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Violent Anti-Government Protests in Nepal; 8th Human Case of Bird Flu in Azerbaijan

11 April 2006

Philadelphia

International SOS, the world's leading provider of medical and security assistance services, international healthcare, and outsourced customer care, offers travel alerts to members traveling overseas to warn them of security risks or medical problems they may encounter at their destinations or en route. The following is a sample of locations that may represent current security and medical risks for global travelers.

Nepal - April 11, 2006 - Day Curfew Extended as Protests Continue
Two protestors were injured when police opened fire on a crowd of demonstrators in Pokhara this afternoon, as activists defied a citywide day curfew from 10:00 to 18:00 local time.

The Nepalese government has extended a day curfew in the capital, Kathmandu, as violent anti-government protests continued in many parts of the country. Today's curfew takes effect from 12:00 to 17:00 local time. The curfew covers central Kathmandu and outskirts such as Lalitpur.

There are no indications at this stage that operations in Kathmandu's international airport were significantly affected by the violent protests and the curfews. Government authorities deployed security personnel to escort passengers traveling between the city and the airport.

On Monday, the government arrested hundreds of protestors in several parts of the country. Several activists were also injured in forced dispersals. Political activists have indicated they will continue to defy the ban on the protest actions as well as curfews.

Violent protests are expected to continue in the near-term despite curfews and other security measures. Foreigners are unlikely to be directly targeted, however, they face the risk from being caught in violent incidents if they are in close proximity to a protest action.  International SOS advises that members travel to Nepal for essential business only. Travelers are advised to heed all local security directives and minimize non-essential local movement. During periods of shutdown strikes and curfew, foreigners are advised to stay indoors and avoid local travel. If a state of emergency is declared, foreigners are advised to defer all travel due to possible suspension of airport operations.

United States - April 11, 2006 - Possible Human Death due to Contamination from Massive Sewage Spill in Hawaii
Record rainfall in Hawaii during March resulted in a crack in a main sewerage pipe in Waikiki on March 24. Though the pipe was repaired by March 31, millions of gallons of untreated sewage were pumped into the Ala Wai Canal. Additional spills occurred in Waimanalo, Kailua, Kane'ohe and central Honolulu. The waste spilled into the surrounding ocean, contaminating many beaches with high levels of bacteria.

The public has been advised not to swim, fish or boat in the waters of closed beaches. Hotels have been notified. As the rain has eased, the situation is expected to continue to improve.

News reports indicate a 34-year-old man died on April 6, six days after immersion in the contaminated waters of Waikiki. He was infected with several bacteria, including vibrio vulnificus, which is present in polluted waters. People are infected through open skin wounds or by eating raw seafood. The organism can cause skin infection, gastroenteritis and infection in the blood stream. These conditions are treated with antibiotics, and the disease is usually only fatal to people with underlying health problems such as chronic illness or compromised immune systems. Investigations are ongoing into the circumstances of death.

Travel to affected areas can proceed. Travelers should heed all warning signs posted by health officials and follow instructions. If a beach is closed, do not swim, fish or boat in the surrounding waters. Travelers are also warned not to eat raw seafood and to ensure all seafood is thoroughly cooked.

Azerbaijan - April 11, 2006 - WHO Confirms 8th Human Case of Bird Flu
A previously reported 17-year-old girl has been retrospectively confirmed as an H5N1 case. She became ill on March 11 and has now fully recovered and been released from the hospital, as has her 15-year-old cousin, who also became ill on March 11. WHO confirmed the cousin’s case last month. Both girls are neighbors in the Daikyand settlement in Salyan rayon. Seven of Azerbaijan's eight human cases are from the settlement, but door-to-door surveillance efforts have not detected any additional human cases.

Avian influenza A/H5N1 has caused outbreaks in poultry in an increasing number of countries. At least 22 countries in Europe, Asia, the Middle East, and Africa have reported their first cases among birds since the beginning of 2006. For further information, see the International SOS Pandemic Preparedness Website. There, you can access the latest news, detailed information on flu-affected countries and pandemic preparedness planning information.

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