Algeria Angola Benin Botswana British Indian Ocean Territory Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Congo, DRC Cote d'Ivoire Djibouti Egypt Equatorial Guinea Eritrea X Ethiopia Gabon Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Libya Madagascar Malawi Mali Mauritania Mauritius Mayotte Morocco Mozambique Namibia Niger Nigeria Rwanda Sao Tome & Principe Senegal Seychelles Sierra Leone Somalia South Africa St. Helena Sudan Swaziland Togo Tunisia Uganda Zambia Zimbabwe
Antarctica (NONE of 4)
Antarctica Bouvet I. French Southern & Antarctic Lands Heard I. & McDonald Is.
Asia (NONE of 48)
Afghanistan Armenia Azerbaijan Bahrain Bangladesh Bhutan Brunei Cambodia China Christmas I. Cocos Is. Gaza Strip Georgia India Indonesia Iran Iraq Israel Japan Jordan Kazakhstan Kuwait Kyrgyzstan Laos Lebanon Malaysia Maldives Mongolia Myanmar Nepal North Korea Oman Pakistan Philippines Qatar Saudi Arabia Singapore South Korea Sri Lanka Syria Tajikistan Thailand Turkey Turkmenistan United Arab Emirates Uzbekistan Vietnam Yemen
Albania Andorra X Austria X Belarus Belgium Bosnia & Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Faroe Is. Finland France Germany Gibraltar Greece Hungary Iceland Ireland Italy Jan Mayen Latvia Liechtenstein Lithuania Luxembourg Macedonia Malta Moldova Monaco Montenegro Netherlands Norway Poland Portugal Reunion Romania Russia San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Ukraine United Kingdom
North America (1 of 36)
Anguilla Antigua & Barbuda Aruba Barbados Belize Bermuda British Virgin Is. Canada Cayman Is. Costa Rica Cuba Dominica Dominican Republic El Salvador Greenland Grenada Guadeloupe Guatemala Haiti Honduras Jamaica Martinique Mexico Montserrat Netherlands Antilles Nicaragua Puerto Rico X St. Kitts & Nevis St. Lucia St. Pierre & Miquelon St. Vincent & the Grenadines The Bahamas Trinidad & Tobago Turks & Caicos Is. United States Virgin Is.
American Samoa Australia Cook Is. X Fiji French Polynesia Guam Jarvis I. Kiribati Marshall Is. Micronesia Nauru New Caledonia New Zealand Niue Norfolk I. Northern Mariana Is. Palau Papua New Guinea Pitcairn Is. Samoa Solomon Is. Timor-Leste Tokelau Tonga Vanuatu Wallis & Futuna X
This small country is situated between France and Spain. Because of its elevation and proximity to the Pyrenees the climate is generally pleasant throughout the year.
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During the summer months the temperatures can rise to 30c but there is usually a cooling breeze. Lightening storms can occur during the summer months associated with torrential rain.
Sun Exposure and Dehydration
Those from Northern Europe can develop significant sun exposure and so remember to use a wide brimmed hat when necessary. The altitude can also lead to significant tiredness and dehydration so take sufficient initial rest and drink plenty of fluids.
The level of crime throughout the country directed at tourists is very low. Nevertheless take care of your personal belongings at all times and use hotel safety boxes where possible.
There are strict laws regarding the use of illegal drugs. Make sure you have sufficient supplies of any medication you required for your trip and that it is clearly marked. The European E111 form is not accepted in Andorra and so it is essential that you have sufficient travel insurance for your trip.
Andorra is one of the regions where many travel to partake of their winter sport facilities. Generally this is well controlled and one of the safer regions. Nevertheless, make certain your travel insurance is adequate for the activities you are planning to undertake.
The only standard vaccine to consider for Andorra would be tetanus in line with many other developed countries of the world.
Government in Andorra vows to kick habit of cigarette advertising
Pollution Andorra - 2 years ago
Andorra la Vella, Andorra, July 12, 2018 (AFP) - The tax haven of Andorra has long been a favourite destination for smokers looking to stock up on cheap cigarettes, but the enclave said Thursday that it would soon stop advertising the fact. The government said it had signed up to the World Health Organization's (WHO) anti-tobacco convention, which aims to encourage people to quit smoking and combat contraband sales. "The goal is to contribute to public health and pursue the fight against trafficking," government spokesman Jordi Cinca said at a press conference.
The tiny principality of Andorra, perched in the Pyrenees on the border between France and Spain, attracts millions of shoppers each year to duty-free stores, where prices of alcohol, cigarettes, electronics and clothes can be up to 20 percent cheaper than elsewhere in the EU. High taxes on tobacco imposed by many countries to help people kick smoking make Andorra's cigarettes a particularly good deal. The average pack costs just three euros ($3.50) compared with eight euros in France, which has said it will gradually raise the price to 10 euros a pack by November 2020.
Tobacco sales bring in some 110 million euros a year for Andorra, whose economy is otherwise based almost entirely on tourism. It is also an enticing destination for smugglers, with French and Spanish border agents regularly seizing cartons from people trying to sneak them out, either by car or by hiking down the mountain trails which criss-cross the Pyrenees. No date has been set for the advertising ban, which will come into effect three months after the ratification of the WHO accord is voted by parliament.
Population in Andorra witness first strike since 1933
Strikes Andorra - 2 years ago
Date: Fri, 16 Mar 2018 02:41:51 +0100
Andorra la Vella, Andorra, March 16, 2018 (AFP) - The tiny principality of Andorra is witnessing a once in a generation phenomenon -- a widespread strike. Around a third of civil servants across the mountainous micro-state have walked out to protest proposed reforms to their sector in what has been described as Andorra's first large-scale strike since 1933.
With no negotiation breakthrough in sight, picket lines are expected to be manned again on Friday with customs officers, police, teachers and prison staff among those taking part. The first major strike in 85 years was sparked by plans from the government of Antoni Marti to reform civil servant contracts. He has assured officials "will not do an hour more" work under the reforms and that 49 million euros would be allocated for the next 25 years to supplement civil servant salaries. But government workers are unconvinced with unions warning the reforms could risk their 35 hour working week and pay.
Customs officers involved in the strike interrupted traffic on the Andorran-Spanish border this week, according to unions, while some 80 percent of teachers have walked out of classes. Strikers have occupied the government's main administrative building and held noisy protests outside parliament calling for Marti's resignation. "We have started collecting signatures to demand the resignation of the head of government and now nobody will stop us," Gabriel Ubach, spokesman for the public service union, told reporters.
Report on 2016 outbreak of Norovirus in Catalonia (Spain) linked to water from Andorra
Disease Norovirus Andorra - 2 years ago
Date: Mon 27 Sep 2017
Source: Contagion Live [edited]
http://www.contagionlive.com/news/2016-norovirus-outbreak-in-spain-linked-with-bottled-water
A recent Dispatch article published in the Centers for Disease Control and Prevention (CDC)'s Emerging Infectious Diseases journal, offers insight into a large norovirus outbreak that sprung up in Spain in 2016 that had been linked with bottled spring water. The Public Health Agency of Catalonia (ASPCAT) reported a staggering 4136 cases of gastroenteritis from 11-25 Apr 2016. Of the 4136 cases, 6 individuals required hospitalization. The CDC defines a "case-patient" as an "exposed person who had vomiting or diarrhoea (3 or more loose stools within 24 hours)," as well as 2 or more of the following symptoms: nausea, stomach pain, or fever.
ASPCAT investigators traced back the outbreak to contaminated bottled spring water in office water coolers. The water came from a source in Andorra, a small independent principality located between Spain and France. Norovirus is a "very contagious virus," according to the CDC, and it is common for individuals to become infected by eating contaminated food. Although it is possible to be infected by consuming contaminated drinking water, this mode of transmission is "rare in developed countries," according to the article.
The investigators collected water samples from a total of 4 19-L water coolers in 2 different offices located in Barcelona, "from which affected persons had drunk; samples 1 and 2 came from 2 water coolers in one office, while samples 3 and 4 came from 2 water coolers in another office. Using "positively charged glass wool and polyethylene glycol precipitation for virus concentration," the investigators tested the samples.
"We detected high RNA levels for norovirus genotype I and II, around 103 and 104 genome copies/L, in 2 of the 4 water cooler samples concentrated by glass wool filtration and polyethylene glycol precipitation," according to the article. The investigators noted that a drawback of using molecular methods is that they are not able to differentiate between particles that are infectious and those that are not. Therefore, they "predicted the infectivity of norovirus in the concentrated samples by treating the samples with the nucleic acid intercalating dye PMA propidium monoazide and Triton X surfactant before RT-qPCR," which allowed them to "distinguish between virions with intact and altered capsids."
In those 2 water samples, they found high genome copy values -- 49 and 327 genome copies/L for norovirus genotype I and 33 and 660 genomes copies/L for norovirus genotype II. This was not an unexpected finding, due to the large number of infected individuals associated with the outbreak. Through "PMA/Triton treatment before RT-qPCR assays," the investigators found that the proportion of infected virions accounted for 0.3% to 5.6% of the total number of physical particles in the water samples, "which was enough to cause gastrointestinal illness."
The investigators also analyzed faecal samples collected from infected individuals who worked at the office in which the 1st 2 water samples were collected. They detected the following genotypes in those faecal samples: GI.2 and GII.17. In the faecal samples collected from the other office, they isolated the following genotypes: GII.4/Sydney/2012, GI.2, GII.17, and GII.2.
"We hypothesize that the spring water was contaminated by all 4 strains (GI.2, GII.2, GII.4, and GII.17) but levels of viral contamination for each genotype were not homogeneous in all bottled coolers," the investigators wrote. "We may have detected only the GII.4 genotype in water samples 1 and 2 because of a higher concentration of this specific genotype or because of bias caused by the sampling, concentration, and molecular detection procedures."
The investigators admit one limitation to their study: the small number of water samples collected and analyzed. They attribute this to the fact that on 15 Apr 2016, 4 days after the onset of the outbreak, the company that produced the drinking water recalled over 6150 containers of water "of suspected quality" as a precautionary measure. The recall prevented the investigators from collecting more samples to assess, according to the article.
Although the exact cause of the contamination has not yet been identified, the investigators posit that "the high number of affected persons from 381 offices that received water coolers, and the many different genotypes found in some patients' faecal specimens" suggest that the spring aquifer had been contaminated by "sewage pollution," and the Andorra Ministry of Health and Welfare banned further use of the spring.
The investigators suggest that assessing commercially-produced mineral waters for different harmful pathogens, such as norovirus would be beneficial. They note, however, that creating, enhancing, and managing such "virus surveillance systems" would be costly. Thus, the investigators suggest taking a "balanced approach to keep both the cost and the time required for the analyses within feasibility limits." [Byline: Kristi Rosa]
[The interesting article published in the September 2017 issue of Emerging Infectious Diseases is:
Blanco A, Guix S, Fuster N, et al: Norovirus in bottled water associated with gastroenteritis outbreak, Spain, 2016. Emerg Infect Dis. 2017; 23(9): 1531-34; https://wwwnc.cdc.gov/eid/article/23/9/16-1489_article. - ProMED Mod.LL]
[Catalonia and Andorra can be located on the HealthMap/ProMED-mail map at http://healthmap.org/promed/p/1341. - ProMED Sr.Tech.Ed.MJ]
Skier and snowboarder die in Europe avalanches
Accident Andorra - 6 years ago
Date: Thu, 26 Dec 2013 22:25:05 +0100 (MET)
ANDORRA LA VELLA, Andorra, Dec 26, 2013 (AFP) - A Spanish skier and a French snowboarder have died in avalanches in different mountain ranges in Europe, officials said Thursday.
The 27-year-old skier, a woman from Barcelona, died Wednesday while going off-piste alone in the Soldeu resort in Andorra, in the Pyrenees mountains between France and Spain, a resort manager told AFP. Although she was rescued within 10 minutes, after her glove was spotted on the surface, she was unable to be revived despite a helicopter dash to hospital.
In the Italian Alps, close to the border with France, a 24-year-old Frenchman who was snowboarding with three friends on a closed run died Thursday when an avalanche swept over him in the resort town of Les Arnauds. Local officials said he succumbed to multiple injuries, asphyxia and hypothermia.
Avalanches are common in Europe's ski resorts at this time of year, when early snows are heavy with moisture, and several deaths occur each winter. Last Sunday, a 35-year-old Frenchman died in an avalanche in the Alps near the Italian border while on a three-day trek with a friend.
Andorra: Independent Outbreaks of Gastroenteritis
Disease Gastroenteritis Andorra - 17 years ago
Date: Fri 7 Feb 2003 From: Jaime R. Torres Source: EFE Salud, Thu 6 Feb 2003 (translated by Maria Jacobs) [edited] -------------------------------------------------- Close to 300 students in one school and 173 tourists staying in 7 hotels in the Principality of Andorra have been affected by outbreaks of gastroenteritis that, according to local authorities, are not related to each other. Monica Codina, Minister of Health, stated that the outbreak that has affected almost 300 children and 8 adults in the San Ermengol school was detected last Monday [3 Feb 2003] but that it may have started Wednesday or Thursday of the previous week. The epidemiological surveys of a group of pre-school and grammar school students that may also be affected have not been performed yet. Also pending are the results of the microbiological tests of the food and water served in the school dining room, but the minister has indicated that the probable cause of the outbreak is the fact that water pitchers were filled with hoses directly from the faucet. The Minister stated that this outbreak of gastroenteritis is not related to the one that affected 173 tourists, most of them young people on holiday, who where staying in 7 hotels of the Principality. The government is also investigating the cause of this outbreak and has indicated that an anomaly in the system that supplies water to the hotels was detected, requiring a process of chlorination, which has not been carried out due to the heavy snowfall of the past few days. * * * * * * * * * * [The suspicion that defective water supplies may be responsible for all of these independent outbreaks suggests that the etiologic agent may be an enterovirus, hepatitis A virus, or non-viral, rather than one of the noroviruses associated with sudden-onset viral gastroenteritis. Information on the outcome of diagnostic tests in progress would be welcomed. - ProMed Mod.CP]
No Profile is available at present Read More Show Less
Thousands of Puerto Rico's earthquake survivors wait for relief
Natural Disaster Puerto Rico - 7 days ago
Date: Thu, 16 Jan 2020 02:45:27 +0100 (MET)
By Ivelisse RIVERA, con Leila MACOR en Miami
Yauco, Puerto Rico, Jan 16, 2020 (AFP) - Living out in the open, their nerves on edge after a series of earthquakes that have shaken Puerto Rico, some 5,000 people are hoping that their president, Donald Trump, will heed the island's plea to be designated a disaster zone and free up much-needed aid. Since December 28, more than 1,000 tremors have rattled the US island territory in the Caribbean, which just two years ago was devastated by two powerful hurricanes in quick succession.
In Yauco, one of the areas worst hit by the earthquakes, dozens of people were sitting on cot beds Wednesday in the parking lot of a municipal stadium, sheltered from the sun by white tents and blue tarps handed out by the federal disaster management agency, known as FEMA. "The most difficult thing is the psychological aspect," said Wilfredo Rodriguez, 31. His house had been fractured by the seismic movement and he has spent a week living with his kids, aged six and 10, under an awning. "We are living in constant fear of another powerful tremor," he said.
He only returns to his house to wash, then hurries back to the shelter. "We worry that there'll be a more powerful tremor while we are inside the house," he said. Throughout the day, volunteers arrive to hand out food and toys for the children who fill the shelters: schools have been suspended because the buildings are not sturdy enough to withstand another quake. The island's earthquake detection system has registered 1,104 tremors in the past two weeks alone, of which 186 could be felt by the population. By comparison, during the whole of 2019 there were 6,442 tremors, of which just 62 could be felt by people on the island.
Further south, in Guanico, Juan Santiago decided to move into a shelter on Saturday after a tremor of 5.9 on the Richter scale hit the island. "The mountain shook and rocks and earth started to come down," said the 30-year-old. "My house has a crack in it and is about to fall down," he added. His home had weathered the Category Five winds of Hurricane Maria in September 2017 and of Hurricane Irma which followed it just two weeks later. "It's different to a hurricane. What is happening now is much nastier," he said.
As he was talking the earth shook again, a tremor of 5.2 magnitude. Vehicles rocked like hammocks in the wind, but the quake-hardened victims barely reacted. The houses in this part of the island are mostly rudimentary constructions built by the people who live in them with scant resources available in the mountains, where no regulations stipulate that buildings should be earthquake resistant. The government of Puerto Rico said that as of Monday, there were 4,924 people living in 28 shelters in 14 municipalities. There were no figures on how many buildings had been damaged or destroyed.
- Seeking disaster designation -
Puerto Rico's governor Wanda Vazquez Garced called on Trump to declare the earthquake a disaster and clear the way for desperately needed aid. Trump had declared an emergency days before, but the governor wanted more. The declaration of an emergency frees up to $5 million dollars in aid for the island, although Congress can bump that figure up. But if the situation is designated a disaster, there is no ceiling on funding, a FEMA spokesman said. On Wednesday, the government said it would release $8.2 billion in delayed hurricane relief that had been stalled after the president threatened to divert Puerto Rico's emergency funds to help pay for his wall on the US-Mexico border.
In the past few days there have been growing calls among Democratic lawmakers for Trump to declare the situation in Puerto Rico a disaster. It is a delicate subject, as Trump has accused the government of Puerto Rico of incompetence and of siphoning off hurricane relief money, triggering a public spat between the president and the mayor of San Juan, Carmen Yulin Cruz, as well as the former governor Ricardo Rossello, who was forced to step down last summer amid massive protests. The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
Puerto Rico rattled by another strong quake
Natural Disaster Puerto Rico - 10 days ago
Date: Sat, 11 Jan 2020 15:43:12 +0100 (MET)
Washington, Jan 11, 2020 (AFP) - A 5.9 magnitude earthquake rocked Puerto Rico Saturday, the latest in a series of powerful tremors that have shaken the US territory in recent days, the US Geological Survey reported.
The latest quake occurred at 8:54 am local time (1254 GMT) around 13 kilometres (eight miles) southeast of Guanica, a town on the island's southern Caribbean coastline that was hard hit by earlier quakes. The USGS revised its initial report of a 6.0 magnitude quake to 5.9. It follows a 6.4 magnitude quake Tuesday that killed one person, knocked
out electric power and caused widespread damage.
Puerto Rico Governor Wanda Vazquez declared a state of emergency after Tuesday's quake, which forced an automatic shutdown of the power grid. Puerto Rico's electric power authority reported outages in the towns of Ponce, Lares, Adjuntas and San German after the latest quake. The Pacific Tsunami Information Center in Hawaii issued a statement saying there was "no significant tsunami threat" but a small possibility of tsunami waves along coasts nearest the epicentre.
The island is still recovering from Hurricane Maria, which came ashore more than two years ago as a devastating Category 4 storm. Starting December 28, a wave of tremors have swept the island, putting residents on edge. The 6.4 quake on January 7 came a day after a 5.8 magnitude quake; it was followed by major aftershocks. Saturday's quakes were also preceded by a string of smaller tremors.
Authorities in Puerto Rico declare state of emergency after wide quake damage
Disturbances Puerto Rico - 13 days ago
Date: Tue, 7 Jan 2020 23:44:45 +0100 (MET)
By Ricardo Arduengo
Guayanilla, Puerto Rico, Jan 7, 2020 (AFP) - Puerto Rico's governor declared a state of emergency on Tuesday after a powerful 6.4 magnitude earthquake killed at least one person in the south of the island and caused widespread damage. Governor Wanda Vazquez said the declaration would allow for the activation of National Guard troops in the US territory still recovering from a devastating 2017 hurricane. The US Geological Survey said the quake struck at 4:24 am (0824 GMT) with the epicenter off the coast of the southern city of Ponce, and was followed by more than a dozen aftershocks.
Tuesday's quake was the most powerful in a series of tremors that have shaken the island since December 28. Scientists initially sent out an alert about a potential tsunami but it was later canceled. The island's electricity authority said the quake had forced an automatic shutdown of the power grid, already severely damaged by Hurricane Maria more than two years ago. The worst damage appeared to be in towns on the southwest coast, including Ponce, Guayanilla and Guanica. El Nuevo Dia newspaper said a 73-year-old man died after a wall fell in his home in Ponce. Eight others there were reported injured.
Two power plants in Guayanilla sustained major damage, the Puerto Rico Electric Power Authority said. The city could be without power for two weeks, its mayor Nelson Torres Yordan said. Celebrity chef Jose Andres announced that a charity he runs, World Central Kitchen, had started serving meals and distributing solar-powered lamps in quake-hit areas. Vazquez announced that $130 million in emergency aid funding will be disbursed. On social media, people wrote of being shaken awake by the force of the quake. One woman on Twitter said she had been "wrenched from sleep." "Everybody is awake & scared all over," she posted. In Guayanilla, the Inmaculada Concepcion church, built in 1841, was heavily damaged. Volunteers salvaged statues and other valuable items from the ruins as a priest consoled distraught parishioners.
- 'Be safe' -
A 5.8 magnitude quake on Monday toppled some structures, caused power outages and small landslides, but did not result in any casualties. It also destroyed a popular tourist landmark, Punta Ventana, a natural stone arch that crumbled on the island's southern coast. Vazquez, the governor, said government employees were being given the day off on Tuesday to take care of their families. "We want everyone to be safe," she said. She said ports were undamaged and there are several weeks' supply of gasoline, diesel and natural gas stored so people need not worry about shortages.
The White House said President Donald Trump had been briefed and Pete Gaynor, head of the Federal Emergency Management Agency (FEMA), had been in touch with the governor. Trump's administration came under severe criticism for its response to Hurricane Maria. The Category 4 storm destroyed the island's already shaky power grid, overwhelmed public services, left many residents homeless and claimed several thousand lives, according to government estimates.
Magnitude 6.5 earthquake hits off Puerto Rico cutting off electricity
Washington, Jan 7, 2020 (AFP) - A strong earthquake struck south of Puerto Rico early Tuesday, the US Geological Survey said, the latest in a series of tremors that have shaken the island since December 28. The shallow 6.5 magnitude quake struck 13.6 kilometres (8.5 miles) south of the city of Ponce, the USGS said, revising down its initial reading of 6.6. The quake struck just off the US territory's southern Caribbean coastline at 4:24 am local time (0824 GMT). "The whole island is without power," the director of Puerto Rico Electric Power Authority, Jose Ortiz, told local media.
Puerto Rico's governor Wanda Vazquez Garced posted on Twitter that the government's security protocols had been activated. She said government employees were not expected at work, adding: "We want everyone to be safe." On social media, people wrote of being shaken awake by the force of the quake. One woman on Twitter said she had been "wrenched from sleep", adding "Everybody is awake & scared all over."
Dramatic images also shared on social media appeared to show widespread damage in the town of Guayanilla, home to around 20,000 people, as well as nearby Guanica. The mayor of Guayanilla told local news channel NotiUno that the town's church had collapsed in the incident.
An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled. Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake. That earthquake toppled houses and caused power outages, but there were no reports of casualties.
5.8 magnitude quake rattles Puerto Rico
Date: Mon, 6 Jan 2020 18:04:21 +0100 (MET)
Miami, Jan 6, 2020 (AFP) - A 5.8-magnitude earthquake shook Puerto Rico Monday, toppling houses and causing power outages and small landslides but there were no reports of casualties, the US Geological Survey said. The quake, just off the US territory's southern Caribbean coastline, was felt throughout much of the island, including the capital San Juan.
Some 250,000 customers were hit by electric power outages after the quake, which struck at 6:32 am local time (1032GMT). Images posted on social media showed houses tumbled from their supporting pillars, cracks in walls, cars crushed under collapsed houses and small scale landslides. The quake was the strongest of a series that have rippled through the island since December 28, and it was followed by at least eight aftershocks, officials said. No tsunami alerts were issued.
Update on Dengue on Cook Islands
Disease Dengue Fever Cook Islands - 5 months ago
Dengue-type1 outbreak was declared on the 27 Feb 2019 following a laboratory (NZLabPlus) confirmation of 7 dengue type 1 cases. From 28 Jan-4 Aug 2019, a cumulative number of 78 dengue cases have been reported (22 confirmed, and 56 probable-NS1Ag positives). Rarotonga and Aitutaki are the only islands affected and most of the cases have been from the main island of Rarotonga. Aitutaki has managed to contain its number of cases to 3. The last case was reported on 18 Apr 2019. A total of 42 cases have been hospitalised and given free mosquito nets to take and use at home. Apart from some severe cases, the hospitalisation was also an effort to contain and minimise the spread of the infection into the community. Unfortunately, some cases refused to be admitted but were given some health advice and mosquito precautionary measures. No deaths reported.
<https://reliefweb.int/report/cook-islands/dengue-1-outbreak-cook-islands-situation-report-3-ending-4th-august-2019>
- Cook Islands. 17 Aug 2019. 78 dengue cases have been reported in Cook Islands since the outbreak began early in the year [2019]. The Cook Islands News reports the Ministry of Health saying 22 were confirmed cases while 56 have been deemed probable positives.
<https://www.rnz.co.nz/international/pacific-news/396839/78-dengue-fever-cases-reported-in-cook-islands>
HealthMap/ProMED-mail map of Cook Islands:
Cass of Dengue Fever reported on Cook Islands
- Cook Islands. 12 Apr 2019
As of Wednesday [10 Apr 2019], the Ministry for Health has 18 confirmed and 12 probable dengue fever cases. This is a total of 30 cases compared to 24 previously identified.
<http://www.cookislandsnews.com/national/item/72449-dengue-18-confirmed-12-probable/72449-dengue-18-confirmed-12-probable>
Cook Islands warns jet blast thrillseekers to stay away
Tourism Cook Islands - 5 years ago
Date: Thu, 2 Jul 2015 05:34:35 +0200 (METDST)
Wellington, July 2, 2015 (AFP) - Airport authorities in the Cook Islands on Thursday warned thrill seekers to stay away from their runway's jet blast zone after three tourists were injured when a plane was taking off. The main road in the tiny Pacific nation passes by the bottom of the runway and daring plane-spotters often stand in the wash of jet engines, clinging to the airport's fence as aircraft hit maximum thrust for ascent. "If you don't hang onto anything, you'll be knocked over," Cook Islands Airport Authority chief executive Joe Ngamata told AFP. "You get the young people and tourists looking for thrills going down there."
Ngamata said three tourists were blown over by the power of the jet blast last Thursday and were lucky to only receive cuts and bruises. "It can be dangerous," he said, adding that the area was clearly marked with red danger signs to deter the practice. "We might need to look at extra barriers or fences to keep people away." However, stopping it may be difficult, with the national tourism authority including the jet blast in a recent marketing video showing "the top 10 reasons to come to the Cook Islands".
Traveller from Cook Islands returns to Australia with Zika Viral infection
Disease Zika Virus Cook Islands - 6 years ago
Date: Tue 1 Apr 2014
From: Dr Alyssa Pyke <Alyssa.Pyke@health.qld.gov.au> [edited]
A female patient in Townsville, Queensland, Australia has been diagnosed with Zika virus infection following a recent trip to the Cook Islands, where the virus is currently circulating. A serum sample collected in March 2014 was positive by 2 separate Zika virus TaqMan real-time RT-PCRs and a pan-Flavivirus RT-PCR. Nucleotide sequencing and phylogenetics revealed 99.1 per cent homology with a previous Cambodia 2010 sequence within the Asian lineage. Flavivirus IgG and IgM antibodies were also detected in the serum sample.
This is the 1st known imported case of Zika virus infection into northern Queensland, where the potential mosquito vector _Aedes aegypti_ is present, and only the 2nd such case diagnosed within Australia.
Dr Alyssa Pyke
Public Health Virology
Forensic and Scientific Services
Coopers Plains, Queensland
Alyssa.Pyke@health.qld.gov.au
[As of 25 Mar 2014, there were 49 confirmed cases of Zika virus infection in the Cook Islands, the source of the virus in the case above. Concern for Zika virus introduction into northern Queensland where vector mosquitoes are present is a serious concern. Transport of this virus by viremic individuals has been the mechanism for its introduction into several Pacific islands. Dengue viruses have been introduced into Townsville, northern Queensland, by infected individuals and started small outbreaks there. Since that has happened with dengue viruses, it can happen with Zika virus as well.
ProMED thanks Alyssa Pyke for sending in this report.
A HealthMap showing the location of Queensland state can be accessed
at <http://healthmap.org/promed/p/285>, and the Cook Islands at
<http://healthmap.org/promed/p/4035>. - ProMed Mod.TY]
49 confirmed cases of infection with Zika virus in the Cook Islands
Date: Tue 25 Mar 2014
<http://www.radionz.co.nz/international/pacific-news/239814/at-least-630-zika-virus-cases-in-cook-islands>
There are now 49 confirmed cases of Zika virus [infection] in the Cook Islands, and as many as 630 people are believed to have suffered from the mosquito-borne disease.
Last month [February 2014], health authorities 1st thought they were dealing with dengue fever, but the 1st batch of test results confirmed 18 cases of Zika [virus infection].
The Director of Community Health Services, Dr Rangi Fariu, says further results from French Polynesia, where the disease 1st broke out in the region, take the number to 49.
He says scientists there are still determining the exact nature of the strain. "Tahiti just asked for those who were already shown positive; they wanted more samples to find out if the Zika [virus] strain that we have here is similar to the one that they have in Tahiti."
Dr Rangi Fariu says doctors have reported about 630 cases of suspected Zika virus [infection] in the Cook Islands and says the real number would be much higher.
[This is the 1st report of Zika virus infections in the Cook Islands. The virus has been circulating in the islands of French Polynesia, New Caledonia and Easter Island. Although the distances between these islands is significant, the virus is being moved by viraemic people who travel between them. One can expect further spread to localities where there are populations of vector mosquitoes that can initiate new outbreaks. Zika virus is a flavivirus. Symptoms of Zika fever may include fever, headache, red eyes, rash, muscle aches, and joint pains. The illness is usually mild and lasts 4-7 days. No fatalities caused by Zika virus infection have been reported.
A HealthMap/ProMED-mail map showing the location of the Cook Islands in the Pacific can be accessed at
Eritrea US Consular Information Sheet
Eritrea is a poor but developing East African country, the capital of which is Asmara. Formerly a province of Ethiopia, Eritrea became an independent country on M Read More Show Less
y 24, 1993, following a 30-year struggle that culminated in an overwhelming referendum vote for independence. Tourism facilities are very limited. Read the Department of State Background Notes on Eritrea for additional information.
All travelers should have a passport and valid visa prior to arrival; visas are not available at the airport unless specifically pre-authorized by the Eritrean government.
Travelers visiting Eritrea using a foreign passport do not need an exit visa, provided they leave before their entrance visa expiration date.
Persons staying beyond their entrance visa expiration date may be subject to fines or imprisonment, or be required to remain in Eritrea for an extended period while their case is reviewed in court.
All long-term residents, regardless of citizenship, must obtain an exit visa 30 days prior to departure, unless they hold a difficult-to-obtain multiple entry visa.
Upon entry and exit, visitors must declare all foreign currency, and may be asked to declare electronic equipment such as cameras, computers and video equipment.
Visitors must save all receipts for foreign exchange and present these upon departure to account for all foreign currency spent in Eritrea.
Failure to report foreign currency or meet customs requirements usually results in both a fine and imprisonment.
There is also a $20 airport departure tax.
Information about the airport tax and entry/exit requirements is available from the Embassy of Eritrea, 1708 New Hampshire Avenue NW, Washington, DC 20009; telephone (202) 319-1991; fax (202) 319-1304.
Overseas, inquiries may be made at the nearest Eritrean embassy or consulate.
U.S. citizens born in Eritrea, to Eritrean parents, or who in any other way appear to have Eritrean origins, are required to register with the Immigration and Nationality office in Asmara within seven business days of their entry into the country.
The Eritrean government sometimes subjects U.S. citizens of Eritrean heritage to the same entry/exit requirements as Eritrean citizens.
See the "Special Circumstances" section below for more information about dual nationality.
Eritrea and Ethiopia fought a border war from 1998-2000.
United Nations peacekeepers patrolled the border until March 2008, when Government of Eritrea diesel fuel restrictions resulted in the peacekeepers' withdrawal.
Both Eritrea and Ethiopia maintain large military presences along the border and currently all border crossings into Ethiopia from Eritrea remain closed.
U.S. citizens are strongly advised to avoid travel near the Eritrean-Ethiopian border and to register their presence in Eritrea with the U.S. Embassy in Asmara.
Since April 2008, large numbers of Eritrean troops have been deployed along the northeastern border of Djibouti.
U.S. citizens are strongly advised to avoid non-essential travel to the Southern Red Sea region of Eritrea, including the port of Assab.
Landmines and unexploded ordnance remain a serious problem throughout the country.
There are reports of accidents and numerous incidents where vehicles and people occasionally detonate mines.
Many detonations occurred on relatively well-traveled roads in and near the Gash Barka region of western Eritrea; subsequent investigations indicated that several mines had been recently laid.
Vast areas of the country still have not been certified free of mines and unexploded ordnance left over from both the 30-year war for independence and the subsequent 1998-2000 conflict with Ethiopia.
Americans should avoid walking alone and hiking in riverbeds or areas that local government officials have not certified as safe.
Although Eritrea and Sudan have diplomatic relations, the procedures for crossing their common border are not clear and subject to change.
Overland travel between the two countries is dangerous and ill advised.
Travelers crossing from Eritrea to Sudan north and west of the Keren-Barentu road risk becoming victims of banditry or Islamic extremist insurgent activity.
Several incidents were reported in 2007, apparently involving insurgents or criminals in this area.
The U.S. Embassy also received reports of sporadic bombings of vehicles and government facilities in the Gash Barka region near Sudan in 2007 and 2008.
If travel near the Eritrean-Sudanese border is essential, travelers should consult both the Eritrean authorities and the U.S. Embassy in advance.
Foreign travelers who wish to visit any area outside of Asmara must apply at least ten days in advance for a travel permit from the Eritrean government.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs' website at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada , a regular toll line at 1-202-501-4444.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphletA Safe Trip Abroad.
Although still a safe city by many measures, Asmara reported significant increases of street crime, such as theft, robbery, and assault in 2008.
Travelers should exercise vigilance in their personal security and safety precautions regarding what valuables they carry and which areas they visit.
Medical facilities in Eritrea are extremely limited.
Travelers must carry their own supplies of prescription drugs and preventative medicines because pharmaceuticals are in short supply.
Food and water-borne illnesses are very common among travelers, so drink only bottled or purified water and eat foods that are cooked or peeled.
Malaria is a serious risk to travelers in the lowlands of Eritrea, but Asmara is generally considered free of the disease.
There is no HIV testing requirement for temporary or permanent entry into Eritrea.
Please verify this information with the Embassy of Eritrea 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 website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at http://www.who.int/en.
The information below concerning Eritrea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
The roads between major cities (Asmara, Massawa, Mendefera, Dekemhare, Barentu, and Keren) are paved and in relatively good condition.
However, secondary roads and those in remote areas are usually unpaved and in poor condition.
U.S. citizens should avoid traveling on these roads, especially at night.
Bad weather can also make the condition of poor roads worse.
If you must take unpaved roads, check first with local government and village officials as new minefields continue to be discovered.
Landmines and unexploded ordnance litter the countryside in many areas, occasionally causing injuries and deaths.
Although the UN conducted de-mining efforts until late 2007, evidence of new mines has been reported, particularly in areas near the Ethiopian border.
All areas that are not well traveled are potentially dangerous due to live mines, especially north and west of Keren.
There are also minefields near Massawa, Ghinda, Agordat, Barentu, south of Tessenae, Nakfa, Adi Keih, Arezza, Dekemhare, and in a roughly 40-kilometer wide region just west of the Eritrean-Ethiopian border between the Setit and Mereb Rivers.
Many Eritreans use inexpensive public transportation, especially bus service.
Travelers should avoid taking buses due to extreme over-crowding.
Taxis are plentiful and inexpensive in Asmara, but usually carry multiple passengers along pre-defined routes.
If an empty taxi is available, a customer may request a "contract" taxi, which accepts no additional passengers, for a significantly higher fixed price.
Drivers should be aware of heavy and erratic pedestrian and bicycle traffic obstructing vehicle flow.
Occasionally horse-drawn carts, cattle, or goats add to the obstacles.
Other hazards are children and the elderly, who sometimes wander into the path of moving traffic, as well as small, slow, motorized carts.
Elderly or disabled people usually drive these carts and do not always yield to faster moving traffic.
When parallel parking on city streets, watch for pedestrians as you back into the space.
Please refer to our Road Safetypage for more information.
As there is no direct commercial air service to the United States by carriers registered in Eritrea, the U.S. Federal Aviation Administration (FAA) has not assessed Eritrea'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.
Due to Eritrean government restrictions impacting Embassy operations, the consular section of the U.S. Embassy in Asmara does not provide routine services to American citizens in Eritrea, including reports of birth, passports, and notaries.
Americans traveling or residing in Eritrea who require such services must travel to a U.S. Embassy or Consulate outside Eritrea, and should plan accordingly.
American citizens should also be aware that U.S. diplomatic personnel are subject to travel restrictions.
The Government of Eritrea requires resident diplomats to apply 10 days in advance for travel outside of Asmara city limits; often travel permission is not given.
This restriction can delay or prevent U.S. Embassy emergency assistance to American citizens outside of Asmara.
The consular section of the U.S. Embassy in Asmara has been closed for visa services since January 2007.
Eritrea has complicated citizenship laws and does not recognize renunciation of Eritrean citizenship.
Dual nationals who enter the country on Eritrean documents are treated as Eritrean citizens, regardless of their other citizenship.
U.S. citizens born in Eritrea, or who otherwise are considered to have acquired Eritrean citizenship, may be subject to certain obligations, including being drafted into national service, regardless of the documents they present at entry.
(National service is approximately six months of military training, followed by an often unspecified number of years in military or other government service.)
U.S.-Eritrean dual nationals who enter the country on an Eritrean passport or national ID card must obtain an exit visa prior to departure.
Exit visa applications can significantly delay travel plans or be denied, even for persons who entered Eritrea legally.
Eritrean dual nationals are also required to pay a 2% income tax on overseas earnings to the Eritrean Government prior to being granted an exit visa.
Additionally, Eritrean authorities sometimes to not allow Eritreans who left the country after 1993 to depart Eritrea after visiting the country, even if they have a U.S. passport and a valid Eritrean visa.
The government of Eritrea does not inform the U.S. Embassy of the detention of American citizens, and does not allow Embassy officials to visit incarcerated Americans.
Visitors are advised to exercise caution when taking photographs in Eritrea.
Foreigners in Asmara have been harassed and detained by local police and plain clothes security officials for taking photographs of street scenes in the city.
No law has been cited, but the arresting officials' justifications have been that (unmarked) government buildings are in the background and/or that the pictures are being taken (illegally) for commercial reasons.
All foreign nationals in Eritrea are required to apply for permits to travel outside of Asmara.
Travel permits must be presented at all checkpoints.
Checkpoints are found on major roads through Eritrea, but locations may change without notice.
Applications for travel permits are available at the Ministry of Tourism located on Harnet Avenue.
There is a high risk of earthquakes in Eritrea.
General information about natural disaster preparedness is available on the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.
Please see our information on Customs Regulations.
Persons violating Eritrean laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Eritrea are severe, and convicted offenders can expect long jail sentences and heavy fines.
For information see our Office of Children's Issues web pages on intercountry adoption
and international parental child abduction.
Americans living or traveling in Eritrea are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site, and to obtain updated information on travel and security within Eritrea.
The U.S. Embassy is located at 179 Alaa Street, PO Box 211, Asmara; telephone (291-1) 12-00-04; fax (291-1) 124-255 and (291-1) 127-584; the Embassy's web site is located at http://eritrea.usembassy.gov/
This replaces the Country Specific Information for Eritrea dated April 28, 2008, to update sections on Entry/Exit Requirements, Safety and Security, Crime,
Medical Facilities and Health Information, and Special Circumstances.
Significant Cholera outbreak in Upper Gash-Barka Region of Eritrea
Disease Cholera Eritrea - 3 years ago
Source: Asmarino Independent [edited]
<http://www.asmarino.com/news/4778-urgent-eritrea-a-serious-case-of-cholera-outbreak>
Activists have reported a serious cholera outbreak in the Upper Gash-Barka Region of Eritrea, which is proving difficult to control. The outbreak was 1st observed at Barentu Referral Hospital 2 weeks ago when people who had travelled from the upper Gash region were reported to be suffering from an illness that was not diagnosed easily. However, as a result of the extended time taken for accurate diagnosis of cholera due to a severe shortage of expertise and infrastructure, the outbreak spread widely, affecting areas of the Gash-Barka Region.
It has now been a week since the Ministry of Health acknowledged the outbreak as being a potential national epidemic and has briefed health professionals in the region to that effect.
So far, the effort to curb the spread is proving futile, and the impact of the outbreak is being felt across the region. Markets were deserted as a result of the spread, and even cattle markets in small villages outside Barentu have been cordoned off to prevent the spread. An expert at the Ministry of Health's public health section for preventing such epidemics stated: "There is currently no national emergency response team to prevent and control such outbreaks; we are, therefore, prone to such epidemics, as it always takes time to pull such a team together to both control the outbreak and treat victims."
Already, the current epidemic is said to have spread from the Upper Gash Region to the Southern Region and particularly to the area of Mai Dima, where an epidemic control team has been dispatched.
According to health experts in the region, when such an outbreak occurs, even able-bodied adults find it impossible to cope with the acute loss of bodily fluids. Without appropriate medical assistance, it is impossible for patients to recover, and the situation is considerably worse for pregnant women and children.
Given the lack of public health awareness, Arbi Harnet calls on the people to take preventive actions by strictly adhering to personal and public hygiene practices.
[A HealthMap/ProMED-mail map showing Eritrea is available at
<http://healthmap.org/promed/p/55445>.]
Eritrea president dismisses food crisis fears despite drought
Famine Eritrea - 4 years ago
Date: Sat, 23 Jan 2016 12:14:06 +0100
Nairobi, Jan 23, 2016 (AFP) - Eritrean President Isaias Afwerki on Saturday dismissed fears the Horn of African nation faces a food crisis, despite sweeping drought across the wider region leaving millions in need of aid. Floods and failed rains caused by the El Nino weather phenomenon have sparked a dramatic rise in the number of people going hungry in east Africa.
But authoritarian and isolated Eritrea has long rejected UN food aid in favour of a policy of self reliance, and Isaias said he was not worried. "In view of the harvest shortfall that has affected the whole Horn of Africa region, President Isaias stated that the country will not face any crisis in spite of reduced agricultural output," the information ministry said, after he was interviewed by state-run media. Isaias praised the government's "judicious policy and approaches of bolstering its strategic food reserves."
In November, the UN warned that Eritrea was among the countries at risk, like all the other nations in the wider region. "The current El Nino pattern, being the strongest ever recorded, has caused severe drought in the Horn of Africa nation, resulting in crop reduction by 50 to 90 percent; even failure in some regions," the United Nations said earlier this month. In Ethiopia, over 10 million people need food aid, it added. In Eritrea, few if any major foreign aid agencies are allowed operate, while the UN has limited access across the country, and most assessments are dependent on government reports.
Thousands of Eritreans flee the county each month, saying they are escaping conscription and rampant rights abuses. Refugees from the repressive Red Sea state make up the third-largest number of people risking the dangerous journey to Europe after Syrians and Afghans, running a gauntlet of ruthless people smugglers to make the treacherous Mediterranean crossing.
Louse borne relapsing fever in asylum seekers from Eritea arriving in Netherlands
Disease Borrelia Infection Eritrea - 4 years ago
Date: Thu 30 Jul 2015
Source: Eurosurveillance edition 2015; 20(30) [edited]
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21196>
Louse-borne relapsing fever (_Borrelia recurrentis_) in asylum seekers from Eritrea, the Netherlands, July 2015
[Authors: Wilting KR, Stienstra Y, Sinha B, Braks M, Cornish D, Grundmann H]
Two patients from Eritrea, recently arrived in the Netherlands, presented with fever and were investigated for malaria. Bloodfilms showed spirochetes but no blood parasites. Louse-borne relapsing fever caused by _Borrelia recurrentis_ was diagnosed. Treatment was complicated by severe Jarisch-Herxheimer reactions [inflammatory reaction observed after antimicrobial treatment of several infectious diseases] in both patients. Physicians should be aware of the possibility of _B. recurrentis_ infection in migrant populations who travel under crowded conditions, especially after passing through endemic areas such as Ethiopia and neighbouring countries.
_Borrelia recurrentis_ has for many centuries caused infections of often epidemic proportions known as relapsing fever. Since the infection is exclusively transmitted by body lice and humans are their only host, large scale outbreaks are only expected under circumstances conducive to louse infestation. We here report the 1st introduction of louse-borne relapsing fever into the Netherlands after World War II.
Case descriptions
On 4 Jul 2015, a young adult from Eritrea was referred from the National Reception Centre for Asylum Seekers (Asielzoekercentrum, AZC) to a regional hospital in the northern Netherlands with a 5-day history of headache, dizziness, right upper quadrant pain, myalgia, and fever (39.3 deg C [102.7 deg F]). Malaria was suspected. The patient had been in the Netherlands for only 2 days after arriving in Europe 14 days earlier. En route to Europe, they travelled through Ethiopia, Sudan, and Libya. Previously, they had noticed chills while sheltering in an unofficial street camp in Rome where they stayed with a small group of fellow Eritreans before travelling to the Netherlands.
Thick and thin bloodfilms did not show malaria parasites and commercial malaria antigen tests were negative. However, filamentous unidentified structures were reported in the thick film by the laboratory of the peripheral hospital. The patient received empirical treatment with a single dose of ceftriaxone (2000 mg intravenously) for suspected bacterial septicaemia. After administration, their condition deteriorated and the patient was transferred within the next 2 hours to the University Medical Center Groningen (UMCG) where they arrived at the emergency department with headache, peripheral hypothermia (35.3 deg C [95.5 deg F]), hypotension (systolic/diastolic blood pressure 78/52 mmHg, heart rate of 106 beats per minute), abdominal pain but no hepatosplenomegaly, and shortness of breath (respiratory rate 23 breaths/min). Laboratory analysis showed leucocytopenia (leucocytes: 1.6 x 10(9)/L, norm: 4.5-10 x 10(9)/L), anaemia (haemoglobin: 6.5mmol/L, norm: 8.6-11.2 mmol/L) and thrombocytopenia (thrombocytes: 16x10(9)/L, norm: 150-450x10(9)/L). C-reactive protein (CRP) was 254 mg/L (norm: less than 1 mg/L). Kidney function was normal. The patient's liver function tests showed mildly elevated transaminases (alanine transaminase: 58 U/L, norm: 7-56 U/L; aspartate transaminase: 108 U/L, norm: 10-40 U/L; alkaline phosphatase: 124 U/L, norm 20-140 U/L; gamma-glutamyl transferase: 93 U/L, norm 0-51 U/L) and total bilirubin levels of 38 micromole/L (norm: less than 26 micromol/L) and direct bilirubin 35 micromol/L (norm: less than 7 micromol/L). Oxygen saturation was 91 percent (norm: 95-100 percent). Giemsa-stained thick and thin films revealed spirochetes in large numbers (Figure 1 [available at the source URL]) and no malaria parasites.
Given the patient's travel history, louse-borne relapsing fever was suspected. The clinical deterioration was provoked by the ceftriaxone administration leading to a severe Jarisch-Herxheimer reaction [1]. Treatment was switched to doxycyline 200 mg per day intravenously intravenously to reduce the risk of relapse [2]. The patient was transferred to the intensive care unit (ICU) for fluid resuscitation, cardiac support with noradrenalin, and supportive oxygen delivery via high flow nose mask.
_B. recurrentis_ was confirmed by 16S rDNA PCR and sequencing directly from blood 2 days later. The patient stayed at the ICU for 2 days, made a full recovery and was discharged after 6 days. The body louse _Pediculus humanus humanus_ was recovered from [the patient's clothing (Figure 2 [available at the source URL]).
In 9 Jul 2015, a 2nd young adult from Eritrea was directly referred by the responsible physician at the AZC to the UMCG. On arrival, the patient presented with general malaise, headache, fever (38.5 deg C [101.3 deg F]) and cough. Blood tests showed elevated inflammatory parameters (leucocytes: leucocytes: 12.7 x 10(9)/L, CRP: 320 mg/L), normal kidney function and slightly elevated transaminases, but the blood sample was haemolytic. Thick and thin films showed spirochetes and treatment was started with doxycyline 200 mg orally. 2 hours later the patient developed a severe Jarisch-Herxheimer reaction [that] required admission to intensive care where they received fluid resuscitation, inotropic treatment with noradrenalin, and oxygen via a face-mask. _B. recurrentis_ was confirmed by 16S rDNA sequencing.
The patient reported symptoms of chills and fever 2 weeks before presentation at our hospital. Their journey through North Africa followed the same route as that of Patient 1, but Patient 2 had arrived in Europe a week earlier. Patient 2 had camped out in the streets for 5 days in Rome (as had Patient 1). Patient 2 arrived in the Netherlands 2 weeks before presenting at our hospitals after travelling through Austria and Germany. The patient made a full recovery and was discharged after 5 days. Lice could not be recovered from the clothing.
_B. recurrentis_ should be suspected in patients presenting with fever and a recent history of migration from or through endemic countries (Ethiopia, Sudan, Eritrea, and Somalia). The infection is transmitted through body lice (_P. humanus humanus_, formally known as _P. humanus corporis_), which typically lives and breeds in the seams of clothes but can occasionally also be found in bed linens. Immigrants may share their clothing and that can pose an additional risk of transmission. The incubation period for relapsing fever is usually 4 to 8 days with a range of 2 to 15 days [3]. It should be noted that head lice (_P. humanus capitis_), which are not uncommon in Northern Europe, are incompetent vectors and cannot transmit _B. recurrentis_. The spirochetes are easily visible under a microscope in a Giemsa-stained thick or thin blood film as used for the diagnosis of _Plasmodium_ spp [4]. In our patients, the diagnosis was confirmed in both cases by 16S rDNA PCR and sequencing from blood.
Published evidence supports a single dose of tetracycline 500 mg intravenously as the conventional treatment, but considering the limited availability of this drug, doxycycline 200 mg can be used as an effective alternative [2,5]. In young children, pregnant women, or patients with a tetracycline allergy, erythromycin 500 mg can be used instead [6].
Both patients had travelled independently along a similar route before arriving in the Netherlands. Given the incubation period, it cannot be ruled out that the infection was acquired within Europe. Crucial information about risk factors such as exact travel history, recollection of louse infestation or bites and onset of symptoms was, however, impossible to obtain from our patients. Apart from being very sick and the fact that communication required an interpreter versed in Tigre our patients appeared to be traumatised and intimidated and not eager to volunteer information for fear of legal consequences.
Both patients developed a severe Jarisch-Herxheimer reaction after starting antibiotic treatment. _B. recurrentis_ evades host immune defences, resulting in very high bacterial loads (10(6)-10(8)/microl), and effective antibiotic therapy is followed by severe reactions characterised by sudden rigors, fever, and hypotension in virtually all treated patients [3]. Clinical symptoms are associated with increased plasma concentrations of tumour necrosis factor alpha (TNF-alpha), interleukin-6 and interleukin-8 [7]. Treating physicians should be aware of this complication and the chances that ICU admission may be warranted. It is advised that patients receive 2 well-placed intravenous lines for rapid fluid resuscitation. Treatment of Jarisch-Herxheimer reaction consists mainly of supportive care. Corticosteroids seem to have limited beneficial effect but studies suggests that TNF-alpha blockers may be useful [8].
An ad hoc survey at the AZC on [16 Jul 2015] found body lice on 2 newly arrived Eritreans. Since then, all asylum seekers arriving from endemic countries to the AZC have been segregated into a different compound, where they turn over all of their personal clothes in exchange for disposable overalls. Personal clothes are then washed and returned on the next day. Used overalls and bed linen are subsequently destroyed. In addition to delousing, all arrivals receive a single dose of ivermectin as pre-emptive treatment against scabies and Eritreans who arrive with clinically manifest scabies (about 80 percent of all new arrivals) receive a 2nd dose a week later. No new cases of _B. recurrentis_ infection have been identified since mandatory delousing was implemented.
Because infections with _B. recurrentis_ pose a significant health risk to other migrants, aid workers, healthcare personnel, and arguably to the general population, screening and delousing should be considered for arriving migrants already at ports of entry into the European Union. Our patients may have acquired body lice before arriving in Europe but transmission of infected lice between migrants after arrival in Europe cannot be ruled out and could pose an additional public health challenge.
[Figures and references are available at the source URL above.]
[Relapsing fever is a bacterial infection caused certain species of the spirochete _Borrelia_. These organisms are able to periodically change their surface protein molecules to evade the host's immune response, thus causing a relapsing illness. Following an incubation period of about 7 days, the illness is characterized by recurring episodes of high fever, headache, muscle and joint pain, nausea and vomiting, each episode lasting several days, followed by a several-day asymptomatic interval. There may be up to 3-4 recurrences. Complications may include involvement of the lungs (ARDS; acute respiratory distress syndrome), central nervous system, spinal cord, eyes, heart, and liver. The bacteremia is intense (more than 10,000 organisms per ml of blood) during febrile episodes, which allows detection of organisms on a Wright-Giemsa stained blood smear. Thick blood smears are more sensitive than thin smears.
There are 2 types of relapsing fever: Tick-borne relapsing fever (TBRF) and louse-borne relapsing fever (LBRF). LBRF is more severe than TBRF, with case-fatality rates without antimicrobial treatment of 30 to 70 percent in outbreaks. TBRF occurs in the Western hemisphere, Africa, Asia, the Mediterranean region and the Middle East. In the western United States, TBRF is usually associated with sleeping in rustic, rodent-infested cabins in mountainous areas. In the United States, 3 species, _Borrelia hermsii_, _B. parkerii_, and _B. turicatae_, transmitted by the bite of soft-bodied ticks (genus _Ornithodoros_) cause TBRF. A recently discovered _Borrelia_ species, _Borrelia miyamotoi_, has been found in hard-bodied ticks (_Ixodes_) in regions where Lyme disease is endemic.
LBRF is caused by a single species, _Borrelia recurrentis_, transmitted through abraded skin when the body louse is crushed during scratching. LBRF is endemic in Ethiopia, Sudan, Eritrea, and Somalia. Outbreaks are found in developing regions affected by war and in refugee camps characterized by overcrowding and poor personal hygiene. While mammals and reptiles may serve as a reservoir for tick-borne _Borrelia_ species, humans are the only host of _B. recurrentis_.
Treatment of relapsing fever consists of either a tetracycline (such as, doxycycline), a macrolide (such as, erythromycin), penicillin, or other beta-lactam antibiotics (such as, ceftriaxone). LBRF can be treated effectively with a single dose of the antibiotic (<http://jid.oxfordjournals.org/content/137/5/573.abstract>), whereas treatment of TBRF requires 7-10 days to prevent relapse. When initiating antibiotic therapy, all patients should be observed for a Jarisch-Herxheimer reaction. The reaction, caused by massive release of tumor necrosis factor alpha (TNF-alpha), interleukin-6, interleukin-8, and other cytokines, is manifest by a worsening of symptoms with rigors, tachycardia, sweating, hypotension, and high ever, occurs in over 50 percent of cases. The Jarisch-Herxheimer reaction can be fatal. Pretreatment with anti TNF-alpha antibody has been found to suppress Jarisch-Herxheimer reactions (<http://www.nejm.org/doi/full/10.1056/NEJM199608013350503>).
Corticosteroids and antipyretic agents have little or no effect (<http://jid.oxfordjournals.org/content/137/5/573.abstract> and <http://www.ncbi.nlm.nih.gov/pubmed/6132178?dopt=Abstract>), whereas meptazinol, an opioid agonist-antagonist, has been reported to reduce the severity of the reaction (<http://www.ncbi.nlm.nih.gov/pubmed/6132178?dopt=Abstract>). Treatment with intravenous fluids and vasopressors to maintain adequate blood pressure may be required. - ProMed Mod.ML]
[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/104>.]
Kidnapped Germans now thought to be in Eritrea after attack
Disturbances Eritrea - 8 years ago
Date: Fri, 20 Jan 2012 13:40:00 +0100 (MET)
ADDIS ABABA, Jan 20, 2012 (AFP) - Addis Ababa said Friday that two Germans kidnapped during a deadly attack by unidentified gunmen on a group of tourists in northern Ethiopia had been taken to neighbouring Ethiopia. Germany said it was still investigating the pair's whereabouts. "There is news that they are in Eritrea by now," foreign ministry spokesman Dina Mufti told AFP.
The Germans are believed to have been abducted when gunmen attacked a group of tourists in Ethiopia's remote Afar region earlier this week. Five people were killed in the attack: two Germans, two Hungarians and one Austrian. The German foreign ministry said three members of Germany's Federal Crime Agency were dispatched to Ethiopia to assist search efforts. "The Federal Crime Agency (has) sent staff to Ethiopia in order to support the Embassy," a spokeswoman for Germany's foreign ministry told AFP from Berlin. "They are trying to investigate where the two missing Germans could be." Six other Germans were among twelve survivors, some of them wounded, who were flown back to Addis Ababa on Wednesday. A Belgian citizen with gunshot wounds remains in hospital in Mekele in northern Ethiopia. The five bodies have been flown to the capital.
The attack took place near the famed Erte Ale volcano in Ethiopia's sparsely populated Danakil desert, close to the tense Ethiopia-Eritrea border. The area, which boasts spectacular moon-like landscapes and is famed to be the hottest place on earth, is popular among travellers. No group has claimed responsibility for the killings, but Ethiopia blamed arch-foe Eritrea for carrying out the attack. Eritrea vehemently denied being behind the incident, calling Ethiopia's claim "ludicrous" and a "smear campaign." The two Horn of Africa countries fought a bloody border war from 1998 to 2000 which killed 70,000 people. The border remains contested, with Ethiopian troops occupying land that international courts say belongs to Eritrea.
Eritreans flee harsh drought
Climate Changes Eritrea - 8 years ago
Date: Tue, 30 Aug 2011 12:41:08 +0200 (METDST)
by Jenny Vaughan
Shire, Ethiopia, Aug 30, 2011 (AFP) - In Ethiopias Endabaguna refugee camp, rows of gaunt Eritreans clad in rubber sandals give vent to their exasperation after days of trekking and dodging soldiers in an attempt to escape failed crops, hunger and an autocratic government. Over 12 million people across the Horn of Africa are struggling from the region's worst drought in decades, but secretive Eritrea is the only country to deny it has been affected by the crisis. "This year I farmed, but there was lack of rain. I dont know whats going to happen, only God knows," said Mehreteab, a refugee. He escaped from the army, risking death or jail if caught crossing the heavily militarized border, leaving his wife and three children behind. "There is no food and no grain in the home," he said. "I dont have any idea whats going to happen to them." Camps in northern Ethiopia receive about 900 refugees every month from Eritrea, one of the regions most isolated countries. A former colony of Italy and then part of Ethiopia, Eritrea fought a 30-year war with Ethiopia and only gained independence in 1991. A subsequent border conflict with Ethiopia from 1998-2000 still simmers. Former rebel leader Issaias Afewoki, who has been in power since 1991 without elections, has cracked down on all dissidents and severely restricted press and religious freedom.
The majority of those arriving in the Ethiopian camps are young men escaping conscription, which forces men above 16 to serve in the military for decades on minimal pay. The UN recently called for tighter economic sanctions after releasing a report linking Eritrea to a failed bomb plot at the African Union. According to satellite imagery from the weather monitoring group FEWSNET, rainfall in parts of Eritrea this year has been "below average" - less than 10 percent of normal levels in some areas. Aid workers admit it is nearly impossible to know just how gravely the Eritrea is affected because access to information is so limited in the country where the only media is state-run. "Its been a black hole for us, we dont know whats going on there," said Matthew Conway, spokesman for the UN humanitarian coordination office in Nairobi. "But thats not to say its not happening."
The US ambassador to the United Nations has said she is "deeply concerned" that Eritrea is facing extreme hunger, and urged the government to allow humanitarian access. "The people of Eritrea who most likely are suffering the very same food shortages that were seeing throughout the region are being left to starve," Susan Rice told reporters in New York. And much like other countries in the region, such as Ethiopia and Kenya, Eritrea is vulnerable to increased food prices, exacerbating the crisis. According to the UN agriculture agency, global food prices jumped 33 percent in the last year. "High international prices affected every country in the world, so from that you can assume Eritrea is affected," said Shukri Ahmed, an economist at the Food and Agriculture Organization. Fiercely self-reliant Eritrea stopped sending market information to FAO about three years ago, Ahmed said, so it is impossible to know how much food prices have risen in the country. "Unfortunately, we dont have any information on the ground," he told AFP by phone from Rome.
Over half of Eritrea's food is imported, the FAO estimate, leaving it vulnerable to market fluctuations for staples such as sorghum and maize. Eritrean refugee Berhane, 35, said the cost of food has surged in recent years, though wages have remained the same. Intermittent work as a labourer earned him about $5 per day. But the cost of grain is about $3 per kilo and a sheep is about $170, more than he could make in a month, he told AFP. "How is someone with no money or daily work supposed to buy this?" he asked. "It is too expensive." Facing steep food costs, he relied on a small plot of land to feed his family. But the rains were two months late this year and his harvest failed. "The government doesnt do anything. Nothing. There are no rations," he told AFP.
The Eritrean authorities deny the country is facing food scarcity. "This nonsense about a hidden famine in Eritrea is utterly false," the Eritrea's information ministry said in an online statement last week. Instead, Asmara claims last year's harvest was the best in a decade, while state run media heap praise on government-run food security programs. But refugee Gebrielxavier, 25, said this is not true. He left Eritrea last November because his crop failed, he could not find work and his family went hungry. "We couldnt live. We were famished," he said. "And the government? It did nothing." He is now running a café in the refugee camp, where he earns less than $2 a day and relies on UN food rations, but says he is still better off. "I got my freedom," he said.
Austria - US Consular Information Sheet
Austria is a highly developed, stable democracy with a modern economy.
Tourism is an important pillar of the Austrian economy and facilities are widely availab Read More Show Less
Read the Department of State Background Notes on Austria for additional information, or see the information at the Austrian National Tourist Office web site, http://www.austria.info.
A valid passport is required. U.S. citizens can stay without a visa for tourist/business for up to 90 days in each six-month period. That 90-day period begins when you enter any of the Schengen countries: Austria, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, and Sweden.
Although European Union regulations require that non-EU visitors obtain a stamp in their passports upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function.
If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry.
Under local law, travelers without a stamp in their passports may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.
There are no vaccination requirements for international travelers.
Visit the Embassy of Austria web site at http://www.austria.org/ for the most current visa information. There are four Austrian Consulates General in the United States. As each one serves clients from a particular region, please contact the appropriate office for assistance. If you reside outside the U.S. please contact the responsible Austrian Embassy or Consulate in your country of residence.
A list of Austrian Embassies/Consulates is available at http://www.bmeia.gv.at/aussenministerium/buergerservice/oesterreichische-vertretungen.html.
Austria remains largely free of terrorist incidents. However, like other countries in the Schengen area, Austria's open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.
Austrian intelligence experts have registered increased radicalization of immigrant Muslim individuals and of small conspiratorial groups, as well as intensified use of the Internet as a propaganda and communications platform. Despite some terrorism-related incidents in 2007 directed against individual Austrian nationals or the Government of Austria, authorities overall believe the likelihood of terrorist attacks in Austria remains relatively low; the State Department rates Austria as a "Medium" threat for transnational terrorism.
Every year, a number of avalanche deaths occur in Austria's alpine regions. Many occur when skiers/snowboarders stray from the designated ski slopes. Leaving the designated slopes to ski off-piste may pose serious risks and may delay rescue attempts in case of emergency. Skiers/snowboarders should monitor weather and terrain conditions, and use the available avalanche rescue equipment. Avalanche beepers (transceivers) are the most common rescue devices and, when properly used, provide the fastest way of locating an avalanche victim, usually enabling authorities to begin rescue operations within minutes.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, Bureau of Consular Affairs' web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
Austria has one of the lowest crime rates in Europe, and violent crime is rare. However, crimes involving theft of personal property have increased in recent years.
As such, most crimes involving Americans are crimes of opportunity involving theft of personal belongings. Travelers are also targets of pickpockets who operate where tourists tend to gather. Some of the spots where such crimes are most frequently reported include Vienna's two largest train stations, the plaza around St. Stephan's Cathedral and the nearby pedestrian shopping areas (in Vienna's First District).
There has been an increase in thefts and pick-pocketing on public transportation lines, especially on those lines coming into and out from the city center. U.S. citizens are advised to secure personal belongings and always take precautions while on public transportation and in public places such as cafes and tourist areas. Many citizens have had to disrupt travel plans while awaiting replacements for lost and stolen passports since emergency passports are generally only authorized in rare circumstances such as critical medical emergencies.
Information on the Austrian crime victim compensation program can be found on the U.S. Embassy web site at http://vienna.usembassy.gov/en/embassy/cons/compens.htm.
The local equivalent to the 911 emergency line in Austria is 133.See our information on Victims of Crime.
There are an adequate number of hospitals available in Austria. Local hospitals will not settle their accounts directly with American insurance companies. The patient is obliged to pay the bill to the local hospital and later claim a refund from his/her insurance carrier in the United States. MEDICARE payments are not available outside the United States.
The Austrian Medicine Import Act generally prohibits the import of prescription drugs into Austria, with two exceptions:
A) Travelers residing outside the European Union are allowed to carry with them (as part of their personal luggage) drugs and medicines, but only the quantity that an individual having a health problem might normally carry; and,
B) Travelers while staying in Austria may receive drugs and medicines for their personal use by mail. The quantity is limited to the length of their stay in Austria and must never exceed three packages.
Generally, it is recommended that travelers have either a prescription or written statement from their personal physician that the medicines are being used under a doctor's direction and are necessary for their physical wellbeing while traveling.
Public health conditions in Austria are excellent. The level of community sanitation in Vienna meets or exceeds that of most large American cities. Disease incidence and type are similar to that seen in the major cities of Western Europe and the United States. At the present time, air pollution is not a major health problem in Vienna.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Austria.
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 (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's web site at: http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization's (WHO) web site at: http://www.who.int/en.
Further health information for travelers is available at: http://www.who.int/ith/en.
Any person, regardless of citizenship, who wants to take up residence in Austria, must be covered by some health insurance plan that covers full medical treatment in Austria. American citizens interested in joining the health insurance plan under the Austrian system should apply to the Health Insurance Agency (Gebietskrankenkasse) in the province (Bundesland) where they reside.
Further information may be obtained from the appropriate "Gebietskrankenkasse" http://www.sozialversicherung.at/portal/index.html?ctrl:cmd=render&ctrl:window=esvportal.channel_content.cmsWindow&p_menuid=955&p_tabid=6&p_pubid=687.
The information below concerning Austria is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road conditions in Austria are generally excellent. During the winter, however, roads in alpine areas may become dangerous due to snowfall, ice, or avalanches. Some mountain roads may be closed for extended periods and tire chains are often required. Drivers should exercise caution during the heavily traveled vacation periods (December-February, Easter, July-August). Extra caution is recommended when driving through autobahn construction zones, particularly on the A-1 East/West Autobahn. Reduced lanes and two-way traffic in these zones have resulted in several deadly accidents in recent years. Traffic information and road conditions are broadcast on the English language channel fm4, located between 91 and 105 FM depending on the locale.
A U.S. driver's license alone is not sufficient to drive in Austria. The U.S. driver's license must be accompanied by an international driver's permit (obtainable in the U.S. from American Automobile Association and the American Automobile Touring Alliance) or by an official translation of the U.S. driver's license, which can be obtained at one of the Austrian automobile clubs (OEAMTC or ARBOE). This arrangement is only acceptable for the first six months of driving in Austria, after which all drivers must obtain an Austrian license.
Austria requires all vehicles using the autobahn to display an "Autobahn Vignette" highway tax sticker on the inside of the vehicle's windshield. The sticker may be purchased at border crossings, gas stations in Austria, and small "Tabak" shops located in Austrian towns. Fines for failing to display a valid autobahn vignette on the windshield of your car are usually around $120.
Austrian autobahns have a maximum speed limit of 130 km/hr, although drivers often drive much faster and pass aggressively. The use of hand-held cell phones while driving is prohibited. Turning right on red is also prohibited throughout Austria. The legal limit for blood alcohol content in Austria is .05 percent and penalties for driving under the influence tend to be stricter than in many U.S. states.
Tourists driving rented vehicles should pay close attention to the provisions of their rental contract. Many contracts prohibit drivers from taking rented vehicles into eastern European countries. Drivers attempting to enter countries listed as "prohibited" on the car rental contract may be arrested, fined, and/or charged with attempted auto theft. Austrian police are authorized to hold the rented vehicle for the car rental company.
Emergency roadside help and information may be reached by dialing 123 or 120 for vehicle assistance and towing services (Austrian automobile clubs), 122 for the fire department, 133 for police, and 144 for ambulance.
The European emergency line is 112.
Austrian Federal Railroads (Österreichische Bundesbahnen) offer excellent railroad service to all major towns of the country and also direct connections with all major cities in Europe. Trains are well maintained and fares are reasonable. There is also an extensive network of bus lines operated by the Austrian Postal Service (Österreichische Post). All major cities also offer excellent public transportation services.
Please refer to our Road Safety page for more information. Visit the web-site of Austria's national tourist office (Österreich Werbung) at http://www.austria.info and the national authority responsible for road safety (Kuratorium für Verkehrssicherheit) at http://www.kfv.at/.
AVIATION SAFETY OVERSIGHT The U.S. Federal Aviation Administration (FAA) has assessed the Government of Austria's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Austria'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.
Travelers using U.S. issued debit cards in Austrian Automatic Teller Machines (ATMs) may encounter problems. If the request for cash is rejected, travelers should check their accounts immediately to see whether the money was in fact debited from their account. If this is the case, they should notify their banking institution immediately. Prompt action may result in a refund of the debited amount. Receipts should always be requested and kept for verification with your home bank.
Persons violating Austrian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Austria are severe, and convicted offenders can expect long jail sentences and heavy fines.
Americans living or traveling in Austria are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site so that they can obtain updated information on travel and security within Austria.
The Consular Section of the U.S. Embassy is located at Parkring 12a, tel. +43- 1-31339-7535, fax: +43-1-5125835, web site: http://vienna.usembassy.gov/en/index.html
This replaces the Country Specific Information sheet for Austria dated January 23, 2008, without substantive changes.
Man dies in landslide as Austria hit by heavy rain and snow
Natural Disaster Austria - 2 months ago
Vienna, Nov 18, 2019 (AFP) - A man died on Monday in a landslide that destroyed much of his home in southern Austria, which has been hit by heavy rainfall and snow affecting transport and electricity. The retiree was behind his house in Carinthia state when part of the hill above it slid off, killing the 79-year-old, police said. Earlier Monday, two women were rescued from the rubble of two houses after another landslide, this one in the spa town of Bad Gastein in Salzburg state. Salzburg, Tyrol and Carinthia states have all seen heavy rain and snowfall since last week, leading to power cuts in thousands of homes. Many roads and railway lines have also been cut, and several schools in these areas remained closed on Monday.
Austrian court says hiker partly to blame for deadly cow attack in 2014
Tourism Austria - 5 months ago
Vienna, Aug 27, 2019 (AFP) - An Austrian court has ruled that a German hiker who was trampled to death by cows was partly to blame for the accident in a case which has sparked national debate. A lower court ordered the cows' owner in February to pay the woman's family 180,000 euros ($200,000) plus a monthly pension of 1,500 euros.
The verdict was seen as potentially harmful for agriculture and tourism in the Alpine country known for its picturesque mountains and cows grazing freely on their slopes in the summer. A higher court however ruled that the 45-year-old who was hiking with her dog bore 50 percent of the blame as she needed to be aware of the risks cows, especially those with calves, posed when confronted by dogs, a court official said Tuesday. She also did not heed warning signs to keep a distance from the herd. The farmer in turn had known his cows with calves to be aggressive and should have fenced off part of his pasture, the official said. The decision means the compensation will also be cut by half. Both parties can appeal the verdict.
The incident took place in July 2014 in the Pinnistal Valley in Tyrol when a herd of cows suddenly surrounded the hiker and trampled her. She died of her injuries at the scene. Her husband and son had accused the farmer of negligence, while the farmer insisted he had put up warning signs on the pasture. The February ruling led to Tyrol's farmers describing it as a threat to their livelihood and threating to close off their lands to hikers. Following the outcry, the government published a "code of conduct" for hikers. The guidelines include keeping a distance from cows and walking dogs on a short lead but unleashing them in case of attack.
Authorities in Austria to finally ban smoking in bars and restaurants
Pollution Austria - 7 months ago
Date: Tue, 2 Jul 2019 18:26:36 +0200
Vienna, July 2, 2019 (AFP) - Smoking in Austrian bars and restaurants will be banned as of November following a vote in parliament on Tuesday, after years of protracted debate on the issue. Only MPs from the far-right Freedom Party (FPOe) voted against the ban, which looks set to finally rid Austria of its status as the "ashtray of Europe".
The FPOe -- whose former leader Heinz-Christian Strache is himself a keen smoker -- had stymied a previous attempt to ban smoking in pubs and restaurants when it entered government in December 2017. That prompted a backlash from large sections of the public and the Austrian medical association, which organised a petition in favour of the ban signed by almost 900,000 people, or around 14 percent of voters.
However, in May the FPOe left government under the shadow of a corruption scandal implicating Strache, paving the way for the smoking ban to come back before parliament. "We are going to protect the health of hundreds of thousands of Austrians and prolong their lives," Pamela Rendi-Wagner, head of the main opposition Social Democrats (SPOe) -- and herself a doctor -- said after the vote.
Austria is currently led by a technocratic government after the so-called "Ibiza-gate" corruption scandal brought down the coalition between the FPOe and the centre-right People's Party (OeVP) and triggered early elections to be scheduled for September. The scandal emerged when footage in May showed Strache in a luxury villa on the island of Ibiza appearing to offer public contracts to a fake Russian backer in an elaborate sting operation, forcing him to step down from all his posts.
Austria was one of the last European countries where smoking was still permitted in bars and restaurants, despite calls for bans dating back more than a decade. Up until now, smoking has been legal in such establishments as long as it was done in a separate area -- although this rule was not always rigidly implemented. No separate area was necessary in establishments smaller than 50 square metres (540 square feet) if the owner was happy to allow smoking on the premises. However, a growing number of restaurants and cafes had already banned smoking of their own accord.
Authorities in Austrian city suspend bus services over Measles case
Disease Measles Austria - 10 months ago
Vienna, April 10, 2019 (AFP) - The Austrian city of Klagenfurt indefinitely suspended its bus services Wednesday after a case of measles was detected in one of the drivers. "All bus traffic is suspended until further notice in order to prevent infection," the city's KMG public transport operator announced.
The company runs all public transport in the southern city of 100,000 inhabitants, which is also the state capital of Carinthia. It took the unusual measure after it was revealed that one driver had been diagnosed with measles on 3 April. Since then two further suspected cases have been reported. KMG said it was working to establish "the vaccination status of all drivers" before authorising bus services to restart and was embarking on a deep clean of its vehicles.
The resurgence of measles, a once-eradicated and highly-contagious disease, is linked to a growing anti-vaccine movement in richer nations -- which the World Health Organization has identified as a major global health threat. On Tuesday, New York mayor Bill de Blasio declared a public health emergency in parts of the city, ordering all residents of certain districts in Brooklyn to be vaccinated to fight a measles outbreak concentrated in the ultra-Orthodox Jewish community.
Full steam ahead for Austria's night trains
Transport Austria - 11 months ago
Date: Sun, 3 Mar 2019 04:10:56 +0100
By Sophie MAKRIS
Vienna, March 3, 2019 (AFP) - It looks like a scene from the halcyon days of the railways: travellers finding their sleeper berth, turning on the reading light and stowing their cases under the bed. But it's still a common nightly ritual at Vienna's main station, where overnight train routes have endured in the age of low-cost flights -- and are even expanding. From early evening onwards, the departures board at Vienna's "Hauptbahnhof" station becomes a roll call of destinations to whet the appetite of any globetrotter: Venice, Rome, Zurich, Berlin, Warsaw... It's an unusual sight in a continent where budget airlines and faster trains have become the norm and led to the closure of many slower overnight routes.
But Austria's state railway company OeBB is looking to expand its network. It already runs 26 such routes, either on its own or in partnerships with other operators. In late 2016, OeBB bought the night train operation of its German counterpart Deutsche Bahn, which was looking to offload a department it judged insufficiently lucrative. Around 60 percent of DB's overnight routes were preserved, including a revamped Vienna-Berlin service which started a few months ago. Pointing to the "moderate growth" in passenger numbers -- more than 1.4 million used the services in 2018 -- OeBB has ordered 13 new trains equipped with state-of-the-art sleeper carriages.
- Eco-friendly -
It's no surprise then that Austria has become the poster child for rail enthusiasts, who say it provides an example of how overnight train travel can provide an alternative to air travel and even help in the fight against climate change. "With regard to the target of becoming carbon-neutral by 2050, night trains which run on renewable energy are an attractive alternative," according to Thomas Sauter-Servaes, transport expert at the Zurich University of Applied Sciences.
But as with all those who have researched the sector, he admits that cross-border overnight rail travel can represent a logistical and financial challenge. The profits per passenger take a hit from the extra space that sleeper compartments require, on top of the higher labour costs for those who have to work on the trains overnight and money spent on laundry. And that's before you take into account the hefty fees sometimes charged by other network owners for use of the rails, the technical difficulty of decoupling and then re-attaching carriages, and navigating the myriad of different rules a train has to adhere to over a long journey.
Sauter-Servaes points out that international air transport has a big commercial advantage in being exempt from VAT and fuel taxes. Among those preparing to board at Vienna station to spend a night on the rails on a recent evening, some told AFP they had chosen a night train with the environment in mind. "It's a small gesture, and it won't stop me taking the plane for my holiday in Madagascar this autumn, but it's better than nothing," said Austrian traveller Yvonne Kemper. David, a 42-year-old from Germany, said he was using the Hamburg service because he needed to get to Goettingen in Germany for a business trip -- a medium-sized town which, typically, is served by night trains but has no airport.
- An Austrian tradition -
OeBB spokesman Bernhard Rieder explained that Austria's attachment to night trains is down to "a tradition stemming from Austria's mountainous terrain, which limited the development of high-speed lines". He added that "the night train sector is distinct in that it can't function without strong cross-border cooperation." "Night trains are and will continue to be a niche market, but that doesn't mean a niche market can't be profitable." But Poul Kattler, from the pan-European "Back on Track" group which campaigns for more cross-border night trains, says the sector should be more ambitious. "If national railway companies were more aggressive in the market and the EU built a truly common rail policy, we could offer a real transport alternative and a very popular European project," he says.
Series of quakes strike off South Pacific islands of Wallis and Futuna
Natural Disaster Wallis and Futuna - 6 years ago
Date: Sun, 29 Jun 2014 22:45:31 +0200 (METDST)
SYDNEY, June 29, 2014 (AFP) - A strong 6.7-magnitude earthquake struck off the South Pacific islands of Wallis and Futuna in the early hours of Monday, following another powerful earthquake off Tonga. The latest quake hit at 5:15 am local time (1715 GMT Sunday) and occurred 205 kilometres (127 miles) southeast of the Wallis and Futuna capital of Mata-Utu, the US Geological Survey said.
It came less than two hours after a 6.4-magnitude quake struck off Tonga. Neither generated tsunami alerts and there were no immediate reports of damage. The undersea quake off Tonga hit at 3:52 am (1552 GMT Sunday) and was 197 kilometres northwest of the town of Hihifo, USGS said. The epicentre was also at a depth of 10 kilometres. That tremor was followed less than three hours later by a 5.6-magnitude quake a few kilometres further west. The region lies in the so-called Pacific Ring of Fire, an area of frequent seismic activity due to collisions between continental plates.
Earthquake measuring 6.6 hits French Pacific islands
Natural Disaster Wallis and Futuna - 14 years ago
Date: Tue, 13 Dec 2005 08:51:25 +0100 (MET) NOUMEA, New Caledonia, Dec 13 (AFP) - An earthquake measuring 6.6 on the open-ended Richter scale shook the French Pacific islands of Wallis and Futuna on Tuesday, but no one was injured, local officials said. The US Geological Survey said the tremor occurred at 0316 GMT. Its epicenter was located in the ocean 115 kilometers (70 miles) from the town of Sigave on Futuna island. "The population clearly felt the quake, but no casualties or damage was reported," said Jean-Jacques Feve, chief of staff to the French government's administrator of Wallis and Futuna. Around 15,000 people live in Wallis and Futuna, which is made up of three main islands located in the Pacific Ocean northeast of Fiji. Earthquakes occur regularly in the islands, which are located near a major fault line. In March 1993, three people were killed and a dozen others injured when a 6.3-magnitude quake hit Futuna. The Hawaii-based Pacific Tsunami center said the quake did not pose any destructive Pacific-wide tsunami threat. It said local tsunamis could sometimes occur within a 100-kilometer (60-mile) radius of the quake's epicenter. In nearby Fiji, the mineral resources department said there had been no reports of a tsunami following the quake and that the quake had not been felt anywhere in the South Pacific nation, the Fijilive online news service said.
Wallis and Futuna Islands: Dengue Fever Outbreak Reported
Disease Dengue Fever Wallis and Futuna - 17 years ago
Date: Fri 24 Jan 2003 From: ProMED-mail Source: MASTA Health Report, Fri 24 Jan 2003 [edited] --------------------------------------------------------- Australian radio reported on 23 Jan 2003 an outbreak of dengue fever affecting the French overseas territory of Wallis and Futuna Islands (Territoire des Iles Wallis et Futuna), which lie to the northeast of Fiji. An awareness campaign was launched in October 2002 to warn people of the dangers of the disease. There is a risk of dengue fever particularly during the rainy season.
New cyclone threatening Fiji, Tonga and French islands
Climate Changes Wallis and Futuna - 17 years ago
Date: Sun, 12 Jan 2003 06:51:27 +0100 (MET) AUCKLAND, Jan 12 (AFP) - A new cyclone, Ami, was born in the South Pacific Sunday and weather experts say it threatens Fiji, Tonga and the French islands of Wallis and Futuna. Ami formed out of a tropical depression 900 kilometres (560 miles) north of Fiji's capital Suva, around two degrees east of where on Christmas Day Cyclone Zoe was formed. It went on to devastate the Polynesian island of Tikopia, in the Solomon Islands. But while Zoe went west, the Fiji Meterological Service in Nadi said Ami Sunday afternoon was moving southwest toward Fiji. It will pass over Wallis and Futuna late Sunday and early Monday, with maximum winds estimated at 74 kilometres per hour (40 knots) within 144 kilometres (90 miles) of the centre and increasing to 83 kph (45 knots) within the next 24 hours. Its forecasts currently put it as less powerful than Zoe which was at the top end of the cyclone intensity scale. However unlike Zoe, Ami is heading towards areas of greater population, with 15,000 people on Wallis and Fatuna. Also in the projected path are Fiji's Lau islands, mostly low lying atolls. Tonga may be in line for Ami. In January last year Cyclone Waka destroyed homes and crops on the northern Vava'u islands in Tonga.
Travel advice for WALLIS AND FUTUNA ISLANDS
Disease Miscellaneous Wallis and Futuna - 17 years ago
UK Department of Foreign Affairs 18/09/2002 10:15:53 ENTRY REQUIREMENTS ************************************************* Wallis and Futuna Islands are an Overseas Territory (Territoire d'outre-mer) of France. UK citizens with a valid passport do not need a visa to enter Wallis and Futuna Islands. Visitors intending to work or to remain in Wallis and Futuna Islands for more than three months should apply for a residence permit at the local Préfecture. GENERAL ************************************************* The E111 medical form does not provide any health cover in Wallis and Futuna Islands. It is recommended therefore that all visitors take out comprehensive travel and medical insurance. CONTACT DETAILS ************************************************* There is no resident British Diplomatic Mission in Wallis and Futuna Islands. Routine consular matters are covered by the British Consulate-General in Paris. In case of real emergency, the British High Commission in Suva may be able to provide some assistance; (tel: +679 311033; fax: +679 301406).