Undiagnosed Pneumonia in Children - China
North and Central America
On 22 November, a chemical spill occurred due to a train derailment between Mullins Station and Livingston in Kentucky. The derailment involved 16 cars, two of which were carrying molten sulphur. Upon impact, the sulphur tanks ruptured, releasing their contents and igniting a fire. The intense heat and hazardous fumes from the burning sulphur prompted authorities to evacuate residents of Livingston and surrounding areas as a precaution. The Governor of Kentucky declared a state of emergency in Rockcastle County, mobilizing state resources to assist in response and recovery efforts. The cause of the derailment remains under investigation.
On 22 November, a vehicle explosion occurred on the Rainbow Bridge in Niagara Falls, leading to the closure of the bridge in both directions. The incident resulted in the death of two people who were in the car. The cause of the explosion is still under investigation, but authorities have ruled out terrorism and explosive materials. The incident occurred on one of the busiest travel days in the US, as people were travelling for Thanksgiving.
The closure of the bridge caused travel delays and led to heightened security measures at other airports and railways managed by the Niagara-Frontier Transit Authority, as well as at various locations around New York City. The Rainbow Bridge, which connects the US to Canada at Niagara Falls, was reopened on 25 November.Â
The partial state of emergency in 158 municipalities of Honduras, initially launched in December 2022, has been extended until at least 1 January. This state of emergency aims to combat rising extortion activities by criminal groups in the country. Under the extended state of emergency, the National Police and other state institutions can carry out various operations to combat gangs and drug trafficking. The government believes that the new extension will maintain active measures to guarantee security and order in crime-ridden areas.Â
South America
As of 21 November, at least eight people were killed by flooding and landslides triggered by heavy rains in southern Brazil in the past week. The affected states include Santa Catarina and Rio Grande do Sul, with significant property damage reported in the latter. Towns in Rio Grande do Sul were flooded due to the overflow of the Taquari River. Thousands sought refuge in gymnasiums as a result of the severe weather conditions.
A state of emergency was declared in 64 towns of Santa Catarina. Around 6,000 families were displaced. Avoid the affected areas, if possible, as power supply, transportation and communication systems may be disrupted. If travelling in the affected area, ensure access to adequate shelter and other essential services. Avoid contact with flood water due to possible risk of contamination. Do not drive through flooded areas. Consult local meteorological reports and plan your trips accordingly.
Between 23 and 25 November, global rallies by several feminist organizations were held across South America. Marches and demonstrations were held to commemorate the International Day for the Elimination of Violence against Women. Activists from Argentina, Chile, Paraguay, Uruguay, Ecuador, Peru, and Colombia gathered to denounce violence against women. Since 1981, advocates for women's rights have marked 25 November as a day to eliminate gender-based violence. Â Â
EuropeÂ
On 23 November, at around 13:30 hours (local time), at least five people, including three children, were injured in a stabbing incident in Gaelscoil Choláiste Mhuire school in Parnell Square East. Violent protests and arson incidents were reported in the area after the stabbing incident.
Protesters clashed with police, set off fireworks, set fire to police vehicles and public transport, and looted stores near the attack location. Holiday Inn Express Hotel at the intersection of O'Connell Street and Cathal Brugha Street was also set on fire. An unspecified number of arrests were made. A police cordon was set up around Leinster House. Other roads were also closed in the area. All bus services and some tram services were suspended. An investigation remains underway.
From 22:59 hours (local time) on 17 November, Finnish authorities closed four of Finland's nine border crossings with Russia to curb the surge in illegal crossings from Russia. The Vaalimaa, Nuijamaa, Niirala and Imatra border crossing stations were closed indefinitely. Subsequently, on 24 November, an additional four border crossings were shut down by Finnish authorities.
These included Salla, Kuusamo, Vainikkala, and Vartius, and these will also remain closed indefinitely. The border crossing stations at Vaalimaa, Nuijamaa, Niirala, and Imatra are slated to stay closed until at least 18 February 2024. The crossing at Raja-Jooseppi will remain open specifically for asylum applications during this period.
Health authorities have reported a very rare case of Bornavirus infection in the Weißenburg-Gunzenhausen district. This exceedingly dangerous and nearly always fatal virus results from direct contact with shrews. Usually, there are 5 or 6 cases diagnosed every year in Bavaria, but this is the first case this year (2023). Infection with this rare virus usually results in meningitis that is often fatal. It may be transmitted to humans through contact with shrews and their body fluids. Public health authorities are warning the public to avoid all contact with shrews.
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Middle East & Asia Pacific
On 26 November, the Bangladesh Nationalist Party and other opposition parties launched their seventh 48-hour nationwide blockade to demand the resignation of the incumbent government and urge fair elections in January 2024. This marks the continuation of a series of blockades, with the first commencing on 31 October. Large-scale demonstrations, limited public transport movement, and severe traffic congestion were reported during previous blockades.
Additionally, there were reports of arson and vandalism at public transportation hubs and on major highways and roads. There is a risk of violent conflict between the local police and party activists. If travelling in high-risk localities in Bangladesh, minimize safety risks by avoiding large public gatherings and protests, as they may become violent unexpectedly. An increased security presence is likely. Expect and prepare for public transportation disruptions. Plan alternate routes and modes of transport to avoid inconvenience.
With approximately 50 new cases of dengue fever diagnosed every day in Tamil Nadu, dengue fever continues to spread. So far this year (2023), a total of almost 6,800 infected people have been reported to health authorities. The risk of exposure will vary from place to place and may be high in many localities where dengue fever carrying mosquitoes are found. The risk of acquiring dengue during travel depends on the destination, season and duration of trip and activities during travel.
Severe dengue and death are relatively rare in general travellers but more frequently in those visiting friends and relatives. Travellers should be aware that where the dengue fever virus is active, there is a possibility in some locations that the chikungunya virus may be present also since it is transmitted by the same mosquito that transmits the dengue virus.
On 20 November, during late afternoon hours (local time), a massive volcanic eruption was reported on Ulawun Volcano, West New Britain Province in Papua New Guinea. A plume of altitude of 15 kilometres (49,000 ft) was produced. The alert level was downgraded from Level 4 to Level 3 on Tuesday. Around 13,000 people were evacuated from Nano, Ubili, Pandi, and the Pata Painave areas near the volcano. On 21 November, flights were cancelled at Hoskins Island Airport after the eruption caused ashfall. Ulawun has been declared one of the Decade Volcanoes, a group of 16 volcanoes selected as deserving of special attention due to their history of massive, devastating eruptions and closeness to human areas.
There are various reports of outbreaks of undiagnosed pneumonia in children in China. Children's hospitals in Beijing, Liaoning and other locations are overwhelmed with sick children. It is not clear when this outbreak began or why so many children were affected so quickly. Only a few adults (mostly teachers exposed in school settings) have been reported.
Infectious agents (viruses, bacteria, others) that cause acute respiratory illnesses like pneumonia are transmitted from person to person by inhaling small airborne respiratory droplets created when infectious persons cough, sneeze or laugh. These agents may be spread by hand-to-hand and hand-to-mouth contact. Maintaining a small distance (at least 1 meter) from a person with a respiratory illness and frequent hand washing will help reduce the risk of exposure. More specific advice is not possible until the infectious agent is identified in this outbreak.
Starting from 1 December, until 30 November 2024, China is introducing a trial visa-free travel initiative for citizens from six countries: France, Germany, Italy, Spain, Malaysia, and the Netherlands, as announced by the Chinese Foreign Ministry. Holders of ordinary passports from these aforementioned countries may enter China for business, tourism, and other personal work for no more than 15 days. Visitors from these countries who fail to meet the visa exemption requirement must obtain a visa before entering China. Travellers are advised to contact their travel agents or the respective embassy prior to airline and accommodation bookings. Plan ahead to avoid inconveniences. Check with the airline for additional information regarding bookings.
On 27 November, many Chinese airlines announced their decision to cancel flights to Thailand due to lower-than-expected bookings. The cancellations will commence from December 2023 and remain in effect until January 2024. Over 5,858 flight operations scheduled for December have been affected. The airlines are: Air China, China Eastern, Shanghai Airlines, Spring Airlines, China Southern, Shenzhen Airlines, Juneyao Airlines, Okay Airways, Hainan Airlines, and Beijing Capital.
Travellers are advised to check with their travel agent or the airline to determine if their travel plans are affected. If impacted by cancellations, know your compensation rights. Reschedule your travel plans or use alternate airlines/modes of transport to minimise inconvenience.
Africa
On 26 November, unidentified gunmen tried to enter the Wilberforce military barracks in Freetown. Sierra Leone's Minister of Information and Civic Education reported that the attack was thwarted. However, following this incident, a nationwide curfew was imposed. A security operation to detain the suspects remains ongoing, particularly in the Wilberforce area. Locals reported gunshots, explosions and firing. The Civil Aviation Authority advised all airlines to suspend operations until the curfew ends.
Flights to and from the country may be cancelled or rescheduled. It is currently unclear when the prohibitory orders will be lifted. To minimize security risks, reschedule your travel plans to Sierra Leone. If travelling, exercise caution. Increased police/military presence is likely. Avoid high-risk areas due to possible armed conflict. Follow local laws during the curfew to avoid fines or legal action. Plan your outings accordingly. Check with your travel agent/airline/airport to determine if your travel plans are affected. If impacted by cancellations, know your compensation rights.Â
A cumulative total of 181 suspected and confirmed cases of West Nile Fever infections were diagnosed in the states of Tozeur, Sfax, Sousse, and Jendouba. Travellers who plan to spend a lot of time outdoors or who will be in areas with a lot of mosquitoes are at increased risk of exposure to West Nile Virus. The risk of exposure for the general traveller is quite low. However, in a small number of infected people, West Nile virus can cause serious neurological illness, including death. Since there is no vaccine or treatment for West Nile fever, travellers to areas where this virus has been found can reduce their risk of exposure by taking all necessary precautions to avoid mosquito bites.
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