INFLUENZA A (H1N1)

For the latest information on the Swine (H1N1) flu, including countries affected, go to the World Health Organization (WHO) website: http://www.who.int/csr/disease/swineflu/en/

Pandemic influenza H1N1 has now been reported in over 170 countries and territories worldwide. While the case counts no longer reflect actual disease activity, WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states. Of particular interest is the situation in temperate countries of the Southern Hemisphere, which are now passing through their winter season. This season, pandemic H1N1 has been the predominant influenza virus in nearly all of the temperate regions of Southern Hemisphere, with South Africa being a notable exception. Australia and countries in the southern part of South America experienced rapid increases in cases of pandemic influenza early in their winter season. These same areas are now starting to report decreases in the numbers of people seeking care and being admitted to hospital. Although the virus is still circulating in these areas as it moves into areas not affected earlier, the overall national trends are downward.

South Africa, in contrast, experienced an early influenza season with a seasonal subtype, influenza A (H3N2). As the influenza season in South Africa reached its peak in early to mid June and began to decline, pandemic influenza H1N1 appeared and has now become the dominant subtype seen there as well. In the temperate areas of the northern hemisphere which experienced early outbreaks of pandemic H1N1 influenza, including countries in North America and Europe, the virus continues to spread to new areas and cause intense local outbreaks. However, the overall national trend in cases is downward in the Americas. Tropical regions of the world, which typically experience year round transmission of influenza viruses with peak transmission at different and often multiple times in a year, are now seeing increases in cases, for example in tropical areas of Central and South America and in South and South East Asia. In summary, the overall picture of transmission globally is one of declining transmission in the temperate regions of the Southern Hemisphere with the exception of southern Africa. The season in these areas was characterized by rapid rise and fall of respiratory disease numbers, as is seen in a normal influenza season.

The impact and severity of the season in these areas in terms of proportion of cases which developed severe disease and the load imposed on health care infrastructure is still being evaluated but generally appeared slightly worse than a normal influenza season in most places with increased hospitalization requiring respiratory critical care. The northern hemisphere is experiencing continued spread of the virus but declining activity is being observed in areas affected early in the course of the pandemic. Tropical areas of the world are now experiencing increasing numbers of cases at a time when the usual seasonal peaks would occur. As the pandemic H1N1 influenza virus is now the dominant strain in most areas of the world, it can be expected to persist into the coming influenza season in the Northern Hemisphere. Additionally, there is a risk of further spread of virus in highly populated areas as community spread starts occurring in Asia and Africa.

Brazil - On August 10 the U.S. Consulate in Rio de Janeiro issued the following Warden Message: "This Warden Message alerts U.S. citizens to the latest information regarding human cases of 2009-H1N1 Influenza, sometimes referred to as swine flu or novel H1N1. The Brazilian Ministry of Health has reported, as of August 4, 2009, 2,959 confirmed cases of H1N1. "State of Rio de Janeiro authorities have postponed the beginning of the semester for all public schools from August 3 to August 17, as have various private schools. "American citizens should be aware that the U.S. Consulate General in Rio de Janeiro cannot demand their immediate release if they have been detained or quarantined in accordance with local public health and legal authorities. Please note that the Consulate General is NOT advising Americans in Brazil to depart. At this time, the Consulate General advises that Americans review the guidance provided by the U.S. Centers for Disease Control and the World Health Organization, and make their own decisions about whether to remain in Brazil."

Tanzania - On August 6 the U.S. Embassy in Dar es Salaam issued the following Warden Message: "This Warden Message alerts U.S. citizens to the latest information regarding human cases of 2009-H1N1 influenza, sometimes referred to as swine flu or novel H1N1. In light of the first case of the 2009-HIN1 influenza virus and subsequent reported cases in Tanzania, the U.S. Embassy in Dar es Salaam is issuing an update of the previous Warden message dated July 9, 2009. "The first confirmed case of 2009-H1N1 infection in Tanzania was tested at the Muhimbili National Hospital laboratory in Dar es Salaam and publicly confirmed on July 9, 2009. Since then, the Tanzanian authorities have discovered several additional cases. Individuals who have tested positive with 2009-H1N1 have been quarantined for several days at Muhimbili National Hospital in accordance with directives set forth by the Ministry of Health. The U.S. Embassy encourages all American citizens to cooperate with local health authorities and to contact their medical professionals regarding questions or concerns about 2009-H1N1 influenza or other illnesses.

State Dept. Travel Warnings and Public Announcements

For the full announcements or further detail on Travel Warnings and Public Announcements, please see http://http://travel.state.gov/travel

Bangladesh - On August 12 the U.S. Embassy in Dhaka issued the following Warden Message: "The Embassy received a report that on Saturday, August 15 (National Mourning Day a National Holiday) large crowds will be making their way to the Banani Muslim Graveyard (near the American Center) to pay their respects to the late founding leader of Bangladesh, Sheikh Mujibur Rahman. The Awami League is also organizing a Milad (prayer for grieving) where they will distribute food in several areas in Dhaka City including Nutun Bazar and Shazadpur. "The Embassy advises that Americans avoid these areas on Saturday, August 15th. If you are required to be in these areas at this time we want to remind you to exercise caution throughout Dhaka. Please be alert and aware at all times and vary routes and schedules. We encourage all American citizens to carry their mobile phones with them at all times."

Central African Republic - On August 11 the U.S. Embassy in Bangui issued the following Warden Message: "The U.S. Embassy in Bangui urges U.S. citizens to exercise extreme caution in southeastern Central African Republic (CAR) and to postpone any travel to the Haut Mbomou. Recent incursions by the Lord's Resistance Army between Zemio and the border with Sudan make it advisable to avoid this region at this time. U.S. citizens are further reminded to be alert at all times when traveling in Bangui, and anywhere in the Central African Republic. The State Department's Travel Warning for CAR recommends that American citizens avoid all non-essential travel outside of Bangui. Avoid crowds and areas of civil unrest. ..."

Dominican Republic - On August 12 the U.S. Embassy in Santo Domingo issued the following Warden Message: "The following Warden Message is being transmitted to alert U.S. citizens to demonstrations occurring throughout the Dominican Republic. The U.S. Embassy's Regional Security Office and local media are reporting the likelihood of demonstrations in several areas to protest slow road repairs and energy shortages. These demonstrations may involve interruption of transit and, as is possible with all demonstrations, some of the protests may include episodes of violence. American citizens are advised that protests related to ongoing problems with infrastructure, government services, and energy shortages continue to occur periodically. Americans should monitor media reports for ongoing developments, and as always, avoid street crowds and exercise caution when traveling throughout the country.

Demonstrations take place in the Dominican Republic from time to time in response to world events or local developments. American citizens are reminded that demonstrations do not generally occur in areas frequented by tourists and are generally not targeted at foreigners. American citizens should be aware, however, that even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence. American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations. Street crowds should be avoided. In urban areas, travel should be conducted on main routes whenever possible.

Jamaica - On August 7 the U.S. Embassy in Kingston issued the following Warden Message: "The U.S. Embassy in Kingston is issuing this Warden Message to alert U.S. citizens in Jamaica to an increase in armed robbery, break-ins, and larceny on the island as a whole and, in particular, the New Kingston area in the capital. The Embassy also reminds U.S. citizens of the crime information provided in the State Department's Country Specific Information for Jamaica.

"In part because of the current world-wide economic recession, crime in Jamaica, and especially in Kingston, has risen substantially. American citizens living in or visiting Jamaica should use caution, be aware of their surroundings, and take these recommendations into account when planning activities, especially if visiting the New Kingson Area: Travel in groups, keep windows up and doors locked while in a vehicle, do not walk alone, especially after dark, do not take shortcuts through alleyways; walk on main streets, do not leave valuables in a vehicle, park vehicles in garages with security services, do not show off jewelry, do conceal cell phones and do cooperate with the perpetrators robbery victims have been assaulted and, in some cases, killed when they attempted to resist."

Pakistan - On August 13 the U.S. Embassy in Islamabad issued the following Warden Message: "This warden message is being issued to advise Americans of potential traffic disruptions and potential safety concerns during the upcoming Pakistan Independence Day celebrations. All U.S. Mission personnel in Pakistan have been advised to take extra care and avoid all unnecessary driving from Thursday evening to Saturday morning. In addition to the known events there will be many other private unannounced events throughout major cities, with celebratory gunfire and large crowds. Previous Pakistan Independence Day celebrations have also included incidents of celebratory gunfire being shot in the air, creating dangerous and unpredictable results.

"The Embassy reiterates its advice to all Americans to take measures for their safety and security at all times. These measures include maintaining good situational awareness, avoiding crowds, and keeping a low profile. The Embassy reminds Americans that even peaceful demonstrations may become violent and advises Americans to avoid demonstrations. Americans should avoid setting patterns by varying times and routes for all required travel. Americans should ensure that their travel documents and visas are valid at all times."

Malawi - On August 12 the U.S. Embassy in Lilongwe issued the following Warden Message: "Malawian Immigration Officials have notified the U.S. Embassy that there is an on-going immigration enforcement effort focused on foreigners who illegally entered Malawi or who have overstayed their visas. Some American citizens have been detained for not being able to show a copy of their passport and immigration status. The Commissioner of Immigration has stated that foreigners must be able to produce a copy of their passport data page and immigration stamp/visa upon demand by police and immigration officials. "We remind all American Citizens to carry a copy of their passport (biodata) page and copy of their visa or immigration permit at all times. You should keep your passport in a safe location not on your person and report to the United States Embassy immediately if it is lost or stolen.

Mauritania - On August 11 the U.S. Embassy in Nouakchott, Mauritania, released a Warden Message, which reads in part as follows: "The U.S. Embassy in Nouakchott is issuing this Warden Message to inform American citizens that Peace Corps volunteers are temporarily being withdrawn from Mauritania due to safety and security concerns. Volunteers presently serving in Mauritania will be given options to serve elsewhere. The Peace Corps and the U.S. Embassy will continue to monitor the safety and security situation in Mauritania in preparation for Peace Corps' return. The Peace Corps office in Nouakchott will remain open.

"U.S. citizens should review the State Department's Worldwide Caution, especially the section on Al Qaeda in the Islamic Maghreb's presence in West Africa. We encourage American citizens to be especially aware of their security and surroundings. The U.S. Mission has advised its personnel to avoid travel after dark, non-essential travel outside of Nouakchott, areas with significant crowds, places where large numbers of foreigners gather, and large cultural or other public events. Enhanced security awareness also includes varying routes and times of movements to and from work. American citizens should stay current on local events and be aware of their surroundings at all times. American citizens are also urged to register with the U.S. Embassy."