jets onto the century-old structure.
It was not immediately known whether anyone was hurt in the fire, in which huge flames consumed part of the facade of the building. "We have just extinguished the fire, it's finished. The roof is gone, it is a catastrophe," firefighter Alfredo Abeso told AFP. Another firefighter at the scene said: "The whole roof is gone, the interior is burned." The cause of the fire is not known but the cathedral has been closed to the public since January 7 for restoration work. Built in a neo-gothic style between 1897 and 1916, the cathedral is one of the central African country's main tourist attractions.
The blaze brought comparisons to the devastating fire that ravaged the 13th century Notre-Dame cathedral in Paris in April 2019. The French Embassy in Malabo said the fire was a "cruel reminder" of the fire at Notre Dame. "We share the emotion of our friends in Malabo and Equatorial Guinea and hope that the fire can be brought under control quickly," it said on Twitter. Paris engineers are still working to stabilise the 13th century cathedral in the French capital after fire tore through its roof and dramatically toppled its spire last year.
Equatorial Guinea struggles for place in world tourism
Tourism Equatorial Guinea - 8 months ago
Date: Sun, 26 May 2019 06:31:33 +0200
By Camille MALPLAT
Sipopo, Equatorial Guinea, May 26, 2019 (AFP) - Gleaming but eerily empty, the luxurious Sipopo resort with its five-star hotel and exclusive facilities rises from a tropical beach, symbolising the dilemma of Equatorial Guinea -- a notoriously closed country that has turned to tourism to help fill its coffers. The purpose-built town was carved out of an ancient forest in 2011 at a cost of 600 million euros ($670 million), initially to host a week-long African Union summit and showcase the rise of the tiny oil-rich state. A 16-kilometre (10-mile) drive from Equatorial Guinea's capital Malabo, the resort boasts a vast conference centre, the Sofitel Malabo Sipopo Le Golf hotel, as well as 52 luxury villas -- one for every head of state to attend the summit -- each with its own swimming pool. There is also an 18-hole golf course, several restaurants and exclusive beaches guarded by police.
For almost a decade, Sipopo has been the crown jewel in a strategy to lure high-end visitors to Equatorial Guinea to diversify an economy badly hit by a slump in oil revenue. But the town, visited by an AFP reporter two months ago, seemed quite empty -- an impression strengthened by conversations with people who live or who work there. "It's depressing, there's no-one," said a visiting Gabonese consultant. A worker, who asked not to be named, said the complex was quiet year-round: "You can hear the sound of your own footsteps." The occasional visitors tend to be well connected, rich and in search of privacy, the sources said. Many are guests of a government described by Human Rights Watch as corrupt and repressive. One of the villas, according to the sources, was occupied by former Gambian dictator Yahya Jammeh after he fled his country in 2017.
- Empty lobby -
At Easter, the 200-room hotel's guests included a Spanish couple on honeymoon, a few families and some businessmen, who were all foreigners. In the echoing lobby, a huge black and white portrait of the country's 76-year-old authoritarian president, Teodoro Obiang Nguema -- Africa's longest-serving ruler -- hung on the wall, watching over the vacant reception area. A 1.5-kilometre (nearly mile-long) beach -- an artificial shore secluded from curious eyes -- was virtually deserted, in contrast to a public beach near the capital. The three-lane highway leading from Malabo to Sipopo was mostly empty of traffic. A hospital was added after the villas were built, but is unused, the sources said. In 2014, a mall was built at the resort to house 50 shops, a bowling alley, two cinemas and a children's play area. But a hotel receptionist said the complex was not open yet, adding: "If you want to buy a souvenir, you will have to go to Malabo." At night-time, shiny limousines arrived at a luxury restaurant to drop off diners.
- Tourism hopes -
Located on the mid-Atlantic coast of central Africa, Equatorial Guinea has flooded social media with messages of its allure as a holiday destination. Plans to build a new passenger terminal at the airport in Bata city have also just received a 120-million-euro ($133-million) injection from the Development Bank of Central African States. Figures for visitors are unavailable, and the tourism ministry in Malabo did not respond to AFP's requests for information. In the latest global compilation of figures posted by the World Bank, the number of tourists for Equatorial Guinea has been left blank. But much of the tourism in evidence are business people, such as oil company workers, relaxing for a few days, or attending energy or economic conferences.
A few travel firms offer trips tailor-made for both luxury and adventure, but they also allude to the difficulties, notably of being allowed to enter the country. "The country has been a mystery to outsiders, who were discouraged from entering by a difficult visa process and a lack of tourism infrastructure," says the website of British tour operator Undiscovered Destinations. The firm claimed, however, that "things are changing fast... with an excellent road network and numerous hotels springing up seemingly overnight." Few Equatoguineans have the chance of staying in such places. At Sipopo's hotel, a basic room costs the equivalent of more than 200 euros ($224) a night, while exclusive accommodation tops 850 euros. The discovery of vast oil reserves off the coast in the mid-1990s has boosted the country's gross national income to a theoretical annual $19,500 per person per year, according to the UN Development Programme. But that wealth benefits a small elite among the country's 1.2 million inhabitants. More than two-thirds of Equatoguineans live below the poverty line, and 55 percent of the population aged over 15 are unemployed.
Africa Cup of Nations gets going in Equatorial Guinea
Tourism Equatorial Guinea - 5 years ago
Date: Wed 14 Jan 2015
Source: Eye Witness News [edited]
<http://ewn.co.za/2015/01/14/Afcon-to-start-following-Ebola-controversy>
The Africa Cup of Nations (Afcon) finally gets underway on Sat [17 Jan 2015] after a controversial build-up to the 30th edition, which included a hasty late switch of hosts to Equatorial Guinea in the wake of concerns over the Ebola virus.
16 nations again line up for the biennial continental championship, seeking Africa's top sporting prize at the tournament, which starts on Sat [17 Jan 2015] and finishes on 8 Feb [2015].
Few previous editions have had such a dramatic backdrop, with the hosting of the 2015 finals being switched 2 months ago after Morocco asked for a postponement in the wake of the spread of the Ebola virus in West Africa. That request precipitated a crisis that left the tournament having to be organised almost from scratch in a few weeks.
Fears that travelling fans could spread Ebola and damage Morocco's tourist industry were seen as alarmist by the Confederation of African Football (CAF), who rejected the request and then stripped Morocco of their hosting rights.
>From a country with plentiful resources, who have previously bid to host the World Cup, Afcon is now being played in one of Africa's smallest and most enigmatic countries.
Equatorial Guinea is a family-ruled former Spanish colony which has newfound oil wealth and is reveling in rescuing the continent's most eagerly anticipated sporting event. ... - more
WHO report on recent Polio cases in Equatorial Guinea
Disease Poliomyelitis Equatorial Guinea - 6 years ago
Date: Thu 17 Apr 2014
Source: WHO Global Alert and Response [edited]
http://who.int/csr/don/don_updates/en/
Update on polio in central Africa -- polio confirmed in Equatorial Guinea, linked to outbreak in Cameroon
In Equatorial Guinea, 3 new wild poliovirus type 1 (WPV1) cases have been reported, the 1st polio in the country since 1999. Genetic sequencing indicates these cases are linked to an on-going WPV1 outbreak in Cameroon which has subsequently been detected in Equatorial Guinea. The cases had onset of paralysis on [28 Jan 2014], [19 Jan 2014] and [24 Mar 2014], from Centro Sur, Bioko Norte and Litoral. Outbreak response in Equatorial Guinea is currently being planned, including National Immunization Days (NIDs) with bivalent oral polio vaccine (OPV) on [21-24 Apr 2014]. An estimated 40 percent of children are fully immunized against polio in the country.
On [17 Mar 2014], the World Health Organization (WHO) had elevated the risk assessment of international spread of polio from Cameroon to 'very high' (http://www.who.int/csr/don/2014_03_17_polio/en/). The risk assessment was elevated due to: confirmation of 3 additional WPV1 cases (with onset of paralysis on [6, 25 and 31 Jan 2014]) from 3 new regions of Cameroon, confirming continued WPV transmission and geographic expansion of infected areas following detection of 4 cases in October 2013; gaps in surveillance; and, influx of vulnerable refugee populations from Central African Republic. The confirmation of new cases in Cameroon resulted in planning additional emergency outbreak response activities, including converting a subnational immunization campaign to a full nationwide activity on [11-13 Apr 2014], and implementing nationwide campaigns in May and June 2014. Critical to success will be to ensure substantial improvement in the quality of immunization campaigns that reach all children multiple times with OPV. Equally important will be efforts to rapidly improve the quality of surveillance so that the full extent of the outbreak can be determined and tracked.
Immunity levels and surveillance sensitivity are also being assessed in neighbouring countries, in particular in Gabon and the Republic of Congo. In Gabon, a nationwide immunization campaign is planned for [22-26 Apr 2014] (targeting all children aged less than 15 years), and in the Republic of Congo, a nationwide activity will be conducted on 1 May 2014.
It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for acute flaccid paralysis (AFP) cases in order to rapidly detect any new virus importations and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.
WHO's International Travel and Health (http://www.who.int/ith/chapters/en/) recommends that all travellers to and from polio-affected areas be fully vaccinated against polio.
New Measles outbreak in Malabo district of Equatorial Guinea
Disease Measles Equatorial Guinea - 8 years ago
Date: Sat 23 June 2012
Source: Guinea Equatorial [in Spanish, trans. ProMed Mod.JG, edited]
<http://www.guineaecuatorialpress.com/noticia.php?id=2759>
After the last measles vaccination campaign that took place last April 2012, a new outbreak of the disease has been reported in some communities in Malabo district, and for this reason, the Ministry of Health initiated a new vaccination campaign [Malabo is the capital of Equatorial Guinea, located on the northern coast of Bioko Island. - ProMed Mod.CP].
Activities started last Thursday, with the cooperation of the National Vaccination Programme (PAV, according to its Spanish initials). The campaign will concentrate its activities in the most severely affected communities, such as Santa Maria III, Lampert and Sunco.
Some medical officers gathered in Madre Bisila Health Centre in order to organise local vaccination units and to deal with mothers who brought their children to the Health Centre in order to have them vaccinated. Vaccine will be dispensed throughout the next 10 days, and subsequently, the vaccination campaign will continue in the Continental region of Equatorial Guinea.
Local officials from the Ministry of Health are inviting the population, particularly mothers, to bring their children to local health centres or to bring their children to mobile vaccination units when these teams arrive to their communities.
[According to La Voz de Rusia (<http://spanish.ruvr.ru/2012_06_22/Guinea-epidemia-sarampion/>), the last major measles epidemic in the country occurred in November 2008, when more than a dozen children died in various hospitals in Equatorial Guinea. No fatalities have been reported in the current outbreak so far.
Equatorial Guinea, officially the Republic of Equatorial Guinea, is a country located in central Africa. It has 2 parts: a Continental Region (Rio Muni), including several small offshore islands including Corisco, Elobey Grande and Elobey Chico; and an insular region containing Annobon island and Bioko island (formerly Fernando Po), where the capital Malabo is situated. A map of Equatorial Guinea can be accessed at: <http://www.africa.upenn.edu/CIA_Maps/Equatorial_Guinea_19871.gif>. - ProMed Mod.CP]
[The ProMED HealthMap for Equatorial Guinea can be found at
<http://healthmap.org/r/1KlO>.]
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.
Singapore - US Consular Information Sheet
COUNTRY DESCRIPTION:Singapore is a small, stable, highly developed country with an elected parliamentary system of government. Tourist facilities are modern and widely available. Singapore' Read More Show Less
resident population of over 4.6 million inhabitants (including permanent residents and foreign workers) comprises 75% Chinese, 14% Malay, 9% Indian and 2% others. English is widely spoken. Criminal penalties are strict and law enforcement rigorous; see sections on "Entry/Exit Requirements," "Special Circumstances," and "Criminal Penalties," below, for further details. Read the Department of State Background Notes on Singapore for additional information.
ENTRY/EXIT REQUIREMENTS: A valid passport is required. U.S. citizens do not need a visa if their visit is for business or social purposes and their stay is for 90 days or less. Travelers to the region should note that Singapore and some neighboring countries do not allow Americans to enter under any circumstances with fewer than six months of validity remaining on their passport. Female U.S. citizens who are pregnant when they apply to enter Singapore for a social visit are no longer required to make prior application through the nearest Singapore overseas mission or to provide documentation from a U.S. embassy concerning the nationality the child will acquire at birth.
Specific information about entry requirements for Singapore may be obtained from the Embassy of the Republic of Singapore at 3501 International Place NW, Washington, DC 20008, tel. (202) 537-3100. Visit the Embassy of Singapore's web site at http://www.mfa.gov.sg/washington/ for the most current visa information.
Find more information about dual nationality and the prevention of international child abduction on our web site. For further information about customs regulations, please read our Customs Information.
SAFETY AND SECURITY: In 2001, Jemaah Islamiyah (JI), a terrorist organization with links to Al Qaeda, planned attacks in Singapore against government and private targets associated with the United States, Singapore and other countries. These plans were disrupted and the JI organization in Singapore was dismantled. On February 27, 2008 suspected JI leader Mas Selamat Kastari escaped from detention in Singapore. His current whereabouts are unknown. Singapore remains a target of interest for terrorist groups. The Department of State remains concerned because extremist groups in Southeast Asia continue to demonstrate the desire and capability to carry out attacks against locations where Westerners congregate. Terrorist groups do not distinguish between official and civilian targets. Americans residing in or traveling to Singapore and neighboring countries should therefore exercise caution, especially in locations where Americans and other Westerners live, work, congregate, shop or visit. U.S. citizens should remain vigilant about their personal security and surroundings.
For the latest security information, Americans traveling abroad should regularly monitor the Department's web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings and Travel Alerts can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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: Major crimes against tourists in Singapore are uncommon. Petty crimes such as pick-pocketing and purse or briefcase snatching occur in tourist areas, hotels and at the airport. Travelers should exercise the same caution that they would in any large city.. Visitors should be aware that credit card fraud is on the rise and should practice standard precautions to avoid falling victim of credit card fraud: do not carry multiple credit cards on your person; do not allow credit cards to be removed from your sight; avoid giving credit card information over the phone and use only secure internet connections for financial transactions.
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.
MEDICAL FACILITIES AND HEALTH INFORMATION: Good medical care is widely available in Singapore. Doctors and hospitals expect immediate payment for health services by credit card or cash and generally do not accept U.S. health insurance. Recipients of health care should be aware that Ministry of Health auditors in certain circumstances may be granted access to patient medical records without the consent of the patient, and, in certain circumstances, physicians may be required to provide information relating to the diagnosis or treatment without the patient's consent.
Despite vigorous mosquito eradication efforts in Singapore, from time to time Singapore experiences a spike in the number of dengue fever cases. Outbreaks tend to be clustered in residential areas, but there have been no reports of clusters in primary tourist areas, such as the Night Safari, the Singapore zoo, or Orchard Road.
In January 2008, a new strain of the viral disease Chikungunya was detected in Singapore. A dozen cases of the disease, which like Dengue Fever is transmitted by the Aedes aegypti mosquito, were documented. There were no deaths. Unlike prior cases in Singapore, these cases were contracted locally and the outbreak centered around guest worker housing on Clive Street.
Information on dengue fever, 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); fax 1-888-CDC-FAXX (1-888-232-3299), or via the CDC's web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. 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 Singapore is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Singapore has a highly developed and well-maintained road and highway network. Driving is done on the left-hand side of the road. Motorists should be particularly aware of motorcyclists, who often ignore lane markings. Lanes are frequently closed without warning due to construction throughout the city. Public transportation and taxis are abundant, inexpensive, and reliable. Visitors should consider using this form of transportation. The Automobile Association of Singapore provides roadside assistance, and the Land Transport Authority has rescue vehicles on the road at all hours. In addition, closed circuit cameras monitor all major roads. As with all laws in Singapore, those involving traffic rules, vehicle registration, and liability in case of accident are strictly enforced, and failure to follow them may result in criminal penalties. Please refer to our Road Safety page for more information.
Singapore has one of the worst road-fatality records among developed countries. In 2007, 2.6 deaths were logged for every 10,000 vehicles in Singapore, compared to 0.8 in Japan, 1.2 in Australia and 1.8 in the United States. For specific information concerning Singaporean driver's permits, vehicle inspection, road tax and mandatory insurance, please contact the Singaporean National Tourist Board located at 590 Fifth Ave., Twelfth Floor, New York, NY 10036, tel. 1-212-302-4861 or fax: 1-212-302-4801.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Singapore's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Singapore'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: Singapore customs authorities enforce strict regulations concerning temporary import and export of items such as weapons, illegal drugs, certain religious materials, pornographic material, videotapes, CDs, DVDs, and software. Singapore customs authorities' definition of "weapon" is very broad, and, in addition to firearms, includes many items which are not necessarily seen as weapons in the United States, such as dive knives, kitchen knives, handcuffs, and expended shell casings. Carrying any of these items without permission may result in your immediate arrest. All baggage is x-rayed at every port of entry, so checked baggage will also be inspected for regulated items.
It is advisable to contact the Embassy of Singapore in Washington, DC at 3501 International Place NW, Washington, DC 20008, tel. (202) 537-3100, http://www.mfa.gov.sg/washington/ for specific information regarding customs requirements. You may also visit Singapore Customs' web site, http://www.customs.gov.sg/. Singapore customs officials encourage the use of an ATA (Admission Temporaire/Temporary Admission) carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes. ATA carnet headquarters located at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, N.Y. 10036, issues and guarantees the ATA carnet in the United States. For additional information, please call 1-212- 354-4480, or send an e-mail to atacarnet@uscib.org or visit http://www.uscib.org/ for details.
In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products are illegal and bringing them back to the United States may result in forfeitures and/or fines. A current list of those countries with serious problems in this regard can be found at http://www.ustr.gov/Document_Library/Reports_Publications/2004/2004_Special_301/Section_Index.html.
Automated teller machines (ATMs) are plentiful in Singapore, and they are the best method of obtaining cash. Bank transfers generally take weeks, and surcharges are steep. Transfers from commercial services such as American Express and Western Union are generally efficient.
Americans may be asked by police, employers or hotels to surrender their passports in lieu of surety (guaranteed) bonds. Americans should carefully consider whether they wish to surrender their passport rather than seek some other type of surety, particularly if the passport is requested by someone who is not a government official (e.g., an employer, or hotel employees).
Note that Singapore does not recognize dual nationality beyond the age of 21, and it strictly enforces universal national service (NS) for all male citizens and permanent residents. Male U.S. citizens who automatically acquired Singaporean citizenship and continue to reside in Singapore are liable for Singapore national service once they reach the age of 18. Travel abroad of Singaporean males may require Singapore Government approval as they approach national service age and may be restricted when they reach sixteen-and-a-half years of age. Under Singaporean law, an individual who acquires Singaporean citizenship at birth retains that status even after acquiring the citizenship of another country, including U.S. citizenship.
Males may renounce Singaporean citizenship only after having completed at least two years of national service. U.S. citizens are subject to this law. Dual nationals, Singapore Permanent Residents, and their parents should contact the Ministry of Defense in Singapore to determine if there will be a national service obligation. For additional information, please see the Bureau of Consular Affairs' web site for our dual nationality flyer, and contact the Ministry of Defense Central Manpower Base (tel. 65-6373-3127), or visit http://www.ns.sg/nsPortal/appmanager/nsp/default?_nfpb=true&_pageLabel=nsPortal_NSREG_ABT&nsp_community=ENLIST.
National-service-liable males who migrated from Singapore before age 11 and have not enjoyed significant socio-economic benefits of citizenship (e.g., applied for a Singapore identity card or studied in Singapore beyond the age of 11) are allowed to renounce their Singapore citizenship, but not before they turn 21. Until then, they are required to register for national service with Central Manpower Base and apply for a deferment. After turning 21, they are then eligible to renounce their Singapore citizenship and, if successful will not be required to serve NS and may continue to make short social visits to Singapore.
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 in Singapore than for similar offenses in the United States, and persons violating Singapore laws, even unknowingly, may be expelled, arrested or imprisoned.
There are strict penalties for possession and use of drugs as well as for trafficking in illegal drugs. Trafficking charges may be brought based on the quantity of illegal drugs in a subject's possession, regardless of whether there is any proven or demonstrated intent to distribute the drugs. Convicted offenders can expect long jail sentences and heavy fines. Singapore has a mandatory death penalty for many narcotics offenses. Singapore police have the authority to compel both residents and non-residents to submit to random drug analysis, and do not distinguish between drugs consumed before or after entering Singapore in applying local laws.
Visitors should be aware of Singapore's strict laws and penalties for a variety of actions that might not be illegal or might be considered minor offenses in the United States. These include jaywalking, littering, and spitting. Singapore has a mandatory caning sentence for vandalism offenses, and caning may also be imposed for immigration violations and other offenses. Commercial disputes that may be handled as civil suits in the United States can escalate to criminal cases in Singapore, and result in heavy fines and prison sentences.
There are no jury trials in Singapore. Judges hear cases and decide sentencing. The Government of Singapore does not provide legal assistance except in capital cases; legal assistance may be available in some other cases through the Law Society.
There are strict penalties for those who possess or carry arms, or who commit crimes with arms. Singaporean authorities define "arm" as any firearm, air-gun, air-pistol, automatic gun, automatic pistol and any other kind of gun or pistol from which any shot, bullet or other projectiles can be discharged or from which noxious liquid, flame or fumes can be emitted, and any component part thereof. This definition also includes any bomb or grenade and any component part thereof. The unlawful possession of any arm or ammunition could result in imprisonment and caning. Any person convicted of committing a crime with an arm could receive punishment which could result in the maximum penalty of imprisonment for life and caning.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. In Singapore, local law prohibits causing or encouraging prostitution of, or engaging in sexual relations with, a female below the age of 18. An indecent assault against anyone, male or female, regardless of age, is also prohibited. Those convicted of facilitating or abetting the prostitution of any woman or girl could be sentenced to imprisonment of up to 5 years and a fine of $7,100 or both. If the crime involves a female below the age of 16, the offender faces an additional charge carrying a possible sentence of imprisonment of up to 3 years and a fine of $2,000 or both.
Singapore enforces strict laws pertaining to the propriety of behavior between people, and the modesty of individuals. The Singaporean law "Outrage of Modesty" is defined as an assault or use of criminal force on any person, intended to, or knowing it to be likely to, outrage the modesty of that person. Penalties may include imprisonment for up to 2 years, a fine, caning, or a combination thereof. Men are sometimes accused of inappropriately touching other people, often women, resulting in their prosecution and punishment under this Singaporean law.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children's Issues web site.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Singapore are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site and obtain updated information on travel and security within Singapore. 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 27 Napier Road, Singapore 258508, tel. [65] 6476-9100, fax [65] 6476-9340; web site http://singapore.usembassy.gov/. In case of emergencies after working hours, the duty officer at the Embassy may be contacted by calling tel. [65] 6476-9100.
This replaces the Country Specific Information dated September 11, 2007, to update sections on Country Description, Safety and Security, and Medical Facilities and Health Information.
Some Singapore hotels using face recognition check-in
Tourism Singapore - 2 months ago
Date: Thu, 7 Nov 2019 09:57:41 +0100 (MET)
Singapore, Nov 7, 2019 (AFP) - Tourists visiting Singapore can now check in at some hotels using facial recognition technology under a pilot programme that could cut waiting times and help tackle a labour crunch. The tech-savvy country of 5.7 million people is increasingly turning to automation to speed up services and deal with workforce shortages, with robots deployed for tasks ranging from cleaning to making noodles.
Under the pilot launched Wednesday, visitors will not need to wait to be checked in by hotel staff but can instead use a phone app fitted with facial recognition technology or machines which scan their passports. The data from the scan is sent to immigration authorities for checks after which the visitor is issued a room key, said the Singapore Tourism Board and Hotel Association, which announced the initiative this week.
The technology, reportedly being trialled at three hotels and is similar to that used in some airports including Singapore's Changi, could reduce check-in times by up to 70 percent, they said. Singapore welcomed a record high 18.5 million visitors last year, up 6.2 percent from the year before. The city has more than 400 hotels with 67,000 rooms.
Measles level in Singapore at highest level for 20 years
Disease Measles Singapore - 3 months ago
Date: Fri 25 Oct 2019
Source: Channel News Asia [abridged, edited]
<https://www.channelnewsasia.com/news/singapore/measles-cases-singapore-highest-level-mmr-vaccine-12033560>
The number of measles cases in Singapore has hit the highest level since an outbreak in 1997, figures from the Ministry of Health on Thursday [24 Oct 2019] showed. According to the latest weekly infectious diseases bulletin published on Thursday [24 Oct 2019], there were 149 measles cases in Singapore as of 19 Oct [2019]. That is more than 4 times the number of cases for the whole of 2018, when there were 34.
The number of measles cases in Singapore hit 1413 in 1997, before the government introduced the 2-dose MMR vaccination schedule in 1998. The number of cases fell to just 114 that year [1998]. In July this year [2019], MOH urged Singaporeans to remain vigilant, as measles cases around the world have increased substantially. "As a travel hub, Singapore is likely to see increased cases from importation," it said.
According to the latest Communicable Diseases Surveillance report released by MOH in 2018, the number of reported measles cases has "rapidly declined" since the introduction of compulsory measles vaccination in August 1985. In 1992 and 1997, there was a spike in the number of reported cases across all age groups. The "catch-up" immunisation initiative was implemented between July 1997 and November 1997, and the 2-dose MMR vaccination started in January 1998.
The number of measles cases ranged between 13 and 96 between 2001 and 2010, before an increase in 2011 to 148 cases. Since then the number of cases has fluctuated, with 38 cases in 2012 and 46 cases in 2013, jumping to 142 cases in 2014.
There were 42 measles cases in 2015 and 136 cases in 2016. That dipped to 70 cases for the whole of 2017 and dropped further to 34 cases in 2018.
There have been outbreaks around the world as the virus exploits gaps in vaccination coverage, the World Health Organization (WHO) said this month [October 2019].
The disease, which is, according to the WHO, one of the world's most contagious, rose by 300% globally in the 1st 3 months of 2019, compared to the same period in 2018. There have been consecutive increases over the last 2 years. [Byline: Michael Yong]
Schools and airports closed as Indonesia fires spark fears for Singapore population
Pollution Singapore - 4 months ago
Date: Wed, 18 Sep 2019 12:26:37 +0200 (METDST)
By Sam Reeves
Kuala Lumpur, Sept 18, 2019 (AFP) - Toxic haze from Indonesian forest fires closed schools and airports across the country and in neighbouring Malaysia Wednesday, while air quality worsened in Singapore just days before the city's Formula One motor race. Illegal fires to clear land for agriculture are blazing out of control on Sumatra and Borneo islands, with Jakarta deploying thousands of security forces and water-bombing aircraft to tackle them.
Indonesian blazes belch smog across Southeast Asia annually, but this year's are the worst since 2015 and have added to concerns about wildfire outbreaks worldwide exacerbating global warming. On Wednesday, air quality deteriorated to "very unhealthy" levels on an official index in many parts of peninsular Malaysia, to the east of Sumatra, with the Kuala Lumpur skyline shrouded by dense smog. Nearly 1,500 schools were closed across Malaysia due to the air pollution, with over one million pupils affected, according to the education ministry.
A growing number of Malaysians were suffering health problems due to the haze, with authorities saying there had been a sharp increase in outpatients at government hospitals -- many suffering dry and itchy eyes. Indonesian authorities said hundreds of schools in hard-hit Riau province on Sumatra were shut, without providing a precise number, while about 1,300 were closed in Central Kalimantan province on Borneo. Borneo is shared between Indonesia, Malaysia and Brunei. Poor visibility closed seven airports in the Indonesian part of Borneo, the transport ministry in Jakarta said. Scores of flights have already been diverted and cancelled in the region in recent days due to the smog.
- Singapore smog race? -
Air quality in Singapore worsened to unhealthy levels and a white smog obscured the striking waterfront skyline, featuring the Marina Bay Sands casino resort with its three towers and boat-shaped top level. The worsening pollution increased fears that this weekend's Formula One race may be affected. Organisers say the possibility of haze is one of the issues in their contingency plan for Sunday's showpiece night race, but have not given further details.
The city-state's tourism board said spectators would be able to buy masks as protection from the haze if conditions did not improve and assistance would be provided for those who feel unwell, the Today news portal reported. The fires have sparked tensions between Indonesia and Malaysia. Indonesia's environment minister initially suggested the haze was from Malaysian fires despite satellite data showing hundreds of blazes in Indonesia and only a handful in its neighbour, prompting anger from her Malaysian counterpart.
Indonesia later sealed off dozens of plantations where it said fires were blazing, including some owned by Malaysia-based firms, deepening the row. But Prime Minister Mahathir Mohamad, who has struck a diplomatic tone throughout the crisis, said Malaysia may pass legislation forcing its companies to tackle fires on plantations abroad. Malaysia wants its firms with sites overseas to put out blazes contributing to the haze, he said, adding: "Of course, if we find they are unwilling to take action, we may have to pass a law to make them responsible."
The Indonesian government has insisted it is doing all it can to fight the blazes. But this year's fires have been worsened by dry weather and experts believe there is little chance of them being extinguished until the onset of the rainy season in October. Indonesia's meteorology, climate and geophysics agency said Wednesday that over 1,000 hotspots -- areas of intense heat detected by satellite that indicate a likely fire -- had been sighted, most of them on Sumatra.
Singapore air 'unhealthy' ahead of F1 race
Date: Sat, 14 Sep 2019 16:08:47 +0200 (METDST)
Singapore, Sept 14, 2019 (AFP) - Pollution from forest fires in Indonesia pushed Singapore's air quality to unhealthy levels for the first time in three years on Saturday, the government said, a week ahead of the Formula One night race in the city. The toxic smoke caused by burning to clear land for plantations is an annual problem for Indonesia's neighbours, but has been worsened this year by particularly dry weather. "There has been a deterioration in the haze conditions in Singapore this afternoon," the National Environment Agency (NEA) said in a statement. "This was due to a confluence of winds over the nearby region that led to more smoke haze from Sumatra being blown toward Singapore," it said, referring to one of the Indonesian islands where fires are raging.
The NEA said the pollutant standards index (PSI) worsened to 112 in parts of the island Saturday night. An index reading between 101-200 is considered unhealthy, with residents advised against doing prolonged strenuous exercises outdoors. Singapore may continue to experience hazy conditions over the next few days, the agency warned. The city-state of 5.6 million people was shrouded in a thin white haze, with a few residents seen wearing face masks, but there was no major disruption to daily activities. The F1 race is scheduled from Friday to Sunday on a street circuit in the Marina Bay financial district.
Singapore GP, the Formula One organisers, said the possibility of haze is one of the potential issues covered in their contingency plan for this year's grand prix. "The plan was formulated and refined with stake holders, government bodies and the Formula One community," Singapore GP said in an emailed statement. "In the event that the haze causes visibility, public health or operational issues, Singapore GP would work closely with the relevant agencies before making any collective decisions regarding the event."
Neighbouring Malaysia has also been affected by the smoke, with air quality in parts of the country including the capital Kuala Lumpur reaching unhealthy levels over the past few days and triggering a diplomatic row with Jakarta. In 2015, the index reached "hazardous" levels of more than 300 in Singapore, forcing the closure of schools. Indonesian forest fires were the worst in two decades that year, firing up smog that blanketed large parts of Southeast Asia for weeks.
Dengue cases continue to increase in Singapore
Disease Dengue Fever Singapore - 5 months ago
The number of dengue fever cases and deaths continue to rise in Singapore. According to the latest National Environment Agency (NEA) data, 8946 cases have been reported through 31 Jul [2019], about 5 times more than the total number of dengue cases reported in the same period last year [2018]. In addition, the dengue death total has risen to 9 through 20 Jul [2019], according to local news accounts.
<http://outbreaknewstoday.com/singapore-dengue-outbreak-nearly-9000-cases-through-july-26099/>
HealthMap/ProMED-mail map of Singapore:
<http://healthmap.org/promed/p/150>
World Travel News Headlines
Authorities in Spain's Balearic Islands crack down on alcohol-fuelled holidays
Tourism Spain - 22 hours ago
Date: Fri, 17 Jan 2020 17:48:09 +0100 (MET)
Barcelona, Jan 17, 2020 (AFP) - Spain's Balearic Islands passed a bill Friday aimed at clamping down on alcohol-fuelled holidays in the Mediterranean archipelago which bans happy hours when drinks are offered a discount and open bars. "This is the first law adopted in Europe which restricts the sale and promotion of alcohol in certain touristic areas," the regional government of the Balearic Islands which have long been a magnet for young German and British tourists, who often drink heavily and enjoy rowdy late-night clubbing.
The restrictions will apply to three areas with a reputation for excess: San Antoni on the island of Ibiza and El Arenal and Magaluf -- which has been nicknamed "Shagaluf" because of its reputation for drunken casual sex -- on Mallorca, the largest of the Balearic's four islands. The law, which was drawn up in consultation with the tourism industry also bans pub crawls and two-for-one drink offers, prohibits the sale of alcohol in shops between 9:30 pm and 8 am and forbids advertising party boats in the designated areas. Establishments that break the new rules risk fines of up to 600,000 euros ($669,000) and the threat of being closed down for three years.
The new law also takes aim at the so-called "balconing" craze, the term given to holidaymakers who decide to jump into a swimming pool from a hotel or apartment balcony, a stunt which claims several lives every year. It bans "balconing" across the entire archipelago and requires hotels to evict anyone who does it. Those caught jumping from balconies face fines of up to 60,000 euros ($67,000). Up until now only some resorts on the Balearics imposed fines for "balconing".
The regional government of the Balearics said the law, which stiffens measures already introduced in 2015, will "fight excesses in certain tourist zones" and "force a real change in the tourism model of those destinations". Magaluf made global headlines in 2014 after a video showing a young woman performing oral sex on several men on the dance floor of a nightclub went viral. Local shops sell souvenir T-shirts with the catchphrase "On it 'till we vomit".
The four islands which make up the Balearics -- Palma de Mallorca, Ibiza, Menorca and Formentera, received nearly fourteen million tourists in 2018, drawn by their crystal clear waters, and in many cases by all-inconclusive package holidays. The archipelago is Spain's second most visited region. Spain is the world's second most visited country after France.
French oysters with Norovirus shut down sales
Disease Norovirus France - 22 hours ago
Rennes, France, Jan 17, 2020 (AFP) - Several oyster farmers along France's Atlantic and Mediterranean coasts have been forced to halt sales since December after their sites were contaminated by the highly contagious norovirus, which they blame on overflowing sewage treatment plants. Authorities ordered the suspensions at 23 of the country's 375 designated fields, and recalls of affected oysters as well as mussels and clams, after tests revealed the virus, which can cause severe vomiting and diarrhoea.
The move came just before the year-end holidays, when oysters are a traditional delicacy on millions of French tables. "The oysters are not sick. They're carrying the virus because it's in the water they are constantly filtering," Philippe Le Gal, president of France's national shellfish council (CNC), told AFP this week. "They were in the wrong place at the wrong time," he said, adding the ban had prompted many people to stop eating oysters altogether. Local officials say oyster farmers are paying the price of insufficient spending on wastewater treatment, with facilities strained to the limit even as development of coastal areas has surged in recent years.
Heavy rains before Christmas prompted treatment basins to overflow, they say, spilling tainted water into rivers. "This was predictable -- they've kept issuing building permits even though treatment sites are already at full capacity," said Joel Labbe, a senator for the Morbihan region in Brittany. Oyster farmers are demanding compensation, and a delegation met with agriculture ministry officials in Paris last week warning that more than 400 businesses had been impacted by the sales ban.
This week, angry growers dumped trash bins full of oysters and mussels in front of the offices of the regional ARS health authority in Montpellier over the decision to halt sales from a nearby basin on the Mediterranean coast. "We're the victims, and we shouldn't have to suffer any financial damages," Le Gal said.
Evacuation centres opened in Fiji as Cyclone Tino hits
Natural Disaster Fiji - 22 hours ago
Suva, Fiji, Jan 17, 2020 (AFP) - Fiji opened evacuation centres and warned of "destructive force winds" Friday as a cyclone bore down on the Pacific island nation for the second time in three weeks. Two people were missing after attempting to swim across a swollen river late Thursday when heavy rain fell ahead of the advancing Cyclone Tino, police said. On the outer islands, locals prepared to go to emergency shelters while many tourists fled beach resorts and made their way to the capital Suva before regional flights and inter-island ferry services were suspended.
The Fiji Meteorological Service said Tino was strengthening as it headed for Fiji's second-largest island, Vanua Levu, warning of wind gusts of up to 130 kilometres per hour (80 mph), heavy rain, coastal flooding and flash flooding in low lying areas. "I'm preparing to go to an evacuation centre soon with my family and wait for the cyclone to pass," Nischal Prasad, who lost his home in northern Vanua Legu when Cyclone Sarai struck just after Christmas, told AFP. "Sarai destroyed my house and almost left my family homeless. My daughters had to hide under their bed from the strong winds. It was a scary experience," he said.
Russian tourist Inna Kostromina, 35, said she sought safety in Suva after being told her island resort was in the path of the cyclone. "We didn't want to get stuck in there and with the authorities warning of coastal flooding, anything can happen. So we decided to move to Suva for now. I think we will be much safer here." Police said a man and his daughter, believed to be aged nine or 10, were attempting to swim across a flooded river when they were caught in the strong currents. The incident happened on Thursday before the storm developed into a tropical cyclone, but a police spokesman linked the tragedy to "heavy rain brought about by the current weather system (which) raised the river level". Although the Pacific islands are popular tourist destinations in summer it is also the cyclone season, and Fiji is being targeted for the second time in three weeks.
In late December, Tropical Cyclone Sarai left two people dead and more than 2,500 needing emergency shelter as it damaged houses, crops and trees and cut electricity supplies. On its present track, Tino would hit Tongatapu, the main island of neighbouring Tonga, on the weekend. Two years ago, Tongatapu was hit by Cyclone Gina, with two people killed and nearly 200 houses destroyed.
Authorities in Japan report case of mystery virus behind China outbreak
Disease Respiratory Disease Japan - 22 hours ago
Date: Thu, 16 Jan 2020 16:38:39 +0100 (MET)
By Hiroshi HIYAMA
Tokyo, Jan 16, 2020 (AFP) - Japan has confirmed a case of a mystery virus that first emerged in China and is from the same family as the deadly SARS pathogen, authorities said Thursday. It appears to be only the second time the novel coronavirus has been detected outside China, after the World Health Organization (WHO) confirmed a case in Thailand. Japan's health ministry said a man who had visited the central Chinese city of Wuhan, the apparent epicentre of the outbreak, was hospitalised on January 10, four days after his return to Japan. He reported a persistent fever.
Tests on the patient, who was released from hospital on Wednesday, confirmed he was infected with the new virus. "This is the first domestic discovery of a pneumonia case related to the new coronavirus," the ministry said in a statement. "We will continue active epidemiological research while also coordinating efforts with the World Health Organization and related agencies to conduct a risk assessment." The outbreak has killed one person so far, with 41 patients reported in Wuhan.
The outbreak has caused alarm because the new virus is from the same family as the pathogen that causes SARS (Severe Acute Respiratory Syndrome), which killed 349 people in mainland China and 299 in Hong Kong in 2002 and 2003. Authorities in Wuhan said a seafood market was the centre of the outbreak. It was closed on January 1. Japanese authorities said the man had not visited the market and that it was possible he had been in contact with a person infected with the virus while in Wuhan.
- Outbreak in Japan 'unlikely' -
Health ministry official Eiji Hinoshita told reporters that the risk of the disease spreading from the patient was considered low, with careful checks done on those who had been in close contact with him. "At this point, we feel it is unlikely this will lead to a dramatic outbreak," he said, adding that the patient was no longer suffering a fever and was recuperating at home.
Officials declined to give further information on the man, including his nationality, citing privacy concerns. Local media said the patient was a Chinese national in his 30s living in Kanagawa, just southwest of Tokyo. Public broadcaster NHK said he had already recovered and was resting at home, as quarantine officials at Tokyo's Narita airport boosted health checks on all travellers.
The health ministry urged people who develop a cough or fever after visiting Wuhan to wear a surgical mask and "swiftly visit a medical institution". Hinoshita said Japan would need to be on guard ahead of the Lunar New Year, a popular travel period in China. "It is expected that Japan will see many visitors from China," he said. It is not yet clear whether the mystery virus can be transmitted between humans, but on Wednesday authorities said it was possible it had spread inside a family.
The woman diagnosed in Thailand, who is in a stable condition, also said she had not visited the Wuhan seafood market. And WHO doctor Maria Van Kerkhove on Tuesday said she "wouldn't be surprised if there was some limited human-to-human transmission, especially among families who have close contact with one another". Hong Kong authorities on Tuesday said several dozen people had been hospitalised with fever or respiratory symptoms after travelling to Wuhan, but no cases of the new virus have so far been confirmed.
First Chinese pneumonia (Wuhan Virus) confirmed in Korea
Disease Respiratory Disease South Korea - 22 hours ago
Source: News Joins [In Korean, machine trans. edited]
<https://news.joins.com/article/23686226>
An unexplained pneumonia in China caused the Korean quarantine authorities to strengthen the quarantine, and a fever-sensing camera is installed to monitor the body temperature of Chinese tourists who entered Korea at Incheon Port 1 International Passenger Terminal.
Pneumonia confirmed by the new coronavirus, which is prevalent in Wuhan, China, was confirmed for the first time on [20 Jan 2020]. According to health officials, a Chinese woman, A, who arrived at Incheon International Airport on a plane from Wuhan last weekend, was confirmed with pneumonia. The patient showed signs of pneumonia, including high fever and cough. The health authorities entered the airport at the same time, confirmed the symptoms of high fever, suspected pneumonia, and went into quarantine and testing. The Centers for Disease Control immediately quarantined A and entered treatment with a nationally designated quarantine bed. The Centers for Disease Control will hold an emergency press conference at 1:30 pm on [20 Jan 2020] and release the reporter A.
Meanwhile, Beijing's Daxing District Health and Welfare Committee said 2 fever patients who had been to Wuhan were confirmed as a new pneumonia patient on [19 Jan 2020]. They are currently being treated at a designated hospital and said they are stable. Daxing District is where Beijing New Airport opened last year [2019]. The Guangdong Provincial Health and Welfare Committee said on [19 Jan 2020] that a 66-year-old man who had visited a relative's home in Wuhan showed fever and lethargy and was diagnosed with Wuhan pneumonia. Confirmation patients have also emerged in Shenzhen, a neighbouring Hong Kong province in southern China, raising concerns that the new pneumonia has already spread throughout China.
The Chinese government has said that "there is no basis for human-to-human propagation," but domestic experts pointed out that "the nature of coronavirus is less likely to prevent human-to-human propagation." [Byline: Esther Toile]
[This is now the 4th international identification of the 2019-nCoV (novel coronavirus) associated illness reported outside of China. To date, all 4 cases have reported being in Wuhan China in the 14 days preceding onset of illness. Illness in each involved a history of fever and dry cough. Cases were reported by Thailand (2 cases) and Japan, and now South Korea. An update following a Ministry of Health Korea press conference mentioned that there were 5 individuals accompanying this woman, none of whom were currently showing symptoms. (<http://news1.kr/articles/?3821049>).
As mentioned in an earlier post (see Novel coronavirus (10): China (HU, GD, BJ) http://promedmail.org/post/20200119.6898567), there have also been cases confirmed in China outside of Wuhan City, with cases reported in Beijing, Guangdong and possibly Shanghai. It is becoming more difficult to conclude that there has been limited person-to-person transmission as the case numbers are climbing both inside of Wuhan City, elsewhere in China, and in individuals travelling from Wuhan China to other countries (Japan, Thailand and South Korea).
A map of South Korea can be found at:
<http://www.orangesmile.com/travelguide/south-korea/country-maps.htm>. - ProMED Mod.MPP]
Update on Polio-like illness in USA on-going since 2014
Disease Poliomyelitis United States of America - 22 hours ago
Source: Fox News [edited]
<https://www.foxnews.com/health/ohio-teen-rare-polio-like-illness-paralyzed-from-waist-down>
CDC is facing criticism over its response to a polio-like illness. The Centers for Disease Control and Prevention has confirmed 10 additional cases of acute flaccid myelitis. An Ohio teen is determined to walk again despite doctors' warnings that she may not after she contracted a rare polio-like illness that's left her paralyzed from the waist down. IK, a catcher on her middle school's softball team, said it started with what felt like a cramp in her leg on Christmas. "I just thought, 'Oh gosh, it's just growing pains or a Charley horse,'" NK, the 13-year-old's mother, told News 5 Cleveland. But the next day, IK couldn't stand on her own, and her worried parents rushed her to Akron Children's Hospital, where she was diagnosed with acute flaccid myelitis (AFM). It's a rare but serious condition that affects the nervous system, specifically the grey matter of the spinal cord, which weakens the body's muscles and reflexes.
Health officials have noticed an increase of cases in children occurring every 2 years since 2014, according to the Centers for Disease Control and Prevention (CDC). And while it often is referred to as a "polio-like" illness, tests so far have tested negative for poliovirus. Symptoms typically begin with sudden onset of arm or leg weakness and loss of muscle tone and reflexes, but can also include facial droop or weakness, difficulty moving eyes, drooping eyelids, difficulty swallowing, slurred speech, and pain in the arms and legs. Severe symptoms may include respiratory failure, or serious neurological complications, according to the CDC. Parents are encouraged to seek medical care right away if a child is suspected of developing any symptoms
Since her diagnosis, IK has been working in physical therapy and has received steroid treatments as well as multiple plasma exchange, according to the news outlet. Her mother said it's been like "a bad dream" for the family as they watch her struggle to gain strength. "It's a lot, but I just try to go with the flow, just to push through," IK, who has received support from her teammates, classmates and members of the community, told News 5 Cleveland. [Byline: Alexandria Hein]
[Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak.
In 2019, there were 33 total confirmed cases in 16 US states
[<https://www.cdc.gov/acute-flaccid-myelitis/cases-in-us.html>].
The case definition for AFM is based on clinical and lab criteria
[<https://c.ymcdn.com/sites/www.cste.org/resource/resmgr/2017PS/2017PSFinal/17-ID-01.pdf>]:
Clinical Criteria: An illness with onset of acute flaccid limb weakness.
Laboratory Criteria:
Confirmatory Laboratory Evidence: a magnetic resonance image (MRI) showing spinal cord lesion largely restricted to grey matter and spanning one or more vertebral segments. Supportive Laboratory Evidence: cerebrospinal fluid (CSF) with pleocytosis (white blood cell count over 5 cells/mm3) Case Classification:
- Confirmed: Clinically compatible case AND Confirmatory laboratory evidence: MRI showing spinal cord lesion largely restricted to grey matter and spanning one or more spinal segments.
- Probable: Clinically compatible case AND Supportive laboratory evidence: CSF showing pleocytosis (white blood cell count over 5 cells/mm3)
With the high number of cases reported in 2018 and 2019, CDC enhanced AFM surveillance through collection of data at the national level by encouraging healthcare providers to recognize and report to their health departments all patients whom they suspect may have AFM; health departments are being asked to send this information to CDC to help us understand AFM activity nationwide. - ProMED Mod.UBA]
[HealthMap/ProMED map available at:
United States: <http://healthmap.org/promed/p/106>]
90 recent cases of Tricinella infection after eating raw sausages from a wild boar in Susa Valley in northern Italy
Disease Trichinosis Italy - 22 hours ago
From: Guido Calleri <guidocalleri@aslcittaditorino.it> [edited]
90 persons presented to the Infectious Diseases Hospital Amedeo di Savoia, Torino, North-West Italy between 24 Dec 2019 and 10 Jan 2020 after consuming raw sausages from a wild boar hunted in the area of Susa Valley, 50 km [31.1 mi] away from Torino, in late November 2019.
All of them either were symptomatic (fever, muscle and/or abdominal pain, nausea) or had peripheral blood eosinophilia over 500/cmm, or both. IgG serology for trichinella was performed by immunoblot (Trichinella E/S IgG kit, EFFEGIEMME, Milan, Italy) and resulted positive in 48/90 (53.3%), allowing a diagnosis of confirmed trichinella infection.
Otherwise, a diagnosis of suspected trichinella infection was made with a negative serology, probably due to performing the test too early, before the development of antibodies or possibly a false negative result. In a few cases (under 10 cases) an alternative diagnosis was considered.
All patients were treated with oral albendazole 400 mg twice daily for 10 days and prednisone 50 mg/day.
Most likely, all patients were infected after eating meat from a single animal, given the low prevalence of the infection in this area: no human case has ever been detected in Torino province, and only one wild boar has been found positive for trichinella at microscopy in Susa valley in the last 10 years.
Guido Calleri, Filippo Lipani, Giovanna Paltrinieri, Silvia Faraoni,
Valeria Ghisetti
ASL Citta di Torino, Infectious Diseases Unit and Microbiology Lab,
and ASL TO3,
Department of Prevention
Torino, Piedmonte, Italy
guidocalleri@aslcittaditorino.it
[ProMED thanks Guido Calleri, Filippo Lipani, Giovanna Paltrinieri, Silvia Faraoni, and Valeria Ghisetti for sending us this information. The report underlines that _Trichinella_ are found in wild boars in Europe and should be assessed by a certified laboratory for _Trichinella_ before used for human consumption. Sausages made of smoked meat are especially dangerous, because the temperatures seldom reach what is needed to kill the trichinella larvae. - ProMED Mod.EP]
Piedmont, Italy: <http://healthmap.org/promed/p/15593>]
Reports of Nipah cases in Bangladesh city of Khulna.
Disease Nipah Virus Bangladesh - 22 hours ago
Date: Fri 17 Jan 2020
<http://outbreaknewstoday.com/nipah-virus-infection-reported-in-khulna-bangladesh-media-reports-51567/>
Media sources in Bangladesh are reporting a Nipah virus infection in the city of Khulna. The reported case is a 20-year-old female who has been hospitalized since last Saturday [11 Jan 2020] at the Khulna Medical College Hospital (KMCH).
"A medical board has confirmed her infection by Nipah virus. As her infection is a risk to other patients, she is being treated separately at the hospital's Medicine unit 1," said SM Kamal Hossain, chief of KMCH Medicine Department.
According to the World Health Organization (WHO), in the Bangladesh and India outbreaks, consumption of fruits or fruit products (e.g. raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection. Fruit bats of the family Pteropodidae -- particularly species belonging to the _Pteropus_ genus -- are the natural hosts for Nipah virus. There is no apparent disease in fruit bats.
In more recent outbreaks of the disease, person-to-person transmission has been seen in Bangladesh and India.
The disease in humans can range from asymptomatic infection to fatal encephalitis. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.
The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for surveillance investigations, according to the WHO.
Those who survive acute encephalitis make a full recovery, but around 20% are left with residual neurological consequences, such as persistent convulsions and personality changes.
There is no treatment or vaccine available for either people or animals.
[Nipah virus infections occur sporadically in Bangladesh in a geographic area termed the Nipah belt and during certain seasons of the year when the reservoir fruit bat is abundant. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and they contaminate date palm sap or fruit. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April.
As noted earlier, it is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur.
Interestingly, a simple skirt constructed out of locally available materials can prevent access of the bats to the palm sap collecting pots, but apparently they are not commonly used. Boiling the palm sap would inactivate the virus, but local consumers indicated that it alters the flavour of the sap.
An image of a _Pteropus_ fruit bat can be found at
<http://upload.wikimedia.org/wikipedia/commons/3/3d/Pteropus_giganteus_fg01.JPG>. - ProMED Mod.TY]
Khulna, Khulna, Bangladesh: <http://healthmap.org/promed/p/14886>]
16 students with Mumps in West Bengal school
Disease Mumps India - 22 hours ago
Source: Hindustan Times [edited]
<https://www.hindustantimes.com/cities/outbreak-declared-tajpur-school-under-surveillance-as-16-kids-found-infected-with-mumps/story-x64XDq5UaBBPc58sgu2zKO.html>
Government High School, Tajpur village, has been put under surveillance after 16 students of the school were found to be infected with mumps, a viral infection that swells up the saliva-producing glands of a person.
A rapid response team had been dispatched to the school last week, after the students, all aged between 11 and 14, were found infected. The school currently has 106 students [enrolled], and all are under observation. The team had also surveyed the entire village and collected samples, to be sent to the Integrated Diseases Surveillance Program (IDSP) lab for testing.
Lack of measles, mumps, and rubella [MMR] vaccination is what leaves a person prone to the infection. Mumps virus spreads from person to person through infected saliva. If an individual is not immune, they can contract the viral by breathing in saliva droplets from an infected person.
Dr. Divjot Singh, epidemiologist, district health department, said the situation is now under control. "We have asked the school's principal to relieve all students infected with mumps. The school will remain under surveillance for 15 more days. Medical officers are also carrying out awareness drive at the school and the village against mumps," said Dr. Divjot Singh.
Last year [2019], a mumps outbreak was reported from 2 areas of the district, including Andlu village in Raikot and Red Cross Bhavan, Sarabha Nagar, Ludhiana. [Byline: Harvinder Kaur]
19 new cases of Mumps repoirted in Devon (UK)
Disease Mumps United Kingdom - 22 hours ago
Source: Devon Live [abridged, edited]
<https://www.devonlive.com/news/devon-news/mumps-outbreak-19-new-cases-3741359>
An outbreak of 19 new cases of mumps has been reported across Devon in the last week. The contagious viral disease particularly affects under 25s. The new mumps figures have been released in the official Government weekly Statutory Notifications of Infectious Diseases report, with the highest number in Exeter.
It follows a warning that mumps is on the rise, particularly in university towns. Traditionally known as the "kissing disease" because it spreads fast between groups of young people, mumps is a contagious viral infection recognisable by the painful swellings in the side of the face under the ears (the parotid glands), giving a person a distinctive "hamster face" appearance.
In severe cases, it can develop into viral meningitis if it moves in the outer layer of the brain. Other complications include swelling of the testicles or ovaries (if the affected person has gone through puberty), which may affect a person's fertility. [Byline: Colleen Smith]
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