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Civilians Attacked in Sri Lanka; New Bird Flu Strain Identified

16 November 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.

Sri Lanka- November 9, 2006- Civilians Killed in Artillery Attack in Eastern Province

At least 45 civilians were reported killed when artillery fire from the Sri Lankan military hit a school housing victims of the 2004 tsunami in the eastern region. Military artillery hit the camp for internally displaced persons in Vaaharai, near Batticaloa. International peace monitors have confirmed the civilian fatalities. The Sri Lankan military accused the Liberation Tigers of Tamil Eelam (LTTE) of using civilians as human shields.

Civilians, especially those living in common shelters, have been caught in continuing hostilities between the Sri Lankan military and the LTTE in the north and northeast since December 2005. Local residents have also been directly targeted due to their ethnic or religious affiliation. Foreigners have not been directly attacked, however, they face the risk of being caught in violent incidents. Earlier this year, one foreign aid worker was injured in grenade attacks on offices of three aid agencies in eastern Sri Lanka. In mid-2006, scores of foreigners were trapped in Jaffna district and had to be evacuated to Trincomalee.

Recent peace talks between the government and the LTTE have been unsuccessful. The security situation in the north and northeast is likely to remain volatile until a viable political compromise is reached. International SOS advises that travel to Sri Lanka should be for essential business purposes only. Please contact International SOS for more information on the security situation in Indonesia.

Taiwan- November 10, 2006- Dengue Outbreak in Southern Taiwan

An outbreak of dengue fever is occurring in Kaohsiung, Pingtung and Tainan, in southern Taiwan. According to the Taiwanese Center for Disease Control, more than 500 cases have been reported since summer, including 14 cases of dengue hemorrhagic fever (DHF). Two people have died, both in the Kaohsiung area.

The Center for Disease Control has issued a warning that the situation is likely to worsen. Local authorities are implementing measures to limit mosquito breeding. Fines may be issued if premises are found to have conditions which favor breeding of mosquitoes. In 2004 there were over 300 cases of dengue fever in Taiwan. Kaohsiung reported an outbreak in 2001-2002.

Dengue or "break-bone" fever is a viral disease found in tropical and sub-tropical areas. It is transmitted by the Aedes aegypti mosquito. This insect bites during the day and is often found in and around human habitation. Symptoms of dengue include high fever, severe headache, cough, and joint and muscle pain. A rash often follows these symptoms. The acute illness can last up to ten days, and complete recovery can take two to four weeks.

Occasionally, a potentially fatal form of dengue called dengue hemorrhagic fever (DHF) occurs. DHF usually occurs in patients who have previously had dengue fever, and its fatality rate is about five percent. As there is no vaccine, preventing mosquito bites is the only way to prevent dengue fever. For more information on the prevention of Dengue fever, please contact your nearest International SOS Alarm Center.

October 31, 2006- National Academy of Sciences Reports New Strain of Bird Flu Identified

In the most recent edition of the Proceedings of the National Academy of Sciences, scientists have analyzed a new strain of H5N1. It is called the Fujian-like virus, named after the province in China where it was first isolated in late 2005. Since then it has infected birds in six other Chinese provinces, displacing other H5N1 viruses. The scientists running the study speculate that the Fujian-like virus may have become dominant in the area as other H5N1 viruses lost ground due to poultry vaccinations (China began vaccinating poultry in late 2005). This particular virus has also caused illness among birds in Laos, Malaysia and Thailand, and infected a human in Thailand. Although tracking new viral strains is important, their evolution is not very surprising since flu viruses are constantly mutating.

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.

Medical and Security Alerts
International SOS alerts are compiled through numerous resources including physicians and security experts on the ground in 48 countries, and individuals coordinating information from a broad range of resources, including the World Health Organization, the Centers for Disease Control and the US State Department.

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