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Visa requirements for Indian citizens

Visa requirements for Indian citizens are administrative entry restrictions by the authorities of other states placed on citizens of India . As of 2024, Indian citizens have visa-free or visa on arrival access to 61 countries and territories, ranking the Indian passport 82nd in the world according to the Henley Passport Index . As the index uses dense ranking , in certain cases, a rank is shared by multiple countries because these countries all have the same level of visa-free or visa-on-arrival access. With visa-free entry to 32 countries and visa on arrival facility to 30 countries India is 85 out of 104 in Global Passport Power Rank . The Indian passport has climbed three spots from 85th to 82nd rank in February 2024.Angola has announced a list of 98 countries, including India, whose citizens can travel visa-free for 30 days (w.e.f 29th September 2023). Thailand has announced a 6-month visa-free travel period for Indian citizens from 10 November 2023 to 10 May 2024. Sri Lanka announced free visa for Indians from 1 December 2023 until 31 March 2024. Malaysia announced temporary visa-free travel for Indians from 1 December 2023 until 31 December 2024. Belarus announced visa-free travel for Indians (with EU countries and Schengen area visa holders), provided they are not transiting to or from (including airside) Russia and are arriving at Minsk International Airport . Japan announced in July 2023 that Indian passport-holders who are residing in Brazil, Cambodia, Canada, Saudi Arabia, Singapore, South Africa, Taiwan, UAE, UK, US can apply single entry e-Visa for tourism purposes only. Russia launched a single entry e-Visa for 16 days from the 1st of August 2023. Egypt announced both single and multiple entry e-visas for solo Indian travellers in April 2023. Jordan E-visas can now be obtained at Ministry of Interior E-Services Site . However, nationals of India can still obtain a visa on arrival. Oman announced visa-free entry to Indian citizens for tourism, as of 12 January 2022 for up to 10 days. Afterwards, the period of stay in Oman was changed to 14 days. Albania announced visa-free travel to Indian citizens as of 23 April 2022 which is extended till the end of 2022. They then introduced e-visa applications for Indians. Morocco announced an e-visa to Indian nationals for tourism and business purposes on 1 August 2022. United States announced that all eligible Indian citizens could now participate in the Global Entry program for expedited entry into the USA. Ecuador suddenly imposed visa restrictions on Indian nationals effective 12 August 2019 because of misuse of visa-free travel. Barbados has announced visa-free tourist and business visas for Indian nationals. Kazakhstan first introduced a procedure for obtaining a single-entry visa in electronic format on 1 January 2019. They then announced a 14-day visa-free travel allowance for tourism and business on 7 July 2022. Kazakhstan announced a 14-day visa exemption to Indian nationals for tourism and business purposes on 8 July 2022. Chile introduced a visa on arrival for Indian citizens already in possession of a valid US visa/residency with at least 6 months validity in April 2019. Argentina allowed Indian nationals with a valid US visa with at least 6 months validity to apply for an ETA since March 2019. Jordan announced that all Indian passport bearers became eligible for a visa on arrival, (but only with a valid Schengen , UK , US or Canadian visa) in December 2019, Myanmar has announced visa-on-arrival for Indian tourists entering the country through the international airports of Nay Pyi Taw, Yangon and Mandalay beginning 12 December 2018. Bangladesh and India both agreed to abolish visa application fees for each other's citizens in 2018. Thus Indian passport holders who apply for a Bangladeshi visa in India do not have to pay the visa application fee. Russia announced an e-Visa status for parts of the Russian Far East : Primorye and the rest of Khabarovsk , Sakhalin , Chukotka , and Kamchatka regions in 2018, this was later expanded to include Saint Petersburg in 2020. Vietnam and Uzbekistan in 2018 introduced e-Visa for Indian nationals. Kyrgyzstan introduced online visitor visas in September 2017 (but they send an email after the application requiring a Letter of Invitation from a Tour company which costs at least USD 50), and Armenia in November 2017. Indian citizens already in possession of a valid UK , United States , Canada or Schengen visa became eligible to apply for a visa on arrival to Oman in October 2017, Armenia in November 2017, and Chile (US visa only) in April 2019. Angola has announced a list of 98 countries, including India, whose citizens can travel visa-free for 30 days (w.e.f 29th September 2023). Thailand has announced a 6-month visa-free travel period for Indian citizens from 10 November 2023 to 10 May 2024. Sri Lanka announced free visa for Indians from 1 December 2023 until 31 March 2024. Malaysia announced temporary visa-free travel for Indians from 1 December 2023 until 31 December 2024. Belarus announced visa-free travel for Indians (with EU countries and Schengen area visa holders), provided they are not transiting to or from (including airside) Russia and are arriving at Minsk International Airport . Japan announced in July 2023 that Indian passport-holders who are residing in Brazil, Cambodia, Canada, Saudi Arabia, Singapore, South Africa, Taiwan, UAE, UK, US can apply single entry e-Visa for tourism purposes only. Russia launched a single entry e-Visa for 16 days from the 1st of August 2023. Egypt announced both single and multiple entry e-visas for solo Indian travellers in April 2023. Jordan E-visas can now be obtained at Ministry of Interior E-Services Site . However, nationals of India can still obtain a visa on arrival. Oman announced visa-free entry to Indian citizens for tourism, as of 12 January 2022 for up to 10 days. Afterwards, the period of stay in Oman was changed to 14 days. Albania announced visa-free travel to Indian citizens as of 23 April 2022 which is extended till the end of 2022. They then introduced e-visa applications for Indians. Morocco announced an e-visa to Indian nationals for tourism and business purposes on 1 August 2022. United States announced that all eligible Indian citizens could now participate in the Global Entry program for expedited entry into the USA. Ecuador suddenly imposed visa restrictions on Indian nationals effective 12 August 2019 because of misuse of visa-free travel. Barbados has announced visa-free tourist and business visas for Indian nationals. Kazakhstan first introduced a procedure for obtaining a single-entry visa in electronic format on 1 January 2019. They then announced a 14-day visa-free travel allowance for tourism and business on 7 July 2022. Kazakhstan announced a 14-day visa exemption to Indian nationals for tourism and business purposes on 8 July 2022. Chile introduced a visa on arrival for Indian citizens already in possession of a valid US visa/residency with at least 6 months validity in April 2019. Argentina allowed Indian nationals with a valid US visa with at least 6 months validity to apply for an ETA since March 2019. Jordan announced that all Indian passport bearers became eligible for a visa on arrival, (but only with a valid Schengen , UK , US or Canadian visa) in December 2019, Myanmar has announced visa-on-arrival for Indian tourists entering the country through the international airports of Nay Pyi Taw, Yangon and Mandalay beginning 12 December 2018. Bangladesh and India both agreed to abolish visa application fees for each other's citizens in 2018. Thus Indian passport holders who apply for a Bangladeshi visa in India do not have to pay the visa application fee. Russia announced an e-Visa status for parts of the Russian Far East : Primorye and the rest of Khabarovsk , Sakhalin , Chukotka , and Kamchatka regions in 2018, this was later expanded to include Saint Petersburg in 2020. Vietnam and Uzbekistan in 2018 introduced e-Visa for Indian nationals. Kyrgyzstan introduced online visitor visas in September 2017 (but they send an email after the application requiring a Letter of Invitation from a Tour company which costs at least USD 50), and Armenia in November 2017. Indian citizens already in possession of a valid UK , United States , Canada or Schengen visa became eligible to apply for a visa on arrival to Oman in October 2017, Armenia in November 2017, and Chile (US visa only) in April 2019. Visa fee waived for regular or ordinary Indian passport holders. Visa Exempt for person: (a) having a valid residence permit in one of the Schengen countries, US or UK. (b) having a valid multiple entry Schengen visa and the visa must have been used once in a Schengen area country. (c) holding a 10-year UAE residence permit with a remaining validity of more than one year. (d) holder of a valid multiple-entry US or UK visa, which must have been used once in the country of issuance. Andorra has no visa regime, but is only accessible through France and Spain: a double- or multiple-entry Schengen Visa or a Schengen Area residence permit is required. May obtain visa through the online portal (Online Visitor e600 visa). Transit visa: required, can apply online. USD 26 payable upon arrival at International Airports, and visa kiosks will provide an eVisa. Prior eVisa required for entry via land borders. Passports with Armenian entry stamp are subject to extra security screening subjective to immigration officer. Visa on arrival for all Indian nationals who have valid Schengen, UK, US, and/or Canadian visas. Due to bilateral agreements, Diplomatic Passport and Official Passport holders are eligible for a visa on arrival if entering by air, road or sea but not train. Visa fee waived for regular or ordinary passport holders who apply in India. Permanent residents and holders of multiple entry visa of the US or Canada may obtain a visa on arrival. Holders of a valid visa issued by a Schengen Member state are visa exempt for a maximum stay of 90 days. Must have an international vaccination certificate. National visa may be substituted with a valid multiple-entry visa issued by an EU or Schengen Area member state or the US. National visa may be substituted with a C visa issued by Cyprus, Romania or a Schengen Area member state Tourism/business visas (B1/B2) or Permanent Residents from the United States of America, with at least 6 months of validity, could travel to Chile without visa. hold a passport valid for at least 3 months from the date of entry; arrive by air, cruise ship or train (except for arriving at certain airports listed below); hold confirmed air, cruise ship or train tickets to a third-country final destination. depart mainland China on a flight, cruise ship or train within 24 hours after arrival. The 24-hour transit rule allows multiple stops within mainland China for most airports, as long as the traveler has a flight, cruise or train segment leaving mainland China in 24 hours, so it is possible to enter through a port of entry in China, take multiple segments of domestic flights within China, and depart from a different port of entry in less than 24 hours. Multi-stop transit is not allowed in some airports listed below. Fuzhou Changle International Airport , Huangshan Tunxi International Airport , Mudanjiang Hailang Airport , Shenzhen Bao'an International Airport , Yanji Chaoyangchuan Airport Visa not required if presenting a V.I.P invitation letter. Visa on arrival if a letter ( visa volant ) issued by the Ministry of Interior and Security is presented. National visa may be substituted with a valid visa issued by the US or with a multiple-entry visa issued by Canada or a member state of the European Union. Eligible to travel to Cuba with a tourist card if they also hold a valid visa or a residence permit issued by Canada, the United States, or an EU member state. National visa may be substituted with a double- or multiple-entry C visa issued by Bulgaria, Romania, or a Schengen Area member state. National visa may be substituted with a valid visa issued by Canada, US or any EU member state. Reinstated from May 2023. National visa may be substituted with a valid visa or residence permit issued by US, UK, Japan, Canada, Australia, New Zealand, Israel, South Korea, Ireland, Schengen, and GCC countries, whose holders may be granted visa-free entry for 90 days in any 180 days. Airport transit visa required, except if: (a) Holding valid visa or residence permit issued by the US, Japan, Canada, Ireland, Bulgaria, Romania, Cyprus, or the Schengen Area. (b) Holders of a residence permit in Andorra, Monaco, or San Marino. National visa may be substituted with a valid visa issued by Canada, the US, or a Schengen Area member state. Visa on arrival if holding a letter of invitation from sponsor or host. National visa may be substituted with a valid visa issued by Canada, the US or a Schengen Area member state. 30 days for tourism purposes, IDR 500000 fee. Visa exemption is available only when entering the country by air. People residing in India except those exempted from short-term visa, must apply for a visa at the Japan Visa Application Center. Residents in Brazil, Cambodia, Canada, Saudi Arabia, Singapore, South Africa, Taiwan, UAE, UK, US can apply single entry e-Visa for Tourism purposes only (unless arriving by boat). Visa fee is refunded if any case visa is rejected. Visa fee INR 510 only for Indian citizens. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Can also be entered on an East Africa tourist visa issued by Rwanda or Uganda. National visa may be substituted with a valid visa issued by a Schengen Area member state, UK, Ireland or the US visa. Nationals of India with a normal passport and a valid visa issued by Canada, the US, or a Schengen Member State can obtain a visa on arrival for a maximum stay of 30 days. (fee: USD 10) National visa may be substituted with a valid double- or multiple-entry C visa issued by a Schengen Area member state or by a British, Canadian, or U.S. visa for maximum stay of 15 days. Proof of onward travel required. A visa waiver for a period of 30 days can be granted on arrival given the following conditions: The passenger must have a confirmed return ticket. Passengers must provide a confirmed hotel reservation booked through the Discover Qatar website only for the entire duration of stay subject to minimum of two nights booking. National visa may be substituted with a double- or multiple-entry C visa issued by Bulgaria, Cyprus or a Schengen Area member state valid for the period of intended stay. may enter with East Africa Tourist Visa (USD 100), valid for 90 days and multiple entries in Kenya, Rwanda, and Uganda. No border control but accessible only via Italy; thus, Italian visa rules apply. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. Transit visa required, except if holding a valid visa or residence permit issued by the US, UK, Japan, Canada, Ireland, Schengen Area, Bulgaria, Romania, or Cyprus or a residence permit issued by Andorra, Monaco, or San Marino. e-Visa holders can enter through all border points. Thailand waived the visa from 10 November 2023 to 10 May 2024 for a stay up to 30 days. Visa must be obtained at the first point of entry. Visa fee of THB 2000 is payable upon entry. Passengers transiting through Suvarnabhumi/Don Mueang International Airport for less than 12 hours do not require a visa. Groups of 5 or more individuals booking through a travel agency and traveling to Tunisia for at least five days will be issued a visa on arrival. Letter of invitation issued by a company registered in Turkmenistan and approved by the Ministry of Foreign Affairs can obtain a visa on arrival for a maximum stay of 10 days. They can apply to extend their stay for an additional 10 days. May enter with East Africa Tourist Visa, valid in Rwanda, Uganda, and Kenya for stays of up to 90 days (fee: USD 100) e-Visa must be obtained prior to arrival. Transit visa required. Schengen Visa Required. Entry can be made only from Italy; thus, Italian visa rules apply. e-Visa is valid for 90 days and multiple entry. In November 2023, the authorities in Vietnam has proposed to waive visas for citizens of India. 30 days for visits on business, 3 months for tourists. Curaçao Sint Eustatius Saba Visa not required if holding a valid multiple-entry visa or residence permit issued by Canada, UK, Ireland or US. Visa not required if holding a multiple-entry short-stay Schengen visa, an authorization for temporary stay, or a residence permit of a Schengen country. Visa not required if holding a residence permit of Overseas France. Visa not required if holding a valid multiple-entry visa or residence permit issued by Canada, UK, Ireland or US. Visa not required if holding a multiple-entry short-stay Schengen visa, an authorization for temporary stay, or a residence permit for a Schengen country. Visa not required if holding a residence permit or visa for Saint Martin (French part). Visa not required if holding a residence permit of Overseas France. The visa policy is the same as for Cyprus , which follows the visa policy of the Schengen Area . Curaçao Sint Eustatius Saba Visa not required if holding a valid multiple-entry visa or residence permit issued by Canada, UK, Ireland or US. Visa not required if holding a multiple-entry short-stay Schengen visa, an authorization for temporary stay, or a residence permit of a Schengen country. Visa not required if holding a residence permit of Overseas France. Visa not required if holding a valid multiple-entry visa or residence permit issued by Canada, UK, Ireland or US. Visa not required if holding a multiple-entry short-stay Schengen visa, an authorization for temporary stay, or a residence permit for a Schengen country. Visa not required if holding a residence permit or visa for Saint Martin (French part). Visa not required if holding a residence permit of Overseas France. The visa policy is the same as for Cyprus , which follows the visa policy of the Schengen Area . The Indian Government has not drafted any laws to mandate reciprocity in visa agreements with other countries. While a very small number of bilateral agreements have concluded with reciprocity for visa arrangements, a large number of visa relationships continue to be highly skewed to one side or the other. In 2015, Iran revoked visa-on-arrival for Indian citizens after it was included as one of the eight countries in India's Prior Reference Category, which would be excluded from India's visa liberalisation plans for foreign tourists. The other countries on the list at the time were Pakistan, Afghanistan, Iraq, Somalia, Nigeria and Sudan. India has, by default, achieved full reciprocity in visa-free or e-Visa privileges with following countries or regions: India has achieved partial reciprocity with following countries, where Indian Immigration rules afford the citizens of the following countries slightly lesser visa privileges than what the following countries provide for Indian Citizens:India has, by default, achieved full reciprocity in visa-free or e-Visa privileges with following countries or regions:India has achieved partial reciprocity with following countries, where Indian Immigration rules afford the citizens of the following countries slightly lesser visa privileges than what the following countries provide for Indian Citizens:Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. (This section is under construction, please help update it.) In some instances, a Visa Exemption permits entry in lieu of obtaining a Visa / Entry Visa if in possession of the following Visas or Permanent Relationships; this is not limited to entitlements or provisions laid down by the country's law. For example: Indian citizens holding valid US visa are permitted to enter Mexico on the basis of their US visa, without the need for a Mexican visa. Indian Citizens in possession of a valid United States Multiple Entry Visa in their passport may enter the following country(ies) visa-free: Albania, Argentina (Indian passport holders with a valid US B2 visa can avail an electronic travel authorization for the purposes of tourism), Bermuda, Bolivia, Bahamas, Belarus, Belize, Bosnia and Herzegovina, Chile, Colombia, Cuba, Dominican Republic, Georgia, Guatemala, Honduras, Mexico, Montenegro, Nicaragua, North Macedonia, Oman, Panama, Peru, Philippines, Saudi Arabia, Serbia, South Korea, Turkey (e-Visa), United Arab Emirates. European Union Family Member - Indian Citizens who are traveling with or joining their EU family members in the European Union in a Country other than where their family member is a citizen of does not require a Visa to enter and enjoy the same entry rights and stay, however, this would be difficult to prove and as a result, entry could be refused. Visa should be applied for in advance which is usually with no or minimal requirements to meet if the applicant is a family member of an EU Citizen. For instance, a person who wants to travel with their spouse to France where their spouse is a Citizen of the Republic of Lithuania should apply for a Schengen Visa in advance or where a person wants to join their Lithuanian spouse who resides in France should also apply for a Schengen Visa in order to prove their right and avoid misconception. In most cases, airlines will not permit travel without a visa. There is no time limit a family member can stay (indefinite stay), they must just enter before the Visa expires if joining their family or traveling at the same time. There are no costs involved either. European Union citizens and their Indian family members will need to apply for settled or pre-settled status if they wish continue residing in the UK after 31 December 2020. Settled Status can be granted when the applicant has resided in the UK for 5 years and is valid indefinitely. In order to maintain settled status, people must visit the UK every 5 years. Pre-Settled status is granted when the applicant has resided in the UK for less than 5 years and is valid for 5 years. In order to maintain pre-settled status, people must visit the UK every 2 years. However, applicants would have to meet continuous residence until they reach 5 years if they want to qualify for settled status after 31 December 2020. It will not be possible to be granted another pre-settled Visa. Schengen Visa (Long Stay) - Holders of a Valid Long Stay Category D Visa who arrive in the Schengen European country of their Visa and apply for a Residence Card shortly after arriving will be able to use their EU residence permit / card for travel within the Schengen States, if granted. Visa-free or Visa on Arrival to : Egypt, Georgia, Armenia, Azerbaijan, Uzbekistan, Kyrgyzstan, Oman, Bahrain (GCC residents only, for Bahrain). United Arab Emirates now giving 1 month, 2 months and 3 months visit visas for Indian nationalities. According to the statistics these are the numbers of Indian visitors to various countries in 2017 (unless otherwise noted)

Wiki

Yellow fever

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Supernatural season 4

The fourth season of Supernatural , an American dark fantasy television series created by Eric Kripke , premiered September 18, 2008, and concluded on May 14, 2009, on The CW . This season focuses on brothers Sam ( Jared Padalecki ) and Dean Winchester ( Jensen Ackles ) encountering angels for the first time in their lives as hunters of the supernatural ; this marks the introduction of eventual series regular, the angel Castiel ( Misha Collins ). The angels intervene to rescue Dean from Hell and bring him back to life after he became trapped there in the third season finale " No Rest for the Wicked ". They explain that they have arrived on Earth for the first time in thousands of years in order to prevent the demons from freeing the fallen angel Lucifer from Hell, as Lucifer would then cause the Apocalypse. The demons are led by the Winchesters' enemy, and Dean's murderer, Lilith . However, it becomes increasingly clear that something is wrong with Heaven and that the angels have their own agendas. Despite an initially happy reunion, tension grows between Sam and Dean because Dean fears Sam's growing demonic powers and distrusts Sam's returning demonic ally Ruby ( Genevieve Cortese ).In this table, the number in the first column refers to the episode's number within the entire series, whereas the number in the second column indicates the episode's number within that particular season. "U.S. viewers in millions" refers to how many Americans watched the episode live or on the day of broadcast.The mythology was expanded even more in the fourth season with the introduction of angels. While Kripke originally did not want angels to be featured in the series, he changed his mind when he realized that he needed them in order to have a "cosmic battle" with the many demons. With this concept added into the series' mythology, the writers came to view the show as being "about two greasers and a muscle car, but the canvas that they're on are demons and angels and battles and the apocalypse..." While it was originally intended for the fourth season to feature an "all-out demon war", budget cuts forced the writers to change their plans, making it "smaller, more contained, underground, more guerrilla-style". Kripke feels this ended up benefiting the series, believing the brothers-centric episodes to be more interesting than the "epic" ones of the third season. Thus, the war was depicted in the writers' "scruffy, angsty, Supernatural way" while focusing more on the characters. The writing staff felt that the fourth season's mythology had been the best since the first season. The review aggregator website Rotten Tomatoes reported a 100% approval rating for Supernatural' s fourth season, with an average rating of 8.7/10 based on 8 reviews. The season received critical acclaim and is widely regarded as one of the show's best seasons.

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Visa_policy_of_Sri_Lanka/html

Visa policy of Sri Lanka

Legislature Judiciary Visitors to Sri Lanka must obtain a visa, either on arrival to Sri Lanka or in advance, unless they are a citizen of one of the visa-exempt countries. Most visitors entering for tourism purposes are required to obtain an electronic visa (e-Visa) or a visa on arrival, unless they are exempt from obtaining one. However, citizens of some countries must obtain a visa in advance instead of an e-Visa before being allowed to enter Sri Lanka. All visitors must hold a passport valid for 6 months. On 17 April 2024, Sri Lanka replaced its previous Electronic Travel Authorisation system with a new e-Visa system, operated by VFS Global . However, the new e-Visa system's increased fees were criticised by Sri Lankan opposition leader , who claimed that Russian airline Red Wings Airlines had ceased operating flights to Sri Lanka due in part to the increased visa fees, and warned that the tourism industry could be brought to a "standstill". On the basis of reciprocity, citizens of the following countries do not need a visa to enter Sri Lanka, for stays up to the duration listed below: Alternatively, nationals of visa-exempt countries who instead choose to apply for a "Standard Tourist Visa" online are exempt from paying visa fees. Holders of diplomatic, official, service or special passports of the following countries do not need a visa to enter Sri Lanka, for stays up to the duration listed below: D - Diplomatic passports O - Official passports S - Service passports Sp - Special passports PA - Passports endorsed for "public affairs". 1 - 90 days 2 - 30 days 3 - 60 days, but no more than 90 days within any 1 year-period. 4 - 90 days within any 180-day period. 5 - 30 days within any 60-day period.On the basis of reciprocity, citizens of the following countries do not need a visa to enter Sri Lanka, for stays up to the duration listed below: Alternatively, nationals of visa-exempt countries who instead choose to apply for a "Standard Tourist Visa" online are exempt from paying visa fees. Holders of diplomatic, official, service or special passports of the following countries do not need a visa to enter Sri Lanka, for stays up to the duration listed below: D - Diplomatic passports O - Official passports S - Service passports Sp - Special passports PA - Passports endorsed for "public affairs". 1 - 90 days 2 - 30 days 3 - 60 days, but no more than 90 days within any 1 year-period. 4 - 90 days within any 180-day period. 5 - 30 days within any 60-day period.Citizens of all other countries except the visa-exempt countries and countries whose citizens require a visa in advance may obtain a visa on arrival, valid for a maximum stay of 30 days. Visas obtained on arrival are generally discouraged as such visas are not automatically approved for entry into Sri Lanka. Citizens of the following countries and territories are ineligible to obtain an e-Visa, but may obtain a visa on arrival in Sri Lanka. When obtaining a visa on arrival, they must provide a passport photo and fill in additional paperwork, such as a "Declaration of Identity for Visa Purpose", in order to be granted the visa.Citizens of all other countries except the countries whose citizens either require a visa obtained on arrival or in advance may also obtain an e-Visa online. The types of e-Visas available online are as follows: Tourist Visa - Single Entry for 30 days Tourist Visa - Standard Tourist Visa for 60 days within any 180 days Tourist Visa - Multiple Entry for 1 year Tourist Visa - Multiple Entry for 2 years Tourist Visa - Multiple Entry for 5 years within any 180 days Tourist Visa - Multiple Entry for 10 years within any 180 days Business Visa - Standard Visitor Visa ( SAARC countries) Business Visa - Standard Visitor Visa (Non SAARC countries) Business Visa - Multiple Entry for 1 year Business Visa - Multiple Entry for 2 years Business Visa - Multiple Entry for 5 years Business Visa - Multiple Entry for 10 years Transit Visa - 4 days Transit Gratis - Multiple Entry for 1 year From 24 October 2023 to 30 April 2024, citizens of the following 7 countries are eligible for a gratis e-Visa (single entry) for tourism purposes only, valid for a maximum stay of 30 days. From 24 October 2023 to 30 April 2024, citizens of the following 7 countries are eligible for a gratis e-Visa (single entry) for tourism purposes only, valid for a maximum stay of 30 days. Citizens of the following countries are ineligible to apply for both an e-Visa and a visa on arrival independently, and thus must obtain a visa in advance from one of the Sri Lankan diplomatic missions around the world: When obtaining a visa at a Sri Lankan diplomatic mission, they must present the following documents: Police Clearance report If the applicant is coming from another country after staying for more than 6 months, are required to provide Police clearance from that country and copy of the Visa Certificate from a Sri Lankan guarantor & a photocopy of the guarantors NIC Affidavit from a Sri Lankan JP (Justice of Peace) or a Lawyer Accommodation information (Place of stay)Citizens of the following countries must present a yellow fever vaccination certificate upon arrival in order to enter Sri Lanka: Citizens of the following countries must present a yellow fever vaccination certificate upon arrival in order to enter Sri Lanka: Most visitors arriving in Sri Lanka on a short-term basis were from the following countries:

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Yellow_fever_in_Buenos_Aires/html

Yellow fever in Buenos Aires

The Yellow Fever in Buenos Aires was a series of epidemics that took place in 1852, 1858, 1870 and 1871, the latter being a disaster that killed about 8% of Porteños : in a city where the daily death rate was less than 20, there were days that killed more than 500 people. The Yellow Fever would have come from Asunción , Paraguay , brought by Argentine soldiers returning from the war just fought in that country , having previously spread in the city of Corrientes . As its worst, Buenos Aires population was reduced to a third because of the exodus of those escaping the scourge. Some of the main causes of the spread of this disease were the insufficient supply of drinking water , pollution of ground water by human waste, the warm and humid climate in summer , the overcrowding suffered by the black people and, since 1871, the overcrowding of the European immigrants who entered the country incessantly and without sanitary measures. Also, the saladeros (manufacturing establishments for producing salted and dried meat ) polluted the Matanza River (south of the city limits), and the infected ditches full of debris which ran through the city encouraged the spread of the mosquito Aedes aegypti , which was responsible of transmitting Yellow Fever . A witness to the epidemic of 1871, named Mardoqueo Navarro, wrote on April 13 the following description in his diary: Businesses closed, streets deserted, a shortage of doctors, corpses without assistance, everyone flees if they can...Since 1881, thanks to Cuban physician Carlos Finlay , it was known that the transmitting agent of Yellow Fever was mosquito Aedes aegypti . Before that discovery, doctors attributed the cause of many epidemics to what they called " miasmas " floating in the air. [ citation needed ] Yellow Fever (or "black vomit", as it was called due to bleeding that occurs in the gastrointestinal) caused an epidemic in Buenos Aires in 1852. However, by a note addressed to practitioner Soler is known that outbreaks occurred even before that year. As for the 1870 epidemic, it would come from Brazil from merchant ship and caused 100 deaths. At the end of 1870 there were large numbers of invalids registered in Asunción , whose populace lived in deplorable poverty. The Paraguayan War had just finished there and the Argentinian intervention began in early 1871, causing the Buenos Aires epidemic by the arrival of the first Argentinian veterans. [ citation needed ] Also, in the city of Corrientes, with a population of 11,000 and the centre of communication and provision for the allied troops between December 1870 and June of the following year, 2000 people died of yellow fever. Most of the population fled. Other towns in the Corrientes Province suffered the punishment of the disease, such as San Luis del Palmar , Bella Vista and San Roque. [ citation needed ] In 1871 the National Government convened in Buenos Aires, presided over by Domingo Faustino Sarmiento , with Buenos Aires Province represented by Emilio Castro , and Narciso Martínez de Hoz presided over the municipal government. [ citation needed ] The city, situated in a plain, had no drainage system nor running water. Hygiene was very precarious and there were many focuses of infection, such as the slums which lacked basic hygiene standards and were crammed with poor black or European immigrants, and the creeks, south of the city limits, which had become a sink for sewage and waste dumped by salting and slaughterhouses along their coasts. As it had no sewerage system, human waste collected in cesspools, which contaminated the ground water and hence the wells, one of the two major sources of the vital element for the majority of the populace. The other source was the Río de la Plata , from which they extracted water by carts, with no process of sanitisation. [ citation needed ] The filth and waste were used for levelling the terrain and streets in a city growing rapidly, mainly due to the influx of migrants. The streets were very narrow and there were no avenues (the first to be constructed was the Avenida de Mayo, which opened in 1894). There were few plazas and almost no vegetation. [ citation needed ] The first census of Argentina in 1869 registered 177,787 inhabitants in the City of Buenos Aires, of which 88,126 were foreigners, and of those 44,233 were Italian and 14,609 were Spanish. In addition there were over 19,000 urban dwellings, of which 2300 were made of wood or clay and straw. [ citation needed ] In addition to the epidemic of yellow fever that we have mentioned, there were outbreaks of cholera in 1867 and 1868, which killed hundreds of people. [ citation needed ] On 27 January 1871, three cases of yellow fever were diagnosed in Buenos Aires. They were all in the San Telmo neighbourhood, which is full of tenements. From this date on, many more cases were registered, mostly in that neighbourhood. The doctors Tamini, Salvador Larrosa and Montes de Oca warned the City Commission of the outbreak of an epidemic. But the commission, under the leadership of Narciso Martínez de Hoz, disregarded their warnings and failed to publicise the cases. The controversy grew and was reported by the newspapers. [ citation needed ] Meanwhile, the Municipality intensified preparations for the official carnival festivities. At the end of February, the doctor Eduardo Wilde said there was an outbreak of the fever (with 10 cases registered on 22 February) and he left some apples, but the people were too entertained by the carnival festivities to listen to his warning. [ citation needed ] By the end of February at total of 300 cases had been registered, and March began with over 40 deaths a day, rising to 100 by day 6. All were caused by the fever. By now, the plague was hitting the aristocratic neighbourhoods too. Dances were prohibited. A third of the inhabitants decided to abandon the city. On 4 March, the Tribune newspaper commented that by night the streets were so dark "it truly appeared as if the terrible scourge had swept away all the residents" . Yet the worst by far was to come. The General Men's Hospital, the General Women's Hospital, the Hospital Italiano and the orphanage were all overwhelmed. So they created other emergency centres such as the Lazareto de San Roque (the Hospital Ramos Mejía today) and others were rented privately. [ citation needed ] The port was quarantined and the provinces closed their borders to people or goods coming from Buenos Aires. [ citation needed ] The municipality was unable to endure the situation, so on 13 March, thanks to a newspaper campaign started by one Evaristo Carriego (although not Evaristo Carriego , the journalist and poet, as he was not born until 12 years later), thousands of neighbours congregated in the Plaza de la Victoria ( Plaza de Mayo today) to design a People's Commission of public health. On the following day, it was decided that the lawyer José Roque Pérez should be its president, with the journalist Héctor F. Varela as his deputy. Other members included the national Vice President Adolfo Alsina , Adolfo Argerich, the poet Carlos Guido y Spano , Bartolomé Mitre , the canon Domingo César and the Irish-born priest Patricio Dillon who died in the epidemic and was named Carriego, who affirmed that "Even when so many are fleeing, that there are even some who stay in this place of danger to help those who cannot get regular assistance." Among other things, the commission's function was to take charge of the streets and those who lived in places affected by the plague, and in some cases was sent to burn their belongings. The situation was more tragic when those evicted were humble immigrants unable to speak much Spanish, and were therefore unable to understand why such measures were being taken. The Italians, who were the majority of the foreigners, were in parts unjustly accused by the rest of the population of having brought the plague from Europe. Around 5,000 of them applied to the Italian consul to return, but the quotas were very small, and many of those who embarked died offshore. As for the black population, they lived in miserable conditions which resulted in them being hit harder by the plague. Also, it is said that the army surrounded the zones where they lived and did not permit any movement into Barrio Norte, where the whites were trying to escape the epidemic. They died in huge numbers and were buried in mass graves. By the middle of the month there were more than 150 deaths per day, rising to 200 by 20 March. Among the dead were Luis J. de la Peña, teacher and former minister of Justo José de Urquiza , the former Deputy Juan Agustín García, the doctor Ventura Bosch, and the painter Franklin Rawson . Others who died were the doctors Francisco Javier Muñiz , Carlos Keen, Adolfo Argerich and, on 24 March, the aforementioned president of the People's Commission José Roque Pérez, who had written his will upon taking office because of the certainty of catching the plague and dying. The president Sarmiento and his deputy, Adolfo Alsina, abandoned the city. As the national and provincial authorities fled the city, the secular and regular clergy remained in their posts and conformed to their evangelical mandate, to help the sick and dying in their homes, and the Sisters of Charity stopped their teaching in order to work in the hospitals instead, although this was hushed up by the anticlerical writers of the time. However the fact is highlighted by Mardoqueo Navarro in his diary, that it was as the Sephardic Mosaic cult had taught. Of the 292 city priests, 22% died, compared to the 12 doctors, 2 practitioners, 4 members of the People's Commission and 22 members of the Council for Public Hygiene, as given by Jorge Ignacio García Cuerva in his writing. There is only one plaque on the Parque Florentina Ameghino Monument which records the victims buried there, listing 21 with the title priest and 2 titled Sister of Charity . The Order of Sisters of Charity added reinforcements from France to help with the emergency, and also others from their congregations. The fever took 7 of these nuns. [ citation needed ] Their parishioners were the doctors, the affected people and the workers of the People's Parish Commission. Municipal regulations obliged the priests to issue grave licences and medical certificates in addition to their evangelical work. As Ruiz Moreno points out in The historical plague of 1871 , the priests weren't let off. The city only had 40 funeral carriages so coffins were piled up in corners waiting for the carriages to pick them up as they travelled along their fixed routes. Due to the huge demand, they added the Plaza carriages, who charged excessively. There was the same problem with daily prices of medicines, which in reality weren't much help for relieving the symptoms. Each day there were more deaths, including the carpenters, so they stopped making coffins from wood and started wrapping the corpses in drapes instead. For the rest, the garbage carts were called into funeral service and they began using mass graves. [ citation needed ] Looting and assaults on citizens increased. There were even cases where thieves disguised themselves as invalids, to gain entrance to hospitals. They formed Commission No. 14, under Comisario Lisandro Suárez, to combat the incessant criminal activity. They patrolled the streets day and night, padlocking the street doors of the San Telmo houses abandoned in a rush by their owners, and the keys were delivered to the Chief of Police. In the South Cemetery, situated at the entrance to what is now Parque Ameghino in the Avenida Caseros, the capacity of 2,300 was overwhelmed. So the municipal government acquired seven hectares in the Chacarita de los Colegiales where the Parque Los Andes is today, which has been La Chacarita Cemetery since 1886. On 4 April 400 invalids died, and the administrator of that cemetery informed the members of the People's Commission that they had 630 corpses without graves, with others being found by the wayside, and 12 of their gravediggers had died. Then the knights Hector Varela, Carlos Guido Spano, and Manuel Bilbao among others took the decision to officiate at burials and rescued anyone from the mass graves who still showed signs of life, including a richly-dressed French lady. On 9–11 April over 500 deaths were registered daily, reaching the peak of the epidemic on 10 April with 583 deaths, compared to the normal rate before the epidemic of around 20 deaths per day. [ citation needed ] The Buenos Aires Western Railway extended a line from the Avenida Corrientes down to the cemetery and started running a train for the dead, with two journeys a day solely for transporting the dead. The track started at the station Bermejo , located in the southwest corner of the street of the same name ( Jean Jaurés today) where it joined the avenue. There were two other corpse pick-up points in addition to the one at Bermejo. These were at the southwest corner of Corrintes with Medrano, and the southeast corner of Corrientes with Scalabrini Ortiz (now called Camino Minisro Inglés). The authorities who had not abandoned the city provided railway wagons as emergency living quarters in what is now Greater Buenos Aires and offered people free tickets to get out there. The People's Commission recommended that people should leave as soon as possible . On the aforementioned date of peak death, 10 April, the National and Provincial government decreed a holiday until the end of the month, which in reality was no more than official recognition of what was actually happening. Then the count began to descend, perhaps helped by the first frosts of winter, falling to 89, but at the end of the month there was a new peak of 161, probably caused by the return of some people from the earlier evacuation. This in turn led to a new flight. The month ended with a total of 8,000 deaths. The deaths reduced during May, and by the middle of that month the city had returned to normal activity, and by the 20th the Commission ended their activity. On 2 June, there wasn't a single case registered. [ citation needed ] The scourge of black vomit never returned to the city. [ citation needed ] In total, 60 priests, 12 doctors (including some with a distinguished career such as Manuel Argerich and Francisco Javier Muñiz ), 22 members of the Commission of Hygiene and 4 of the People's Commission gave their lives for their citizens. [ citation needed ] It's difficult to establish the precise number of deaths caused by the fever, but it's fairly certain to be between 13,500 and 26,200. The count considered as official is the one given by the Revista Médico Quirúrgica by the Bonaerense Medical Association who said there had been 13,641 deaths. They in turn had taken the figure from Mardoqueo Navarro, a witness to the tragedy who wrote it in his personal diary. His account was used by the historian Miguel Ángel Scenna . Mardoqueo also counted the nationalities of the dead: 3,397 Argentinians, 6,201 Italians, 1,608 Spanish, 1,384 French, 220 English, 233 Germans, 571 unidentified. According to Dr Penna, who collated the registers of the cemeteries (including those from Parque Ameghino, where there were graves of 11,000 people), the correct figure is 14,467. The English newspaper The Standard published a count of 26,000 dead, which is considered an exaggeration and provoked indignation. Many historians consider that this epidemic was one of the main causes of the reduction of the Black population in Buenos Aires, because they mostly lived in the miserable conditions in the south of the city. [ citation needed ] Many lawsuits began, related to wills suspected of being forged by criminals looking to make their fortune at the expense of the true heirs. Other cases involved the abandoned houses that thieves had broken into. [ citation needed ] The flight of the population caused the failure of most public and private establishments. On 21 June the first Order of Argentinian Knights was founded, called the Iron Cross of the Knights of the Order of Martyrs , and was awarded to those who had helped the victims of the plague. Awareness grew of the urgency of establishing a solution to the problem of obtaining and distributing water clean enough to drink. In 1869, the English engineer John F. La Trobe Bateman had presented a project of running water, sewers and drains, which enhanced a previous proposal of the engineer John Coghlan . These were put into practice and in 1874 Batement started construction of the network, which by 1880 provided water to a quarter of the city. In 1873 he started construction of the sewage works. In 1875, the collection of waste was centralised with the creation of rubbish dumps. Until then, most people had just thrown all their waste into ditches and streams. [ citation needed ] Juan Manuel Blanes , the Uruguayan painter who lived in Buenos Aires, painted an oil on canvas (currently in Montevideo ) called The Episode of the Yellow Fever , reproduced in this article, inspired by one done during the tragedy, probably on 17 March 1871 in Balcarce Street. In it we see a woman (Ana Bristani), dead of the fever, lying across the floor of a tenement. Her son, a baby of a few months, searches for his mother's breast. His father's corpse lies on a bed on the right. The door is open and through it you can see the doctors Roque Pérez (centre) and Manuel Argerich (on the right) entering the room. They were members of the People's Commission who themselves died of the fever. The famous picture became an emotional tribute to those who gave their own lives trying to save those of their citizens. [ citation needed ] Guillermo Enrique Hudson , the naturalist and writer born in Argentina, wrote a story in 1888 called "Ralph Herne", which goes through the epidemic of 1871. In it he relates the following description: ...But the years of peace and prosperity did not delete the memory of that terrible period when during three long months the shadow of the Angel of Death extended over the city of the nice name, when the daily harvest of victims were thrown together—old and young, rich and poor, virtuous and villains—to mix their bones in a communal grave, when each day the echo of footsteps interrupted the silence less often, when like the past the streets became "desolate and grassy". In 1884, fearing the appearance of a new outbreak, the doctors José María Ramos Mejía , director of public assistance, and José Penna, director of the Casa de Aislamiento (now the Hospital Muñiz ), decided to cremate the body of a Pedro Doime, who had been affected by the yellow fever. That was the first cremation to take place in Buenos Aires. Only one monument, erected in 1899, exists today in the city to commemorate the victims of the worst tragedy, in terms of number of victims, to hit Buenos Aires. It is situated in what was the South Cemetery, which as we have said is now Ameghino Park, in the place where the cemetery administration took place. One of the inscriptions there reads: The people of Buenos Aires who fell victim due to the yellow fever epidemic of 1871.At the end of 1870 there were large numbers of invalids registered in Asunción , whose populace lived in deplorable poverty. The Paraguayan War had just finished there and the Argentinian intervention began in early 1871, causing the Buenos Aires epidemic by the arrival of the first Argentinian veterans. [ citation needed ] Also, in the city of Corrientes, with a population of 11,000 and the centre of communication and provision for the allied troops between December 1870 and June of the following year, 2000 people died of yellow fever. Most of the population fled. Other towns in the Corrientes Province suffered the punishment of the disease, such as San Luis del Palmar , Bella Vista and San Roque. [ citation needed ] In 1871 the National Government convened in Buenos Aires, presided over by Domingo Faustino Sarmiento , with Buenos Aires Province represented by Emilio Castro , and Narciso Martínez de Hoz presided over the municipal government. [ citation needed ] The city, situated in a plain, had no drainage system nor running water. Hygiene was very precarious and there were many focuses of infection, such as the slums which lacked basic hygiene standards and were crammed with poor black or European immigrants, and the creeks, south of the city limits, which had become a sink for sewage and waste dumped by salting and slaughterhouses along their coasts. As it had no sewerage system, human waste collected in cesspools, which contaminated the ground water and hence the wells, one of the two major sources of the vital element for the majority of the populace. The other source was the Río de la Plata , from which they extracted water by carts, with no process of sanitisation. [ citation needed ] The filth and waste were used for levelling the terrain and streets in a city growing rapidly, mainly due to the influx of migrants. The streets were very narrow and there were no avenues (the first to be constructed was the Avenida de Mayo, which opened in 1894). There were few plazas and almost no vegetation. [ citation needed ] The first census of Argentina in 1869 registered 177,787 inhabitants in the City of Buenos Aires, of which 88,126 were foreigners, and of those 44,233 were Italian and 14,609 were Spanish. In addition there were over 19,000 urban dwellings, of which 2300 were made of wood or clay and straw. [ citation needed ] In addition to the epidemic of yellow fever that we have mentioned, there were outbreaks of cholera in 1867 and 1868, which killed hundreds of people. [ citation needed ]On 27 January 1871, three cases of yellow fever were diagnosed in Buenos Aires. They were all in the San Telmo neighbourhood, which is full of tenements. From this date on, many more cases were registered, mostly in that neighbourhood. The doctors Tamini, Salvador Larrosa and Montes de Oca warned the City Commission of the outbreak of an epidemic. But the commission, under the leadership of Narciso Martínez de Hoz, disregarded their warnings and failed to publicise the cases. The controversy grew and was reported by the newspapers. [ citation needed ] Meanwhile, the Municipality intensified preparations for the official carnival festivities. At the end of February, the doctor Eduardo Wilde said there was an outbreak of the fever (with 10 cases registered on 22 February) and he left some apples, but the people were too entertained by the carnival festivities to listen to his warning. [ citation needed ] By the end of February at total of 300 cases had been registered, and March began with over 40 deaths a day, rising to 100 by day 6. All were caused by the fever. By now, the plague was hitting the aristocratic neighbourhoods too. Dances were prohibited. A third of the inhabitants decided to abandon the city. On 4 March, the Tribune newspaper commented that by night the streets were so dark "it truly appeared as if the terrible scourge had swept away all the residents" . Yet the worst by far was to come. The General Men's Hospital, the General Women's Hospital, the Hospital Italiano and the orphanage were all overwhelmed. So they created other emergency centres such as the Lazareto de San Roque (the Hospital Ramos Mejía today) and others were rented privately. [ citation needed ] The port was quarantined and the provinces closed their borders to people or goods coming from Buenos Aires. [ citation needed ] The municipality was unable to endure the situation, so on 13 March, thanks to a newspaper campaign started by one Evaristo Carriego (although not Evaristo Carriego , the journalist and poet, as he was not born until 12 years later), thousands of neighbours congregated in the Plaza de la Victoria ( Plaza de Mayo today) to design a People's Commission of public health. On the following day, it was decided that the lawyer José Roque Pérez should be its president, with the journalist Héctor F. Varela as his deputy. Other members included the national Vice President Adolfo Alsina , Adolfo Argerich, the poet Carlos Guido y Spano , Bartolomé Mitre , the canon Domingo César and the Irish-born priest Patricio Dillon who died in the epidemic and was named Carriego, who affirmed that "Even when so many are fleeing, that there are even some who stay in this place of danger to help those who cannot get regular assistance." Among other things, the commission's function was to take charge of the streets and those who lived in places affected by the plague, and in some cases was sent to burn their belongings. The situation was more tragic when those evicted were humble immigrants unable to speak much Spanish, and were therefore unable to understand why such measures were being taken. The Italians, who were the majority of the foreigners, were in parts unjustly accused by the rest of the population of having brought the plague from Europe. Around 5,000 of them applied to the Italian consul to return, but the quotas were very small, and many of those who embarked died offshore. As for the black population, they lived in miserable conditions which resulted in them being hit harder by the plague. Also, it is said that the army surrounded the zones where they lived and did not permit any movement into Barrio Norte, where the whites were trying to escape the epidemic. They died in huge numbers and were buried in mass graves. By the middle of the month there were more than 150 deaths per day, rising to 200 by 20 March. Among the dead were Luis J. de la Peña, teacher and former minister of Justo José de Urquiza , the former Deputy Juan Agustín García, the doctor Ventura Bosch, and the painter Franklin Rawson . Others who died were the doctors Francisco Javier Muñiz , Carlos Keen, Adolfo Argerich and, on 24 March, the aforementioned president of the People's Commission José Roque Pérez, who had written his will upon taking office because of the certainty of catching the plague and dying. The president Sarmiento and his deputy, Adolfo Alsina, abandoned the city. As the national and provincial authorities fled the city, the secular and regular clergy remained in their posts and conformed to their evangelical mandate, to help the sick and dying in their homes, and the Sisters of Charity stopped their teaching in order to work in the hospitals instead, although this was hushed up by the anticlerical writers of the time. However the fact is highlighted by Mardoqueo Navarro in his diary, that it was as the Sephardic Mosaic cult had taught. Of the 292 city priests, 22% died, compared to the 12 doctors, 2 practitioners, 4 members of the People's Commission and 22 members of the Council for Public Hygiene, as given by Jorge Ignacio García Cuerva in his writing. There is only one plaque on the Parque Florentina Ameghino Monument which records the victims buried there, listing 21 with the title priest and 2 titled Sister of Charity . The Order of Sisters of Charity added reinforcements from France to help with the emergency, and also others from their congregations. The fever took 7 of these nuns. [ citation needed ] Their parishioners were the doctors, the affected people and the workers of the People's Parish Commission. Municipal regulations obliged the priests to issue grave licences and medical certificates in addition to their evangelical work. As Ruiz Moreno points out in The historical plague of 1871 , the priests weren't let off. The city only had 40 funeral carriages so coffins were piled up in corners waiting for the carriages to pick them up as they travelled along their fixed routes. Due to the huge demand, they added the Plaza carriages, who charged excessively. There was the same problem with daily prices of medicines, which in reality weren't much help for relieving the symptoms. Each day there were more deaths, including the carpenters, so they stopped making coffins from wood and started wrapping the corpses in drapes instead. For the rest, the garbage carts were called into funeral service and they began using mass graves. [ citation needed ] Looting and assaults on citizens increased. There were even cases where thieves disguised themselves as invalids, to gain entrance to hospitals. They formed Commission No. 14, under Comisario Lisandro Suárez, to combat the incessant criminal activity. They patrolled the streets day and night, padlocking the street doors of the San Telmo houses abandoned in a rush by their owners, and the keys were delivered to the Chief of Police. In the South Cemetery, situated at the entrance to what is now Parque Ameghino in the Avenida Caseros, the capacity of 2,300 was overwhelmed. So the municipal government acquired seven hectares in the Chacarita de los Colegiales where the Parque Los Andes is today, which has been La Chacarita Cemetery since 1886. On 4 April 400 invalids died, and the administrator of that cemetery informed the members of the People's Commission that they had 630 corpses without graves, with others being found by the wayside, and 12 of their gravediggers had died. Then the knights Hector Varela, Carlos Guido Spano, and Manuel Bilbao among others took the decision to officiate at burials and rescued anyone from the mass graves who still showed signs of life, including a richly-dressed French lady. On 9–11 April over 500 deaths were registered daily, reaching the peak of the epidemic on 10 April with 583 deaths, compared to the normal rate before the epidemic of around 20 deaths per day. [ citation needed ] The Buenos Aires Western Railway extended a line from the Avenida Corrientes down to the cemetery and started running a train for the dead, with two journeys a day solely for transporting the dead. The track started at the station Bermejo , located in the southwest corner of the street of the same name ( Jean Jaurés today) where it joined the avenue. There were two other corpse pick-up points in addition to the one at Bermejo. These were at the southwest corner of Corrintes with Medrano, and the southeast corner of Corrientes with Scalabrini Ortiz (now called Camino Minisro Inglés). The authorities who had not abandoned the city provided railway wagons as emergency living quarters in what is now Greater Buenos Aires and offered people free tickets to get out there. The People's Commission recommended that people should leave as soon as possible . On the aforementioned date of peak death, 10 April, the National and Provincial government decreed a holiday until the end of the month, which in reality was no more than official recognition of what was actually happening. Then the count began to descend, perhaps helped by the first frosts of winter, falling to 89, but at the end of the month there was a new peak of 161, probably caused by the return of some people from the earlier evacuation. This in turn led to a new flight. The month ended with a total of 8,000 deaths. The deaths reduced during May, and by the middle of that month the city had returned to normal activity, and by the 20th the Commission ended their activity. On 2 June, there wasn't a single case registered. [ citation needed ] The scourge of black vomit never returned to the city. [ citation needed ]In total, 60 priests, 12 doctors (including some with a distinguished career such as Manuel Argerich and Francisco Javier Muñiz ), 22 members of the Commission of Hygiene and 4 of the People's Commission gave their lives for their citizens. [ citation needed ] It's difficult to establish the precise number of deaths caused by the fever, but it's fairly certain to be between 13,500 and 26,200. The count considered as official is the one given by the Revista Médico Quirúrgica by the Bonaerense Medical Association who said there had been 13,641 deaths. They in turn had taken the figure from Mardoqueo Navarro, a witness to the tragedy who wrote it in his personal diary. His account was used by the historian Miguel Ángel Scenna . Mardoqueo also counted the nationalities of the dead: 3,397 Argentinians, 6,201 Italians, 1,608 Spanish, 1,384 French, 220 English, 233 Germans, 571 unidentified. According to Dr Penna, who collated the registers of the cemeteries (including those from Parque Ameghino, where there were graves of 11,000 people), the correct figure is 14,467. The English newspaper The Standard published a count of 26,000 dead, which is considered an exaggeration and provoked indignation. Many historians consider that this epidemic was one of the main causes of the reduction of the Black population in Buenos Aires, because they mostly lived in the miserable conditions in the south of the city. [ citation needed ] Many lawsuits began, related to wills suspected of being forged by criminals looking to make their fortune at the expense of the true heirs. Other cases involved the abandoned houses that thieves had broken into. [ citation needed ] The flight of the population caused the failure of most public and private establishments. On 21 June the first Order of Argentinian Knights was founded, called the Iron Cross of the Knights of the Order of Martyrs , and was awarded to those who had helped the victims of the plague. Awareness grew of the urgency of establishing a solution to the problem of obtaining and distributing water clean enough to drink. In 1869, the English engineer John F. La Trobe Bateman had presented a project of running water, sewers and drains, which enhanced a previous proposal of the engineer John Coghlan . These were put into practice and in 1874 Batement started construction of the network, which by 1880 provided water to a quarter of the city. In 1873 he started construction of the sewage works. In 1875, the collection of waste was centralised with the creation of rubbish dumps. Until then, most people had just thrown all their waste into ditches and streams. [ citation needed ] Juan Manuel Blanes , the Uruguayan painter who lived in Buenos Aires, painted an oil on canvas (currently in Montevideo ) called The Episode of the Yellow Fever , reproduced in this article, inspired by one done during the tragedy, probably on 17 March 1871 in Balcarce Street. In it we see a woman (Ana Bristani), dead of the fever, lying across the floor of a tenement. Her son, a baby of a few months, searches for his mother's breast. His father's corpse lies on a bed on the right. The door is open and through it you can see the doctors Roque Pérez (centre) and Manuel Argerich (on the right) entering the room. They were members of the People's Commission who themselves died of the fever. The famous picture became an emotional tribute to those who gave their own lives trying to save those of their citizens. [ citation needed ] Guillermo Enrique Hudson , the naturalist and writer born in Argentina, wrote a story in 1888 called "Ralph Herne", which goes through the epidemic of 1871. In it he relates the following description: ...But the years of peace and prosperity did not delete the memory of that terrible period when during three long months the shadow of the Angel of Death extended over the city of the nice name, when the daily harvest of victims were thrown together—old and young, rich and poor, virtuous and villains—to mix their bones in a communal grave, when each day the echo of footsteps interrupted the silence less often, when like the past the streets became "desolate and grassy". In 1884, fearing the appearance of a new outbreak, the doctors José María Ramos Mejía , director of public assistance, and José Penna, director of the Casa de Aislamiento (now the Hospital Muñiz ), decided to cremate the body of a Pedro Doime, who had been affected by the yellow fever. That was the first cremation to take place in Buenos Aires. Only one monument, erected in 1899, exists today in the city to commemorate the victims of the worst tragedy, in terms of number of victims, to hit Buenos Aires. It is situated in what was the South Cemetery, which as we have said is now Ameghino Park, in the place where the cemetery administration took place. One of the inscriptions there reads: The people of Buenos Aires who fell victim due to the yellow fever epidemic of 1871.Notable people who died during the epidemic were: [ citation needed ]

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Yellow fever

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Visa requirements for Canadian citizens

Visa requirements for Canadian citizens are administrative entry restrictions by the authorities of other states placed on citizens of Canada. As of 2024, Canadian citizens had visa-free or visa on arrival access to 188 countries and territories, ranking the Canadian passport 7th in the world according to the Henley Passport Index . The following table indicates the entry requirements and duration of stay for a given country, along with any notes that may be relevant for that given country. 90 days on each visit in 12-month period. Canadian Passport Holders may enter using Smartgate system . Must have an international vaccination certificate. 90 days within any 6-month period. Visa is also obtainable online. 72-hour visit without a visa when in transit at Changsha, Chengdu, Chongqing, Guangzhou, Guilin, Harbin, Kunming, Qingdao, Wuhan, Xi'an and Xiamen. 144-hour visit without a visa when in transit through Beijing Capital International Airport, Dalian, Hangzhou, Shijiazhuang Zhengding International Airport in Hebei, Nanjing, Shanghai Hongqiao International Airport and Shanghai Pudong International Airport, Shanghai Railway Station and the Port of Shanghai; Shenyang and Tianjin Binhai International Airport Visas for Canadian citizens are valid for up to 9 years and 11 months . Extendable up to 180-days stay within a one-year period. 256,000 Colombian Pesos (equivalent to CAD$85) must be paid upon arrival. Passengers older than 79 years or younger than 14 years are exempt. Tourist card is generally included in airfare, with most Canadians unaware that they need a tourist visa for Cuba due to the tourist card being handed out on flights, but it can also be purchased from the airline transporting the passenger into Cuba and must be obtained before taking a flight that will land in Cuba. Tourist card is valid up to 90 days stay for Canadian citizens. Visa on arrival if holding proof of valid or expired Egyptian nationality. May enter on an ID card if not departing from the United States. Beginning on 1 December 2020, all travellers to Grenada will be required to complete an online application in order to receive a Pure Safe Travel Authorization Certificate to enter Grenada. 30 day VOA (IDR 500,000) renewable a maximum of once for 30 days. Canadian citizens can now obtain a visa on arrival at Iraq's airports, land and sea crossings for 60 days, for a fee of USD 75. The Canadian government advises its citizens not to visit Iraq due to the volatile security situation. 90 days (business), 6 months (tourist) Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Can also be entered on an East Africa tourist visa issued by Rwanda or Uganda. May not exceed 90 days within any given 12 months period. Extendable stay. Actual permitted duration of stay is decided on arrival by border agents, and is often shorter than 180 days 90 days within any 180-day period. 90 days within any 180-day period. Monaco does not have a visa policy of its own and the Schengen visa policy applies. Travelers must register on the e-Visa platform at least 48 hours prior to travel and pay a processing fee of 650 MT. Extendable stay by twice only with a fee. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. 3 months with any year period. Obtainable online. Printed visa authorization must be presented at the time of travel. The Canadian government advises its citizens not to visit South Sudan due to armed conflicts, inter-ethnic violence and high levels of violent crime. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). e-Visa also available. e-Visa holders can enter through all border points. Maximum two visits annually if not arriving by air. 90 days within any 180-day period. e-Visa is valid for 90 days and multiple entry. Also eligible for a universal visa allowing access to Zimbabwe. Also eligible for a universal visa allowing access to Zambia. Visa requirements for Canadian citizens for visits to various territories, disputed areas, partially recognized countries, and restricted zones:The following table indicates the entry requirements and duration of stay for a given country, along with any notes that may be relevant for that given country. 90 days on each visit in 12-month period. Canadian Passport Holders may enter using Smartgate system . Must have an international vaccination certificate. 90 days within any 6-month period. Visa is also obtainable online. 72-hour visit without a visa when in transit at Changsha, Chengdu, Chongqing, Guangzhou, Guilin, Harbin, Kunming, Qingdao, Wuhan, Xi'an and Xiamen. 144-hour visit without a visa when in transit through Beijing Capital International Airport, Dalian, Hangzhou, Shijiazhuang Zhengding International Airport in Hebei, Nanjing, Shanghai Hongqiao International Airport and Shanghai Pudong International Airport, Shanghai Railway Station and the Port of Shanghai; Shenyang and Tianjin Binhai International Airport Visas for Canadian citizens are valid for up to 9 years and 11 months . Extendable up to 180-days stay within a one-year period. 256,000 Colombian Pesos (equivalent to CAD$85) must be paid upon arrival. Passengers older than 79 years or younger than 14 years are exempt. Tourist card is generally included in airfare, with most Canadians unaware that they need a tourist visa for Cuba due to the tourist card being handed out on flights, but it can also be purchased from the airline transporting the passenger into Cuba and must be obtained before taking a flight that will land in Cuba. Tourist card is valid up to 90 days stay for Canadian citizens. Visa on arrival if holding proof of valid or expired Egyptian nationality. May enter on an ID card if not departing from the United States. Beginning on 1 December 2020, all travellers to Grenada will be required to complete an online application in order to receive a Pure Safe Travel Authorization Certificate to enter Grenada. 30 day VOA (IDR 500,000) renewable a maximum of once for 30 days. Canadian citizens can now obtain a visa on arrival at Iraq's airports, land and sea crossings for 60 days, for a fee of USD 75. The Canadian government advises its citizens not to visit Iraq due to the volatile security situation. 90 days (business), 6 months (tourist) Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Can also be entered on an East Africa tourist visa issued by Rwanda or Uganda. May not exceed 90 days within any given 12 months period. Extendable stay. Actual permitted duration of stay is decided on arrival by border agents, and is often shorter than 180 days 90 days within any 180-day period. 90 days within any 180-day period. Monaco does not have a visa policy of its own and the Schengen visa policy applies. Travelers must register on the e-Visa platform at least 48 hours prior to travel and pay a processing fee of 650 MT. Extendable stay by twice only with a fee. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. 3 months with any year period. Obtainable online. Printed visa authorization must be presented at the time of travel. The Canadian government advises its citizens not to visit South Sudan due to armed conflicts, inter-ethnic violence and high levels of violent crime. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). e-Visa also available. e-Visa holders can enter through all border points. Maximum two visits annually if not arriving by air. 90 days within any 180-day period. e-Visa is valid for 90 days and multiple entry. Also eligible for a universal visa allowing access to Zimbabwe. Also eligible for a universal visa allowing access to Zambia.Visa requirements for Canadian citizens for visits to various territories, disputed areas, partially recognized countries, and restricted zones:Canada has diplomatic and consular offices (including honorary consuls ) in over 270 locations in approximately 180 foreign countries. In some countries Canadians may receive consular assistance from Australian missions under the Canada–Australia Consular Services Sharing Agreement . On the last page of a standard Canadian passport, under "Reach Us", it states "In case of an emergency you can reach us by: contacting the nearest Canadian government office (in countries where there is no Canadian office, you should contact the nearest British or Australian office...)". Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. Visa requirements for Canadian citizens were lifted by Austria in 1956, Finland in 1958, Japan (20 September 1964), Micronesia (18 December 1980), Taiwan (1 January 1994), Ukraine (1 August 2005), Kyrgyzstan (27 July 2012), Mongolia (1 January 2014), Kazakhstan (1 January 2017), Argentina (1 January 2018), Armenia (10 July 2018), and Brazil (17 June 2019). Canadian citizens were made eligible for eVisas by India (1 May 2015), Brazil (25 January 2018, visa free since 17 June 2019) and Angola (30 March 2018). According to the statistics these are the numbers of Canadian visitors to various countries per annum in 2015 (unless otherwise noted): 1400 300 1000 100

Wiki

Yellow fever

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Malaria

Malaria is a mosquito-borne infectious disease that affects humans and other vertebrates. Human malaria causes symptoms that typically include fever , fatigue , vomiting , and headaches . In severe cases, it can cause jaundice , seizures , coma , or death . Symptoms usually begin 10 to 15 days after being bitten by an infected Anopheles mosquito . If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria. Human malaria is caused by single-celled microorganisms of the Plasmodium group. It is spread exclusively through bites of infected female Anopheles mosquitoes. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to the liver where they mature and reproduce. Five species of Plasmodium commonly infect humans. The three species associated with more severe cases are P. falciparum (which is responsible for the vast majority of malaria deaths), P. vivax , and P. knowlesi (a simian malaria that spills over into thousands of people a year). P. ovale and P. malariae generally cause a milder form of malaria. Malaria is typically diagnosed by the microscopic examination of blood using blood films , or with antigen-based rapid diagnostic tests . Methods that use the polymerase chain reaction to detect the parasite's DNA have been developed, but they are not widely used in areas where malaria is common, due to their cost and complexity. The risk of disease can be reduced by preventing mosquito bites through the use of mosquito nets and insect repellents or with mosquito-control measures such as spraying insecticides and draining standing water . Several medications are available to prevent malaria for travellers in areas where the disease is common. Occasional doses of the combination medication sulfadoxine/pyrimethamine are recommended in infants and after the first trimester of pregnancy in areas with high rates of malaria. As of 2023, two malaria vaccines have been endorsed by the World Health Organization . The recommended treatment for malaria is a combination of antimalarial medications that includes artemisinin . The second medication may be either mefloquine , lumefantrine , or sulfadoxine/pyrimethamine. Quinine , along with doxycycline , may be used if artemisinin is not available. In areas where the disease is common, malaria should be confirmed if possible before treatment is started due to concerns of increasing drug resistance . Resistance among the parasites has developed to several antimalarial medications; for example, chloroquine -resistant P. falciparum has spread to most malarial areas, and resistance to artemisinin has become a problem in some parts of Southeast Asia. The disease is widespread in the tropical and subtropical regions that exist in a broad band around the equator . This includes much of sub-Saharan Africa , Asia , and Latin America . In 2022, some 249 million cases of malaria worldwide resulted in an estimated 608000 deaths, with 80 percent being five years old or less. Around 95% of the cases and deaths occurred in sub-Saharan Africa. Rates of disease decreased from 2010 to 2014, but increased from 2015 to 2021. According to UNICEF, nearly every minute, a child under five died of malaria in 2021, and "many of these deaths are preventable and treatable". Malaria is commonly associated with poverty and has a significant negative effect on economic development. In Africa, it is estimated to result in losses of US$12 billion a year due to increased healthcare costs, lost ability to work, and adverse effects on tourism. Adults with malaria tend to experience chills and fever – classically in periodic intense bouts lasting around six hours, followed by a period of sweating and fever relief – as well as headache, fatigue, abdominal discomfort, and muscle pain . Children tend to have more general symptoms: fever, cough, vomiting, and diarrhea. Initial manifestations of the disease—common to all malaria species—are similar to flu-like symptoms , and can resemble other conditions such as sepsis , gastroenteritis , and viral diseases . The presentation may include headache , fever , shivering , joint pain , vomiting , hemolytic anemia , jaundice , hemoglobin in the urine , retinal damage , and convulsions . The classic symptom of malaria is paroxysm —a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days ( tertian fever ) in P. vivax and P. ovale infections, and every three days ( quartan fever ) for P. malariae . P. falciparum infection can cause recurrent fever every 36–48 hours, or a less pronounced and almost continuous fever. Symptoms typically begin 10–15 days after the initial mosquito bite, but can occur as late as several months after infection with some P. vivax strains. Travellers taking preventative malaria medications may develop symptoms once they stop taking the drugs. Severe malaria is usually caused by P. falciparum (often referred to as falciparum malaria). Symptoms of falciparum malaria arise 9–30 days after infection. Individuals with cerebral malaria frequently exhibit neurological symptoms, including abnormal posturing , nystagmus , conjugate gaze palsy (failure of the eyes to turn together in the same direction), opisthotonus , seizures , or coma . Malaria has several serious complications , including the development of respiratory distress , which occurs in up to 25% of adults and 40% of children with severe P. falciparum malaria. Possible causes include respiratory compensation of metabolic acidosis , noncardiogenic pulmonary oedema , concomitant pneumonia , and severe anaemia . Although rare in young children with severe malaria, acute respiratory distress syndrome occurs in 5–25% of adults and up to 29% of pregnant women. Coinfection of HIV with malaria increases mortality. Kidney failure is a feature of blackwater fever , where haemoglobin from lysed red blood cells leaks into the urine. Infection with P. falciparum may result in cerebral malaria, a form of severe malaria that involves encephalopathy . It is associated with retinal whitening, which may be a useful clinical sign in distinguishing malaria from other causes of fever. An enlarged spleen , enlarged liver or both of these , severe headache, low blood sugar , and haemoglobin in the urine with kidney failure may occur. Complications may include spontaneous bleeding, coagulopathy , and shock . Malaria in pregnant women is an important cause of stillbirths , infant mortality , miscarriage , and low birth weight , particularly in P. falciparum infection, but also with P. vivax . Malaria has several serious complications , including the development of respiratory distress , which occurs in up to 25% of adults and 40% of children with severe P. falciparum malaria. Possible causes include respiratory compensation of metabolic acidosis , noncardiogenic pulmonary oedema , concomitant pneumonia , and severe anaemia . Although rare in young children with severe malaria, acute respiratory distress syndrome occurs in 5–25% of adults and up to 29% of pregnant women. Coinfection of HIV with malaria increases mortality. Kidney failure is a feature of blackwater fever , where haemoglobin from lysed red blood cells leaks into the urine. Infection with P. falciparum may result in cerebral malaria, a form of severe malaria that involves encephalopathy . It is associated with retinal whitening, which may be a useful clinical sign in distinguishing malaria from other causes of fever. An enlarged spleen , enlarged liver or both of these , severe headache, low blood sugar , and haemoglobin in the urine with kidney failure may occur. Complications may include spontaneous bleeding, coagulopathy , and shock . Malaria in pregnant women is an important cause of stillbirths , infant mortality , miscarriage , and low birth weight , particularly in P. falciparum infection, but also with P. vivax . Malaria is caused by infection with parasites in the genus Plasmodium . In humans, malaria is caused by six Plasmodium species: P. falciparum , P. malariae , P. ovale curtisi , P. ovale wallikeri , P. vivax and P. knowlesi . Among those infected, P. falciparum is the most common species identified (~75%) followed by P. vivax (~20%). Although P. falciparum traditionally accounts for the majority of deaths, recent evidence suggests that P. vivax malaria is associated with potentially life-threatening conditions about as often as with a diagnosis of P. falciparum infection. P. vivax proportionally is more common outside Africa. Some cases have been documented of human infections with several species of Plasmodium from higher apes , but except for P. knowlesi —a zoonotic species that causes malaria in macaques —these are mostly of limited public health importance. The Anopheles mosquitos initially get infected by Plasmodium by taking a blood meal from a previously Plasmodium infected person. Parasites are then typically introduced by the bite of an infected Anopheles mosquito. Some of these inoculated parasites, called " sporozoites ", probably remain in the skin, but others travel in the bloodstream to the liver , where they invade hepatocytes . They grow and divide in the liver for 2–10 days, with each infected hepatocyte eventually harboring up to 40,000 parasites. The infected hepatocytes break down, releasing this invasive form of Plasmodium cells, called " merozoites " into the bloodstream. In the blood, the merozoites rapidly invade individual red blood cells , replicating over 24–72 hours to form 16–32 new merozoites. The infected red blood cell lyses, and the new merozoites infect new red blood cells, resulting in a cycle that continuously amplifies the number of parasites in an infected person. Over rounds of this infection cycle, a small portion of parasites do not replicate, but instead develop into early sexual stage parasites called male and female " gametocytes ". These gametocytes develop in the bone marrow for 11 days, then return to the blood circulation to await uptake by the bite of another mosquito. Once inside a mosquito, the gametocytes undergo sexual reproduction, and eventually form daughter sporozoites that migrate to the mosquito's salivary glands to be injected into a new host when the mosquito bites. The liver infection causes no symptoms; all symptoms of malaria result from the infection of red blood cells. Symptoms develop once there are more than around 100,000 parasites per milliliter of blood. Many of the symptoms associated with severe malaria are caused by the tendency of P. falciparum to bind to blood vessel walls, resulting in damage to the affected vessels and surrounding tissue. Parasites sequestered in the blood vessels of the lung contribute to respiratory failure . In the brain, they contribute to coma . In the placenta they contribute to low birthweight and preterm labor, and increase the risk of abortion and stillbirth. The destruction of red blood cells during infection often results in anemia, exacerbated by reduced production of new red blood cells during infection. Only female mosquitoes feed on blood; male mosquitoes feed on plant nectar and do not transmit the disease. Females of the mosquito genus Anopheles prefer to feed at night. They usually start searching for a meal at dusk, and continue through the night until they succeed. However, in Africa, due to the extensive use of bed nets, they began to bite earlier, before bed-net time. Malaria parasites can also be transmitted by blood transfusions , although this is rare. Symptoms of malaria can recur after varying symptom-free periods. Depending upon the cause, recurrence can be classified as either recrudescence , relapse , or reinfection. Recrudescence is when symptoms return after a symptom-free period due to failure to remove blood-stage parasites by adequate treatment. Relapse is when symptoms reappear after the parasites have been eliminated from the blood but have persisted as dormant hypnozoites in liver cells. Relapse commonly occurs between 8 and 24 weeks after the initial symptoms and is often seen in P. vivax and P. ovale infections. P. vivax malaria cases in temperate areas often involve overwintering by hypnozoites, with relapses beginning the year after the mosquito bite. Reinfection means that parasites were eliminated from the entire body but new parasites were then introduced. Reinfection cannot readily be distinguished from relapse and recrudescence, although recurrence of infection within two weeks of treatment ending is typically attributed to treatment failure. People may develop some immunity when exposed to frequent infections. Symptoms of malaria can recur after varying symptom-free periods. Depending upon the cause, recurrence can be classified as either recrudescence , relapse , or reinfection. Recrudescence is when symptoms return after a symptom-free period due to failure to remove blood-stage parasites by adequate treatment. Relapse is when symptoms reappear after the parasites have been eliminated from the blood but have persisted as dormant hypnozoites in liver cells. Relapse commonly occurs between 8 and 24 weeks after the initial symptoms and is often seen in P. vivax and P. ovale infections. P. vivax malaria cases in temperate areas often involve overwintering by hypnozoites, with relapses beginning the year after the mosquito bite. Reinfection means that parasites were eliminated from the entire body but new parasites were then introduced. Reinfection cannot readily be distinguished from relapse and recrudescence, although recurrence of infection within two weeks of treatment ending is typically attributed to treatment failure. People may develop some immunity when exposed to frequent infections. Malaria infection develops via two phases: one that involves the liver (exoerythrocytic phase), and one that involves red blood cells, or erythrocytes (erythrocytic phase). When an infected mosquito pierces a person's skin to take a blood meal, sporozoites in the mosquito's saliva enter the bloodstream and migrate to the liver where they infect hepatocytes, multiplying asexually and asymptomatically for a period of 8–30 days. After a potential dormant period in the liver, these organisms differentiate to yield thousands of merozoites, which, following rupture of their host cells, escape into the blood and infect red blood cells to begin the erythrocytic stage of the life cycle. The parasite escapes from the liver undetected by wrapping itself in the cell membrane of the infected host liver cell. Within the red blood cells, the parasites multiply further, again asexually, periodically breaking out of their host cells to invade fresh red blood cells. Several such amplification cycles occur. Thus, classical descriptions of waves of fever arise from simultaneous waves of merozoites escaping and infecting red blood cells. Some P. vivax sporozoites do not immediately develop into exoerythrocytic-phase merozoites, but instead, produce hypnozoites that remain dormant for periods ranging from several months (7–10 months is typical) to several years. After a period of dormancy, they reactivate and produce merozoites. Hypnozoites are responsible for long incubation and late relapses in P. vivax infections, although their existence in P. ovale is uncertain. The parasite is relatively protected from attack by the body's immune system because for most of its human life cycle it resides within the liver and blood cells and is relatively invisible to immune surveillance. However, circulating infected blood cells are destroyed in the spleen . To avoid this fate, the P. falciparum parasite displays adhesive proteins on the surface of the infected blood cells, causing the blood cells to stick to the walls of small blood vessels, thereby sequestering the parasite from passage through the general circulation and the spleen. The blockage of the microvasculature causes symptoms such as those in placental malaria. Sequestered red blood cells can breach the blood–brain barrier and cause cerebral malaria. According to a 2005 review, due to the high levels of mortality and morbidity caused by malaria—especially the P. falciparum species—it has placed the greatest selective pressure on the human genome in recent history. Several genetic factors provide some resistance to it including sickle cell trait , thalassaemia traits, glucose-6-phosphate dehydrogenase deficiency , and the absence of Duffy antigens on red blood cells. The impact of sickle cell trait on malaria immunity illustrates some evolutionary trade-offs that have occurred because of endemic malaria. Sickle cell trait causes a change in the haemoglobin molecule in the blood. Normally, red blood cells have a very flexible, biconcave shape that allows them to move through narrow capillaries ; however, when the modified haemoglobin S molecules are exposed to low amounts of oxygen, or crowd together due to dehydration, they can stick together forming strands that cause the cell to distort into a curved sickle shape. In these strands, the molecule is not as effective in taking or releasing oxygen, and the cell is not flexible enough to circulate freely. In the early stages of malaria, the parasite can cause infected red cells to sickle, and so they are removed from circulation sooner. This reduces the frequency with which malaria parasites complete their life cycle in the cell. Individuals who are homozygous (with two copies of the abnormal haemoglobin beta allele ) have sickle-cell anaemia , while those who are heterozygous (with one abnormal allele and one normal allele) experience resistance to malaria without severe anaemia. Although the shorter life expectancy for those with the homozygous condition would tend to disfavour the trait's survival, the trait is preserved in malaria-prone regions because of the benefits provided by the heterozygous form. Liver dysfunction as a result of malaria is uncommon and usually only occurs in those with another liver condition such as viral hepatitis or chronic liver disease . The syndrome is sometimes called malarial hepatitis . While it has been considered a rare occurrence, malarial hepatopathy has seen an increase, particularly in Southeast Asia and India. Liver compromise in people with malaria correlates with a greater likelihood of complications and death. According to a 2005 review, due to the high levels of mortality and morbidity caused by malaria—especially the P. falciparum species—it has placed the greatest selective pressure on the human genome in recent history. Several genetic factors provide some resistance to it including sickle cell trait , thalassaemia traits, glucose-6-phosphate dehydrogenase deficiency , and the absence of Duffy antigens on red blood cells. The impact of sickle cell trait on malaria immunity illustrates some evolutionary trade-offs that have occurred because of endemic malaria. Sickle cell trait causes a change in the haemoglobin molecule in the blood. Normally, red blood cells have a very flexible, biconcave shape that allows them to move through narrow capillaries ; however, when the modified haemoglobin S molecules are exposed to low amounts of oxygen, or crowd together due to dehydration, they can stick together forming strands that cause the cell to distort into a curved sickle shape. In these strands, the molecule is not as effective in taking or releasing oxygen, and the cell is not flexible enough to circulate freely. In the early stages of malaria, the parasite can cause infected red cells to sickle, and so they are removed from circulation sooner. This reduces the frequency with which malaria parasites complete their life cycle in the cell. Individuals who are homozygous (with two copies of the abnormal haemoglobin beta allele ) have sickle-cell anaemia , while those who are heterozygous (with one abnormal allele and one normal allele) experience resistance to malaria without severe anaemia. Although the shorter life expectancy for those with the homozygous condition would tend to disfavour the trait's survival, the trait is preserved in malaria-prone regions because of the benefits provided by the heterozygous form. Liver dysfunction as a result of malaria is uncommon and usually only occurs in those with another liver condition such as viral hepatitis or chronic liver disease . The syndrome is sometimes called malarial hepatitis . While it has been considered a rare occurrence, malarial hepatopathy has seen an increase, particularly in Southeast Asia and India. Liver compromise in people with malaria correlates with a greater likelihood of complications and death. Due to the non-specific nature of malaria symptoms, diagnosis is typically suspected based on symptoms and travel history, then confirmed with a laboratory test to detect the presence of the parasite in the blood (parasitological test). In areas where malaria is common, the World Health Organization (WHO) recommends clinicians suspect malaria in any person who reports having fevers, or who has a current temperature above 37.5 °C without any other obvious cause. Malaria should be suspected in children with signs of anemia : pale palms or a laboratory test showing hemoglobin levels below 8 grams per deciliter of blood. In areas of the world with little to no malaria, the WHO recommends only testing people with possible exposure to malaria (typically travel to a malaria-endemic area) and unexplained fever. In sub-Saharan Africa, testing is low, with only about one in four (28%) of children with a fever receiving medical advice or a rapid diagnostic test in 2021. There was a 10-percentage point gap in testing between the richest and the poorest children (33% vs 23%). Additionally, a greater proportion of children in Eastern and Southern Africa (36%) were tested than in West and Central Africa (21%). According to UNICEF, 61% of children with a fever were taken for advice or treatment from a health facility or provider in 2021. Disparities are also observed by wealth, with an 18 percentage point difference in care-seeking behaviour between children in the richest (71%) and the poorest (53%) households. Malaria is usually confirmed by the microscopic examination of blood films or by antigen -based rapid diagnostic tests (RDT). Microscopy – i.e. examining Giemsa -stained blood with a light microscope – is the gold standard for malaria diagnosis. Microscopists typically examine both a "thick film" of blood, allowing them to scan many blood cells in a short time, and a "thin film" of blood, allowing them to clearly see individual parasites and identify the infecting Plasmodium species. Under typical field laboratory conditions, a microscopist can detect parasites when there are at least 100 parasites per microliter of blood, which is around the lower range of symptomatic infection. Microscopic diagnosis is relatively resource intensive, requiring trained personnel, specific equipment, electricity, and a consistent supply of microscopy slides and stains. In places where microscopy is unavailable, malaria is diagnosed with RDTs, rapid antigen tests that detect parasite proteins in a fingerstick blood sample. A variety of RDTs are commercially available, targeting the parasite proteins histidine rich protein 2 (HRP2, detects P. falciparum only), lactate dehydrogenase , or aldolase . The HRP2 test is widely used in Africa, where P. falciparum predominates. However, since HRP2 persists in the blood for up to five weeks after an infection is treated, an HRP2 test sometimes cannot distinguish whether someone currently has malaria or previously had it. Additionally, some P. falciparum parasites in the Amazon region lack the HRP2 gene, complicating detection. RDTs are fast and easily deployed to places without full diagnostic laboratories. However they give considerably less information than microscopy, and sometimes vary in quality from producer to producer and lot to lot. Serological tests to detect antibodies against Plasmodium from the blood have been developed, but are not used for malaria diagnosis due to their relatively poor sensitivity and specificity. Highly sensitive nucleic acid amplification tests have been developed, but are not used clinically due to their relatively high cost, and poor specificity for active infections. Malaria is classified into either "severe" or "uncomplicated" by the World Health Organization (WHO). It is deemed severe when any of the following criteria are present, otherwise it is considered uncomplicated. Cerebral malaria is defined as a severe P. falciparum -malaria presenting with neurological symptoms, including coma (with a Glasgow coma scale less than 11, or a Blantyre coma scale less than 3), or with a coma that lasts longer than 30 minutes after a seizure. Malaria is classified into either "severe" or "uncomplicated" by the World Health Organization (WHO). It is deemed severe when any of the following criteria are present, otherwise it is considered uncomplicated. Cerebral malaria is defined as a severe P. falciparum -malaria presenting with neurological symptoms, including coma (with a Glasgow coma scale less than 11, or a Blantyre coma scale less than 3), or with a coma that lasts longer than 30 minutes after a seizure. Methods used to prevent malaria include medications, mosquito elimination and the prevention of bites. As of 2023, there are two malaria vaccines , approved for use in children by the WHO: RTS,S and R21 . The presence of malaria in an area requires a combination of high human population density, high Anopheles mosquito population density and high rates of transmission from humans to mosquitoes and from mosquitoes to humans. If any of these is lowered sufficiently, the parasite eventually disappears from that area, as happened in North America, Europe, and parts of the Middle East. However, unless the parasite is eliminated from the whole world, it could re-establish if conditions revert to a combination that favors the parasite's reproduction. Furthermore, the cost per person of eliminating anopheles mosquitoes rises with decreasing population density, making it economically unfeasible in some areas. Prevention of malaria may be more cost-effective than treatment of the disease in the long run, but the initial costs required are out of reach of many of the world's poorest people. There is a wide difference in the costs of control (i.e. maintenance of low endemicity) and elimination programs between countries. For example, in China—whose government in 2010 announced a strategy to pursue malaria elimination in the Chinese provinces —the required investment is a small proportion of public expenditure on health. In contrast, a similar programme in Tanzania would cost an estimated one-fifth of the public health budget. In 2021, the World Health Organization confirmed that China has eliminated malaria. In 2023, the World Health Organization confirmed that Azerbaijan, Tajikistan, and Belize have eliminated Malaria. In areas where malaria is common, children under five years old often have anaemia , which is sometimes due to malaria. Giving children with anaemia in these areas preventive antimalarial medication improves red blood cell levels slightly but does not affect the risk of death or need for hospitalisation. Vector control refers to methods used to decrease malaria by reducing the levels of transmission by mosquitoes. For individual protection, the most effective insect repellents are based on DEET or picaridin . However, there is insufficient evidence that mosquito repellents can prevent malaria infection. Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are effective, have been commonly used to prevent malaria, and their use has contributed significantly to the decrease in malaria in the 21st century. ITNs and IRS may not be sufficient to eliminate the disease, as these interventions depend on how many people use nets, how many gaps in insecticide there are (low coverage areas), if people are not protected when outside of the home, and an increase in mosquitoes that are resistant to insecticides. Modifications to people's houses to prevent mosquito exposure may be an important long term prevention measure. Mosquito nets help keep mosquitoes away from people and reduce infection rates and transmission of malaria. Nets are not a perfect barrier and are often treated with an insecticide designed to kill the mosquito before it has time to find a way past the net. Insecticide-treated nets (ITNs) are estimated to be twice as effective as untreated nets and offer greater than 70% protection compared with no net. Between 2000 and 2008, the use of ITNs saved the lives of an estimated 250,000 infants in Sub-Saharan Africa. According to UNICEF, only 36% of households had sufficient ITNs for all household members in 2019. In 2000, 1.7 million (1.8%) African children living in areas of the world where malaria is common were protected by an ITN. That number increased to 20.3 million (18.5%) African children using ITNs in 2007, leaving 89.6 million children unprotected and to 68% African children using mosquito nets in 2015. The percentage of children sleeping under ITNs in sub-Saharan Africa increased from less than 40% in 2011 to over 50% in 2021. Most nets are impregnated with pyrethroids , a class of insecticides with low toxicity . They are most effective when used from dusk to dawn. It is recommended to hang a large "bed net" above the center of a bed and either tuck the edges under the mattress or make sure it is large enough such that it touches the ground. ITNs are beneficial towards pregnancy outcomes in malaria-endemic regions in Africa but more data is needed in Asia and Latin America. In areas of high malaria resistance, piperonyl butoxide (PBO) combined with pyrethroids in mosquito netting is effective in reducing malaria infection rates. Questions remain concerning the durability of PBO on nets as the impact on mosquito mortality was not sustained after twenty washes in experimental trials. UNICEF notes that the use of insecticide-treated nets has been increased since 2000 through accelerated production, procurement and delivery, stating that "over 2.5 billion ITNs have been distributed globally since 2004, with 87% (2.2 billion) distributed in sub-Saharan Africa. In 2021, manufacturers delivered about 220 million ITNs to malaria endemic countries, a decrease of 9 million ITNs compared with 2020 and 33 million less than were delivered in 2019". As of 2021, 66% of households in sub-Saharan Africa had ITNs, with figures "ranging from 31 per cent in Angola in 2016 to approximately 97 per cent in Guinea-Bissau in 2019". Slightly more than half of the households with an ITN had enough of them to protect all members of the household, however. Indoor residual spraying is the spraying of insecticides on the walls inside a home. After feeding, many mosquitoes rest on a nearby surface while digesting the bloodmeal, so if the walls of houses have been coated with insecticides, the resting mosquitoes can be killed before they can bite another person and transfer the malaria parasite. As of 2006, the World Health Organization recommends 12 insecticides in IRS operations, including DDT and the pyrethroids cyfluthrin and deltamethrin . This public health use of small amounts of DDT is permitted under the Stockholm Convention , which prohibits its agricultural use. One problem with all forms of IRS is insecticide resistance . Mosquitoes affected by IRS tend to rest and live indoors, and due to the irritation caused by spraying, their descendants tend to rest and live outdoors, meaning that they are less affected by the IRS. Communities using insecticide treated nets, in addition to indoor residual spraying with 'non-pyrethroid-like' insecticides found associated reductions in malaria. Additionally, the use of 'pyrethroid-like' insecticides in addition to indoor residual spraying did not result in a detectable additional benefit in communities using insecticide treated nets. Housing is a risk factor for malaria and modifying the house as a prevention measure may be a sustainable strategy that does not rely on the effectiveness of insecticides such as pyrethroids . The physical environment inside and outside the home that may improve the density of mosquitoes are considerations. Examples of potential modifications include how close the home is to mosquito breeding sites, drainage and water supply near the home, availability of mosquito resting sites (vegetation around the home), the proximity to live stock and domestic animals, and physical improvements or modifications to the design of the home to prevent mosquitoes from entering, such as window screens . Mass drug administration Mass drug administration (MDA) involves the administration of drugs to the entire population of an area regardless of disease status. A 2021 Cochrane review on the use of community administration of ivermectin found that, to date, low quality evidence shows no significant impact on reducing incidence of malaria transmission from the community administration of ivermectin. People have tried a number of other methods to reduce mosquito bites and slow the spread of malaria. Efforts to decrease mosquito larvae by decreasing the availability of open water where they develop, or by adding substances to decrease their development, are effective in some locations. Electronic mosquito repellent devices, which make very high-frequency sounds that are supposed to keep female mosquitoes away, have no supporting evidence of effectiveness. There is a low certainty evidence that fogging may have an effect on malaria transmission. Larviciding by hand delivery of chemical or microbial insecticides into water bodies containing low larval distribution may reduce malarial transmission. There is insufficient evidence to determine whether larvivorous fish can decrease mosquito density and transmission in the area. There are a number of medications that can help prevent or interrupt malaria in travellers to places where infection is common. Many of these medications are also used in treatment. In places where Plasmodium is resistant to one or more medications, three medications— mefloquine , doxycycline , or the combination of atovaquone/proguanil ( Malarone )—are frequently used for prevention. Doxycycline and the atovaquone/proguanil are better tolerated while mefloquine is taken once a week. Areas of the world with chloroquine -sensitive malaria are uncommon. Antimalarial mass drug administration to an entire population at the same time may reduce the risk of contracting malaria in the population, however the effectiveness of mass drug administration may vary depending on the prevalence of malaria in the area. Other factors such as drug administration plus other protective measures such as mosquito control, the proportion of people treated in the area, and the risk of reinfection with malaria may play a role in the effectiveness of mass drug treatment approaches. The protective effect does not begin immediately, and people visiting areas where malaria exists usually start taking the drugs one to two weeks before they arrive, and continue taking them for four weeks after leaving (except for atovaquone/proguanil, which only needs to be started two days before and continued for seven days afterward). The use of preventive drugs is often not practical for those who live in areas where malaria exists, and their use is usually given only to pregnant women and short-term visitors. This is due to the cost of the drugs, side effects from long-term use, and the difficulty in obtaining antimalarial drugs outside of wealthy nations. During pregnancy, medication to prevent malaria has been found to improve the weight of the baby at birth and decrease the risk of anaemia in the mother. The use of preventive drugs where malaria-bearing mosquitoes are present may encourage the development of partial resistance. Giving antimalarial drugs to infants through intermittent preventive therapy can reduce the risk of having malaria infection, hospital admission, and anaemia. Mefloquine is more effective than sulfadoxine-pyrimethamine in preventing malaria for HIV-negative pregnant women. Cotrimoxazole is effective in preventing malaria infection and reduce the risk of getting anaemia in HIV-positive women. Giving sulfadoxine-pyrimethamine for three or more doses as intermittent preventive therapy is superior than two doses for HIV-positive women living in malaria-endemic areas. Prompt treatment of confirmed cases with artemisinin-based combination therapies (ACTs) may also reduce transmission. Malaria vaccines have been another goal of research. The first promising studies demonstrating the potential for a malaria vaccine were performed in 1967 by immunising mice with live, radiation- attenuated sporozoites, which provided significant protection to the mice upon subsequent injection with normal, viable sporozoites. Since the 1970s, there has been considerable progress in developing similar vaccination strategies for humans. In 2013, WHO and the malaria vaccine funders group set a goal to develop vaccines designed to interrupt malaria transmission with malaria eradication's long-term goal. The first vaccine, called RTS,S , was approved by European regulators in 2015. As of 2023, two malaria vaccine have been licensed for use. Other approaches to combat malaria may require investing more in research and greater primary health care. Continuing surveillance will also be important to prevent the return of malaria in countries where the disease has been eliminated. As of 2019 it is undergoing pilot trials in 3 sub-Saharan African countries – Ghana, Kenya and Malawi – as part of the WHO's Malaria Vaccine Implementation Programme (MVIP). Immunity (or, more accurately, tolerance ) to P. falciparum malaria does occur naturally, but only in response to years of repeated infection. An individual can be protected from a P. falciparum infection if they receive about a thousand bites from mosquitoes that carry a version of the parasite rendered non-infective by a dose of X-ray irradiation . The highly polymorphic nature of many P. falciparum proteins results in significant challenges to vaccine design. Vaccine candidates that target antigens on gametes, zygotes, or ookinetes in the mosquito midgut aim to block the transmission of malaria. These transmission-blocking vaccines induce antibodies in the human blood; when a mosquito takes a blood meal from a protected individual, these antibodies prevent the parasite from completing its development in the mosquito. Other vaccine candidates, targeting the blood-stage of the parasite's life cycle, have been inadequate on their own. For example, SPf66 was tested extensively in areas where the disease was common in the 1990s, but trials showed it to be insufficiently effective. As of 2020, the RTS,S vaccine has been shown to reduce the risk of malaria by about 40% in children in Africa. A preprint study of the R21 vaccine has shown 77% vaccine efficacy. [ needs update ] In 2021, researchers from the University of Oxford reported findings from a Phase IIb trial of a candidate malaria vaccine, R21/Matrix-M, which demonstrated efficacy of 77% over 12-months of follow-up. This vaccine is the first to meet the World Health Organization 's Malaria Vaccine Technology Roadmap goal of a vaccine with at least 75% efficacy. Germany-based BioNTECH SE are developing an mRNA-based malaria vaccine BN165 which has recently initiated a Phase 1 study [clinicaltrials.gov identifier: NCT05581641] in December 2022. The vaccine, based on the circumsporozite protein (CSP) is being tested in adults aged 18–55 yrs at 3 dose levels to select a safe and tolerable dose of a 3-dose schedule. Unlike GSK's RTS,S (AS01) and Serum Institute of India's R21/MatrixM, BNT-165 is being studied in adult age groups meaning it could be developed for Western travelers as well as those living in endemic countries. For the travelers profile, a recent commercial assessment forecast potential gross revenues of BNT-165 at $479m (2030) 5-yrs post launch, POS-adjusted revenues. Community participation and health education strategies promoting awareness of malaria and the importance of control measures have been successfully used to reduce the incidence of malaria in some areas of the developing world. Recognising the disease in the early stages can prevent it from becoming fatal. Education can also inform people to cover over areas of stagnant, still water, such as water tanks that are ideal breeding grounds for the parasite and mosquito, thus cutting down the risk of the transmission between people. This is generally used in urban areas where there are large centers of population in a confined space and transmission would be most likely in these areas. Intermittent preventive therapy is another intervention that has been used successfully to control malaria in pregnant women and infants, and in preschool children where transmission is seasonal. Vector control refers to methods used to decrease malaria by reducing the levels of transmission by mosquitoes. For individual protection, the most effective insect repellents are based on DEET or picaridin . However, there is insufficient evidence that mosquito repellents can prevent malaria infection. Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are effective, have been commonly used to prevent malaria, and their use has contributed significantly to the decrease in malaria in the 21st century. ITNs and IRS may not be sufficient to eliminate the disease, as these interventions depend on how many people use nets, how many gaps in insecticide there are (low coverage areas), if people are not protected when outside of the home, and an increase in mosquitoes that are resistant to insecticides. Modifications to people's houses to prevent mosquito exposure may be an important long term prevention measure. Mosquito nets help keep mosquitoes away from people and reduce infection rates and transmission of malaria. Nets are not a perfect barrier and are often treated with an insecticide designed to kill the mosquito before it has time to find a way past the net. Insecticide-treated nets (ITNs) are estimated to be twice as effective as untreated nets and offer greater than 70% protection compared with no net. Between 2000 and 2008, the use of ITNs saved the lives of an estimated 250,000 infants in Sub-Saharan Africa. According to UNICEF, only 36% of households had sufficient ITNs for all household members in 2019. In 2000, 1.7 million (1.8%) African children living in areas of the world where malaria is common were protected by an ITN. That number increased to 20.3 million (18.5%) African children using ITNs in 2007, leaving 89.6 million children unprotected and to 68% African children using mosquito nets in 2015. The percentage of children sleeping under ITNs in sub-Saharan Africa increased from less than 40% in 2011 to over 50% in 2021. Most nets are impregnated with pyrethroids , a class of insecticides with low toxicity . They are most effective when used from dusk to dawn. It is recommended to hang a large "bed net" above the center of a bed and either tuck the edges under the mattress or make sure it is large enough such that it touches the ground. ITNs are beneficial towards pregnancy outcomes in malaria-endemic regions in Africa but more data is needed in Asia and Latin America. In areas of high malaria resistance, piperonyl butoxide (PBO) combined with pyrethroids in mosquito netting is effective in reducing malaria infection rates. Questions remain concerning the durability of PBO on nets as the impact on mosquito mortality was not sustained after twenty washes in experimental trials. UNICEF notes that the use of insecticide-treated nets has been increased since 2000 through accelerated production, procurement and delivery, stating that "over 2.5 billion ITNs have been distributed globally since 2004, with 87% (2.2 billion) distributed in sub-Saharan Africa. In 2021, manufacturers delivered about 220 million ITNs to malaria endemic countries, a decrease of 9 million ITNs compared with 2020 and 33 million less than were delivered in 2019". As of 2021, 66% of households in sub-Saharan Africa had ITNs, with figures "ranging from 31 per cent in Angola in 2016 to approximately 97 per cent in Guinea-Bissau in 2019". Slightly more than half of the households with an ITN had enough of them to protect all members of the household, however. Indoor residual spraying is the spraying of insecticides on the walls inside a home. After feeding, many mosquitoes rest on a nearby surface while digesting the bloodmeal, so if the walls of houses have been coated with insecticides, the resting mosquitoes can be killed before they can bite another person and transfer the malaria parasite. As of 2006, the World Health Organization recommends 12 insecticides in IRS operations, including DDT and the pyrethroids cyfluthrin and deltamethrin . This public health use of small amounts of DDT is permitted under the Stockholm Convention , which prohibits its agricultural use. One problem with all forms of IRS is insecticide resistance . Mosquitoes affected by IRS tend to rest and live indoors, and due to the irritation caused by spraying, their descendants tend to rest and live outdoors, meaning that they are less affected by the IRS. Communities using insecticide treated nets, in addition to indoor residual spraying with 'non-pyrethroid-like' insecticides found associated reductions in malaria. Additionally, the use of 'pyrethroid-like' insecticides in addition to indoor residual spraying did not result in a detectable additional benefit in communities using insecticide treated nets. Housing is a risk factor for malaria and modifying the house as a prevention measure may be a sustainable strategy that does not rely on the effectiveness of insecticides such as pyrethroids . The physical environment inside and outside the home that may improve the density of mosquitoes are considerations. Examples of potential modifications include how close the home is to mosquito breeding sites, drainage and water supply near the home, availability of mosquito resting sites (vegetation around the home), the proximity to live stock and domestic animals, and physical improvements or modifications to the design of the home to prevent mosquitoes from entering, such as window screens . Mass drug administration Mass drug administration (MDA) involves the administration of drugs to the entire population of an area regardless of disease status. A 2021 Cochrane review on the use of community administration of ivermectin found that, to date, low quality evidence shows no significant impact on reducing incidence of malaria transmission from the community administration of ivermectin. People have tried a number of other methods to reduce mosquito bites and slow the spread of malaria. Efforts to decrease mosquito larvae by decreasing the availability of open water where they develop, or by adding substances to decrease their development, are effective in some locations. Electronic mosquito repellent devices, which make very high-frequency sounds that are supposed to keep female mosquitoes away, have no supporting evidence of effectiveness. There is a low certainty evidence that fogging may have an effect on malaria transmission. Larviciding by hand delivery of chemical or microbial insecticides into water bodies containing low larval distribution may reduce malarial transmission. There is insufficient evidence to determine whether larvivorous fish can decrease mosquito density and transmission in the area. Mosquito nets help keep mosquitoes away from people and reduce infection rates and transmission of malaria. Nets are not a perfect barrier and are often treated with an insecticide designed to kill the mosquito before it has time to find a way past the net. Insecticide-treated nets (ITNs) are estimated to be twice as effective as untreated nets and offer greater than 70% protection compared with no net. Between 2000 and 2008, the use of ITNs saved the lives of an estimated 250,000 infants in Sub-Saharan Africa. According to UNICEF, only 36% of households had sufficient ITNs for all household members in 2019. In 2000, 1.7 million (1.8%) African children living in areas of the world where malaria is common were protected by an ITN. That number increased to 20.3 million (18.5%) African children using ITNs in 2007, leaving 89.6 million children unprotected and to 68% African children using mosquito nets in 2015. The percentage of children sleeping under ITNs in sub-Saharan Africa increased from less than 40% in 2011 to over 50% in 2021. Most nets are impregnated with pyrethroids , a class of insecticides with low toxicity . They are most effective when used from dusk to dawn. It is recommended to hang a large "bed net" above the center of a bed and either tuck the edges under the mattress or make sure it is large enough such that it touches the ground. ITNs are beneficial towards pregnancy outcomes in malaria-endemic regions in Africa but more data is needed in Asia and Latin America. In areas of high malaria resistance, piperonyl butoxide (PBO) combined with pyrethroids in mosquito netting is effective in reducing malaria infection rates. Questions remain concerning the durability of PBO on nets as the impact on mosquito mortality was not sustained after twenty washes in experimental trials. UNICEF notes that the use of insecticide-treated nets has been increased since 2000 through accelerated production, procurement and delivery, stating that "over 2.5 billion ITNs have been distributed globally since 2004, with 87% (2.2 billion) distributed in sub-Saharan Africa. In 2021, manufacturers delivered about 220 million ITNs to malaria endemic countries, a decrease of 9 million ITNs compared with 2020 and 33 million less than were delivered in 2019". As of 2021, 66% of households in sub-Saharan Africa had ITNs, with figures "ranging from 31 per cent in Angola in 2016 to approximately 97 per cent in Guinea-Bissau in 2019". Slightly more than half of the households with an ITN had enough of them to protect all members of the household, however. Indoor residual spraying is the spraying of insecticides on the walls inside a home. After feeding, many mosquitoes rest on a nearby surface while digesting the bloodmeal, so if the walls of houses have been coated with insecticides, the resting mosquitoes can be killed before they can bite another person and transfer the malaria parasite. As of 2006, the World Health Organization recommends 12 insecticides in IRS operations, including DDT and the pyrethroids cyfluthrin and deltamethrin . This public health use of small amounts of DDT is permitted under the Stockholm Convention , which prohibits its agricultural use. One problem with all forms of IRS is insecticide resistance . Mosquitoes affected by IRS tend to rest and live indoors, and due to the irritation caused by spraying, their descendants tend to rest and live outdoors, meaning that they are less affected by the IRS. Communities using insecticide treated nets, in addition to indoor residual spraying with 'non-pyrethroid-like' insecticides found associated reductions in malaria. Additionally, the use of 'pyrethroid-like' insecticides in addition to indoor residual spraying did not result in a detectable additional benefit in communities using insecticide treated nets. Housing is a risk factor for malaria and modifying the house as a prevention measure may be a sustainable strategy that does not rely on the effectiveness of insecticides such as pyrethroids . The physical environment inside and outside the home that may improve the density of mosquitoes are considerations. Examples of potential modifications include how close the home is to mosquito breeding sites, drainage and water supply near the home, availability of mosquito resting sites (vegetation around the home), the proximity to live stock and domestic animals, and physical improvements or modifications to the design of the home to prevent mosquitoes from entering, such as window screens . Mass drug administration Mass drug administration (MDA) involves the administration of drugs to the entire population of an area regardless of disease status. A 2021 Cochrane review on the use of community administration of ivermectin found that, to date, low quality evidence shows no significant impact on reducing incidence of malaria transmission from the community administration of ivermectin. People have tried a number of other methods to reduce mosquito bites and slow the spread of malaria. Efforts to decrease mosquito larvae by decreasing the availability of open water where they develop, or by adding substances to decrease their development, are effective in some locations. Electronic mosquito repellent devices, which make very high-frequency sounds that are supposed to keep female mosquitoes away, have no supporting evidence of effectiveness. There is a low certainty evidence that fogging may have an effect on malaria transmission. Larviciding by hand delivery of chemical or microbial insecticides into water bodies containing low larval distribution may reduce malarial transmission. There is insufficient evidence to determine whether larvivorous fish can decrease mosquito density and transmission in the area. There are a number of medications that can help prevent or interrupt malaria in travellers to places where infection is common. Many of these medications are also used in treatment. In places where Plasmodium is resistant to one or more medications, three medications— mefloquine , doxycycline , or the combination of atovaquone/proguanil ( Malarone )—are frequently used for prevention. Doxycycline and the atovaquone/proguanil are better tolerated while mefloquine is taken once a week. Areas of the world with chloroquine -sensitive malaria are uncommon. Antimalarial mass drug administration to an entire population at the same time may reduce the risk of contracting malaria in the population, however the effectiveness of mass drug administration may vary depending on the prevalence of malaria in the area. Other factors such as drug administration plus other protective measures such as mosquito control, the proportion of people treated in the area, and the risk of reinfection with malaria may play a role in the effectiveness of mass drug treatment approaches. The protective effect does not begin immediately, and people visiting areas where malaria exists usually start taking the drugs one to two weeks before they arrive, and continue taking them for four weeks after leaving (except for atovaquone/proguanil, which only needs to be started two days before and continued for seven days afterward). The use of preventive drugs is often not practical for those who live in areas where malaria exists, and their use is usually given only to pregnant women and short-term visitors. This is due to the cost of the drugs, side effects from long-term use, and the difficulty in obtaining antimalarial drugs outside of wealthy nations. During pregnancy, medication to prevent malaria has been found to improve the weight of the baby at birth and decrease the risk of anaemia in the mother. The use of preventive drugs where malaria-bearing mosquitoes are present may encourage the development of partial resistance. Giving antimalarial drugs to infants through intermittent preventive therapy can reduce the risk of having malaria infection, hospital admission, and anaemia. Mefloquine is more effective than sulfadoxine-pyrimethamine in preventing malaria for HIV-negative pregnant women. Cotrimoxazole is effective in preventing malaria infection and reduce the risk of getting anaemia in HIV-positive women. Giving sulfadoxine-pyrimethamine for three or more doses as intermittent preventive therapy is superior than two doses for HIV-positive women living in malaria-endemic areas. Prompt treatment of confirmed cases with artemisinin-based combination therapies (ACTs) may also reduce transmission. Malaria vaccines have been another goal of research. The first promising studies demonstrating the potential for a malaria vaccine were performed in 1967 by immunising mice with live, radiation- attenuated sporozoites, which provided significant protection to the mice upon subsequent injection with normal, viable sporozoites. Since the 1970s, there has been considerable progress in developing similar vaccination strategies for humans. In 2013, WHO and the malaria vaccine funders group set a goal to develop vaccines designed to interrupt malaria transmission with malaria eradication's long-term goal. The first vaccine, called RTS,S , was approved by European regulators in 2015. As of 2023, two malaria vaccine have been licensed for use. Other approaches to combat malaria may require investing more in research and greater primary health care. Continuing surveillance will also be important to prevent the return of malaria in countries where the disease has been eliminated. As of 2019 it is undergoing pilot trials in 3 sub-Saharan African countries – Ghana, Kenya and Malawi – as part of the WHO's Malaria Vaccine Implementation Programme (MVIP). Immunity (or, more accurately, tolerance ) to P. falciparum malaria does occur naturally, but only in response to years of repeated infection. An individual can be protected from a P. falciparum infection if they receive about a thousand bites from mosquitoes that carry a version of the parasite rendered non-infective by a dose of X-ray irradiation . The highly polymorphic nature of many P. falciparum proteins results in significant challenges to vaccine design. Vaccine candidates that target antigens on gametes, zygotes, or ookinetes in the mosquito midgut aim to block the transmission of malaria. These transmission-blocking vaccines induce antibodies in the human blood; when a mosquito takes a blood meal from a protected individual, these antibodies prevent the parasite from completing its development in the mosquito. Other vaccine candidates, targeting the blood-stage of the parasite's life cycle, have been inadequate on their own. For example, SPf66 was tested extensively in areas where the disease was common in the 1990s, but trials showed it to be insufficiently effective. As of 2020, the RTS,S vaccine has been shown to reduce the risk of malaria by about 40% in children in Africa. A preprint study of the R21 vaccine has shown 77% vaccine efficacy. [ needs update ] In 2021, researchers from the University of Oxford reported findings from a Phase IIb trial of a candidate malaria vaccine, R21/Matrix-M, which demonstrated efficacy of 77% over 12-months of follow-up. This vaccine is the first to meet the World Health Organization 's Malaria Vaccine Technology Roadmap goal of a vaccine with at least 75% efficacy. Germany-based BioNTECH SE are developing an mRNA-based malaria vaccine BN165 which has recently initiated a Phase 1 study [clinicaltrials.gov identifier: NCT05581641] in December 2022. The vaccine, based on the circumsporozite protein (CSP) is being tested in adults aged 18–55 yrs at 3 dose levels to select a safe and tolerable dose of a 3-dose schedule. Unlike GSK's RTS,S (AS01) and Serum Institute of India's R21/MatrixM, BNT-165 is being studied in adult age groups meaning it could be developed for Western travelers as well as those living in endemic countries. For the travelers profile, a recent commercial assessment forecast potential gross revenues of BNT-165 at $479m (2030) 5-yrs post launch, POS-adjusted revenues. Community participation and health education strategies promoting awareness of malaria and the importance of control measures have been successfully used to reduce the incidence of malaria in some areas of the developing world. Recognising the disease in the early stages can prevent it from becoming fatal. Education can also inform people to cover over areas of stagnant, still water, such as water tanks that are ideal breeding grounds for the parasite and mosquito, thus cutting down the risk of the transmission between people. This is generally used in urban areas where there are large centers of population in a confined space and transmission would be most likely in these areas. Intermittent preventive therapy is another intervention that has been used successfully to control malaria in pregnant women and infants, and in preschool children where transmission is seasonal. Malaria is treated with antimalarial medications ; the ones used depends on the type and severity of the disease. While medications against fever are commonly used, their effects on outcomes are not clear. Providing free antimalarial drugs to households may reduce childhood deaths when used appropriately. Programmes which presumptively treat all causes of fever with antimalarial drugs may lead to overuse of antimalarials and undertreat other causes of fever. Nevertheless, the use of malaria rapid-diagnostic kits can help to reduce over-usage of antimalarials. Simple or uncomplicated malaria may be treated with oral medications. Artemisinin drugs are effective and safe in treating uncomplicated malaria. Artemisinin in combination with other antimalarials (known as artemisinin-combination therapy , or ACT) is about 90% effective when used to treat uncomplicated malaria. The most effective treatment for P. falciparum infection is the use of ACT, which decreases resistance to any single drug component. Artemether-lumefantrine (six-dose regimen) is more effective than the artemether-lumefantrine (four-dose regimen) or other regimens not containing artemisinin derivatives in treating falciparum malaria. Another recommended combination is dihydroartemisinin and piperaquine . Artemisinin-naphthoquine combination therapy showed promising results in treating falciparum malaria but more research is needed to establish its efficacy as a reliable treatment. Artesunate plus mefloquine performs better than mefloquine alone in treating uncomplicated falciparum malaria in low transmission settings. Atovaquone-proguanil is effective against uncomplicated falciparum with a possible failure rate of 5% to 10%; the addition of artesunate may reduce failure rate. Azithromycin monotherapy or combination therapy has not shown effectiveness in treating Plasmodium falciparum or Plasmodium vivax malaria. Amodiaquine plus sulfadoxine-pyrimethamine may achieve less treatment failures when compared to sulfadoxine-pyrimethamine alone in uncomplicated falciparum malaria. There is insufficient data on chlorproguanil-dapsone in treating uncomplicated falciparum malaria. The addition of primaquine with artemisinin-based combination therapy for falciparum malaria reduces its transmission at day 3-4 and day 8 of infection. Sulfadoxine-pyrimethamine plus artesunate is better than sulfadoxine-pyrimethamine plus amodiaquine in controlling treatment failure at day 28. However, the latter is better than the former in reducing gametocytes in blood at day 7. Infection with P. vivax , P. ovale or P. malariae usually does not require hospitalisation. Treatment of P. vivax malaria requires both elimination of the parasite in the blood with chloroquine or with artemisinin-based combination therapy and clearance of parasites from the liver with an 8-aminoquinoline agent such as primaquine or tafenoquine . These two drugs act against blood stages as well, the extent to which they do so still being under investigation. To treat malaria during pregnancy, the WHO recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and ACT in later stages (2nd and 3rd trimesters). There is limited safety data on the antimalarial drugs in pregnancy. Cases of severe and complicated malaria are almost always caused by infection with P. falciparum . The other species usually cause only febrile disease. Severe and complicated malaria cases are medical emergencies since mortality rates are high (10% to 50%). Recommended treatment for severe malaria is the intravenous use of antimalarial drugs. For severe malaria, parenteral artesunate was superior to quinine in both children and adults. In another systematic review, artemisinin derivatives (artemether and arteether) were as efficacious as quinine in the treatment of cerebral malaria in children. Treatment of severe malaria involves supportive measures that are best done in a critical care unit . This includes the management of high fevers and the seizures that may result from it. It also includes monitoring for poor breathing effort , low blood sugar, and low blood potassium . Artemisinin derivatives have the same or better efficacy than quinolones in preventing deaths in severe or complicated malaria. Quinine loading dose helps to shorten the duration of fever and increases parasite clearance from the body. There is no difference in effectiveness when using intrarectal quinine compared to intravenous or intramuscular quinine in treating uncomplicated/complicated falciparum malaria. There is insufficient evidence for intramuscular arteether to treat severe malaria. The provision of rectal artesunate before transfer to hospital may reduce the rate of death for children with severe malaria. In children with malaria and concomitant hypoglycaemia, sublingual administration of glucose appears to result in better increases in blood sugar after 20 minutes when compared to oral administration, based on very limited data. Cerebral malaria is the form of severe and complicated malaria with the worst neurological symptoms. There is insufficient data on whether osmotic agents such as mannitol or urea are effective in treating cerebral malaria. Routine phenobarbitone in cerebral malaria is associated with fewer convulsions but possibly more deaths. There is no evidence that steroids would bring treatment benefits for cerebral malaria. Managing Cerebral Malaria Cerebral malaria usually makes a patient comatose. If the cause of the coma is in doubt, testing for other locally prevalent causes of encephalopathy (bacterial, viral or fungal infection) should be carried out. In areas where there is a high prevalence of malaria infection (e.g. tropical region) treatment can start without testing first. To manage the cerebral malaria when confirmed the following can be done: Patients in coma should be given meticulous nursing care ( monitor vital signs, turn patient every 2 hours, avoid lying the patient in a wet bed etc.) A sterile urethral catheter should be inserted to help with urinating To aspirate stomach content, a sterile nasogastric tube should be inserted. In the occasion of convulsions, a slow intravenous injection of benzodiazepine is administered. There is insufficient evidence to show that blood transfusion is useful in either reducing deaths for children with severe anaemia or in improving their haematocrit in one month. There is insufficient evidence that iron chelating agents such as deferoxamine and deferiprone improve outcomes of those with malaria falciparum infection. A 2022 clinical trial shows that a monoclonal antibody mAb L9LS offers protection against malaria. It binds the Plasmodium falciparum circumsporozoite protein (CSP-1), essential to disease, and makes it ineffective. Drug resistance poses a growing problem in 21st-century malaria treatment. In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia. Resistance is now common against all classes of antimalarial drugs apart from artemisinins . Treatment of resistant strains became increasingly dependent on this class of drugs. The cost of artemisinins limits their use in the developing world. Malaria strains found on the Cambodia–Thailand border are resistant to combination therapies that include artemisinins, and may, therefore, be untreatable. Exposure of the parasite population to artemisinin monotherapies in subtherapeutic doses for over 30 years and the availability of substandard artemisinins likely drove the selection of the resistant phenotype. Resistance to artemisinin has been detected in Cambodia, Myanmar, Thailand, and Vietnam, and there has been emerging resistance in Laos. Resistance to the combination of artemisinin and piperaquine was first detected in 2013 in Cambodia, and by 2019 had spread across Cambodia and into Laos , Thailand and Vietnam (with up to 80 percent of malaria parasites resistant in some regions). There is insufficient evidence in unit packaged antimalarial drugs in preventing treatment failures of malaria infection. However, if supported by training of healthcare providers and patient information, there is improvement in compliance of those receiving treatment. Simple or uncomplicated malaria may be treated with oral medications. Artemisinin drugs are effective and safe in treating uncomplicated malaria. Artemisinin in combination with other antimalarials (known as artemisinin-combination therapy , or ACT) is about 90% effective when used to treat uncomplicated malaria. The most effective treatment for P. falciparum infection is the use of ACT, which decreases resistance to any single drug component. Artemether-lumefantrine (six-dose regimen) is more effective than the artemether-lumefantrine (four-dose regimen) or other regimens not containing artemisinin derivatives in treating falciparum malaria. Another recommended combination is dihydroartemisinin and piperaquine . Artemisinin-naphthoquine combination therapy showed promising results in treating falciparum malaria but more research is needed to establish its efficacy as a reliable treatment. Artesunate plus mefloquine performs better than mefloquine alone in treating uncomplicated falciparum malaria in low transmission settings. Atovaquone-proguanil is effective against uncomplicated falciparum with a possible failure rate of 5% to 10%; the addition of artesunate may reduce failure rate. Azithromycin monotherapy or combination therapy has not shown effectiveness in treating Plasmodium falciparum or Plasmodium vivax malaria. Amodiaquine plus sulfadoxine-pyrimethamine may achieve less treatment failures when compared to sulfadoxine-pyrimethamine alone in uncomplicated falciparum malaria. There is insufficient data on chlorproguanil-dapsone in treating uncomplicated falciparum malaria. The addition of primaquine with artemisinin-based combination therapy for falciparum malaria reduces its transmission at day 3-4 and day 8 of infection. Sulfadoxine-pyrimethamine plus artesunate is better than sulfadoxine-pyrimethamine plus amodiaquine in controlling treatment failure at day 28. However, the latter is better than the former in reducing gametocytes in blood at day 7. Infection with P. vivax , P. ovale or P. malariae usually does not require hospitalisation. Treatment of P. vivax malaria requires both elimination of the parasite in the blood with chloroquine or with artemisinin-based combination therapy and clearance of parasites from the liver with an 8-aminoquinoline agent such as primaquine or tafenoquine . These two drugs act against blood stages as well, the extent to which they do so still being under investigation. To treat malaria during pregnancy, the WHO recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and ACT in later stages (2nd and 3rd trimesters). There is limited safety data on the antimalarial drugs in pregnancy. Cases of severe and complicated malaria are almost always caused by infection with P. falciparum . The other species usually cause only febrile disease. Severe and complicated malaria cases are medical emergencies since mortality rates are high (10% to 50%). Recommended treatment for severe malaria is the intravenous use of antimalarial drugs. For severe malaria, parenteral artesunate was superior to quinine in both children and adults. In another systematic review, artemisinin derivatives (artemether and arteether) were as efficacious as quinine in the treatment of cerebral malaria in children. Treatment of severe malaria involves supportive measures that are best done in a critical care unit . This includes the management of high fevers and the seizures that may result from it. It also includes monitoring for poor breathing effort , low blood sugar, and low blood potassium . Artemisinin derivatives have the same or better efficacy than quinolones in preventing deaths in severe or complicated malaria. Quinine loading dose helps to shorten the duration of fever and increases parasite clearance from the body. There is no difference in effectiveness when using intrarectal quinine compared to intravenous or intramuscular quinine in treating uncomplicated/complicated falciparum malaria. There is insufficient evidence for intramuscular arteether to treat severe malaria. The provision of rectal artesunate before transfer to hospital may reduce the rate of death for children with severe malaria. In children with malaria and concomitant hypoglycaemia, sublingual administration of glucose appears to result in better increases in blood sugar after 20 minutes when compared to oral administration, based on very limited data. Cerebral malaria is the form of severe and complicated malaria with the worst neurological symptoms. There is insufficient data on whether osmotic agents such as mannitol or urea are effective in treating cerebral malaria. Routine phenobarbitone in cerebral malaria is associated with fewer convulsions but possibly more deaths. There is no evidence that steroids would bring treatment benefits for cerebral malaria. Managing Cerebral Malaria Cerebral malaria usually makes a patient comatose. If the cause of the coma is in doubt, testing for other locally prevalent causes of encephalopathy (bacterial, viral or fungal infection) should be carried out. In areas where there is a high prevalence of malaria infection (e.g. tropical region) treatment can start without testing first. To manage the cerebral malaria when confirmed the following can be done: Patients in coma should be given meticulous nursing care ( monitor vital signs, turn patient every 2 hours, avoid lying the patient in a wet bed etc.) A sterile urethral catheter should be inserted to help with urinating To aspirate stomach content, a sterile nasogastric tube should be inserted. In the occasion of convulsions, a slow intravenous injection of benzodiazepine is administered. There is insufficient evidence to show that blood transfusion is useful in either reducing deaths for children with severe anaemia or in improving their haematocrit in one month. There is insufficient evidence that iron chelating agents such as deferoxamine and deferiprone improve outcomes of those with malaria falciparum infection. A 2022 clinical trial shows that a monoclonal antibody mAb L9LS offers protection against malaria. It binds the Plasmodium falciparum circumsporozoite protein (CSP-1), essential to disease, and makes it ineffective. Drug resistance poses a growing problem in 21st-century malaria treatment. In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia. Resistance is now common against all classes of antimalarial drugs apart from artemisinins . Treatment of resistant strains became increasingly dependent on this class of drugs. The cost of artemisinins limits their use in the developing world. Malaria strains found on the Cambodia–Thailand border are resistant to combination therapies that include artemisinins, and may, therefore, be untreatable. Exposure of the parasite population to artemisinin monotherapies in subtherapeutic doses for over 30 years and the availability of substandard artemisinins likely drove the selection of the resistant phenotype. Resistance to artemisinin has been detected in Cambodia, Myanmar, Thailand, and Vietnam, and there has been emerging resistance in Laos. Resistance to the combination of artemisinin and piperaquine was first detected in 2013 in Cambodia, and by 2019 had spread across Cambodia and into Laos , Thailand and Vietnam (with up to 80 percent of malaria parasites resistant in some regions). There is insufficient evidence in unit packaged antimalarial drugs in preventing treatment failures of malaria infection. However, if supported by training of healthcare providers and patient information, there is improvement in compliance of those receiving treatment. When properly treated, people with malaria can usually expect a complete recovery. However, severe malaria can progress extremely rapidly and cause death within hours or days. In the most severe cases of the disease, fatality rates can reach 20%, even with intensive care and treatment. Over the longer term, developmental impairments have been documented in children who have had episodes of severe malaria. Chronic infection without severe disease can occur in an immune-deficiency syndrome associated with a decreased responsiveness to Salmonella bacteria and the Epstein–Barr virus . During childhood, malaria causes anaemia during a period of rapid brain development, and also direct brain damage resulting from cerebral malaria. Some survivors of cerebral malaria have an increased risk of neurological and cognitive deficits, behavioural disorders , and epilepsy . Malaria prophylaxis was shown to improve cognitive function and school performance in clinical trials when compared to placebo groups. The WHO estimates that in 2021 there were 247 million new cases of malaria resulting in 619,000 deaths. Children under five years old are the most affected, accounting for 67% of malaria deaths worldwide in 2019. About 125 million pregnant women are at risk of infection each year; in Sub-Saharan Africa , maternal malaria is associated with up to 200,000 estimated infant deaths yearly. Since 2015, the WHO European Region has been free of malaria. The last country to report an indigenous malaria case was Tajikistan in 2014. There are about 1300–1500 malaria cases per year in the United States. The United States eradicated malaria as a major public health concern in 1951, though small outbreaks persist. Locally acquired mosquito-borne malaria occurred in the United States in 2003, when eight cases of locally acquired P. vivax malaria were identified in Florida, and again in May 2023, in four cases, as well as one case in Texas, and in August in one case in Maryland. About 900 people died from the disease in Europe between 1993 and 2003. Both the global incidence of disease and resulting mortality have declined in recent years. According to the WHO and UNICEF, deaths attributable to malaria in 2015 were reduced by 60% from a 2000 estimate of 985,000, largely due to the widespread use of insecticide-treated nets and artemisinin-based combination therapies. Between 2000 and 2019, malaria mortality rates among all ages halved from about 30 to 13 per 100,000 population at risk. During this period, malaria deaths among children under five also declined by nearly half (47%) from 781,000 in 2000 to 416,000 in 2019. Malaria is presently endemic in a broad band around the equator, in areas of the Americas, many parts of Asia, and much of Africa; in Sub-Saharan Africa, 85–90% of malaria fatalities occur. An estimate for 2009 reported that countries with the highest death rate per 100,000 of population were Ivory Coast (86.15), Angola (56.93) and Burkina Faso (50.66). A 2010 estimate indicated the deadliest countries per population were Burkina Faso, Mozambique and Mali . The Malaria Atlas Project aims to map global levels of malaria , providing a way to determine the global spatial limits of the disease and to assess disease burden . This effort led to the publication of a map of P. falciparum endemicity in 2010 and an update in 2019. As of 2021, 84 countries have endemic malaria. The geographic distribution of malaria within large regions is complex, and malaria-afflicted and malaria-free areas are often found close to each other. Malaria is prevalent in tropical and subtropical regions because of rainfall, consistent high temperatures and high humidity, along with stagnant waters where mosquito larvae readily mature, providing them with the environment they need for continuous breeding. In drier areas, outbreaks of malaria have been predicted with reasonable accuracy by mapping rainfall. Malaria is more common in rural areas than in cities. For example, several cities in the Greater Mekong Subregion of Southeast Asia are essentially malaria-free, but the disease is prevalent in many rural regions, including along international borders and forest fringes. In contrast, malaria in Africa is present in both rural and urban areas, though the risk is lower in the larger cities. Climate change is likely to affect malaria transmission, but the degree of effect and the areas affected is uncertain. Greater rainfall in certain areas of India, and following an El Niño event is associated with increased mosquito numbers. Since 1900 there has been substantial change in temperature and rainfall over Africa. However, factors that contribute to how rainfall results in water for mosquito breeding are complex, incorporating the extent to which it is absorbed into soil and vegetation for example, or rates of runoff and evaporation. Recent research has provided a more in-depth picture of conditions across Africa, combining a malaria climatic suitability model with a continental-scale model representing real-world hydrological processes. Climate change is likely to affect malaria transmission, but the degree of effect and the areas affected is uncertain. Greater rainfall in certain areas of India, and following an El Niño event is associated with increased mosquito numbers. Since 1900 there has been substantial change in temperature and rainfall over Africa. However, factors that contribute to how rainfall results in water for mosquito breeding are complex, incorporating the extent to which it is absorbed into soil and vegetation for example, or rates of runoff and evaporation. Recent research has provided a more in-depth picture of conditions across Africa, combining a malaria climatic suitability model with a continental-scale model representing real-world hydrological processes. Although the parasite responsible for P. falciparum malaria has been in existence for 50,000–100,000 years, the population size of the parasite did not increase until about 10,000 years ago, concurrently with advances in agriculture and the development of human settlements. Close relatives of the human malaria parasites remain common in chimpanzees. Some evidence suggests that the P. falciparum malaria may have originated in gorillas. References to the unique periodic fevers of malaria are found throughout history. Hippocrates described periodic fevers, labelling them tertian, quartan, subtertian and quotidian. The Roman Columella associated the disease with insects from swamps. Malaria may have contributed to the decline of the Roman Empire , and was so pervasive in Rome that it was known as the " Roman fever ". Several regions in ancient Rome were considered at-risk for the disease because of the favourable conditions present for malaria vectors. This included areas such as southern Italy, the island of Sardinia , the Pontine Marshes , the lower regions of coastal Etruria and the city of Rome along the Tiber . The presence of stagnant water in these places was preferred by mosquitoes for breeding grounds. Irrigated gardens, swamp-like grounds, run-off from agriculture, and drainage problems from road construction led to the increase of standing water. The term malaria originates from Mediaeval Italian : mala aria —"bad air", a part of miasma theory ; the disease was formerly called ague or marsh fever due to its association with swamps and marshland. The term appeared in English at least as early as 1768. Malaria was once common in most of Europe and North America, where it is no longer endemic, though imported cases do occur. Malaria is not referenced in the medical books of the Mayans or Aztecs . Despite this, antibodies against malaria have been detected in some South American mummies, indicating that some malaria strains in the Americas might have a pre-Columbian origin. European settlers and the West Africans they enslaved likely brought malaria to the Americas starting in the 16th century. Scientific studies on malaria made their first significant advance in 1880, when Charles Louis Alphonse Laveran —a French army doctor working in the military hospital of Constantine in Algeria —observed parasites inside the red blood cells of infected people for the first time. He, therefore, proposed that malaria is caused by this organism, the first time a protist was identified as causing disease. For this and later discoveries, he was awarded the 1907 Nobel Prize for Physiology or Medicine . A year later, Carlos Finlay , a Cuban doctor treating people with yellow fever in Havana , provided strong evidence that mosquitoes were transmitting disease to and from humans. This work followed earlier suggestions by Josiah C. Nott , and work by Sir Patrick Manson , the "father of tropical medicine", on the transmission of filariasis . In April 1894, a Scottish physician, Sir Ronald Ross , visited Sir Patrick Manson at his house on Queen Anne Street, London. This visit was the start of four years of collaboration and fervent research that culminated in 1897 when Ross, who was working in the Presidency General Hospital in Calcutta , proved the complete life-cycle of the malaria parasite in mosquitoes. He thus proved that the mosquito was the vector for malaria in humans by showing that certain mosquito species transmit malaria to birds. He isolated malaria parasites from the salivary glands of mosquitoes that had fed on infected birds. For this work, Ross received the 1902 Nobel Prize in Medicine. After resigning from the Indian Medical Service , Ross worked at the newly established Liverpool School of Tropical Medicine and directed malaria-control efforts in Egypt , Panama , Greece and Mauritius . The findings of Finlay and Ross were later confirmed by a medical board headed by Walter Reed in 1900. Its recommendations were implemented by William C. Gorgas in the health measures undertaken during construction of the Panama Canal . This public-health work saved the lives of thousands of workers and helped develop the methods used in future public-health campaigns against the disease. In 1896, Amico Bignami discussed the role of mosquitoes in malaria. In 1898, Bignami, Giovanni Battista Grassi and Giuseppe Bastianelli succeeded in showing experimentally the transmission of malaria in humans, using infected mosquitoes to contract malaria themselves which they presented in November 1898 to the Accademia dei Lincei . The first effective treatment for malaria came from the bark of cinchona tree , which contains quinine . This tree grows on the slopes of the Andes , mainly in Peru . The indigenous peoples of Peru made a tincture of cinchona to control fever. Its effectiveness against malaria was found and the Jesuits introduced the treatment to Europe around 1640; by 1677, it was included in the London Pharmacopoeia as an antimalarial treatment. It was not until 1820 that the active ingredient, quinine, was extracted from the bark, isolated and named by the French chemists Pierre Joseph Pelletier and Joseph Bienaimé Caventou . Quinine was the predominant malarial medication until the 1920s when other medications began to appear. In the 1940s, chloroquine replaced quinine as the treatment of both uncomplicated and severe malaria until resistance supervened, first in Southeast Asia and South America in the 1950s and then globally in the 1980s. The medicinal value of Artemisia annua has been used by Chinese herbalists in traditional Chinese medicines for 2,000 years. In 1596, Li Shizhen recommended tea made from qinghao specifically to treat malaria symptoms in his " Compendium of Materia Medica ", however the efficacy of tea, made with A. annua , for the treatment of malaria is dubious, and is discouraged by the World Health Organization (WHO). Artemisinins, discovered by Chinese scientist Tu Youyou and colleagues in the 1970s from the plant Artemisia annua , became the recommended treatment for P. falciparum malaria, administered in severe cases in combination with other antimalarials. Tu says she was influenced by a traditional Chinese herbal medicine source, The Handbook of Prescriptions for Emergency Treatments , written in 340 by Ge Hong . For her work on malaria, Tu Youyou received the 2015 Nobel Prize in Physiology or Medicine . Plasmodium vivax was used between 1917 and the 1940s for malariotherapy —deliberate injection of malaria parasites to induce a fever to combat certain diseases such as tertiary syphilis . In 1927, the inventor of this technique, Julius Wagner-Jauregg , received the Nobel Prize in Physiology or Medicine for his discoveries. The technique was dangerous, killing about 15% of patients, so it is no longer in use. The first pesticide used for indoor residual spraying was DDT . Although it was initially used exclusively to combat malaria, its use quickly spread to agriculture . In time, pest control, rather than disease control, came to dominate DDT use, and this large-scale agricultural use led to the evolution of pesticide-resistant mosquitoes in many regions. The DDT resistance shown by Anopheles mosquitoes can be compared to antibiotic resistance shown by bacteria. During the 1960s, awareness of the negative consequences of its indiscriminate use increased, ultimately leading to bans on agricultural applications of DDT in many countries in the 1970s. Before DDT, malaria was successfully eliminated or controlled in tropical areas like Brazil and Egypt by removing or poisoning the breeding grounds of the mosquitoes or the aquatic habitats of the larval stages, for example by applying the highly toxic arsenic compound Paris Green to places with standing water. Various types of malaria have been called by the names below: Various types of malaria have been called by the names below: Malaria has been successfully eliminated or significantly reduced in certain areas, but not globally. Malaria was once common in the United States, but the US eliminated malaria from most parts of the country in the early 20th century using vector control programs, which combined the monitoring and treatment of infected humans, draining of wetland breeding grounds for agriculture and other changes in water management practices, and advances in sanitation, including greater use of glass windows and screens in dwellings. The use of the pesticide DDT and other means eliminated malaria from the remaining pockets in southern states of the US the 1950s, as part of the National Malaria Eradication Program . Most of Europe , North America , Australia , North Africa and the Caribbean , and parts of South America , Asia and Southern Africa have also eliminated malaria. The WHO defines "elimination" (or "malaria-free") as having no domestic transmission (indigenous cases) for the past three years. They also define "pre-elimination" and "elimination" stages when a country has fewer than 5 or 1, respectively, cases per 1000 people at risk per year. In 2021, the total of international and national funding for malaria control and elimination was $3.5 billion – only half of what is estimated to be needed. According to UNICEF, to achieve the goal of a malaria-free world, annual funding would need to more than double to reach the US$6.8 billion target. In parts of the world with rising living standards, the elimination of malaria was often a collateral benefit of the introduction of window screens and improved sanitation. A variety of usually simultaneous interventions represents best practice. These include antimalarial drugs to prevent or treat infection; improvements in public health infrastructure to diagnose, sequester and treat infected individuals; bednets and other methods intended to keep mosquitoes from biting humans; and vector control strategies such as larvaciding with insecticides, ecological controls such as draining mosquito breeding grounds or introducing fish to eat larvae and indoor residual spraying (IRS) with insecticides. In 1955 the WHO launched the Global Malaria Eradication Program (GMEP). The program relied largely on DDT for mosquito control and rapid diagnosis and treatment to break the transmission cycle. The program eliminated the disease in "North America, Europe, the former Soviet Union ", and in " Taiwan , much of the Caribbean , the Balkans , parts of northern Africa, the northern region of Australia, and a large swath of the South Pacific" and dramatically reduced mortality in Sri Lanka and India. However, failure to sustain the program, increasing mosquito tolerance to DDT, and increasing parasite tolerance led to a resurgence. In many areas early successes partially or completely reversed, and in some cases rates of transmission increased. Experts tie malarial resurgence to multiple factors, including poor leadership, management and funding of malaria control programs; poverty; civil unrest; and increased irrigation . The evolution of resistance to first-generation drugs (e.g. chloroquine ) and to insecticides exacerbated the situation. The program succeeded in eliminating malaria only in areas with "high socio-economic status, well-organized healthcare systems, and relatively less intensive or seasonal malaria transmission". For example, in Sri Lanka , the program reduced cases from about one million per year before spraying to just 18 in 1963 and 29 in 1964. Thereafter the program was halted to save money and malaria rebounded to 600,000 cases in 1968 and the first quarter of 1969. The country resumed DDT vector control but the mosquitoes had evolved resistance in the interim, presumably because of continued agricultural use. The program switched to malathion , but despite initial successes, malaria continued its resurgence into the 1980s. Due to vector and parasite resistance and other factors, the feasibility of eradicating malaria with the strategy used at the time and resources available led to waning support for the program. WHO suspended the program in 1969 and attention instead focused on controlling and treating the disease. Spraying programs (especially using DDT) were curtailed due to concerns over safety and environmental effects, as well as problems in administrative, managerial and financial implementation. Efforts shifted from spraying to the use of bednets impregnated with insecticides and other interventions. Target 6C of the Millennium Development Goals included reversal of the global increase in malaria incidence by 2015, with specific targets for children under five years old. Since 2000, support for malaria eradication increased, although some actors in the global health community (including voices within the WHO) view malaria eradication as a premature goal and suggest that the establishment of strict deadlines for malaria eradication may be counterproductive as they are likely to be missed. One of the targets of Goal 3 of the UN 's Sustainable Development Goals is to end the malaria epidemic in all countries by 2030. In 2006, the organization Malaria No More set a public goal of eliminating malaria from Africa by 2015, and the organization claimed they planned to dissolve if that goal was accomplished. In 2007, World Malaria Day was established by the 60th session of the World Health Assembly . As of 2018, they are still functioning. As of 2012 [ update ] , The Global Fund to Fight AIDS, Tuberculosis, and Malaria has distributed 230 million insecticide-treated nets intended to stop mosquito-borne transmission of malaria. The U.S.-based Clinton Foundation has worked to manage demand and stabilize prices in the artemisinin market. Other efforts, such as the Malaria Atlas Project, focus on analysing climate and weather information required to accurately predict malaria spread based on the availability of habitat of malaria-carrying parasites. The Malaria Policy Advisory Committee (MPAC) of the World Health Organization (WHO) was formed in 2012, "to provide strategic advice and technical input to WHO on all aspects of malaria control and elimination". In 2015 the WHO targeted a 90% reduction in malaria deaths by 2030, and Bill Gates said in 2016 that he thought global eradication would be possible by 2040. According to the WHO's World Malaria Report 2015, the global mortality rate for malaria fell by 60% between 2000 and 2015. The WHO targeted a further 90% reduction between 2015 and 2030, with a 40% reduction and eradication in 10 countries by 2020. However, the 2020 goal was missed with a slight increase in cases compared to 2015. Additionally, UNICEF reported that the number of malaria deaths for all ages increased by 10% between 2019 and 2020, in part due to service disruptions related to the COVID-19 pandemic, before experiencing a minor decline in 2021. Before 2016, the Global Fund against HIV/AIDS, Tuberculosis and Malaria had provided 659 million ITN (insecticide treated bed nets), organise support and education to prevents malaria. The challenges are high due to the lack of funds, the fragile health structure and the remote indigenous population that could be hard to reach and educate. Most of indigenous population rely on self-diagnosis, self-treatment, healer, and traditional medicine. The WHO applied for fund to the Gates Foundation which favour the action of malaria eradication in 2007. Six countries, the United Arab Emirates, Morocco, Armenia, Turkmenistan, Kyrgyzstan, and Sri Lanka managed to have no endemic cases of malaria for three consecutive years and certified malaria-free by the WHO despite the stagnation of the funding in 2010. The funding is essential to finance the cost of medication and hospitalisation cannot be supported by the poor countries where the disease is widely spread. The goal of eradication has not been met; nevertheless, the decrease rate of the disease is considerable. While 31 out of 92 endemic countries were estimated to be on track with the WHO goals for 2020, 15 countries reported an increase of 40% or more between 2015 and 2020. Between 2000 and 30 June 2021, twelve countries were certified by the WHO as being malaria-free. Argentina and Algeria were declared free of malaria in 2019. El Salvador and China were declared malaria-free in the first half of 2021. Regional disparities were evident: Southeast Asia was on track to meet WHO's 2020 goals, while Africa, Americas, Eastern Mediterranean and West Pacific regions were off-track. The six Greater Mekong Subregion countries aim for elimination of P. falciparum transmitted malaria by 2025 and elimination of all malaria by 2030, having achieved a 97% and 90% reduction of cases respectively since 2000. Ahead of World Malaria Day , 25 April 2021, WHO named 25 countries in which it is working to eliminate malaria by 2025 as part of its E-2025 initiative. A major challenge to malaria elimination is the persistence of malaria in border regions, making international cooperation crucial. In 2018, WHO announced that Paraguay was free of malaria, after a national malaria eradication effort that began in 1950. As of 2019, the eradication process is ongoing, but it will be difficult to achieve a world free of malaria with the current approaches and tools. In March 2023, the WHO certified Azerbaijan and Tajikistan as malaria-free, and Belize in June 2023. Cabo Verde, the latest country to eradicate Malaria, was certified in January 2024, bringing the total number of countries and territories certified malaria-free to 44. In 1955 the WHO launched the Global Malaria Eradication Program (GMEP). The program relied largely on DDT for mosquito control and rapid diagnosis and treatment to break the transmission cycle. The program eliminated the disease in "North America, Europe, the former Soviet Union ", and in " Taiwan , much of the Caribbean , the Balkans , parts of northern Africa, the northern region of Australia, and a large swath of the South Pacific" and dramatically reduced mortality in Sri Lanka and India. However, failure to sustain the program, increasing mosquito tolerance to DDT, and increasing parasite tolerance led to a resurgence. In many areas early successes partially or completely reversed, and in some cases rates of transmission increased. Experts tie malarial resurgence to multiple factors, including poor leadership, management and funding of malaria control programs; poverty; civil unrest; and increased irrigation . The evolution of resistance to first-generation drugs (e.g. chloroquine ) and to insecticides exacerbated the situation. The program succeeded in eliminating malaria only in areas with "high socio-economic status, well-organized healthcare systems, and relatively less intensive or seasonal malaria transmission". For example, in Sri Lanka , the program reduced cases from about one million per year before spraying to just 18 in 1963 and 29 in 1964. Thereafter the program was halted to save money and malaria rebounded to 600,000 cases in 1968 and the first quarter of 1969. The country resumed DDT vector control but the mosquitoes had evolved resistance in the interim, presumably because of continued agricultural use. The program switched to malathion , but despite initial successes, malaria continued its resurgence into the 1980s. Due to vector and parasite resistance and other factors, the feasibility of eradicating malaria with the strategy used at the time and resources available led to waning support for the program. WHO suspended the program in 1969 and attention instead focused on controlling and treating the disease. Spraying programs (especially using DDT) were curtailed due to concerns over safety and environmental effects, as well as problems in administrative, managerial and financial implementation. Efforts shifted from spraying to the use of bednets impregnated with insecticides and other interventions. Target 6C of the Millennium Development Goals included reversal of the global increase in malaria incidence by 2015, with specific targets for children under five years old. Since 2000, support for malaria eradication increased, although some actors in the global health community (including voices within the WHO) view malaria eradication as a premature goal and suggest that the establishment of strict deadlines for malaria eradication may be counterproductive as they are likely to be missed. One of the targets of Goal 3 of the UN 's Sustainable Development Goals is to end the malaria epidemic in all countries by 2030. In 2006, the organization Malaria No More set a public goal of eliminating malaria from Africa by 2015, and the organization claimed they planned to dissolve if that goal was accomplished. In 2007, World Malaria Day was established by the 60th session of the World Health Assembly . As of 2018, they are still functioning. As of 2012 [ update ] , The Global Fund to Fight AIDS, Tuberculosis, and Malaria has distributed 230 million insecticide-treated nets intended to stop mosquito-borne transmission of malaria. The U.S.-based Clinton Foundation has worked to manage demand and stabilize prices in the artemisinin market. Other efforts, such as the Malaria Atlas Project, focus on analysing climate and weather information required to accurately predict malaria spread based on the availability of habitat of malaria-carrying parasites. The Malaria Policy Advisory Committee (MPAC) of the World Health Organization (WHO) was formed in 2012, "to provide strategic advice and technical input to WHO on all aspects of malaria control and elimination". In 2015 the WHO targeted a 90% reduction in malaria deaths by 2030, and Bill Gates said in 2016 that he thought global eradication would be possible by 2040. According to the WHO's World Malaria Report 2015, the global mortality rate for malaria fell by 60% between 2000 and 2015. The WHO targeted a further 90% reduction between 2015 and 2030, with a 40% reduction and eradication in 10 countries by 2020. However, the 2020 goal was missed with a slight increase in cases compared to 2015. Additionally, UNICEF reported that the number of malaria deaths for all ages increased by 10% between 2019 and 2020, in part due to service disruptions related to the COVID-19 pandemic, before experiencing a minor decline in 2021. Before 2016, the Global Fund against HIV/AIDS, Tuberculosis and Malaria had provided 659 million ITN (insecticide treated bed nets), organise support and education to prevents malaria. The challenges are high due to the lack of funds, the fragile health structure and the remote indigenous population that could be hard to reach and educate. Most of indigenous population rely on self-diagnosis, self-treatment, healer, and traditional medicine. The WHO applied for fund to the Gates Foundation which favour the action of malaria eradication in 2007. Six countries, the United Arab Emirates, Morocco, Armenia, Turkmenistan, Kyrgyzstan, and Sri Lanka managed to have no endemic cases of malaria for three consecutive years and certified malaria-free by the WHO despite the stagnation of the funding in 2010. The funding is essential to finance the cost of medication and hospitalisation cannot be supported by the poor countries where the disease is widely spread. The goal of eradication has not been met; nevertheless, the decrease rate of the disease is considerable. While 31 out of 92 endemic countries were estimated to be on track with the WHO goals for 2020, 15 countries reported an increase of 40% or more between 2015 and 2020. Between 2000 and 30 June 2021, twelve countries were certified by the WHO as being malaria-free. Argentina and Algeria were declared free of malaria in 2019. El Salvador and China were declared malaria-free in the first half of 2021. Regional disparities were evident: Southeast Asia was on track to meet WHO's 2020 goals, while Africa, Americas, Eastern Mediterranean and West Pacific regions were off-track. The six Greater Mekong Subregion countries aim for elimination of P. falciparum transmitted malaria by 2025 and elimination of all malaria by 2030, having achieved a 97% and 90% reduction of cases respectively since 2000. Ahead of World Malaria Day , 25 April 2021, WHO named 25 countries in which it is working to eliminate malaria by 2025 as part of its E-2025 initiative. A major challenge to malaria elimination is the persistence of malaria in border regions, making international cooperation crucial. In 2018, WHO announced that Paraguay was free of malaria, after a national malaria eradication effort that began in 1950. As of 2019, the eradication process is ongoing, but it will be difficult to achieve a world free of malaria with the current approaches and tools. In March 2023, the WHO certified Azerbaijan and Tajikistan as malaria-free, and Belize in June 2023. Cabo Verde, the latest country to eradicate Malaria, was certified in January 2024, bringing the total number of countries and territories certified malaria-free to 44. Malaria is not just a disease commonly associated with poverty : some evidence suggests that it is also a cause of poverty and a major hindrance to economic development . Although tropical regions are most affected, malaria's furthest influence reaches into some temperate zones that have extreme seasonal changes. The disease has been associated with major negative economic effects on regions where it is widespread. During the late 19th and early 20th centuries, it was a major factor in the slow economic development of the American southern states. A comparison of average per capita GDP in 1995, adjusted for parity of purchasing power , between countries with malaria and countries without malaria gives a fivefold difference (US$1,526 versus US$8,268). In the period 1965 to 1990, countries where malaria was common had an average per capita GDP that increased only 0.4% per year, compared to 2.4% per year in other countries. Poverty can increase the risk of malaria since those in poverty do not have the financial capacities to prevent or treat the disease. In its entirety, the economic impact of malaria has been estimated to cost Africa US$12 billion every year. The economic impact includes costs of health care, working days lost due to sickness, days lost in education, decreased productivity due to brain damage from cerebral malaria, and loss of investment and tourism. The disease has a heavy burden in some countries, where it may be responsible for 30–50% of hospital admissions, up to 50% of outpatient visits, and up to 40% of public health spending. Cerebral malaria is one of the leading causes of neurological disabilities in African children. Studies comparing cognitive functions before and after treatment for severe malarial illness continued to show significantly impaired school performance and cognitive abilities even after recovery. Consequently, severe and cerebral malaria have far-reaching socioeconomic consequences that extend beyond the immediate effects of the disease. Sophisticated counterfeits have been found in several Asian countries such as Cambodia , China , Indonesia , Laos , Thailand , and Vietnam , and are a major cause of avoidable death in those countries. The WHO said that studies indicate that up to 40% of artesunate-based malaria medications are counterfeit, especially in the Greater Mekong region. They have established a rapid alert system to rapidly report information about counterfeit drugs to relevant authorities in participating countries. There is no reliable way for doctors or lay people to detect counterfeit drugs without help from a laboratory. Companies are attempting to combat the persistence of counterfeit drugs by using new technology to provide security from source to distribution. Another clinical and public health concern is the proliferation of substandard antimalarial medicines resulting from inappropriate concentration of ingredients, contamination with other drugs or toxic impurities, poor quality ingredients, poor stability and inadequate packaging. A 2012 study demonstrated that roughly one-third of antimalarial medications in Southeast Asia and Sub-Saharan Africa failed chemical analysis, packaging analysis, or were falsified. Throughout history, the contraction of malaria has played a prominent role in the fates of government rulers, nation-states, military personnel, and military actions. In 1910, Nobel Prize in Medicine -winner Ronald Ross (himself a malaria survivor), published a book titled The Prevention of Malaria that included a chapter titled "The Prevention of Malaria in War". The chapter's author, Colonel C. H. Melville, Professor of Hygiene at Royal Army Medical College in London, addressed the prominent role that malaria has historically played during wars: "The history of malaria in war might almost be taken to be the history of war itself, certainly the history of war in the Christian era. ... It is probably the case that many of the so-called camp fevers, and probably also a considerable proportion of the camp dysentery, of the wars of the sixteenth, seventeenth and eighteenth centuries were malarial in origin." In British-occupied India the cocktail gin and tonic may have come about as a way of taking quinine, known for its antimalarial properties. Malaria was the most significant health hazard encountered by U.S. troops in the South Pacific during World War II , where about 500,000 men were infected. According to Joseph Patrick Byrne, "Sixty thousand American soldiers died of malaria during the African and South Pacific campaigns." Significant financial investments have been made to procure existing and create new antimalarial agents. During World War I and World War II, inconsistent supplies of the natural antimalaria drugs cinchona bark and quinine prompted substantial funding into research and development of other drugs and vaccines. American military organisations conducting such research initiatives include the Navy Medical Research Center, Walter Reed Army Institute of Research , and the U.S. Army Medical Research Institute of Infectious Diseases of the US Armed Forces. Additionally, initiatives have been founded such as Malaria Control in War Areas (MCWA), established in 1942, and its successor, the Communicable Disease Center (now known as the Centers for Disease Control and Prevention , or CDC) established in 1946. According to the CDC, MCWA "was established to control malaria around military training bases in the southern United States and its territories, where malaria was still problematic". Malaria is not just a disease commonly associated with poverty : some evidence suggests that it is also a cause of poverty and a major hindrance to economic development . Although tropical regions are most affected, malaria's furthest influence reaches into some temperate zones that have extreme seasonal changes. The disease has been associated with major negative economic effects on regions where it is widespread. During the late 19th and early 20th centuries, it was a major factor in the slow economic development of the American southern states. A comparison of average per capita GDP in 1995, adjusted for parity of purchasing power , between countries with malaria and countries without malaria gives a fivefold difference (US$1,526 versus US$8,268). In the period 1965 to 1990, countries where malaria was common had an average per capita GDP that increased only 0.4% per year, compared to 2.4% per year in other countries. Poverty can increase the risk of malaria since those in poverty do not have the financial capacities to prevent or treat the disease. In its entirety, the economic impact of malaria has been estimated to cost Africa US$12 billion every year. The economic impact includes costs of health care, working days lost due to sickness, days lost in education, decreased productivity due to brain damage from cerebral malaria, and loss of investment and tourism. The disease has a heavy burden in some countries, where it may be responsible for 30–50% of hospital admissions, up to 50% of outpatient visits, and up to 40% of public health spending. Cerebral malaria is one of the leading causes of neurological disabilities in African children. Studies comparing cognitive functions before and after treatment for severe malarial illness continued to show significantly impaired school performance and cognitive abilities even after recovery. Consequently, severe and cerebral malaria have far-reaching socioeconomic consequences that extend beyond the immediate effects of the disease. Sophisticated counterfeits have been found in several Asian countries such as Cambodia , China , Indonesia , Laos , Thailand , and Vietnam , and are a major cause of avoidable death in those countries. The WHO said that studies indicate that up to 40% of artesunate-based malaria medications are counterfeit, especially in the Greater Mekong region. They have established a rapid alert system to rapidly report information about counterfeit drugs to relevant authorities in participating countries. There is no reliable way for doctors or lay people to detect counterfeit drugs without help from a laboratory. Companies are attempting to combat the persistence of counterfeit drugs by using new technology to provide security from source to distribution. Another clinical and public health concern is the proliferation of substandard antimalarial medicines resulting from inappropriate concentration of ingredients, contamination with other drugs or toxic impurities, poor quality ingredients, poor stability and inadequate packaging. A 2012 study demonstrated that roughly one-third of antimalarial medications in Southeast Asia and Sub-Saharan Africa failed chemical analysis, packaging analysis, or were falsified. Throughout history, the contraction of malaria has played a prominent role in the fates of government rulers, nation-states, military personnel, and military actions. In 1910, Nobel Prize in Medicine -winner Ronald Ross (himself a malaria survivor), published a book titled The Prevention of Malaria that included a chapter titled "The Prevention of Malaria in War". The chapter's author, Colonel C. H. Melville, Professor of Hygiene at Royal Army Medical College in London, addressed the prominent role that malaria has historically played during wars: "The history of malaria in war might almost be taken to be the history of war itself, certainly the history of war in the Christian era. ... It is probably the case that many of the so-called camp fevers, and probably also a considerable proportion of the camp dysentery, of the wars of the sixteenth, seventeenth and eighteenth centuries were malarial in origin." In British-occupied India the cocktail gin and tonic may have come about as a way of taking quinine, known for its antimalarial properties. Malaria was the most significant health hazard encountered by U.S. troops in the South Pacific during World War II , where about 500,000 men were infected. According to Joseph Patrick Byrne, "Sixty thousand American soldiers died of malaria during the African and South Pacific campaigns." Significant financial investments have been made to procure existing and create new antimalarial agents. During World War I and World War II, inconsistent supplies of the natural antimalaria drugs cinchona bark and quinine prompted substantial funding into research and development of other drugs and vaccines. American military organisations conducting such research initiatives include the Navy Medical Research Center, Walter Reed Army Institute of Research , and the U.S. Army Medical Research Institute of Infectious Diseases of the US Armed Forces. Additionally, initiatives have been founded such as Malaria Control in War Areas (MCWA), established in 1942, and its successor, the Communicable Disease Center (now known as the Centers for Disease Control and Prevention , or CDC) established in 1946. According to the CDC, MCWA "was established to control malaria around military training bases in the southern United States and its territories, where malaria was still problematic". The Malaria Eradication Research Agenda (malERA) initiative was a consultative process to identify which areas of research and development (R&D) must be addressed for worldwide eradication of malaria. Malaria parasites contain apicoplasts , organelles related to the plastids found in plants, complete with their own genomes . These apicoplasts are thought to have originated through the endosymbiosis of algae and play a crucial role in various aspects of parasite metabolism , such as fatty acid biosynthesis . Over 400 proteins have been found to be produced by apicoplasts and these are now being investigated as possible targets for novel antimalarial drugs. With the onset of drug-resistant Plasmodium parasites, new strategies are being developed to combat the widespread disease. One such approach lies in the introduction of synthetic pyridoxal -amino acid adducts , which are taken up by the parasite and ultimately interfere with its ability to create several essential B vitamins . Antimalarial drugs using synthetic metal-based complexes are attracting research interest. On the basis of molecular docking outcomes, compounds 3j, 4b, 4h, 4m were exhibited selectivity towards PfLDH. The post docking analysis displayed stable dynamic behavior of all the selected compounds compared to Chloroquine. The end state thermodynamics analysis stated 3j compound as a selective and potent PfLDH inhibitor. Targeting Plasmodium liver-stage parasites selectively is emerging as an alternative strategy in the face of resistance to the latest frontline combination therapies against blood stages of the parasite. In research conducted in 2019, using experimental analysis with knockout (KO) mutants of Plasmodium berghei , the authors were able to identify genes that are potentially essential in the liver stage. Moreover, they generated a computational model to analyse pre–erytrocytic development and liver–stage metabolism. Combining both methods they identified seven metabolic subsystems that become essential compared to the blood stage. Some of these metabolic pathways are fatty acid synthesis and elongation, tricarboxylic acid, amino acid and heme metabolism among others. Specifically, they studied 3 subsystems: fatty acid synthesis and elongation, and amino sugar biosynthesis. For the first two pathways they demonstrated a clear dependence of the liver stage on its own fatty acid metabolism. They proved for the first time the critical role of amino sugar biosynthesis in the liver stage of P. berghei . The uptake of N–acetyl–glucosamine appears to be limited in the liver stage, being its synthesis needed for the parasite development. These findings and the computational model provide a basis for the design of antimalarial therapies targeting metabolic proteins. A non-chemical vector control strategy involves genetic manipulation of malaria mosquitoes. Advances in genetic engineering technologies make it possible to introduce foreign DNA into the mosquito genome and either decrease the lifespan of the mosquito, or make it more resistant to the malaria parasite. Sterile insect technique is a genetic control method whereby large numbers of sterile male mosquitoes are reared and released. Mating with wild females reduces the wild population in the subsequent generation; repeated releases eventually eliminate the target population. Genomics is central to malaria research. With the sequencing of P. falciparum , one of its vectors Anopheles gambiae , and the human genome , the genetics of all three organisms in the malaria life cycle can be studied. Another new application of genetic technology is the ability to produce genetically modified mosquitoes that do not transmit malaria, potentially allowing biological control of malaria transmission. In one study, a genetically modified strain of Anopheles stephensi was created that no longer supported malaria transmission, and this resistance was passed down to mosquito offspring. Gene drive is a technique for changing wild populations, for instance to combat or eliminate insects so they cannot transmit diseases (in particular mosquitoes in the cases of malaria, zika , dengue and yellow fever). In a study conducted in 2015, researchers observed a specific interaction between malaria and co-infection with the nematode Nippostrongylus brasiliensis, a pulmonary migrating helminth , in mice. The co-infection was found to reduce the virulence of the Plasmodium parasite, the causative agent of malaria. This reduction was attributed to the nematode infection causing increased destruction of erythrocytes , or red blood cells. Given that Plasmodium has a predilection for older host erythrocytes, the increased erythrocyte destruction and ensuing erythropoiesis result in a predominantly younger erythrocyte population, which in turn leads to a decrease in Plasmodium population. Notably, this effect appears to be largely independent of the host's immune control of Plasmodium . Finally, a review article published in December 2020 noted a correlation between malaria-endemic regions and COVID-19 case fatality rates. The study found that, on average, regions where malaria is endemic reported lower COVID-19 case fatality rates compared to regions without endemic malaria. In 2017, a bacterial strain of the genus Serratia was genetically modified to prevent malaria in mosquitos and in 2023, it has been reported that the bacterium Delftia tsuruhatensis naturally prevents the development of malaria by secreting a molecule called Harmane . Malaria parasites contain apicoplasts , organelles related to the plastids found in plants, complete with their own genomes . These apicoplasts are thought to have originated through the endosymbiosis of algae and play a crucial role in various aspects of parasite metabolism , such as fatty acid biosynthesis . Over 400 proteins have been found to be produced by apicoplasts and these are now being investigated as possible targets for novel antimalarial drugs. With the onset of drug-resistant Plasmodium parasites, new strategies are being developed to combat the widespread disease. One such approach lies in the introduction of synthetic pyridoxal -amino acid adducts , which are taken up by the parasite and ultimately interfere with its ability to create several essential B vitamins . Antimalarial drugs using synthetic metal-based complexes are attracting research interest. On the basis of molecular docking outcomes, compounds 3j, 4b, 4h, 4m were exhibited selectivity towards PfLDH. The post docking analysis displayed stable dynamic behavior of all the selected compounds compared to Chloroquine. The end state thermodynamics analysis stated 3j compound as a selective and potent PfLDH inhibitor. Targeting Plasmodium liver-stage parasites selectively is emerging as an alternative strategy in the face of resistance to the latest frontline combination therapies against blood stages of the parasite. In research conducted in 2019, using experimental analysis with knockout (KO) mutants of Plasmodium berghei , the authors were able to identify genes that are potentially essential in the liver stage. Moreover, they generated a computational model to analyse pre–erytrocytic development and liver–stage metabolism. Combining both methods they identified seven metabolic subsystems that become essential compared to the blood stage. Some of these metabolic pathways are fatty acid synthesis and elongation, tricarboxylic acid, amino acid and heme metabolism among others. Specifically, they studied 3 subsystems: fatty acid synthesis and elongation, and amino sugar biosynthesis. For the first two pathways they demonstrated a clear dependence of the liver stage on its own fatty acid metabolism. They proved for the first time the critical role of amino sugar biosynthesis in the liver stage of P. berghei . The uptake of N–acetyl–glucosamine appears to be limited in the liver stage, being its synthesis needed for the parasite development. These findings and the computational model provide a basis for the design of antimalarial therapies targeting metabolic proteins. A non-chemical vector control strategy involves genetic manipulation of malaria mosquitoes. Advances in genetic engineering technologies make it possible to introduce foreign DNA into the mosquito genome and either decrease the lifespan of the mosquito, or make it more resistant to the malaria parasite. Sterile insect technique is a genetic control method whereby large numbers of sterile male mosquitoes are reared and released. Mating with wild females reduces the wild population in the subsequent generation; repeated releases eventually eliminate the target population. Genomics is central to malaria research. With the sequencing of P. falciparum , one of its vectors Anopheles gambiae , and the human genome , the genetics of all three organisms in the malaria life cycle can be studied. Another new application of genetic technology is the ability to produce genetically modified mosquitoes that do not transmit malaria, potentially allowing biological control of malaria transmission. In one study, a genetically modified strain of Anopheles stephensi was created that no longer supported malaria transmission, and this resistance was passed down to mosquito offspring. Gene drive is a technique for changing wild populations, for instance to combat or eliminate insects so they cannot transmit diseases (in particular mosquitoes in the cases of malaria, zika , dengue and yellow fever). In a study conducted in 2015, researchers observed a specific interaction between malaria and co-infection with the nematode Nippostrongylus brasiliensis, a pulmonary migrating helminth , in mice. The co-infection was found to reduce the virulence of the Plasmodium parasite, the causative agent of malaria. This reduction was attributed to the nematode infection causing increased destruction of erythrocytes , or red blood cells. Given that Plasmodium has a predilection for older host erythrocytes, the increased erythrocyte destruction and ensuing erythropoiesis result in a predominantly younger erythrocyte population, which in turn leads to a decrease in Plasmodium population. Notably, this effect appears to be largely independent of the host's immune control of Plasmodium . Finally, a review article published in December 2020 noted a correlation between malaria-endemic regions and COVID-19 case fatality rates. The study found that, on average, regions where malaria is endemic reported lower COVID-19 case fatality rates compared to regions without endemic malaria. In 2017, a bacterial strain of the genus Serratia was genetically modified to prevent malaria in mosquitos and in 2023, it has been reported that the bacterium Delftia tsuruhatensis naturally prevents the development of malaria by secreting a molecule called Harmane . While none of the main four species of malaria parasite that cause human infections are known to have animal reservoirs , P. knowlesi is known to regularly infect both humans and non-human primates. Other non-human primate malarias (particularly P. cynomolgi and P. simium ) have also been found to have spilled over into humans. Nearly 200 Plasmodium species have been identified that infect birds , reptiles , and other mammals , and about 30 of them naturally infect non-human primates. Some malaria parasites of non-human primates (NHP) serve as model organisms for human malarial parasites, such as P. coatneyi (a model for P. falciparum ) and P. cynomolgi (a model for P. vivax ). Diagnostic techniques used to detect parasites in NHP are similar to those employed for humans. Malaria parasites that infect rodents are widely used as models in research, such as P. berghei . Avian malaria primarily affects species of the order Passeriformes , and poses a substantial threat to birds of Hawaii , the Galapagos , and other archipelagoes . The parasite P. relictum is known to play a role in limiting the distribution and abundance of endemic Hawaiian birds . Global warming is expected to increase the prevalence and global distribution of avian malaria , as elevated temperatures provide optimal conditions for parasite reproduction.

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Yellow fever

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Lassa fever

Lassa fever , also known as Lassa hemorrhagic fever , is a type of viral hemorrhagic fever caused by the Lassa virus . Many of those infected by the virus do not develop symptoms . When symptoms occur they typically include fever , weakness, headaches, vomiting , and muscle pains . Less commonly there may be bleeding from the mouth or gastrointestinal tract . The risk of death once infected is about one percent and frequently occurs within two weeks of the onset of symptoms. Of those who survive, about a quarter have hearing loss , which improves within three months in about half of these cases. The disease is usually initially spread to people via contact with the urine or feces of an infected multimammate mouse . Spread can then occur via direct contact between people. Diagnosis based on symptoms is difficult. Confirmation is by laboratory testing to detect the virus's RNA , antibodies for the virus, or the virus itself in cell culture . Other conditions that may present similarly include Ebola , malaria , typhoid fever , and yellow fever . The Lassa virus is a member of the Arenaviridae family of viruses . There is no vaccine . Prevention requires isolating those who are infected and decreasing contact with the mice. Other efforts to control the spread of disease include having a cat to hunt vermin , and storing food in sealed containers. Treatment is directed at addressing dehydration and improving symptoms. The antiviral medication ribavirin has been recommended, but evidence to support its use is weak. Descriptions of the disease date from the 1950s. The virus was first described in 1969 from a case in the town of Lassa, in Borno State , Nigeria . Lassa fever is relatively common in West Africa including the countries of Nigeria , Liberia , Sierra Leone , Guinea , and Ghana . There are about 300,000 to 500,000 cases which result in 5,000 deaths a year. Onset of symptoms is typically 7 to 21 days after exposure. In 80% of those who are infected few or no symptoms occur. These mild symptoms may include fever, tiredness, weakness, and headache. In 20% of people more severe symptoms such as bleeding gums, breathing problems, vomiting, chest pain, or dangerously low blood pressure may occur. Long term complications may include hearing loss . In those who are pregnant , miscarriage may occur in 95% of child-bearing females . Lassa fever can be difficult to distinguish clinically from other viral hemorrhagic fevers, such as Ebola virus disease . A combination of pharyngitis , pain behind the sternum , presence of excess protein in the urine and fever can indicate Lassa fever with higher specificity. In cases in which death occurs, this typically occurs within 14 days of onset. About 1% of all Lassa virus infections result in death. Approximately 15%-20% of those who have required hospitalization for Lassa fever die. The risk of death is greater in those who are pregnant. A "Swollen baby syndrome" may occur in newborns, infants and toddlers with pitting edema , abdominal distension and bleeding. Lassa virus is a member of the Arenaviridae , a family of negative-sense, single-stranded RNA viruses . Specifically it is an old world arenavirus, which is enveloped, single-stranded, and bi-segmented RNA. Lassa virus contains both a large and a small genome section, with seven lineages identified to date: Lineages I, II, and III from Nigeria ; Lineage IV from Sierra Leone , Guinea , and Liberia ; Lineage V from Cote D'Ivoire and Mali Lineage VI from Togo ; and Lineage VII from Benin . Lassa virus commonly spreads to humans from other animals, specifically the Natal multimammate mouse or African rat, also called the Natal multimammate rat ( Mastomys natalensis ). This is probably the most common mouse in equatorial Africa, common in human households and eaten as a delicacy in some areas. The multimammate mouse can quickly produce a large number of offspring, tends to colonize human settlements, increasing the risk of rodent-human contact, and is found throughout the west, central and eastern parts of the African continent. Once the mouse has become a carrier, it will excrete the virus throughout the rest of its lifetime through feces and urine creating ample opportunity for exposure. The virus is probably transmitted by contact with the feces or urine of animals accessing grain stores in residences. No study has proven presence in breast milk, but the high level of viremia suggests it may be possible. Individuals who are at a higher risk of contracting the infection are those who live in rural areas where Mastomys are discovered, and where sanitation is not prevalent. Infection typically occurs by direct or indirect exposure to animal excrement through the respiratory or gastrointestinal tracts. Inhalation of tiny particles of infectious material (aerosol) is believed to be the most significant means of exposure. It is possible to acquire the infection through broken skin or mucous membranes that are directly exposed to infectious material. Transmission from person to person has been established, presenting a disease risk for healthcare workers. The virus is present in urine for between three and nine weeks after infection, and it can be transmitted in semen for up to three months after becoming infected. Lassa virus is a member of the Arenaviridae , a family of negative-sense, single-stranded RNA viruses . Specifically it is an old world arenavirus, which is enveloped, single-stranded, and bi-segmented RNA. Lassa virus contains both a large and a small genome section, with seven lineages identified to date: Lineages I, II, and III from Nigeria ; Lineage IV from Sierra Leone , Guinea , and Liberia ; Lineage V from Cote D'Ivoire and Mali Lineage VI from Togo ; and Lineage VII from Benin . Lassa virus commonly spreads to humans from other animals, specifically the Natal multimammate mouse or African rat, also called the Natal multimammate rat ( Mastomys natalensis ). This is probably the most common mouse in equatorial Africa, common in human households and eaten as a delicacy in some areas. The multimammate mouse can quickly produce a large number of offspring, tends to colonize human settlements, increasing the risk of rodent-human contact, and is found throughout the west, central and eastern parts of the African continent. Once the mouse has become a carrier, it will excrete the virus throughout the rest of its lifetime through feces and urine creating ample opportunity for exposure. The virus is probably transmitted by contact with the feces or urine of animals accessing grain stores in residences. No study has proven presence in breast milk, but the high level of viremia suggests it may be possible. Individuals who are at a higher risk of contracting the infection are those who live in rural areas where Mastomys are discovered, and where sanitation is not prevalent. Infection typically occurs by direct or indirect exposure to animal excrement through the respiratory or gastrointestinal tracts. Inhalation of tiny particles of infectious material (aerosol) is believed to be the most significant means of exposure. It is possible to acquire the infection through broken skin or mucous membranes that are directly exposed to infectious material. Transmission from person to person has been established, presenting a disease risk for healthcare workers. The virus is present in urine for between three and nine weeks after infection, and it can be transmitted in semen for up to three months after becoming infected. A range of laboratory investigations are performed, where possible, to diagnose the disease and assess its course and complications. The confidence of a diagnosis can be compromised if laboratory tests are not available. One comprising factor is the number of febrile illnesses present in Africa, such as malaria or typhoid fever that could potentially exhibit similar symptoms, particularly for non-specific manifestations of Lassa fever. In cases with abdominal pain , in countries where Lassa is common, Lassa fever is often misdiagnosed as appendicitis and intussusception which delays treatment with the antiviral ribavirin . In West Africa, where Lassa is most common, it is difficult to diagnose due to the absence of proper equipment to perform testing. The FDA has yet to approve a widely validated laboratory test for Lassa, but there are tests that have been able to provide definitive proof of the presence of the LASV virus. These tests include cell cultures, PCR, ELISA antigen assays, plaque neutralization assays, and immunofluorescence essays. However, immunofluorescence essays provide less definitive proof of Lassa infection. An ELISA test for antigen and Immunoglobulin M antibodies give 88% sensitivity and 90% specificity for the presence of the infection. Other laboratory findings in Lassa fever include lymphocytopenia (low white blood cell count), thrombocytopenia (low platelets), and elevated aspartate transaminase levels in the blood. Lassa fever virus can also be found in cerebrospinal fluid . Control of the Mastomys rodent population is impractical, so measures focus on keeping rodents out of homes and food supplies, encouraging effective personal hygiene, storing grain and other foodstuffs in rodent-proof containers, and disposing of garbage far from the home to help sustain clean households. Gloves, masks, laboratory coats, and goggles are advised while in contact with an infected person, to avoid contact with blood and body fluids. These issues in many countries are monitored by a department of public health . In less developed countries, these types of organizations may not have the necessary means to effectively control outbreaks. There is no vaccine for humans as of 2023. Researchers at the United States Army Medical Research Institute of Infectious Diseases facility had a promising vaccine candidate in 2002. They have developed a replication -competent vaccine against Lassa virus based on recombinant vesicular stomatitis virus vectors expressing the Lassa virus glycoprotein. After a single intramuscular injection , test primates have survived lethal challenge, while showing no clinical symptoms. There is no vaccine for humans as of 2023. Researchers at the United States Army Medical Research Institute of Infectious Diseases facility had a promising vaccine candidate in 2002. They have developed a replication -competent vaccine against Lassa virus based on recombinant vesicular stomatitis virus vectors expressing the Lassa virus glycoprotein. After a single intramuscular injection , test primates have survived lethal challenge, while showing no clinical symptoms. Treatment is directed at addressing dehydration and improving symptoms. All persons suspected of Lassa fever infection should be admitted to isolation facilities and their body fluids and excreta properly disposed of. [ citation needed ] The antiviral medication ribavirin has been recommended, but evidence to support its use is weak. Some evidence has found that it may worsen outcomes in certain cases. Fluid replacement, blood transfusions, and medication for low blood pressure may be required. Intravenous interferon therapy has also been used. When Lassa fever infects pregnant women late in their third trimester, inducing delivery is necessary for the mother to have a good chance of survival. This is because the virus has an affinity for the placenta and other highly vascular tissues. The fetus has only a one in ten chance of survival no matter what course of action is taken; hence, the focus is always on saving the life of the mother. Following delivery, women should receive the same treatment as other people with Lassa fever. [ citation needed ]The antiviral medication ribavirin has been recommended, but evidence to support its use is weak. Some evidence has found that it may worsen outcomes in certain cases. Fluid replacement, blood transfusions, and medication for low blood pressure may be required. Intravenous interferon therapy has also been used. When Lassa fever infects pregnant women late in their third trimester, inducing delivery is necessary for the mother to have a good chance of survival. This is because the virus has an affinity for the placenta and other highly vascular tissues. The fetus has only a one in ten chance of survival no matter what course of action is taken; hence, the focus is always on saving the life of the mother. Following delivery, women should receive the same treatment as other people with Lassa fever. [ citation needed ]About 15–20% of hospitalized people with Lassa fever will die from the illness. The overall case fatality rate is estimated to be 1%, but during epidemics , mortality can climb as high as 50%. The mortality rate is greater than 80% when it occurs in pregnant women during their third trimester; fetal death also occurs in nearly all those cases. Abortion decreases the risk of death to the mother. Some survivors experience lasting effects of the disease, and can include partial or complete deafness. Because of treatment with ribavirin , fatality rates have declined. There are about 300,000 to 500,000 cases which result in 5,000 deaths a year. One estimate places the number as high as 3 million cases per year. Estimates of Lassa fever are complicated by the lack of easy-available diagnosis, limited public health surveillance infrastructure, and high clustering of incidence near high intensity sampling. The infection affects females 1.2 times more than males. The age group predominantly infected is 21–30 years. Lassa high risk areas are near the western and eastern extremes of West Africa. As of 2018, the Lassa belt includes Guinea, Nigeria, Sierra Leone and Liberia. As of 2003, 10-16% of people in Sierra Leone and Liberia admitted to hospital had the virus. The case fatality rate for those who are hospitalized for the disease is about 15-20%. Research showed a twofold increase risk of infection for those living in close proximity to someone with infection symptoms within the last year. [ citation needed ] The high risk areas cannot be well defined by any known biogeographical or environmental breaks except for the multimammate rat, particularly Guinea ( Kindia , Faranah and Nzérékoré regions), Liberia (mostly in Lofa , Bong , and Nimba counties), Nigeria (in about 10 of 36 states) and Sierra Leone (typically from Kenema and Kailahun districts). It is less common in the Central African Republic, Mali, Senegal and other nearby countries, and less common yet in Ghana and the Democratic Republic of the Congo. Benin had its first confirmed cases in 2014, and Togo had its first confirmed cases in 2016. As of 2013, the spread of Lassa outside of West Africa had been very limited. Twenty to thirty cases had been described in Europe, as being caused by importation through infected individuals. These cases found outside of West Africa were found to have a high fatality risk because of the delay of diagnosis and treatment due to being unaware of the risk associated with the symptoms. Imported cases have not manifested in larger epidemics outside of Africa due to a lack of human to human transmission in hospital settings. An exception had occurred in 2003 when a healthcare worker became infected before the person showed clear symptoms. An outbreak of Lassa fever occurred in Nigeria during 2018 and spread to 18 of the country's states; it was the largest outbreak of Lassa recorded. On 25 February 2018, there were 1081 suspected cases and 90 reported deaths; 317 of the cases and 72 deaths were confirmed as Lassa which increased to a total of 431 reported cases in 2018. The total cases in Nigeria in 2019 was 810 with 167 deaths, the largest case fatality rate (23.3%) until then. The epidemic started from the second week of the January. By the tenth week the total number of cases has risen to 855 and deaths to 144, the case fatality rate of 16.8%. On the 8th of December 2021, the Nigeria Centre for Disease Control (NCDC) was notified of the death of two persons from Lassa fever. The epidemic took a new form, from 3 to 30 January 2022, 211 laboratory confirmed Lassa fever cases including 40 deaths (case fatality ratio: 19%) have been cumulatively reported in 14 of the 36 Nigerian states and the Federal Capital Territory across the country. In total from January until March, 132 deaths have been reported with a case fatality rate (CFR) of 19.1% which is lower than the CFR for the same period in 2021 (21.0%). Lassa high risk areas are near the western and eastern extremes of West Africa. As of 2018, the Lassa belt includes Guinea, Nigeria, Sierra Leone and Liberia. As of 2003, 10-16% of people in Sierra Leone and Liberia admitted to hospital had the virus. The case fatality rate for those who are hospitalized for the disease is about 15-20%. Research showed a twofold increase risk of infection for those living in close proximity to someone with infection symptoms within the last year. [ citation needed ] The high risk areas cannot be well defined by any known biogeographical or environmental breaks except for the multimammate rat, particularly Guinea ( Kindia , Faranah and Nzérékoré regions), Liberia (mostly in Lofa , Bong , and Nimba counties), Nigeria (in about 10 of 36 states) and Sierra Leone (typically from Kenema and Kailahun districts). It is less common in the Central African Republic, Mali, Senegal and other nearby countries, and less common yet in Ghana and the Democratic Republic of the Congo. Benin had its first confirmed cases in 2014, and Togo had its first confirmed cases in 2016. As of 2013, the spread of Lassa outside of West Africa had been very limited. Twenty to thirty cases had been described in Europe, as being caused by importation through infected individuals. These cases found outside of West Africa were found to have a high fatality risk because of the delay of diagnosis and treatment due to being unaware of the risk associated with the symptoms. Imported cases have not manifested in larger epidemics outside of Africa due to a lack of human to human transmission in hospital settings. An exception had occurred in 2003 when a healthcare worker became infected before the person showed clear symptoms. An outbreak of Lassa fever occurred in Nigeria during 2018 and spread to 18 of the country's states; it was the largest outbreak of Lassa recorded. On 25 February 2018, there were 1081 suspected cases and 90 reported deaths; 317 of the cases and 72 deaths were confirmed as Lassa which increased to a total of 431 reported cases in 2018. The total cases in Nigeria in 2019 was 810 with 167 deaths, the largest case fatality rate (23.3%) until then. The epidemic started from the second week of the January. By the tenth week the total number of cases has risen to 855 and deaths to 144, the case fatality rate of 16.8%. On the 8th of December 2021, the Nigeria Centre for Disease Control (NCDC) was notified of the death of two persons from Lassa fever. The epidemic took a new form, from 3 to 30 January 2022, 211 laboratory confirmed Lassa fever cases including 40 deaths (case fatality ratio: 19%) have been cumulatively reported in 14 of the 36 Nigerian states and the Federal Capital Territory across the country. In total from January until March, 132 deaths have been reported with a case fatality rate (CFR) of 19.1% which is lower than the CFR for the same period in 2021 (21.0%). An outbreak of Lassa fever occurred in Nigeria during 2018 and spread to 18 of the country's states; it was the largest outbreak of Lassa recorded. On 25 February 2018, there were 1081 suspected cases and 90 reported deaths; 317 of the cases and 72 deaths were confirmed as Lassa which increased to a total of 431 reported cases in 2018. The total cases in Nigeria in 2019 was 810 with 167 deaths, the largest case fatality rate (23.3%) until then. The epidemic started from the second week of the January. By the tenth week the total number of cases has risen to 855 and deaths to 144, the case fatality rate of 16.8%. On the 8th of December 2021, the Nigeria Centre for Disease Control (NCDC) was notified of the death of two persons from Lassa fever. The epidemic took a new form, from 3 to 30 January 2022, 211 laboratory confirmed Lassa fever cases including 40 deaths (case fatality ratio: 19%) have been cumulatively reported in 14 of the 36 Nigerian states and the Federal Capital Territory across the country. In total from January until March, 132 deaths have been reported with a case fatality rate (CFR) of 19.1% which is lower than the CFR for the same period in 2021 (21.0%). Lassa fever is endemic in Liberia. From 1 January 2017 through 23 January 2018, 91 suspected cases were reported from six counties: Bong, Grand Bassa, Grand Kru, Lofa, Margibi, and Nimba. Thirty-three of these cases were laboratory confirmed, including 15 deaths (case fatality rate for confirmed cases = 45.4%). In February 2020, a total of 24 confirmed cases with nine associated deaths has been reported from nine health districts in six counties. Grand Bossa and Bong counties account for 20 of the confirmed cases. The disease was identified in Nigeria in 1969. It is named after the town of Lassa, where it was discovered. A prominent expert in the disease, Aniru Conteh , died from the disease. The Lassa virus is one of several viruses identified by WHO as a likely cause of a future epidemic. They therefore list it for urgent research and development to develop new diagnostic tests, vaccines, and medicines. In 2007, SIGA Technologies , studied a medication in guinea pig with Lassa fever. Work on a vaccine is continuing, with multiple approaches showing positive results in animal trials.

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Yellow fever

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Visa requirements for French citizens

Visa requirements for French citizens are administrative entry restrictions by the authorities of other states placed on citizens of France . As of January 2024, French citizens had visa-free or visa on arrival access to 194 countries and territories, ranking the French passport 1st in terms of travel freedom (tied with the passports of Germany , Italy , Japan , Singapore , and Spain ), according to the Henley Passport Index . eVisitor is considered to be a visa under Australia law. 90 days on each visit in 12-month period if granted. Extendable for an additional 2 weeks. Visa is also obtainable online. Hong Kong, Macau, and Taiwan count as third countries under the 24, 72 and 144-hours transit without visa (TWOV) policies. Can be extended up to 90 days with a fee. Cost for Visa on arrival approx. 30 Euro for 30 days. You can extend it once in Bali by another 30 days. As of February 2024. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Can also be entered on an East Africa tourist visa issued by Rwanda or Uganda. The Ministry of Foreign Affairs of Mongolia has exempted visas for 34 countries from January 2023 to December 2025. Travelers must register on the e-Visa platform at least 48 hours prior to travel and pay a processing fee of 650 MT. 90 days within any 6-month period. Obtainable online. Printed visa authorization must be presented at the time of travel. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). Visa also available online. e-Visa holders can enter through all border points. A single entry e-Visa valid for 90 days is also available. Without visa, 30 days need to pass between exit and re-entry. [ citation needed ] Also eligible for a universal visa. Visa requirements for French citizens for visits to various territories, disputed areas, partially recognized countries and restricted zones: 6 months from January 2021.Visa requirements for French citizens for visits to various territories, disputed areas, partially recognized countries and restricted zones: 6 months from January 2021.Certain countries and territories require travellers arriving from France to be vaccinated against specific diseases. This is a map of vaccination requirements for French citizens and residents arriving directly from the Schengen area , excluding those arriving from third countries. Many countries increasingly consider the vaccination status of travellers with regard to quarantine requirements or when deciding to allow them entry at all. This is justified by research that shows that the Pfizer vaccine effect lasts for six months or so. Certain countries and territories require travellers arriving from France to be vaccinated against specific diseases. This is a map of vaccination requirements for French citizens and residents arriving directly from the Schengen area , excluding those arriving from third countries.Many countries increasingly consider the vaccination status of travellers with regard to quarantine requirements or when deciding to allow them entry at all. This is justified by research that shows that the Pfizer vaccine effect lasts for six months or so. French identity card is valid for these countries : Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many countries require passports to be valid for at least 6 months upon arrival and one or two blank pages. Countries requiring passports to be validity at least 6 months on arrival include Afghanistan , Algeria , Bangladesh , Bhutan , Botswana , Brunei , Cambodia , Comoros , Côte d'Ivoire , Ecuador , Egypt , El Salvador , Fiji , Guyana , Haiti , Indonesia , Iran , Iraq (except when arriving at Basra – 3 months and Erbil or Sulaimaniyah – on arrival), Jordan , Kenya , Kiribati , Kuwait , Laos , Madagascar , Malaysia , Marshall Islands , Mauritania , Mongolia , Myanmar , Namibia , Nicaragua , Nigeria , Oman , Palau , Papua New Guinea , Philippines , Rwanda , Samoa , Saudi Arabia , Singapore , Solomon Islands , Somalia , Sri Lanka , Sudan , Suriname , Syria , Taiwan , Tanzania , Timor-Leste , Tonga , Tuvalu , Uganda , United Arab Emirates , Vanuatu , Venezuela , Vietnam , Yemen . Turkey usually requires passports to be valid for at least 5 months (150 days) upon entry, but for French citizens Turkish authorities allow to enter even with passport expired within last 5 years. Countries requiring passport validity of at least 4 months on arrival include Azerbaijan , Micronesia , Zambia . Countries requiring passport validity of at least 3 months on arrival include Albania , Bosnia and Herzegowina , Honduras , Moldova , Nauru , North Macedonia , Panama , Qatar and Senegal Countries requiring passport validity of at least 1 month on arrival include Eritrea , Hong Kong , Lebanon , Macao , Maldives , New Zealand , South Africa . Other countries require either a passport valid on arrival or passport valid throughout the period of intended stay. Many African countries, including Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Gabon , Guinea-Bissau , Kenya , Liberia , Niger , Rwanda , Sierra Leone and Togo , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . French identity card is valid for these countries :Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many countries require passports to be valid for at least 6 months upon arrival and one or two blank pages. Countries requiring passports to be validity at least 6 months on arrival include Afghanistan , Algeria , Bangladesh , Bhutan , Botswana , Brunei , Cambodia , Comoros , Côte d'Ivoire , Ecuador , Egypt , El Salvador , Fiji , Guyana , Haiti , Indonesia , Iran , Iraq (except when arriving at Basra – 3 months and Erbil or Sulaimaniyah – on arrival), Jordan , Kenya , Kiribati , Kuwait , Laos , Madagascar , Malaysia , Marshall Islands , Mauritania , Mongolia , Myanmar , Namibia , Nicaragua , Nigeria , Oman , Palau , Papua New Guinea , Philippines , Rwanda , Samoa , Saudi Arabia , Singapore , Solomon Islands , Somalia , Sri Lanka , Sudan , Suriname , Syria , Taiwan , Tanzania , Timor-Leste , Tonga , Tuvalu , Uganda , United Arab Emirates , Vanuatu , Venezuela , Vietnam , Yemen . Turkey usually requires passports to be valid for at least 5 months (150 days) upon entry, but for French citizens Turkish authorities allow to enter even with passport expired within last 5 years. Countries requiring passport validity of at least 4 months on arrival include Azerbaijan , Micronesia , Zambia . Countries requiring passport validity of at least 3 months on arrival include Albania , Bosnia and Herzegowina , Honduras , Moldova , Nauru , North Macedonia , Panama , Qatar and Senegal Countries requiring passport validity of at least 1 month on arrival include Eritrea , Hong Kong , Lebanon , Macao , Maldives , New Zealand , South Africa . Other countries require either a passport valid on arrival or passport valid throughout the period of intended stay.Many African countries, including Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Gabon , Guinea-Bissau , Kenya , Liberia , Niger , Rwanda , Sierra Leone and Togo , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. In a non-EU country where there is no French embassy, French citizens, like all other EU citizens, have the right to get consular protection from the embassy of any other EU country present in that country. See also List of diplomatic missions of France .

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Yellow fever

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Samuel Mudd

Samuel Alexander Mudd Sr. (December 20, 1833 – January 10, 1883) was an American physician who was imprisoned for conspiring with John Wilkes Booth concerning the assassination of Abraham Lincoln . Mudd worked as a doctor and tobacco farmer in Southern Maryland . The Civil War seriously damaged his business, especially when Maryland abolished slavery in 1864. That year, he first met Booth, who was planning to kidnap Lincoln, and Mudd was seen in company with three of the conspirators. However, his part in the plot, if any, remains unclear. Booth fatally shot Lincoln on April 14, 1865, but was injured during his escape from the scene. He subsequently rode with conspirator David Herold to Mudd's home in the early hours of April 15 for surgery on his fractured leg before he crossed into Virginia . Sometime that day, Mudd must have learned of the assassination but did not report Booth's visit to the authorities for another 24 hours. This fact appeared to link him to the crime, as did his various changes of story under interrogation. A military commission found Mudd guilty of aiding and conspiring in a murder, and he was sentenced to life imprisonment, escaping execution by a single vote. Mudd was pardoned by President Andrew Johnson and released from prison in 1869. Despite repeated attempts by family members and others to have it expunged, his conviction was never overturned.Born in Charles County, Maryland , Mudd was the fourth of 10 children of Henry Lowe and Sarah Ann Reeves Mudd. He grew up on Oak Hill, his father's tobacco plantation of several hundred acres, which was worked by 89 slaves and was located about 30 miles (48 km) southeast of Washington, DC . : 161 At age 15, after several years of home tutoring, Mudd went off to boarding school at St. John's Literary Institute, now known as Saint John's Catholic Prep School , in Frederick, Maryland . Two years later, he enrolled at Georgetown College in Washington, DC. He then studied medicine at the University of Maryland, Baltimore , writing his thesis on dysentery . Upon graduation in 1856, Mudd returned to Charles County to practice medicine, marrying his childhood sweetheart, Sarah Frances (Frankie) Dyer Mudd one year later. As a wedding present, Mudd's father gave the couple 218 acres (88 ha) of his best farmland and a new house named St. Catharine . While the house was under construction, the Mudds lived with Frankie's bachelor brother, Jeremiah Dyer, finally moving into their new home in 1859. They had nine children in all: four before Mudd's arrest and five more after his release from prison. To supplement his income from his medical practice, Mudd became a small-scale tobacco grower, using five slaves according to the 1860 census. Mudd believed that slavery was divinely ordained and wrote a letter to the theologian Orestes Brownson to that effect. : 164 With the outbreak of the American Civil War in 1861, Southern Maryland's slave system and the economy that it supported rapidly began to collapse. In 1863, the Union Army established Camp Stanton, just 10 miles (16 km) from the Mudd farm, to enlist black freedmen and runaway slaves. Six regiments totaling over 8,700 black soldiers, many from Southern Maryland, were trained there. In 1864, Maryland , which was exempt from Lincoln's 1863 Emancipation Proclamation , abolished slavery, making it difficult for growers like Mudd to operate their plantations. As a result, Mudd considered selling his farm and depending on his medical practice. As Mudd pondered his alternatives, he was introduced to someone who said he might be interested in buying his property; 26 year-old actor John Wilkes Booth .According to a statement made by associated conspirator George Atzerodt , discovered long after his death and recorded while he was in federal custody on May 1, 1865, Mudd knew in advance about Booth's plans; Atzerodt was sure the doctor knew, he said, because Booth had "sent (as he told me) liquors and provisions ... about two weeks before the murder to Dr. Mudd's." Although that is true, some historians believe there may have been other reasons behind Mudd's relationship with Booth. The trial brought forth many theories of Mudd's involvement in the assassination of Lincoln. One theory posits that Mudd was involved in a completely different conspiracy to gain an upper hand for the southern states. Prior to killing Lincoln, Booth had intended to kidnap the president and ransom him and other political affiliates of the Union for a large sum of money. This plan was in effect until the night of the assassination, when Booth met up with Atzerodt, David Herold, and Lewis Powell [lower-alpha 1] and disclosed the plot to assassinate the president instead. Following the assassination, Powell came forth by stating that Booth had not told him until this meeting and that the other men did not know about the plot until the night of the assassination. This supports the theory that Mudd may have been an accomplice to the plot to kidnap the president, but not a conspirator to the assassination. After Booth shot Lincoln on the night of April 14, 1865, he broke his left fibula when he jumped from the presidential box while fleeing Ford's Theater . Booth met up with Herold and both men made for Virginia via southern Maryland. They stopped at Mudd's house around 4 AM on April 15; Mudd splinted Booth's leg and gave him a shoe to wear. He also arranged for a carpenter, John Best, to make a pair of crutches for Booth. Booth paid Mudd $25 in greenbacks for his medical treatment. He and Herold spent between twelve and fifteen hours at Mudd's house. They slept in the front bedroom on the second floor. It is unclear whether Mudd had yet been informed that Booth had killed Lincoln. Mudd went to Bryantown during the day on April 15 to run errands; if he had not already heard the news of the assassination from Booth, he certainly learned of it on the trip. He returned home that evening, and accounts differ as to whether Booth and Herold had already left, whether Mudd met them as they were leaving, and whether they left at Mudd's urging and with his assistance. It is certain that Mudd did not immediately contact the authorities. When questioned, he stated that he had not wanted to leave his family alone in the house in case the assassins returned and found him absent and his family unprotected. He waited until Mass the following day, Easter Sunday , when he asked his second cousin, Dr. George Mudd, a resident of Bryantown, to notify the 13th New York Cavalry in Bryantown, under the command of Lieutenant David Dana. Mudd's delay in contacting the authorities drew suspicion and was a significant factor in tying him to the conspiracy. During his initial investigative interview on April 18, Mudd stated that he had never seen either of the parties before. In his sworn statement of April 22, he told about Booth's visit to Bryantown in November 1864 but then said, "I have never seen Booth since that time to my knowledge until last Saturday morning." Later testimony from Louis J. Weichmann revealed that Mudd hid his meeting with Booth in Washington in December 1864. In prison, Mudd admitted the Washington meeting and said he ran into Booth by chance during a Christmas shopping trip. Mudd's failure to mention the meeting in his interview with detectives proved to be a big mistake: When Weichmann told the authorities of the meeting, they realized that Mudd had misled them and immediately began to treat him as a suspect, rather than a witness. During the conspiracy trial, Lieutenant Alexander Lovett testifiedAfter Booth's death on April 26, 1865, Mudd was arrested and charged with conspiracy to murder Lincoln. Representative Frederick Stone was the senior defense counsel for Mudd. On May 1, President Johnson ordered the formation of a nine-man military commission to try the conspirators. Mudd was represented by General Thomas Ewing Jr. The trial began on May 10. Mary Surratt , Lewis Powell, George Atzerodt, David Herold, Samuel Mudd, Michael O'Laughlen , Edmund Spangler and Samuel Arnold were all charged with conspiring to murder Lincoln. The prosecution called 366 witnesses. The defense sought to prove that Mudd was a loyal citizen, citing his self-description as a "Union man" and asserting that he was "a deeply religious man, devoted to family, and a kind master to his slaves." The prosecution presented witnesses who testified that he had shot one of his slaves in the leg and threatened to send others to Richmond, Virginia , to assist in the construction of Confederate defenses. The prosecution also contended that he had been a member of a Confederate communications distribution agency and had sheltered Confederate soldiers on his plantation. On June 29, Mudd was found guilty with the others. The testimony of Louis J. Weichmann was crucial in obtaining the convictions. According to historian Edward Steers , the testimony presented by former slaves was also crucial, but it faded from public memory. Mudd escaped execution by one vote and was sentenced to life imprisonment. Surratt, Powell, Atzerodt, and Herold were hanged at the Old Penitentiary at the Washington Arsenal on July 7, 1865.Mudd, O'Laughlen, Arnold, and Spangler were imprisoned at Fort Jefferson , in the Dry Tortugas , about 70 miles (110 km) west of Key West , Florida . The fort housed Union Army deserters and held about 600 prisoners when Mudd and the others arrived. Prisoners lived on the second tier of the fort, in unfinished, open-air gun rooms called casemates . Mudd and his three companions lived in the casemate directly above the fort's main entrance, called the sally port . In September 1865, two months after Mudd arrived, the control of Fort Jefferson was transferred from the 161st New York Volunteer Infantry Regiment to the 82nd US Colored Troops. On September 25, 1865, Mudd attempted to escape from Fort Jefferson by stowing away on the transport Thomas A. Scott . He was quickly discovered and placed, along with Arnold, O'Laughlen, Spangler, and George St. Leger Grenfell , in a large empty ground-level gunroom that soldiers referred to as "the dungeon ". The men were let out of the dungeon every working day for 12 hours and were required to wear leg irons. However, following a December 22 letter from his wife to President Johnson, the War Department ordered the discontinuance of the shackles and the move to better quarters, which was accomplished by January. : 88–89, 95–99, 101, 103 After three months in the dungeon, Mudd and the others were returned to the general prison population. However, because of his attempted escape, Mudd lost his privilege of working in the prison hospital and was assigned to work in the prison carpentry shop with Spangler. There was an outbreak of yellow fever in the fall of 1867 at the fort. O'Laughlen eventually died of it on September 23. The prison doctor died, and Mudd agreed to take over the position. He was able to help stem the spread of the disease. The soldiers in the fort wrote a petition to Johnson in October 1867 stating the degree of Mudd's assistance: "He inspired the hopeless with courage and by his constant presence in the midst of danger and infection.... [Many] doubtless owe their lives to the care and treatment they received at his hands." Probably as a reward for his work in the yellow fever epidemic, Mudd was reassigned from the carpentry shop to a clerical job in the Provost Marshal's office, where he remained until his pardon.The influence of his defense attorney, Thomas Ewing Jr., who had connections in President Johnson's administration, was one reason why Mudd was pardoned by Johnson on February 8, 1869. He was released from prison on March 8, 1869, and returned to his home in Maryland on March 20, 1869. On March 2, 1869, three weeks after he pardoned Mudd, Johnson also pardoned Spangler and Arnold. When Mudd returned home, well-wishing friends and strangers, as well as inquiring newspaper reporters, besieged him. Mudd was very reluctant to talk to the press because he felt it had misquoted him in the past. He gave one interview to the New York Herald after his release but immediately regretted it, and complained that the article had several factual errors and misrepresented his work during the yellow fever epidemic. On the whole, though, Mudd continued to enjoy the support of his friends and neighbors. He resumed his medical practice and slowly brought the family farm back to productivity. In 1873, Spangler traveled to the Mudd farm, where Mudd and his wife welcomed him. Spangler lived with the Mudd family for about 18 months, earning his keep by doing carpentry, gardening, and other farm chores, : 322 until Spangler's death on February 7, 1875. Mudd always had an interest in politics. In prison, he learned about political happenings by reading the newspapers that were sent to him. After his release, he again became active in community affairs. In 1874, he was elected chief officer of the local farmers association, the Bryantown Grange. In 1876, he was elected Vice President of the local Democratic Tilden - Hendricks presidential election committee. Tilden lost that year to Republican Rutherford B. Hayes in a hotly-disputed election. The next year, Mudd ran as a Democratic candidate for the Maryland House of Delegates , but was defeated by the popular Republican William Mitchell. Mudd's ninth child, Mary Eleanor "Nettie" Mudd, was born in 1878. In 1880, the Port Tobacco Times reported that Mudd's barn which contained almost 8000 lb. of tobacco, two horses, a wagon, and farm implements was destroyed by fire.Mudd was just 49 years old when he died of pneumonia , on January 10, 1883, and was buried in the cemetery at St. Mary's Catholic Church in Bryantown, the same church in which he once met Booth. : 326The degree of Samuel Mudd's culpability has remained controversial. Some claim that Mudd was innocent of any wrongdoing, including Mudd's grandson Richard Mudd, and that he had merely been imprisoned for treating a man who came to his house late at night with a fractured leg. Over a century after the assassination, Presidents Jimmy Carter and Ronald Reagan both wrote letters to Richard Mudd in which they argued that his grandfather had committed no crime. However, others, including authors Edward Steers, Jr. and James Swanson , assert that there is evidence that Samuel Mudd visited Booth three times in the months before the failed kidnapping attempt. The first time was November 1864 when Booth was looking for help in his kidnapping plot and was directed to Mudd by agents of the Confederate Secret Service . In December, Booth again met with Mudd and spent the night at his farm. Later that December, Mudd went to Washington and introduced Booth to Confederate agent John Surratt. Additionally, George Atzerodt testified that Booth sent supplies to Mudd's house in preparation for the kidnapping plan. Mudd lied to the authorities who came to his house after the assassination, claiming that he did not recognize the man who showed up on his doorstep in need of treatment, and giving them false information about where Booth and Herold went. : 211–2, 378 : 234–235 He also hid the monogrammed boot that he had cut off Booth's injured leg behind a panel in his attic, but the thorough search of Mudd's house soon revealed this further piece of evidence which was later used against him. One hypothesis is that Mudd was originally complicit in the kidnapping plot, likely as the person whom the conspirators would have turned to for medical treatment in case Lincoln was injured, and that Booth thus remembered the doctor and went to his house to get help in the early hours of April 15. : 126-129 : 59–61 Mudd's grandson Richard unsuccessfully tried to clear his grandfather's name of the stigma of aiding Booth. In 1951, he published The Mudd Family of the United States , a two-volume history of the Mudd family beginning with Thomas Mudd, who arrived from England in 1665. A second edition was published in 1969. His papers detailed his attempts to clear his grandfather's name; they were donated to Georgetown University 's Lauinger Library after his death in 2002. They are available to the public in the Special Collections Department. In 1992, Representatives Steny Hoyer and Thomas W. Ewing introduced House Bill 1885 to overturn the conviction, but it failed in committee. Mudd then turned to the Army Board for Correction of Military Records, which recommended that the conviction be overturned on the basis that Mudd should have been tried by a civilian court. The recommendation was rejected by Acting Army Assistant Secretary William D. Clark. Mudd attempted several other legal venues, ending in 2003 when the US Supreme Court refused to hear the case because the deadline for filing had been missed. The Dr. Samuel A. Mudd House was listed on the National Register of Historic Places in 1974. Mudd's life was the subject of a 1936 film, The Prisoner of Shark Island , directed by John Ford and scripted by Nunnally Johnson . Mudd was portrayed by Warner Baxter . Film critic Leonard Maltin in his Classic Movie Guide (2015) described Baxter's performance as "superb". A radio adaptation of The Prisoner of Shark Island aired, as an episode of the radio series Lux Radio Theater , with Gary Cooper as Dr. Mudd, on May 2, 1938, in which significant dramatic license was used by introducing fictional characters and altering several of the known facts of the case for melodramatic expediency. For example, Fort Jefferson was never called "Shark Island". Another production, with the same title, aired on the radio series Encore Theatre in 1946. Another film, The Ordeal of Dr. Mudd , was made in 1980, starring Dennis Weaver as Mudd. At the end, a written message appears, incorrectly stating that President Carter gave Mudd a posthumous pardon. All of these productions espoused the point of view that Mudd was essentially innocent of any conspiracy. Roger Mudd (1928–2021), an Emmy Award -winning journalist, television host and former CBS, NBC, and PBS news anchor , was related to Samuel Mudd, but he was not a descendant, as has mistakenly been reported. Samuel Mudd's life was the subject of an episode of the TV western Laramie , "Time of the Traitor" which aired in 1962. On the episode " Swiss Diplomacy " on The West Wing , the First Lady and cardiac surgeon, Dr. Abby Bartlet commented on the duty of a physician to treat an injured patient despite potential legal repercussions. She responded to Mudd's conviction: "So that's the way it goes. You set the leg." Samuel Mudd's name is sometimes given as the origin of the phrase "your name is mud," as in, for example, the 2007 feature film National Treasure: Book of Secrets . However, according to an online etymology dictionary, the phrase has its earliest known recorded instance in 1823, ten years before Mudd's birth, and it is based on an obsolete sense of the word "mud" meaning "a stupid twaddling fellow."

Wiki

Yellow fever

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Quarantine

A quarantine is a restriction on the movement of people , animals and goods which is intended to prevent the spread of disease or pests . It is often used in connection to disease and illness, preventing the movement of those who may have been exposed to a communicable disease , yet do not have a confirmed medical diagnosis . It is distinct from medical isolation , in which those confirmed to be infected with a communicable disease are isolated from the healthy population. Quarantine considerations are often one aspect of border control . [ citation needed ] The concept of quarantine has been known since biblical times, and is known to have been practised through history in various places. Notable quarantines in modern history include the village of Eyam in 1665 during the bubonic plague outbreak in England; East Samoa during the 1918 flu pandemic ; the Diphtheria outbreak during the 1925 serum run to Nome , the 1972 Yugoslav smallpox outbreak , the SARS pandemic, the Ebola pandemic and extensive quarantines applied throughout the world during the COVID-19 pandemic since 2020. Ethical and practical considerations need to be considered when applying quarantine to people. Practice differs from country to country; in some countries, quarantine is just one of many measures governed by legislation relating to the broader concept of biosecurity ; for example, Australian biosecurity is governed by the single overarching Biosecurity Act 2015 .The word quarantine comes from quarantena or quarantaine , meaning "forty days", used in the Venetian language in the 14th and 15th centuries and also in France. The word is designated in the period during which all ships were required to be isolated before passengers and crew could go ashore during the Black Death plague. The quarantena followed the trentino , or "thirty-day isolation" period, first imposed in 1347 in the Republic of Ragusa , Dalmatia (modern Dubrovnik in Croatia). Merriam-Webster gives various meanings to the noun form, including "a period of 40 days", several relating to ships, "a state of enforced isolation", and as "a restriction on the movement of people and goods which is intended to prevent the spread of disease or pests ". The word is also used as a verb. Quarantine is distinct from medical isolation , in which those confirmed to be infected with a communicable disease are isolated from the healthy population. Quarantine may be used interchangeably with cordon sanitaire , and although the terms are related, cordon sanitaire refers to the restriction of movement of people into or out of a defined geographic area, such as a community, in order to prevent an infection from spreading. An early mention of isolation occurs in the Biblical book of Leviticus , written in the 7th century BC or perhaps earlier, which describes the procedure for separating out people infected with the skin disease Tzaraath . The medical nature of this isolation is, however, disputed. As traditional exegesis (dated 700 CE) sees it as a punishment for trespassing one of several negative commandment, most notably Evil Speech . A more recent hypothesis postulates that the infected are required to isolate themselves in order to prevent spread of disease [ citation needed ] (although the Bible does not imply contagiousness of Tzaraath ): Anyone with such a defiling disease must wear torn clothes, let their hair be unkempt, cover the lower part of their face and cry out, "Unclean! Unclean!" As long as they have the disease they remain unclean. They must live alone; they must live outside the camp. [ non-primary source needed ] Moses ordered that dwellings from which infected Jews had gone should be inspected before being occupied again, and that people recovering from contagious disease were not to be allowed to go abroad until examined. [ citation needed ] A hadith attributed to the Islamic prophet Muhammad advised individuals present in a region with a plague outbreak to remain in place, and advised healthy individuals to avoid traveling there. The Persian Muslim polymath Avicenna argued for controlling "the spread of diseases" in his medical encyclopedia The Canon [Al-Qanun] of Medicine, published in 1025. He also recommended quarantine for patients with infectious diseases, especially tuberculosis . Since the sixteenth century, the Ottoman empire has isolated travellers coming from epidemic areas during the Bubonic plague. A quarantine involved isolating healthy travellers for a period of time so that it could be ascertained if they were sick or not. The mandatory quarantine of special groups of patients, including those with leprosy, started early in Islamic history. In the early 8th century the sixth Umayyad caliph Al-Walid I segregated lepers from the general population, with some later sources crediting the caliph with opening a hospital . The separation of lepers from the general population was also practiced in the Moroccan city of Fez, where lepers were relocated to a cave system outside of the city. Dedicated leprosariums were built in the time of the Ottoman sultan Murad II in the 15th century, with some of the facilities operating for centuries. The word "quarantine" originates from quarantena , the Venetian language form, meaning "forty days". This is due to the 40-day isolation of ships and people practised as a measure of disease prevention related to the plague . Between 1348 and 1359, the Black Death wiped out an estimated 30% of Europe's population, and a significant percentage of Asia's population. Such a disaster led governments to establish measures of containment to handle recurrent epidemics. A document from 1377 states that before entering the city-state of Ragusa in Dalmatia (modern Dubrovnik in Croatia), newcomers had to spend 30 days (a trentine ) in a restricted place (originally nearby islands) waiting to see whether the symptoms of Black Death would develop. In 1448 the Venetian Senate prolonged the waiting period to 40 days, thus giving birth to the term "quarantine". The forty-day quarantine proved to be an effective formula for handling outbreaks of the plague. Dubrovnik was the first city in Europe to set up quarantine sites such as the Lazzarettos of Dubrovnik where arriving ship personnel were held for up to 40 days. According to current estimates, the bubonic plague had a 37-day period from infection to death; therefore, the European quarantines would have been highly successful in determining the health of crews from potential trading and supply ships. Other diseases lent themselves to the practice of quarantine before and after the devastation of the plague. Those affected by leprosy were historically isolated long-term from society, and attempts were made to check the spread of syphilis in northern Europe after 1492, the advent of yellow fever in Spain at the beginning of the 19th century, and the arrival of Asiatic cholera in 1831. [ citation needed ] Venice took the lead in measures to check the spread of plague, having appointed three guardians of public health in the first years of the Black Death (1348). The next record of preventive measures comes from Reggio / Modena in 1374. Venice founded the first lazaret (on a small island adjoining the city) in 1403. In 1467 Genoa followed the example of Venice, and in 1476 the old leper hospital of Marseille was converted into a plague hospital. The great lazaret of Marseille, perhaps the most complete of its kind, was founded in 1526 on the island of Pomègues . The practise at all the Mediterranean lazarets did not differ from the English procedure in the Levantine and North African trade. On the arrival of cholera in 1831 some new lazarets were set up at western ports; notably, a very extensive establishment near Bordeaux . Afterwards, they were used for other purposes. [ citation needed ] Epidemics of yellow fever ravaged urban communities in North America throughout the late-eighteenth and early-nineteenth centuries, the best-known examples being the 1793 Philadelphia yellow fever epidemic and outbreaks in Georgia (1856) and Florida (1888). Cholera and smallpox epidemics continued throughout the nineteenth century, and plague epidemics affected Honolulu and San Francisco from 1899 until 1901. State governments generally relied on the cordon sanitaire as a geographic quarantine measure to control the movement of people into and out of affected communities. During the 1918 influenza pandemic, some communities instituted protective sequestration (sometimes referred to as "reverse quarantine") to keep the infected from introducing influenza into healthy populations. Additionally, the nature of the influenza virus that caused the 1918 pandemic gave rise to a public awareness of the dichotomy between "crowd" and "home" diseases. Simply quarantining the sick in isolation was ineffective in halting the spread of the disease, and new quarantine standards that extended regulations to public spaces became increasingly more common. Most Western countries implemented a range of containment strategies, including isolation, surveillance, and the closure of schools, churches, theatres, and public events. People were prevented from entering the Ashanti Empire at border checkpoints if they exhibited symptoms of smallpox. Those who discovered symptoms of the disease after entering Ashanti were quarantined in remote villages. In the 1830s, both the Ottoman Empire and Egypt established new quarantine systems. In 1831, Mehmet Ali of Egypt founded the Quarantine Board in Alexandria. In 1838, the Ottoman government installed the Supreme Council of Health, including the Quarantine Administration, in Istanbul. These two institutions set up permanent quarantines throughout the eastern Mediterranean, based on the western Mediterranean quarantine model. For example, at the port of İzmir , all ships and their cargo would be inspected and those suspected of carrying the plague would be towed to separate docks and their personnel housed in separate buildings for a determined period of time. In Thessaly , along the Greek-Turkish border, all travellers entering and exiting the Ottoman Empire would be quarantined for 9–15 days. Upon appearance of the plague, the quarantine stations would be militarised and the Ottoman army would be involved in border control and disease monitoring . Since 1852, several conferences were held involving European powers, with a view to uniform action in keeping out infection from the East and preventing its spread within Europe. All but that of 1897 were concerned with cholera . No result came of those at Paris (1852), Constantinople (1866), Vienna (1874), and Rome (1885), but each of the subsequent ones doctrine of constructive infection of a ship as coming from a scheduled port, and an approximation to the principles advocated by the United Kingdom for many years. The principal countries which retained the old system at the time were Spain, Portugal, Turkey, Greece, and Russia (the British possessions at the time, Gibraltar, Malta, and Cyprus, being under the same influence). The aim of each international sanitary convention had been to bind the governments to a uniform minimum of preventive action, with further restrictions permissible to individual countries. The minimum specified by international conventions was very nearly the same as the British practice, which had been in turn adapted to continental opinion in the matter of the importation of rags. [ citation needed ] The Venice convention of 30 January 1892 dealt with cholera by the Suez Canal route; that of Dresden of 15 April 1893, with cholera within European countries; that of Paris of 3 April 1894, with cholera by the pilgrim traffic; and that of Venice, on 19 March 1897, was in connection with the outbreak of plague in the East, and the conference met to settle on an international basis the steps to be taken to prevent, if possible, its spread into Europe. An additional convention was signed in Paris on 3 December 1903. A multilateral international sanitary convention was concluded at Paris on 17 January 1912. This convention was most comprehensive and was designated to replace all previous conventions on that matter. It was signed by 40 countries, and consisted of 160 articles. Ratifications by 16 of the signatories were exchanged in Paris on 7 October 1920. Another multilateral convention was signed in Paris on 21 June 1926, to replace that of 1912. It was signed by 58 countries worldwide, and consisted of 172 articles. In Latin America, a series of regional sanitary conventions were concluded. Such a convention was concluded in Rio de Janeiro on 12 June 1904. A sanitary convention between the governments of Argentina, Brazil, Paraguay, and Uruguay was concluded in Montevideo on 21 April 1914. The convention covers cases of Asiatic cholera , oriental plague and yellow fever . It was ratified by the Uruguayan government on 13 October 1914, by the Paraguayan government on 27 September 1917 and by the Brazilian government on 18 January 1921. Sanitary conventions were also concluded between European states. A Soviet-Latvian sanitary convention was signed on 24 June 1922, for which ratifications were exchanged on 18 October 1923. A bilateral sanitary convention was concluded between the governments of Latvia and Poland on 7 July 1922, for which ratifications were exchanged on 7 April 1925. Another was concluded between the governments of Germany and Poland in Dresden on 18 December 1922, and entered into effect on 15 February 1923. Another one was signed between the governments of Poland and Romania on 20 December 1922. Ratifications were exchanged on 11 July 1923. The Polish government also concluded such a convention with the Soviet government on 7 February 1923, for which ratifications were exchanged on 8 January 1924. A sanitary convention was also concluded between the governments of Poland and Czechoslovakia on 5 September 1925, for which ratifications were exchanged on 22 October 1926. A convention was signed between the governments of Germany and Latvia on 9 July 1926, for which ratifications were exchanged on 6 July 1927. In 1897, the incubation period for this disease was determined and this was to be adopted for administrative purposes. The incubation period was comparatively short, some three or four days. After much discussion ten days was accepted by a majority. The principle of disease notification was unanimously adopted. Each government had to notify other governments of the existence of plague within their jurisdictions and state the measures of prevention being carried out to prevent its spread. The area declared infected was limited to the district or village where the disease prevailed, and no locality was deemed to be infected because of the importation into it of a few cases of plague while there has been no spread. It was decided during the prevalence of plague, every country had the right to close its land borders to traffic. At the Red Sea , it was decided after discussion a healthy vessel could pass through the Suez Canal and continue its voyage in the Mediterranean during the incubation period of the disease and that vessels passing through the Canal in quarantine might, subject to the use of the electric light, coal up in quarantine at Port Said by night or by day, and that passengers might embark in quarantine at that port. Infected vessels, if these carry a doctor and a disinfecting stove, have a right to navigate the Canal in quarantine and subject only to the landing of those who have plague. [ citation needed ] In the 20th and 21st centuries, people suspected of carrying infectious diseases have been quarantined, as in the cases of Andrew Speaker (multi-drug-resistant tuberculosis, 2007) and Kaci Hickox (Ebola, 2014). During the 1957–58 influenza pandemic and the 1968 flu pandemic , several countries implemented measures to control spread of the disease. In addition, the World Health Organization applied a global influenza surveillance network. During the 1994 plague in India , many people were quarantined. Vessels and aircraft carrying passengers were fumigated. In the SARS epidemic , thousands of Chinese people were quarantined and checkpoints to take temperatures were set up. Moving infected patients to isolation wards and home-based self-quarantine of people potentially exposed was the main way the Western African Ebola virus epidemic was ended in 2016; members of the 8th WHO Emergency Committee criticised international travel restrictions imposed during the epidemic as ineffective due to difficulty of enforcement, and counterproductive as they slowed down aid efforts. The People's Republic of China has employed mass quarantines – firstly of the city of Wuhan and subsequently of all of the Hubei province (population 55.5 million) – in the coronavirus disease 2019 pandemic . After a few weeks, the Italian government imposed lockdowns for the entire country (more than 60 million people) in an attempt to stop the spread of the disease there . India quarantined itself from the world for a period of one month. Most governments around the world restricted or advised against all non-essential travel to and from countries and areas affected by the outbreak. By late 2020, the virus had already spread within communities in large parts of the world, with many not knowing where or how they were infected. An early mention of isolation occurs in the Biblical book of Leviticus , written in the 7th century BC or perhaps earlier, which describes the procedure for separating out people infected with the skin disease Tzaraath . The medical nature of this isolation is, however, disputed. As traditional exegesis (dated 700 CE) sees it as a punishment for trespassing one of several negative commandment, most notably Evil Speech . A more recent hypothesis postulates that the infected are required to isolate themselves in order to prevent spread of disease [ citation needed ] (although the Bible does not imply contagiousness of Tzaraath ): Anyone with such a defiling disease must wear torn clothes, let their hair be unkempt, cover the lower part of their face and cry out, "Unclean! Unclean!" As long as they have the disease they remain unclean. They must live alone; they must live outside the camp. [ non-primary source needed ] Moses ordered that dwellings from which infected Jews had gone should be inspected before being occupied again, and that people recovering from contagious disease were not to be allowed to go abroad until examined. [ citation needed ] A hadith attributed to the Islamic prophet Muhammad advised individuals present in a region with a plague outbreak to remain in place, and advised healthy individuals to avoid traveling there. The Persian Muslim polymath Avicenna argued for controlling "the spread of diseases" in his medical encyclopedia The Canon [Al-Qanun] of Medicine, published in 1025. He also recommended quarantine for patients with infectious diseases, especially tuberculosis . Since the sixteenth century, the Ottoman empire has isolated travellers coming from epidemic areas during the Bubonic plague. A quarantine involved isolating healthy travellers for a period of time so that it could be ascertained if they were sick or not. The mandatory quarantine of special groups of patients, including those with leprosy, started early in Islamic history. In the early 8th century the sixth Umayyad caliph Al-Walid I segregated lepers from the general population, with some later sources crediting the caliph with opening a hospital . The separation of lepers from the general population was also practiced in the Moroccan city of Fez, where lepers were relocated to a cave system outside of the city. Dedicated leprosariums were built in the time of the Ottoman sultan Murad II in the 15th century, with some of the facilities operating for centuries. The word "quarantine" originates from quarantena , the Venetian language form, meaning "forty days". This is due to the 40-day isolation of ships and people practised as a measure of disease prevention related to the plague . Between 1348 and 1359, the Black Death wiped out an estimated 30% of Europe's population, and a significant percentage of Asia's population. Such a disaster led governments to establish measures of containment to handle recurrent epidemics. A document from 1377 states that before entering the city-state of Ragusa in Dalmatia (modern Dubrovnik in Croatia), newcomers had to spend 30 days (a trentine ) in a restricted place (originally nearby islands) waiting to see whether the symptoms of Black Death would develop. In 1448 the Venetian Senate prolonged the waiting period to 40 days, thus giving birth to the term "quarantine". The forty-day quarantine proved to be an effective formula for handling outbreaks of the plague. Dubrovnik was the first city in Europe to set up quarantine sites such as the Lazzarettos of Dubrovnik where arriving ship personnel were held for up to 40 days. According to current estimates, the bubonic plague had a 37-day period from infection to death; therefore, the European quarantines would have been highly successful in determining the health of crews from potential trading and supply ships. Other diseases lent themselves to the practice of quarantine before and after the devastation of the plague. Those affected by leprosy were historically isolated long-term from society, and attempts were made to check the spread of syphilis in northern Europe after 1492, the advent of yellow fever in Spain at the beginning of the 19th century, and the arrival of Asiatic cholera in 1831. [ citation needed ] Venice took the lead in measures to check the spread of plague, having appointed three guardians of public health in the first years of the Black Death (1348). The next record of preventive measures comes from Reggio / Modena in 1374. Venice founded the first lazaret (on a small island adjoining the city) in 1403. In 1467 Genoa followed the example of Venice, and in 1476 the old leper hospital of Marseille was converted into a plague hospital. The great lazaret of Marseille, perhaps the most complete of its kind, was founded in 1526 on the island of Pomègues . The practise at all the Mediterranean lazarets did not differ from the English procedure in the Levantine and North African trade. On the arrival of cholera in 1831 some new lazarets were set up at western ports; notably, a very extensive establishment near Bordeaux . Afterwards, they were used for other purposes. [ citation needed ]Epidemics of yellow fever ravaged urban communities in North America throughout the late-eighteenth and early-nineteenth centuries, the best-known examples being the 1793 Philadelphia yellow fever epidemic and outbreaks in Georgia (1856) and Florida (1888). Cholera and smallpox epidemics continued throughout the nineteenth century, and plague epidemics affected Honolulu and San Francisco from 1899 until 1901. State governments generally relied on the cordon sanitaire as a geographic quarantine measure to control the movement of people into and out of affected communities. During the 1918 influenza pandemic, some communities instituted protective sequestration (sometimes referred to as "reverse quarantine") to keep the infected from introducing influenza into healthy populations. Additionally, the nature of the influenza virus that caused the 1918 pandemic gave rise to a public awareness of the dichotomy between "crowd" and "home" diseases. Simply quarantining the sick in isolation was ineffective in halting the spread of the disease, and new quarantine standards that extended regulations to public spaces became increasingly more common. Most Western countries implemented a range of containment strategies, including isolation, surveillance, and the closure of schools, churches, theatres, and public events. People were prevented from entering the Ashanti Empire at border checkpoints if they exhibited symptoms of smallpox. Those who discovered symptoms of the disease after entering Ashanti were quarantined in remote villages. In the 1830s, both the Ottoman Empire and Egypt established new quarantine systems. In 1831, Mehmet Ali of Egypt founded the Quarantine Board in Alexandria. In 1838, the Ottoman government installed the Supreme Council of Health, including the Quarantine Administration, in Istanbul. These two institutions set up permanent quarantines throughout the eastern Mediterranean, based on the western Mediterranean quarantine model. For example, at the port of İzmir , all ships and their cargo would be inspected and those suspected of carrying the plague would be towed to separate docks and their personnel housed in separate buildings for a determined period of time. In Thessaly , along the Greek-Turkish border, all travellers entering and exiting the Ottoman Empire would be quarantined for 9–15 days. Upon appearance of the plague, the quarantine stations would be militarised and the Ottoman army would be involved in border control and disease monitoring . Since 1852, several conferences were held involving European powers, with a view to uniform action in keeping out infection from the East and preventing its spread within Europe. All but that of 1897 were concerned with cholera . No result came of those at Paris (1852), Constantinople (1866), Vienna (1874), and Rome (1885), but each of the subsequent ones doctrine of constructive infection of a ship as coming from a scheduled port, and an approximation to the principles advocated by the United Kingdom for many years. The principal countries which retained the old system at the time were Spain, Portugal, Turkey, Greece, and Russia (the British possessions at the time, Gibraltar, Malta, and Cyprus, being under the same influence). The aim of each international sanitary convention had been to bind the governments to a uniform minimum of preventive action, with further restrictions permissible to individual countries. The minimum specified by international conventions was very nearly the same as the British practice, which had been in turn adapted to continental opinion in the matter of the importation of rags. [ citation needed ] The Venice convention of 30 January 1892 dealt with cholera by the Suez Canal route; that of Dresden of 15 April 1893, with cholera within European countries; that of Paris of 3 April 1894, with cholera by the pilgrim traffic; and that of Venice, on 19 March 1897, was in connection with the outbreak of plague in the East, and the conference met to settle on an international basis the steps to be taken to prevent, if possible, its spread into Europe. An additional convention was signed in Paris on 3 December 1903. A multilateral international sanitary convention was concluded at Paris on 17 January 1912. This convention was most comprehensive and was designated to replace all previous conventions on that matter. It was signed by 40 countries, and consisted of 160 articles. Ratifications by 16 of the signatories were exchanged in Paris on 7 October 1920. Another multilateral convention was signed in Paris on 21 June 1926, to replace that of 1912. It was signed by 58 countries worldwide, and consisted of 172 articles. In Latin America, a series of regional sanitary conventions were concluded. Such a convention was concluded in Rio de Janeiro on 12 June 1904. A sanitary convention between the governments of Argentina, Brazil, Paraguay, and Uruguay was concluded in Montevideo on 21 April 1914. The convention covers cases of Asiatic cholera , oriental plague and yellow fever . It was ratified by the Uruguayan government on 13 October 1914, by the Paraguayan government on 27 September 1917 and by the Brazilian government on 18 January 1921. Sanitary conventions were also concluded between European states. A Soviet-Latvian sanitary convention was signed on 24 June 1922, for which ratifications were exchanged on 18 October 1923. A bilateral sanitary convention was concluded between the governments of Latvia and Poland on 7 July 1922, for which ratifications were exchanged on 7 April 1925. Another was concluded between the governments of Germany and Poland in Dresden on 18 December 1922, and entered into effect on 15 February 1923. Another one was signed between the governments of Poland and Romania on 20 December 1922. Ratifications were exchanged on 11 July 1923. The Polish government also concluded such a convention with the Soviet government on 7 February 1923, for which ratifications were exchanged on 8 January 1924. A sanitary convention was also concluded between the governments of Poland and Czechoslovakia on 5 September 1925, for which ratifications were exchanged on 22 October 1926. A convention was signed between the governments of Germany and Latvia on 9 July 1926, for which ratifications were exchanged on 6 July 1927. In 1897, the incubation period for this disease was determined and this was to be adopted for administrative purposes. The incubation period was comparatively short, some three or four days. After much discussion ten days was accepted by a majority. The principle of disease notification was unanimously adopted. Each government had to notify other governments of the existence of plague within their jurisdictions and state the measures of prevention being carried out to prevent its spread. The area declared infected was limited to the district or village where the disease prevailed, and no locality was deemed to be infected because of the importation into it of a few cases of plague while there has been no spread. It was decided during the prevalence of plague, every country had the right to close its land borders to traffic. At the Red Sea , it was decided after discussion a healthy vessel could pass through the Suez Canal and continue its voyage in the Mediterranean during the incubation period of the disease and that vessels passing through the Canal in quarantine might, subject to the use of the electric light, coal up in quarantine at Port Said by night or by day, and that passengers might embark in quarantine at that port. Infected vessels, if these carry a doctor and a disinfecting stove, have a right to navigate the Canal in quarantine and subject only to the landing of those who have plague. [ citation needed ] In the 20th and 21st centuries, people suspected of carrying infectious diseases have been quarantined, as in the cases of Andrew Speaker (multi-drug-resistant tuberculosis, 2007) and Kaci Hickox (Ebola, 2014). During the 1957–58 influenza pandemic and the 1968 flu pandemic , several countries implemented measures to control spread of the disease. In addition, the World Health Organization applied a global influenza surveillance network. During the 1994 plague in India , many people were quarantined. Vessels and aircraft carrying passengers were fumigated. In the SARS epidemic , thousands of Chinese people were quarantined and checkpoints to take temperatures were set up. Moving infected patients to isolation wards and home-based self-quarantine of people potentially exposed was the main way the Western African Ebola virus epidemic was ended in 2016; members of the 8th WHO Emergency Committee criticised international travel restrictions imposed during the epidemic as ineffective due to difficulty of enforcement, and counterproductive as they slowed down aid efforts. The People's Republic of China has employed mass quarantines – firstly of the city of Wuhan and subsequently of all of the Hubei province (population 55.5 million) – in the coronavirus disease 2019 pandemic . After a few weeks, the Italian government imposed lockdowns for the entire country (more than 60 million people) in an attempt to stop the spread of the disease there . India quarantined itself from the world for a period of one month. Most governments around the world restricted or advised against all non-essential travel to and from countries and areas affected by the outbreak. By late 2020, the virus had already spread within communities in large parts of the world, with many not knowing where or how they were infected. Since 1852, several conferences were held involving European powers, with a view to uniform action in keeping out infection from the East and preventing its spread within Europe. All but that of 1897 were concerned with cholera . No result came of those at Paris (1852), Constantinople (1866), Vienna (1874), and Rome (1885), but each of the subsequent ones doctrine of constructive infection of a ship as coming from a scheduled port, and an approximation to the principles advocated by the United Kingdom for many years. The principal countries which retained the old system at the time were Spain, Portugal, Turkey, Greece, and Russia (the British possessions at the time, Gibraltar, Malta, and Cyprus, being under the same influence). The aim of each international sanitary convention had been to bind the governments to a uniform minimum of preventive action, with further restrictions permissible to individual countries. The minimum specified by international conventions was very nearly the same as the British practice, which had been in turn adapted to continental opinion in the matter of the importation of rags. [ citation needed ] The Venice convention of 30 January 1892 dealt with cholera by the Suez Canal route; that of Dresden of 15 April 1893, with cholera within European countries; that of Paris of 3 April 1894, with cholera by the pilgrim traffic; and that of Venice, on 19 March 1897, was in connection with the outbreak of plague in the East, and the conference met to settle on an international basis the steps to be taken to prevent, if possible, its spread into Europe. An additional convention was signed in Paris on 3 December 1903. A multilateral international sanitary convention was concluded at Paris on 17 January 1912. This convention was most comprehensive and was designated to replace all previous conventions on that matter. It was signed by 40 countries, and consisted of 160 articles. Ratifications by 16 of the signatories were exchanged in Paris on 7 October 1920. Another multilateral convention was signed in Paris on 21 June 1926, to replace that of 1912. It was signed by 58 countries worldwide, and consisted of 172 articles. In Latin America, a series of regional sanitary conventions were concluded. Such a convention was concluded in Rio de Janeiro on 12 June 1904. A sanitary convention between the governments of Argentina, Brazil, Paraguay, and Uruguay was concluded in Montevideo on 21 April 1914. The convention covers cases of Asiatic cholera , oriental plague and yellow fever . It was ratified by the Uruguayan government on 13 October 1914, by the Paraguayan government on 27 September 1917 and by the Brazilian government on 18 January 1921. Sanitary conventions were also concluded between European states. A Soviet-Latvian sanitary convention was signed on 24 June 1922, for which ratifications were exchanged on 18 October 1923. A bilateral sanitary convention was concluded between the governments of Latvia and Poland on 7 July 1922, for which ratifications were exchanged on 7 April 1925. Another was concluded between the governments of Germany and Poland in Dresden on 18 December 1922, and entered into effect on 15 February 1923. Another one was signed between the governments of Poland and Romania on 20 December 1922. Ratifications were exchanged on 11 July 1923. The Polish government also concluded such a convention with the Soviet government on 7 February 1923, for which ratifications were exchanged on 8 January 1924. A sanitary convention was also concluded between the governments of Poland and Czechoslovakia on 5 September 1925, for which ratifications were exchanged on 22 October 1926. A convention was signed between the governments of Germany and Latvia on 9 July 1926, for which ratifications were exchanged on 6 July 1927. In 1897, the incubation period for this disease was determined and this was to be adopted for administrative purposes. The incubation period was comparatively short, some three or four days. After much discussion ten days was accepted by a majority. The principle of disease notification was unanimously adopted. Each government had to notify other governments of the existence of plague within their jurisdictions and state the measures of prevention being carried out to prevent its spread. The area declared infected was limited to the district or village where the disease prevailed, and no locality was deemed to be infected because of the importation into it of a few cases of plague while there has been no spread. It was decided during the prevalence of plague, every country had the right to close its land borders to traffic. At the Red Sea , it was decided after discussion a healthy vessel could pass through the Suez Canal and continue its voyage in the Mediterranean during the incubation period of the disease and that vessels passing through the Canal in quarantine might, subject to the use of the electric light, coal up in quarantine at Port Said by night or by day, and that passengers might embark in quarantine at that port. Infected vessels, if these carry a doctor and a disinfecting stove, have a right to navigate the Canal in quarantine and subject only to the landing of those who have plague. [ citation needed ] In the 20th and 21st centuries, people suspected of carrying infectious diseases have been quarantined, as in the cases of Andrew Speaker (multi-drug-resistant tuberculosis, 2007) and Kaci Hickox (Ebola, 2014). During the 1957–58 influenza pandemic and the 1968 flu pandemic , several countries implemented measures to control spread of the disease. In addition, the World Health Organization applied a global influenza surveillance network. During the 1994 plague in India , many people were quarantined. Vessels and aircraft carrying passengers were fumigated. In the SARS epidemic , thousands of Chinese people were quarantined and checkpoints to take temperatures were set up. Moving infected patients to isolation wards and home-based self-quarantine of people potentially exposed was the main way the Western African Ebola virus epidemic was ended in 2016; members of the 8th WHO Emergency Committee criticised international travel restrictions imposed during the epidemic as ineffective due to difficulty of enforcement, and counterproductive as they slowed down aid efforts. The People's Republic of China has employed mass quarantines – firstly of the city of Wuhan and subsequently of all of the Hubei province (population 55.5 million) – in the coronavirus disease 2019 pandemic . After a few weeks, the Italian government imposed lockdowns for the entire country (more than 60 million people) in an attempt to stop the spread of the disease there . India quarantined itself from the world for a period of one month. Most governments around the world restricted or advised against all non-essential travel to and from countries and areas affected by the outbreak. By late 2020, the virus had already spread within communities in large parts of the world, with many not knowing where or how they were infected. Plain yellow, green, and even black flags have been used to symbolise disease in both ships and ports, with the colour yellow having a longer historical precedent, as a colour of marking for houses of infection, previous to its use as a maritime marking colour for disease. The former flag used for the purpose was the "Lima" ( L ) flag, which is a mixture of yellow and black flags previously used. It is sometimes called the "yellow jack" but this was also a name for yellow fever , which probably derives its common name from the flag, not the colour of the victims (cholera ships also used a yellow flag). The plain yellow flag ("Quebec" or Q in international maritime signal flags ) probably derives its letter symbol for its initial use in quarantine , but this flag in modern times indicates the opposite—a ship that 'requests free pratique ', i.e. that declares itself free of quarantinable disease, and requests boarding and routine port inspection. Ships in quarantine today would fly either the Q flag alone, meaning "My vessel is 'healthy' and I request free pratique", or the double Q flag (QQ), meaning "I require health clearance". The quarantining of people often raises questions of civil rights , especially in cases of long confinement or segregation from society, such as that of Mary Mallon (also known as Typhoid Mary), a typhoid fever carrier who was arrested and quarantined in 1907 and later spent the last 23 years and 7 months of her life in medical isolation at Riverside Hospital on North Brother Island . Guidance on when and how human rights can be restricted to prevent the spread of infectious disease is found in the Siracusa Principles , a non-binding document developed by the Siracusa International Institute for Criminal Justice and Human Rights and adopted by the United Nations Economic and Social Council in 1984. The Siracusa Principles state that restrictions on human rights under the International Covenant on Civil and Political Rights must meet standards of legality, evidence-based necessity , proportionality, and gradualism, noting that public health can be used as grounds for limiting certain rights if the state needs to take measures 'aimed at preventing disease or injury or providing care for the sick and injured.' Limitations on rights (such as quarantine) must be 'strictly necessary,' meaning that they must: respond to a pressing public or social need (health) proportionately pursue a legitimate aim (prevent the spread of infectious disease) be the least restrictive means required for achieving the purpose of the limitation be provided for and carried out in accordance with the law be neither arbitrary nor discriminatory only limit rights that are within the jurisdiction of the state seeking to impose the limitation. In addition, when quarantine is imposed, public health ethics specify that: all restrictive actions must be well-supported by data and scientific evidence all information must be made available to the public all actions must be explained clearly to those whose rights are restricted and to the public all actions must be subject to regular review and reconsideration. Finally, the state is ethically obligated to guarantee that: infected people will not be threatened or abused basic needs such as food, water, medical care, and preventive care will be provided communication with loved ones and with caretakers will be permitted constraints on freedom will be applied equally, regardless of social considerations patients will be compensated fairly for economic and material losses, including salary. Quarantine can have adverse psychological effects on the quarantined, including post-traumatic stress , confusion, and anger. According to a "Rapid Review" published in The Lancet in response to the COVID-19 pandemic , "Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable." Although youngsters appear to be less vulnerable to COVID-19 , the side effects of the pandemic can be devastating. Quarantine from the pandemic led to an increase the prevalence of violence in the family, depression, anxiety, and post-traumatic stress disorder. Children and adolescents may be highly exposed to biopsychosocial stressors generated by the pandemic and once population's containment measures to reduce virus spread are required, they could be potentially affected by the disruption in daily life routine as a result of social isolation and their unseasoned ability to conceive and comprehend the short- and long-term consequences of this outbreak. Quarantine periods can be very short, such as in the case of a suspected anthrax attack, in which people are allowed to leave as soon as they shed their potentially contaminated garments and undergo a decontamination shower. For example, an article entitled "Daily News workers quarantined" describes a brief quarantine that lasted until people could be showered in a decontamination tent. The February–March 2003 issue of HazMat Magazine suggests that people be "locked in a room until proper decon could be performed", in the event of "suspect anthrax". [ citation needed ] Standard-Times senior correspondent Steve Urbon (14 February 2003) describes such temporary quarantine powers: Civil rights activists in some cases have objected to people being rounded up, stripped and showered against their will. But Capt. Chmiel said local health authorities have "certain powers to quarantine people". The purpose of such quarantine-for-decontamination is to prevent the spread of contamination and to contain the contamination such that others are not put at risk from a person fleeing a scene where contamination is suspect. It can also be used to limit exposure, as well as eliminate a vector . New developments for quarantine include new concepts in quarantine vehicles such as the ambulance bus , mobile hospitals, and lockdown/invacuation (inverse evacuation) procedures, as well as docking stations for an ambulance bus to dock to a facility under lockdown. Guidance on when and how human rights can be restricted to prevent the spread of infectious disease is found in the Siracusa Principles , a non-binding document developed by the Siracusa International Institute for Criminal Justice and Human Rights and adopted by the United Nations Economic and Social Council in 1984. The Siracusa Principles state that restrictions on human rights under the International Covenant on Civil and Political Rights must meet standards of legality, evidence-based necessity , proportionality, and gradualism, noting that public health can be used as grounds for limiting certain rights if the state needs to take measures 'aimed at preventing disease or injury or providing care for the sick and injured.' Limitations on rights (such as quarantine) must be 'strictly necessary,' meaning that they must: respond to a pressing public or social need (health) proportionately pursue a legitimate aim (prevent the spread of infectious disease) be the least restrictive means required for achieving the purpose of the limitation be provided for and carried out in accordance with the law be neither arbitrary nor discriminatory only limit rights that are within the jurisdiction of the state seeking to impose the limitation. In addition, when quarantine is imposed, public health ethics specify that: all restrictive actions must be well-supported by data and scientific evidence all information must be made available to the public all actions must be explained clearly to those whose rights are restricted and to the public all actions must be subject to regular review and reconsideration. Finally, the state is ethically obligated to guarantee that: infected people will not be threatened or abused basic needs such as food, water, medical care, and preventive care will be provided communication with loved ones and with caretakers will be permitted constraints on freedom will be applied equally, regardless of social considerations patients will be compensated fairly for economic and material losses, including salary. Quarantine can have adverse psychological effects on the quarantined, including post-traumatic stress , confusion, and anger. According to a "Rapid Review" published in The Lancet in response to the COVID-19 pandemic , "Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable." Although youngsters appear to be less vulnerable to COVID-19 , the side effects of the pandemic can be devastating. Quarantine from the pandemic led to an increase the prevalence of violence in the family, depression, anxiety, and post-traumatic stress disorder. Children and adolescents may be highly exposed to biopsychosocial stressors generated by the pandemic and once population's containment measures to reduce virus spread are required, they could be potentially affected by the disruption in daily life routine as a result of social isolation and their unseasoned ability to conceive and comprehend the short- and long-term consequences of this outbreak. Quarantine periods can be very short, such as in the case of a suspected anthrax attack, in which people are allowed to leave as soon as they shed their potentially contaminated garments and undergo a decontamination shower. For example, an article entitled "Daily News workers quarantined" describes a brief quarantine that lasted until people could be showered in a decontamination tent. The February–March 2003 issue of HazMat Magazine suggests that people be "locked in a room until proper decon could be performed", in the event of "suspect anthrax". [ citation needed ] Standard-Times senior correspondent Steve Urbon (14 February 2003) describes such temporary quarantine powers: Civil rights activists in some cases have objected to people being rounded up, stripped and showered against their will. But Capt. Chmiel said local health authorities have "certain powers to quarantine people". The purpose of such quarantine-for-decontamination is to prevent the spread of contamination and to contain the contamination such that others are not put at risk from a person fleeing a scene where contamination is suspect. It can also be used to limit exposure, as well as eliminate a vector . New developments for quarantine include new concepts in quarantine vehicles such as the ambulance bus , mobile hospitals, and lockdown/invacuation (inverse evacuation) procedures, as well as docking stations for an ambulance bus to dock to a facility under lockdown. Biosecurity in Australia is governed by the Biosecurity Act 2015 . The Department of Agriculture, Water and the Environment (DAWE) is responsible for border inspection of products brought into Australia, and assesses the risks the products might harm Australian environment. No person, goods, and vessels are permitted into Australia without clearance from DAFF. Visitors are required to fill in the information card on arriving in Australia. Besides other risk factors, visitors are required to declare what food and products made of wood and other natural materials they have. Visitors who fail to do so may be subject to a fine of A$444, or may face criminal prosecution and be fined up to A$444,000 or imprisonment of up to 10 years. Australia has very strict quarantine standards. Quarantine in northern Australia is especially important because of its proximity to South-East Asia and the Pacific, which have many pests and diseases not present in Australia. For this reason, the region from Cairns to Broome—including the Torres Strait —is the focus for quarantine activities that protect all Australians. As Australia has been geographically isolated from other major continents for millions of years, there is an endemically unique ecosystem free of several severe pests and diseases that are present in many parts of the world. If other products are brought inside along with pests and diseases, it would damage the ecosystem seriously and add millions of costs in the local agricultural businesses. There are three quarantine Acts of Parliament in Canada: Quarantine Act (humans), Health of Animals Act (animals), and Plant Protection Act (vegetations). The first legislation is enforced by the Canada Border Services Agency after a complete rewrite in 2005. The second and third legislations are enforced by the Canadian Food Inspection Agency . If a health emergency exists, the Governor in Council can prohibit importation of anything that it deems necessary under the Quarantine Act . Under the Quarantine Act , all travellers must submit to screening and if they believe they might have come into contact with communicable diseases or vectors , they must disclose their whereabouts to a Border Services Officer . If the officer has reasonable grounds to believe that the traveller is or might have been infected with a communicable disease or refused to provide answers, a quarantine officer (QO) must be called and the person is to be isolated. If a person refuses to be isolated, any peace officer may arrest without warrant. A QO who has reasonable grounds to believe that the traveller has or might have a communicable disease or is infested with vectors, after the medical examination of a traveller, can order him/her into treatment or measures to prevent the person from spreading the disease. QO can detain any traveller who refuses to comply with his/her orders or undergo health assessments as required by law. Under the Health of Animals Act and Plant Protection Act , inspectors can prohibit access to an infected area, dispose or treat any infected or suspected to be infected animals or plants. The Minister can order for compensation to be given if animals/plants were destroyed pursuant to these acts. Each province also enacts its own quarantine/environmental health legislation. Under the Prevention and Control of Disease Ordinance (HK Laws. Chap 599), a health officer may seize articles they believe to be infectious or containing infectious agents. All travellers, if requested, must submit themselves to a health officer. Failure to do so is against the law and is subject to arrest and prosecution. The law allows for health officers who have reasonable grounds to detain, isolate, quarantine anyone or anything believed to be infected, and to restrict any articles from leaving a designated quarantine area. He/she may also order the Civil Aviation Department to prohibit the landing or leaving, embarking or disembarking of an aircraft. This power also extends to land, sea or air crossings. Under the same ordinance, any police officer, health officer, member of the Civil Aid Service , or member of the Auxiliary Medical Service can arrest a person who obstructs or escapes from detention. To reduce the risk of introducing rabies from continental Europe, the United Kingdom used to require that dogs, and most other animals introduced to the country, spend six months in quarantine at an HM Customs and Excise pound; this policy was abolished in 2000 in favour of a scheme generally known as Pet Passports , where animals can avoid quarantine if they have documentation showing they are up to date on their appropriate vaccinations . The plague had disappeared from England for more than thirty years before the practice of quarantine against it was definitely established by the Quarantine Act 1710 ( 9 Ann. ). The first act was called for due to fears that the plague might be imported from Poland and the Baltic region . The second act of 1721 was due to the prevalence of plague at Marseille and other places in Provence, France . It was renewed in 1733 after a new outbreak in continental Europe , and again in 1743, due to an epidemic in Messina . In 1752 a rigorous quarantine clause was introduced into an act regulating trade with the Levant , and various arbitrary orders were issued during the next twenty years to meet the supposed danger of infection from the Baltic region. Although no plague cases ever came to England during that period, the restrictions on traffic became more stringent, and in 1788 a very strict Quarantine Act was passed, with provisions affecting cargoes in particular. The act was revised in 1801 and 1805, and in 1823–24 an elaborate inquiry was followed by an act making quarantine only at discretion of the privy council , which recognised yellow fever or other highly infectious diseases as calling for quarantine, along with plague. The threat of cholera in 1831 was the last occasion in England of the use of quarantine restrictions. Cholera affected every country in Europe, despite all efforts to keep it out. When cholera returned to England in 1849, 1853 and 1865–66, no attempt was made to seal the ports. In 1847 the privy council ordered all arrivals with a clean bill of health from the Black Sea and the Levant to be admitted, provided there had been no case of plague during the voyage, and afterwards the practice of quarantine was discontinued. After the passing of the first Quarantine Act (1710) the protective practices in England were haphazard and arbitrary. In 1721 two vessels carrying cotton goods from Cyprus, then affected by the plague, were ordered to be burned with their cargoes, the owners receiving an indemnity . By the clause in the Levant Trade Act of 1752, ships arriving in the United Kingdom with a "foul bill" (i.e. coming from a country where plague existed) had to return to the lazarets of Malta, Venice, Messina, Livorno, Genoa, or Marseille, to complete a quarantine or to have their cargoes opened and aired. Since 1741 Stangate Creek (on the Medway ) had been the quarantine station but it was available only for vessels with clean bills of health. In 1755 lazarets in the form of floating hulks were established in England for the first time, the cleansing of cargo (particularly by exposure to dews ) having been done previously on the ship's deck. No medical inspections were conducted, but control was the responsibility of the Officers of Royal Customs and quarantine. In 1780, when plague was in Poland, even vessels with grain from the Baltic region had to spend forty days in quarantine, and unpack and air their cargoes, but due to complaints mainly from Edinburgh and Leith , an exception was made for grain after that date. About 1788 an order of the council required every ship liable to quarantine to hoist a yellow flag in the daytime and show a light at the main topmast head at night, in case of meeting any vessel at sea, or upon arriving within four leagues of the coast of Great Britain or Ireland , the Channel Islands , or the Isle of Man . After 1800, ships from plague-affected countries (or with foul bills) were permitted to complete their quarantine in the Medway instead of at a Mediterranean port on the way, and an extensive lazaret was built on Chetney Hill near Chatham (although it was later demolished). The use of floating hulks as lazarets continued as before. In 1800 two ships with hides from Mogador in Morocco were ordered to be sunk with their cargoes at the Nore , the owners receiving an indemnity. Animal hides were suspected of harbouring infections, along with a long list of other items, and these had to be exposed on the ship's deck for twenty-one days or less (six days for each instalment of the cargo), and then transported to the lazaret, where they were opened and aired for another forty days. The whole detention of the vessel was from sixty to sixty-five days, including the time for reshipment of her cargo. Pilots had to pass fifteen days on board a convalescent ship. From 1846 onwards the quarantine establishments in the United Kingdom were gradually reduced, while the last vestige of the British quarantine law was removed by the Public Health Act of 1896, which repealed the Quarantine Act of 1825 (with dependent clauses of other acts), and transferred from the privy council to the Local Government Board the powers to deal with ships arriving infected with yellow fever or plague. The powers to deal with cholera ships had been already transferred by the Public Health Act 1875 . British regulations of 9 November 1896 applied to yellow fever , plague and cholera . Officers of Her Majesty's Customs , as well as of Her Majesty's Coastguard and the Board of Trade (for signalling), were empowered to take the initial steps. They certified in writing the master of a supposedly infected ship, and detained the vessel provisionally for not more than twelve hours, giving notice meanwhile to the port sanitary authority . The medical officer of the port boarded the ship and examined every person in it. Every person found infected was taken to a hospital and quarantined under the orders of the medical officer, and the vessel remained under his orders. Every person suspected could be detained on board for 48 hours or removed to the hospital for a similar period. All others were free to land upon giving the addresses of their destinations to be sent to the respective local authorities, so that the dispersed passengers and crew could be kept individually under observation for a few days. The ship was then disinfected, dead bodies buried at sea, infected clothing, bedding, etc., destroyed or disinfected, and bilge-water and water-ballast pumped out at a suitable distance before the ship entered a dock or basin. Mail was subject to no detention. A stricken ship within 3 miles of the shore had to fly a yellow and black flag at the main mast from sunrise to sunset. In the United States, authority to quarantine people with infectious diseases is split between the state and federal governments. States (and tribal governments recognised by the federal government) have primary authority to quarantine people within their boundaries. Federal jurisdiction only applies to people moving across state or national borders, or people on federal property. Communicable diseases for which apprehension, detention, or conditional release of people are authorised must be specified in Executive Orders of the President. As of 2014, these include Executive Orders 13295 13375, and 13674; the latest executive order specifies the following infectious diseases: cholera , diphtheria , infectious tuberculosis , plague , smallpox , yellow fever , viral haemorrhagic fevers ( Lassa , Marburg , Ebola , Crimean-Congo , South American , and others not yet isolated or named), severe acute respiratory syndromes (SARS), and influenza from a novel or re-emergent source. The Department of Health and Human Services is responsible for quarantine decisions, specifically the Centers for Disease Control and Prevention 's Division of Global Migration and Quarantine . As of 21 March 2017, Centers for Disease Control and Prevention (CDC) regulations specify: All commercial passenger flights must report deaths or illnesses to the CDC. Individuals must apply for a travel permit if they are under a Federal quarantine, isolation, or conditional release order. When an individual who is moving between U.S. states is "reasonably believed to be infected" with a quarantinable communicable disease in a "qualifying stage", the CDC may apprehend or examine that individual for potential infection. This includes new regulatory authority permitting the CDC Director to prohibit the importation of animals or products that pose a threat to public health. The rules: The Division of Global Migration Health (DGMH) of the US Centers for Disease Control (CDC) operates small quarantine facilities at a number of US ports of entry. As of 2014, these included one land crossing (in El Paso, Texas ) and 19 international airports. [note 1] Besides the port of entry where it is located, each station is also responsible for quarantining potentially infected travellers entering through any ports of entry in its assigned region. These facilities are fairly small; each one is operated by a few staff members and capable of accommodating 1–2 travellers for a short observation period. Cost estimates for setting up a temporary larger facility, capable of accommodating 100 to 200 travellers for several weeks, have been published by the Airport Cooperative Research Program (ACRP) in 2008 of the Transportation Research Board . The United States puts immediate quarantines on imported products if a contagious disease is identified and can be traced back to a certain shipment or product. All imports will also be quarantined if the disease appears in other countries. [ citation needed ] According to Title 42 U.S.C. §§264 and 266 Archived 24 September 2015 at the Wayback Machine , these statutes provide the Secretary of Health and Human Services peacetime and wartime authority to control the movement of people into and within the United States to prevent the spread of communicable disease. Quarantine law began in Colonial America in 1663, when in an attempt to curb an outbreak of smallpox , the city of New York established a quarantine. In the 1730s, the city built a quarantine station on the Bedloe's Island . The Philadelphia Lazaretto was the first quarantine hospital in the United States, built in 1799, in Tinicum Township , Delaware County , Pennsylvania. There are similar national landmarks such as the Columbia River Quarantine Station , Swinburne Island and Angel Island . The Pest House in Concord, Massachusetts was used as early as 1752 to quarantine those with cholera, tuberculosis and smallpox. In early June 1832, during the cholera epidemic in New York, Governor Enos Throop called a special session of the Legislature for 21 June, to pass a Public Health Act by both Houses of the State Legislature. It included to a strict quarantine along the Upper and Lower New York-Canadian frontier. In addition, New York City Mayor Walter Browne established a quarantine against all peoples and products of Europe and Asia, which prohibited ships from approaching closer than 300 yards to the city, and all vehicles were ordered to stop 1.5 miles away. The Immigrant Inspection Station on Ellis Island , built in 1892, is often mistakenly assumed to have been a quarantine station, however its marine hospital ( Ellis Island Immigrant Hospital ) only qualified as a contagious disease facility to handle less virulent diseases like measles, trachoma and less advanced stages of tuberculosis and diphtheria; those affected by smallpox, yellow fever, cholera, leprosy or typhoid fever, could neither be received nor treated there. Mary Mallon was quarantined in 1907 under the Greater New York Charter, Sections 1169–1170, which permitted the New York City Board of Health to "remove to a proper place…any person sick with any contagious, pestilential or infectious disease." During the 1918 flu pandemic , people were also quarantined. Most commonly suspect cases of infectious diseases are requested to voluntarily quarantine themselves, and Federal and local quarantine statutes only have been uncommonly invoked since then, including for a suspected smallpox case in 1963. The 1944 Public Health Service Act "to apprehend, detain, and examine certain infected persons who are peculiarly likely to cause the interstate spread of disease" clearly established the federal government 's quarantine authority for the first time. It gave the United States Public Health Service responsibility for preventing the introduction, transmission and spread of communicable diseases from foreign countries into the United States, and expanded quarantine authority to include incoming aircraft. The act states that "...any individual reasonably believed to be infected with a communicable disease in a qualifying stage and...if found to be infected, may be detained for such time and in such manner as may be reasonably necessary." No federal quarantine orders were issued from 1963 until 2020, as American citizens were evacuated from China during the COVID-19 pandemic . Biosecurity in Australia is governed by the Biosecurity Act 2015 . The Department of Agriculture, Water and the Environment (DAWE) is responsible for border inspection of products brought into Australia, and assesses the risks the products might harm Australian environment. No person, goods, and vessels are permitted into Australia without clearance from DAFF. Visitors are required to fill in the information card on arriving in Australia. Besides other risk factors, visitors are required to declare what food and products made of wood and other natural materials they have. Visitors who fail to do so may be subject to a fine of A$444, or may face criminal prosecution and be fined up to A$444,000 or imprisonment of up to 10 years. Australia has very strict quarantine standards. Quarantine in northern Australia is especially important because of its proximity to South-East Asia and the Pacific, which have many pests and diseases not present in Australia. For this reason, the region from Cairns to Broome—including the Torres Strait —is the focus for quarantine activities that protect all Australians. As Australia has been geographically isolated from other major continents for millions of years, there is an endemically unique ecosystem free of several severe pests and diseases that are present in many parts of the world. If other products are brought inside along with pests and diseases, it would damage the ecosystem seriously and add millions of costs in the local agricultural businesses. There are three quarantine Acts of Parliament in Canada: Quarantine Act (humans), Health of Animals Act (animals), and Plant Protection Act (vegetations). The first legislation is enforced by the Canada Border Services Agency after a complete rewrite in 2005. The second and third legislations are enforced by the Canadian Food Inspection Agency . If a health emergency exists, the Governor in Council can prohibit importation of anything that it deems necessary under the Quarantine Act . Under the Quarantine Act , all travellers must submit to screening and if they believe they might have come into contact with communicable diseases or vectors , they must disclose their whereabouts to a Border Services Officer . If the officer has reasonable grounds to believe that the traveller is or might have been infected with a communicable disease or refused to provide answers, a quarantine officer (QO) must be called and the person is to be isolated. If a person refuses to be isolated, any peace officer may arrest without warrant. A QO who has reasonable grounds to believe that the traveller has or might have a communicable disease or is infested with vectors, after the medical examination of a traveller, can order him/her into treatment or measures to prevent the person from spreading the disease. QO can detain any traveller who refuses to comply with his/her orders or undergo health assessments as required by law. Under the Health of Animals Act and Plant Protection Act , inspectors can prohibit access to an infected area, dispose or treat any infected or suspected to be infected animals or plants. The Minister can order for compensation to be given if animals/plants were destroyed pursuant to these acts. Each province also enacts its own quarantine/environmental health legislation.Under the Prevention and Control of Disease Ordinance (HK Laws. Chap 599), a health officer may seize articles they believe to be infectious or containing infectious agents. All travellers, if requested, must submit themselves to a health officer. Failure to do so is against the law and is subject to arrest and prosecution. The law allows for health officers who have reasonable grounds to detain, isolate, quarantine anyone or anything believed to be infected, and to restrict any articles from leaving a designated quarantine area. He/she may also order the Civil Aviation Department to prohibit the landing or leaving, embarking or disembarking of an aircraft. This power also extends to land, sea or air crossings. Under the same ordinance, any police officer, health officer, member of the Civil Aid Service , or member of the Auxiliary Medical Service can arrest a person who obstructs or escapes from detention.To reduce the risk of introducing rabies from continental Europe, the United Kingdom used to require that dogs, and most other animals introduced to the country, spend six months in quarantine at an HM Customs and Excise pound; this policy was abolished in 2000 in favour of a scheme generally known as Pet Passports , where animals can avoid quarantine if they have documentation showing they are up to date on their appropriate vaccinations . The plague had disappeared from England for more than thirty years before the practice of quarantine against it was definitely established by the Quarantine Act 1710 ( 9 Ann. ). The first act was called for due to fears that the plague might be imported from Poland and the Baltic region . The second act of 1721 was due to the prevalence of plague at Marseille and other places in Provence, France . It was renewed in 1733 after a new outbreak in continental Europe , and again in 1743, due to an epidemic in Messina . In 1752 a rigorous quarantine clause was introduced into an act regulating trade with the Levant , and various arbitrary orders were issued during the next twenty years to meet the supposed danger of infection from the Baltic region. Although no plague cases ever came to England during that period, the restrictions on traffic became more stringent, and in 1788 a very strict Quarantine Act was passed, with provisions affecting cargoes in particular. The act was revised in 1801 and 1805, and in 1823–24 an elaborate inquiry was followed by an act making quarantine only at discretion of the privy council , which recognised yellow fever or other highly infectious diseases as calling for quarantine, along with plague. The threat of cholera in 1831 was the last occasion in England of the use of quarantine restrictions. Cholera affected every country in Europe, despite all efforts to keep it out. When cholera returned to England in 1849, 1853 and 1865–66, no attempt was made to seal the ports. In 1847 the privy council ordered all arrivals with a clean bill of health from the Black Sea and the Levant to be admitted, provided there had been no case of plague during the voyage, and afterwards the practice of quarantine was discontinued. After the passing of the first Quarantine Act (1710) the protective practices in England were haphazard and arbitrary. In 1721 two vessels carrying cotton goods from Cyprus, then affected by the plague, were ordered to be burned with their cargoes, the owners receiving an indemnity . By the clause in the Levant Trade Act of 1752, ships arriving in the United Kingdom with a "foul bill" (i.e. coming from a country where plague existed) had to return to the lazarets of Malta, Venice, Messina, Livorno, Genoa, or Marseille, to complete a quarantine or to have their cargoes opened and aired. Since 1741 Stangate Creek (on the Medway ) had been the quarantine station but it was available only for vessels with clean bills of health. In 1755 lazarets in the form of floating hulks were established in England for the first time, the cleansing of cargo (particularly by exposure to dews ) having been done previously on the ship's deck. No medical inspections were conducted, but control was the responsibility of the Officers of Royal Customs and quarantine. In 1780, when plague was in Poland, even vessels with grain from the Baltic region had to spend forty days in quarantine, and unpack and air their cargoes, but due to complaints mainly from Edinburgh and Leith , an exception was made for grain after that date. About 1788 an order of the council required every ship liable to quarantine to hoist a yellow flag in the daytime and show a light at the main topmast head at night, in case of meeting any vessel at sea, or upon arriving within four leagues of the coast of Great Britain or Ireland , the Channel Islands , or the Isle of Man . After 1800, ships from plague-affected countries (or with foul bills) were permitted to complete their quarantine in the Medway instead of at a Mediterranean port on the way, and an extensive lazaret was built on Chetney Hill near Chatham (although it was later demolished). The use of floating hulks as lazarets continued as before. In 1800 two ships with hides from Mogador in Morocco were ordered to be sunk with their cargoes at the Nore , the owners receiving an indemnity. Animal hides were suspected of harbouring infections, along with a long list of other items, and these had to be exposed on the ship's deck for twenty-one days or less (six days for each instalment of the cargo), and then transported to the lazaret, where they were opened and aired for another forty days. The whole detention of the vessel was from sixty to sixty-five days, including the time for reshipment of her cargo. Pilots had to pass fifteen days on board a convalescent ship. From 1846 onwards the quarantine establishments in the United Kingdom were gradually reduced, while the last vestige of the British quarantine law was removed by the Public Health Act of 1896, which repealed the Quarantine Act of 1825 (with dependent clauses of other acts), and transferred from the privy council to the Local Government Board the powers to deal with ships arriving infected with yellow fever or plague. The powers to deal with cholera ships had been already transferred by the Public Health Act 1875 . British regulations of 9 November 1896 applied to yellow fever , plague and cholera . Officers of Her Majesty's Customs , as well as of Her Majesty's Coastguard and the Board of Trade (for signalling), were empowered to take the initial steps. They certified in writing the master of a supposedly infected ship, and detained the vessel provisionally for not more than twelve hours, giving notice meanwhile to the port sanitary authority . The medical officer of the port boarded the ship and examined every person in it. Every person found infected was taken to a hospital and quarantined under the orders of the medical officer, and the vessel remained under his orders. Every person suspected could be detained on board for 48 hours or removed to the hospital for a similar period. All others were free to land upon giving the addresses of their destinations to be sent to the respective local authorities, so that the dispersed passengers and crew could be kept individually under observation for a few days. The ship was then disinfected, dead bodies buried at sea, infected clothing, bedding, etc., destroyed or disinfected, and bilge-water and water-ballast pumped out at a suitable distance before the ship entered a dock or basin. Mail was subject to no detention. A stricken ship within 3 miles of the shore had to fly a yellow and black flag at the main mast from sunrise to sunset. The plague had disappeared from England for more than thirty years before the practice of quarantine against it was definitely established by the Quarantine Act 1710 ( 9 Ann. ). The first act was called for due to fears that the plague might be imported from Poland and the Baltic region . The second act of 1721 was due to the prevalence of plague at Marseille and other places in Provence, France . It was renewed in 1733 after a new outbreak in continental Europe , and again in 1743, due to an epidemic in Messina . In 1752 a rigorous quarantine clause was introduced into an act regulating trade with the Levant , and various arbitrary orders were issued during the next twenty years to meet the supposed danger of infection from the Baltic region. Although no plague cases ever came to England during that period, the restrictions on traffic became more stringent, and in 1788 a very strict Quarantine Act was passed, with provisions affecting cargoes in particular. The act was revised in 1801 and 1805, and in 1823–24 an elaborate inquiry was followed by an act making quarantine only at discretion of the privy council , which recognised yellow fever or other highly infectious diseases as calling for quarantine, along with plague. The threat of cholera in 1831 was the last occasion in England of the use of quarantine restrictions. Cholera affected every country in Europe, despite all efforts to keep it out. When cholera returned to England in 1849, 1853 and 1865–66, no attempt was made to seal the ports. In 1847 the privy council ordered all arrivals with a clean bill of health from the Black Sea and the Levant to be admitted, provided there had been no case of plague during the voyage, and afterwards the practice of quarantine was discontinued. After the passing of the first Quarantine Act (1710) the protective practices in England were haphazard and arbitrary. In 1721 two vessels carrying cotton goods from Cyprus, then affected by the plague, were ordered to be burned with their cargoes, the owners receiving an indemnity . By the clause in the Levant Trade Act of 1752, ships arriving in the United Kingdom with a "foul bill" (i.e. coming from a country where plague existed) had to return to the lazarets of Malta, Venice, Messina, Livorno, Genoa, or Marseille, to complete a quarantine or to have their cargoes opened and aired. Since 1741 Stangate Creek (on the Medway ) had been the quarantine station but it was available only for vessels with clean bills of health. In 1755 lazarets in the form of floating hulks were established in England for the first time, the cleansing of cargo (particularly by exposure to dews ) having been done previously on the ship's deck. No medical inspections were conducted, but control was the responsibility of the Officers of Royal Customs and quarantine. In 1780, when plague was in Poland, even vessels with grain from the Baltic region had to spend forty days in quarantine, and unpack and air their cargoes, but due to complaints mainly from Edinburgh and Leith , an exception was made for grain after that date. About 1788 an order of the council required every ship liable to quarantine to hoist a yellow flag in the daytime and show a light at the main topmast head at night, in case of meeting any vessel at sea, or upon arriving within four leagues of the coast of Great Britain or Ireland , the Channel Islands , or the Isle of Man . After 1800, ships from plague-affected countries (or with foul bills) were permitted to complete their quarantine in the Medway instead of at a Mediterranean port on the way, and an extensive lazaret was built on Chetney Hill near Chatham (although it was later demolished). The use of floating hulks as lazarets continued as before. In 1800 two ships with hides from Mogador in Morocco were ordered to be sunk with their cargoes at the Nore , the owners receiving an indemnity. Animal hides were suspected of harbouring infections, along with a long list of other items, and these had to be exposed on the ship's deck for twenty-one days or less (six days for each instalment of the cargo), and then transported to the lazaret, where they were opened and aired for another forty days. The whole detention of the vessel was from sixty to sixty-five days, including the time for reshipment of her cargo. Pilots had to pass fifteen days on board a convalescent ship. From 1846 onwards the quarantine establishments in the United Kingdom were gradually reduced, while the last vestige of the British quarantine law was removed by the Public Health Act of 1896, which repealed the Quarantine Act of 1825 (with dependent clauses of other acts), and transferred from the privy council to the Local Government Board the powers to deal with ships arriving infected with yellow fever or plague. The powers to deal with cholera ships had been already transferred by the Public Health Act 1875 . British regulations of 9 November 1896 applied to yellow fever , plague and cholera . Officers of Her Majesty's Customs , as well as of Her Majesty's Coastguard and the Board of Trade (for signalling), were empowered to take the initial steps. They certified in writing the master of a supposedly infected ship, and detained the vessel provisionally for not more than twelve hours, giving notice meanwhile to the port sanitary authority . The medical officer of the port boarded the ship and examined every person in it. Every person found infected was taken to a hospital and quarantined under the orders of the medical officer, and the vessel remained under his orders. Every person suspected could be detained on board for 48 hours or removed to the hospital for a similar period. All others were free to land upon giving the addresses of their destinations to be sent to the respective local authorities, so that the dispersed passengers and crew could be kept individually under observation for a few days. The ship was then disinfected, dead bodies buried at sea, infected clothing, bedding, etc., destroyed or disinfected, and bilge-water and water-ballast pumped out at a suitable distance before the ship entered a dock or basin. Mail was subject to no detention. A stricken ship within 3 miles of the shore had to fly a yellow and black flag at the main mast from sunrise to sunset. In the United States, authority to quarantine people with infectious diseases is split between the state and federal governments. States (and tribal governments recognised by the federal government) have primary authority to quarantine people within their boundaries. Federal jurisdiction only applies to people moving across state or national borders, or people on federal property. Communicable diseases for which apprehension, detention, or conditional release of people are authorised must be specified in Executive Orders of the President. As of 2014, these include Executive Orders 13295 13375, and 13674; the latest executive order specifies the following infectious diseases: cholera , diphtheria , infectious tuberculosis , plague , smallpox , yellow fever , viral haemorrhagic fevers ( Lassa , Marburg , Ebola , Crimean-Congo , South American , and others not yet isolated or named), severe acute respiratory syndromes (SARS), and influenza from a novel or re-emergent source. The Department of Health and Human Services is responsible for quarantine decisions, specifically the Centers for Disease Control and Prevention 's Division of Global Migration and Quarantine . As of 21 March 2017, Centers for Disease Control and Prevention (CDC) regulations specify: All commercial passenger flights must report deaths or illnesses to the CDC. Individuals must apply for a travel permit if they are under a Federal quarantine, isolation, or conditional release order. When an individual who is moving between U.S. states is "reasonably believed to be infected" with a quarantinable communicable disease in a "qualifying stage", the CDC may apprehend or examine that individual for potential infection. This includes new regulatory authority permitting the CDC Director to prohibit the importation of animals or products that pose a threat to public health. The rules: The Division of Global Migration Health (DGMH) of the US Centers for Disease Control (CDC) operates small quarantine facilities at a number of US ports of entry. As of 2014, these included one land crossing (in El Paso, Texas ) and 19 international airports. [note 1] Besides the port of entry where it is located, each station is also responsible for quarantining potentially infected travellers entering through any ports of entry in its assigned region. These facilities are fairly small; each one is operated by a few staff members and capable of accommodating 1–2 travellers for a short observation period. Cost estimates for setting up a temporary larger facility, capable of accommodating 100 to 200 travellers for several weeks, have been published by the Airport Cooperative Research Program (ACRP) in 2008 of the Transportation Research Board . The United States puts immediate quarantines on imported products if a contagious disease is identified and can be traced back to a certain shipment or product. All imports will also be quarantined if the disease appears in other countries. [ citation needed ] According to Title 42 U.S.C. §§264 and 266 Archived 24 September 2015 at the Wayback Machine , these statutes provide the Secretary of Health and Human Services peacetime and wartime authority to control the movement of people into and within the United States to prevent the spread of communicable disease. Quarantine law began in Colonial America in 1663, when in an attempt to curb an outbreak of smallpox , the city of New York established a quarantine. In the 1730s, the city built a quarantine station on the Bedloe's Island . The Philadelphia Lazaretto was the first quarantine hospital in the United States, built in 1799, in Tinicum Township , Delaware County , Pennsylvania. There are similar national landmarks such as the Columbia River Quarantine Station , Swinburne Island and Angel Island . The Pest House in Concord, Massachusetts was used as early as 1752 to quarantine those with cholera, tuberculosis and smallpox. In early June 1832, during the cholera epidemic in New York, Governor Enos Throop called a special session of the Legislature for 21 June, to pass a Public Health Act by both Houses of the State Legislature. It included to a strict quarantine along the Upper and Lower New York-Canadian frontier. In addition, New York City Mayor Walter Browne established a quarantine against all peoples and products of Europe and Asia, which prohibited ships from approaching closer than 300 yards to the city, and all vehicles were ordered to stop 1.5 miles away. The Immigrant Inspection Station on Ellis Island , built in 1892, is often mistakenly assumed to have been a quarantine station, however its marine hospital ( Ellis Island Immigrant Hospital ) only qualified as a contagious disease facility to handle less virulent diseases like measles, trachoma and less advanced stages of tuberculosis and diphtheria; those affected by smallpox, yellow fever, cholera, leprosy or typhoid fever, could neither be received nor treated there. Mary Mallon was quarantined in 1907 under the Greater New York Charter, Sections 1169–1170, which permitted the New York City Board of Health to "remove to a proper place…any person sick with any contagious, pestilential or infectious disease." During the 1918 flu pandemic , people were also quarantined. Most commonly suspect cases of infectious diseases are requested to voluntarily quarantine themselves, and Federal and local quarantine statutes only have been uncommonly invoked since then, including for a suspected smallpox case in 1963. The 1944 Public Health Service Act "to apprehend, detain, and examine certain infected persons who are peculiarly likely to cause the interstate spread of disease" clearly established the federal government 's quarantine authority for the first time. It gave the United States Public Health Service responsibility for preventing the introduction, transmission and spread of communicable diseases from foreign countries into the United States, and expanded quarantine authority to include incoming aircraft. The act states that "...any individual reasonably believed to be infected with a communicable disease in a qualifying stage and...if found to be infected, may be detained for such time and in such manner as may be reasonably necessary." No federal quarantine orders were issued from 1963 until 2020, as American citizens were evacuated from China during the COVID-19 pandemic . Communicable diseases for which apprehension, detention, or conditional release of people are authorised must be specified in Executive Orders of the President. As of 2014, these include Executive Orders 13295 13375, and 13674; the latest executive order specifies the following infectious diseases: cholera , diphtheria , infectious tuberculosis , plague , smallpox , yellow fever , viral haemorrhagic fevers ( Lassa , Marburg , Ebola , Crimean-Congo , South American , and others not yet isolated or named), severe acute respiratory syndromes (SARS), and influenza from a novel or re-emergent source. The Department of Health and Human Services is responsible for quarantine decisions, specifically the Centers for Disease Control and Prevention 's Division of Global Migration and Quarantine . As of 21 March 2017, Centers for Disease Control and Prevention (CDC) regulations specify: All commercial passenger flights must report deaths or illnesses to the CDC. Individuals must apply for a travel permit if they are under a Federal quarantine, isolation, or conditional release order. When an individual who is moving between U.S. states is "reasonably believed to be infected" with a quarantinable communicable disease in a "qualifying stage", the CDC may apprehend or examine that individual for potential infection. This includes new regulatory authority permitting the CDC Director to prohibit the importation of animals or products that pose a threat to public health. The rules:The Division of Global Migration Health (DGMH) of the US Centers for Disease Control (CDC) operates small quarantine facilities at a number of US ports of entry. As of 2014, these included one land crossing (in El Paso, Texas ) and 19 international airports. [note 1] Besides the port of entry where it is located, each station is also responsible for quarantining potentially infected travellers entering through any ports of entry in its assigned region. These facilities are fairly small; each one is operated by a few staff members and capable of accommodating 1–2 travellers for a short observation period. Cost estimates for setting up a temporary larger facility, capable of accommodating 100 to 200 travellers for several weeks, have been published by the Airport Cooperative Research Program (ACRP) in 2008 of the Transportation Research Board . The United States puts immediate quarantines on imported products if a contagious disease is identified and can be traced back to a certain shipment or product. All imports will also be quarantined if the disease appears in other countries. [ citation needed ] According to Title 42 U.S.C. §§264 and 266 Archived 24 September 2015 at the Wayback Machine , these statutes provide the Secretary of Health and Human Services peacetime and wartime authority to control the movement of people into and within the United States to prevent the spread of communicable disease.Quarantine law began in Colonial America in 1663, when in an attempt to curb an outbreak of smallpox , the city of New York established a quarantine. In the 1730s, the city built a quarantine station on the Bedloe's Island . The Philadelphia Lazaretto was the first quarantine hospital in the United States, built in 1799, in Tinicum Township , Delaware County , Pennsylvania. There are similar national landmarks such as the Columbia River Quarantine Station , Swinburne Island and Angel Island . The Pest House in Concord, Massachusetts was used as early as 1752 to quarantine those with cholera, tuberculosis and smallpox. In early June 1832, during the cholera epidemic in New York, Governor Enos Throop called a special session of the Legislature for 21 June, to pass a Public Health Act by both Houses of the State Legislature. It included to a strict quarantine along the Upper and Lower New York-Canadian frontier. In addition, New York City Mayor Walter Browne established a quarantine against all peoples and products of Europe and Asia, which prohibited ships from approaching closer than 300 yards to the city, and all vehicles were ordered to stop 1.5 miles away. The Immigrant Inspection Station on Ellis Island , built in 1892, is often mistakenly assumed to have been a quarantine station, however its marine hospital ( Ellis Island Immigrant Hospital ) only qualified as a contagious disease facility to handle less virulent diseases like measles, trachoma and less advanced stages of tuberculosis and diphtheria; those affected by smallpox, yellow fever, cholera, leprosy or typhoid fever, could neither be received nor treated there. Mary Mallon was quarantined in 1907 under the Greater New York Charter, Sections 1169–1170, which permitted the New York City Board of Health to "remove to a proper place…any person sick with any contagious, pestilential or infectious disease." During the 1918 flu pandemic , people were also quarantined. Most commonly suspect cases of infectious diseases are requested to voluntarily quarantine themselves, and Federal and local quarantine statutes only have been uncommonly invoked since then, including for a suspected smallpox case in 1963. The 1944 Public Health Service Act "to apprehend, detain, and examine certain infected persons who are peculiarly likely to cause the interstate spread of disease" clearly established the federal government 's quarantine authority for the first time. It gave the United States Public Health Service responsibility for preventing the introduction, transmission and spread of communicable diseases from foreign countries into the United States, and expanded quarantine authority to include incoming aircraft. The act states that "...any individual reasonably believed to be infected with a communicable disease in a qualifying stage and...if found to be infected, may be detained for such time and in such manner as may be reasonably necessary." No federal quarantine orders were issued from 1963 until 2020, as American citizens were evacuated from China during the COVID-19 pandemic . Eyam was a village in Britain that imposed a cordon sanitaire on itself to stop the spread of the bubonic plague to other communities in 1665. The plague ran its course over 14 months and one account states that it killed at least 260 villagers. The church in Eyam has a record of 273 individuals who were victims of the plague. On 28 July 1814, the convict ship Surry arrived in Sydney Harbour from England. Forty-six people had died of typhoid during the voyage, including 36 convicts, and the ship was placed in quarantine on the North Shore. Convicts were landed, and a camp was established in the immediate vicinity of what is now Jeffrey Street in Kirribilli . This was the first site in Australia to be used for quarantine purposes. Mary Mallon was a cook who was found to be a carrier of Salmonella enterica subsp. enterica , the cause of typhoid fever , and was forcibly isolated from 1907 to 1910. At least 53 cases of the infection were traced to her, and three deaths. Subsequently, she spent a further 23 years in isolation prior to her death in 1938. The presence of the bacteria in her gallbladder was confirmed on autopsy. During the 1918 flu pandemic , the then Governor of American Samoa , John Martin Poyer , imposed a full protective sequestration of the islands from all incoming ships, successfully preventing influenza from infecting the population and thus achieving zero deaths within the territory. In contrast, the neighbouring New Zealand-controlled Western Samoa was among the hardest hit, with a 90% infection rate and over 20% of its adults dying from the disease. This failure by the New Zealand government to prevent and contain the Spanish Flu subsequently rekindled Samoan anti-colonial sentiments that led to its eventual independence. In 1942, during World War II , British forces tested out their biological weapons program on Gruinard Island and infected it with anthrax . Subsequently, a quarantine order was placed on the island. The quarantine was lifted in 1990, when the island was declared safe, and a flock of sheep was released onto the island. Between 24 July 1969 and 9 February 1971, the astronauts of Apollo 11 , Apollo 12 , and Apollo 14 , were quarantined (in each case for a total of 21 days) after returning to Earth, initially where they were recovered, and then were transferred to the Lunar Receiving Laboratory , to prevent possible interplanetary contamination by microorganisms from the Moon . All lunar samples were also held in the biosecure environment of the Lunar Receiving Laboratory for initial assay. The 1972 Yugoslav smallpox outbreak was the final outbreak of smallpox in Europe. The World Health Organization fought the outbreak with extensive quarantine and a cordon sanitaire , and the government instituted martial law . In 2014, Kaci Hickox , a Doctors Without Borders nurse from Maine, legally battled 21-day quarantines imposed by the states of New Jersey and Maine after returning home from treating Ebola patients in Sierra Leone . "Hickox was sequestered in a medical tent for days because New Jersey announced new Ebola regulations the day she arrived. She eventually was allowed to travel to Maine, where the state sought to impose a 'voluntary quarantine' before trying and failing to create a buffer between her and others. A state judge rejected attempts to restrict her movements, saying she posed no threat as long as she wasn't demonstrating any symptoms of Ebola. Hickox said health care professionals like those at the U.S. Centers for Disease Control and Prevention – not politicians like New Jersey Gov. Chris Christie and Maine Gov. Paul LePage – should be in charge of making decisions that are grounded in science, not fear." During the COVID-19 pandemic , multiple governmental actors enacted quarantines in an effort to curb the rapid spread of the virus. Quarantine-like restrictions on movement included curfews and restrictions variously described as stay-at-home orders , shelter-in-place orders, shutdowns or lockdowns . [ citation needed ] On 26 March 2020, 1.7 billion people worldwide were under some form of lockdown , which increased to 2.6 billion people two days later—around a third of the world's population . In Hubei, the origin of the epidemic, a cordon sanitaire was imposed on Wuhan and other major cities in China, affecting around 500 million people, which is unprecedented in scale in human history, to limit the rate of spread of the disease. The 'lockdown' of Wuhan, and subsequently a wider-scale 'lockdown' throughout Hubei province, began on 23 January 2020. At this stage, the spread of the virus in mainland China was running at approximately 50% growth in cases per day. On 8 February, the daily rate of spread fell below 10%. [ citation needed ] As the outbreak spread there, beginning 22 February 2020, a cordon sanitaire was imposed on a group of at least 10 different municipalities in Northern Italy , effectively quarantining more than 50,000 people. This followed a second day when the declared detected cases leapt enormously (the period from 21 to 23 February saw daily increases of 567%, 295% and 90% respectively). A week later the rate of increase of cases in Italy was significantly reduced (the period from 29 February to 4 March saw daily increases of 27%, 50%, 20%, 23%, and 23%). On 8 March 2020, a much wider region of Northern Italy was placed under quarantine restrictions, involving around 16 million people. On the next day, the quarantine was extended to the whole of Italy, effective on 10 March 2020, placing roughly 60 million people under quarantine. A team of Chinese experts, together with some 31 tonnes of supplies, arrived in Rome on 13 March 2020 to help Italy fight the virus. On 22 March 2020, Russia sent nine Ilyushin 76 planes with expert virologists, epidemiologists, medical equipment, and pharmaceuticals in a humanitarian aid operation that Italian media dubbed "From Russia With Love". Eventually the lockdown was extended until 3 May, although starting from 14 April stationery shops, bookshops, and children clothing's shops were allowed to open. On 26 April 2020, the so-called "Phase 2" was announced, to start from 4 May. Movements across regions were still forbidden, while movements between municipalities were allowed only to visit relatives or for work and health reasons. Moreover, closed factories could re-open, but schools, bars, restaurants, and barbers were still closed. As at 4 May 2020, when new cases were running around 0.5%, ( c. 1600 persons) per day and consistently falling, it was expected that museums and retailers might reopen from 18 May, while hairdressers, bars and restaurants were expected to reopen fully on 1 June. Regional lockdowns were subsequently imposed as further waves of the virus spread through the country. As cases of the virus spread to and took hold in more European countries, many followed the earlier examples of China and Italy and began instituting policies of lockdown. Notable among these were Ireland (where schools were closed in mid March for the rest of the month, and limits were set on sizes of meetings), Spain (where a lockdown was announced on 14 March), Czech Republic , Norway , Denmark , Iceland , Poland , Turkey , and France , while the United Kingdom noticeably lagged behind in adopting such measures. As of 18 March 2020, more than 250 million people were in lockdown across Europe. In the immediate context of the start of the pandemic in Wuhan, countries neighbouring or close to China adopted a cautious approach. For example, Sri Lanka, Macau, Hong Kong, Vietnam, Japan, and South Korea had all imposed some degree of lockdown by 19 February. As countries across the world reported escalating case numbers and deaths, more and more countries began to announce travel restrictions and lockdowns. Africa and Latin America were relatively delayed in the spread of the virus, but even on these continents, countries began to impose travel bans and lockdowns. Brazil and Mexico began lockdowns in late February and much of the rest of Latin America followed suit in early March. Much of Africa was on lockdown by the start of April. Kenya, for example, blocked certain international flights and subsequently placed a ban on 'global' meetings. As of 1 April 2020 [ update ] , more than 280 million people, or about 86% of the population, were under some form of lockdown in the United States , 59 million people were in lockdown in South Africa , and 1.3 billion people were in lockdown in India . Eyam was a village in Britain that imposed a cordon sanitaire on itself to stop the spread of the bubonic plague to other communities in 1665. The plague ran its course over 14 months and one account states that it killed at least 260 villagers. The church in Eyam has a record of 273 individuals who were victims of the plague. On 28 July 1814, the convict ship Surry arrived in Sydney Harbour from England. Forty-six people had died of typhoid during the voyage, including 36 convicts, and the ship was placed in quarantine on the North Shore. Convicts were landed, and a camp was established in the immediate vicinity of what is now Jeffrey Street in Kirribilli . This was the first site in Australia to be used for quarantine purposes. Mary Mallon was a cook who was found to be a carrier of Salmonella enterica subsp. enterica , the cause of typhoid fever , and was forcibly isolated from 1907 to 1910. At least 53 cases of the infection were traced to her, and three deaths. Subsequently, she spent a further 23 years in isolation prior to her death in 1938. The presence of the bacteria in her gallbladder was confirmed on autopsy. During the 1918 flu pandemic , the then Governor of American Samoa , John Martin Poyer , imposed a full protective sequestration of the islands from all incoming ships, successfully preventing influenza from infecting the population and thus achieving zero deaths within the territory. In contrast, the neighbouring New Zealand-controlled Western Samoa was among the hardest hit, with a 90% infection rate and over 20% of its adults dying from the disease. This failure by the New Zealand government to prevent and contain the Spanish Flu subsequently rekindled Samoan anti-colonial sentiments that led to its eventual independence. In 1942, during World War II , British forces tested out their biological weapons program on Gruinard Island and infected it with anthrax . Subsequently, a quarantine order was placed on the island. The quarantine was lifted in 1990, when the island was declared safe, and a flock of sheep was released onto the island.Between 24 July 1969 and 9 February 1971, the astronauts of Apollo 11 , Apollo 12 , and Apollo 14 , were quarantined (in each case for a total of 21 days) after returning to Earth, initially where they were recovered, and then were transferred to the Lunar Receiving Laboratory , to prevent possible interplanetary contamination by microorganisms from the Moon . All lunar samples were also held in the biosecure environment of the Lunar Receiving Laboratory for initial assay. The 1972 Yugoslav smallpox outbreak was the final outbreak of smallpox in Europe. The World Health Organization fought the outbreak with extensive quarantine and a cordon sanitaire , and the government instituted martial law .In 2014, Kaci Hickox , a Doctors Without Borders nurse from Maine, legally battled 21-day quarantines imposed by the states of New Jersey and Maine after returning home from treating Ebola patients in Sierra Leone . "Hickox was sequestered in a medical tent for days because New Jersey announced new Ebola regulations the day she arrived. She eventually was allowed to travel to Maine, where the state sought to impose a 'voluntary quarantine' before trying and failing to create a buffer between her and others. A state judge rejected attempts to restrict her movements, saying she posed no threat as long as she wasn't demonstrating any symptoms of Ebola. Hickox said health care professionals like those at the U.S. Centers for Disease Control and Prevention – not politicians like New Jersey Gov. Chris Christie and Maine Gov. Paul LePage – should be in charge of making decisions that are grounded in science, not fear." During the COVID-19 pandemic , multiple governmental actors enacted quarantines in an effort to curb the rapid spread of the virus. Quarantine-like restrictions on movement included curfews and restrictions variously described as stay-at-home orders , shelter-in-place orders, shutdowns or lockdowns . [ citation needed ] On 26 March 2020, 1.7 billion people worldwide were under some form of lockdown , which increased to 2.6 billion people two days later—around a third of the world's population . In Hubei, the origin of the epidemic, a cordon sanitaire was imposed on Wuhan and other major cities in China, affecting around 500 million people, which is unprecedented in scale in human history, to limit the rate of spread of the disease. The 'lockdown' of Wuhan, and subsequently a wider-scale 'lockdown' throughout Hubei province, began on 23 January 2020. At this stage, the spread of the virus in mainland China was running at approximately 50% growth in cases per day. On 8 February, the daily rate of spread fell below 10%. [ citation needed ] As the outbreak spread there, beginning 22 February 2020, a cordon sanitaire was imposed on a group of at least 10 different municipalities in Northern Italy , effectively quarantining more than 50,000 people. This followed a second day when the declared detected cases leapt enormously (the period from 21 to 23 February saw daily increases of 567%, 295% and 90% respectively). A week later the rate of increase of cases in Italy was significantly reduced (the period from 29 February to 4 March saw daily increases of 27%, 50%, 20%, 23%, and 23%). On 8 March 2020, a much wider region of Northern Italy was placed under quarantine restrictions, involving around 16 million people. On the next day, the quarantine was extended to the whole of Italy, effective on 10 March 2020, placing roughly 60 million people under quarantine. A team of Chinese experts, together with some 31 tonnes of supplies, arrived in Rome on 13 March 2020 to help Italy fight the virus. On 22 March 2020, Russia sent nine Ilyushin 76 planes with expert virologists, epidemiologists, medical equipment, and pharmaceuticals in a humanitarian aid operation that Italian media dubbed "From Russia With Love". Eventually the lockdown was extended until 3 May, although starting from 14 April stationery shops, bookshops, and children clothing's shops were allowed to open. On 26 April 2020, the so-called "Phase 2" was announced, to start from 4 May. Movements across regions were still forbidden, while movements between municipalities were allowed only to visit relatives or for work and health reasons. Moreover, closed factories could re-open, but schools, bars, restaurants, and barbers were still closed. As at 4 May 2020, when new cases were running around 0.5%, ( c. 1600 persons) per day and consistently falling, it was expected that museums and retailers might reopen from 18 May, while hairdressers, bars and restaurants were expected to reopen fully on 1 June. Regional lockdowns were subsequently imposed as further waves of the virus spread through the country. As cases of the virus spread to and took hold in more European countries, many followed the earlier examples of China and Italy and began instituting policies of lockdown. Notable among these were Ireland (where schools were closed in mid March for the rest of the month, and limits were set on sizes of meetings), Spain (where a lockdown was announced on 14 March), Czech Republic , Norway , Denmark , Iceland , Poland , Turkey , and France , while the United Kingdom noticeably lagged behind in adopting such measures. As of 18 March 2020, more than 250 million people were in lockdown across Europe. In the immediate context of the start of the pandemic in Wuhan, countries neighbouring or close to China adopted a cautious approach. For example, Sri Lanka, Macau, Hong Kong, Vietnam, Japan, and South Korea had all imposed some degree of lockdown by 19 February. As countries across the world reported escalating case numbers and deaths, more and more countries began to announce travel restrictions and lockdowns. Africa and Latin America were relatively delayed in the spread of the virus, but even on these continents, countries began to impose travel bans and lockdowns. Brazil and Mexico began lockdowns in late February and much of the rest of Latin America followed suit in early March. Much of Africa was on lockdown by the start of April. Kenya, for example, blocked certain international flights and subsequently placed a ban on 'global' meetings. As of 1 April 2020 [ update ] , more than 280 million people, or about 86% of the population, were under some form of lockdown in the United States , 59 million people were in lockdown in South Africa , and 1.3 billion people were in lockdown in India . In Hubei, the origin of the epidemic, a cordon sanitaire was imposed on Wuhan and other major cities in China, affecting around 500 million people, which is unprecedented in scale in human history, to limit the rate of spread of the disease. The 'lockdown' of Wuhan, and subsequently a wider-scale 'lockdown' throughout Hubei province, began on 23 January 2020. At this stage, the spread of the virus in mainland China was running at approximately 50% growth in cases per day. On 8 February, the daily rate of spread fell below 10%. [ citation needed ]As the outbreak spread there, beginning 22 February 2020, a cordon sanitaire was imposed on a group of at least 10 different municipalities in Northern Italy , effectively quarantining more than 50,000 people. This followed a second day when the declared detected cases leapt enormously (the period from 21 to 23 February saw daily increases of 567%, 295% and 90% respectively). A week later the rate of increase of cases in Italy was significantly reduced (the period from 29 February to 4 March saw daily increases of 27%, 50%, 20%, 23%, and 23%). On 8 March 2020, a much wider region of Northern Italy was placed under quarantine restrictions, involving around 16 million people. On the next day, the quarantine was extended to the whole of Italy, effective on 10 March 2020, placing roughly 60 million people under quarantine. A team of Chinese experts, together with some 31 tonnes of supplies, arrived in Rome on 13 March 2020 to help Italy fight the virus. On 22 March 2020, Russia sent nine Ilyushin 76 planes with expert virologists, epidemiologists, medical equipment, and pharmaceuticals in a humanitarian aid operation that Italian media dubbed "From Russia With Love". Eventually the lockdown was extended until 3 May, although starting from 14 April stationery shops, bookshops, and children clothing's shops were allowed to open. On 26 April 2020, the so-called "Phase 2" was announced, to start from 4 May. Movements across regions were still forbidden, while movements between municipalities were allowed only to visit relatives or for work and health reasons. Moreover, closed factories could re-open, but schools, bars, restaurants, and barbers were still closed. As at 4 May 2020, when new cases were running around 0.5%, ( c. 1600 persons) per day and consistently falling, it was expected that museums and retailers might reopen from 18 May, while hairdressers, bars and restaurants were expected to reopen fully on 1 June. Regional lockdowns were subsequently imposed as further waves of the virus spread through the country. As cases of the virus spread to and took hold in more European countries, many followed the earlier examples of China and Italy and began instituting policies of lockdown. Notable among these were Ireland (where schools were closed in mid March for the rest of the month, and limits were set on sizes of meetings), Spain (where a lockdown was announced on 14 March), Czech Republic , Norway , Denmark , Iceland , Poland , Turkey , and France , while the United Kingdom noticeably lagged behind in adopting such measures. As of 18 March 2020, more than 250 million people were in lockdown across Europe. In the immediate context of the start of the pandemic in Wuhan, countries neighbouring or close to China adopted a cautious approach. For example, Sri Lanka, Macau, Hong Kong, Vietnam, Japan, and South Korea had all imposed some degree of lockdown by 19 February. As countries across the world reported escalating case numbers and deaths, more and more countries began to announce travel restrictions and lockdowns. Africa and Latin America were relatively delayed in the spread of the virus, but even on these continents, countries began to impose travel bans and lockdowns. Brazil and Mexico began lockdowns in late February and much of the rest of Latin America followed suit in early March. Much of Africa was on lockdown by the start of April. Kenya, for example, blocked certain international flights and subsequently placed a ban on 'global' meetings. As of 1 April 2020 [ update ] , more than 280 million people, or about 86% of the population, were under some form of lockdown in the United States , 59 million people were in lockdown in South Africa , and 1.3 billion people were in lockdown in India . Self-quarantine (or self-isolation ) is a popular term that emerged during the COVID-19 pandemic , which spread to most countries in 2020. Citizens able to do so were encouraged to stay home to limit the spread of the disease . Health specialists advise that self-quarantine lasts 14 days. Two weeks gives the necessary time for them to determine whether or not they will become ill and become contagious to others. U.S. President John F. Kennedy euphemistically referred to the U.S. Navy's interdiction of shipping en route to Cuba during the Cuban Missile Crisis as a "quarantine" rather than a blockade , because a quarantine is a legal act in peacetime, whereas a blockade is defined as an act of aggression under the U.N. Charter . In computer science, "quarantining" describes putting files infected by computer viruses into a special directory, so as to eliminate the threat they pose, without irreversibly deleting them. The Spanish term for quarantine, (la) cuarentena , refers also to the period of postpartum confinement in which a new mother and her baby are sheltered from the outside world.

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Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/West_Nile_virus/html

West Nile virus

West Nile virus ( WNV ) is a single-stranded RNA virus that causes West Nile fever . It is a member of the family Flaviviridae , from the genus Flavivirus , which also contains the Zika virus , dengue virus , and yellow fever virus. The virus is primarily transmitted by mosquitoes , mostly species of Culex . The primary hosts of WNV are birds, so that the virus remains within a "bird–mosquito–bird" transmission cycle. The virus is genetically related to the Japanese encephalitis family of viruses. Humans and horses both exhibit disease symptoms from the virus, and symptoms rarely occur in other animals.Contrary to popular belief, West Nile virus was not named after the Nile River , rather, the West Nile district of Uganda where the virus was first isolated in 1937. After its original discovery in this region, it was found in many other parts of the world. Most likely, it spread from the original West Nile district.Like most other flaviviruses, WNV is an enveloped virus with icosahedral symmetry . Electron microscope studies reveal a 45–50 nm virion covered with a relatively smooth protein shell; this structure is similar to the dengue fever virus, another Flavivirus . The protein shell is made of two structural proteins: the glycoprotein E and the small membrane protein M. Protein E has numerous functions including receptor binding, viral attachment, and entry into the cell through membrane fusion . The outer protein shell is covered by a host-derived lipid membrane , the viral envelope . The flavivirus lipid membrane has been found to contain cholesterol and phosphatidylserine , but other elements of the membrane have yet to be identified. The lipid membrane has many roles in viral infection , including acting as signaling molecules and enhancing entry into the cell. Cholesterol, in particular, plays an integral part in WNV entering a host cell. The two viral envelope proteins, E and M, are inserted into the membrane. The RNA genome is bound to capsid (C) proteins, which are 105 amino-acid residues long, to form the nucleocapsid . The capsid proteins are one of the first proteins created in an infected cell; the capsid protein is a structural protein whose main purpose is to package RNA into the developing viruses. The capsid has been found to prevent apoptosis by affecting the Akt pathway. WNV is a positive-sense, single-stranded RNA virus . Its genome is approximately 11,000 nucleotides long and is flanked by 5′ and 3′ non-coding stem loop structures. The coding region of the genome codes for three structural proteins and seven nonstructural (NS) proteins , proteins that are not incorporated into the structure of new viruses. The WNV genome is first translated into a polyprotein and later cleaved by virus and host proteases into separate proteins (i.e. NS1, C, E). Structural proteins (C, prM/M, E) are capsid, precursor membrane proteins, and envelope proteins, respectively. The structural proteins are located at the 5′ end of the genome and are cleaved into mature proteins by both host and viral proteases. [ citation needed ] Nonstructural proteins consist of NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5. These proteins mainly assist with viral replication or act as proteases. The nonstructural proteins are located near the 3′ end of the genome.WNV is a positive-sense, single-stranded RNA virus . Its genome is approximately 11,000 nucleotides long and is flanked by 5′ and 3′ non-coding stem loop structures. The coding region of the genome codes for three structural proteins and seven nonstructural (NS) proteins , proteins that are not incorporated into the structure of new viruses. The WNV genome is first translated into a polyprotein and later cleaved by virus and host proteases into separate proteins (i.e. NS1, C, E). Structural proteins (C, prM/M, E) are capsid, precursor membrane proteins, and envelope proteins, respectively. The structural proteins are located at the 5′ end of the genome and are cleaved into mature proteins by both host and viral proteases. [ citation needed ]Nonstructural proteins consist of NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5. These proteins mainly assist with viral replication or act as proteases. The nonstructural proteins are located near the 3′ end of the genome.Once WNV has successfully entered the bloodstream of a host animal, the envelope protein, E, binds to attachment factors called glycosaminoglycans on the host cell. These attachment factors aid entry into the cell, however, binding to primary receptors is also necessary. Primary receptors include DC-SIGN , DC-SIGN-R, and the integrin α v β 3 . By binding to these primary receptors, WNV enters the cell through clathrin-mediated endocytosis . As a result of endocytosis, WNV enters the cell within an endosome . [ citation needed ] The acidity of the endosome catalyzes the fusion of the endosomal and viral membranes, allowing the genome to be released into the cytoplasm. Translation of the positive-sense single-stranded RNA occurs at the endoplasmic reticulum ; the RNA is translated into a polyprotein which is then cleaved by both host and viral proteases NS2B-NS3 to produce mature proteins. In order to replicate its genome, NS5, a RNA polymerase , forms a replication complex with other nonstructural proteins to produce an intermediary negative-sense single-stranded RNA ; the negative-sense strand serves as a template for synthesis of the final positive-sense RNA. Once the positive-sense RNA has been synthesized, the capsid protein, C, encloses the RNA strands into immature virions. The rest of the virus is assembled along the endoplasmic reticulum and through the Golgi apparatus , and results in non-infectious immature virions. The E protein is then glycosylated and prM is cleaved by furin , a host cell protease, into the M protein, thereby producing an infectious mature virion. The mature viruses are then secreted out of the cell. [ citation needed ]WNV is one of the Japanese encephalitis antigenic serocomplex of viruses, together with Japanese encephalitis virus, Murray Valley encephalitis virus , Saint Louis encephalitis virus and some other flaviviruses. Studies of phylogenetic lineages have determined that WNV emerged as a distinct virus around 1000 years ago. This initial virus developed into two distinct lineages. Lineage 1 and its multiple profiles is the source of the epidemic transmission in Africa and throughout the world. Lineage 2 was considered an African zoonosis . However, in 2008, lineage 2, previously only seen in horses in sub-Saharan Africa and Madagascar, began to appear in horses in Europe, where the first known outbreak affected 18 animals in Hungary. Lineage 1 West Nile virus was detected in South Africa in 2010 in a mare and her aborted fetus ; previously, only lineage 2 West Nile virus had been detected in horses and humans in South Africa. Kunjin virus is a subtype of West Nile virus endemic to Oceania . A 2007 fatal case in a killer whale in Texas broadened the known host range of West Nile virus to include cetaceans . Since the first North American cases in 1999, the virus has been reported throughout the United States, Canada, Mexico, the Caribbean, and Central America. There have been human cases and equine cases, and many birds are infected. The Barbary macaque , Macaca sylvanus , was the first nonhuman primate to contract WNV. Both the American and Israeli strains are marked by high mortality rates in infected avian populations; the presence of dead birds—especially Corvidae —can be an early indicator of the arrival of the virus. [ citation needed ]The natural hosts for WNV are birds and mosquitoes. Over 300 different species of bird have been shown to be infected with the virus. Some birds, including the American crow ( Corvus brachyrhynchos ), blue jay ( Cyanocitta cristata ) and greater sage-grouse ( Centrocercus urophasianus ), are killed by the infection, but others survive. The American robin ( Turdus migratorius ) and house sparrow ( Passer domesticus ) are thought to be among the most important reservoir species in N. American and European cities. Brown thrashers ( Toxostoma rufum ), gray catbirds ( Dumetella carolinensis ), northern cardinals ( Cardinalis cardinalis ), northern mockingbirds ( Mimus polyglottos ), wood thrushes ( Hylocichla mustelina ) and the dove family are among the other common N. American birds in which high levels of antibodies against WNV have been found. WNV has been demonstrated in a large number of mosquito species, but the most significant for viral transmission are Culex species that feed on birds, including Culex pipiens , C. restuans , C. salinarius , C. quinquefasciatus , C. nigripalpus , C. erraticus and C. tarsalis . Experimental infection has also been demonstrated with soft tick vectors, but is unlikely to be important in natural transmission. WNV has a broad host range, and is also known to be able to infect at least 30 mammalian species, including humans, some non-human primates, horses, dogs and cats. Some infected humans and horses experience disease but dogs and cats rarely show symptoms. Reptiles and amphibians can also be infected, including some species of crocodiles, alligators, snakes, lizards and frogs. Mammals are considered incidental or dead-end hosts for the virus: they do not usually develop a high enough level of virus in the blood ( viremia ) to infect another mosquito feeding on them and carry on the transmission cycle; some birds are also dead-end hosts. In the normal rural or enzootic transmission cycle, the virus alternates between the bird reservoir and the mosquito vector. It can also be transmitted between birds via direct contact, by eating an infected bird carcass or by drinking infected water. Vertical transmission between female and offspring is possible in mosquitoes, and might potentially be important in overwintering. In the urban or spillover cycle, infected mosquitoes that have fed on infected birds transmit the virus to humans. This requires mosquito species that bite both birds and humans, which are termed bridge vectors. The virus can also rarely be spread through blood transfusions, organ transplants, or from mother to baby during pregnancy, delivery, or breastfeeding. Unlike in birds, it does not otherwise spread directly between people. West Nile fever is an infection by the West Nile virus, which is typically spread by mosquitoes . In about 80% of infections people have few or no symptoms . About 20% of people develop a fever , headache, vomiting, or a rash. In less than 1% of people, encephalitis or meningitis occurs, with associated neck stiffness, confusion, or seizures. Recovery may take weeks to months. The risk of death among those in whom the nervous system is affected is about 10 percent. West Nile virus (WNV) is usually spread by mosquitoes that become infected when they feed on infected birds, which often carry the disease . Rarely the virus is spread through blood transfusions, organ transplants, or from mother to baby during pregnancy, delivery, or breastfeeding, but it otherwise does not spread directly between people. Risks for severe disease include being over 60 years old and having other health problems. Diagnosis is typically based on symptoms and blood tests. There is no human vaccine . The best way to reduce the risk of infection is to avoid mosquito bites. Mosquito populations may be reduced by eliminating standing pools of water, such as in old tires, buckets, gutters, and swimming pools. When mosquitoes cannot be avoided, mosquito repellent , window screens , and mosquito nets reduce the likelihood of being bitten. There is no specific treatment for the disease; pain medications may reduce symptoms. Severe disease may also occur in horses. Several vaccines for these animals are now available. Before the availability of veterinary vaccines, around 40% of horses infected in North America died. West Nile fever is an infection by the West Nile virus, which is typically spread by mosquitoes . In about 80% of infections people have few or no symptoms . About 20% of people develop a fever , headache, vomiting, or a rash. In less than 1% of people, encephalitis or meningitis occurs, with associated neck stiffness, confusion, or seizures. Recovery may take weeks to months. The risk of death among those in whom the nervous system is affected is about 10 percent. West Nile virus (WNV) is usually spread by mosquitoes that become infected when they feed on infected birds, which often carry the disease . Rarely the virus is spread through blood transfusions, organ transplants, or from mother to baby during pregnancy, delivery, or breastfeeding, but it otherwise does not spread directly between people. Risks for severe disease include being over 60 years old and having other health problems. Diagnosis is typically based on symptoms and blood tests. There is no human vaccine . The best way to reduce the risk of infection is to avoid mosquito bites. Mosquito populations may be reduced by eliminating standing pools of water, such as in old tires, buckets, gutters, and swimming pools. When mosquitoes cannot be avoided, mosquito repellent , window screens , and mosquito nets reduce the likelihood of being bitten. There is no specific treatment for the disease; pain medications may reduce symptoms. Severe disease may also occur in horses. Several vaccines for these animals are now available. Before the availability of veterinary vaccines, around 40% of horses infected in North America died. According to the Center for Disease Control , infection with West Nile Virus is seasonal in temperate zones. Climates that are temperate, such as those in the United States and Europe, see peak season from July to October. Peak season changes depending on geographic region and warmer and humid climates can see longer peak seasons. All ages are equally likely to be infected but there is a higher amount of death and neuroinvasive West Nile Virus in people 60–89 years old. People of older age are more likely to have adverse effects. [ citation needed ] There are several modes of transmission, but the most common cause of infection in humans is by being bitten by an infected mosquito. Other modes of transmission include blood transfusion, organ transplantation, breast-feeding, transplacental transmission, and laboratory acquisition. These alternative modes of transmission are extremely rare. Prevention efforts against WNV mainly focus on preventing human contact with and being bitten by infected mosquitoes. This is twofold, first by personal protective actions and second by mosquito-control actions. When a person is in an area that has WNV, it is important to avoid outdoor activity, and if they go outside they should use a mosquito repellent with DEET. A person can also wear clothing that covers more skin, such as long sleeves and pants. Mosquito control can be done at the community level and include surveillance programs and control programs including pesticides and reducing mosquito habitats. This includes draining standing water. Surveillance systems in birds is particularly useful. If dead birds are found in a neighborhood, the event should be reported to local authorities. This may help health departments do surveillance and determine if the birds are infected with West Nile Virus. Despite the commercial availability of four veterinary vaccines for horses, no human vaccine has progressed beyond phase II clinical trials . Efforts have been made to produce a vaccine for human use and several candidates have been produced but none are licensed to use. The best method to reduce the risk of infections is avoiding mosquito bites. This may be done by eliminating standing pools of water, such as in old tires, buckets, gutters, and swimming pools. Mosquito repellent , window screens , mosquito nets , and avoiding areas where mosquitoes occur may also be useful. Like other tropical diseases which are expected to have increased spread due to climate change, there is concern that changing weather conditions will increase West Nile Virus spread. Climate change will affect disease rates, ranges, and seasonality and affects the distribution of West Nile Virus. Projected changes in flood frequency and severity can bring new challenges in flood risk management , allowing for increased mosquito populations in urban areas. Weather conditions affected by climate change including temperature, precipitation and wind may affect the survival and reproduction rates of mosquitoes, suitable habitats, distribution, and abundance. Ambient temperatures drive mosquito replication rates and transmission of WNV by affecting the peak season of mosquitoes and geographic variations. For example, increased temperatures can affect the rate of virus replication, speed up the virus evolution rate, and viral transmission efficiency. Furthermore, higher winter temperatures and warmer spring may lead to larger summer mosquito populations, increasing the risk for WNV. Similarly, rainfall may also drive mosquito replication rates and affect the seasonality and geographic variations of the virus. Studies show an association between heavy precipitation and higher incidence of reported WNV. Likewise, wind is another environmental factor that serves as a dispersal mechanism for mosquitoes. Mosquitoes have extremely wide environmental tolerances and a nearly ubiquitous geographical distribution, being present on all major land masses except Antarctica and Iceland. Nevertheless, changes in climate and land use on ecological timescales can variously expand or fragment their distribution patterns, raising consequent concerns for human health.

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Yellow fever

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Visa requirements for Democratic Republic of the Congo citizens

Visa requirements for Democratic Republic of the Congo citizens are administrative entry restrictions by the authorities of other states placed on citizens of the Democratic Republic of the Congo . As of 2024, Democratic Republic of the Congo citizens had visa-free or visa on arrival access to 47 countries and territories, ranking the Democratic Republic of the Congo passport 96th in the world according to the Henley Passport Index . May apply online (Online Visitor e600 visa). Conditions apply. Can be extended up to 90 days with a fee. Tourist Card can be purchased if holding valid visas issued by United States, Canada, or Schengen Member State. e-Visa is eligible with valid visa/travel documents any OCED country. Prior authorization obtained online for visa on arrival or border visa. Visa on arrival if holding valid visas issued by United States, Canada, or Schengen Member State. You can apply for a visa online under the "Tourist - Own Itinerary" category. Travelers can apply for a visa on the Hayya website. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. Electronic Travel Authorization can also be obtained on arrival. 30 days extendable to 6 months. e-Visa can be obtained by holders of a valid physical visa or residence permit from Schengen or OECD countries. e-Visa is valid for 90 days and multiple entry. Many countries have entry restrictions on foreigners that go beyond the common requirement of having either a valid visa or a visa exemption. Such restrictions may be health related or impose additional documentation requirements on certain classes of people for diplomatic or political purposes. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa.

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Yellow fever

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Timeline of New York City

This article is a timeline of the history of New York City in the U.S. state of New York .January 1: Michael Bloomberg becomes the 108th Mayor of New York. January: New York City is put in a "Drought Warning" after a warm and dry winter. That is upgraded to a "Drought Emergency" in March until the Fall. March 11: The Tribute in Light memorial is unveiled and lit up every day for the next month. It has since been lit up every September 11. The Tribeca Film Festival was founded by Robert De Niro, Jane Rosenthal and Craig Hatkoff.January 1: Michael Bloomberg becomes the 108th Mayor of New York. January: New York City is put in a "Drought Warning" after a warm and dry winter. That is upgraded to a "Drought Emergency" in March until the Fall. March 11: The Tribute in Light memorial is unveiled and lit up every day for the next month. It has since been lit up every September 11. The Tribeca Film Festival was founded by Robert De Niro, Jane Rosenthal and Craig Hatkoff.

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Yellow fever

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List of people who caught yellow fever

This articles documents notable people who were afflicted with yellow fever , whether or not they died from the disease. In 2013, approximately 127,000 individuals were diagnosed with severe cases of yellow fever.

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Yellow fever

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Visa requirements for German citizens

Visa requirements for German citizens are administrative entry restrictions by the authorities of other states placed on citizens of Germany. As of 9 January 2024, German citizens had visa-free or visa on arrival access to 194 countries and territories. Ranking the German passport 1st in terms of travel freedom (tied with the passports of France , Italy , Japan , Singapore , and Spain ), and tied with the greatest access of all European Union member states along with France, Italy, and Spain, according to the Henley Passport Index . eVisitor is considered to be a visa under Australia law. 90 days on each visit in 12-month period if granted. Extendable for an additional 2 weeks. Must have an international vaccination certificate. Pre-approved visa can be picked up on arrival. Visa is also obtainable online. Must register online at least five days prior to arrival. Hong Kong, Macau, and Taiwan count as third countries under the 24, 72 and 144-hours transit without visa (TWOV) policies. 90 days – extendable up to 180-days stay within a one-year period. Can be extended up to 90 days with a fee. Cost for Visa on arrival approx. 30 Euro for 30 days. You can extend it once in Bali by another 30 days. As of February 2024. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Travelers must register on the e-Visa platform at least 48 hours prior to travel and pay a processing fee of 650 MT. 90 days within any 6-month period. Obtainable online. Printed visa authorization must be presented at the time of travel. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). Visa also available online. e-Visa holders can enter through all border points. 90 days within any 180-day period. 90 days within any 180-day period. A single entry e-Visa valid for 90 days is also available. Also eligible for a universal visa allowing access to Zimbabwe. Also eligible for a universal visa allowing access to Zambia. Visa requirements for German citizens for visits to various territories, disputed areas, partially recognized countries and restricted zones: Visa requirements for German citizens were lifted by China (1 December 2023), Zambia (1 October 2022), Oman (9 December 2020, previously visa on arrival), Uzbekistan (15 January 2019), Cape Verde (1 January 2019), Belarus (February 2017), Solomon Islands (October 2016), Tuvalu (July 2016), Marshall Islands (June 2016), Palau (December 2015), Tonga (November 2015), São Tomé and Príncipe (August 2015), Vietnam (July 2015 – June 30, 2021 at least), Indonesia (June 2015), United Arab Emirates, Timor-Leste , Samoa (May 2015), Kazakhstan (July 2014), Mongolia (September 2013) and Kyrgyzstan (July 2012). German citizens were made eligible for eVisas by Russia (January 2021, suspended during COVID-19 pandemic, previously only Kaliningrad and Far East), Guinea and Malawi (October 2019), Saudi Arabia (September 2019), Suriname and Pakistan (April 2019), Tanzania and Papua New Guinea (November 2018), Angola (March 2018), Djibouti (February 2018), Egypt (December 2017), Azerbaijan (January 2017), Tajikistan (June 2016), India (e-Tourist visa from November 2014) and Myanmar (September 2014). Visa requirements for German citizens for visits to various territories, disputed areas, partially recognized countries and restricted zones:Visa requirements for German citizens were lifted by China (1 December 2023), Zambia (1 October 2022), Oman (9 December 2020, previously visa on arrival), Uzbekistan (15 January 2019), Cape Verde (1 January 2019), Belarus (February 2017), Solomon Islands (October 2016), Tuvalu (July 2016), Marshall Islands (June 2016), Palau (December 2015), Tonga (November 2015), São Tomé and Príncipe (August 2015), Vietnam (July 2015 – June 30, 2021 at least), Indonesia (June 2015), United Arab Emirates, Timor-Leste , Samoa (May 2015), Kazakhstan (July 2014), Mongolia (September 2013) and Kyrgyzstan (July 2012). German citizens were made eligible for eVisas by Russia (January 2021, suspended during COVID-19 pandemic, previously only Kaliningrad and Far East), Guinea and Malawi (October 2019), Saudi Arabia (September 2019), Suriname and Pakistan (April 2019), Tanzania and Papua New Guinea (November 2018), Angola (March 2018), Djibouti (February 2018), Egypt (December 2017), Azerbaijan (January 2017), Tajikistan (June 2016), India (e-Tourist visa from November 2014) and Myanmar (September 2014). Certain countries and territories require travellers arriving from Germany to be vaccinated against specific diseases. This is a map of vaccination requirements for German citizens and residents arriving directly from the Schengen area , excluding those arriving from third countries. Many countries increasingly consider the vaccination status of travellers with regard to quarantine requirements or when deciding to allow them entry at all. This is justified by research that shows that the Pfizer vaccine effect lasts for six months or so. Certain countries and territories require travellers arriving from Germany to be vaccinated against specific diseases. This is a map of vaccination requirements for German citizens and residents arriving directly from the Schengen area , excluding those arriving from third countries.Many countries increasingly consider the vaccination status of travellers with regard to quarantine requirements or when deciding to allow them entry at all. This is justified by research that shows that the Pfizer vaccine effect lasts for six months or so. German identity card is valid for these countries: Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many countries require passports to be valid for at least 6 months upon arrival and one or two blank pages. Countries requiring passports to be validity at least 6 months on arrival include Afghanistan , Algeria , Bangladesh , Bhutan , Botswana , Brunei , Cambodia , Comoros , Côte d'Ivoire , Ecuador , Egypt , El Salvador , Fiji , Guyana , Haiti , Indonesia , Iran , Iraq (except when arriving at Basra – 3 months and Erbil or Sulaimaniyah – on arrival), Jordan , Kenya , Kiribati , Kuwait , Laos , Madagascar , Malaysia , Marshall Islands , Mauritania , Mongolia , Myanmar , Namibia , Nicaragua , Nigeria , Oman , Palau , Papua New Guinea , Philippines , Rwanda , Samoa , Saudi Arabia , Singapore , Solomon Islands , Somalia , Sri Lanka , Sudan , Suriname , Syria , Taiwan , Tanzania , Timor-Leste , Tonga , Tuvalu , Uganda , United Arab Emirates , Vanuatu , Venezuela , Vietnam , Yemen . Turkey usually requires passports to be valid for at least 5 months (150 days) upon entry, but for German citizens Turkish authorities allow to enter even with passport or identity card expired within last year. Countries requiring passport validity of at least 4 months on arrival include Azerbaijan , Micronesia , Zambia . Countries requiring passport validity of at least 3 months on arrival include Albania , Bosnia and Herzegowina , Honduras , Moldova , Nauru , North Macedonia , Panama , Qatar , Senegal and French territories in the Pacific (i.e. French Polynesia , New Caledonia and Wallis and Futuna ) Countries requiring passport validity of at least 1 month on arrival include Eritrea , Hong Kong , Lebanon , Macau , Maldives , New Zealand , South Africa Other countries require either a passport valid on arrival or passport valid throughout the period of intended stay. Many African countries, including Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Gabon , Guinea-Bissau , Kenya , Liberia , Niger , Rwanda , Sierra Leone and Togo , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . German identity card is valid for these countries:Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many countries require passports to be valid for at least 6 months upon arrival and one or two blank pages. Countries requiring passports to be validity at least 6 months on arrival include Afghanistan , Algeria , Bangladesh , Bhutan , Botswana , Brunei , Cambodia , Comoros , Côte d'Ivoire , Ecuador , Egypt , El Salvador , Fiji , Guyana , Haiti , Indonesia , Iran , Iraq (except when arriving at Basra – 3 months and Erbil or Sulaimaniyah – on arrival), Jordan , Kenya , Kiribati , Kuwait , Laos , Madagascar , Malaysia , Marshall Islands , Mauritania , Mongolia , Myanmar , Namibia , Nicaragua , Nigeria , Oman , Palau , Papua New Guinea , Philippines , Rwanda , Samoa , Saudi Arabia , Singapore , Solomon Islands , Somalia , Sri Lanka , Sudan , Suriname , Syria , Taiwan , Tanzania , Timor-Leste , Tonga , Tuvalu , Uganda , United Arab Emirates , Vanuatu , Venezuela , Vietnam , Yemen . Turkey usually requires passports to be valid for at least 5 months (150 days) upon entry, but for German citizens Turkish authorities allow to enter even with passport or identity card expired within last year. Countries requiring passport validity of at least 4 months on arrival include Azerbaijan , Micronesia , Zambia . Countries requiring passport validity of at least 3 months on arrival include Albania , Bosnia and Herzegowina , Honduras , Moldova , Nauru , North Macedonia , Panama , Qatar , Senegal and French territories in the Pacific (i.e. French Polynesia , New Caledonia and Wallis and Futuna ) Countries requiring passport validity of at least 1 month on arrival include Eritrea , Hong Kong , Lebanon , Macau , Maldives , New Zealand , South Africa Other countries require either a passport valid on arrival or passport valid throughout the period of intended stay.Many African countries, including Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Gabon , Guinea-Bissau , Kenya , Liberia , Niger , Rwanda , Sierra Leone and Togo , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. In a non-EU country where there is no German embassy, German citizens, like all other EU citizens, have the right to get consular protection from the embassy of any other EU country present in that country. See also List of diplomatic missions of Germany .

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Rocky_Mountain_Laboratories/html

Rocky Mountain Laboratories

Hygienic Laboratory Rocky Mountain Laboratories (RML) is part of the NIH Intramural Research Program and is located in Hamilton, Montana . Operated by the National Institute of Allergy and Infectious Diseases , RML conducts research on maximum containment pathogens such as Ebola as well as research on prions and intracellular pathogens such as Coxiella burnetii and Francisella tularensis . RML operates one of the few Biosafety level 4 laboratories in the United States, as well as Biosafety level 3 and ABSL3/4 laboratories. In February 2020, electron microscope images of SARS-CoV-2 were collected at RML. Rocky Mountain Laboratories began as the Montana Board of Entomology Laboratory. It was opened in 1928 by the Montana State Board of Entomology to study Rocky Mountain spotted fever and the ticks, Dermacentor andersoni , that carry it. Local opposition to the "tick lab" was strong, as residents worried ticks would escape the laboratory and cause an outbreak in the community. To allay their fears, the original laboratory building featured a small moat around its perimeter. In 1932, after spotted fever was diagnosed in other states, the federal government bought the facility and renamed it Rocky Mountain Laboratory. The laboratory expanded, adding faculty to study zoonotic diseases including typhus , tularemia , and Q-fever . During World War II , the United States Public Health Service used the laboratory to manufacture Yellow fever vaccine . When the human serum–base vaccine caused an outbreak of Hepatitis B that infected more than 350,000 U.S. soldiers, two researchers at the laboratory, Dr. Mason Hargett and Harry Burruss , developed an aqueous-base vaccine that combined distilled water with virus grown in chicken eggs. By the end of the war, the laboratory distributed more than 1 million doses of the improved yellow fever vaccine. In the post-war decades, the laboratory broadened its scope to study chlamydia trachomatis and transmissible spongiform encephalopathies including scrapie , mad cow disease , and chronic wasting disease . In 1982, Dr. Willy Burgdorfer discovered Borrelia burgdorferi , the tick-borne bacterium that causes Lyme disease .

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Carlos_Finlay/html

Carlos Finlay

Carlos Juan Finlay (December 3, 1833 – August 20, 1915) was a Cuban epidemiologist recognized as a pioneer in the research of yellow fever , determining that it was transmitted through mosquitoes Aedes aegypti . Finlay was born Juan Carlos Finlay y de Barrés in Puerto Príncipe (now Camagüey), Cuba to Scottish-born Dr. Edward (Eduardo) Finlay and French-born Elisa (Isabel) de Barrés. At that time Cuba was part of the Kingdom of Spain. He reversed the order of his given names to "Carlos Juan" later in his life. His father was a physician who had fought alongside Simón Bolívar , and his family owned a coffee plantation in Alquízar . He attended school in France in 1844, but was forced to return to Cuba after two years because he contracted chorea . After recovering, he returned to Europe in 1848, but became stuck in England for another two years due to political turmoil, and after arriving in France to continue his education, he contracted typhoid fever and again returned to Cuba. Because the University of Havana would not recognize his European academic credits, he enrolled at Jefferson Medical College in Philadelphia, Pennsylvania , which did not require prerequisites. Here Finlay met John Kearsley Mitchell , a proponent of the germ theory of disease , and his son Silas Weir Mitchell , who supervised his studies. He graduated from Jefferson Medical College in 1855. He then returned to Havana and set up an ophthalmology practice in 1857, and then studied in Paris in 1860–61. In October 1865 he married Adela Shine, a native of the Island of Trinidad . They had three sons, Charles, George and Frank Finlay. Finlay's work, carried out during the 1870s, finally came to prominence in 1900. He was the first to theorize, in 1881, that a mosquito was a carrier, now known as a disease vector , of the organism causing yellow fever : a mosquito that bites a victim of the disease could subsequently bite and thereby infect a healthy person. He presented this theory at the 1881 International Sanitary Conference , where it was well received. A year later Finlay identified a mosquito of the genus Aedes as the organism transmitting yellow fever. His theory was followed by the recommendation to control the mosquito population as a way to control the spread of the disease. His hypothesis and exhaustive proofs were confirmed nearly twenty years later by the Walter Reed Commission of 1900. Finlay went on to become the chief health officer of Cuba from 1902 to 1909. Although Reed received much of the credit in history books for "beating" yellow fever, Reed himself credited Finlay with the discovery of the yellow fever vector, and thus how it might be controlled. Reed often cited Finlay's papers in his own articles and gave him credit for the discovery in his personal correspondence. In the words of General Leonard Wood , a physician and U.S. military governor of Cuba in 1900: "The confirmation of Dr. Finlay's doctrine is the greatest step forward made in medical science since Jenner 's discovery of the vaccination [for smallpox ]." This discovery helped William C. Gorgas reduce the incidence and prevalence of mosquito-borne diseases in Panama during the American campaign, from 1903 onwards, to construct the Panama Canal . Prior to this, about 10% of the workforce had died each year from malaria and yellow fever. [ citation needed ] Finlay was a member of Havana's Royal Academy of Medical, Physical and Natural Sciences. He was fluent in French , German , Spanish , and English and could read Latin . His interests were widespread and he wrote articles on subjects as varied as leprosy , cholera , gravity , and plant diseases . His main interest, however, was yellow fever, and he was the author of 40 articles on this disease. His theory that an intermediary host was responsible for the spread of the disease was treated with ridicule for years. A humane man, he often took on patients who could not afford medical care. As a result of his work, Finlay was nominated seven times for the Nobel Prize in Physiology or Medicine , although he was never awarded the prize. He received the National Order of the Legion of Honour of France in 1908. Finlay died from a stroke , caused by severe brain seizures, at his house in Havana on August 20, 1915. Finlay was born Juan Carlos Finlay y de Barrés in Puerto Príncipe (now Camagüey), Cuba to Scottish-born Dr. Edward (Eduardo) Finlay and French-born Elisa (Isabel) de Barrés. At that time Cuba was part of the Kingdom of Spain. He reversed the order of his given names to "Carlos Juan" later in his life. His father was a physician who had fought alongside Simón Bolívar , and his family owned a coffee plantation in Alquízar . He attended school in France in 1844, but was forced to return to Cuba after two years because he contracted chorea . After recovering, he returned to Europe in 1848, but became stuck in England for another two years due to political turmoil, and after arriving in France to continue his education, he contracted typhoid fever and again returned to Cuba. Because the University of Havana would not recognize his European academic credits, he enrolled at Jefferson Medical College in Philadelphia, Pennsylvania , which did not require prerequisites. Here Finlay met John Kearsley Mitchell , a proponent of the germ theory of disease , and his son Silas Weir Mitchell , who supervised his studies. He graduated from Jefferson Medical College in 1855. He then returned to Havana and set up an ophthalmology practice in 1857, and then studied in Paris in 1860–61. In October 1865 he married Adela Shine, a native of the Island of Trinidad . They had three sons, Charles, George and Frank Finlay. Finlay's work, carried out during the 1870s, finally came to prominence in 1900. He was the first to theorize, in 1881, that a mosquito was a carrier, now known as a disease vector , of the organism causing yellow fever : a mosquito that bites a victim of the disease could subsequently bite and thereby infect a healthy person. He presented this theory at the 1881 International Sanitary Conference , where it was well received. A year later Finlay identified a mosquito of the genus Aedes as the organism transmitting yellow fever. His theory was followed by the recommendation to control the mosquito population as a way to control the spread of the disease. His hypothesis and exhaustive proofs were confirmed nearly twenty years later by the Walter Reed Commission of 1900. Finlay went on to become the chief health officer of Cuba from 1902 to 1909. Although Reed received much of the credit in history books for "beating" yellow fever, Reed himself credited Finlay with the discovery of the yellow fever vector, and thus how it might be controlled. Reed often cited Finlay's papers in his own articles and gave him credit for the discovery in his personal correspondence. In the words of General Leonard Wood , a physician and U.S. military governor of Cuba in 1900: "The confirmation of Dr. Finlay's doctrine is the greatest step forward made in medical science since Jenner 's discovery of the vaccination [for smallpox ]." This discovery helped William C. Gorgas reduce the incidence and prevalence of mosquito-borne diseases in Panama during the American campaign, from 1903 onwards, to construct the Panama Canal . Prior to this, about 10% of the workforce had died each year from malaria and yellow fever. [ citation needed ] Finlay was a member of Havana's Royal Academy of Medical, Physical and Natural Sciences. He was fluent in French , German , Spanish , and English and could read Latin . His interests were widespread and he wrote articles on subjects as varied as leprosy , cholera , gravity , and plant diseases . His main interest, however, was yellow fever, and he was the author of 40 articles on this disease. His theory that an intermediary host was responsible for the spread of the disease was treated with ridicule for years. A humane man, he often took on patients who could not afford medical care. As a result of his work, Finlay was nominated seven times for the Nobel Prize in Physiology or Medicine , although he was never awarded the prize. He received the National Order of the Legion of Honour of France in 1908. Finlay died from a stroke , caused by severe brain seizures, at his house in Havana on August 20, 1915. In 1928, President Gerardo Machado established the National Order of Merit Carlos J. Finlay, rewarding contributions to healthcare and medicine. It is the highest scientific decoration awarded by the Cuban Council of State . The order was discontinued between 1959 and 1981. On Cuba Street in downtown Old Havana , the Revolutionary Government in 1962 founded a medical history museum in honor of Carlos J. Finlay. On the wall of the Finlay Medical History Museum in Havana, the inscription states, "History Museum of the Medical Sciences ' Carlos J. Finlay', created by the Revolutionary Government in eternal homage to the men who contributed to the advance of the sciences in Cuba. National Commission of the Academy of Sciences of the Republic of Cuba. Havana, 13 June 1962." [ citation needed ] In the municipality of Marianao , now within the city of Havana , there is a monument in the shape of a syringe, honoring Finlay and usually referred to as El Obelisco ( The Obelisk ). Finlay was also commemorated on a 1981 Cuban stamp. A statue commemorating Finlay is located on the bayfront in Panama City , near the canal he helped make possible. The UNESCO Carlos J. Finlay Prize for Microbiology is named in his honor. Finlay was honoured with a Google Doodle on December 3, 2013, on the 180th anniversary of his birth. Carlos J. Finlay Military Hospital is named after him. The Finlay Institute for Vaccines (Instituto Finlay de Vacunas, in Spanish), created in 1991, is named after him, [ citation needed ] as is the exoplanet BD−17 63 b in Cetus . Miami-Dade County Public Schools operates Dr. Carlos J. Finlay Elementary School on the campus of Florida International University , in Westchester, Florida (formerly in the University Park census-designated place ).

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Aedes_albopictus/html

Aedes albopictus

Culex albopictus Skuse , 1894 Aedes albopictus ( Stegomyia albopicta ), from the mosquito (Culicidae) family , also known as the (Asian) tiger mosquito or forest mosquito , is a mosquito native to the tropical and subtropical areas of Southeast Asia. In the past few centuries, however, this species has spread to many countries through the transport of goods and international travel. It is characterized by the white bands on its legs and body. This mosquito has become a significant pest in many communities because it closely associates with humans (rather than living in wetlands), and typically flies and feeds in the daytime in addition to at dusk and dawn. The insect is called a tiger mosquito for its striped appearance, which resembles that of the tiger . Ae. albopictus is an epidemiologically important vector for the transmission of many viral pathogens , including the yellow fever virus , dengue fever , and Chikungunya fever , as well as several filarial nematodes such as Dirofilaria immitis . Aedes albopictus is capable of hosting the Zika virus and is considered a potential vector for Zika transmission among humans.In 1894, a British-Australian entomologist, Frederick A. Askew Skuse , was the first to scientifically describe the Asian tiger mosquito, which he named Culex albopictus ( lat. culex "gnat", "midge" and albopictus "white-painted"). Later, the species was assigned to the genus Aedes ( gr. άηδής , "unpleasant") and referred to as Aedes albopictus . Like the yellow fever mosquito , it belongs to the subgenus Stegomyia (Gr. στέγος , "covered, roofed", referring to the scales that completely cover the dorsal surface in this subgenus, and Î¼Ï Î¯Î± , "fly") within the genus Aedes . In 2004, scientists explored higher-level relationships and proposed a new classification within the genus Aedes and Stegomyia was elevated to the genus level, making Aedes albopictus now Stegomyia albopicta . This is, however, a controversial matter, and the use of Stegomyia albopicta versus Aedes albopictus is continually debated. The adult Asian tiger mosquito is less than 10 mm (0.39 in) long from end to end with a striking white and black pattern. The variation of the body size in adult mosquitoes depends on the density of the larval population and food supply within the breeding water. Since these circumstances are seldom optimal, the average body size of adult mosquitoes is considerably smaller than 10 mm. For example, the average length of the abdomen was calculated to be 2.63 mm (0.104 in) , the wings 2.7 mm (0.11 in) , and the proboscis 1.88 mm (0.074 in) . The males are roughly 20% smaller than the females, but they are morphologically very similar. However, as in all mosquito species, the antennae of the males in comparison to the females are noticeably bushier and contain auditory receptors to detect the characteristic whine, almost inaudible to humans, of the female. The maxillary palps of the males are also longer than their proboscis, whereas the females' maxillary palps are much shorter. (This is typical for the males of the Culicinae .) In addition, the tarsus of the hind legs of the males is more silvery. Tarsomere IV is roughly 75% silver in the males whereas the females' is only about 60% silver. [ citation needed ] The other characteristics do not differentiate between sexes. A single silvery-white line of tight scales begins between the eyes and continues down the dorsal side of the thorax. This characteristic marking is the easiest and surest way to identify the Asian tiger mosquito. [ citation needed ] The proboscis is dark colored, the upper surface of the end segment of the palps is covered in silvery scales, and the labium does not feature a light line on its underside. The compound eyes are distinctly separated from one another. The scute , the dorsal portion of an insect's thoracic segment, is black alongside the characteristic white midline. On the side of the thorax, the scutellum , and the abdomen are numerous spots covered in white-silvery scales. [ citation needed ] Such white-silvery scales can also be found on the tarsus, particularly on the hind legs that are commonly suspended in the air. The bases of tarsomeres I through IV have a ring of white scales, creating the appearance of white and black rings. On the forelegs and middle legs, only the first three tarsomeres have the ring of white scales, whereas tarsomere V on the hind legs is completely white. The femur of each leg is also black with white scales on the end of the "knee". The femora of the middle legs do not feature a silver line on the base of the upper side, whereas, the femora on the hind legs have short white lines on base of the upper side. The tibiae are black on the base and have no white scales. [ citation needed ] The terga on segments II through VI of the abdomen are dark and have an almost triangular silvery-white marking on the base that is not aligned with the silvery bands of scales on the ventral side of the abdomen. The triangular marking and the silvery band are only aligned on abdominal segment VII. The transparent wings have white spots on the base of the costae. With older mosquito specimens, the scales could be partially worn off, making these characteristics not stand out as much. As with other members of the mosquito family, the female is equipped with an elongated proboscis that she uses to collect blood to feed her eggs. The Asian tiger mosquito has a rapid bite and an agility that allows it to escape most attempts by people to swat it. By contrast, the male member of the species primarily feeds on nectar and does not bite. The female lays her eggs near water, not directly into it as other mosquitoes do, but typically near a stagnant pool. However, any open container containing water will suffice for larvae development, even with less than one US fl oz (30 ml) of water. It can also breed in running water, so stagnant pools of water are not its only breeding sites. It is more likely to lay eggs in water sources near flowers than in water sources without flowers. It has a short flight range (less than 200 m (220 yd) ), so breeding sites are likely to be close to where this mosquito is found. Other mosquito species may be visually confused with the tiger mosquito. Comparison with approved pictures is the best way to determine the species with certainty. Behavioral cues like almost-silent flight and difficulty in catching combined with knowledge of the range of local endemic mosquitoes may also aid this process. Some mosquitoes in North America, such as Ochlerotatus canadensis , have a similar leg pattern. In North and South America, Ae. albopictus can be distinguished from Aedes taeniorhynchus since only Ae. albopictus has back markings. In Europe, the mosquito Culiseta annulata , which is very common, but does not occur in high densities, can be mistaken for an Asian tiger mosquito because of its black-and-white-ringed legs. However, this species is missing the distinctive white line that runs from the middle of its head and down the thorax. It is also considerably larger than Ae. albopictus , is not black and white, but rather beige and grey striped, and has wings with noticeable veins and four dark, indistinct spots. The Tree Hole mosquito or Aedes geniculatus – a native to Europe and North Africa – has also been mistaken for Ae. albopictus. This is because the Tree Hole mosquito has very white scales on a very similar body. In the eastern Mediterranean area, Ae. albopictus species can be mistaken for Aedes cretinus , which also belongs to the subgenus Stegomyia and uses similar breeding waters. Aedes cretinus also has a white stripe on the scute , but it ends shortly before the abdomen, and also has two additional stripes to the left and right of the middle stripe. So far Aedes cretinus is only located in Cyprus, Greece, North Macedonia, Georgia and Turkey. In Asia, the Asian tiger mosquito can be mistaken for other members of the subgenus Stegomyia , particularly the yellow fever mosquito Aedes aegypti (the most prevalent species in the tropics and subtropics), because both species display a similar black and white pattern. It can be hard to distinguish Ae. albopictus from the closely related Aedes scutellaris (India, Indonesia, Papua New Guinea , and the Philippines ), Aedes pseudoalbopictus ( India , Indonesia, Malaysia , Myanmar , Nepal, Taiwan , Thailand, and Vietnam ) and Aedes seatoi (Thailand). Like other mosquito species, only the females require a blood meal to develop their eggs. Apart from that, they feed on nectar and other sweet plant juices just as the males do. In regards to host location, carbon dioxide and organic substances produced from the host, humidity, and optical recognition play important roles. [ citation needed ] The search for a host takes place in two phases. First, the mosquito exhibits a nonspecific searching behavior until it perceives host stimulants, whereupon it secondly takes a targeted approach. For catching tiger mosquitoes with special traps, carbon dioxide and a combination of chemicals that naturally occur in human skin ( fatty acids , ammonia , and lactic acid ) are the most attractive. The Asian tiger mosquito particularly bites in forests during the day, so has been known as the forest day mosquito. Depending upon region and biotype, activity peaks differ, but for the most part, they rest during the morning and night hours. They search for their hosts inside and outside human dwellings, but are particularly active outside. The size of the blood meal depends upon the size of the mosquito, but it is usually around 2 μl. Their bites are not necessarily painful, but they are more noticeable than those from other kinds of mosquitoes. Tiger mosquitoes generally tend to bite a human host more than once if they are able to. Ae. albopictus also bites other mammals besides humans, as well as birds. The females are always on the search for a host and are persistent but cautious when it comes to their blood meal and host location. Their blood meal is often broken off before enough blood has been ingested for the development of their eggs, so Asian tiger mosquitoes bite multiple hosts during their development cycle of the egg, making them particularly efficient at transmitting diseases. The mannerism of biting diverse host species enables the Asian tiger mosquito to be a potential bridge vector for certain pathogens that can jump species boundaries, for example the West Nile virus . [ citation needed ] Primarily, other mosquito larvae, flatworms , swimming beetles, fungi , ciliates , paramecia , protozoans which act as parasites, predatory copepods , and spiders are natural enemies of the larval stage of Asian tiger mosquitoes. [ citation needed ] Toxorhynchites larvae, a mosquito genus that does not suck blood, feeds upon other mosquito larvae and are often found with tiger mosquito larvae. Flatworms and small swimming beetles are considered natural predators. Fungi from the genus Coelomomyces (order Blastocladiales ) develop inside the visceral cavity of mosquito larvae. The species Coelomomyces stegomyiae was first found on the Asian tiger mosquito. Paramecia , or ciliates, can also affect Ae. albopictus larvae, and the first detected species was Lambornella stegomyiae (Hymenostomatida: Tetrahymenidae). The virulence, mortality rate, and subsequent possibilities of Lambornella being implemented as a biological remedy to control Ae. albopictus , however, has conflicting views. Sporozoans of the genus Ascogregarina ( Lecudinidae ) infect the larval stage of mosquitoes. The species Ascogregarina taiwanensis was found in Asian tiger mosquitoes. When the adult mosquitoes emerge from their pupal case, they leave the infectious intermediary stage of parasites in the water and close off the infection cycle. Infected adults are generally smaller than non-infected adults and have an insignificantly higher mortality rate; therefore, food supply and larval density apparently play a role. In competitive situations, an infection with sporozoans can also reduce the biological fitness of other uninfected mosquitoes. However, the use of the parasites as an effective biological remedy to control mosquito populations is implausible because the host must reach the adult stage for the transmission of the parasites. Though they do not commonly occur in the natural habitats of Asian tiger mosquitoes, predatory copepods from the family Cyclopidae seem to willingly feed on them given the opportunity. Relatives of different genera could therefore present a possibility in the control of tiger mosquitoes. Predators of adult Ae. albopictus in Malaysia include various spider species. Up to 90% of the gathered spiders from rubber plantations and a cemetery fed upon Asian tiger mosquitoes. Whether the spiders would have an effect on the mosquito population is still unclear. Tiger mosquitoes were abundantly present despite the existence of the spiders. In 1894, a British-Australian entomologist, Frederick A. Askew Skuse , was the first to scientifically describe the Asian tiger mosquito, which he named Culex albopictus ( lat. culex "gnat", "midge" and albopictus "white-painted"). Later, the species was assigned to the genus Aedes ( gr. άηδής , "unpleasant") and referred to as Aedes albopictus . Like the yellow fever mosquito , it belongs to the subgenus Stegomyia (Gr. στέγος , "covered, roofed", referring to the scales that completely cover the dorsal surface in this subgenus, and Î¼Ï Î¯Î± , "fly") within the genus Aedes . In 2004, scientists explored higher-level relationships and proposed a new classification within the genus Aedes and Stegomyia was elevated to the genus level, making Aedes albopictus now Stegomyia albopicta . This is, however, a controversial matter, and the use of Stegomyia albopicta versus Aedes albopictus is continually debated. The adult Asian tiger mosquito is less than 10 mm (0.39 in) long from end to end with a striking white and black pattern. The variation of the body size in adult mosquitoes depends on the density of the larval population and food supply within the breeding water. Since these circumstances are seldom optimal, the average body size of adult mosquitoes is considerably smaller than 10 mm. For example, the average length of the abdomen was calculated to be 2.63 mm (0.104 in) , the wings 2.7 mm (0.11 in) , and the proboscis 1.88 mm (0.074 in) . The males are roughly 20% smaller than the females, but they are morphologically very similar. However, as in all mosquito species, the antennae of the males in comparison to the females are noticeably bushier and contain auditory receptors to detect the characteristic whine, almost inaudible to humans, of the female. The maxillary palps of the males are also longer than their proboscis, whereas the females' maxillary palps are much shorter. (This is typical for the males of the Culicinae .) In addition, the tarsus of the hind legs of the males is more silvery. Tarsomere IV is roughly 75% silver in the males whereas the females' is only about 60% silver. [ citation needed ] The other characteristics do not differentiate between sexes. A single silvery-white line of tight scales begins between the eyes and continues down the dorsal side of the thorax. This characteristic marking is the easiest and surest way to identify the Asian tiger mosquito. [ citation needed ] The proboscis is dark colored, the upper surface of the end segment of the palps is covered in silvery scales, and the labium does not feature a light line on its underside. The compound eyes are distinctly separated from one another. The scute , the dorsal portion of an insect's thoracic segment, is black alongside the characteristic white midline. On the side of the thorax, the scutellum , and the abdomen are numerous spots covered in white-silvery scales. [ citation needed ] Such white-silvery scales can also be found on the tarsus, particularly on the hind legs that are commonly suspended in the air. The bases of tarsomeres I through IV have a ring of white scales, creating the appearance of white and black rings. On the forelegs and middle legs, only the first three tarsomeres have the ring of white scales, whereas tarsomere V on the hind legs is completely white. The femur of each leg is also black with white scales on the end of the "knee". The femora of the middle legs do not feature a silver line on the base of the upper side, whereas, the femora on the hind legs have short white lines on base of the upper side. The tibiae are black on the base and have no white scales. [ citation needed ] The terga on segments II through VI of the abdomen are dark and have an almost triangular silvery-white marking on the base that is not aligned with the silvery bands of scales on the ventral side of the abdomen. The triangular marking and the silvery band are only aligned on abdominal segment VII. The transparent wings have white spots on the base of the costae. With older mosquito specimens, the scales could be partially worn off, making these characteristics not stand out as much. As with other members of the mosquito family, the female is equipped with an elongated proboscis that she uses to collect blood to feed her eggs. The Asian tiger mosquito has a rapid bite and an agility that allows it to escape most attempts by people to swat it. By contrast, the male member of the species primarily feeds on nectar and does not bite. The female lays her eggs near water, not directly into it as other mosquitoes do, but typically near a stagnant pool. However, any open container containing water will suffice for larvae development, even with less than one US fl oz (30 ml) of water. It can also breed in running water, so stagnant pools of water are not its only breeding sites. It is more likely to lay eggs in water sources near flowers than in water sources without flowers. It has a short flight range (less than 200 m (220 yd) ), so breeding sites are likely to be close to where this mosquito is found. Other mosquito species may be visually confused with the tiger mosquito. Comparison with approved pictures is the best way to determine the species with certainty. Behavioral cues like almost-silent flight and difficulty in catching combined with knowledge of the range of local endemic mosquitoes may also aid this process.Some mosquitoes in North America, such as Ochlerotatus canadensis , have a similar leg pattern. In North and South America, Ae. albopictus can be distinguished from Aedes taeniorhynchus since only Ae. albopictus has back markings. In Europe, the mosquito Culiseta annulata , which is very common, but does not occur in high densities, can be mistaken for an Asian tiger mosquito because of its black-and-white-ringed legs. However, this species is missing the distinctive white line that runs from the middle of its head and down the thorax. It is also considerably larger than Ae. albopictus , is not black and white, but rather beige and grey striped, and has wings with noticeable veins and four dark, indistinct spots. The Tree Hole mosquito or Aedes geniculatus – a native to Europe and North Africa – has also been mistaken for Ae. albopictus. This is because the Tree Hole mosquito has very white scales on a very similar body. In the eastern Mediterranean area, Ae. albopictus species can be mistaken for Aedes cretinus , which also belongs to the subgenus Stegomyia and uses similar breeding waters. Aedes cretinus also has a white stripe on the scute , but it ends shortly before the abdomen, and also has two additional stripes to the left and right of the middle stripe. So far Aedes cretinus is only located in Cyprus, Greece, North Macedonia, Georgia and Turkey. In Asia, the Asian tiger mosquito can be mistaken for other members of the subgenus Stegomyia , particularly the yellow fever mosquito Aedes aegypti (the most prevalent species in the tropics and subtropics), because both species display a similar black and white pattern. It can be hard to distinguish Ae. albopictus from the closely related Aedes scutellaris (India, Indonesia, Papua New Guinea , and the Philippines ), Aedes pseudoalbopictus ( India , Indonesia, Malaysia , Myanmar , Nepal, Taiwan , Thailand, and Vietnam ) and Aedes seatoi (Thailand). Like other mosquito species, only the females require a blood meal to develop their eggs. Apart from that, they feed on nectar and other sweet plant juices just as the males do. In regards to host location, carbon dioxide and organic substances produced from the host, humidity, and optical recognition play important roles. [ citation needed ] The search for a host takes place in two phases. First, the mosquito exhibits a nonspecific searching behavior until it perceives host stimulants, whereupon it secondly takes a targeted approach. For catching tiger mosquitoes with special traps, carbon dioxide and a combination of chemicals that naturally occur in human skin ( fatty acids , ammonia , and lactic acid ) are the most attractive. The Asian tiger mosquito particularly bites in forests during the day, so has been known as the forest day mosquito. Depending upon region and biotype, activity peaks differ, but for the most part, they rest during the morning and night hours. They search for their hosts inside and outside human dwellings, but are particularly active outside. The size of the blood meal depends upon the size of the mosquito, but it is usually around 2 μl. Their bites are not necessarily painful, but they are more noticeable than those from other kinds of mosquitoes. Tiger mosquitoes generally tend to bite a human host more than once if they are able to. Ae. albopictus also bites other mammals besides humans, as well as birds. The females are always on the search for a host and are persistent but cautious when it comes to their blood meal and host location. Their blood meal is often broken off before enough blood has been ingested for the development of their eggs, so Asian tiger mosquitoes bite multiple hosts during their development cycle of the egg, making them particularly efficient at transmitting diseases. The mannerism of biting diverse host species enables the Asian tiger mosquito to be a potential bridge vector for certain pathogens that can jump species boundaries, for example the West Nile virus . [ citation needed ]Primarily, other mosquito larvae, flatworms , swimming beetles, fungi , ciliates , paramecia , protozoans which act as parasites, predatory copepods , and spiders are natural enemies of the larval stage of Asian tiger mosquitoes. [ citation needed ] Toxorhynchites larvae, a mosquito genus that does not suck blood, feeds upon other mosquito larvae and are often found with tiger mosquito larvae. Flatworms and small swimming beetles are considered natural predators. Fungi from the genus Coelomomyces (order Blastocladiales ) develop inside the visceral cavity of mosquito larvae. The species Coelomomyces stegomyiae was first found on the Asian tiger mosquito. Paramecia , or ciliates, can also affect Ae. albopictus larvae, and the first detected species was Lambornella stegomyiae (Hymenostomatida: Tetrahymenidae). The virulence, mortality rate, and subsequent possibilities of Lambornella being implemented as a biological remedy to control Ae. albopictus , however, has conflicting views. Sporozoans of the genus Ascogregarina ( Lecudinidae ) infect the larval stage of mosquitoes. The species Ascogregarina taiwanensis was found in Asian tiger mosquitoes. When the adult mosquitoes emerge from their pupal case, they leave the infectious intermediary stage of parasites in the water and close off the infection cycle. Infected adults are generally smaller than non-infected adults and have an insignificantly higher mortality rate; therefore, food supply and larval density apparently play a role. In competitive situations, an infection with sporozoans can also reduce the biological fitness of other uninfected mosquitoes. However, the use of the parasites as an effective biological remedy to control mosquito populations is implausible because the host must reach the adult stage for the transmission of the parasites. Though they do not commonly occur in the natural habitats of Asian tiger mosquitoes, predatory copepods from the family Cyclopidae seem to willingly feed on them given the opportunity. Relatives of different genera could therefore present a possibility in the control of tiger mosquitoes. Predators of adult Ae. albopictus in Malaysia include various spider species. Up to 90% of the gathered spiders from rubber plantations and a cemetery fed upon Asian tiger mosquitoes. Whether the spiders would have an effect on the mosquito population is still unclear. Tiger mosquitoes were abundantly present despite the existence of the spiders. The Asian tiger mosquito originally came from Southeast Asia. In 1966, parts of Asia and the island worlds of India and the Pacific Ocean were denoted as the area of circulation for the Asian tiger mosquito. Ae. albopictus as a native to tropical and subtropical regions with warm and humid climate, is active all year long; however, it has been adapting successfully to cooler, temperate regions, where they hibernate over winter. Eggs from strains in the temperate zones are more tolerant to the cold than ones from warmer regions. The species can even tolerate snow and temperatures under freezing. Adult tiger mosquitoes can survive throughout winter in suitable microhabitats. Since the mid-1960s, the tiger mosquito has spread to Europe, the Americas, the Caribbean, Africa, and the Middle East. As of 2008 Ae. albopictus was one of the 100 world's worst invasive species according to the Global Invasive Species Database. As of 2006, Ae. albopictus was not native to Australia and New Zealand. The species was introduced there multiple times, but has yet to establish itself. This is due to the well-organized entomological surveillance programs in the harbors and airports of these countries. Nevertheless, as of 2006 it has become domestic on the islands in the Torres Strait between Queensland, Australia, and New Guinea. In Europe, Asian tiger mosquitos first emerged in Albania in 1979, introduced through a shipment of goods from China. In 1990–1991, they were most likely brought to Italy in used tires from Georgia (USA), and since then have spread throughout the entire mainland of Italy, as well as parts of Sicily and Sardinia . Since 1999, they have established themselves on the mainland of France, primarily southern France. In 2002, they were also discovered in a vacation town on the island of Corsica , but did not completely establish themselves there until 2005. In Belgium , they were detected in 2000 and 2013, in 2001 in Montenegro, 2003 in Canton Ticino in southern Switzerland , and Greece , 2004 in Spain and Croatia , 2005 in the Netherlands and Slovenia , 2006 in Bosnia and Herzegovina and 2022 in Cyprus. In the fall of 2007, the first tiger mosquito eggs were discovered in Rastatt ( Baden-Wuerttemberg , Germany). Shortly before, they were found in the northern Alps of Switzerland in Canton Aargau. Since 2010, it has also been sighted increasingly in Malta during summer. [ citation needed ] In September 2016, Public Health England found eggs, though no mosquitos, in a lorry park at Folkestone service station on the M20 , near Westenhanger , which is 6 miles West of the Eurotunnel. The Swiss Autobahns are especially of concern. Governments and universities in Switzerland cooperate every year to monitor the invasion using traps at Autobahn rest stations, and also at airports and commercial hubs. In Slovakia , two independent observations events have been observed in recent years: first in 2012 near KoÅ¡ice and the second in 2023 in the populated Ružinov borough of Bratislava . The species had failed to settle during the first occurrence but had likely settled in the latter, increasing the risk of concern for public health and safety. In the United States, this species invaded the Southern United States in the 1980s and rapidly spread northward into novel climate compared to its native range. It was initially found in 1983 in Memphis, Tennessee . then at the Port of Houston in a 1985 shipment of used tires, and spread across the South up the East Coast to become prevalent in the Northeast . It was not discovered in Southern California until 2001, then eradicated for over a decade; however, by 2011, it was again being found in Los Angeles County traps, then over the next two years expanded its range to Kern County and San Diego County . As of 2013 [ update ] , North American land favoring the environmental conditions of the Asian tiger mosquito was expected to more than triple in size in the coming 20 years, especially in urban areas. As of 2017 [ update ] Aedes albopictus mosquitoes have been identified in 1,368 counties in 40 U.S states. A 2019 study in Nature Microbiology that modeled expansion of Aedes albopictus due to climate change, urbanization, and human movement found that the species would likely continue to spread throughout the coming decades. In Latin America, the Asian tiger mosquito was first discovered 1986 in Brazil and in 1988 in Argentina and Mexico , as well. Other parts of Latin America where the Asian tiger mosquito was discovered are the Dominican Republic in 1993, Bolivia , Cuba, Honduras , and Guatemala in 1995, El Salvador in 1996, Paraguay in 1999, Panama in 2002, and Uruguay and Nicaragua in 2003. In Africa, the species was first detected in 1990 in South Africa. In Nigeria , it has been domestic since at least 1991. It spread to Cameroon in 1999/2000, to the Bioko Island of Equatorial Guinea in 2001, and to Gabon in 2006. In the Middle East, the species was detected in Lebanon in 2003 and in Syria in 2005; the first record in Israel was published in 2003. Ae. albopictus can outcompete and even eradicate other species with similar breeding habitats from the very start of its dispersal to other regions and biotopes. In Kolkata , for example, it was observed in the 1960s that egg depositing containers were being settled by the Asian tiger mosquito in city districts where the malaria mosquito (genus Anopheles ) and yellow fever mosquito ( Aedes aegypti ) had both been eliminated by the application of DDT . This may be because primarily the inner walls of the houses were treated with DDT to kill the mosquitoes resting there and fight the malaria mosquito. The yellow fever mosquito also lingers particularly in the inside of buildings and would have been also affected. The Asian tiger mosquito rests in the vicinity of human dwellings would therefore have an advantage over the other two species. In other cases where the yellow fever mosquito was repressed by the Asian tiger mosquito, for instance in Florida, this explanation does not fit. Other hypotheses include competition in the larval breeding waters, differences in metabolism and reproductive biology, or a major susceptibility to sporozoans (Apicomplexa). Another species which was suppressed by the migrating Ae. albopictus was Ae. guamensis in Guam . The Asian tiger mosquito is similar, in terms of its close socialization with humans, to the common house mosquito ( Culex pipiens ). Among other differences in their biology, Culex pipiens prefers larger breeding waters and is more tolerant to cold. In this respect, no significant competition or suppression between the two species likely occurs. A possible competition among mosquito species that all lay their eggs in knotholes and other similar places ( Ae. cretinus , Ae. geniculatus , and Anopheles plumbeus ) has yet to be observed. [ citation needed ] In Europe, the Asian tiger mosquito apparently covers an extensive new niche. This means that no native, long-established species conflict with the dispersal of Ae. albopictus . [ citation needed ]The Asian tiger mosquito originally came from Southeast Asia. In 1966, parts of Asia and the island worlds of India and the Pacific Ocean were denoted as the area of circulation for the Asian tiger mosquito. Ae. albopictus as a native to tropical and subtropical regions with warm and humid climate, is active all year long; however, it has been adapting successfully to cooler, temperate regions, where they hibernate over winter. Eggs from strains in the temperate zones are more tolerant to the cold than ones from warmer regions. The species can even tolerate snow and temperatures under freezing. Adult tiger mosquitoes can survive throughout winter in suitable microhabitats. Since the mid-1960s, the tiger mosquito has spread to Europe, the Americas, the Caribbean, Africa, and the Middle East. As of 2008 Ae. albopictus was one of the 100 world's worst invasive species according to the Global Invasive Species Database. As of 2006, Ae. albopictus was not native to Australia and New Zealand. The species was introduced there multiple times, but has yet to establish itself. This is due to the well-organized entomological surveillance programs in the harbors and airports of these countries. Nevertheless, as of 2006 it has become domestic on the islands in the Torres Strait between Queensland, Australia, and New Guinea. In Europe, Asian tiger mosquitos first emerged in Albania in 1979, introduced through a shipment of goods from China. In 1990–1991, they were most likely brought to Italy in used tires from Georgia (USA), and since then have spread throughout the entire mainland of Italy, as well as parts of Sicily and Sardinia . Since 1999, they have established themselves on the mainland of France, primarily southern France. In 2002, they were also discovered in a vacation town on the island of Corsica , but did not completely establish themselves there until 2005. In Belgium , they were detected in 2000 and 2013, in 2001 in Montenegro, 2003 in Canton Ticino in southern Switzerland , and Greece , 2004 in Spain and Croatia , 2005 in the Netherlands and Slovenia , 2006 in Bosnia and Herzegovina and 2022 in Cyprus. In the fall of 2007, the first tiger mosquito eggs were discovered in Rastatt ( Baden-Wuerttemberg , Germany). Shortly before, they were found in the northern Alps of Switzerland in Canton Aargau. Since 2010, it has also been sighted increasingly in Malta during summer. [ citation needed ] In September 2016, Public Health England found eggs, though no mosquitos, in a lorry park at Folkestone service station on the M20 , near Westenhanger , which is 6 miles West of the Eurotunnel. The Swiss Autobahns are especially of concern. Governments and universities in Switzerland cooperate every year to monitor the invasion using traps at Autobahn rest stations, and also at airports and commercial hubs. In Slovakia , two independent observations events have been observed in recent years: first in 2012 near KoÅ¡ice and the second in 2023 in the populated Ružinov borough of Bratislava . The species had failed to settle during the first occurrence but had likely settled in the latter, increasing the risk of concern for public health and safety. In the United States, this species invaded the Southern United States in the 1980s and rapidly spread northward into novel climate compared to its native range. It was initially found in 1983 in Memphis, Tennessee . then at the Port of Houston in a 1985 shipment of used tires, and spread across the South up the East Coast to become prevalent in the Northeast . It was not discovered in Southern California until 2001, then eradicated for over a decade; however, by 2011, it was again being found in Los Angeles County traps, then over the next two years expanded its range to Kern County and San Diego County . As of 2013 [ update ] , North American land favoring the environmental conditions of the Asian tiger mosquito was expected to more than triple in size in the coming 20 years, especially in urban areas. As of 2017 [ update ] Aedes albopictus mosquitoes have been identified in 1,368 counties in 40 U.S states. A 2019 study in Nature Microbiology that modeled expansion of Aedes albopictus due to climate change, urbanization, and human movement found that the species would likely continue to spread throughout the coming decades. In Latin America, the Asian tiger mosquito was first discovered 1986 in Brazil and in 1988 in Argentina and Mexico , as well. Other parts of Latin America where the Asian tiger mosquito was discovered are the Dominican Republic in 1993, Bolivia , Cuba, Honduras , and Guatemala in 1995, El Salvador in 1996, Paraguay in 1999, Panama in 2002, and Uruguay and Nicaragua in 2003. In Africa, the species was first detected in 1990 in South Africa. In Nigeria , it has been domestic since at least 1991. It spread to Cameroon in 1999/2000, to the Bioko Island of Equatorial Guinea in 2001, and to Gabon in 2006. In the Middle East, the species was detected in Lebanon in 2003 and in Syria in 2005; the first record in Israel was published in 2003. Ae. albopictus can outcompete and even eradicate other species with similar breeding habitats from the very start of its dispersal to other regions and biotopes. In Kolkata , for example, it was observed in the 1960s that egg depositing containers were being settled by the Asian tiger mosquito in city districts where the malaria mosquito (genus Anopheles ) and yellow fever mosquito ( Aedes aegypti ) had both been eliminated by the application of DDT . This may be because primarily the inner walls of the houses were treated with DDT to kill the mosquitoes resting there and fight the malaria mosquito. The yellow fever mosquito also lingers particularly in the inside of buildings and would have been also affected. The Asian tiger mosquito rests in the vicinity of human dwellings would therefore have an advantage over the other two species. In other cases where the yellow fever mosquito was repressed by the Asian tiger mosquito, for instance in Florida, this explanation does not fit. Other hypotheses include competition in the larval breeding waters, differences in metabolism and reproductive biology, or a major susceptibility to sporozoans (Apicomplexa). Another species which was suppressed by the migrating Ae. albopictus was Ae. guamensis in Guam . The Asian tiger mosquito is similar, in terms of its close socialization with humans, to the common house mosquito ( Culex pipiens ). Among other differences in their biology, Culex pipiens prefers larger breeding waters and is more tolerant to cold. In this respect, no significant competition or suppression between the two species likely occurs. A possible competition among mosquito species that all lay their eggs in knotholes and other similar places ( Ae. cretinus , Ae. geniculatus , and Anopheles plumbeus ) has yet to be observed. [ citation needed ] In Europe, the Asian tiger mosquito apparently covers an extensive new niche. This means that no native, long-established species conflict with the dispersal of Ae. albopictus . [ citation needed ]Ae. albopictus is known to transmit pathogens and viruses, such as the yellow fever virus, dengue fever , Chikungunya fever, and Usutu virus . There is some evidence supporting the role of Ae. albopictus in the transmission of Zika virus , which is primarily transmitted by the related Ae. aegypti . The Asian tiger mosquito was responsible for the Chikungunya epidemic on the French Island La Réunion in 2005–2006. By September 2006, an estimated 266,000 people were infected with the virus, and 248 fatalities occurred on the island. The Asian tiger mosquito was also the transmitter of the virus in the first outbreak of Chikungunya fever on the European continent. This outbreak occurred in the Italian province of Ravenna in the summer of 2007, and infected over 200 people. Evidently, mutated strains of the Chikungunya virus are being directly transmitted through Ae. albopictus particularly well and in such a way that another dispersal of the disease in regions with the Asian tiger mosquito is feared. On the basis of experimental evidence and probability estimates, the likelihood of mechanical or biological transmission of HIV by insects is virtually nonexistent. The tiger mosquito is relevant to veterinary medicine. For example, tiger mosquitoes are transmitters of Dirofilaria immitis , a parasitic roundworm that causes heart failure in dogs and cats. Wolbachia infection are the most common infection in arthropods today, and over 40% of arthropods have contracted it. Wolbachia can be transmitted from parent to offspring or between breeding individuals. Wolbachia is easily transmitted within the Ae. albopictus mosquito due to the effects it has on fecundity in females. Once female Asian tiger mosquitos have contracted the infection, they produce more eggs, give birth more frequently, and live longer than uninfected females. In this way, Wolbachia provides a fitness advantage to the infected females and prevents uninfected females from reproducing. This allows control of the spread of diseases that many species carry by suppressing reproduction of the individuals with the harmful disease, but without the Wolbachia infection. Wolbachia can also be used to transfer certain genes into the population to further control the spread of diseases. In the natural environment, Wolbachia and the Asian tiger mosquito are in a symbiotic relationship, so both species benefit from each other and can evolve together. The relationship between Wolbachia and its host might not have always been mutualistic, as Drosophila populations once experienced decreased fecundity in infected females, suggesting that Wolbachia evolved over time so that infected individuals would actually reproduce much more. The mechanism by which Wolbachia is inherited through maternal heredity is called cytoplasmic incompatibility . This changes the gamete cells of males and females, making some individuals unable to mate with each other. Although little is known about why cytoplasmic incompatibility exists, Wolbachia infection creates a fitness advantage for infected females, as they can mate with either infected or uninfected males. Despite this, infected males cannot reproduce with uninfected females. Therefore, over time, a population exposed to Wolbachia transitions from a few infected individuals to all individuals becoming infected, as the males that cannot reproduce successfully do not contribute to future generations. This is called population replacement, where the population's overall genotype is replaced by a new genotype. This shows how populations of Asian tiger mosquitoes can vary in number of Wolbachia -infected individuals, based on how often the infection is transmitted. Due to Wolbachia's ability to transmit from one host to the next, it can change the average genotype of a population, potentially reducing the population's gene flow with other nearby populations. [ citation needed ] This type of cytoplasmic incompatibility where an infected male cannot reproduce successfully with an uninfected female is called unidirectional cytoplasmic incompatibility. It occurs because Wolbachia modifies the paternal chromosomes during sperm development, leading to complications for these offspring during embryonic development. Also, bidirectional cytoplasmic incompatibility occurs when an infected male carrying one strain of Wolbachia reproduces with an infected female carrying a different strain of Wolbachia . This also results in failed reproduction. Bidirectional cytoplasmic incompatibility also has evolutionary implications for populations of Ae. albopictus and other vectors of the infection. This is because bidirectional cytoplasmic incompatibility in Wolbachia creates unviable offspring, reducing gene flow between two populations, which can eventually lead to speciation . [ citation needed ]Ae. albopictus is known to transmit pathogens and viruses, such as the yellow fever virus, dengue fever , Chikungunya fever, and Usutu virus . There is some evidence supporting the role of Ae. albopictus in the transmission of Zika virus , which is primarily transmitted by the related Ae. aegypti . The Asian tiger mosquito was responsible for the Chikungunya epidemic on the French Island La Réunion in 2005–2006. By September 2006, an estimated 266,000 people were infected with the virus, and 248 fatalities occurred on the island. The Asian tiger mosquito was also the transmitter of the virus in the first outbreak of Chikungunya fever on the European continent. This outbreak occurred in the Italian province of Ravenna in the summer of 2007, and infected over 200 people. Evidently, mutated strains of the Chikungunya virus are being directly transmitted through Ae. albopictus particularly well and in such a way that another dispersal of the disease in regions with the Asian tiger mosquito is feared. On the basis of experimental evidence and probability estimates, the likelihood of mechanical or biological transmission of HIV by insects is virtually nonexistent. The tiger mosquito is relevant to veterinary medicine. For example, tiger mosquitoes are transmitters of Dirofilaria immitis , a parasitic roundworm that causes heart failure in dogs and cats. Wolbachia infection are the most common infection in arthropods today, and over 40% of arthropods have contracted it. Wolbachia can be transmitted from parent to offspring or between breeding individuals. Wolbachia is easily transmitted within the Ae. albopictus mosquito due to the effects it has on fecundity in females. Once female Asian tiger mosquitos have contracted the infection, they produce more eggs, give birth more frequently, and live longer than uninfected females. In this way, Wolbachia provides a fitness advantage to the infected females and prevents uninfected females from reproducing. This allows control of the spread of diseases that many species carry by suppressing reproduction of the individuals with the harmful disease, but without the Wolbachia infection. Wolbachia can also be used to transfer certain genes into the population to further control the spread of diseases. In the natural environment, Wolbachia and the Asian tiger mosquito are in a symbiotic relationship, so both species benefit from each other and can evolve together. The relationship between Wolbachia and its host might not have always been mutualistic, as Drosophila populations once experienced decreased fecundity in infected females, suggesting that Wolbachia evolved over time so that infected individuals would actually reproduce much more. The mechanism by which Wolbachia is inherited through maternal heredity is called cytoplasmic incompatibility . This changes the gamete cells of males and females, making some individuals unable to mate with each other. Although little is known about why cytoplasmic incompatibility exists, Wolbachia infection creates a fitness advantage for infected females, as they can mate with either infected or uninfected males. Despite this, infected males cannot reproduce with uninfected females. Therefore, over time, a population exposed to Wolbachia transitions from a few infected individuals to all individuals becoming infected, as the males that cannot reproduce successfully do not contribute to future generations. This is called population replacement, where the population's overall genotype is replaced by a new genotype. This shows how populations of Asian tiger mosquitoes can vary in number of Wolbachia -infected individuals, based on how often the infection is transmitted. Due to Wolbachia's ability to transmit from one host to the next, it can change the average genotype of a population, potentially reducing the population's gene flow with other nearby populations. [ citation needed ] This type of cytoplasmic incompatibility where an infected male cannot reproduce successfully with an uninfected female is called unidirectional cytoplasmic incompatibility. It occurs because Wolbachia modifies the paternal chromosomes during sperm development, leading to complications for these offspring during embryonic development. Also, bidirectional cytoplasmic incompatibility occurs when an infected male carrying one strain of Wolbachia reproduces with an infected female carrying a different strain of Wolbachia . This also results in failed reproduction. Bidirectional cytoplasmic incompatibility also has evolutionary implications for populations of Ae. albopictus and other vectors of the infection. This is because bidirectional cytoplasmic incompatibility in Wolbachia creates unviable offspring, reducing gene flow between two populations, which can eventually lead to speciation . [ citation needed ]In the natural environment, Wolbachia and the Asian tiger mosquito are in a symbiotic relationship, so both species benefit from each other and can evolve together. The relationship between Wolbachia and its host might not have always been mutualistic, as Drosophila populations once experienced decreased fecundity in infected females, suggesting that Wolbachia evolved over time so that infected individuals would actually reproduce much more. The mechanism by which Wolbachia is inherited through maternal heredity is called cytoplasmic incompatibility . This changes the gamete cells of males and females, making some individuals unable to mate with each other. Although little is known about why cytoplasmic incompatibility exists, Wolbachia infection creates a fitness advantage for infected females, as they can mate with either infected or uninfected males. Despite this, infected males cannot reproduce with uninfected females. Therefore, over time, a population exposed to Wolbachia transitions from a few infected individuals to all individuals becoming infected, as the males that cannot reproduce successfully do not contribute to future generations. This is called population replacement, where the population's overall genotype is replaced by a new genotype. This shows how populations of Asian tiger mosquitoes can vary in number of Wolbachia -infected individuals, based on how often the infection is transmitted. Due to Wolbachia's ability to transmit from one host to the next, it can change the average genotype of a population, potentially reducing the population's gene flow with other nearby populations. [ citation needed ]This type of cytoplasmic incompatibility where an infected male cannot reproduce successfully with an uninfected female is called unidirectional cytoplasmic incompatibility. It occurs because Wolbachia modifies the paternal chromosomes during sperm development, leading to complications for these offspring during embryonic development. Also, bidirectional cytoplasmic incompatibility occurs when an infected male carrying one strain of Wolbachia reproduces with an infected female carrying a different strain of Wolbachia . This also results in failed reproduction. Bidirectional cytoplasmic incompatibility also has evolutionary implications for populations of Ae. albopictus and other vectors of the infection. This is because bidirectional cytoplasmic incompatibility in Wolbachia creates unviable offspring, reducing gene flow between two populations, which can eventually lead to speciation . [ citation needed ]Ae. albopictus is very difficult to suppress or to control due to its remarkable ability to adapt to various environments, its close contact with humans, and its reproductive biology. [ citation needed ] The containment of infestations is generally effected by public health services through area-wide integrated control plans, which aim to reduce the nuisance perceived by populations and the risks of viraemic transmission. Such plans consist of different activities that include entomological surveillance, larvicide treatments in public and private areas, information campaigns, and treatments against adult mosquitoes in the zones affected by suspected cases of transmissible viruses. Efficient monitoring or surveillance is essential to prevent the spread and establishment of this species. In addition to the monitoring of ports, warehouses with imported plants, and stockpiles of tires, rest areas on highways and train stations should be monitored with appropriate methods. The control of Asian tiger mosquitoes begins with destroying the places where they lay their eggs, which are never far from where people are being bitten, since they are weak fliers, with only about a 180-metre (590 ft) lifetime flying radius. Puddles that last more than three days, sagging or plugged roof gutters, old tires holding water, litter, and any other possible containers or pools of standing water should be drained or removed. Bird baths, inlets to sewers and drainage systems holding stagnant water, flower pots, standing flower vases, knotholes, and other crevices that can collect water should be filled with sand or fine gravel to prevent mosquitoes from laying their eggs in them. [ citation needed ] Any standing water in pools, catchment basins, etc., that cannot be drained, or dumped, can be periodically treated with properly labeled insecticides or Bacillus thuringiensis israelensis (Bti), often formed into doughnut-shaped "mosquito dunks". Bti produces toxins which are effective in killing larvae of mosquitoes and certain other dipterans , while having almost no effect on other organisms. Bti preparations are readily available at farm, garden, and pool suppliers. [ citation needed ] Flowing water will not be a breeding spot, [ contradictory ] and water that contains minnows is not usually a problem, because the fish eat the mosquito larvae. [ citation needed ] Adult and nymphal dragonflies have been proposed as biological control of mosquito species. Dragonfly nymphs eat mosquito larvae, at least in laboratory conditions, though studies of wild dragonfly diets have not shown mosquitoes to be part of dragonfly nymph diets. A study of adult dragonfly diets in Europe showed that adult mosquitoes were not an important food source. In any case, an efficient surveillance is essential to monitor the presence of tiger mosquitoes and the effect of control programs. Ovitraps are normally used for the monitoring of Ae. albopictus . They are black water containers with floating Styrofoam blocks or small wooden paddles that are in contact with the surface of the water. Female tiger mosquitoes lay their eggs on these surfaces. Through the identification of these eggs or of the larvae that hatch from these eggs in the laboratory, the presence and abundance of mosquito species can be estimated. Versions of these traps with an adhesive film (sticky traps) that catch the egg-depositing mosquitoes make the analysis much easier and quicker, but are more complicated in terms of handling. The results of ovitraps are often variable and depend on the availability of alternative egg-depositing waters. Due to this, it is best to use them in large numbers and in conjunction with other monitoring methods. [ citation needed ] To date, few effective traps for adult Asian tiger mosquitoes are available. Those traps that catch other species of mosquitoes do not catch tiger mosquitoes efficiently. A form of an ovitrap called a lethal ovitrap mimics the breeding site for Ae. albopictus just like the monitoring tool, but it has the added benefit of containing chemicals that are toxic to the mosquitoes when they enter, but do not harm humans. These traps have had success in some countries to control Aedes mosquito populations. A new trap type has now been shown to catch significant numbers of Ae. albopictus . This device, with the help of a ventilator, produces an upward air current of ammonia , fatty acids , and lactic acids that takes a similar form and smell of a human body. With the addition of carbon dioxide , the efficacy of the trap is increased. This means a suitable tool is available for trapping adult tiger mosquitoes, and for example, examining the existence of viruses in the trapped mosquitoes. Previously, the mosquitoes had to be collected from volunteers to be studied, which is ethically questionable, especially during epidemics. Recent research also indicates this trap type may also have a use as a control tool; in a study in Cesena , Italy , the number of biting tiger mosquitoes was reduced in places where traps were installed. An amino acid substitution mutation – F1534C – is overwhelmingly the most common voltage-gated sodium channel in A. albopictus in Singapore . This channel being the target of pyrethroids , this is suspected to be a knockdown resistance ( kdr ) mutation, and that that is the reason for its prevalence. The control of Asian tiger mosquitoes begins with destroying the places where they lay their eggs, which are never far from where people are being bitten, since they are weak fliers, with only about a 180-metre (590 ft) lifetime flying radius. Puddles that last more than three days, sagging or plugged roof gutters, old tires holding water, litter, and any other possible containers or pools of standing water should be drained or removed. Bird baths, inlets to sewers and drainage systems holding stagnant water, flower pots, standing flower vases, knotholes, and other crevices that can collect water should be filled with sand or fine gravel to prevent mosquitoes from laying their eggs in them. [ citation needed ] Any standing water in pools, catchment basins, etc., that cannot be drained, or dumped, can be periodically treated with properly labeled insecticides or Bacillus thuringiensis israelensis (Bti), often formed into doughnut-shaped "mosquito dunks". Bti produces toxins which are effective in killing larvae of mosquitoes and certain other dipterans , while having almost no effect on other organisms. Bti preparations are readily available at farm, garden, and pool suppliers. [ citation needed ] Flowing water will not be a breeding spot, [ contradictory ] and water that contains minnows is not usually a problem, because the fish eat the mosquito larvae. [ citation needed ]Adult and nymphal dragonflies have been proposed as biological control of mosquito species. Dragonfly nymphs eat mosquito larvae, at least in laboratory conditions, though studies of wild dragonfly diets have not shown mosquitoes to be part of dragonfly nymph diets. A study of adult dragonfly diets in Europe showed that adult mosquitoes were not an important food source. In any case, an efficient surveillance is essential to monitor the presence of tiger mosquitoes and the effect of control programs. Ovitraps are normally used for the monitoring of Ae. albopictus . They are black water containers with floating Styrofoam blocks or small wooden paddles that are in contact with the surface of the water. Female tiger mosquitoes lay their eggs on these surfaces. Through the identification of these eggs or of the larvae that hatch from these eggs in the laboratory, the presence and abundance of mosquito species can be estimated. Versions of these traps with an adhesive film (sticky traps) that catch the egg-depositing mosquitoes make the analysis much easier and quicker, but are more complicated in terms of handling. The results of ovitraps are often variable and depend on the availability of alternative egg-depositing waters. Due to this, it is best to use them in large numbers and in conjunction with other monitoring methods. [ citation needed ] To date, few effective traps for adult Asian tiger mosquitoes are available. Those traps that catch other species of mosquitoes do not catch tiger mosquitoes efficiently. A form of an ovitrap called a lethal ovitrap mimics the breeding site for Ae. albopictus just like the monitoring tool, but it has the added benefit of containing chemicals that are toxic to the mosquitoes when they enter, but do not harm humans. These traps have had success in some countries to control Aedes mosquito populations. A new trap type has now been shown to catch significant numbers of Ae. albopictus . This device, with the help of a ventilator, produces an upward air current of ammonia , fatty acids , and lactic acids that takes a similar form and smell of a human body. With the addition of carbon dioxide , the efficacy of the trap is increased. This means a suitable tool is available for trapping adult tiger mosquitoes, and for example, examining the existence of viruses in the trapped mosquitoes. Previously, the mosquitoes had to be collected from volunteers to be studied, which is ethically questionable, especially during epidemics. Recent research also indicates this trap type may also have a use as a control tool; in a study in Cesena , Italy , the number of biting tiger mosquitoes was reduced in places where traps were installed. An amino acid substitution mutation – F1534C – is overwhelmingly the most common voltage-gated sodium channel in A. albopictus in Singapore . This channel being the target of pyrethroids , this is suspected to be a knockdown resistance ( kdr ) mutation, and that that is the reason for its prevalence. Although the Wolbachia infection is prevalent in arthropod species, especially the Asian tiger mosquito, it is a useful mechanism for inhibiting the spread of dengue . Ae. aegypti individuals, a close relative of Ae. albopictus , with an artificial Wolbachia infection, cannot transmit dengue, an infectious virus, but they can pass on the Wolbachia infection to other populations. This could lead to many more discoveries in disease control for Ae. albopictus and other mosquito species. In addition, due to the cytoplasmic incompatibility caused by Wolbachia , the artificial infection of males can serve as a biological control as they are unable to reproduce successfully with uninfected females (unidirectional CI). When artificially infected males are unable to reproduce, the population size can be controlled, thereby reducing the transmission of the harmful disease of interest. Artificial infection of males is achieved by the removal of cytoplasm from infected oocytes, which is then transferred into embryos prior to the blastoderm stage. [ citation needed ]

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History of Memphis, Tennessee

The history of Memphis, Tennessee and its area began many thousands of years ago with succeeding cultures of indigenous peoples. In the first millennium, it was settled by the Mississippian culture . The Chickasaw Indian tribe emerged about the 17th century, or migrated into the area. The earliest European exploration may have encountered remnants of the Mississippian culture by Spanish explorer Hernando de Soto . Later French explorers led by René-Robert Cavelier, Sieur de La Salle likely encountered the Chickasaw. The city of Memphis was not founded until 1819. The city was named after the ancient capital of Egypt on the Nile River in North Africa . It rapidly developed as a major trading center for cotton cultivated at the region's large plantations and dependent on the work of enslaved African Americans. In the 19th century, and especially 1878 and 1879, the city suffered severe yellow fever epidemics. In 1878 tens of thousands of residents fled and more than 5,000 died, with hundreds more dying in the next year's epidemic, causing the city to go bankrupt and give up its charter until 1893. In the early 20th century cotton was still a major commodity crop; Memphis grew into the world's largest spot cotton market and the world's largest hardwood lumber market. During the 1960s the city was at the center of civil rights actions, with a major strike by city sanitation workers in 1968. Having come to the city to support the workers, Rev. Martin Luther King Jr. was assassinated by a lone sniper on April 4, 1968, at the Lorraine Motel . Many notable blues musicians grew up in and around the Memphis and northern Mississippi area. These included musical artists such as Muddy Waters , Robert Johnson , B.B. King , Howlin' Wolf , Isaac Hayes , Young Dolph and Elvis Presley .From about 10,000 BCE , Paleo-Indians and later Archaic-Indians lived as communities of hunter-gatherers in the area that covers the modern-day southern United States. Approximately 800 CE to 1600 CE, the Mississippi River Delta was populated by tribes of the Mississippian culture , a mound-building Native American people who had developed in the late Woodland Indian period. The Tipton phase people were a local expression of the Mississippian culture. They inhabited the region of modern-day Tipton , Lauderdale and Shelby counties during the time of first contact with Europeans, at the arrival of the de Soto Expedition. By the end of the Mississippian period, the land was claimed and populated by the Chickasaw tribe . The exact origins of the Chickasaw are uncertain. Noted historian Horatio Cushman indicates that the Chickasaw, along with the Choctaw, may have had origins in present-day Mexico and migrated north. When Europeans first encountered them, the Chickasaw were living in villages in what is now Mississippi, with a smaller number in the area of Savannah Town, South Carolina . Twentieth-century scholar Patricia Galloway says that the Chickasaw may have been migrants to the area from the west and may not have been descendants of the pre-historic Mississippian culture . Their oral history supports this, indicating they moved along with the Choctaw from west of the Mississippi in pre-history. These people (the choctaw) are the only nation from whom I could learn any idea of a traditional account of a first origin; and that is their coming out of a hole in the ground, which they shew between their nation and the Chickasaws; they tell us also that their neighbours were surprised at seeing a people rise at once out of the earth." European exploration came years later, with Spanish explorer Hernando de Soto believed to have visited what is now the Memphis area as early as the 1540s. By the 1680s, French explorers led by René-Robert Cavelier, Sieur de La Salle built Fort Prudhomme in the vicinity, the first European settlement in what would become Memphis, predating Anglo-American settlement in East Tennessee by more than 70 years. Fort Assumption was a French fortification constructed in 1739 on the fourth Chickasaw Bluff on the Mississippi River by Jean-Baptiste Le Moyne, Sieur de Bienville 's French army. The fort was used as a base against the Chickasaw in the abortive Campaign of 1739 . Despite such early outposts, the land comprising present-day Memphis remained in a largely unorganized territory throughout most of the 18th century in terms of European settlement. The boundaries of what would become Tennessee continued to evolve from its parent — the Carolina Colony , later North Carolina and South Carolina . In 1796, the site became the westernmost point of the newly admitted "state" of Tennessee in the newly independent United States. However, West Tennessee was at that time occupied and historically controlled by the Chickasaw tribe, owned by possession and tribal rights. On April 3, 1790 promotion of a town at Chickasaw Bluffs was undertaken with leases offered by John Rice, Esq. of Cumberland or purchases to families that arrived at the landing near the mouth of the Big Hatcha-river. European exploration came years later, with Spanish explorer Hernando de Soto believed to have visited what is now the Memphis area as early as the 1540s. By the 1680s, French explorers led by René-Robert Cavelier, Sieur de La Salle built Fort Prudhomme in the vicinity, the first European settlement in what would become Memphis, predating Anglo-American settlement in East Tennessee by more than 70 years. Fort Assumption was a French fortification constructed in 1739 on the fourth Chickasaw Bluff on the Mississippi River by Jean-Baptiste Le Moyne, Sieur de Bienville 's French army. The fort was used as a base against the Chickasaw in the abortive Campaign of 1739 . Despite such early outposts, the land comprising present-day Memphis remained in a largely unorganized territory throughout most of the 18th century in terms of European settlement. The boundaries of what would become Tennessee continued to evolve from its parent — the Carolina Colony , later North Carolina and South Carolina . In 1796, the site became the westernmost point of the newly admitted "state" of Tennessee in the newly independent United States. However, West Tennessee was at that time occupied and historically controlled by the Chickasaw tribe, owned by possession and tribal rights. On April 3, 1790 promotion of a town at Chickasaw Bluffs was undertaken with leases offered by John Rice, Esq. of Cumberland or purchases to families that arrived at the landing near the mouth of the Big Hatcha-river. The area of West Tennessee became available for white settlement after the Federal Government purchased it from the Chickasaw Nation in the 1818 Jackson Purchase . Memphis was founded on May 22, 1819 by a group of investors, John Overton , James Winchester , and Andrew Jackson , and was incorporated as a city in 1826. The city was named after the ancient capital of Egypt on the Nile River , itself named Memphis in Greek after the Egyptian name Mennefer for the Pyramid complex of pharaoh Pepi I . The founders planned for a large city to be built on the site and laid out a plan featuring a regular grid of streets interrupted by four town squares, to be named Exchange, Market, Court, and Auction. Of these squares Market, Court, and Auction remain as public parks in downtown Memphis. The Exchange square site was developed in the 20th century as the Cook Convention Center. Memphis was a departure point on the Mississippi River for Native Americans removed in the 1830s from their historic lands to Indian Territory on the Trail of Tears . In 1831 French writer Alexis De Tocqueville witnessed "a numerous band of Choctaws " crossing the River at Memphis. The State of Mississippi insisted the boundary with the State of Tennessee be resurveyed with the object of some advocates being the capture of the young city of Memphis, but the new boundary proved Memphis was well outside the bounds. The city grew in the 19th century as a center for transporting, grading and marketing the growing volumes of cotton produced in the nearby Mississippi Delta (for background, see " King Cotton "). The cotton economy of the antebellum South depended on the forced labor of hundreds of thousands of African-American slaves , and Memphis became a major slave market. Prior to the Civil War, one quarter of the city's population were slaves. Seeking their freedom, many slaves turned to the Underground Railroad to escape to the free states of the North, and the Memphis home of Jacob Burkle was a way-station on their route to freedom. The Gayoso House Hotel was built overlooking the Mississippi River in 1842 and became a Memphis landmark; it stood until 1899, where it burned down. The original Gayoso House was a first-class hotel, designed by James H. Dakin , a well-known architect of that era, and was appointed with the latest conveniences, including indoor plumbing with marble tubs, silver faucets and flush toilets. In 1857 the Memphis & Charleston Railroad was completed, linking an Atlantic Ocean port and one on the Mississippi River. Memphis was one of the two eastern termini of the Butterfield Overland Mail stagecoach route to California from 1857 to 1861. Through the railroad, Memphis traders could export cotton through Charleston, South Carolina , to London and the European continent. Hopefield, Arkansas was founded by the Spanish Governor in 1795, across from Memphis near present-day West Memphis, Arkansas . Hopefield became the eastern terminal for the Memphis and Little Rock Railroad in 1857 and prospered until the Civil War. It was burned by Union forces in retaliation for Confederate Raids. Although Hopefield was rebuilt afterward, it was destroyed in a flood. The area of Crittenden County, Arkansas has been subject to some of the country's most disastrous floods, due to the Mississippi River backing into the St. Francis River . These frequent disasters have prevented much population growth on the Arkansas side. Because of its location on a bluff, Memphis was not subject to flooding. Randolph, Tennessee was founded in the 1820s at the second Chickasaw Bluff upriver of Memphis; for a time it was a major competitor to Memphis for commerce along the Mississippi River. However, Randolph gradually lost commerce and influence to Memphis, particularly after it was bypassed by railroad construction. At the time of the American Civil War , Memphis was already an important regional city because of its river trade and railroad connections, particularly the Memphis and Charleston Railroad , the only east–west rail link across the South. Tennessee seceded from the Union in June 1861 and Memphis briefly became a Confederate stronghold. Union forces moving down the Mississippi River captured Memphis from the Confederacy in the Battle of Memphis on June 6, 1862. The city remained under Union control for the duration of the war, except for a dramatic raid conducted by Nathan Bedford Forrest . During that time the Gayoso House Hotel was a Union headquarters. According to local legend, General Forrest's brother Captain William Forrest, an escort on the raid, rode his horse into the lobby seeking to capture a Union general. Memphis became a Union supply base and continued to prosper throughout the war. The city became a focus for illicit trade in raw cotton, which was in great demand by northern cotton mills because of the Union blockade and the Confederate embargo . In January 1863 Charles Dana , a special investigator for the Federal War Department , reported from Memphis that a "mania" for illicit cotton had "corrupted and demoralized" Union Army officers. Thousands of slaves with families fled from rural plantations to Union lines, and the Army established a contraband camp south of the city lines. By 1865 there were 20,000 blacks in the city, a sevenfold increase from the 3,000 before the war. The presence of black Union soldiers was resented by ethnic whites in the city; thousands of Irish had immigrated since the mid-19th century. In 1866 there was a major massacre with whites attacking blacks. Forty-five blacks were reported killed, and nearly twice as many wounded; much of their makeshift housing was destroyed. By 1870, the black population was 15,000 in a city total of 40,226. Memphis emerged from the Civil War undamaged from the fighting. On July 24, 1866, Tennessee was the first southern state to be re-admitted to the Union. The Memphis Cotton Exchange was founded in 1873 by a group of cotton traders led by Napoleon Hill . Hill became immensely wealthy with interests in wholesale groceries, railroads, steel and banking, as well as cotton, and was known to his contemporaries as "the merchant prince of Memphis." He built an ornate French Renaissance style mansion in Downtown Memphis. Extensive yellow fever epidemics in the 1870s (1873, 1878 and 1879) devastated the city. In 1873 some 2,000 people died, the highest fatalities of any inland city. Because of the severity of the 1873 epidemic, when yellow fever was diagnosed on August 5, 1878 , more than 25,000 people left the city within two weeks. Many moved permanently to other cities such as St. Louis and Atlanta. It was reported that such terror gripped the town in August 1878 that fleeing families "left their houses with the doors wide open and silver standing on the sideboards." The population had been roughly 50,000 before the start of the epidemic. Of the 19,000 who stayed in Memphis, 17,000 came down with yellow fever, and 5,150 died. At that time it was not known that this fatal disease was carried by mosquitoes, so public health measures were unsuccessful. Remaining in the city to care for the sick, a number of Catholic Franciscan Sisters of Mary , Episcopalian nuns of the Sisterhood of St. Mary and clergymen sacrificed themselves. An epidemic also broke out in 1879, in which several hundred people died. So many people died or fled the epidemics that in 1879 Memphis lost its city charter and went bankrupt. Until 1893 Memphis was governed by the state as a Taxing District. Robert R. Church, Sr. , a freedman who became known later as the South's first African-American millionaire (although his total wealth is believed to reach "only" $700,000), was the first citizen to buy a $1,000 bond to pay off the debt and help restore the city's charter. He built much of his wealth by having bought real estate when the city became depopulated after the epidemics. He founded the city's first black-owned bank, Solvent Savings Bank, ensuring that the black community could get loans to establish businesses and buy houses. Because of the drop in city population, blacks gained other opportunities. They were hired to the police force as patrolmen and retained positions in it until 1895, when imposed segregation forced them out. Under a commission form of government, the city made improvements in sanitation, particularly the construction of an innovative sewer system designed by George E. Waring Jr. Construction of the sewers began in January 1880, and by 1893 had expanded to over 50 miles of sewers. This removed the breeding grounds of the mosquito vector. It is likely that survivors' acquired immunity from the 1870s epidemics contributed more to lesser fatalities from the disease in future years. In 1887, a source of abundant and pure artesian water was found beneath the city, which guaranteed its water supply and aided its recovery. In 1892 the first Mississippi River bridge at Memphis opened. As a result, the city began to prosper again, and it regained its charter and home rule in 1893. African Americans in the city were closed out of many opportunities by the segregated school system, in which their facilities were underfunded, and disenfranchisement by state laws passed in the late 1880s, which resulted in their exclusion from voting and other participation in the political system. State law and local custom imposed a system of Jim Crow based on white supremacy , and in the late 1890s the police force was closed against blacks. In 1897 as a conspicuous claim to its revival, Memphis had a pyramid -shaped pavilion prominently displayed at the Tennessee Centennial exposition.The area of West Tennessee became available for white settlement after the Federal Government purchased it from the Chickasaw Nation in the 1818 Jackson Purchase . Memphis was founded on May 22, 1819 by a group of investors, John Overton , James Winchester , and Andrew Jackson , and was incorporated as a city in 1826. The city was named after the ancient capital of Egypt on the Nile River , itself named Memphis in Greek after the Egyptian name Mennefer for the Pyramid complex of pharaoh Pepi I . The founders planned for a large city to be built on the site and laid out a plan featuring a regular grid of streets interrupted by four town squares, to be named Exchange, Market, Court, and Auction. Of these squares Market, Court, and Auction remain as public parks in downtown Memphis. The Exchange square site was developed in the 20th century as the Cook Convention Center. Memphis was a departure point on the Mississippi River for Native Americans removed in the 1830s from their historic lands to Indian Territory on the Trail of Tears . In 1831 French writer Alexis De Tocqueville witnessed "a numerous band of Choctaws " crossing the River at Memphis. The State of Mississippi insisted the boundary with the State of Tennessee be resurveyed with the object of some advocates being the capture of the young city of Memphis, but the new boundary proved Memphis was well outside the bounds. The city grew in the 19th century as a center for transporting, grading and marketing the growing volumes of cotton produced in the nearby Mississippi Delta (for background, see " King Cotton "). The cotton economy of the antebellum South depended on the forced labor of hundreds of thousands of African-American slaves , and Memphis became a major slave market. Prior to the Civil War, one quarter of the city's population were slaves. Seeking their freedom, many slaves turned to the Underground Railroad to escape to the free states of the North, and the Memphis home of Jacob Burkle was a way-station on their route to freedom. The Gayoso House Hotel was built overlooking the Mississippi River in 1842 and became a Memphis landmark; it stood until 1899, where it burned down. The original Gayoso House was a first-class hotel, designed by James H. Dakin , a well-known architect of that era, and was appointed with the latest conveniences, including indoor plumbing with marble tubs, silver faucets and flush toilets. In 1857 the Memphis & Charleston Railroad was completed, linking an Atlantic Ocean port and one on the Mississippi River. Memphis was one of the two eastern termini of the Butterfield Overland Mail stagecoach route to California from 1857 to 1861. Through the railroad, Memphis traders could export cotton through Charleston, South Carolina , to London and the European continent.Hopefield, Arkansas was founded by the Spanish Governor in 1795, across from Memphis near present-day West Memphis, Arkansas . Hopefield became the eastern terminal for the Memphis and Little Rock Railroad in 1857 and prospered until the Civil War. It was burned by Union forces in retaliation for Confederate Raids. Although Hopefield was rebuilt afterward, it was destroyed in a flood. The area of Crittenden County, Arkansas has been subject to some of the country's most disastrous floods, due to the Mississippi River backing into the St. Francis River . These frequent disasters have prevented much population growth on the Arkansas side. Because of its location on a bluff, Memphis was not subject to flooding. Randolph, Tennessee was founded in the 1820s at the second Chickasaw Bluff upriver of Memphis; for a time it was a major competitor to Memphis for commerce along the Mississippi River. However, Randolph gradually lost commerce and influence to Memphis, particularly after it was bypassed by railroad construction.At the time of the American Civil War , Memphis was already an important regional city because of its river trade and railroad connections, particularly the Memphis and Charleston Railroad , the only east–west rail link across the South. Tennessee seceded from the Union in June 1861 and Memphis briefly became a Confederate stronghold. Union forces moving down the Mississippi River captured Memphis from the Confederacy in the Battle of Memphis on June 6, 1862. The city remained under Union control for the duration of the war, except for a dramatic raid conducted by Nathan Bedford Forrest . During that time the Gayoso House Hotel was a Union headquarters. According to local legend, General Forrest's brother Captain William Forrest, an escort on the raid, rode his horse into the lobby seeking to capture a Union general. Memphis became a Union supply base and continued to prosper throughout the war. The city became a focus for illicit trade in raw cotton, which was in great demand by northern cotton mills because of the Union blockade and the Confederate embargo . In January 1863 Charles Dana , a special investigator for the Federal War Department , reported from Memphis that a "mania" for illicit cotton had "corrupted and demoralized" Union Army officers. Thousands of slaves with families fled from rural plantations to Union lines, and the Army established a contraband camp south of the city lines. By 1865 there were 20,000 blacks in the city, a sevenfold increase from the 3,000 before the war. The presence of black Union soldiers was resented by ethnic whites in the city; thousands of Irish had immigrated since the mid-19th century. In 1866 there was a major massacre with whites attacking blacks. Forty-five blacks were reported killed, and nearly twice as many wounded; much of their makeshift housing was destroyed. By 1870, the black population was 15,000 in a city total of 40,226. Memphis emerged from the Civil War undamaged from the fighting. On July 24, 1866, Tennessee was the first southern state to be re-admitted to the Union. The Memphis Cotton Exchange was founded in 1873 by a group of cotton traders led by Napoleon Hill . Hill became immensely wealthy with interests in wholesale groceries, railroads, steel and banking, as well as cotton, and was known to his contemporaries as "the merchant prince of Memphis." He built an ornate French Renaissance style mansion in Downtown Memphis.Extensive yellow fever epidemics in the 1870s (1873, 1878 and 1879) devastated the city. In 1873 some 2,000 people died, the highest fatalities of any inland city. Because of the severity of the 1873 epidemic, when yellow fever was diagnosed on August 5, 1878 , more than 25,000 people left the city within two weeks. Many moved permanently to other cities such as St. Louis and Atlanta. It was reported that such terror gripped the town in August 1878 that fleeing families "left their houses with the doors wide open and silver standing on the sideboards." The population had been roughly 50,000 before the start of the epidemic. Of the 19,000 who stayed in Memphis, 17,000 came down with yellow fever, and 5,150 died. At that time it was not known that this fatal disease was carried by mosquitoes, so public health measures were unsuccessful. Remaining in the city to care for the sick, a number of Catholic Franciscan Sisters of Mary , Episcopalian nuns of the Sisterhood of St. Mary and clergymen sacrificed themselves. An epidemic also broke out in 1879, in which several hundred people died. So many people died or fled the epidemics that in 1879 Memphis lost its city charter and went bankrupt. Until 1893 Memphis was governed by the state as a Taxing District. Robert R. Church, Sr. , a freedman who became known later as the South's first African-American millionaire (although his total wealth is believed to reach "only" $700,000), was the first citizen to buy a $1,000 bond to pay off the debt and help restore the city's charter. He built much of his wealth by having bought real estate when the city became depopulated after the epidemics. He founded the city's first black-owned bank, Solvent Savings Bank, ensuring that the black community could get loans to establish businesses and buy houses. Because of the drop in city population, blacks gained other opportunities. They were hired to the police force as patrolmen and retained positions in it until 1895, when imposed segregation forced them out. Under a commission form of government, the city made improvements in sanitation, particularly the construction of an innovative sewer system designed by George E. Waring Jr. Construction of the sewers began in January 1880, and by 1893 had expanded to over 50 miles of sewers. This removed the breeding grounds of the mosquito vector. It is likely that survivors' acquired immunity from the 1870s epidemics contributed more to lesser fatalities from the disease in future years. In 1887, a source of abundant and pure artesian water was found beneath the city, which guaranteed its water supply and aided its recovery. In 1892 the first Mississippi River bridge at Memphis opened. As a result, the city began to prosper again, and it regained its charter and home rule in 1893. African Americans in the city were closed out of many opportunities by the segregated school system, in which their facilities were underfunded, and disenfranchisement by state laws passed in the late 1880s, which resulted in their exclusion from voting and other participation in the political system. State law and local custom imposed a system of Jim Crow based on white supremacy , and in the late 1890s the police force was closed against blacks. In 1897 as a conspicuous claim to its revival, Memphis had a pyramid -shaped pavilion prominently displayed at the Tennessee Centennial exposition.Memphis developed as the world's largest spot cotton market and the world's largest hardwood lumber market, both commodity products of the Mississippi Delta. Into the 1950s, it was the world's largest mule market. Attracting workers from rural areas as well as new immigrants, from 1900 to 1950 the city increased nearly fourfold in population, from 102,350 to 396,000 residents. Memphis developed an extensive network of parks and public works as part of the national City Beautiful Movement . The Memphis Park and Parkway System (including Overton Park and the later M.L. King Riverside Park) was designed as a comprehensive plan by landscape architect George Kessler at the beginning of the 20th century. Clarence Saunders , a Memphis inventor and entrepreneur, opened a self-service grocery store in 1916 and founded the first supermarket chain, Piggly Wiggly . Saunders, who became very wealthy from these ventures, lost his fortune on Wall Street and was forced to sell his partly completed Memphis mansion, dubbed the Pink Palace . The Pink Palace was adapted for use as the City's historical and natural history museum. Other parts of the Saunders estate were developed for upscale residences, known as Chickasaw Gardens . The storied Peabody Hotel opened in 1923 and became a symbol of upper-class Southern elegance. In 1935 Mississippi author David Cohn wrote, The Mississippi Delta begins in the lobby of the Peabody and ends on Catfish Row in Vicksburg. The Peabody is the Paris Ritz, the Cairo Shepheard's, the London Savoy of this section. If you stand near its fountain in the middle of the lobby, where ducks waddle and turtles drowse, ultimately you will see everybody who is anybody in the Delta. To the east of the city lay a large railroad yard, with tracks of four railroads of that era. While the railroads were integral to the city's commerce, by the late 1920s the yard had become a barrier to automobile traffic and, hence, to eastward expansion of the city. In 1927 - 1928 the "Poplar Boulevard Viaduct" was constructed to span the railyards and allow eastward expansion. The viaduct was a joint effort between the City of Memphis and the railroads. From the 1910s to the 1950s, Memphis was a locus of machine politics under the direction of E. H. "Boss" Crump , a Democrat. He obtained a state law in 1911 to establish a small commission to manage the city. The city retained a form of commission government until 1967 But Crump was in full control at all times, Using all the familiar techniques of the big city boss, who is willing to engage in ballot manipulation, patronage for friends, and frustrating bureaucratic obstacles for the opposition. Crump build a complex alliance with established power figures at the local state and national levels. He ensured the dissidents had little or no voice. At the center of his network was Cotton Row—The business elite that dominated the cotton industry. Second he included the modernizers, the business-oriented progressives who were most concerned with upgrading the infrastructure in terms of the waterfront, parks, highways and skyscrapers, as well as a moderately good school system. Working-class whites got their share of jobs. AFL labor unions were of marginal influence; CIO unions were not tolerated. Roger Biles argues that the political system was virtually unchanged from 1910 into the 1950s and 1960s, thanks to Crump's wire-pulling. Crump Was the leading Tennessee supporter of Franklin Roosevelt and the New Deal . In turn the city received ample relief programs – which provided jobs for the unemployed, as selected by local machine lieutenants. As well the city was provided with major federal building projects, which helped fund the business community. Crump incorporated the black leadership in his outer circle, dispensing patronage in return for the black vote. Memphis was one of the largest southern cities in which blacks could vote, but segregation was as rigid as anywhere. Crump successfully lobbied Washington for large-scale public housing projects. The city installed a revolutionary sewer system and upgraded sanitation and drainage to prevent another epidemic. Pure water from an artesian well was discovered in the 1880s, securing the city's water supply. The commissioners developed an extensive network of parks and public works as part of the national City Beautiful movement , but did not encourage heavy industry, which might have provided substantial employment for the white working-class population. The lack of representation in city government resulted in the poor and minorities being underrepresented. The majority controlled the election of all the at-large positions. During the Second World War , the War Department constructed large supply depots in Memphis for the Army and the Army Air Force . The Memphis Army Depot also served as a prisoner-of-war camp, housing 800 Axis prisoners. By the time it closed in 1997, the Memphis Army Depot had 130 buildings on site with more than 4,000,000 square feet (370,000 m 2 ) of enclosed industrial space. Meanwhile, in 1942, the US Navy built the Millington Naval Air Station (now the Naval Support Activity Mid-South ) in Millington, Tennessee , just north of Memphis. This 3,500-acre (14 km 2 ) facility provided pilot training during World War II, and later became the major naval air technical training center for enlisted personnel aviation specialty training. It is currently used as a naval personnel center and Headquarters for the US Army Corps of Engineers Finance Center. Its flight facilities have been transferred to civilian use as the Millington Regional Jetport . The first national motel chain, Holiday Inn , was founded in Memphis by Kemmons Wilson in 1952. His first inn was located in Berclair near the city limit on Summer Avenue, then the main highway to Nashville, Tennessee . In 1970, the Census Bureau reported Memphis' population as 60.8% white and 38.9% black. Suburbanization was attracting wealthier residents to newer housing outside the city. After the riots and court-ordered busing in 1973 to achieve desegregation of public schools, "about 40,000 of the system's 71,000 white students abandon[ed] the system in four years." The city now has a majority-black population; the larger metropolitan area is narrowly majority white. Memphis is well known for its cultural contributions to the identity of the American South . Many renowned musicians grew up in and around Memphis and moved to Chicago and other areas from the Mississippi Delta , carrying their music with them to influence other cities and listeners over radio airwaves. These included such musical greats as Elvis Presley , Jerry Lee Lewis , Muddy Waters , Carl Perkins , Johnny Cash , Robert Johnson , W. C. Handy , B.B. King , Howlin' Wolf , Isaac Hayes , Booker T. Jones , Eric Gales , Al Green , Alex Chilton , Justin Timberlake , Three 6 Mafia , the Sylvers , Jay Reatard , Zach Myers , and many others. Aretha Franklin was born in Memphis. At the start of the 1950s, Memphis was a compact city with limited boundaries, compared to the sprawl seen today. The southern boundary of the city was an irregular line starting on the Mississippi opposite President's Island , about two miles (3 km) north of Nonconnah Creek. The northern boundary was close to Chelsea Avenue, not much south of the Wolf River but with an unpopulated wetland area beyond the city before reaching the Wolf River. The Eastern Boundary of the city was near Highland Street. By the mid-1950s, Memphis stretched southward to the Mississippi State Line, but only directly south of President's Island. Such communities as West Junction , Nonconnah , Raines and Oakville still remained beyond the city boundaries, with the southern city line running on the north side of Nonconnah Creek . On the east, most of White Station, Tennessee had been annexed. The Northern boundary of Memphis was the Wolf River. By the mid-1960s, Memphis had annexed Frayser, Tennessee on the north side of the Wolf River. It had also annexed Berclair, Tennessee and all of White Station on its eastern border, extending south-westward along Poplar Avenue, past the recently built freeway that is today designated I-240, and bordering on Germantown, Tennessee , Memphis' current eastern limit. During the 1960s, the city was a center of activity during the Civil Rights Movement , as its large African-American population had been affected by state segregation practices and disenfranchisement in the early 20th century. African-American residents drew from the civil rights movement to improve their lives. In 1968, the Memphis sanitation strike began for living wages and better working conditions; the workers were overwhelmingly African American. They marched to gain public awareness and support for their plight: the danger of their work, and the struggles to support families with their low pay. Their drive for better pay had been met with resistance by the city government. Rev. Martin Luther King Jr. of the Southern Christian Leadership Conference , known for his leadership in the non-violent movement, came to lend his support to the workers' cause. He stayed at the Lorraine Motel in the city, where he was assassinated by a sniper on April 4, 1968, the day after giving his prophetic " I've Been to the Mountaintop " speech at the Mason Temple . Grief-stricken and enraged after learning of King's murder, some in the city rioted, looting and destroying businesses and other facilities, some by arson. The governor ordered Tennessee National Guardsmen into the city within hours, where small, roving bands of rioters continued to be active. Fearing the violence, more of the middle-class began to leave the city for the suburbs. The entertainer and philanthropist Danny Thomas helped open St. Jude Children's Research Hospital in downtown Memphis in 1962. St. Jude specializes in the study and treatment of catastrophic diseases affecting children, especially leukemia and other childhood cancers, AIDS, sickle cell disease , and inherited immune disorders . Its success rates and free treatment for its patients have made it one of the most reputable children's hospitals in the world. FedEx Corporation (originally, Federal Express ) was founded in Little Rock, Arkansas in 1971, but moved its operations to Memphis in 1973 to take advantage of its more extensive airport facilities. As Memphis developed as the major hub of operations for FedEx, the Memphis International Airport became the largest airfreight terminal in the world. In 1974 Harold Ford, Sr. of Memphis was elected to Congress, becoming the first black elected national official from Tennessee; he was re-elected for several terms. He was one of several Ford brothers who became active in politics in Memphis, Shelby County and the state; his son Harold Ford Jr. also became a Congressman. In 1991 the city of Memphis elected its first African-American mayor, Dr. W.W. Herenton . On December 23, 1988, a tanker truck hauling liquefied propane crashed at the I-40/I-240 interchange in Midtown and exploded , starting multiple vehicle and structural fires. The tank was the propelled 125 yards (114 m) from the crash site into a nearby duplex apartment. Nine people were killed and ten were injured. It was one of the deadliest motor vehicle accidents in state history and eventually led to the reconstruction of the interchange where it occurred. Memphis developed as the world's largest spot cotton market and the world's largest hardwood lumber market, both commodity products of the Mississippi Delta. Into the 1950s, it was the world's largest mule market. Attracting workers from rural areas as well as new immigrants, from 1900 to 1950 the city increased nearly fourfold in population, from 102,350 to 396,000 residents. Memphis developed an extensive network of parks and public works as part of the national City Beautiful Movement . The Memphis Park and Parkway System (including Overton Park and the later M.L. King Riverside Park) was designed as a comprehensive plan by landscape architect George Kessler at the beginning of the 20th century. Clarence Saunders , a Memphis inventor and entrepreneur, opened a self-service grocery store in 1916 and founded the first supermarket chain, Piggly Wiggly . Saunders, who became very wealthy from these ventures, lost his fortune on Wall Street and was forced to sell his partly completed Memphis mansion, dubbed the Pink Palace . The Pink Palace was adapted for use as the City's historical and natural history museum. Other parts of the Saunders estate were developed for upscale residences, known as Chickasaw Gardens . The storied Peabody Hotel opened in 1923 and became a symbol of upper-class Southern elegance. In 1935 Mississippi author David Cohn wrote, The Mississippi Delta begins in the lobby of the Peabody and ends on Catfish Row in Vicksburg. The Peabody is the Paris Ritz, the Cairo Shepheard's, the London Savoy of this section. If you stand near its fountain in the middle of the lobby, where ducks waddle and turtles drowse, ultimately you will see everybody who is anybody in the Delta. To the east of the city lay a large railroad yard, with tracks of four railroads of that era. While the railroads were integral to the city's commerce, by the late 1920s the yard had become a barrier to automobile traffic and, hence, to eastward expansion of the city. In 1927 - 1928 the "Poplar Boulevard Viaduct" was constructed to span the railyards and allow eastward expansion. The viaduct was a joint effort between the City of Memphis and the railroads. From the 1910s to the 1950s, Memphis was a locus of machine politics under the direction of E. H. "Boss" Crump , a Democrat. He obtained a state law in 1911 to establish a small commission to manage the city. The city retained a form of commission government until 1967 But Crump was in full control at all times, Using all the familiar techniques of the big city boss, who is willing to engage in ballot manipulation, patronage for friends, and frustrating bureaucratic obstacles for the opposition. Crump build a complex alliance with established power figures at the local state and national levels. He ensured the dissidents had little or no voice. At the center of his network was Cotton Row—The business elite that dominated the cotton industry. Second he included the modernizers, the business-oriented progressives who were most concerned with upgrading the infrastructure in terms of the waterfront, parks, highways and skyscrapers, as well as a moderately good school system. Working-class whites got their share of jobs. AFL labor unions were of marginal influence; CIO unions were not tolerated. Roger Biles argues that the political system was virtually unchanged from 1910 into the 1950s and 1960s, thanks to Crump's wire-pulling. Crump Was the leading Tennessee supporter of Franklin Roosevelt and the New Deal . In turn the city received ample relief programs – which provided jobs for the unemployed, as selected by local machine lieutenants. As well the city was provided with major federal building projects, which helped fund the business community. Crump incorporated the black leadership in his outer circle, dispensing patronage in return for the black vote. Memphis was one of the largest southern cities in which blacks could vote, but segregation was as rigid as anywhere. Crump successfully lobbied Washington for large-scale public housing projects. The city installed a revolutionary sewer system and upgraded sanitation and drainage to prevent another epidemic. Pure water from an artesian well was discovered in the 1880s, securing the city's water supply. The commissioners developed an extensive network of parks and public works as part of the national City Beautiful movement , but did not encourage heavy industry, which might have provided substantial employment for the white working-class population. The lack of representation in city government resulted in the poor and minorities being underrepresented. The majority controlled the election of all the at-large positions. During the Second World War , the War Department constructed large supply depots in Memphis for the Army and the Army Air Force . The Memphis Army Depot also served as a prisoner-of-war camp, housing 800 Axis prisoners. By the time it closed in 1997, the Memphis Army Depot had 130 buildings on site with more than 4,000,000 square feet (370,000 m 2 ) of enclosed industrial space. Meanwhile, in 1942, the US Navy built the Millington Naval Air Station (now the Naval Support Activity Mid-South ) in Millington, Tennessee , just north of Memphis. This 3,500-acre (14 km 2 ) facility provided pilot training during World War II, and later became the major naval air technical training center for enlisted personnel aviation specialty training. It is currently used as a naval personnel center and Headquarters for the US Army Corps of Engineers Finance Center. Its flight facilities have been transferred to civilian use as the Millington Regional Jetport . The first national motel chain, Holiday Inn , was founded in Memphis by Kemmons Wilson in 1952. His first inn was located in Berclair near the city limit on Summer Avenue, then the main highway to Nashville, Tennessee . In 1970, the Census Bureau reported Memphis' population as 60.8% white and 38.9% black. Suburbanization was attracting wealthier residents to newer housing outside the city. After the riots and court-ordered busing in 1973 to achieve desegregation of public schools, "about 40,000 of the system's 71,000 white students abandon[ed] the system in four years." The city now has a majority-black population; the larger metropolitan area is narrowly majority white. Memphis is well known for its cultural contributions to the identity of the American South . Many renowned musicians grew up in and around Memphis and moved to Chicago and other areas from the Mississippi Delta , carrying their music with them to influence other cities and listeners over radio airwaves. These included such musical greats as Elvis Presley , Jerry Lee Lewis , Muddy Waters , Carl Perkins , Johnny Cash , Robert Johnson , W. C. Handy , B.B. King , Howlin' Wolf , Isaac Hayes , Booker T. Jones , Eric Gales , Al Green , Alex Chilton , Justin Timberlake , Three 6 Mafia , the Sylvers , Jay Reatard , Zach Myers , and many others. Aretha Franklin was born in Memphis. At the start of the 1950s, Memphis was a compact city with limited boundaries, compared to the sprawl seen today. The southern boundary of the city was an irregular line starting on the Mississippi opposite President's Island , about two miles (3 km) north of Nonconnah Creek. The northern boundary was close to Chelsea Avenue, not much south of the Wolf River but with an unpopulated wetland area beyond the city before reaching the Wolf River. The Eastern Boundary of the city was near Highland Street. By the mid-1950s, Memphis stretched southward to the Mississippi State Line, but only directly south of President's Island. Such communities as West Junction , Nonconnah , Raines and Oakville still remained beyond the city boundaries, with the southern city line running on the north side of Nonconnah Creek . On the east, most of White Station, Tennessee had been annexed. The Northern boundary of Memphis was the Wolf River. By the mid-1960s, Memphis had annexed Frayser, Tennessee on the north side of the Wolf River. It had also annexed Berclair, Tennessee and all of White Station on its eastern border, extending south-westward along Poplar Avenue, past the recently built freeway that is today designated I-240, and bordering on Germantown, Tennessee , Memphis' current eastern limit. At the start of the 1950s, Memphis was a compact city with limited boundaries, compared to the sprawl seen today. The southern boundary of the city was an irregular line starting on the Mississippi opposite President's Island , about two miles (3 km) north of Nonconnah Creek. The northern boundary was close to Chelsea Avenue, not much south of the Wolf River but with an unpopulated wetland area beyond the city before reaching the Wolf River. The Eastern Boundary of the city was near Highland Street. By the mid-1950s, Memphis stretched southward to the Mississippi State Line, but only directly south of President's Island. Such communities as West Junction , Nonconnah , Raines and Oakville still remained beyond the city boundaries, with the southern city line running on the north side of Nonconnah Creek . On the east, most of White Station, Tennessee had been annexed. The Northern boundary of Memphis was the Wolf River. By the mid-1960s, Memphis had annexed Frayser, Tennessee on the north side of the Wolf River. It had also annexed Berclair, Tennessee and all of White Station on its eastern border, extending south-westward along Poplar Avenue, past the recently built freeway that is today designated I-240, and bordering on Germantown, Tennessee , Memphis' current eastern limit. During the 1960s, the city was a center of activity during the Civil Rights Movement , as its large African-American population had been affected by state segregation practices and disenfranchisement in the early 20th century. African-American residents drew from the civil rights movement to improve their lives. In 1968, the Memphis sanitation strike began for living wages and better working conditions; the workers were overwhelmingly African American. They marched to gain public awareness and support for their plight: the danger of their work, and the struggles to support families with their low pay. Their drive for better pay had been met with resistance by the city government. Rev. Martin Luther King Jr. of the Southern Christian Leadership Conference , known for his leadership in the non-violent movement, came to lend his support to the workers' cause. He stayed at the Lorraine Motel in the city, where he was assassinated by a sniper on April 4, 1968, the day after giving his prophetic " I've Been to the Mountaintop " speech at the Mason Temple . Grief-stricken and enraged after learning of King's murder, some in the city rioted, looting and destroying businesses and other facilities, some by arson. The governor ordered Tennessee National Guardsmen into the city within hours, where small, roving bands of rioters continued to be active. Fearing the violence, more of the middle-class began to leave the city for the suburbs.The entertainer and philanthropist Danny Thomas helped open St. Jude Children's Research Hospital in downtown Memphis in 1962. St. Jude specializes in the study and treatment of catastrophic diseases affecting children, especially leukemia and other childhood cancers, AIDS, sickle cell disease , and inherited immune disorders . Its success rates and free treatment for its patients have made it one of the most reputable children's hospitals in the world. FedEx Corporation (originally, Federal Express ) was founded in Little Rock, Arkansas in 1971, but moved its operations to Memphis in 1973 to take advantage of its more extensive airport facilities. As Memphis developed as the major hub of operations for FedEx, the Memphis International Airport became the largest airfreight terminal in the world. In 1974 Harold Ford, Sr. of Memphis was elected to Congress, becoming the first black elected national official from Tennessee; he was re-elected for several terms. He was one of several Ford brothers who became active in politics in Memphis, Shelby County and the state; his son Harold Ford Jr. also became a Congressman. In 1991 the city of Memphis elected its first African-American mayor, Dr. W.W. Herenton . On December 23, 1988, a tanker truck hauling liquefied propane crashed at the I-40/I-240 interchange in Midtown and exploded , starting multiple vehicle and structural fires. The tank was the propelled 125 yards (114 m) from the crash site into a nearby duplex apartment. Nine people were killed and ten were injured. It was one of the deadliest motor vehicle accidents in state history and eventually led to the reconstruction of the interchange where it occurred. Memphis is well known for its cultural contributions to the identity of the American south . Col. Henry Van Pelt began publishing The Appeal newspaper, ancestor of today's Commercial Appeal , in a wooden shack along the Wolf River in 1841. A pro-Confederacy newspaper, The Appeal moved frequently during the Civil War to avoid capture by Union forces. The Commercial Appeal was awarded a Pulitzer Prize in 1923 for its coverage of, and editorial opposition to, the activities of the Ku Klux Klan , which was at a peak in urban areas following the Klan's revival in 1915. From the earliest days of the steamboat , through the present day, Memphis has been a major center of river transportation. Passenger steamers linked Memphis with river ports up and down the Mississippi , Ohio and Missouri Rivers as late as the 1920s. Tom Lee Park on the Memphis riverfront is named for an African-American riverworker who became a civic hero. Tom Lee could not swim. But, he single-handedly rescued thirty-two people from drowning when the steamer M.E. Norman sank in 1925. Today, Memphis Riverboats offers tourist excursions from the Memphis waterfront on paddlewheel steamers. Beginning in the early 20th century, Memphis became famous for its innovative strains of African-American music, including gospel , blues , jazz , soul , and Rhythm and Blues genres, a tradition that continues to this day. Many notable blues musicians grew up in and around the Memphis and northern Mississippi, and performed there regularly. These included such musical greats as Muddy Waters , Robert Johnson , B.B. King , and Howlin' Wolf . Stax Records , which opened in Memphis in 1957, produced almost exclusively African-American music. Stax was a major factor in the creation of the Southern soul and Memphis soul music styles, also releasing gospel, funk, jazz, and blues recordings. Stax recordings and artists included Rufus and Carla Thomas , Sam and Dave , Otis Redding , William Bell , The Bar-Kays and their house band, Booker T. & the MG's . Several Stax hits were written and produced by the team of Isaac Hayes and David Porter . In 1950, Sam Phillips opened the "Memphis Recording Service," where he recorded for his Sun Records label. B.B. King , Howlin' Wolf , Elvis Presley , Johnny Cash , Jerry Lee Lewis , Carl Perkins , and Roy Orbison were all recorded there in its early years. The young Elvis Presley frequently listened to gospel and soul music, and many of his early recordings were inspired or written by African-American composers and recording artists in the Mid-South area. The first African American-formatted radio station, WDIA , was founded in the city in 1947 by Bert Ferguson and John Pepper. A young B. B. King worked there as a disc jockey. B. B. King's moniker was derived from his WDIA nickname, "Beale Street Blues Boy", a reference to Memphis' Beale Street on which many nightclubs and blues venues were located. WHER , the first all-female station ("All-Girl Radio"), was founded in 1955 by the recording studio owner Sam Phillips and Holiday Inn founder Kemmons Wilson . In addition to a rich musical heritage, Memphis also boasts a long culinary legacy dominated by regional barbecue . Memphis barbecue is rendered distinct by its sole usage of pork (as opposed to beef), focus on rib and shoulder cuts of meat, and multiple locally owned barbecue restaurants. Celebration of this local culinary tradition reaches its climax each year in May, when the Memphis in May Festival holds its annual World-Championship Barbecue Cooking Contest . Downtown Memphis is the oldest section of the city, built on a bluff overlooking the Mississippi River . Downtown includes the old central business and government districts. Beale Street and the Lorraine Motel (now preserved and operating as the National Civil Rights Museum , where Martin Luther King Jr. was assassinated on April 4, 1968) are located in the Downtown area. The Pinch District or just The Pinch is an area of Uptown, Memphis that played an important role in local immigration patterns beginning in the early 19th century. Memphis' first business district, the Pinch encompassed all of Memphis north of Adams Street, from the River to Third Street. The name was originally a term of derision, referring to emaciated Irish immigrants who fled the Great Famine . Later, Italian, Russian, Greek and, especially, Jewish immigrants also called it home before migrating to more affluent sections of the city. Victorian Village is a series of grand Victorian-era mansions built just east of Downtown Memphis in what was then the outskirts of the city. Several of these homes have been opened to the public for tours. Orange Mound was the first African-American neighborhood in the United States to be built by and for African Americans. Orange Mound was developed on the grounds of a former plantation beginning in the 1890s; it provided affordable land and residences for the less affluent. The neighborhood provided a refuge for blacks moving to the city for the first time from the rural South. Orange Mound residents largely owned their own homes and enjoyed a strong sense of community and identity. Midtown, Memphis , a very diverse area in the center of the city, has buildings largely dating from the first half of the 20th century. Midtown is Memphis' most ethnically and culturally diverse area. Many educational and cultural institutions are located in Midtown, including the University of Tennessee Health Science Center , Rhodes College , the Memphis Brooks Museum of Art , the Memphis Zoo , and the Memphis College of Art . Evergreen Historic District , one of Memphis' oldest residential districts, is located in Midtown. Tennessee Williams wrote his first produced play, Cairo, Shanghai, Bombay! at the Midtown home of his grandparents in 1935. It was performed by a Midtown Memphis amateur theater group that year.From the earliest days of the steamboat , through the present day, Memphis has been a major center of river transportation. Passenger steamers linked Memphis with river ports up and down the Mississippi , Ohio and Missouri Rivers as late as the 1920s. Tom Lee Park on the Memphis riverfront is named for an African-American riverworker who became a civic hero. Tom Lee could not swim. But, he single-handedly rescued thirty-two people from drowning when the steamer M.E. Norman sank in 1925. Today, Memphis Riverboats offers tourist excursions from the Memphis waterfront on paddlewheel steamers.Beginning in the early 20th century, Memphis became famous for its innovative strains of African-American music, including gospel , blues , jazz , soul , and Rhythm and Blues genres, a tradition that continues to this day. Many notable blues musicians grew up in and around the Memphis and northern Mississippi, and performed there regularly. These included such musical greats as Muddy Waters , Robert Johnson , B.B. King , and Howlin' Wolf . Stax Records , which opened in Memphis in 1957, produced almost exclusively African-American music. Stax was a major factor in the creation of the Southern soul and Memphis soul music styles, also releasing gospel, funk, jazz, and blues recordings. Stax recordings and artists included Rufus and Carla Thomas , Sam and Dave , Otis Redding , William Bell , The Bar-Kays and their house band, Booker T. & the MG's . Several Stax hits were written and produced by the team of Isaac Hayes and David Porter .In 1950, Sam Phillips opened the "Memphis Recording Service," where he recorded for his Sun Records label. B.B. King , Howlin' Wolf , Elvis Presley , Johnny Cash , Jerry Lee Lewis , Carl Perkins , and Roy Orbison were all recorded there in its early years. The young Elvis Presley frequently listened to gospel and soul music, and many of his early recordings were inspired or written by African-American composers and recording artists in the Mid-South area. The first African American-formatted radio station, WDIA , was founded in the city in 1947 by Bert Ferguson and John Pepper. A young B. B. King worked there as a disc jockey. B. B. King's moniker was derived from his WDIA nickname, "Beale Street Blues Boy", a reference to Memphis' Beale Street on which many nightclubs and blues venues were located. WHER , the first all-female station ("All-Girl Radio"), was founded in 1955 by the recording studio owner Sam Phillips and Holiday Inn founder Kemmons Wilson .In addition to a rich musical heritage, Memphis also boasts a long culinary legacy dominated by regional barbecue . Memphis barbecue is rendered distinct by its sole usage of pork (as opposed to beef), focus on rib and shoulder cuts of meat, and multiple locally owned barbecue restaurants. Celebration of this local culinary tradition reaches its climax each year in May, when the Memphis in May Festival holds its annual World-Championship Barbecue Cooking Contest .Downtown Memphis is the oldest section of the city, built on a bluff overlooking the Mississippi River . Downtown includes the old central business and government districts. Beale Street and the Lorraine Motel (now preserved and operating as the National Civil Rights Museum , where Martin Luther King Jr. was assassinated on April 4, 1968) are located in the Downtown area. The Pinch District or just The Pinch is an area of Uptown, Memphis that played an important role in local immigration patterns beginning in the early 19th century. Memphis' first business district, the Pinch encompassed all of Memphis north of Adams Street, from the River to Third Street. The name was originally a term of derision, referring to emaciated Irish immigrants who fled the Great Famine . Later, Italian, Russian, Greek and, especially, Jewish immigrants also called it home before migrating to more affluent sections of the city. Victorian Village is a series of grand Victorian-era mansions built just east of Downtown Memphis in what was then the outskirts of the city. Several of these homes have been opened to the public for tours. Orange Mound was the first African-American neighborhood in the United States to be built by and for African Americans. Orange Mound was developed on the grounds of a former plantation beginning in the 1890s; it provided affordable land and residences for the less affluent. The neighborhood provided a refuge for blacks moving to the city for the first time from the rural South. Orange Mound residents largely owned their own homes and enjoyed a strong sense of community and identity. Midtown, Memphis , a very diverse area in the center of the city, has buildings largely dating from the first half of the 20th century. Midtown is Memphis' most ethnically and culturally diverse area. Many educational and cultural institutions are located in Midtown, including the University of Tennessee Health Science Center , Rhodes College , the Memphis Brooks Museum of Art , the Memphis Zoo , and the Memphis College of Art . Evergreen Historic District , one of Memphis' oldest residential districts, is located in Midtown. Tennessee Williams wrote his first produced play, Cairo, Shanghai, Bombay! at the Midtown home of his grandparents in 1935. It was performed by a Midtown Memphis amateur theater group that year.The first Memphis schools were chartered in 1826, but until 1848 all Memphis schools were private. During this time the Memphis City Schools was formed in the early 1830s. [ citation needed ] The first "free" public schools opened in 1848, but at first nominally charged a $2 tuition. By 1852, there were 13 public schools supported by taxpayers. The first city school for black students opened in 1868 during Reconstruction, when the biracial state legislature founded public education. For a century the city maintained separate, racially segregated school facilities. Memphis City Schools began desegregation in the late 1950s, but progress was slow. [ citation needed ] A federal court order in 1973 required the city to provide busing to fully integrate the schools. This order was so unpopular with white families that within four years, 40,000 white students were pulled out of the public system, which effect many white families to move out of the city. Within a short time other white families enrolled their children in private schools, some founded at this time as " segregation academies ". The University of Tennessee College of Dentistry was founded in 1878, making it the oldest dental college in the South, and the third-oldest public college of dentistry in the United States. The University of Tennessee College of Medicine in Memphis was created in 1911 through the merger of five independent Tennessee medical schools following the influential Flexner Report . The University of Memphis first opened as the West Tennessee State Normal School in 1912. Christian Brothers University was founded in 1871, first on Adams Street downtown before moving to its current location on East Parkway. Rhodes College , then known as Southwestern at Memphis , moved to Memphis from Clarksville, Tennessee in 1925. LeMoyne-Owen College a private, historically black, church-affiliated college traces its history to 1862 when the American Missionary Association (AMA) opened an elementary school for freedmen and escaped slaves. The Memphis and Shelby County Room in the Benjamin L. Hooks Central Library provides facilities for researchers to view items from the library's archives and its manuscript collections. These include historical records of people and families, maps, photographs, newspaper vertical files, books, city directories, and music and video recordings. These materials document the development of the community, government, economy, culture, and heritage of Memphis and Shelby County, Tennessee. The Genealogy Collection includes microfilmed and indexed Memphis and Shelby County records. The Tennessee Genealogical Society maintains a Regional History and Genealogy Center Library in suburban Germantown, TN . The Shelby County Register of Deeds website has many important records available on-line, including real estate transactions, court cases and vital records.

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Yellow fever

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Free African Society

The Free African Society ( FAS ), founded in 1787, was a benevolent organization that held religious services and provided mutual aid for "free Africans and their descendants" in Philadelphia . The Society was founded by Richard Allen and Absalom Jones . It was the first Black religious institution in the city and led to the establishment of the first independent Black churches in the United States. Founding members, all free Black men, included Samuel Baston, Joseph Johnson, Cato Freedman, Caesar Cranchell, James Potter and William White. Notable members included African-American abolitionists such as Cyrus Bustill , James Forten , and William Gray. The Free African Society (FAS) developed as part of the rise in civic organizing following American independence in the 1776 to 1783 Revolutionary War; it was the first black mutual aid society in Philadelphia. The city was a growing center of free blacks, attracted to its jobs and other opportunities. By 1790, the city had 2,000 free black residents, a number that continued to increase. In the first two decades after the war, inspired by revolutionary ideals, many slaveholders freed their slaves, especially in the Upper South . Northern states largely abolished slavery. Numerous freedmen migrated to Philadelphia from rural areas of Pennsylvania and the South; it was a growing center of free black society. In addition, their number 69 was increased by free people of color who were refugees from the Haitian Revolution in Saint-Domingue , as well as fugitive slaves escaping from the South. The FAS was founded in the spring of 1787 in Philadelphia, shortly before the Constitutional Convention was held in the city. Richard Allen , a Methodist preacher, and Absalom Jones rejected the second-class status blacks were forced into at their white-dominated Methodist church. As their numbers had increased, the church congregation had built a gallery where it asked them to sit separately from the white congregation. The men and their supporters wanted to create an independent group to meet African-American needs. They designed the Free African Society as a mutual aid society to help support widows and orphans, as well as the sick or unemployed. They supported the education of children, or arranged apprenticeships if the children could not attend one of the free schools that were developed. The FAS provided social and economic guidance, and medical care. It also helped new citizens establish their new sense of self-determination. While teaching thriftiness and how to save to build wealth, it became the model for banks in the African-American community. It sought to improve the morals of its members by regulating marriages, condemning drunkenness and adultery. Working with the city, it acquired land at Potter's Field for a burying ground; it began to perform and record marriages and also to record births for the people of its community. To encourage responsibility and create a common aid fund, the FAS asked members to pay dues of one shilling per month. If they failed to pay dues for three months, they were cut off from the society, no longer able to share in its benefits. The dues collected were the fund for the community service projects that the FAS organized. Among these was a food program to help support the community's poor and widowed.In aid to the sick, the FAS became famous for its members' charitable work as nurses and aides during the Yellow Fever Epidemic of 1793 , when many residents abandoned the city. The doctor Benjamin Rush believed African Americans were immune to the disease. He wrote an open letter in the newspaper, under the pseudonym of a well-known Quaker who helped educate blacks, and appealed to blacks to aid others in the city during the epidemic. Allen and Jones decided to respond, together with other members of the FAS who served both black and white residents as nurses and aides during those terrible months. After all their work, Allen and Jones wrote a memoir about the events, which they published the following year, A Narrative of the Proceedings of the Black People during the late awful calamity ... They were trying to set the record straight and defend themselves against an accusatory pamphlet published by Mathew Carey , after he had fled the city for much of September 1793. He accused blacks of charging high prices for nursing, taking advantage of whites, and even of stealing from them during the epidemic. His pamphlet was entitled A Short Account of the Malignant Fever (1793). Allen and Jones noted that it was whites who charged high rates for nursing during the crisis. Many members who wanted more religious affiliation followed Absalom Jones when he founded African Episcopal Church of St. Thomas . It opened its doors in 1794 as the firs.E. Church|Bethel African Methodist Episcopal Church]] (AME Church). In 1803, Cyrus Bustill opened a school for black children in his home, and a year later, Absalom Jones opened another school. By 1837, with financial help from the Quakers and the Pennsylvania Abolition Society , ten private schools for blacks were operating in Philadelphia.PREAMBLE OF THE FREE AFRICAN SOCIETY Philadelphia [12th, 4th mo., 1778]-- Whereas, Absalom Jones and Richard Allen, two men of the African race, who, for their religious life and conversation have obtained a good report among men, these persons, from a love to the people of their complexion whom they beheld with sorrow, because of their irreligious and uncivilized state, often communed together upon this painful and important subject in order to form some kind of religious society, but there being too few to be found under the like concern, and those who were, differed in their religious sentiments; with these circumstances they labored for some time, till it was proposed, after a serious communication of sentiments, that a society should be formed, without regard to religious tenets, provided, the persons lived an orderly and sober life, in order to support one another in sickness, and for the benefit of their widows and fatherless children. ARTICLES. [17th, 5th mo., 1787] — We, the free Africans and their descendants, of the City of Philadelphia, in the State of Pennsylvania, or elsewhere, do unanimously agree, for the benefit of each other, to advance one shilling in silver Pennsylvania currency a month; and after one year's subscription from the date hereof, then to hand forth to the needy of this Society, if any should require, the sum of three shillings and nine pence per week of the said money: provided, this necessity is not brought on them by their own imprudence. And it is further agreed, that no drunkard nor disorderly person be admitted as a member, and if any should prove disorderly after having been received, the said disorderly person shall be disjointed from us if there is not an amendment, by being informed by two of the members, without having any of his subscription money returned. And if any should neglect paying his monthly subscription for three months, and after having been informed of the same by two of the members, and no sufficient reason appearing for such neglect, if he do not pay the whole the next ensuing meeting, he shall be disjointed from us, by being informed by two of the members its an offender, without having any of his subscription money returned. Also, if any person neglect meeting every month, for every omission he shall pay three pence, except in case or sickness or any other complaint that should require the assistance of the Society, then, and in such a case, he shall be exempt from the fines and subscription during the said sickness. Also, we apprehend it to be just and reasonable, that the surviving widow of a deceased member should enjoy the benefit of this Society so long as she remains his widow, complying with the rules thereof, excepting the subscriptions. And we apprehend it to be necessary, that the children of our deceased members be under the care of the Society, so far as to pay for the education of their children, if they cannot attend the free school; also to put them out apprentices to suitable trades or places, if required. Also, that no member shall convene the Society together; but, it shall be the sole business of the committee, and that only on special occasions, and to dispose of the money in hand to the best advantage, for the use of the Society, after they are granted the liberty at a monthly meeting, and to transact all other business whatsoever, except that of Clerk and Treasurer. And we unanimously agree to choose Joseph Clarke to be our Clerk and Treasurer; and whenever another should succeed him, it is always understood, that one of the people called Quakers, belonging to one of the three monthly meetings in Philadelphia, is to be chosen to act as Clerk and Treasurer of this useful Institution. The following persons met, viz., Absalom Jones, Richard Allen, Samuel Baston, Joseph Johnson, Cato Freeman, Caesar Cranchell, and James Potter, also William White, whose early assistance and useful remarks we found truly profitable. This evening the articles were read, and after some beneficial remarks were made, they were agreed unto.

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Yellow fever

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Visa requirements for British citizens

Visa requirements for British citizens are administrative entry restrictions by the authorities of other states placed on citizens of the United Kingdom . As of 2024, British citizens had visa-free or visa on arrival access to 192 countries and territories, ranking the British passport 3rd in the world according to the Henley Passport Index . Additionally, the World Tourism Organisation also published a report on 15 January 2016 ranking the passport 1st in the world (tied with Denmark, Finland, Germany, Italy, Luxembourg and Singapore) in terms of travel freedom, with the mobility index of 160 (out of 215 with no visa weighted by: 1, visa on arrival weighted by 0.7, e-Visa weighted by 0.5 and traditional visa weighted by 0). The United Kingdom left the European Union on 31 January 2020, and consequently discontinued the freedom of movement for its citizens to EU countries on 31 December 2020. However, UK citizens are still eligible for visa-free access for short-term visits to the Schengen Area. Visa requirements for other classes of British nationals such as British Nationals (Overseas) , British Overseas Citizens , British Overseas Territories Citizens , British Protected Persons or British Subjects are different.Visa requirements for British citizens were lifted by many European nations in the few years after World War II. The first changes occurred in 1947. These were removed by France on 1 January 1947. This was then quickly followed by Belgium on 15 February 1947, Luxembourg 15 February 1947, Norway on 1 March 1947, Denmark on 22 March 1947, Sweden on 1 April 1947, Netherlands on 15 April 1947, Switzerland on 24 June 1947 Liechtenstein on 24 June 1947 and Iceland on 1 July 1947. The requirement was lifted by Italy on 1 January 1948, Monaco (8 November 1948), Austria (15 May 1955), Paraguay (27 November 1966), United States (1 July 1988), Poland (1 July 1992), Bulgaria (March 1997), Romania (1 January 2001), Serbia and Montenegro (31 May 2003), Ukraine (1 May 2005), Georgia (1 June 2006), Moldova (1 January 2007), Kyrgyzstan (27 July 2012), Armenia (10 January 2013), Kazakhstan (15 July 2014), Indonesia (13 June 2015), Vietnam (1 July 2015) Belarus (12 February 2017), Cape Verde (1 January 2019), Uzbekistan (1 February 2019), Turkey (2 March 2020) and Oman (December 2020). Electronic visas for British citizens were introduced: India (15 August 2015), Djibouti (18 February 2018) and Malawi (October 2019). Visas on arrival have been waived for British citizens by Mali (March 2015) and were for Malawi (1 October 2015 for four years, see above). In April 2021 India announced that it would stop issuing Electronic visas for British citizens from August 2021, however this was reinstated on 05 December 2022 . In November 2021 Mongolia introduced e-Visa for British citizens.If granted, eVisitor allows British citizens to stay in Australia for 90 days per visit. Issued free of charge and valid for one year. According to HPI (Henley Passport Index) methodology pre-departure government approval, like eVisitor manual processing is not considered as visa free. Extendable up to eight months. By air via any of six Belarusian international airports and not from Russia. Visa-free arrangement does not apply when travelling on a diplomatic or official passport. Due to safety concerns, the UK Government advises its citizens to avoid travelling to Belarus. Must have an international vaccination certificate. Be aware you may be given an initial 30 days and can extend it for another 60 days. The Department of Immigration has imposed an annual limit for tourists of 90 days without a visa. For longer periods you must seek advice from the Bolivian Embassy in London or the Department of Immigration office in La Paz. 90 days within any 6-month period. Extendable for another 30 days. Pre-approved visa can be picked up on arrival. May be extended. Hong Kong, Macau, and Taiwan count as third countries under the 24, 72 and 144-hours transit without visa (TWOV) policies. A tourist card is needed before you travel. Apply through the Cuban Embassy in the UK or check with your travel agent or tour operator. The tourist card grants you a single entry and exit. Can be extended up to 90 days with a fee. 90 days within 180-day period. May be extended. Pre-approved visa can be picked up on arrival. Pre-approved visa can be picked up on arrival. British citizens must have their visa stamped in their passport in advance of arrival in Iran. Due to security concerns, the UK Government advises its citizens to avoid travelling to Iran. British citizens can obtain a visa on arrival at Iraq's airports, land and sea crossings for 60 days, for a fee of USD 75. The Iraqi government lifted pre-arrival visa requirements, allowing British citizens to apply for visa on arrival in any entry point. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Can also be entered on an East Africa tourist visa issued by Rwanda or Uganda. Pre-approved visa can be picked up on arrival. For stays of less than 15 days, the visa fee is free, but an administrative fee of EUR 10 must be paid. 30 days - EUR 35; 60 days - EUR 40. 90 days within any 180-day period. Visa stamp (up to 180 days) length determined on arrival. 90 days within any 180-day period. The Ministry of Foreign Affairs of Mongolia has exempted visas for 34 countries from January 2023 to December 2025. Travelers must pay a fee of 650 MT upon entry. In addition of a visa, an application should be obtained by email via the Directorate of Immigration. Pre-approved visa can be picked up on arrival. Visa stamp (up to 183 days) length determined on arrival Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). If not arriving by air, British citizens are only permitted two visits per year. For longer periods up to 60 days, a Tourist visa is available online. 90 days within any 180-day period (as of 2 March 2020)/ Pre-approved visa can be picked up on arrival. A single entry e-Visa valid for 90 days is also available. The United Kingdom, together with its Crown Dependencies of Guernsey, Jersey and the Isle of Man and the Republic of Ireland make up a Common Travel Area where: No ID is required for travel by land for British or Irish citizens Only photographic ID is required for travel by air or sea for British or Irish citizens (but some airlines - such as Ryanair - may mandate passports for all) However, there are occasionally checks on coaches and trains moving between Northern Ireland and the Republic of Ireland. British citizens living in Ireland have many of the same rights and entitlements as an Irish citizen. Citizens of third countries must have passports and, if required, visas to travel between the United Kingdom and Republic of Ireland. British visas don't enable travel to Ireland for people without agreement with Ireland, and vice versa. Passengers travelling between the Common Travel Area and the Schengen Area are subject to systematic passport/identity checks. British citizens with a connection to the territory have right of abode. British citizens with a connection to the territory have right of abode. Extension of stay possible. British citizens with a connection to the territory have right of abode. British citizens with a connection to the territory have right of abode. A visitor permit is normally issued as a stamp in the passport on arrival. Visitors who have a connection with the Falkland Islands have right of abode. British citizens have right of abode in Gibraltar. British citizens with a connection to the territory have right of abode. The entry permit costs £25 and is issued on arrival. British citizens with a connection to the territory have right of abode. 90 days within 180-day period Valid ID or Passport Required. 90 days within 180-day period Valid ID or Passport Required.If granted, eVisitor allows British citizens to stay in Australia for 90 days per visit. Issued free of charge and valid for one year. According to HPI (Henley Passport Index) methodology pre-departure government approval, like eVisitor manual processing is not considered as visa free. Extendable up to eight months. By air via any of six Belarusian international airports and not from Russia. Visa-free arrangement does not apply when travelling on a diplomatic or official passport. Due to safety concerns, the UK Government advises its citizens to avoid travelling to Belarus. Must have an international vaccination certificate. Be aware you may be given an initial 30 days and can extend it for another 60 days. The Department of Immigration has imposed an annual limit for tourists of 90 days without a visa. For longer periods you must seek advice from the Bolivian Embassy in London or the Department of Immigration office in La Paz. 90 days within any 6-month period. Extendable for another 30 days. Pre-approved visa can be picked up on arrival. May be extended. Hong Kong, Macau, and Taiwan count as third countries under the 24, 72 and 144-hours transit without visa (TWOV) policies. A tourist card is needed before you travel. Apply through the Cuban Embassy in the UK or check with your travel agent or tour operator. The tourist card grants you a single entry and exit. Can be extended up to 90 days with a fee. 90 days within 180-day period. May be extended. Pre-approved visa can be picked up on arrival. Pre-approved visa can be picked up on arrival. British citizens must have their visa stamped in their passport in advance of arrival in Iran. Due to security concerns, the UK Government advises its citizens to avoid travelling to Iran. British citizens can obtain a visa on arrival at Iraq's airports, land and sea crossings for 60 days, for a fee of USD 75. The Iraqi government lifted pre-arrival visa requirements, allowing British citizens to apply for visa on arrival in any entry point. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Can also be entered on an East Africa tourist visa issued by Rwanda or Uganda. Pre-approved visa can be picked up on arrival. For stays of less than 15 days, the visa fee is free, but an administrative fee of EUR 10 must be paid. 30 days - EUR 35; 60 days - EUR 40. 90 days within any 180-day period. Visa stamp (up to 180 days) length determined on arrival. 90 days within any 180-day period. The Ministry of Foreign Affairs of Mongolia has exempted visas for 34 countries from January 2023 to December 2025. Travelers must pay a fee of 650 MT upon entry. In addition of a visa, an application should be obtained by email via the Directorate of Immigration. Pre-approved visa can be picked up on arrival. Visa stamp (up to 183 days) length determined on arrival Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). If not arriving by air, British citizens are only permitted two visits per year. For longer periods up to 60 days, a Tourist visa is available online. 90 days within any 180-day period (as of 2 March 2020)/ Pre-approved visa can be picked up on arrival. A single entry e-Visa valid for 90 days is also available. The United Kingdom, together with its Crown Dependencies of Guernsey, Jersey and the Isle of Man and the Republic of Ireland make up a Common Travel Area where: No ID is required for travel by land for British or Irish citizens Only photographic ID is required for travel by air or sea for British or Irish citizens (but some airlines - such as Ryanair - may mandate passports for all) However, there are occasionally checks on coaches and trains moving between Northern Ireland and the Republic of Ireland. British citizens living in Ireland have many of the same rights and entitlements as an Irish citizen. Citizens of third countries must have passports and, if required, visas to travel between the United Kingdom and Republic of Ireland. British visas don't enable travel to Ireland for people without agreement with Ireland, and vice versa. Passengers travelling between the Common Travel Area and the Schengen Area are subject to systematic passport/identity checks. British citizens with a connection to the territory have right of abode. British citizens with a connection to the territory have right of abode. Extension of stay possible. British citizens with a connection to the territory have right of abode. British citizens with a connection to the territory have right of abode. A visitor permit is normally issued as a stamp in the passport on arrival. Visitors who have a connection with the Falkland Islands have right of abode. British citizens have right of abode in Gibraltar. British citizens with a connection to the territory have right of abode. The entry permit costs £25 and is issued on arrival. British citizens with a connection to the territory have right of abode. 90 days within 180-day period Valid ID or Passport Required. 90 days within 180-day period Valid ID or Passport Required.The United Kingdom, together with its Crown Dependencies of Guernsey, Jersey and the Isle of Man and the Republic of Ireland make up a Common Travel Area where: No ID is required for travel by land for British or Irish citizens Only photographic ID is required for travel by air or sea for British or Irish citizens (but some airlines - such as Ryanair - may mandate passports for all) However, there are occasionally checks on coaches and trains moving between Northern Ireland and the Republic of Ireland. British citizens living in Ireland have many of the same rights and entitlements as an Irish citizen. Citizens of third countries must have passports and, if required, visas to travel between the United Kingdom and Republic of Ireland. British visas don't enable travel to Ireland for people without agreement with Ireland, and vice versa. Passengers travelling between the Common Travel Area and the Schengen Area are subject to systematic passport/identity checks.British citizens with a connection to the territory have right of abode. British citizens with a connection to the territory have right of abode. Extension of stay possible. British citizens with a connection to the territory have right of abode. British citizens with a connection to the territory have right of abode. A visitor permit is normally issued as a stamp in the passport on arrival. Visitors who have a connection with the Falkland Islands have right of abode. British citizens have right of abode in Gibraltar. British citizens with a connection to the territory have right of abode. The entry permit costs £25 and is issued on arrival. British citizens with a connection to the territory have right of abode.90 days within 180-day period Valid ID or Passport Required. 90 days within 180-day period Valid ID or Passport Required.Holders of exclusive categories of British passports have this visa-free access, to: China (diplomatic passports) , Kuwait (diplomatic or official passports) , Mongolia (diplomatic passports) , Qatar (diplomatic or official passports and British Diplomatic Messenger or Queen's Messenger Passports) and the United Arab Emirates (diplomatic or official passports) . Holders of diplomatic or service passports of any country have visa-free access to Ethiopia , and Zimbabwe . Holders of British official and diplomatic passports require a visa for South Africa . Many countries have entry restrictions on foreigners that go beyond the common requirement of having either a valid visa or a visa exemption. Such restrictions may be health related or impose additional documentation requirements on certain classes of people for diplomatic or political purposes. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. Owing to the COVID-19 pandemic , several countries temporarily suspended visa-free entry for British citizens: Most countries also imposed additional non-visa requirements such as the need to show a COVID-19 vaccination record .Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. Owing to the COVID-19 pandemic , several countries temporarily suspended visa-free entry for British citizens: Most countries also imposed additional non-visa requirements such as the need to show a COVID-19 vaccination record .On 23 June 2016, a majority of the British electorate who voted, did so to leave the European Union in a nationwide referendum . In March 2017, the UK sent notification of their intention to leave the EU to the European Council through Article 50 of the Lisbon Treaty. British citizens ceased to be EU citizens upon the UK's departure from the EU thus forfeiting the rights of citizens. The UK withdrew from the EU on 31 January 2020, but British citizens retained the right of freedom of movement until the transitional period ended on 31 December 2020. From 1 January 2021, when EU law ceased to apply to the United Kingdom, British citizens are afforded visa-free visits to the Schengen Area , for 90 days in any 180-day period. British citizens also enjoy visa-free entry to Bulgaria and Romania. From sometime in 2025, most visa-exempt travellers seeking entry to the EU and EEA must apply and pay for travel authorisation through ETIAS . This was confirmed on 12 September 2018 and has no exception, yet agreed, for British citizens. This excludes British-Irish travel which is governed by laws that pre-date the European Community. When in a non-EU country where there is no British embassy, British citizens no longer have the right to consular protection from the embassy of any other EU country present in that country. When in a country where there is no British embassy, British citizens may get help from the embassy of any other commonwealth country present in that country. There are also informal arrangements with some other countries, including New Zealand and Australia, to help British nationals in some countries. See also List of diplomatic missions of the United Kingdom .According to the Foreign travel advice provided by the British Government (unless otherwise noted) these are the numbers of British visitors to various countries per annum in 2015 (unless otherwise noted): Foreign travel statistics

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Attenuated_vaccine/html

Attenuated vaccine

An attenuated vaccine (or a live attenuated vaccine, LAV) is a vaccine created by reducing the virulence of a pathogen , but still keeping it viable (or "live"). Attenuation takes an infectious agent and alters it so that it becomes harmless or less virulent. These vaccines contrast to those produced by "killing" the pathogen ( inactivated vaccine ). Attenuated vaccines stimulate a strong and effective immune response that is long-lasting. In comparison to inactivated vaccines, attenuated vaccines produce a stronger and more durable immune response with a quick immunity onset. They are generally avoided in patients with severe immunodeficiencies. Attenuated vaccines function by encouraging the body to create antibodies and memory immune cells in response to the specific pathogen which the vaccine protects against. Common examples of live attenuated vaccines are measles , mumps , rubella , yellow fever , and some influenza vaccines. Viruses may be attenuated using the principles of evolution via serial passage of the virus through a foreign host species, such as: The initial virus population is applied to a foreign host. Through natural genetic variability or induced mutation , a small percentage of the viral particles should have the capacity to infect the new host. These strains will continue to evolve within the new host and the virus will gradually lose its efficacy in the original host, due to lack of selection pressure . This process is known as "passage" in which the virus becomes so well adapted to the foreign host that it is no longer harmful to the subject that is to receive the vaccine. This makes it easier for the host immune system to eliminate the agent and create the immunological memory cells which will likely protect the patient if they are infected with a similar version of the virus in "the wild". Viruses may also be attenuated via reverse genetics . Attenuation by genetics is also used in the production of oncolytic viruses . Bacteria is typically attenuated by passage, similar to the method used in viruses. Gene knockout guided by reverse genetics is also used. Viruses may be attenuated using the principles of evolution via serial passage of the virus through a foreign host species, such as: The initial virus population is applied to a foreign host. Through natural genetic variability or induced mutation , a small percentage of the viral particles should have the capacity to infect the new host. These strains will continue to evolve within the new host and the virus will gradually lose its efficacy in the original host, due to lack of selection pressure . This process is known as "passage" in which the virus becomes so well adapted to the foreign host that it is no longer harmful to the subject that is to receive the vaccine. This makes it easier for the host immune system to eliminate the agent and create the immunological memory cells which will likely protect the patient if they are infected with a similar version of the virus in "the wild". Viruses may also be attenuated via reverse genetics . Attenuation by genetics is also used in the production of oncolytic viruses . Bacteria is typically attenuated by passage, similar to the method used in viruses. Gene knockout guided by reverse genetics is also used. Attenuated vaccines can be administered in a variety of ways: Oral vaccines or subcutaneous/intramuscular injection are for individuals older than 12 months. Live attenuated vaccines, with the exception of the rotavirus vaccine given at 6 weeks, is not indicated for infants younger than 9 months. Vaccines function by encouraging the creation of cells, such as CD8+ and CD4+ T lymphocytes , or molecules, such as antibodies , that are specific to the pathogen . The cells and molecules can either prevent or reduce infection by killing infected cells or by producing interleukins . The specific effectors evoked can be different based on the vaccine. Live attenuated vaccines tend to help with the production of CD8+ cytotoxic T lymphocytes and T-dependent antibody responses. A vaccine is only effective for as long as the body maintains a population of these cells. Attenuated vaccines are "weakened" version of pathogens (virus or bacteria). They are modified so that it cannot cause harm or disease in the body but are still able to activate the immune system. This type of vaccine works by activating both the cellular and humoral immune responses of the adaptive immune system. When a person receives an oral or injection of the vaccine, B cells, which help make antibodies, are activated in two ways: T cell-dependent and T-cell independent. In T-cell dependent activation of B cells, B cells first recognize and present the antigen on MHCII receptors. T-cells can then recognize this presentation and bind to the B cell, resulting in clonal proliferation. This also helps IgM and plasma cells production as well as immunoglobulin switching. On the other hand, T-cell independent activation of B cells is due to non-protein antigens. This can lead to production of IgM antibodies. Being able to produce a B-cell response as well as memory killer T cells is a key feature of attenuated virus vaccines that help induce a potent immunity. Live-attenuated vaccines are safe and stimulate a strong and effective immune response that is long-lasting. Given pathogens are attenuated, it is extremely rare for pathogens to revert to their pathogenic form and subsequently cause disease. Additionally, within the five WHO-recommended live attenuated vaccines (tuberculosis, oral polio, measles, rotavirus, and yellow fever), severe adverse reactions are extremely rare. Individuals with severely compromised immune systems (e.g., HIV-infection , chemotherapy , immunosuppressive therapy , lymphoma , leukemia , combined immunodeficiencies ) typically should not receive live-attenuated vaccines as they may not be able to produce an adequate and safe immune response. Household contacts of immunodeficient individuals are still able to receive most attenuated vaccines since there is no increased risk of infection transmission, with the exception being the oral polio vaccine. As precaution, live-attenuated vaccines are not typically administered during pregnancy . This is due to the risk of transmission of virus between mother and fetus. In particular, the varicella and yellow fever vaccines have been shown to have adverse effects on fetuses and nursing babies. Some live attenuated vaccines have additional common, mild adverse effects due to their administration route. For example, the live attenuated influenza vaccine is given nasally and is associated with nasal congestion. Compared to inactivated vaccines , live-attenuated vaccines are more prone to immunization errors as they must be kept under strict conditions during the cold chain and carefully prepared (e.g., during reconstitution). The history of vaccine development started with the creation of the smallpox vaccine by Edward Jenner in the late 18th century. Jenner discovered that inoculating a human with an animal pox virus would grant immunity against smallpox , a disease considered to be one of the most devastating in human history. Although the original smallpox vaccine is sometimes considered to be an attenuated vaccine due to its live nature, it was not strictly-speaking attenuated since it was not derived directly from smallpox. Instead, it was based on the related and milder cowpox disease. The discovery that diseases could be artificially attenuated came in the late 19th century when Louis Pasteur was able to derive an attenuated strain of chicken cholera . Pasteur applied this knowledge to develop an attenuated anthrax vaccine and demonstrating its effectiveness in a public experiment. The first rabies vaccine was subsequently produced by Pasteur and Emile Roux by growing the virus in rabbits and drying the affected nervous tissue. The technique of cultivating a virus repeatedly in artificial media and isolating less virulent strains was pioneered in the early 20th century by Albert Calmette and Camille Guérin who developed an attenuated tuberculosis vaccine called the BCG vaccine . This technique was later used by several teams when developing the vaccine for yellow fever , first by Sellards and Laigret , and then by Theiler and Smith. The vaccine developed by Theiler and Smith proved to be hugely successful and helped establish recommended practices and regulations for many other vaccines. These include the growth of viruses in primary tissue culture (e.g., chick embryos), as opposed to animals, and the use of the seed stock system which uses the original attenuated viruses as opposed to derived viruses (done to reduce variance in vaccine development and decrease the chance of adverse effects). The middle of the 20th century saw the work of many prominent virologists including Sabin , Hilleman , and Enders , and the introduction of several successful attenuated vaccines, such as those against polio , measles , mumps , and rubella . For many of the pathogens listed below there are many vaccines, the list below simply indicates that there are one (or more) attenuated vaccines for that particular pathogen, not that all vaccines for that pathogen are attenuated. [ citation needed ]For many of the pathogens listed below there are many vaccines, the list below simply indicates that there are one (or more) attenuated vaccines for that particular pathogen, not that all vaccines for that pathogen are attenuated. [ citation needed ]

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Democratic_Republic_of_the_Congo/html

Democratic Republic of the Congo

The Democratic Republic of the Congo [lower-alpha 3] is a country in Central Africa . By land area, the DRC is the second-largest country in Africa and the 11th-largest in the world . With a population of around 112 million, the Democratic Republic of the Congo is the most populous Francophone country in the world. The national capital and largest city is Kinshasa , which is also the economic center. The country is bordered by the Republic of the Congo , Central African Republic , South Sudan , Uganda , Rwanda , Burundi , Tanzania (across Lake Tanganyika ), Zambia , Angola , the Cabinda exclave of Angola , and the South Atlantic Ocean . Centered on the Congo Basin , the territory of the DRC was first inhabited by Central African foragers around 90,000 years ago and was reached by the Bantu expansion about 3,000 years ago. In the west, the Kingdom of Kongo ruled around the mouth of the Congo River from the 14th to 19th centuries. In the northeast, center, and east, the kingdoms of Azande , Luba , and Lunda ruled from the 16th and 17th centuries to the 19th century. King Leopold II of Belgium formally acquired rights to the Congo territory from the colonial nations of Europe in 1885 and declared the land his private property, naming it the Congo Free State . From 1885 to 1908, his colonial military forced the local population to produce rubber and committed widespread atrocities . In 1908, Leopold ceded the territory, which thus became a Belgian colony . Congo achieved independence from Belgium on 30 June 1960 and was immediately confronted by a series of secessionist movements , the assassination of Prime Minister Patrice Lumumba , and the seizure of power by Mobutu Sese Seko in a 1965 coup d'état . Mobutu renamed the country Zaire in 1971 and imposed a harsh personalist dictatorship until his overthrow in 1997 by the First Congo War . The country then had its name changed back and was confronted by the Second Congo War from 1998 to 2003, which resulted in the deaths of 5.4 million people. The war ended under President Joseph Kabila , who governed the country from 2001 to 2019, under whom human rights in the country remained poor and included frequent abuses such as forced disappearances , torture, arbitrary imprisonment and restrictions on civil liberties. Following the 2018 general election , in the country's first peaceful transition of power since independence, Kabila was succeeded as president by Félix Tshisekedi , who has served as president since. Since 2015, the Eastern DR Congo has been the site of an ongoing military conflict in Kivu . The Democratic Republic of the Congo is extremely rich in natural resources but has suffered from political instability, a lack of infrastructure, corruption, and centuries of both commercial and colonial extraction and exploitation, followed by more than 60 years of independence, with little widespread development. Besides the capital Kinshasa, the two next largest cities, Lubumbashi and Mbuji-Mayi , are both mining communities. The DRC's largest export is raw minerals, with China accepting over 50% of its exports in 2019. In 2021, DR Congo's level of human development was ranked 179th out of 191 countries by the Human Development Index and is classed as a least developed country by the UN . As of 2018 [ update ] , following two decades of various civil wars and continued internal conflicts , around 600,000 Congolese refugees were still living in neighbouring countries. Two million children risk starvation, and the fighting has displaced 4.5 million people. The country is a member of the United Nations , Non-Aligned Movement , African Union , COMESA , Southern African Development Community , Organisation Internationale de la Francophonie , and Economic Community of Central African States .The Democratic Republic of the Congo is named after the Congo River , which flows through the country. The Congo River is the world's deepest river and the world's third-largest river by discharge . The Comité d'études du haut Congo ("Committee for the Study of the Upper Congo"), established by King Leopold II of Belgium in 1876, and the International Association of the Congo , established by him in 1879, were also named after the river. The Congo River was named by early European sailors after the Kingdom of Kongo and its Bantu inhabitants, the Kongo people , when they encountered them in the 16th century. The word Kongo comes from the Kongo language (also called Kikongo ). According to American writer Samuel Henry Nelson: "It is probable that the word 'Kongo' itself implies a public gathering and that it is based on the root konga , 'to gather' (trans[itive])." The modern name of the Kongo people, Bakongo , was introduced in the early 20th century. [ citation needed ] The Democratic Republic of the Congo has been known in the past as, in chronological order, the Congo Free State , Belgian Congo , the Republic of the Congo-Léopoldville , the Democratic Republic of the Congo and the Republic of Zaire , before returning to its current name the Democratic Republic of the Congo. At the time of independence, the country was named the Republic of the Congo-Léopoldville to distinguish it from its neighbour the Republic of the Congo-Brazzaville . With the promulgation of the Luluabourg Constitution on 1 August 1964, the country became the DRC but was renamed Zaire (a past name for the Congo River) on 27 October 1971 by President Mobutu Sese Seko as part of his Authenticité initiative. The word Zaire is from a Portuguese adaptation of a Kikongo word nzadi ("river"), a truncation of nzadi o nzere ("river swallowing rivers"). The river was known as Zaire during the 16th and 17th centuries; Congo seems to have replaced Zaire gradually in English usage during the 18th century, and Congo is the preferred English name in 19th-century literature, although references to Zaire as the name used by the natives (i.e. derived from Portuguese usage) remained common. In 1992, the Sovereign National Conference voted to change the name of the country to the "Democratic Republic of the Congo", but the change was not made. The country's name was later restored by President Laurent-Désiré Kabila when he overthrew Mobutu in 1997. To distinguish it from the neighboring Republic of the Congo, it is sometimes referred to as Congo (Kinshasa) , Congo-Kinshasa , or Big Congo . Its name is sometimes also abbreviated as DR Congo , DRC , the DROC and RDC (in French). Before Bantu expansion , the territory comprising the Democratic Republic of the Congo was home to Central Africa's oldest settled groups, the Mbuti peoples . Most of the remnants of their hunter-gatherer culture remain in the present time. The geographical area now known as the Democratic Republic of the Congo was populated as early as 90,000 years ago, as shown by the 1988 discovery of the Semliki harpoon at Katanda , one of the oldest barbed harpoons ever found, believed to have been used to catch giant river catfish . Bantu peoples reached Central Africa at some point during the first millennium BC, then gradually started to expand southward. Their propagation was accelerated by the adoption of pastoralism and of Iron Age techniques. The people living in the south and southwest were foraging groups, whose technology involved only minimal use of metal technologies. The development of metal tools during this time period revolutionized agriculture. This led to the displacement of the hunter-gatherer groups in the east and southeast. The final wave of the Bantu expansion was complete by the 10th century, followed by the establishment of the Bantu kingdoms, whose rising populations soon made possible intricate local, regional and foreign commercial networks that traded mostly in slaves, salt, iron and copper. Belgian exploration and administration took place from the 1870s until the 1920s. It was first led by Henry Morton Stanley , who undertook his explorations under the sponsorship of King Leopold II of Belgium . The eastern regions of the precolonial Congo were heavily disrupted by constant slave raiding , mainly from Arab–Swahili slave traders such as the infamous Tippu Tip , who was well known to Stanley. Leopold had designs on what was to become the Congo as a colony. In a succession of negotiations, Leopold, professing humanitarian objectives in his capacity as chairman of the front organization Association Internationale Africaine , actually played one European rival against another. [ citation needed ] King Leopold formally acquired rights to the Congo territory at the Conference of Berlin in 1885 and made the land his private property. He named it the Congo Free State . Leopold's regime began various infrastructure projects, such as the construction of the railway that ran from the coast to the capital of Leopoldville (now Kinshasa), which took eight years to complete. In the Free State, colonists coerced the local population into producing rubber, for which the spread of automobiles and development of rubber tires created a growing international market. Rubber sales made a fortune for Leopold, who built several buildings in Brussels and Ostend to honor himself and his country. To enforce the rubber quotas, the Force Publique was called in and made the practice of cutting off the limbs of the natives a matter of policy. During 1885–1908, millions of Congolese died as a consequence of exploitation and disease. In some areas the population declined dramatically – it has been estimated that sleeping sickness and smallpox killed nearly half the population in the areas surrounding the lower Congo River. News of the abuses began to circulate. In 1904, the British consul at Boma in the Congo, Roger Casement , was instructed by the British government to investigate. His report, called the Casement Report , confirmed the accusations of humanitarian abuses. The Belgian Parliament forced Leopold II to set up an independent commission of inquiry. Its findings confirmed Casement's report of abuses, concluding that the population of the Congo had been "reduced by half" during this period. Determining precisely how many people died is impossible, as no accurate records exist. In 1908, the Belgian parliament, in spite of initial reluctance, bowed to international pressure (especially from the United Kingdom ) and took over the Free State from King Leopold II. On 18 October 1908, the Belgian parliament voted in favour of annexing the Congo as a Belgian colony. Executive power went to the Belgian minister of colonial affairs , assisted by a Colonial Council (Conseil Colonial) (both located in Brussels). The Belgian parliament exercised legislative authority over the Belgian Congo. In 1923 the colonial capital moved from Boma to Léopoldville, some 300 kilometres (190 mi) further upstream into the interior. The transition from the Congo Free State to the Belgian Congo was a break, but it also featured a large degree of continuity. The last governor-general of the Congo Free State, Baron Théophile Wahis , remained in office in the Belgian Congo and the majority of Leopold II's administration with him. Opening up the Congo and its natural and mineral riches to the Belgian economy remained the main motive for colonial expansion – however, other priorities, such as healthcare and basic education, slowly gained in importance. Colonial administrators ruled the territory and a dual legal system existed (a system of European courts and another one of indigenous courts, tribunaux indigènes ). Indigenous courts had only limited powers and remained under the firm control of the colonial administration. The Belgian authorities permitted no political activity in the Congo whatsoever, and the Force Publique put down any attempts at rebellion. The Belgian Congo was directly involved in the two world wars. During World War I (1914–1918), an initial stand-off between the Force Publique and the German colonial army in German East Africa turned into open warfare with a joint Anglo-Belgian-Portuguese invasion of German colonial territory in 1916 and 1917 during the East African campaign . The Force Publique gained a notable victory when it marched into Tabora in September 1916 under the command of General Charles Tombeur after heavy fighting. After 1918, Belgium was rewarded for the participation of the Force Publique in the East African campaign with a League of Nations mandate over the previously German colony of Ruanda-Urundi . During World War II , the Belgian Congo provided a crucial source of income for the Belgian government in exile in London, and the Force Publique again participated in Allied campaigns in Africa . Belgian Congolese forces under the command of Belgian officers notably fought against the Italian colonial army in Ethiopia in Asosa , Bortaï and Saïo under Major-General Auguste-Eduard Gilliaert . In May 1960, a growing nationalist movement, the Mouvement National Congolais led by Patrice Lumumba , won the parliamentary elections . Lumumba became the first Prime Minister of the Republic of the Congo, on 24 June 1960. The parliament elected Joseph Kasa-Vubu as president , of the Alliance des Bakongo ( ABAKO ) party. Other parties that emerged included the Parti Solidaire Africain led by Antoine Gizenga , and the Parti National du Peuple led by Albert Delvaux and Laurent Mbariko . The Belgian Congo achieved independence on 30 June 1960 under the name "République du Congo" ("Republic of Congo" or "Republic of the Congo" in English). As the neighboring French colony of Middle Congo ( Moyen Congo ) also chose the name "Republic of Congo" upon achieving its independence, the two countries were more commonly known as "Congo-Léopoldville" and "Congo-Brazzaville", after their capital cities. Shortly after independence the Force Publique mutinied, and on 11 July the province of Katanga (led by Moïse Tshombe ) and South Kasai engaged in secessionist struggles against the new leadership. Most of the 100,000 Europeans who had remained behind after independence fled the country, opening the way for Congolese to replace the European military and administrative elite. After the United Nations rejected Lumumba's call for help to put down the secessionist movements, Lumumba asked for assistance from the Soviet Union, who accepted and sent military supplies and advisers. On 23 August, the Congolese armed forces invaded South Kasai . Lumumba was dismissed from office on 5 September 1960 by Kasa-Vubu who publicly blamed him for massacres by the armed forces in South Kasai and for involving Soviets in the country. Lumumba declared Kasa-Vubu's action unconstitutional, and a crisis between the two leaders developed. On 14 September, Colonel Joseph Mobutu , with the backing of the US and Belgium, removed Lumumba from office. On 17 January 1961, Lumumba was handed over to Katangan authorities and executed by Belgian-led Katangan troops. A 2001 investigation by Belgium's Parliament found Belgium "morally responsible" for the murder of Lumumba, and the country has since officially apologised for its role in his death. On 18 September 1961, in ongoing negotiations of a ceasefire, a plane crash near Ndola resulted in the death of Dag Hammarskjöld , the Secretary-General of the United Nations , along with all 15 passengers, setting off a succession crisis. Amidst widespread confusion and chaos, a temporary government was led by technicians (the Collège des commissaires généraux ). Katangan secession ended in January 1963 with the assistance of UN forces . Several short-lived governments of Joseph Ileo , Cyrille Adoula , and Moise Kapenda Tshombe took over in quick succession. Meanwhile, in the east of the country, Soviet and Cuban-backed rebels called the Simbas rose up, taking a significant amount of territory and proclaiming a communist "People's Republic of the Congo" in Stanleyville. The Simbas were pushed out of Stanleyville in November 1964 during Operation Dragon Rouge , a military operation conducted by Belgian and American forces to rescue hundreds of hostages. Congolese government forces fully defeated the Simba rebels by November 1965. Lumumba had previously appointed Mobutu chief of staff of the new Congo army, Armée Nationale Congolaise . Taking advantage of the leadership crisis between Kasavubu and Tshombe, Mobutu garnered enough support within the army to launch a coup. A constitutional referendum the year before Mobutu's coup of 1965 resulted in the country's official name being changed to the "Democratic Republic of the Congo". In 1971 Mobutu changed the name again, this time to "Republic of Zaire". Mobutu had the staunch support of the United States because of his opposition to communism ; the U.S. believed that his administration would serve as an effective counter to communist movements in Africa. A single-party system was established, and Mobutu declared himself head of state . He periodically held elections in which he was the only candidate. Although relative peace and stability were achieved, Mobutu's government was guilty of severe human rights violations, political repression , a cult of personality and corruption . By late 1967 Mobutu had successfully neutralized his political opponents and rivals, either through co-opting them into his regime, arresting them, or rendering them otherwise politically impotent. Throughout the late 1960s, Mobutu continued to shuffle his governments and cycle officials in and out of the office to maintain control. Joseph Kasa-Vubu's death in April 1969 ensured that no person with First Republic credentials could challenge his rule. By the early 1970s, Mobutu was attempting to assert Zaire as a leading African nation. He traveled frequently across the continent while the government became more vocal about African issues, particularly those relating to the southern region. Zaire established semi-clientelist relationships with several smaller African states, especially Burundi, Chad, and Togo. Corruption became so common the term " le mal Zairois " or "Zairian sickness", meaning gross corruption, theft and mismanagement, was coined, reportedly by Mobutu. International aid, most often in the form of loans, enriched Mobutu while he allowed national infrastructure such as roads to deteriorate to as little as one-quarter of what had existed in 1960. Zaire became a kleptocracy as Mobutu and his associates embezzled government funds. In a campaign to identify himself with African nationalism, starting on 1 June 1966, Mobutu renamed the nation's cities: Léopoldville became Kinshasa (the country was known as Congo-Kinshasa), Stanleyville became Kisangani , Elisabethville became Lubumbashi , and Coquilhatville became Mbandaka . In 1971, Mobutu renamed the country the Republic of Zaire , its fourth name change in eleven years and its sixth overall. The Congo River was renamed the Zaire River. During the 1970s and 1980s, Mobutu was invited to visit the United States on several occasions, meeting with U.S. Presidents Richard Nixon , Ronald Reagan and George H. W. Bush . Following the dissolution of the Soviet Union U.S. relations with Mobutu cooled, as he was no longer deemed necessary as a Cold War ally. Opponents within Zaire stepped up demands for reform. This atmosphere contributed to Mobutu's declaring the Third Republic in 1990, whose constitution was supposed to pave the way for democratic reform. The reforms turned out to be largely cosmetic. Mobutu continued in power until armed forces forced him to flee in 1997. "From 1990 to 1993, the United States facilitated Mobutu's attempts to hijack political change", one academic wrote, and "also assisted the rebellion of Laurent-Desire Kabila that overthrew the Mobutu regime." In September 1997, Mobutu died in exile in Morocco. By 1996, following the Rwandan Civil War and genocide and the ascension of a Tutsi -led government in Rwanda, Rwandan Hutu militia forces ( Interahamwe ) fled to eastern Zaire and used refugee camps as bases for incursions against Rwanda. They allied with the Zairian Armed Forces to launch a campaign against Congolese ethnic Tutsis in eastern Zaire. A coalition of Rwandan and Ugandan armies invaded Zaire to overthrow the government of Mobutu, launching the First Congo War. The coalition allied with some opposition figures, led by Laurent-Désiré Kabila , becoming the Alliance of Democratic Forces for the Liberation of Congo . In 1997 Mobutu fled and Kabila marched into Kinshasa, naming himself as president and reverting the name of the country to the Democratic Republic of the Congo. Kabila later requested that foreign military forces return to their own countries. Rwandan troops retreated to Goma and launched a new Tutsi-led rebel military movement called the Rassemblement Congolais pour la Democratie to fight Kabila, while Uganda instigated the creation of a rebel movement called the Movement for the Liberation of the Congo , led by Congolese warlord Jean-Pierre Bemba . [ citation needed ] The two rebel movements, along with Rwandan and Ugandan troops, started the Second Congo War by attacking the DRC army in 1998. Angolan, Zimbabwean, and Namibian militaries entered the hostilities on the side of the government. Kabila was assassinated in 2001. His son Joseph Kabila succeeded him and called for multilateral peace talks. UN peacekeepers, MONUC, now known as MONUSCO , arrived in April 2001. In 2002–03 Bemba intervened in the Central African Republic on behalf of its former president, Ange-Félix Patassé . Talks led to a peace accord under which Kabila would share power with former rebels. By June 2003 all foreign armies except those of Rwanda had pulled out of Congo. A transitional government was set up until after the election. A constitution was approved by voters, and on 30 July 2006 DRC held its first multi-party elections . These were the first free national elections since 1960, which many believed would mark the end to violence in the region. However, an election-result dispute between Kabila and Bemba turned into a skirmish between their supporters in Kinshasa. MONUC took control of the city. A new election took place in October 2006, which Kabila won, and in December 2006 he was sworn in as president. Laurent Nkunda , a member of Rally for Congolese Democracy–Goma , defected along with troops loyal to him and formed the National Congress for the Defence of the People (CNDP), which began an armed rebellion against the government. In March 2009, after a deal between the DRC and Rwanda, Rwandan troops entered the DRC and arrested Nkunda and were allowed to pursue FDLR militants. The CNDP signed a peace treaty with the government in which it agreed to become a political party and to have its soldiers integrated into the national army in exchange for the release of its imprisoned members. In 2012 Bosco Ntaganda , the leader of the CNDP, and troops loyal to him, mutinied and formed the rebel military March 23 Movement (M23), claiming the government had violated the treaty. In the resulting M23 rebellion , M23 briefly captured the provincial capital of Goma in November 2012. Neighboring countries, particularly Rwanda, have been accused of arming rebels groups and using them as proxies to gain control of the resource-rich country, an accusation they deny. In March 2013, the United Nations Security Council authorized the United Nations Force Intervention Brigade to neutralize armed groups. On 5 November 2013, M23 declared an end to its insurgency. Additionally, in northern Katanga , the Mai-Mai created by Laurent Kabila slipped out of the control of Kinshasa with Gédéon Kyungu Mutanga 's Mai Mai Kata Katanga briefly invading the provincial capital of Lubumbashi in 2013 and 400,000 persons displaced in the province as of 2013 [ update ] . On and off fighting in the Ituri conflict occurred between the Nationalist and Integrationist Front and the Union of Congolese Patriots who claimed to represent the Lendu and Hema ethnic groups, respectively. In the northeast, Joseph Kony 's Lord's Resistance Army moved from their original bases in Uganda and South Sudan to DR Congo in 2005 and set up camps in the Garamba National Park . The war in the Congo has been described as the bloodiest war since World War II. In 2009, The New York Times reported that people in the Congo continued to die at a rate of an estimated 45,000 per month – estimates of the number who have died from the long conflict range from 900,000 to 5,400,000. The death toll is caused by widespread disease and famine; reports indicate that almost half of the individuals who have died are children under five years of age. There have been frequent reports of weapon bearers killing civilians, of the destruction of property, of widespread sexual violence, causing hundreds of thousands of people to flee their homes, and of other breaches of humanitarian and human rights law. One study found that more than 400,000 women are raped in the Democratic Republic of Congo every year. In 2018 and 2019, Congo reported the highest levels of sexual violence in the world. According to the Human Rights Watch and the New York University-based Congo Research Group, armed troops in DRC's eastern Kivu region have killed over 1,900 civilians and kidnapped at least 3,300 people since June 2017 to June 2019. On 10 May 2018, Congolese gynecologist Denis Mukwege was awarded the Nobel Peace Prize for his effort to end the use of sexual violence as a weapon of war and armed conflict . In 2015, major protests broke out across the country and protesters demanded that Kabila step down as president. The protests began after the passage of a law by the Congolese lower house that, if also passed by the Congolese upper house, would keep Kabila in power at least until a national census was conducted (a process which would likely take several years and therefore keep him in power past the planned 2016 elections, which he is constitutionally barred from participating in). This bill passed; however, it was gutted of the provision that would keep Kabila in power until a census took place. A census is supposed to take place, but it is no longer tied to when the elections take place. In 2015, elections were scheduled for late 2016 and a tenuous peace held in the Congo. On 27 November 2016 Congolese foreign minister Raymond Tshibanda told the press no elections would be held in 2016: "it has been decided that the voter registration operation will end on July 31, 2017, and that election will take place in April 2018." Protests broke out in the country on 20 December when Kabila's term in office ended. Across the country, dozens of protesters were killed and hundreds were arrested. According to Jan Egeland , presently Secretary-General of the Norwegian Refugee Council , the situation in the DRC became much worse in 2016 and 2017 and is a major moral and humanitarian challenge comparable to the wars in Syria and Yemen, which receive much more attention. Women and children are abused sexually and "abused in all possible manners". Besides the conflict in North Kivu , violence increased in the Kasai region . The armed groups were after gold, diamonds, oil, and cobalt to line the pockets of rich men both in the region and internationally. There were also ethnic and cultural rivalries at play, as well as religious motives and the political crisis with postponed elections. Egeland says people believe the situation in the DRC is "stably bad" but in fact, it has become much, much worse. "The big wars of the Congo that were really on top of the agenda 15 years ago are back and worsening". Disruption in planting and harvesting caused by the conflict was estimated to escalate starvation in about two million children. Human Rights Watch said in 2017 that Kabila recruited former March 23 Movement fighters to put down country-wide protests over his refusal to step down from office at the end of his term. "M23 fighters patrolled the streets of Congo's main cities, firing on or arresting protesters or anyone else deemed to be a threat to the president," they said. Fierce fighting has erupted in Masisi between government forces and a powerful local warlord, General Delta. The United Nations mission in the DRC is its largest and most expensive peacekeeping effort, but it shut down five UN bases near Masisi in 2017, after the U.S. led a push to cut costs. A tribal conflict erupted on 16–17 December 2018 at Yumbi in Mai-Ndombe Province . Nearly 900 Banunu people from four villages were slaughtered by members of the Batende community in a deep-rooted rivalry over monthly tribal duties, land, fields and water resources. Some 100 Banunus fled to Moniende island in the Congo River, and another 16,000 to Makotimpoko District in Republic of Congo. Military-style tactics were employed in the bloodbath, and some assailants were clothed in army uniforms. Local authorities and elements within the security forces were suspected of lending them support. On 30 December 2018 a general election was held. On 10 January 2019, the electoral commission announced opposition candidate Félix Tshisekedi as the winner of the presidential vote, and he was officially sworn in as president on 24 January. However, there were widespread suspicions that the results were rigged and that a deal had been made between Tshisekedi and Kabila. The Catholic Church said that the official results did not correspond to the information its election monitors had collected. The government had also "delayed" the vote until March in some areas, citing the Ebola outbreak in Kivu as well as the ongoing military conflict. This was criticized as these regions are known as opposition strongholds. In August 2019, six months after the inauguration of Félix Tshisekedi, a coalition government was announced. The political allies of Kabila maintained control of key ministries, the legislature, judiciary and security services. However, Tshisekedi succeeded in strengthening his hold on power. In a series of moves, he won over more legislators, gaining the support of almost 400 out of 500 members of the National Assembly. The pro-Kabila speakers of both houses of parliament were forced out. In April 2021, the new government was formed without the supporters of Kabila. A major measles outbreak in the country left nearly 5,000 dead in 2019. The Ebola outbreak ended in June 2020, which had caused 2,280 deaths over 2 years. Another, smaller Ebola outbreak in the Équateur Province began in June 2020, ultimately causing 55 deaths. The global COVID-19 pandemic also reached the DRC in March 2020, with a vaccination campaign beginning on 19 April 2021. The Italian ambassador to the DRC, Luca Attanasio , and his bodyguard were killed in North Kivu on 22 February 2021 . On 22 April 2021, meetings between Kenyan President Uhuru Kenyatta and Tshisekedi resulted in new agreements increasing international trade and security (counterterrorism, immigration, cyber security, and customs) between the two countries. In February 2022, allegations of a coup d'état in the country led to uncertainty, but the coup attempt failed. After the 2023 presidential election , Tshisekedi had a clear lead in his run for a second term. On 31 December 2023, officials said that President Felix Tshisekedi had been re-elected with 73% of the vote. Nine opposition candidates signed a declaration rejecting the election and called for a rerun. The geographical area now known as the Democratic Republic of the Congo was populated as early as 90,000 years ago, as shown by the 1988 discovery of the Semliki harpoon at Katanda , one of the oldest barbed harpoons ever found, believed to have been used to catch giant river catfish . Bantu peoples reached Central Africa at some point during the first millennium BC, then gradually started to expand southward. Their propagation was accelerated by the adoption of pastoralism and of Iron Age techniques. The people living in the south and southwest were foraging groups, whose technology involved only minimal use of metal technologies. The development of metal tools during this time period revolutionized agriculture. This led to the displacement of the hunter-gatherer groups in the east and southeast. The final wave of the Bantu expansion was complete by the 10th century, followed by the establishment of the Bantu kingdoms, whose rising populations soon made possible intricate local, regional and foreign commercial networks that traded mostly in slaves, salt, iron and copper.Belgian exploration and administration took place from the 1870s until the 1920s. It was first led by Henry Morton Stanley , who undertook his explorations under the sponsorship of King Leopold II of Belgium . The eastern regions of the precolonial Congo were heavily disrupted by constant slave raiding , mainly from Arab–Swahili slave traders such as the infamous Tippu Tip , who was well known to Stanley. Leopold had designs on what was to become the Congo as a colony. In a succession of negotiations, Leopold, professing humanitarian objectives in his capacity as chairman of the front organization Association Internationale Africaine , actually played one European rival against another. [ citation needed ] King Leopold formally acquired rights to the Congo territory at the Conference of Berlin in 1885 and made the land his private property. He named it the Congo Free State . Leopold's regime began various infrastructure projects, such as the construction of the railway that ran from the coast to the capital of Leopoldville (now Kinshasa), which took eight years to complete. In the Free State, colonists coerced the local population into producing rubber, for which the spread of automobiles and development of rubber tires created a growing international market. Rubber sales made a fortune for Leopold, who built several buildings in Brussels and Ostend to honor himself and his country. To enforce the rubber quotas, the Force Publique was called in and made the practice of cutting off the limbs of the natives a matter of policy. During 1885–1908, millions of Congolese died as a consequence of exploitation and disease. In some areas the population declined dramatically – it has been estimated that sleeping sickness and smallpox killed nearly half the population in the areas surrounding the lower Congo River. News of the abuses began to circulate. In 1904, the British consul at Boma in the Congo, Roger Casement , was instructed by the British government to investigate. His report, called the Casement Report , confirmed the accusations of humanitarian abuses. The Belgian Parliament forced Leopold II to set up an independent commission of inquiry. Its findings confirmed Casement's report of abuses, concluding that the population of the Congo had been "reduced by half" during this period. Determining precisely how many people died is impossible, as no accurate records exist.In 1908, the Belgian parliament, in spite of initial reluctance, bowed to international pressure (especially from the United Kingdom ) and took over the Free State from King Leopold II. On 18 October 1908, the Belgian parliament voted in favour of annexing the Congo as a Belgian colony. Executive power went to the Belgian minister of colonial affairs , assisted by a Colonial Council (Conseil Colonial) (both located in Brussels). The Belgian parliament exercised legislative authority over the Belgian Congo. In 1923 the colonial capital moved from Boma to Léopoldville, some 300 kilometres (190 mi) further upstream into the interior. The transition from the Congo Free State to the Belgian Congo was a break, but it also featured a large degree of continuity. The last governor-general of the Congo Free State, Baron Théophile Wahis , remained in office in the Belgian Congo and the majority of Leopold II's administration with him. Opening up the Congo and its natural and mineral riches to the Belgian economy remained the main motive for colonial expansion – however, other priorities, such as healthcare and basic education, slowly gained in importance. Colonial administrators ruled the territory and a dual legal system existed (a system of European courts and another one of indigenous courts, tribunaux indigènes ). Indigenous courts had only limited powers and remained under the firm control of the colonial administration. The Belgian authorities permitted no political activity in the Congo whatsoever, and the Force Publique put down any attempts at rebellion. The Belgian Congo was directly involved in the two world wars. During World War I (1914–1918), an initial stand-off between the Force Publique and the German colonial army in German East Africa turned into open warfare with a joint Anglo-Belgian-Portuguese invasion of German colonial territory in 1916 and 1917 during the East African campaign . The Force Publique gained a notable victory when it marched into Tabora in September 1916 under the command of General Charles Tombeur after heavy fighting. After 1918, Belgium was rewarded for the participation of the Force Publique in the East African campaign with a League of Nations mandate over the previously German colony of Ruanda-Urundi . During World War II , the Belgian Congo provided a crucial source of income for the Belgian government in exile in London, and the Force Publique again participated in Allied campaigns in Africa . Belgian Congolese forces under the command of Belgian officers notably fought against the Italian colonial army in Ethiopia in Asosa , Bortaï and Saïo under Major-General Auguste-Eduard Gilliaert . In May 1960, a growing nationalist movement, the Mouvement National Congolais led by Patrice Lumumba , won the parliamentary elections . Lumumba became the first Prime Minister of the Republic of the Congo, on 24 June 1960. The parliament elected Joseph Kasa-Vubu as president , of the Alliance des Bakongo ( ABAKO ) party. Other parties that emerged included the Parti Solidaire Africain led by Antoine Gizenga , and the Parti National du Peuple led by Albert Delvaux and Laurent Mbariko . The Belgian Congo achieved independence on 30 June 1960 under the name "République du Congo" ("Republic of Congo" or "Republic of the Congo" in English). As the neighboring French colony of Middle Congo ( Moyen Congo ) also chose the name "Republic of Congo" upon achieving its independence, the two countries were more commonly known as "Congo-Léopoldville" and "Congo-Brazzaville", after their capital cities. Shortly after independence the Force Publique mutinied, and on 11 July the province of Katanga (led by Moïse Tshombe ) and South Kasai engaged in secessionist struggles against the new leadership. Most of the 100,000 Europeans who had remained behind after independence fled the country, opening the way for Congolese to replace the European military and administrative elite. After the United Nations rejected Lumumba's call for help to put down the secessionist movements, Lumumba asked for assistance from the Soviet Union, who accepted and sent military supplies and advisers. On 23 August, the Congolese armed forces invaded South Kasai . Lumumba was dismissed from office on 5 September 1960 by Kasa-Vubu who publicly blamed him for massacres by the armed forces in South Kasai and for involving Soviets in the country. Lumumba declared Kasa-Vubu's action unconstitutional, and a crisis between the two leaders developed. On 14 September, Colonel Joseph Mobutu , with the backing of the US and Belgium, removed Lumumba from office. On 17 January 1961, Lumumba was handed over to Katangan authorities and executed by Belgian-led Katangan troops. A 2001 investigation by Belgium's Parliament found Belgium "morally responsible" for the murder of Lumumba, and the country has since officially apologised for its role in his death. On 18 September 1961, in ongoing negotiations of a ceasefire, a plane crash near Ndola resulted in the death of Dag Hammarskjöld , the Secretary-General of the United Nations , along with all 15 passengers, setting off a succession crisis. Amidst widespread confusion and chaos, a temporary government was led by technicians (the Collège des commissaires généraux ). Katangan secession ended in January 1963 with the assistance of UN forces . Several short-lived governments of Joseph Ileo , Cyrille Adoula , and Moise Kapenda Tshombe took over in quick succession. Meanwhile, in the east of the country, Soviet and Cuban-backed rebels called the Simbas rose up, taking a significant amount of territory and proclaiming a communist "People's Republic of the Congo" in Stanleyville. The Simbas were pushed out of Stanleyville in November 1964 during Operation Dragon Rouge , a military operation conducted by Belgian and American forces to rescue hundreds of hostages. Congolese government forces fully defeated the Simba rebels by November 1965. Lumumba had previously appointed Mobutu chief of staff of the new Congo army, Armée Nationale Congolaise . Taking advantage of the leadership crisis between Kasavubu and Tshombe, Mobutu garnered enough support within the army to launch a coup. A constitutional referendum the year before Mobutu's coup of 1965 resulted in the country's official name being changed to the "Democratic Republic of the Congo". In 1971 Mobutu changed the name again, this time to "Republic of Zaire". Mobutu had the staunch support of the United States because of his opposition to communism ; the U.S. believed that his administration would serve as an effective counter to communist movements in Africa. A single-party system was established, and Mobutu declared himself head of state . He periodically held elections in which he was the only candidate. Although relative peace and stability were achieved, Mobutu's government was guilty of severe human rights violations, political repression , a cult of personality and corruption . By late 1967 Mobutu had successfully neutralized his political opponents and rivals, either through co-opting them into his regime, arresting them, or rendering them otherwise politically impotent. Throughout the late 1960s, Mobutu continued to shuffle his governments and cycle officials in and out of the office to maintain control. Joseph Kasa-Vubu's death in April 1969 ensured that no person with First Republic credentials could challenge his rule. By the early 1970s, Mobutu was attempting to assert Zaire as a leading African nation. He traveled frequently across the continent while the government became more vocal about African issues, particularly those relating to the southern region. Zaire established semi-clientelist relationships with several smaller African states, especially Burundi, Chad, and Togo. Corruption became so common the term " le mal Zairois " or "Zairian sickness", meaning gross corruption, theft and mismanagement, was coined, reportedly by Mobutu. International aid, most often in the form of loans, enriched Mobutu while he allowed national infrastructure such as roads to deteriorate to as little as one-quarter of what had existed in 1960. Zaire became a kleptocracy as Mobutu and his associates embezzled government funds. In a campaign to identify himself with African nationalism, starting on 1 June 1966, Mobutu renamed the nation's cities: Léopoldville became Kinshasa (the country was known as Congo-Kinshasa), Stanleyville became Kisangani , Elisabethville became Lubumbashi , and Coquilhatville became Mbandaka . In 1971, Mobutu renamed the country the Republic of Zaire , its fourth name change in eleven years and its sixth overall. The Congo River was renamed the Zaire River. During the 1970s and 1980s, Mobutu was invited to visit the United States on several occasions, meeting with U.S. Presidents Richard Nixon , Ronald Reagan and George H. W. Bush . Following the dissolution of the Soviet Union U.S. relations with Mobutu cooled, as he was no longer deemed necessary as a Cold War ally. Opponents within Zaire stepped up demands for reform. This atmosphere contributed to Mobutu's declaring the Third Republic in 1990, whose constitution was supposed to pave the way for democratic reform. The reforms turned out to be largely cosmetic. Mobutu continued in power until armed forces forced him to flee in 1997. "From 1990 to 1993, the United States facilitated Mobutu's attempts to hijack political change", one academic wrote, and "also assisted the rebellion of Laurent-Desire Kabila that overthrew the Mobutu regime." In September 1997, Mobutu died in exile in Morocco. By 1996, following the Rwandan Civil War and genocide and the ascension of a Tutsi -led government in Rwanda, Rwandan Hutu militia forces ( Interahamwe ) fled to eastern Zaire and used refugee camps as bases for incursions against Rwanda. They allied with the Zairian Armed Forces to launch a campaign against Congolese ethnic Tutsis in eastern Zaire. A coalition of Rwandan and Ugandan armies invaded Zaire to overthrow the government of Mobutu, launching the First Congo War. The coalition allied with some opposition figures, led by Laurent-Désiré Kabila , becoming the Alliance of Democratic Forces for the Liberation of Congo . In 1997 Mobutu fled and Kabila marched into Kinshasa, naming himself as president and reverting the name of the country to the Democratic Republic of the Congo. Kabila later requested that foreign military forces return to their own countries. Rwandan troops retreated to Goma and launched a new Tutsi-led rebel military movement called the Rassemblement Congolais pour la Democratie to fight Kabila, while Uganda instigated the creation of a rebel movement called the Movement for the Liberation of the Congo , led by Congolese warlord Jean-Pierre Bemba . [ citation needed ] The two rebel movements, along with Rwandan and Ugandan troops, started the Second Congo War by attacking the DRC army in 1998. Angolan, Zimbabwean, and Namibian militaries entered the hostilities on the side of the government. Kabila was assassinated in 2001. His son Joseph Kabila succeeded him and called for multilateral peace talks. UN peacekeepers, MONUC, now known as MONUSCO , arrived in April 2001. In 2002–03 Bemba intervened in the Central African Republic on behalf of its former president, Ange-Félix Patassé . Talks led to a peace accord under which Kabila would share power with former rebels. By June 2003 all foreign armies except those of Rwanda had pulled out of Congo. A transitional government was set up until after the election. A constitution was approved by voters, and on 30 July 2006 DRC held its first multi-party elections . These were the first free national elections since 1960, which many believed would mark the end to violence in the region. However, an election-result dispute between Kabila and Bemba turned into a skirmish between their supporters in Kinshasa. MONUC took control of the city. A new election took place in October 2006, which Kabila won, and in December 2006 he was sworn in as president.Laurent Nkunda , a member of Rally for Congolese Democracy–Goma , defected along with troops loyal to him and formed the National Congress for the Defence of the People (CNDP), which began an armed rebellion against the government. In March 2009, after a deal between the DRC and Rwanda, Rwandan troops entered the DRC and arrested Nkunda and were allowed to pursue FDLR militants. The CNDP signed a peace treaty with the government in which it agreed to become a political party and to have its soldiers integrated into the national army in exchange for the release of its imprisoned members. In 2012 Bosco Ntaganda , the leader of the CNDP, and troops loyal to him, mutinied and formed the rebel military March 23 Movement (M23), claiming the government had violated the treaty. In the resulting M23 rebellion , M23 briefly captured the provincial capital of Goma in November 2012. Neighboring countries, particularly Rwanda, have been accused of arming rebels groups and using them as proxies to gain control of the resource-rich country, an accusation they deny. In March 2013, the United Nations Security Council authorized the United Nations Force Intervention Brigade to neutralize armed groups. On 5 November 2013, M23 declared an end to its insurgency. Additionally, in northern Katanga , the Mai-Mai created by Laurent Kabila slipped out of the control of Kinshasa with Gédéon Kyungu Mutanga 's Mai Mai Kata Katanga briefly invading the provincial capital of Lubumbashi in 2013 and 400,000 persons displaced in the province as of 2013 [ update ] . On and off fighting in the Ituri conflict occurred between the Nationalist and Integrationist Front and the Union of Congolese Patriots who claimed to represent the Lendu and Hema ethnic groups, respectively. In the northeast, Joseph Kony 's Lord's Resistance Army moved from their original bases in Uganda and South Sudan to DR Congo in 2005 and set up camps in the Garamba National Park . The war in the Congo has been described as the bloodiest war since World War II. In 2009, The New York Times reported that people in the Congo continued to die at a rate of an estimated 45,000 per month – estimates of the number who have died from the long conflict range from 900,000 to 5,400,000. The death toll is caused by widespread disease and famine; reports indicate that almost half of the individuals who have died are children under five years of age. There have been frequent reports of weapon bearers killing civilians, of the destruction of property, of widespread sexual violence, causing hundreds of thousands of people to flee their homes, and of other breaches of humanitarian and human rights law. One study found that more than 400,000 women are raped in the Democratic Republic of Congo every year. In 2018 and 2019, Congo reported the highest levels of sexual violence in the world. According to the Human Rights Watch and the New York University-based Congo Research Group, armed troops in DRC's eastern Kivu region have killed over 1,900 civilians and kidnapped at least 3,300 people since June 2017 to June 2019. On 10 May 2018, Congolese gynecologist Denis Mukwege was awarded the Nobel Peace Prize for his effort to end the use of sexual violence as a weapon of war and armed conflict . In 2015, major protests broke out across the country and protesters demanded that Kabila step down as president. The protests began after the passage of a law by the Congolese lower house that, if also passed by the Congolese upper house, would keep Kabila in power at least until a national census was conducted (a process which would likely take several years and therefore keep him in power past the planned 2016 elections, which he is constitutionally barred from participating in). This bill passed; however, it was gutted of the provision that would keep Kabila in power until a census took place. A census is supposed to take place, but it is no longer tied to when the elections take place. In 2015, elections were scheduled for late 2016 and a tenuous peace held in the Congo. On 27 November 2016 Congolese foreign minister Raymond Tshibanda told the press no elections would be held in 2016: "it has been decided that the voter registration operation will end on July 31, 2017, and that election will take place in April 2018." Protests broke out in the country on 20 December when Kabila's term in office ended. Across the country, dozens of protesters were killed and hundreds were arrested. According to Jan Egeland , presently Secretary-General of the Norwegian Refugee Council , the situation in the DRC became much worse in 2016 and 2017 and is a major moral and humanitarian challenge comparable to the wars in Syria and Yemen, which receive much more attention. Women and children are abused sexually and "abused in all possible manners". Besides the conflict in North Kivu , violence increased in the Kasai region . The armed groups were after gold, diamonds, oil, and cobalt to line the pockets of rich men both in the region and internationally. There were also ethnic and cultural rivalries at play, as well as religious motives and the political crisis with postponed elections. Egeland says people believe the situation in the DRC is "stably bad" but in fact, it has become much, much worse. "The big wars of the Congo that were really on top of the agenda 15 years ago are back and worsening". Disruption in planting and harvesting caused by the conflict was estimated to escalate starvation in about two million children. Human Rights Watch said in 2017 that Kabila recruited former March 23 Movement fighters to put down country-wide protests over his refusal to step down from office at the end of his term. "M23 fighters patrolled the streets of Congo's main cities, firing on or arresting protesters or anyone else deemed to be a threat to the president," they said. Fierce fighting has erupted in Masisi between government forces and a powerful local warlord, General Delta. The United Nations mission in the DRC is its largest and most expensive peacekeeping effort, but it shut down five UN bases near Masisi in 2017, after the U.S. led a push to cut costs. A tribal conflict erupted on 16–17 December 2018 at Yumbi in Mai-Ndombe Province . Nearly 900 Banunu people from four villages were slaughtered by members of the Batende community in a deep-rooted rivalry over monthly tribal duties, land, fields and water resources. Some 100 Banunus fled to Moniende island in the Congo River, and another 16,000 to Makotimpoko District in Republic of Congo. Military-style tactics were employed in the bloodbath, and some assailants were clothed in army uniforms. Local authorities and elements within the security forces were suspected of lending them support. On 30 December 2018 a general election was held. On 10 January 2019, the electoral commission announced opposition candidate Félix Tshisekedi as the winner of the presidential vote, and he was officially sworn in as president on 24 January. However, there were widespread suspicions that the results were rigged and that a deal had been made between Tshisekedi and Kabila. The Catholic Church said that the official results did not correspond to the information its election monitors had collected. The government had also "delayed" the vote until March in some areas, citing the Ebola outbreak in Kivu as well as the ongoing military conflict. This was criticized as these regions are known as opposition strongholds. In August 2019, six months after the inauguration of Félix Tshisekedi, a coalition government was announced. The political allies of Kabila maintained control of key ministries, the legislature, judiciary and security services. However, Tshisekedi succeeded in strengthening his hold on power. In a series of moves, he won over more legislators, gaining the support of almost 400 out of 500 members of the National Assembly. The pro-Kabila speakers of both houses of parliament were forced out. In April 2021, the new government was formed without the supporters of Kabila. A major measles outbreak in the country left nearly 5,000 dead in 2019. The Ebola outbreak ended in June 2020, which had caused 2,280 deaths over 2 years. Another, smaller Ebola outbreak in the Équateur Province began in June 2020, ultimately causing 55 deaths. The global COVID-19 pandemic also reached the DRC in March 2020, with a vaccination campaign beginning on 19 April 2021. The Italian ambassador to the DRC, Luca Attanasio , and his bodyguard were killed in North Kivu on 22 February 2021 . On 22 April 2021, meetings between Kenyan President Uhuru Kenyatta and Tshisekedi resulted in new agreements increasing international trade and security (counterterrorism, immigration, cyber security, and customs) between the two countries. In February 2022, allegations of a coup d'état in the country led to uncertainty, but the coup attempt failed. After the 2023 presidential election , Tshisekedi had a clear lead in his run for a second term. On 31 December 2023, officials said that President Felix Tshisekedi had been re-elected with 73% of the vote. Nine opposition candidates signed a declaration rejecting the election and called for a rerun. The DRC is located in central sub-Saharan Africa , bordered to the northwest by the Republic of the Congo , to the north by the Central African Republic , to the northeast by South Sudan , to the east by Uganda , Rwanda and Burundi , and by Tanzania (across Lake Tanganyika), to the south and southeast by Zambia , to the southwest by Angola , and to the west by the South Atlantic Ocean and the Cabinda Province exclave of Angola . The country lies between latitudes 6°N and 14°S , and longitudes 12°E and 32°E . It straddles the Equator , with one-third to the north and two-thirds to the south. With an area of 2,345,408 square kilometres (905,567 sq mi) , it is the second-largest country in Africa by area, after Algeria. As a result of its equatorial location, the DRC experiences high precipitation and has the highest frequency of thunderstorms in the world. The annual rainfall can total upwards of 2,000 millimetres (80 in) in some places, and the area sustains the Congo rainforest , the second-largest rain forest in the world after the Amazon rainforest . This massive expanse of lush jungle covers most of the vast, low-lying central basin of the river, which slopes toward the Atlantic Ocean in the west. This area is surrounded by plateaus merging into savannas in the south and southwest, by mountainous terraces in the west, and dense grasslands extending beyond the Congo River in the north. The glaciated Rwenzori Mountains are found in the extreme eastern region. The tropical climate produced the Congo River system which dominates the region topographically along with the rainforest it flows through. The Congo Basin occupies nearly the entire country and an area of nearly 1,000,000 km 2 (390,000 sq mi) . The river and its tributaries form the backbone of Congolese economics and transportation. Major tributaries include the Kasai , Sangha , Ubangi , Ruzizi , Aruwimi , and Lulonga . The Congo River has the second-largest flow and the second-largest watershed of any river in the world (trailing the Amazon in both respects). The sources of the Congo River are in the Albertine Rift Mountains that flank the western branch of the East African Rift , as well as Lake Tanganyika and Lake Mweru . The river flows generally west from Kisangani just below Boyoma Falls , then gradually bends southwest, passing by Mbandaka , joining with the Ubangi River, and running into the Pool Malebo (Stanley Pool). Kinshasa and Brazzaville are on opposite sides of the river at the Pool. Then the river narrows and falls through a number of cataracts in deep canyons, collectively known as the Livingstone Falls , and runs past Boma into the Atlantic Ocean. The river and a 37-kilometre-wide (23 mi) strip of coastline on its north bank provide the country's only outlet to the Atlantic. The Albertine Rift plays a key role in shaping the Congo's geography. Not only is the northeastern section of the country much more mountainous, but tectonic movement results in volcanic activity, occasionally with loss of life. The geologic activity in this area also created the African Great Lakes , four of which lie on the Congo's eastern frontier: Lake Albert , Lake Kivu , Lake Edward , and Lake Tanganyika . The rift valley has exposed an enormous amount of mineral wealth throughout the south and east of the Congo, making it accessible to mining. Cobalt , copper, cadmium , industrial and gem-quality diamonds , gold, silver, zinc , manganese , tin , germanium , uranium , radium , bauxite , iron ore, and coal are all found in plentiful supply, especially in the Congo's southeastern Katanga region. On 17 January 2002, Mount Nyiragongo erupted , with three streams of extremely fluid lava running out at 64 km/h (40 mph) and 46 m (50 yd) wide. One of the three streams flowed directly through Goma, killing 45 people and leaving 120,000 homeless. Over 400,000 people were evacuated from the city during the eruption. The lava flowed into and poisoned the water of Lake Kivu killing its plants, animals and fish. Only two planes left the local airport because of the possibility of the explosion of stored petrol. The lava flowed through and past the airport, destroying a runway and trapping several parked airplanes. Six months after the event, nearby Mount Nyamuragira also erupted. The mountain subsequently erupted again in 2006, and once again in January 2010. The rainforests of the Democratic Republic of the Congo contain great biodiversity , including many rare and endemic species, such as the common chimpanzee and the bonobo (or pygmy chimpanzee), the African forest elephant , mountain gorilla , okapi , forest buffalo , leopard and, further south in the country, the southern white rhinoceros . Five of the country's national parks are listed as World Heritage Sites : the Garumba , Kahuzi-Biega , Salonga and Virunga National Parks , and the Okapi Wildlife Reserve . The Democratic Republic of the Congo is one of 17 Megadiverse countries and is the most biodiverse African country. Conservationists have particularly worried about primates . The Congo is inhabited by several great ape species: the common chimpanzee ( Pan troglodytes ), the bonobo ( Pan paniscus ), the eastern gorilla ( Gorilla beringei ), and possibly a population of the western gorilla ( Gorilla gorilla ). It is the only country in the world in which bonobos are found in the wild. Much concern has been raised about great ape extinction. Because of hunting and habitat destruction, the numbers of chimpanzee, bonobo and gorilla (each of whose populations once numbered in the millions) have now dwindled down to only about 200,000 gorillas, 100,000 chimpanzees and possibly only about 10,000 bonobos. The gorillas, chimpanzee, bonobo, and okapi are all classified as endangered by the World Conservation Union . Major environmental issues in DRC include deforestation , poaching , which threatens wildlife populations, water pollution and mining. From 2015 to 2019, the rate of deforestation in the Democratic Republic of the Congo doubled. In 2021, deforestation of the Congolian rainforests increased by 5%. The rainforests of the Democratic Republic of the Congo contain great biodiversity , including many rare and endemic species, such as the common chimpanzee and the bonobo (or pygmy chimpanzee), the African forest elephant , mountain gorilla , okapi , forest buffalo , leopard and, further south in the country, the southern white rhinoceros . Five of the country's national parks are listed as World Heritage Sites : the Garumba , Kahuzi-Biega , Salonga and Virunga National Parks , and the Okapi Wildlife Reserve . The Democratic Republic of the Congo is one of 17 Megadiverse countries and is the most biodiverse African country. Conservationists have particularly worried about primates . The Congo is inhabited by several great ape species: the common chimpanzee ( Pan troglodytes ), the bonobo ( Pan paniscus ), the eastern gorilla ( Gorilla beringei ), and possibly a population of the western gorilla ( Gorilla gorilla ). It is the only country in the world in which bonobos are found in the wild. Much concern has been raised about great ape extinction. Because of hunting and habitat destruction, the numbers of chimpanzee, bonobo and gorilla (each of whose populations once numbered in the millions) have now dwindled down to only about 200,000 gorillas, 100,000 chimpanzees and possibly only about 10,000 bonobos. The gorillas, chimpanzee, bonobo, and okapi are all classified as endangered by the World Conservation Union . Major environmental issues in DRC include deforestation , poaching , which threatens wildlife populations, water pollution and mining. From 2015 to 2019, the rate of deforestation in the Democratic Republic of the Congo doubled. In 2021, deforestation of the Congolian rainforests increased by 5%. The country is currently divided into the city-province of Kinshasa and 25 other provinces . The provinces are subdivided into 145 territories and 32 cities. Before 2015, the country had 11 provinces. After a four-year interlude between two constitutions, with new political institutions established at the various levels of government, as well as new administrative divisions for the provinces throughout the country, a new constitution came into effect in 2006 and politics in the Democratic Republic of the Congo finally settled into a stable presidential democratic republic . The 2003 transitional constitution had established a parliament with a bicameral legislature, consisting of a Senate and a National Assembly . The Senate had, among other things, the charge of drafting the new constitution of the country. The executive branch was vested in a 60-member cabinet, headed by a President and four vice presidents. The President was also the Commander-in-Chief of the armed forces. The transitional constitution also established a relatively independent judiciary, headed by a Supreme Court with constitutional interpretation powers. The 2006 constitution, also known as the Constitution of the Third Republic, came into effect in February 2006. It had concurrent authority, however, with the transitional constitution until the inauguration of the elected officials who emerged from the July 2006 elections. Under the new constitution, the legislature remained bicameral; the executive was concomitantly undertaken by a President and the government, led by a Prime Minister, appointed from the party able to secure a majority in the National Assembly. The government – not the President – is responsible to the Parliament. The new constitution also granted new powers to the provincial governments, creating provincial parliaments which have oversight of the Governor and the head of the provincial government, whom they elect. The new constitution also saw the disappearance of the Supreme Court, which was divided into three new institutions. The constitutional interpretation prerogative of the Supreme Court is now held by the Constitutional Court . Although located in the Central African UN subregion , the nation is also economically and regionally affiliated with Southern Africa as a member of the Southern African Development Community (SADC). The global growth in demand for scarce raw materials and the industrial surges in China, India, Russia, Brazil and other developing countries require that developed countries employ new, integrated and responsive strategies for identifying and ensuring, on a continual basis, an adequate supply of strategic and critical materials required for their security needs. Highlighting the DR Congo's importance to United States national security, the effort to establish an elite Congolese unit is the latest push by the U.S. to professionalize armed forces in this strategically important region. There are economic and strategic incentives to bring more security to the Congo, which is rich in natural resources such as cobalt , a strategic and critical metal used in many industrial and military applications. The largest use of cobalt is in superalloys , used to make jet engine parts. Cobalt is also used in magnetic alloys and in cutting and wear-resistant materials such as cemented carbides . The chemical industry consumes significant quantities of cobalt in a variety of applications including catalysts for petroleum and chemical processing; drying agents for paints and inks; ground coats for porcelain enamels; decolorant for ceramics and glass; and pigments for ceramics, paints, and plastics. The country possesses 80% of the world's cobalt reserves. It is thought that due to the importance of cobalt for batteries for electric vehicles and stabilization of electric grids with large proportions of intermittent renewables in the electricity mix, the DRC could become an object of increased geopolitical competition. In the 21st century, Chinese investment in the DRC and Congolese exports to China have grown rapidly. In July 2019, UN ambassadors of 37 countries, including DRC, have signed a joint letter to the UNHRC defending China's treatment of Uyghurs and other Muslim ethnic minorities. In 2021, President Félix Tshisekedi called for a review of mining contracts signed with China by his predecessor Joseph Kabila , in particular the Sicomines multibillion 'minerals-for-infrastructure' deal . The military of the Democratic Republic of the Congo, known as the FARDC , consists of the Land Forces , the Air Force , and the Navy . The FARDC was established in 2003 after the end of the Second Congo War and integrated many former rebel groups into its ranks. Due to the presence of undisciplined and poorly trained ex-rebels, as well as a lack of funding and having spent years fighting against different militias, the FARDC suffers from rampant corruption and inefficiency. The agreements signed at the end of the Second Congo War called for a new "national, restructured and integrated" army that would be made up of Kabila's government forces (the FAC), the RCD, and the MLC. Also stipulated was that rebels like the RCD-N, RCD-ML, and the Mai-Mai would become part of the new armed forces. It also provided for the creation of a Conseil Supérieur de la Défense (Superior Defence Council) which would declare states of siege or war and give advice on security sector reform, disarmament/demobilisation, and national defence policy. The FARDC is organised on the basis of brigades, which are dispersed throughout the provinces of the Democratic Republic of the Congo . Congolese troops have been fighting the Kivu conflict in the eastern North Kivu region, the Ituri conflict in the Ituri region, and other rebellions since the Second Congo War. Besides the FARDC, the largest peacekeeping mission of the United Nations , known as MONUSCO , is also present in the country with about 18,000 peacekeepers. The Democratic Republic of Congo signed the UN treaty on the Prohibition of Nuclear Weapons . A relative of Mobutu explained how the government illicitly collected revenue during his rule: "Mobutu would ask one of us to go to the bank and take out a million. We'd go to an intermediary and tell him to get five million. He would go to the bank with Mobutu's authority and take out ten. Mobutu got one, and we took the other nine." Mobutu institutionalized corruption to prevent political rivals from challenging his control, leading to an economic collapse in 1996 . Mobutu allegedly amassed between US$50 million and $125 million during his rule. He was not the first corrupt Congolese leader by any means: "Government as a system of organized theft goes back to King Leopold II," noted Adam Hochschild in 2009. In July 2009, a Swiss court determined that the statute of limitations had run out on an international asset recovery case of about $6.7 million of deposits of Mobutu's in a Swiss bank, and therefore the assets should be returned to Mobutu's family. President Kabila established the Commission of Repression of Economic Crimes upon his ascension to power in 2001. However, in 2016 the Enough Project issued a report claiming that the Congo is run as a violent kleptocracy . In June 2020, a court in the Democratic Republic of Congo found President Tshisekedi's chief of staff Vital Kamerhe guilty of corruption. He was sentenced to 20 years' hard labour, after facing charges of embezzling almost $50m (£39m) of public funds. He was the most high-profile figure to be convicted of corruption in the DRC. However, Kamerhe was released already in December 2021. In November 2021, a judicial investigation targeting Kabila and his associates was opened in Kinshasa after revelations of alleged embezzlement of $138 million. The International Criminal Court investigation in the Democratic Republic of the Congo was initiated by Kabila in April 2004. The International Criminal Court prosecutor opened the case in June 2004. Child soldiers have been used on a large scale in DRC, and in 2011 it was estimated that 30,000 children were still operating with armed groups. Instances of child labor and forced labor have been observed and reported in the U.S. Department of Labor 's Findings on the Worst Forms of Child Labor in the DRC in 2013 and six goods produced by the country's mining industry appear on the department's December 2014 List of Goods Produced by Child Labor or Forced Labor . The Democratic Republic of the Congo has prohibited same-sex marriage since 2006, and attitudes towards the LGBT community are generally negative throughout the nation. Violence against women seems to be perceived by large sectors of society to be normal. The 2013–2014 DHS survey (pp. 299) found that 74.8% of women agreed that a husband is justified in beating his wife in certain circumstances. The United Nations Committee on the Elimination of Discrimination against Women in 2006 expressed concern that in the post-war transition period, the promotion of women's human rights and gender equality is not seen as a priority. Mass rapes, sexual violence and sexual slavery are used as a weapon of war by the Armed Forces of the Democratic Republic of the Congo and armed groups in the eastern part of the country. The eastern part of the country in particular has been described as the "rape capital of the world" and the prevalence of sexual violence there described as the worst in the world. Female genital mutilation (FGM) is also practiced in DRC, although not on a large scale. The prevalence of FGM is estimated at 5% of women. FGM is illegal: the law imposes a penalty of two to five years of prison and a fine of 200,000 Congolese francs on any person who violates the "physical or functional integrity" of the genital organs. In July 2007, the International Committee of the Red Cross expressed concern about the situation in eastern DRC. A phenomenon of "pendulum displacement" has developed, where people hasten at night to safety. According to Yakin Ertürk, the UN Special Rapporteur on Violence against Women who toured eastern Congo in July 2007, violence against women in North and South Kivu included "unimaginable brutality". Ertürk added that "Armed groups attack local communities, loot, rape, kidnap women and children, and make them work as sexual slaves". In December 2008, GuardianFilms of The Guardian released a film documenting the testimony of over 400 women and girls who had been abused by marauding militia. In June 2010, Oxfam reported a dramatic increase in the number of rapes in the Democratic Republic of the Congo, and researchers from Harvard discovered that rapes committed by civilians had increased seventeenfold. In June 2014, Freedom from Torture published reported rape and sexual violence being used routinely by state officials in Congolese prisons as punishment for politically active women. The women included in the report were abused in several locations across the country including the capital Kinshasa and other areas away from the conflict zones. In 2015, figures both inside and outside of the country, such as Filimbi and Emmanuel Weyi, spoke out about the need to curb violence and instability as the 2016 elections approached. The Congolese National Police are the primary police force in the Democratic Republic of the Congo. The global growth in demand for scarce raw materials and the industrial surges in China, India, Russia, Brazil and other developing countries require that developed countries employ new, integrated and responsive strategies for identifying and ensuring, on a continual basis, an adequate supply of strategic and critical materials required for their security needs. Highlighting the DR Congo's importance to United States national security, the effort to establish an elite Congolese unit is the latest push by the U.S. to professionalize armed forces in this strategically important region. There are economic and strategic incentives to bring more security to the Congo, which is rich in natural resources such as cobalt , a strategic and critical metal used in many industrial and military applications. The largest use of cobalt is in superalloys , used to make jet engine parts. Cobalt is also used in magnetic alloys and in cutting and wear-resistant materials such as cemented carbides . The chemical industry consumes significant quantities of cobalt in a variety of applications including catalysts for petroleum and chemical processing; drying agents for paints and inks; ground coats for porcelain enamels; decolorant for ceramics and glass; and pigments for ceramics, paints, and plastics. The country possesses 80% of the world's cobalt reserves. It is thought that due to the importance of cobalt for batteries for electric vehicles and stabilization of electric grids with large proportions of intermittent renewables in the electricity mix, the DRC could become an object of increased geopolitical competition. In the 21st century, Chinese investment in the DRC and Congolese exports to China have grown rapidly. In July 2019, UN ambassadors of 37 countries, including DRC, have signed a joint letter to the UNHRC defending China's treatment of Uyghurs and other Muslim ethnic minorities. In 2021, President Félix Tshisekedi called for a review of mining contracts signed with China by his predecessor Joseph Kabila , in particular the Sicomines multibillion 'minerals-for-infrastructure' deal . The military of the Democratic Republic of the Congo, known as the FARDC , consists of the Land Forces , the Air Force , and the Navy . The FARDC was established in 2003 after the end of the Second Congo War and integrated many former rebel groups into its ranks. Due to the presence of undisciplined and poorly trained ex-rebels, as well as a lack of funding and having spent years fighting against different militias, the FARDC suffers from rampant corruption and inefficiency. The agreements signed at the end of the Second Congo War called for a new "national, restructured and integrated" army that would be made up of Kabila's government forces (the FAC), the RCD, and the MLC. Also stipulated was that rebels like the RCD-N, RCD-ML, and the Mai-Mai would become part of the new armed forces. It also provided for the creation of a Conseil Supérieur de la Défense (Superior Defence Council) which would declare states of siege or war and give advice on security sector reform, disarmament/demobilisation, and national defence policy. The FARDC is organised on the basis of brigades, which are dispersed throughout the provinces of the Democratic Republic of the Congo . Congolese troops have been fighting the Kivu conflict in the eastern North Kivu region, the Ituri conflict in the Ituri region, and other rebellions since the Second Congo War. Besides the FARDC, the largest peacekeeping mission of the United Nations , known as MONUSCO , is also present in the country with about 18,000 peacekeepers. The Democratic Republic of Congo signed the UN treaty on the Prohibition of Nuclear Weapons . A relative of Mobutu explained how the government illicitly collected revenue during his rule: "Mobutu would ask one of us to go to the bank and take out a million. We'd go to an intermediary and tell him to get five million. He would go to the bank with Mobutu's authority and take out ten. Mobutu got one, and we took the other nine." Mobutu institutionalized corruption to prevent political rivals from challenging his control, leading to an economic collapse in 1996 . Mobutu allegedly amassed between US$50 million and $125 million during his rule. He was not the first corrupt Congolese leader by any means: "Government as a system of organized theft goes back to King Leopold II," noted Adam Hochschild in 2009. In July 2009, a Swiss court determined that the statute of limitations had run out on an international asset recovery case of about $6.7 million of deposits of Mobutu's in a Swiss bank, and therefore the assets should be returned to Mobutu's family. President Kabila established the Commission of Repression of Economic Crimes upon his ascension to power in 2001. However, in 2016 the Enough Project issued a report claiming that the Congo is run as a violent kleptocracy . In June 2020, a court in the Democratic Republic of Congo found President Tshisekedi's chief of staff Vital Kamerhe guilty of corruption. He was sentenced to 20 years' hard labour, after facing charges of embezzling almost $50m (£39m) of public funds. He was the most high-profile figure to be convicted of corruption in the DRC. However, Kamerhe was released already in December 2021. In November 2021, a judicial investigation targeting Kabila and his associates was opened in Kinshasa after revelations of alleged embezzlement of $138 million. The International Criminal Court investigation in the Democratic Republic of the Congo was initiated by Kabila in April 2004. The International Criminal Court prosecutor opened the case in June 2004. Child soldiers have been used on a large scale in DRC, and in 2011 it was estimated that 30,000 children were still operating with armed groups. Instances of child labor and forced labor have been observed and reported in the U.S. Department of Labor 's Findings on the Worst Forms of Child Labor in the DRC in 2013 and six goods produced by the country's mining industry appear on the department's December 2014 List of Goods Produced by Child Labor or Forced Labor . The Democratic Republic of the Congo has prohibited same-sex marriage since 2006, and attitudes towards the LGBT community are generally negative throughout the nation. Violence against women seems to be perceived by large sectors of society to be normal. The 2013–2014 DHS survey (pp. 299) found that 74.8% of women agreed that a husband is justified in beating his wife in certain circumstances. The United Nations Committee on the Elimination of Discrimination against Women in 2006 expressed concern that in the post-war transition period, the promotion of women's human rights and gender equality is not seen as a priority. Mass rapes, sexual violence and sexual slavery are used as a weapon of war by the Armed Forces of the Democratic Republic of the Congo and armed groups in the eastern part of the country. The eastern part of the country in particular has been described as the "rape capital of the world" and the prevalence of sexual violence there described as the worst in the world. Female genital mutilation (FGM) is also practiced in DRC, although not on a large scale. The prevalence of FGM is estimated at 5% of women. FGM is illegal: the law imposes a penalty of two to five years of prison and a fine of 200,000 Congolese francs on any person who violates the "physical or functional integrity" of the genital organs. In July 2007, the International Committee of the Red Cross expressed concern about the situation in eastern DRC. A phenomenon of "pendulum displacement" has developed, where people hasten at night to safety. According to Yakin Ertürk, the UN Special Rapporteur on Violence against Women who toured eastern Congo in July 2007, violence against women in North and South Kivu included "unimaginable brutality". Ertürk added that "Armed groups attack local communities, loot, rape, kidnap women and children, and make them work as sexual slaves". In December 2008, GuardianFilms of The Guardian released a film documenting the testimony of over 400 women and girls who had been abused by marauding militia. In June 2010, Oxfam reported a dramatic increase in the number of rapes in the Democratic Republic of the Congo, and researchers from Harvard discovered that rapes committed by civilians had increased seventeenfold. In June 2014, Freedom from Torture published reported rape and sexual violence being used routinely by state officials in Congolese prisons as punishment for politically active women. The women included in the report were abused in several locations across the country including the capital Kinshasa and other areas away from the conflict zones. In 2015, figures both inside and outside of the country, such as Filimbi and Emmanuel Weyi, spoke out about the need to curb violence and instability as the 2016 elections approached. The Congolese National Police are the primary police force in the Democratic Republic of the Congo. The Central Bank of the Congo is responsible for developing and maintaining the Congolese franc , which serves as the primary form of currency in the Democratic Republic of the Congo. In 2007, The World Bank decided to grant the Democratic Republic of Congo up to $1.3 billion in assistance funds over the following three years. The Congolese government started negotiating membership in the Organization for the Harmonization of Business Law in Africa (OHADA), in 2009. The DRC is widely considered one of the world's richest countries in natural resources; its untapped deposits of raw minerals are estimated to be worth in excess of US$24 trillion. The DRC has 70% of the world's coltan , a third of its cobalt, more than 30% of its diamond reserves, and a tenth of its copper. Despite such vast mineral wealth, the economy of the Democratic Republic of the Congo has declined drastically since the mid-1980s. The DRC generated up to 70% of its export revenue from minerals in the 1970s and 1980s and was particularly hit when resource prices deteriorated at that time. By 2005, 90% of the DRC's revenues derived from its minerals. Congolese citizens are among the poorest people on Earth. In 2023, 60% of Congolese subsisted on less than $2.15 a day, and food-price inflation had reached 173%. DR Congo consistently has the lowest, or nearly the lowest, nominal GDP per capita in the world. The DRC is also one of the twenty lowest-ranked countries on the Corruption Perceptions Index . The DRC is the world's largest producer of cobalt ore, and a major producer of copper and diamonds. As of 2023, the country is estimated to possess around 70% of the world's cobalt production. Diamonds come from Kasaï Province in the west. By far the largest mines in the DRC are located in southern Katanga Province and are highly mechanized, with a capacity of several million tons per year of copper and cobalt ore, and refining capability for metal ore. The DRC is the second-largest diamond-producing nation in the world, [lower-alpha 4] and artisanal and small-scale miners account for most of its production. At independence in 1960, DRC was the second-most-industrialized country in Africa after South Africa; it boasted a thriving mining sector and a relatively productive agriculture sector. Foreign businesses have curtailed operations because of uncertainty about the outcome of long-term conflicts, lack of infrastructure, and the difficult operating environment. The wars intensified the impact of such basic problems as an uncertain legal framework, corruption, inflation, and lack of openness in government economic policy and financial operations. Conditions improved in late 2002, when a large portion of the invading foreign troops withdrew. A number of International Monetary Fund and World Bank missions met with the government to help it develop a coherent economic plan, and President Kabila began implementing reforms. Much economic activity still lies outside the GDP data. Through 2011 the DRC had the lowest Human Development Index of the 187 ranked countries. The economy of DRC relies heavily on mining. However, the smaller-scale economic activity from artisanal mining occurs in the informal sector and is not reflected in GDP data. A third of the DRC's diamonds are believed to be smuggled out of the country, making it difficult to quantify diamond production levels. In 2002, tin was discovered in the east of the country but to date has only been mined on a small scale. Smuggling of conflict minerals such as coltan and cassiterite , ores of tantalum and tin, respectively, helped to fuel the war in the eastern Congo. Katanga Mining Limited , a Swiss-owned company, owns the Luilu Metallurgical Plant, which has a capacity of 175,000 tonnes of copper and 8,000 tonnes of cobalt per year, making it the largest cobalt refinery in the world. After a major rehabilitation program, the company resumed copper production operations in December 2007 and cobalt production in May 2008. In April 2013, anti-corruption NGOs revealed that Congolese tax authorities had failed to account for $88 million from the mining sector, despite booming production and positive industrial performance. The missing funds date from 2010 and tax bodies should have paid them into the central bank. Later in 2013, the Extractive Industries Transparency Initiative suspended the country's candidacy for membership due to insufficient reporting, monitoring and independent audits, but in July 2013 the country improved its accounting and transparency practices to the point where the EITI gave the country full membership. In February 2018, global asset management firm AllianceBernstein defined the DRC as economically "the Saudi Arabia of the electric vehicle age," because of its cobalt resources, as essential to the lithium-ion batteries that drive electric vehicles . Ground transport in the Democratic Republic of Congo has always been difficult. The terrain and climate of the Congo Basin present serious barriers to road and rail construction, and the distances are enormous across this vast country. The DRC has more navigable rivers and moves more passengers and goods by boat and ferry than any other country in Africa, but air transport remains the only effective means of moving goods and people between many places within the country, especially in rural areas. Chronic economic mismanagement, political corruption and internal conflicts have led to long-term under-investment of infrastructure. [ citation needed ] Rail transportation is provided by the Congo Railroad Company ( Société nationale des chemins de fer du Congo ), the Office National des Transports Congo and the Office of the Uele Railways (Office des Chemins de fer des Ueles, CFU). The DRC has fewer all-weather paved highways than any country of its population and size in Africa — a total of 2,250 km (1,400 mi) , of which only 1,226 km (762 mi) is in good condition. To put this in perspective, the road distance across the country in any direction is more than 2,500 km (1,600 mi) (e.g. Matadi to Lubumbashi, 2,700 km (1,700 mi) by road). The figure of 2,250 km (1,400 mi) converts to 35 km (22 mi) of paved road per one million of population. Comparative figures for Zambia and Botswana are 721 km (448 mi) and 3,427 km (2,129 mi) , respectively. [lower-alpha 5] Three routes in the Trans-African Highway network pass through DR Congo: The DRC has thousands of kilometres of navigable waterways . Traditionally water transport has been the dominant means of moving around in approximately two-thirds of the country. As of February 2024 [ update ] , DR Congo had one major national airline ( Congo Airways ) that offered flights inside DR Congo. Congo Airways was based at Kinshasa's international airport . All air carriers certified by the DRC have been banned from European Union airports by the European Commission, because of inadequate safety standards. Several international airlines service Kinshasa's international airport and a few also offer international flights to Lubumbashi International Airport . Both coal and crude oil resources were mainly used domestically up to 2008. The DRC has the infrastructure for hydro-electricity from the Congo River at the Inga dams . The country also possesses 50% of Africa's forests and a river system that could provide hydro-electric power to the entire continent, according to a UN report on the country's strategic significance and its potential role as an economic power in central Africa. The generation and distribution of electricity are controlled by Société nationale d'électricité , but only 15% of the country has access to electricity. The DRC is a member of three electrical power pools. These are Southern African Power Pool, East African Power Pool, and Central African Power Pool. Because of abundant sunlight, the potential for solar development is very high in the DRC. There are already about 836 solar power systems in the DRC, with a total power of 83 MW, located in Équateur (167), Katanga (159), Nord-Kivu (170), the two Kasaï provinces (170), and Bas-Congo (170). Also, the 148 Caritas network system has a total power of 6.31 MW. The DRC is the world's largest producer of cobalt ore, and a major producer of copper and diamonds. As of 2023, the country is estimated to possess around 70% of the world's cobalt production. Diamonds come from Kasaï Province in the west. By far the largest mines in the DRC are located in southern Katanga Province and are highly mechanized, with a capacity of several million tons per year of copper and cobalt ore, and refining capability for metal ore. The DRC is the second-largest diamond-producing nation in the world, [lower-alpha 4] and artisanal and small-scale miners account for most of its production. At independence in 1960, DRC was the second-most-industrialized country in Africa after South Africa; it boasted a thriving mining sector and a relatively productive agriculture sector. Foreign businesses have curtailed operations because of uncertainty about the outcome of long-term conflicts, lack of infrastructure, and the difficult operating environment. The wars intensified the impact of such basic problems as an uncertain legal framework, corruption, inflation, and lack of openness in government economic policy and financial operations. Conditions improved in late 2002, when a large portion of the invading foreign troops withdrew. A number of International Monetary Fund and World Bank missions met with the government to help it develop a coherent economic plan, and President Kabila began implementing reforms. Much economic activity still lies outside the GDP data. Through 2011 the DRC had the lowest Human Development Index of the 187 ranked countries. The economy of DRC relies heavily on mining. However, the smaller-scale economic activity from artisanal mining occurs in the informal sector and is not reflected in GDP data. A third of the DRC's diamonds are believed to be smuggled out of the country, making it difficult to quantify diamond production levels. In 2002, tin was discovered in the east of the country but to date has only been mined on a small scale. Smuggling of conflict minerals such as coltan and cassiterite , ores of tantalum and tin, respectively, helped to fuel the war in the eastern Congo. Katanga Mining Limited , a Swiss-owned company, owns the Luilu Metallurgical Plant, which has a capacity of 175,000 tonnes of copper and 8,000 tonnes of cobalt per year, making it the largest cobalt refinery in the world. After a major rehabilitation program, the company resumed copper production operations in December 2007 and cobalt production in May 2008. In April 2013, anti-corruption NGOs revealed that Congolese tax authorities had failed to account for $88 million from the mining sector, despite booming production and positive industrial performance. The missing funds date from 2010 and tax bodies should have paid them into the central bank. Later in 2013, the Extractive Industries Transparency Initiative suspended the country's candidacy for membership due to insufficient reporting, monitoring and independent audits, but in July 2013 the country improved its accounting and transparency practices to the point where the EITI gave the country full membership. In February 2018, global asset management firm AllianceBernstein defined the DRC as economically "the Saudi Arabia of the electric vehicle age," because of its cobalt resources, as essential to the lithium-ion batteries that drive electric vehicles . Ground transport in the Democratic Republic of Congo has always been difficult. The terrain and climate of the Congo Basin present serious barriers to road and rail construction, and the distances are enormous across this vast country. The DRC has more navigable rivers and moves more passengers and goods by boat and ferry than any other country in Africa, but air transport remains the only effective means of moving goods and people between many places within the country, especially in rural areas. Chronic economic mismanagement, political corruption and internal conflicts have led to long-term under-investment of infrastructure. [ citation needed ] Rail transportation is provided by the Congo Railroad Company ( Société nationale des chemins de fer du Congo ), the Office National des Transports Congo and the Office of the Uele Railways (Office des Chemins de fer des Ueles, CFU). The DRC has fewer all-weather paved highways than any country of its population and size in Africa — a total of 2,250 km (1,400 mi) , of which only 1,226 km (762 mi) is in good condition. To put this in perspective, the road distance across the country in any direction is more than 2,500 km (1,600 mi) (e.g. Matadi to Lubumbashi, 2,700 km (1,700 mi) by road). The figure of 2,250 km (1,400 mi) converts to 35 km (22 mi) of paved road per one million of population. Comparative figures for Zambia and Botswana are 721 km (448 mi) and 3,427 km (2,129 mi) , respectively. [lower-alpha 5] Three routes in the Trans-African Highway network pass through DR Congo: The DRC has thousands of kilometres of navigable waterways . Traditionally water transport has been the dominant means of moving around in approximately two-thirds of the country. As of February 2024 [ update ] , DR Congo had one major national airline ( Congo Airways ) that offered flights inside DR Congo. Congo Airways was based at Kinshasa's international airport . All air carriers certified by the DRC have been banned from European Union airports by the European Commission, because of inadequate safety standards. Several international airlines service Kinshasa's international airport and a few also offer international flights to Lubumbashi International Airport .Both coal and crude oil resources were mainly used domestically up to 2008. The DRC has the infrastructure for hydro-electricity from the Congo River at the Inga dams . The country also possesses 50% of Africa's forests and a river system that could provide hydro-electric power to the entire continent, according to a UN report on the country's strategic significance and its potential role as an economic power in central Africa. The generation and distribution of electricity are controlled by Société nationale d'électricité , but only 15% of the country has access to electricity. The DRC is a member of three electrical power pools. These are Southern African Power Pool, East African Power Pool, and Central African Power Pool. Because of abundant sunlight, the potential for solar development is very high in the DRC. There are already about 836 solar power systems in the DRC, with a total power of 83 MW, located in Équateur (167), Katanga (159), Nord-Kivu (170), the two Kasaï provinces (170), and Bas-Congo (170). Also, the 148 Caritas network system has a total power of 6.31 MW. The CIA World Factbook estimated the population to be over 111 million as of 2023. Between 1950 and 2000, the country's population nearly quadrupled from 12.2 million to 46.9 million. French is the official language of the Democratic Republic of the Congo. It is culturally accepted as the lingua franca , facilitating communication among the many different ethnic groups of the Congo. According to a 2018 OIF report, 49 million Congolese people (51% of the population) could read and write in French. A 2021 survey found that 74% of the population could speak French, making it the most widely spoken language in the country. In Kinshasa, 67% of the population in 2014 could read and write French, and 68.5% could speak and understand it. Approximately 242 languages are spoken in the country, of which four have the status of national languages: Kituba (Kikongo), Lingala , Tshiluba , and Swahili . Although some limited number of people speak these as first languages, most of the population speak them as a second language, after the native language of their own ethnic group. Lingala was the official language of the Force Publique under Belgian colonial rule and remains to this day the predominant language of the armed forces. Since the recent rebellions, a good part of the army in the east also uses Swahili, where it competes to be the regional lingua franca. Under Belgian rule, the Belgians instituted teaching and use of the four national languages in primary schools, making it one of the few African nations to have had literacy in local languages during the European colonial period. This trend was reversed after independence, when French became the sole language of education at all levels. Since 1975, the four national languages have been reintroduced in the first two years of primary education, with French becoming the sole language of education from the third year onward, but in practice many primary schools in urban areas solely use French from the first year of school onward. Portuguese is taught in the Congolese schools as a foreign language. The lexical similarity and phonology with French makes Portuguese a relatively easy language for the people to learn. Most of the roughly 175,000 Portuguese speakers in the DRC are Angolan and Mozambican expatriates. Over 250 ethnic groups and 450 tribes (ethnic subgroups) populate the DRC. They are in the Bantu , Sudanic , Nilotic , Ubangian and Pygmy linguistic groups. Because of this diversity, there is no dominant ethnic group in Congo, however the following ethnic groups account for 51.5% of the population: In 2021 , the UN estimated the country's population to be 96 million, a rapid increase from 39.1 million in 1992 despite the ongoing war. As many as 250 ethnic groups have been identified and named. About 600,000 Pygmies live in the DRC. Christianity is the predominant religion of the DRC. A 2013–14 survey, conducted by the Demographic and Health Surveys Program in 2013–2014 indicated that Christians constituted 93.7% of the population (with Catholics making up 29.7%, Protestants 26.8%, and other Christians 37.2%). A new Christian religious movement, Kimbanguism , had the adherence of 2.8%, while Muslims made up 1%. Other recent estimates have found Christianity the majority religion, followed by 95.8% of the population according to a 2010 Pew Research Center estimate, while the CIA World Factbook reports this figure to be 95.9%. The proportion of followers of Islam is variously estimated from 1% to 12%. There are about 35 million Catholics in the country with six archdioceses and 41 dioceses . The impact of the Catholic Church is difficult to overestimate. Schatzberg has called it the country's "only truly national institution apart from the state." Its schools have educated over 60% of the nation's primary school students and more than 40% of its secondary students. The church owns and manages an extensive network of hospitals, schools, and clinics, as well as many diocesan economic enterprises, including farms, ranches, stores, and artisans' shops. [ citation needed ] Sixty-two Protestant denominations are federated under the umbrella of the Church of Christ in the Congo . It is often referred to as the Protestant Church , since it covers most of the DRC Protestants. With more than 25 million members, it constitutes one of the largest Protestant bodies in the world. Kimbanguism was seen as a threat to the colonial regime and was banned by the Belgians. Kimbanguism, officially "the church of Christ on Earth by the prophet Simon Kimbangu", has about three million members, primarily among the Bakongo of Kongo Central and Kinshasa. Islam has been present in the Democratic Republic of the Congo since the 18th century, when Arab traders from East Africa pushed into the interior for ivory- and slave-trading purposes. Today, Muslims constitute approximately 1% of the Congolese population according to the Pew Research Center . The majority are Sunni Muslims. [ citation needed ] The first members of the Bahá'í Faith to live in the country came from Uganda in 1953. Four years later the first local administrative council was elected. In 1970 the National Spiritual Assembly (national administrative council) was first elected. Though the religion was banned in the 1970s and 1980s, due to misrepresentations of foreign governments, the ban was lifted by the end of the 1980s. In 2012 plans were announced to build a national Bahá'í House of Worship in the country. [ citation needed ] Traditional religions embody such concepts as monotheism , animism , vitalism , spirit and ancestor worship , witchcraft , and sorcery and vary widely among ethnic groups. The syncretic sects often merge elements of Christianity with traditional beliefs and rituals and are not recognized by mainstream churches as part of Christianity. New variants of ancient beliefs have become widespread, led by US-inspired Pentecostal churches which have been in the forefront of witchcraft accusations, particularly against children and the elderly. [ clarification needed ] Children accused of witchcraft are sent away from homes and family, often to live on the street, which can lead to physical violence against these children. [ clarification needed ] There are charities supporting street children such as the Congo Children Trust . The Congo Children Trust 's flagship project is Kimbilio, which works to reunite street children in Lubumbashi . The usual term for these children is enfants sorciers (child witches) or enfants dits sorciers (children accused of witchcraft). Non-denominational church organizations have been formed to capitalize on this belief by charging exorbitant fees for exorcisms . Though recently outlawed, children have been subjected in these exorcisms to often-violent abuse at the hands of self-proclaimed prophets and priests. In 2014, the literacy rate for the population between the ages of 15 and 49 was estimated to be 75.9% (88.1% male and 63.8% female) according to a DHS nationwide survey. The education system is governed by three government ministries: the Ministère de l'Enseignement Primaire, Secondaire et Professionnel (MEPSP ), the Ministère de l'Enseignement Supérieur et Universitaire (MESU) and the Ministère des Affaires Sociales (MAS) . Primary education is not free nor compulsory, [ citation needed ] even though the Congolese constitution says it should be (Article 43 of the 2005 Congolese Constitution). As a result of the First and Second Congo Wars in the late 1990s—early 2000s, over 5.2 million children in the country did not receive any education. Since the end of the civil war, the situation has improved tremendously, with the number of children enrolled in primary schools rising from 5.5 million in 2002 to 16.8 million in 2018, and the number of children enrolled in secondary schools rising from 2.8 million in 2007 to 4.6 million in 2015 according to UNESCO . Actual school attendance has also improved greatly in recent years, with primary school net attendance estimated to be 82.4% in 2014 (82.4% of children ages 6–11 attended school; 83.4% for boys, 80.6% for girls). The hospitals in the Democratic Republic of the Congo (DRC) include the General Hospital of Kinshasa . The DRC has the world's second-highest rate of infant mortality (after Chad). In April 2011, through aid from Global Alliance for Vaccines , a new vaccine to prevent pneumococcal disease was introduced around Kinshasa. In 2012, it was estimated that about 1.1% of adults aged 15–49 were living with HIV/AIDS . Malaria and yellow fever are problems. In May 2019, the death toll from the Ebola outbreak in DRC surpassed 1,000. The incidence of yellow fever-related fatalities in DRC is relatively low. According to the World Health Organization's (WHO) report in 2021, only two individuals died due to yellow fever in DRC. According to the World Bank Group , in 2016, 26,529 people died on the roads in DRC due to traffic accidents. Maternal health is poor in DRC. According to 2010 estimates, DRC has the 17th highest maternal mortality rate in the world. According to UNICEF , 43.5% of children under five are stunted . United Nations emergency food relief agency warned that amid the escalating conflict and worsening situation following COVID-19 in the DRC, millions of lives were at risk as they could die of hunger. According to the data of the World Food Programme , in 2020 four in ten people in Congo lacked food security and about 15.6 million were facing a potential hunger crisis. Air pollution levels in the Democratic Republic of the Congo are very unhealthy. In 2020, annual average air pollution in the DRC stood at 34.2 µg/m³, which is almost 6.8 times the World Health Organization PM2.5 guideline (5 µg/m³: set in September 2021). These pollution levels are estimated to reduce the life expectancy of an average citizen of the DRC by almost 2.9 years. Currently, the DRC does not have a national ambient air quality standard. Given the often unstable situation in the country and the condition of state structures, it is extremely difficult to obtain reliable migration data. However, evidence suggests that DRC continues to be a destination country for immigrants, in spite of recent declines in their numbers. Immigration is very diverse in nature; refugees and asylum-seekers – products of the numerous and violent conflicts in the Great Lakes Region – constitute an important subset of the population. Additionally, the country's large mine operations attract migrant workers from Africa and beyond. There is also considerable migration for commercial activities from other African countries and the rest of the world, but these movements are not well studied. Transit migration towards South Africa and Europe also plays a role. Immigration to the DRC has decreased steadily over the past two decades, most likely as a result of the armed violence that the country has experienced. According to the International Organization for Migration , the number of immigrants in the DRC has fallen from just over one million in 1960, to 754,000 in 1990, to 480,000 in 2005, to an estimated 445,000 in 2010. Official figures are unavailable, partly due to the predominance of the informal economy in the DRC. Data are also lacking on irregular immigrants, however given neighbouring countries' ethnic links to DRC nationals, irregular migration is assumed to be a significant phenomenon. Figures for Congolese nationals abroad vary greatly depending on the source, from three to six million. This discrepancy is due to a lack of official, reliable data. Emigrants from the DRC are above all long-term emigrants, the majority of whom live in Africa and to a lesser extent in Europe; 79.7% and 15.3% respectively, according to estimated 2000 data. New destination countries include South Africa and various points en route to Europe. The DRC has produced a considerable number of refugees and asylum-seekers located in the region and beyond. These numbers peaked in 2004 when, according to UNHCR , there were more than 460,000 refugees from the DRC; in 2008, Congolese refugees numbered 367,995 in total, 68% of whom were living in other African countries. Since 2003, more than 400,000 Congolese migrants have been expelled from Angola . The CIA World Factbook estimated the population to be over 111 million as of 2023. Between 1950 and 2000, the country's population nearly quadrupled from 12.2 million to 46.9 million. French is the official language of the Democratic Republic of the Congo. It is culturally accepted as the lingua franca , facilitating communication among the many different ethnic groups of the Congo. According to a 2018 OIF report, 49 million Congolese people (51% of the population) could read and write in French. A 2021 survey found that 74% of the population could speak French, making it the most widely spoken language in the country. In Kinshasa, 67% of the population in 2014 could read and write French, and 68.5% could speak and understand it. Approximately 242 languages are spoken in the country, of which four have the status of national languages: Kituba (Kikongo), Lingala , Tshiluba , and Swahili . Although some limited number of people speak these as first languages, most of the population speak them as a second language, after the native language of their own ethnic group. Lingala was the official language of the Force Publique under Belgian colonial rule and remains to this day the predominant language of the armed forces. Since the recent rebellions, a good part of the army in the east also uses Swahili, where it competes to be the regional lingua franca. Under Belgian rule, the Belgians instituted teaching and use of the four national languages in primary schools, making it one of the few African nations to have had literacy in local languages during the European colonial period. This trend was reversed after independence, when French became the sole language of education at all levels. Since 1975, the four national languages have been reintroduced in the first two years of primary education, with French becoming the sole language of education from the third year onward, but in practice many primary schools in urban areas solely use French from the first year of school onward. Portuguese is taught in the Congolese schools as a foreign language. The lexical similarity and phonology with French makes Portuguese a relatively easy language for the people to learn. Most of the roughly 175,000 Portuguese speakers in the DRC are Angolan and Mozambican expatriates.Over 250 ethnic groups and 450 tribes (ethnic subgroups) populate the DRC. They are in the Bantu , Sudanic , Nilotic , Ubangian and Pygmy linguistic groups. Because of this diversity, there is no dominant ethnic group in Congo, however the following ethnic groups account for 51.5% of the population: In 2021 , the UN estimated the country's population to be 96 million, a rapid increase from 39.1 million in 1992 despite the ongoing war. As many as 250 ethnic groups have been identified and named. About 600,000 Pygmies live in the DRC. Christianity is the predominant religion of the DRC. A 2013–14 survey, conducted by the Demographic and Health Surveys Program in 2013–2014 indicated that Christians constituted 93.7% of the population (with Catholics making up 29.7%, Protestants 26.8%, and other Christians 37.2%). A new Christian religious movement, Kimbanguism , had the adherence of 2.8%, while Muslims made up 1%. Other recent estimates have found Christianity the majority religion, followed by 95.8% of the population according to a 2010 Pew Research Center estimate, while the CIA World Factbook reports this figure to be 95.9%. The proportion of followers of Islam is variously estimated from 1% to 12%. There are about 35 million Catholics in the country with six archdioceses and 41 dioceses . The impact of the Catholic Church is difficult to overestimate. Schatzberg has called it the country's "only truly national institution apart from the state." Its schools have educated over 60% of the nation's primary school students and more than 40% of its secondary students. The church owns and manages an extensive network of hospitals, schools, and clinics, as well as many diocesan economic enterprises, including farms, ranches, stores, and artisans' shops. [ citation needed ] Sixty-two Protestant denominations are federated under the umbrella of the Church of Christ in the Congo . It is often referred to as the Protestant Church , since it covers most of the DRC Protestants. With more than 25 million members, it constitutes one of the largest Protestant bodies in the world. Kimbanguism was seen as a threat to the colonial regime and was banned by the Belgians. Kimbanguism, officially "the church of Christ on Earth by the prophet Simon Kimbangu", has about three million members, primarily among the Bakongo of Kongo Central and Kinshasa. Islam has been present in the Democratic Republic of the Congo since the 18th century, when Arab traders from East Africa pushed into the interior for ivory- and slave-trading purposes. Today, Muslims constitute approximately 1% of the Congolese population according to the Pew Research Center . The majority are Sunni Muslims. [ citation needed ] The first members of the Bahá'í Faith to live in the country came from Uganda in 1953. Four years later the first local administrative council was elected. In 1970 the National Spiritual Assembly (national administrative council) was first elected. Though the religion was banned in the 1970s and 1980s, due to misrepresentations of foreign governments, the ban was lifted by the end of the 1980s. In 2012 plans were announced to build a national Bahá'í House of Worship in the country. [ citation needed ] Traditional religions embody such concepts as monotheism , animism , vitalism , spirit and ancestor worship , witchcraft , and sorcery and vary widely among ethnic groups. The syncretic sects often merge elements of Christianity with traditional beliefs and rituals and are not recognized by mainstream churches as part of Christianity. New variants of ancient beliefs have become widespread, led by US-inspired Pentecostal churches which have been in the forefront of witchcraft accusations, particularly against children and the elderly. [ clarification needed ] Children accused of witchcraft are sent away from homes and family, often to live on the street, which can lead to physical violence against these children. [ clarification needed ] There are charities supporting street children such as the Congo Children Trust . The Congo Children Trust 's flagship project is Kimbilio, which works to reunite street children in Lubumbashi . The usual term for these children is enfants sorciers (child witches) or enfants dits sorciers (children accused of witchcraft). Non-denominational church organizations have been formed to capitalize on this belief by charging exorbitant fees for exorcisms . Though recently outlawed, children have been subjected in these exorcisms to often-violent abuse at the hands of self-proclaimed prophets and priests. In 2014, the literacy rate for the population between the ages of 15 and 49 was estimated to be 75.9% (88.1% male and 63.8% female) according to a DHS nationwide survey. The education system is governed by three government ministries: the Ministère de l'Enseignement Primaire, Secondaire et Professionnel (MEPSP ), the Ministère de l'Enseignement Supérieur et Universitaire (MESU) and the Ministère des Affaires Sociales (MAS) . Primary education is not free nor compulsory, [ citation needed ] even though the Congolese constitution says it should be (Article 43 of the 2005 Congolese Constitution). As a result of the First and Second Congo Wars in the late 1990s—early 2000s, over 5.2 million children in the country did not receive any education. Since the end of the civil war, the situation has improved tremendously, with the number of children enrolled in primary schools rising from 5.5 million in 2002 to 16.8 million in 2018, and the number of children enrolled in secondary schools rising from 2.8 million in 2007 to 4.6 million in 2015 according to UNESCO . Actual school attendance has also improved greatly in recent years, with primary school net attendance estimated to be 82.4% in 2014 (82.4% of children ages 6–11 attended school; 83.4% for boys, 80.6% for girls). The hospitals in the Democratic Republic of the Congo (DRC) include the General Hospital of Kinshasa . The DRC has the world's second-highest rate of infant mortality (after Chad). In April 2011, through aid from Global Alliance for Vaccines , a new vaccine to prevent pneumococcal disease was introduced around Kinshasa. In 2012, it was estimated that about 1.1% of adults aged 15–49 were living with HIV/AIDS . Malaria and yellow fever are problems. In May 2019, the death toll from the Ebola outbreak in DRC surpassed 1,000. The incidence of yellow fever-related fatalities in DRC is relatively low. According to the World Health Organization's (WHO) report in 2021, only two individuals died due to yellow fever in DRC. According to the World Bank Group , in 2016, 26,529 people died on the roads in DRC due to traffic accidents. Maternal health is poor in DRC. According to 2010 estimates, DRC has the 17th highest maternal mortality rate in the world. According to UNICEF , 43.5% of children under five are stunted . United Nations emergency food relief agency warned that amid the escalating conflict and worsening situation following COVID-19 in the DRC, millions of lives were at risk as they could die of hunger. According to the data of the World Food Programme , in 2020 four in ten people in Congo lacked food security and about 15.6 million were facing a potential hunger crisis. Air pollution levels in the Democratic Republic of the Congo are very unhealthy. In 2020, annual average air pollution in the DRC stood at 34.2 µg/m³, which is almost 6.8 times the World Health Organization PM2.5 guideline (5 µg/m³: set in September 2021). These pollution levels are estimated to reduce the life expectancy of an average citizen of the DRC by almost 2.9 years. Currently, the DRC does not have a national ambient air quality standard. Given the often unstable situation in the country and the condition of state structures, it is extremely difficult to obtain reliable migration data. However, evidence suggests that DRC continues to be a destination country for immigrants, in spite of recent declines in their numbers. Immigration is very diverse in nature; refugees and asylum-seekers – products of the numerous and violent conflicts in the Great Lakes Region – constitute an important subset of the population. Additionally, the country's large mine operations attract migrant workers from Africa and beyond. There is also considerable migration for commercial activities from other African countries and the rest of the world, but these movements are not well studied. Transit migration towards South Africa and Europe also plays a role. Immigration to the DRC has decreased steadily over the past two decades, most likely as a result of the armed violence that the country has experienced. According to the International Organization for Migration , the number of immigrants in the DRC has fallen from just over one million in 1960, to 754,000 in 1990, to 480,000 in 2005, to an estimated 445,000 in 2010. Official figures are unavailable, partly due to the predominance of the informal economy in the DRC. Data are also lacking on irregular immigrants, however given neighbouring countries' ethnic links to DRC nationals, irregular migration is assumed to be a significant phenomenon. Figures for Congolese nationals abroad vary greatly depending on the source, from three to six million. This discrepancy is due to a lack of official, reliable data. Emigrants from the DRC are above all long-term emigrants, the majority of whom live in Africa and to a lesser extent in Europe; 79.7% and 15.3% respectively, according to estimated 2000 data. New destination countries include South Africa and various points en route to Europe. The DRC has produced a considerable number of refugees and asylum-seekers located in the region and beyond. These numbers peaked in 2004 when, according to UNHCR , there were more than 460,000 refugees from the DRC; in 2008, Congolese refugees numbered 367,995 in total, 68% of whom were living in other African countries. Since 2003, more than 400,000 Congolese migrants have been expelled from Angola . The culture reflects the diversity of its numerous ethnic groups and their differing ways of life throughout the country—from the mouth of the River Congo on the coast, upriver through the rainforest and savanna in its centre, to the more densely populated mountains in the far east. Since the late 19th century, traditional ways of life have undergone changes brought about by colonialism, the struggle for independence, the stagnation of the Mobutu era, and most recently, the First and Second Congo Wars. Despite these pressures, the customs and cultures of the Congo have retained much of their individuality. The country's 81 million inhabitants (2016) are mainly rural. The 30% who live in urban areas have been the most open to Western influences. The DRC has a rich musical heritage rooted in traditional rhythms. The earliest known form of popular partnered dance music in Congo was Maringa , denoting a Kongolese dance practiced within the former Kingdom of Loango , encompassing parts of the present-day Republic of the Congo, Southern Gabon and Cabinda . The style gained popularity in the 1920s-1930s, introducing the "bar-dancing" culture in Léopoldville (now Kinshasa), incorporating unique elements like a bass drum , a bottle as a triangle , and an accordion . In the 1940s and 1950s, the influence of Cuban son bands transformed Maringa into " Congolese rumba ". Imported records by Sexteto Habanero and Trio Matamoros, often mislabeled as "rumba", played a significant role. Artists such as Antoine Kasongo, Paul Kamba, Henri Bowane , Antoine Wendo Kolosoy , Franco Luambo , Le Grand Kallé , Vicky Longomba , Nico Kasanda , Tabu Ley Rochereau , and Papa Noel Nedule authentically popularized the style and made significant contributions to it in the 1940s and 1950s. The 1960s and 1970s saw the emergence of soukous , an urban dance music style that evolved from Congolese rumba. Soukous led to diverse offshoots, such as ekonda saccadé , reflecting the Mongo rhythmic influence, and mokonyonyon , emulating pelvic thrust dance movements from the Otetela ethnic background. The same soukous, under the guidance of " le sapeur ", Papa Wemba , have set the tone for a generation of young men always dressed up in exorbitant designer clothes. They came to be known as the fourth generation of Congolese music and mostly come from the former prominent band Wenge Musica . Political and economic challenges under Mobutu prompted a mass exodus of musicians to Kenya, Tanzania, Uganda, Zambia, Sierra Leone , Liberia , Europe and Asia , expanding the spread of Congolese urban music. Notably, the quartet Ry-Co Jazz played a crucial role in globalizing Congolese music, touring West Africa , the Caribbean , and France. By the 1980s, numerous Congolese musicians were based in Europe, facilitating the global dissemination of their musical prowess. Congolese lead guitarists became a sought-after commodity, attracting bands worldwide eager to infuse a Congolese flavor into their compositions or learn the intricate art of Congolese guitar dexterity. In the late 1980s, Ndombolo emerged as a fast-paced, hip-swaying dance music, drawing inspiration from Congolese rumba and soukous. This genre gained widespread popularity in Africa, Europe, and the Americas , with musicians like Papa Wemba, Koffi Olomide , Werrason , Awilo Longomba , Quartier Latin International , Général Defao , Aurlus Mabélé , Exra Musica, Wenge Musica , Wenge Musica Maison Mére and Fally Ipupa making significant contributions to its evolution and international stage. Many sports are played in the DRC, including football , basketball, baseball, and rugby . The sports are played in numerous stadiums throughout the country, including the Stade Frederic Kibassa Maliba . As Zaire they participated in the 1974 FIFA World Cup . Internationally, the country is especially famous for its professional basketball NBA and football players. Dikembe Mutombo is one of the best African basketball players to ever play the game. Mutombo is well known for humanitarian projects in his home country. Bismack Biyombo , Christian Eyenga , Jonathan Kuminga , and Emmanuel Mudiay are others who gained significant international attention in basketball. Several Congolese players and players of Congolese descent—including strikers Romelu Lukaku , Yannick Bolasie , and Dieumerci Mbokani —have gained prominence in world football. DR Congo has twice won the African Cup of Nations football tournament. DR Congo's women's national volleyball team lastly qualified for the 2021 Women's African Nations Volleyball Championship . The country featured a national team in beach volleyball that competed at the 2018–2020 CAVB Beach Volleyball Continental Cup in both the women's and the men's section. Newspapers of the DRC include L'Avenir , Radion Télévision Mwangaza , La Conscience [ fr ] , L'Observateur [ fr ] , Le Phare , Le Potentiel , Le Soft and LeCongolais.CD , a web-based daily. Radio Télévision Nationale Congolaise (RTNC) is the national broadcaster of the Democratic Republic of the Congo. RTNC currently broadcasts in Lingala , French, and English. Congolese authors use literature as a way to develop a sense of national consciousness amongst the people of the DRC. Frederick Kambemba Yamusangie writes literature for the between generations of those who grew up in the Congo, during the time when they were colonised, fighting for independence and after. Yamusangie in an interview said he felt the distance in literature and wanted to remedy that he wrote the novel, Full Circle, which is a story of a boy named Emanuel who in the beginning of the book feels a difference in culture among the different groups in the Congo and elsewhere. Rais Neza Boneza , an author from the Katanga province, wrote novels and poems to promote artistic expressions as a way to address and deal with conflicts. The DRC has a rich musical heritage rooted in traditional rhythms. The earliest known form of popular partnered dance music in Congo was Maringa , denoting a Kongolese dance practiced within the former Kingdom of Loango , encompassing parts of the present-day Republic of the Congo, Southern Gabon and Cabinda . The style gained popularity in the 1920s-1930s, introducing the "bar-dancing" culture in Léopoldville (now Kinshasa), incorporating unique elements like a bass drum , a bottle as a triangle , and an accordion . In the 1940s and 1950s, the influence of Cuban son bands transformed Maringa into " Congolese rumba ". Imported records by Sexteto Habanero and Trio Matamoros, often mislabeled as "rumba", played a significant role. Artists such as Antoine Kasongo, Paul Kamba, Henri Bowane , Antoine Wendo Kolosoy , Franco Luambo , Le Grand Kallé , Vicky Longomba , Nico Kasanda , Tabu Ley Rochereau , and Papa Noel Nedule authentically popularized the style and made significant contributions to it in the 1940s and 1950s. The 1960s and 1970s saw the emergence of soukous , an urban dance music style that evolved from Congolese rumba. Soukous led to diverse offshoots, such as ekonda saccadé , reflecting the Mongo rhythmic influence, and mokonyonyon , emulating pelvic thrust dance movements from the Otetela ethnic background. The same soukous, under the guidance of " le sapeur ", Papa Wemba , have set the tone for a generation of young men always dressed up in exorbitant designer clothes. They came to be known as the fourth generation of Congolese music and mostly come from the former prominent band Wenge Musica . Political and economic challenges under Mobutu prompted a mass exodus of musicians to Kenya, Tanzania, Uganda, Zambia, Sierra Leone , Liberia , Europe and Asia , expanding the spread of Congolese urban music. Notably, the quartet Ry-Co Jazz played a crucial role in globalizing Congolese music, touring West Africa , the Caribbean , and France. By the 1980s, numerous Congolese musicians were based in Europe, facilitating the global dissemination of their musical prowess. Congolese lead guitarists became a sought-after commodity, attracting bands worldwide eager to infuse a Congolese flavor into their compositions or learn the intricate art of Congolese guitar dexterity. In the late 1980s, Ndombolo emerged as a fast-paced, hip-swaying dance music, drawing inspiration from Congolese rumba and soukous. This genre gained widespread popularity in Africa, Europe, and the Americas , with musicians like Papa Wemba, Koffi Olomide , Werrason , Awilo Longomba , Quartier Latin International , Général Defao , Aurlus Mabélé , Exra Musica, Wenge Musica , Wenge Musica Maison Mére and Fally Ipupa making significant contributions to its evolution and international stage. Many sports are played in the DRC, including football , basketball, baseball, and rugby . The sports are played in numerous stadiums throughout the country, including the Stade Frederic Kibassa Maliba . As Zaire they participated in the 1974 FIFA World Cup . Internationally, the country is especially famous for its professional basketball NBA and football players. Dikembe Mutombo is one of the best African basketball players to ever play the game. Mutombo is well known for humanitarian projects in his home country. Bismack Biyombo , Christian Eyenga , Jonathan Kuminga , and Emmanuel Mudiay are others who gained significant international attention in basketball. Several Congolese players and players of Congolese descent—including strikers Romelu Lukaku , Yannick Bolasie , and Dieumerci Mbokani —have gained prominence in world football. DR Congo has twice won the African Cup of Nations football tournament. DR Congo's women's national volleyball team lastly qualified for the 2021 Women's African Nations Volleyball Championship . The country featured a national team in beach volleyball that competed at the 2018–2020 CAVB Beach Volleyball Continental Cup in both the women's and the men's section. Newspapers of the DRC include L'Avenir , Radion Télévision Mwangaza , La Conscience [ fr ] , L'Observateur [ fr ] , Le Phare , Le Potentiel , Le Soft and LeCongolais.CD , a web-based daily. Radio Télévision Nationale Congolaise (RTNC) is the national broadcaster of the Democratic Republic of the Congo. RTNC currently broadcasts in Lingala , French, and English.Congolese authors use literature as a way to develop a sense of national consciousness amongst the people of the DRC. Frederick Kambemba Yamusangie writes literature for the between generations of those who grew up in the Congo, during the time when they were colonised, fighting for independence and after. Yamusangie in an interview said he felt the distance in literature and wanted to remedy that he wrote the novel, Full Circle, which is a story of a boy named Emanuel who in the beginning of the book feels a difference in culture among the different groups in the Congo and elsewhere. Rais Neza Boneza , an author from the Katanga province, wrote novels and poems to promote artistic expressions as a way to address and deal with conflicts.

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Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Visa_requirements_for_Mexican_citizens/html

Visa requirements for Mexican citizens

Visa requirements for Mexican citizens are administrative entry restrictions by the authorities of other states placed on citizens of Mexico As of 2024, Mexican citizens had visa-free or visa on arrival access to 161 countries and territories, ranking the Mexican passport 23rd in the world according to the Henley Passport Index . Visa on arrival available to business travelers if they are holding a letter of invitation issued by an accredited organization in Bangladesh that has notified the Immigration authorities prior to arrival. Must have an international vaccination certificate. 90 days within any 6-month period. Visa is also obtainable online. Fee 37 USD. Hong Kong, Macau, and Taiwan count as third countries under the 24, 72 and 144-hours transit without visa (TWOV) policies. 90 days – extendable up to 180-days stay within a one-year period. 90 days purchasing Tourist Card. 90 days within any 180 day period. On-arrival visa costs 25 USD. 10 USD Tourist Card must be purchased upon arrival. 90 days (business), 6 months (tourist). Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. 90 days within any 12-month period. 90 days within any 180 day period. Eligible for eVisa if holding a valid Schengen Visa, or a valid visa or residence permit from Australia, Canada, UK or USA. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). Fee is 50 USD. e-Visa holders can enter through all border points. Issued free of charge. Fee is 50 USD. e-Visa (30 days) is currently suspended. 30 days for visits on business, 3 months for tourists.Visa on arrival available to business travelers if they are holding a letter of invitation issued by an accredited organization in Bangladesh that has notified the Immigration authorities prior to arrival. Must have an international vaccination certificate. 90 days within any 6-month period. Visa is also obtainable online. Fee 37 USD. Hong Kong, Macau, and Taiwan count as third countries under the 24, 72 and 144-hours transit without visa (TWOV) policies. 90 days – extendable up to 180-days stay within a one-year period. 90 days purchasing Tourist Card. 90 days within any 180 day period. On-arrival visa costs 25 USD. 10 USD Tourist Card must be purchased upon arrival. 90 days (business), 6 months (tourist). Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. 90 days within any 12-month period. 90 days within any 180 day period. Eligible for eVisa if holding a valid Schengen Visa, or a valid visa or residence permit from Australia, Canada, UK or USA. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). Fee is 50 USD. e-Visa holders can enter through all border points. Issued free of charge. Fee is 50 USD. e-Visa (30 days) is currently suspended. 30 days for visits on business, 3 months for tourists.Holders of an APEC Business Travel Card (ABTC) travelling on business do not require a visa to the following countries: 1 - Up to 90 days 2 - Up to 90 days in a period of 180 days 3 - Up to 60 days The card must be used in conjunction with a passport and has the following advantages: Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints.

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Visa_requirements_for_Turkish_citizens/html

Visa requirements for Turkish citizens

Visa requirements for Turkish citizens are administrative entry obligations by the authorities of other states placed on Turkey . As of 2024, Turkish citizens had visa-free or visa on arrival access to 118 countries and territories, ranking the Turkish passport 52nd in the world according to the Henley Passport Index . Turkey is the only EU candidate country whose citizens are still required visas for their travels to the European Union member countries . However the European Union is planning to introduce visa free travel for Turkish citizens as well as the United States lists Turkey as an aspiring country for inclusion to the Visa Waiver Program . Turkish citizens can also use their identity cards in lieu of a Turkish passport to travel to the following countries under bilateral agreements that have been concluded between the Turkish Government and governments of the respective countries:Turkish citizens can also use their identity cards in lieu of a Turkish passport to travel to the following countries under bilateral agreements that have been concluded between the Turkish Government and governments of the respective countries:Because this landlocked country has no airport of its own, you need to arrive in France or Spain first and visas are required to enter into these countries. May apply online (Online Visitor e600 visa). 90 days within any 6-month period. 90 days - extendable up to 180-day stay within a 1-year period. Can be extended up to 90 days with a fee. Visa not required when travelling as part of the tourist group that consists of at least 10 persons. Egypt starts issuing Visa on Arrival to Turkish Citizens. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Extendable for 1 additional month. Granted free of charge at Beirut International Airport or any other port of entry if there is no Israeli visa or seal, holding a telephone number, an address in Lebanon and a non refundable return or circle trip ticket. 180 days visa free if holding a valid visa for Canada, Japan, USA, United Kingdom or a Schengen member state. Visitors may apply for a visa online under the "Tourist - Own Itinerary" category. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). Only if arriving directly from Turkey. Maximum two visits annually if not arriving by air. Determined at the port of entry. Visa requirements for Turkish citizens for visits to various territories, disputed areas, partially recognized countries and restricted zones: Visa requirements for Turkish citizens for visits to various territories, disputed areas, partially recognized countries and restricted zones: In addition to countries that provide visa-free access to all Turkish passport holders, holders of diplomatic, official or service Turkish passports have visa-free access to the following additional countries:Main articles: List of diplomatic missions of Turkey . There are 142 resident embassies, 89 consulates and Total of 235 states that recognise Turkey.Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints.

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Yellow fever

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Travel requirements for stateless persons

Travel requirements for stateless persons are public health and administrative entry restrictions by the authorities of states placed on stateless persons. As of April 2024, stateless persons had visa-free or visa on arrival access to 1 territory, ranking last in terms of travel freedom (tied with the citizens of no state).Certain countries and territories require travellers arriving from certain jurisdictions to be vaccinated against specific diseases. This is a map of the minimal vaccination requirements for stateless persons arriving from countries that aren't classified as "risk countries". Many countries increasingly consider the vaccination status of travellers with regard to quarantine requirements or when deciding to allow them entry at all. This is justified by research that shows that the Pfizer vaccine effect lasts for six months or so. Certain countries and territories require travellers arriving from certain jurisdictions to be vaccinated against specific diseases. This is a map of the minimal vaccination requirements for stateless persons arriving from countries that aren't classified as "risk countries".Many countries increasingly consider the vaccination status of travellers with regard to quarantine requirements or when deciding to allow them entry at all. This is justified by research that shows that the Pfizer vaccine effect lasts for six months or so.

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Yellow fever

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Yellow Fever Commission

The Yellow Fever Commission was a research team of the United States Army which researched treatment for yellow fever . The commission was originally formed as the Reed Commission by Army Surgeon General George Sternberg in 1900. The medical research board was forged as a four member board consisting of Walter Reed , James Carroll , Jesse W. Lazear , and Aristides Agramonte . The U.S. Army research detachment was commissioned for public health surveillance regarding a tropical disease susceptible by the predatorial Aedes aegypti or an infectious mosquito in Cuba . The mosquito-borne disease or yellow fever pathogen was found to have inflicted an elevated casualty count during the Spanish–American War . The research process itself became a focus of study for later generations. A United States nurse named Clara Maass and two Spanish immigrants were among those who died as a result of their research participation. Researchers mark the research of the Yellow Fever Commission as the origin of the model of modern consent in medical research. The 1934 Yellow Jack theatrical production told the story of Walter Reed in the Yellow Fever Commission. The theatre production was cast with Sam Levene , James Stewart , Eddie Acuff , and Myron McCormick . The Broadway play was the basis of Yellow Jack , a 1938 movie presenting the same narrative .

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Yellow fever

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Yellow jack (disambiguation)

The yellow jack is a species of offshore marine fish in the jack family. Yellow Jack or Yellow Jack fever may also refer to:

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Yellow fever

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Nicholas Way

Nicholas Way (c.1747–1797) was an American physician . From New Castle County, Delaware , Way studied medicine at the University of Pennsylvania , and graduated in 1771. He was elected as a member of the American Philosophical Society in 1773. He did not fight in the Revolutionary War due to his Quaker beliefs. He joined the Delaware convention that ratified the federal constitution in 1787. He helped organize the Medical Society of Delaware, becoming a founding member in 1789. During the yellow fever outbreak of 1793 in Philadelphia, Way personally hosted a large group of refugees from the disease at his mansion in Wilmington. The following year, his friend President George Washington appointed him Treasurer of the United States Mint . He died of yellow fever three years later in 1797.

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Yellow fever

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Dodge Ram SRT-10

The Dodge Ram SRT-10 is a sport pickup truck produced by Dodge , based on the standard Ram 1500 , with only 10,046 units built. It was introduced as a concept at the January 2002 North American International Auto Show , while the production model was introduced in 2003 as a 2004 model year.The Dodge Ram SRT was created by DaimlerChrysler's PVO ( Performance Vehicle Operations ) division, using Dodge Viper and Plymouth Prowler engineers. Extensive wind tunnel testing was used in styling the exterior of the Ram SRT-10. This is the second time that Dodge has put a Viper engine into a Ram pickup. At the 1996 Chicago Auto Show , Dodge introduced a concept Dodge Ram with a Viper Generation 2 engine, but it was not put into production. The Dodge Ram VTS was painted Banzai Blue with dual white skunk stripes, housed an 8.0 L (488 cid) V10, a six-speed Borg-Warner manual gearbox, and 17 in (432 mm) Viper GTS wheels wrapped in BF Goodrich 275/60-HR17 Comp T/A HR4 tires.The SRT-10 featured a Chrysler 8.3 liter V10 that was first used in the third generation Viper. This engine produced 500 bhp (373 kW; 507 PS) at 5,600 rpm and 525 lb⋠ft (712 N⋠m) of torque at 4,200 rpm. The regular cab, with a total curb weight of 5,130 lb (2,327 kg) , reached a top speed of 154 mph (248 km/h) , and could accelerate from 0 to 60 mph (97 km/h) in 4.9 seconds, whereas the Quad Cab, weighing 5,618 lb (2,548 kg) , achieved 0-60 mph (97 km/h) in 5.3 seconds and reached a top speed of 147 mph (237 km/h) . The regular cab could complete the 1 ⁄ 4 mi (400 m) in 13.6 seconds at 106 mph (171 km/h) , the Quad Cab in 13.7 seconds at 100 mph (161 km/h) . The engine produced one horsepower for every 10.3 lbs of vehicle weight in the regular cab. The regular cab generated .86 g of grip on a 300 ft (91 m) skidpad, while the Quad Cab generated .83 g. The regular cab was rated by the EPA at 9 MPG city/15 highway, while the Quad Cab was rated at 9 city/12 MPG highway. The V10 Viper engine delivered 90 percent of its torque from 1500 to 5600 rpm. The cast aluminum cylinder block had cast-iron liners and cross-bolted main caps. The bore and stroke had been increased over previous Viper models. Compression ratio, firing order, rod length, block height and block length were unchanged from the second-generation Viper engine. The regular cab featured a Tremec T-56 transmission , while the Quad Cab utilized a 48RE four-speed automatic transmission modified from the Ram Heavy Duty transmission. Both regular cab and Quad Cab used a Dana 60 rear axle. 48RE PVO engineers modified the Ram Heavy Duty's rack and pinion steering and independent front suspension for use in the Ram SRT-10. A fully hydroformed Dodge Ram frame was used in conjunction with a custom-tuned suspension, lowering the Ram SRT-10's ride height one inch in the front and 2.5 inches in the rear. Bilstein shock absorbers, performance-tuned springs and unique aerodynamic aids were used to enhance the Ram SRT-10's higher-speed performance. An additional 5th shock was used on the rear axle to prevent wheel hop during wheel-spin. The Ram SRT-10 had a unique hood that featured a wide power bulge and honeycomb grill hood scoop. The hood scoop allowed cool air to enter as well as forcing hot air to exit from the engine bay, thus helping the engine to run cooler. "Viper Powered" badges were added to the sides of the power bulge, to indicate the SRT-10 engine under the hood. Large chrome SRT-10 logos were mounted to the driver and passenger side doors and rear tailgate right side on the Quad cab and Single Cab 2005 models replaced in 2006 by smaller chrome and red SRT-10 logo badges . All models were outfitted with large molded kickerpanels painted to match body color. Another exterior feature was a tonneau cover with an attached spoiler that was supposed to come standard on the 2005 Quad Cab version and all 2006 models, but due to manufacturing problems was not installed on nearly half of the Ram SRT-10s intended. To help remedy this situation, Dodge added a $1000 credit and a regular spoiler to the Ram SRT-10s that did not receive the tonneau cover. In addition to style, the spoiler also helped with air flow and provided a reduction in lift and drag. The Ram SRT-10 had a bed size of 6 ft 3 in (1.91 m) , giving the regular cab an overall length of 17 ft 7 in (5.36 m) , and 19 ft 2 in (5.84 m) overall length for the Quad Cab. The Truck audio had 3 options of the Dodge Ram SRT-10 by 2006 and consisted of 8 Infinity brand speakers with a DVD based large color LCD map navigation system and a mid-tier CD turn by turn graphics CD-based system with small color LCD, and finally a standard LED Radio with CD player; all built and designed by Infinity audio and 10 inch woofer mounted in between the seats with silver bezel and 575 watts of total system output, Bluetooth by U-Connect for hands free communication through your car stereo as a factory option also full digital Satellite radio. The doors on both the Standard cab and Quad had silver accents along the middle above the arm rest. It also came with a leather trimmed steering wheel and with heavily bolstered racing-derived suede-trimmed charcoal leather seats. The center stack was adorned with silver trim, and a silver trim strip with the SRT-10 logo resided under the passenger-side air bag cover. Taking a cue from the Dodge Viper, the Ram SRT-10 came with a red start button on the dash. The manual transmission regular cab featured a Hurst shift lever, which sprouted from a silver metal shift bezel and was fitted with a Viper shift knob. Aluminum performance-inspired pedals replaced the stock setup. The gauge cluster featured satin silver-faced gauges and Viper font and graphics. The A-Pillar on Driver's side has an Oil Temperature Gauge, sporting the SRT logo. The speedometer and tachometer were re-calibrated to match the Ram SRT-10's increased performance. Optional sunroof was electric, as was a small electric rear window. Excluding the special editions, the 2004–2005 Ram SRT-10 came in three colors: Black Clear Coat, Bright Silver Metallic Clear Coat, and Flame Red Clear Coat. The redesigned 2006 Ram SRT-10 came in Mineral Gray Metallic, Inferno Red Crystal Pearl Coat, Brilliant Black Crystal Clear Coat, Flame Red Clear Coat and Black Clear Coat. The stock 22 in (559 mm) wheels were fitted with Pirelli Scorpion P305/40R-22 performance tires and modeled after the 10-spoke wheels available on the Viper. The brakes for the 2004 model (front and rear) and 2005-06 (rear) were modified from the Ram Heavy Duty truck for use in the Ram SRT-10. The standard ABS-equipped brakes were fitted with 15 in (381 mm) rotors in front and 14 in (356 mm) rotors out back. 2004 models used red-painted two-piston sliding brake calipers front and rear; these were replaced with larger four-piston monoblock calipers up front in 2005–06, designed by TRW and unique to the SRT-10. Two NASCAR -inspired brake cooling ducts integrated into the front fascia provide cooling for the Ram SRT-10's brakes.The V10 Viper engine delivered 90 percent of its torque from 1500 to 5600 rpm. The cast aluminum cylinder block had cast-iron liners and cross-bolted main caps. The bore and stroke had been increased over previous Viper models. Compression ratio, firing order, rod length, block height and block length were unchanged from the second-generation Viper engine. The regular cab featured a Tremec T-56 transmission , while the Quad Cab utilized a 48RE four-speed automatic transmission modified from the Ram Heavy Duty transmission. Both regular cab and Quad Cab used a Dana 60 rear axle. 48REPVO engineers modified the Ram Heavy Duty's rack and pinion steering and independent front suspension for use in the Ram SRT-10. A fully hydroformed Dodge Ram frame was used in conjunction with a custom-tuned suspension, lowering the Ram SRT-10's ride height one inch in the front and 2.5 inches in the rear. Bilstein shock absorbers, performance-tuned springs and unique aerodynamic aids were used to enhance the Ram SRT-10's higher-speed performance. An additional 5th shock was used on the rear axle to prevent wheel hop during wheel-spin.The Ram SRT-10 had a unique hood that featured a wide power bulge and honeycomb grill hood scoop. The hood scoop allowed cool air to enter as well as forcing hot air to exit from the engine bay, thus helping the engine to run cooler. "Viper Powered" badges were added to the sides of the power bulge, to indicate the SRT-10 engine under the hood. Large chrome SRT-10 logos were mounted to the driver and passenger side doors and rear tailgate right side on the Quad cab and Single Cab 2005 models replaced in 2006 by smaller chrome and red SRT-10 logo badges . All models were outfitted with large molded kickerpanels painted to match body color. Another exterior feature was a tonneau cover with an attached spoiler that was supposed to come standard on the 2005 Quad Cab version and all 2006 models, but due to manufacturing problems was not installed on nearly half of the Ram SRT-10s intended. To help remedy this situation, Dodge added a $1000 credit and a regular spoiler to the Ram SRT-10s that did not receive the tonneau cover. In addition to style, the spoiler also helped with air flow and provided a reduction in lift and drag. The Ram SRT-10 had a bed size of 6 ft 3 in (1.91 m) , giving the regular cab an overall length of 17 ft 7 in (5.36 m) , and 19 ft 2 in (5.84 m) overall length for the Quad Cab.The Truck audio had 3 options of the Dodge Ram SRT-10 by 2006 and consisted of 8 Infinity brand speakers with a DVD based large color LCD map navigation system and a mid-tier CD turn by turn graphics CD-based system with small color LCD, and finally a standard LED Radio with CD player; all built and designed by Infinity audio and 10 inch woofer mounted in between the seats with silver bezel and 575 watts of total system output, Bluetooth by U-Connect for hands free communication through your car stereo as a factory option also full digital Satellite radio. The doors on both the Standard cab and Quad had silver accents along the middle above the arm rest. It also came with a leather trimmed steering wheel and with heavily bolstered racing-derived suede-trimmed charcoal leather seats. The center stack was adorned with silver trim, and a silver trim strip with the SRT-10 logo resided under the passenger-side air bag cover. Taking a cue from the Dodge Viper, the Ram SRT-10 came with a red start button on the dash. The manual transmission regular cab featured a Hurst shift lever, which sprouted from a silver metal shift bezel and was fitted with a Viper shift knob. Aluminum performance-inspired pedals replaced the stock setup. The gauge cluster featured satin silver-faced gauges and Viper font and graphics. The A-Pillar on Driver's side has an Oil Temperature Gauge, sporting the SRT logo. The speedometer and tachometer were re-calibrated to match the Ram SRT-10's increased performance. Optional sunroof was electric, as was a small electric rear window.Excluding the special editions, the 2004–2005 Ram SRT-10 came in three colors: Black Clear Coat, Bright Silver Metallic Clear Coat, and Flame Red Clear Coat. The redesigned 2006 Ram SRT-10 came in Mineral Gray Metallic, Inferno Red Crystal Pearl Coat, Brilliant Black Crystal Clear Coat, Flame Red Clear Coat and Black Clear Coat.The stock 22 in (559 mm) wheels were fitted with Pirelli Scorpion P305/40R-22 performance tires and modeled after the 10-spoke wheels available on the Viper. The brakes for the 2004 model (front and rear) and 2005-06 (rear) were modified from the Ram Heavy Duty truck for use in the Ram SRT-10. The standard ABS-equipped brakes were fitted with 15 in (381 mm) rotors in front and 14 in (356 mm) rotors out back. 2004 models used red-painted two-piston sliding brake calipers front and rear; these were replaced with larger four-piston monoblock calipers up front in 2005–06, designed by TRW and unique to the SRT-10. Two NASCAR -inspired brake cooling ducts integrated into the front fascia provide cooling for the Ram SRT-10's brakes.Following the success of the Ram SRT-10 regular cab, Dodge decided to introduce a Quad Cab version starting in the 2005 model year. The new Quad Cab was aimed at enthusiasts who wanted a performance truck, but did not want a single cab. The Quad Cab was fitted with a 4.56 final-drive gear ratio to improve low-end acceleration and was rated at 7,500 lb (3,402 kg) towing capacity. A body-color aluminum tonneau cover with an aerodynamic spoiler came standard on the Quad Cab. The Quad Cab was only offered with a 4-speed automatic transmission (the 48RE borrowed from the Heavy Duty with the Cummins ISB turbo-diesel). The 48RE was rated to handle up to 700 lb⋠ft (949 N⋠m) of torque.Dodge released several limited editions of the Ram SRT-10 alongside the standard regular cab and Quad Cab versions. VCA (Viper Club of America) Edition – 52 produced, released at the 2004 Daytona Motor Speedway Race in February. Where people were able to enter a raffle, and only the winners of the raffle were able to purchase the vehicle, but, of course the winners were able to sell them again to a third-party. Its paint scheme was white rally stripes on Electric Blue. Engine was also signed by Wolfgang Bernhard, Chrysler Group's former chief operating officer. Available as a 2004 model. 50 of the VCA Edition trucks were manual transmission. Two were converted to an automatic transmission to be Pace Vehicles. The whereabouts of these two RAM SRT-10's is unknown and presumed decommissioned by FCA. Yellow Fever – 500 produced was announced, final total produced 497, painted in Solar Yellow exterior paint and black "fanged" stripe on top of hood, came with two-tone interior which featured a yellow center stack bezel, yellow door spears, yellow stitching on steering wheel, seats and Regular Cab manual transmission shifter and yellow embroidering on the SRT-10 floor mats. Also came with special Yellow Fever Edition badges and a serialized Yellow Fever dash plaque. Available as a 2005 model. Commemorative Edition – 200 produced was announced, featured Bright White exterior paint with Electric Blue stripes. Interior enhancements included blue stitching on the seats, shift boot, shift knob and steering wheel. Floor mats were embroidered in matching stitching with the SRT-10 logo. In addition, the Commemorative Edition included standard polished wheels, brushed aluminum scuff plates, and a hard tonneau cover. Available as a 2005 model. FCA Records show a total of 201 painted White with Blue Stripes Night Runner – 400 produced was announced final total produced 370, painted in Brilliant Black exterior paint, came with Dark Nickel Pearl finish 22 in (559 mm) wheels, black chrome grill inserts, unique Night Runner badges, a black center stack and center console bezel overlay, and a serialized Night Runner dash plaque. Available as a 2006 model.The first SRT-10 was produced November 10, 2003. Ram SRT-10 production ended after the 2006 model year Total production for the 2004 Dodge Ram SRT-10 was 3,057. For 2005, the total production was 5,113 and the 2006 total production was 1,973. Over the 3-year lifespan of this truck, 10,046 Dodge Ram SRT-10s were manufactured.In July 2004, a Dodge Ram SRT-10, driven by NASCAR driver Brendan Gaughan set both the Guinness World Record and Sports Car Club of America 's record for the world's fastest production truck with an average speed of 154.587 mph (248.784 km/h) .

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Yellow fever

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Visa requirements for Indonesian citizens

Visa requirements for Indonesian citizens are administrative entry restrictions imposed on citizens of Indonesia by the authorities of other states. As of 2024, Indonesian citizens had visa-free or visa on arrival access to 78 countries and territories, ranking the Indonesian passport 68th in the world according to the Henley Passport Index . Visa requirement is waived for used and valid, multiple-entry US, UK or Schengen visa holders. A maximum of 90 days of stay within a 180-day period. There are no visa requirements for entry into Andorra, but it can only be accessed by passing through France or Spain. A multiple-entry Schengen visa is required to re-enter either France or Spain when leaving Andorra. A maximum of 90 days of stay within a 180-day period. Visa exemption agreement was signed on 27 August 2021. A maximum of 90 days of stay per period. ETA is available for holders of US B2 visa or Schengen C visa (with at least 3 months' validity left) at a fee of 50 USD and for a stay of up to 90 days. Visa on arrival for holders of a valid sticker visa or resident card issued by Australia, Canada, GCC countries, Japan, New Zealand, Russia, South Korea, EU or Schengen Area member states, United Kingdom or United States. May apply online (Online Visitor e600 visa). Transit visa is not required. e-Visa option is also available for Indonesian citizens for maximum stay of 30 days. Visas are issued only to tourists booked with a local licensed tour operator. Visa requirement is waived for Romania, Cyprus, Croatia or Schengen visa holders for a maximum of 90 days of stay within a 180-day period. Visa on arrival is available for Indonesian passport holders with specific conditions and at only some ports of entry. Visa not required when arriving and departing from Hainan Island (HAK) Passengers traveling as tourists can obtain a visa on arrival at Shenzhen (SZX) for a maximum stay of 5 days. They must not leave Shenzhen during their stay. This is commonly done by entering Shenzhen from Hong Kong through the Lo Wu (Luohu) border crossing where VoA formalities are done. Can be extended to a maximum of 180 days within a one-year period. May obtain online and must arrive at Port Bouet Airport. A maximum of 90 days of stay within a 180-day period in the Schengen Area. Can be extended up to 90 days with a fee. Tourist Card required in advance. Visa requirement is waived for Romania, Cyprus, Bulgaria or Schengen visa holders for a maximum of 90 days of stay within a 180-day period. Required if travelling from a country with risk of yellow fever. e-Visa will be valid for 120 days with the right to stay in Georgia up to 30 days during the validity period. National visa may be substituted with a valid visa or residence permit issued by USA, UK, Japan, Canada, Australia, New Zealand, Israel, South Korea, Schengen, and GCC countries, whose holders may be granted visa-free entry for 90 days in any 180 days. The visa and other documentation must be presented at the border. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. 90 days within any 12-month period. Visa not required for a maximum stay of 30 days if: holding a visa issued by Australia, Canada, USA or New Zealand and only if in transit from or to those countries via South Korea. arriving and departing from Jeju (CJU) for tourism purpose. having previously entered Korea at least 4 times within the last 2 years or at least 10 visits in total. Group tourists from Indonesia can travel visa-free through Yangyang International Airport until May 2024. Group tourists can only travel to the Gangwon-do region and the metropolitan area of South Korea, and the maximum stay is 15 days. holding a visa issued by Australia, Canada, USA or New Zealand and only if in transit from or to those countries via South Korea. arriving and departing from Jeju (CJU) for tourism purpose. having previously entered Korea at least 4 times within the last 2 years or at least 10 visits in total. Travelers must register on the e-Visa platform at least 48 hours prior to travel and pay a processing fee of 650 MT. Visa is not needed for holders of a permanent residence in an EU Member State or a country signatory of the Schengen Agreement, they may stay no longer than 15 (fifteen) days upon every entry into the territory of the Republic of North Macedonia as long as the total length of stay does not exceed 90 days in any 180-day period. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. Extendable once. Visa is not required for Indonesian passport holders starting 1 July 2023. A maximum of 90 days of stay within a 180-day period. 24-hour visa-free transit: when in transit to/from Australia, Canada, New Zealand or USA, or if holder of residence permit issued by Australia, Canada, New Zealand or USA, or if holder of certain EEA or Switzerland visas, or if holder of certain Irish visas. when in transit to/from Australia, Canada, New Zealand or USA, or if holder of residence permit issued by Australia, Canada, New Zealand or USA, or if holder of certain EEA or Switzerland visas, or if holder of certain Irish visas. Online Application for Travel Authorization Certificate (TAC) available for Indonesian passport holders if: holding visa/residence permit/permanent residence certificate issued by USA/Canada/South Korea/UK/Schengen Convention countries, which may be valid or has expired less than 10 years prior to the date of arrival holding electronic visa issued by Australia/New Zealand, that is still valid by the date of arrival holding Japanese visa/visa waiver together with proof of record of entering Japan or confirmed onward ticket to Japan holding South Korean visa together with proof of record of entering South Korea. holding visa/residence permit issued by Taiwan (ROC) which has expired less than 10 years prior to the date of arrival; holders of entry visas bearing the remark FL (migrant worker), X (others), or P with "Special permission from MOFA" (visa and eVisa for "Project for Simplifying Visa Regulations for High-end Group Tourists from Southeast Asian Countries (Project Kuan-Hong)" ever issued), as well as holders of Taiwan (ROC) resident cards with stated purpose of residence being migrant worker (移工), are not eligible for a TAC holding visa/residence permit/permanent residence certificate issued by USA/Canada/South Korea/UK/Schengen Convention countries, which may be valid or has expired less than 10 years prior to the date of arrival holding electronic visa issued by Australia/New Zealand, that is still valid by the date of arrival holding Japanese visa/visa waiver together with proof of record of entering Japan or confirmed onward ticket to Japan holding South Korean visa together with proof of record of entering South Korea. holding visa/residence permit issued by Taiwan (ROC) which has expired less than 10 years prior to the date of arrival; holders of entry visas bearing the remark FL (migrant worker), X (others), or P with "Special permission from MOFA" (visa and eVisa for "Project for Simplifying Visa Regulations for High-end Group Tourists from Southeast Asian Countries (Project Kuan-Hong)" ever issued), as well as holders of Taiwan (ROC) resident cards with stated purpose of residence being migrant worker (移工), are not eligible for a TACOnline Application for Travel Authorization Certificate (TAC) available for Indonesian passport holders if: holding visa/residence permit/permanent residence certificate issued by USA/Canada/South Korea/UK/Schengen Convention countries, which may be valid or has expired less than 10 years prior to the date of arrival holding electronic visa issued by Australia/New Zealand, that is still valid by the date of arrival holding Japanese visa/visa waiver together with proof of record of entering Japan or confirmed onward ticket to Japan holding South Korean visa together with proof of record of entering South Korea. holding visa/residence permit issued by Taiwan (ROC) which has expired less than 10 years prior to the date of arrival; holders of entry visas bearing the remark FL (migrant worker), X (others), or P with "Special permission from MOFA" (visa and eVisa for "Project for Simplifying Visa Regulations for High-end Group Tourists from Southeast Asian Countries (Project Kuan-Hong)" ever issued), as well as holders of Taiwan (ROC) resident cards with stated purpose of residence being migrant worker (移工), are not eligible for a TAC holding visa/residence permit/permanent residence certificate issued by USA/Canada/South Korea/UK/Schengen Convention countries, which may be valid or has expired less than 10 years prior to the date of arrival holding electronic visa issued by Australia/New Zealand, that is still valid by the date of arrival holding Japanese visa/visa waiver together with proof of record of entering Japan or confirmed onward ticket to Japan holding South Korean visa together with proof of record of entering South Korea. holding visa/residence permit issued by Taiwan (ROC) which has expired less than 10 years prior to the date of arrival; holders of entry visas bearing the remark FL (migrant worker), X (others), or P with "Special permission from MOFA" (visa and eVisa for "Project for Simplifying Visa Regulations for High-end Group Tourists from Southeast Asian Countries (Project Kuan-Hong)" ever issued), as well as holders of Taiwan (ROC) resident cards with stated purpose of residence being migrant worker (移工), are not eligible for a TACHolders of Indonesian diplomatic or official / service passports may enter the following countries without a visa for 30 days (unless otherwise stated): D - Diplomatic passports only. 1 - 90 days 2 - 90 days within any 180-day period. 3 - 60 days 4 - 30 days within any 180-day period. 5 - 14 daysAlthough a visa is generally needed by Indonesian citizens who hold ordinary passports, some countries apply visa waivers providing the Indonesian passport holders are also in possession of a visa or residence permit for certain countries (mainly USA / Canada / UK / Schengen / Australia/New Zealand). Some countries who apply such rules are these:Holders of an APEC Business Travel Card (ABTC) travelling on business do not require a visa to the following countries: 1 - Up to 180 days 2 - Up to 90 days 3 - Up to 90 days in a period of 180 days 4 - Up to 60 days The card must be used in conjunction with a passport and has the following advantages: 24 August 2015: During a meeting with the Vice President of Panama, Isabel Saint Malo at the East Asia-Latin America Cooperation in San José , Costa Rica , the foreign minister of Indonesia, Retno Marsudi formally requested Panama to provide a visa on arrival facility to Indonesians. 30 September 2015: In a bilateral meeting with the foreign minister of Mexico , Claudia Ruiz Massieu in the United Nations headquarters in New York, Retno Marsudi requested Mexico to give reciprocal treatment for a visa waiver policy for Indonesians to visit Mexico. 26 October 2015: In response to Indonesia's recent policy to abolish visa requirements for American citizens, the United States government plans to extend non-immigrant visas' validity issued to nationals of Indonesia to up to 10 years. 22 May 2018: Indonesian Foreign Minister, Retno Marsudi on her meeting with her Argentine counterpart, Jorge Faurie in Buenos Aires requests Argentina to ease visa application procedure for Indonesian citizens wanting to visit the South American nation. 5 August 2015: During her visit to the 48th AMM in Kuala Lumpur , the foreign minister of Indonesia, Retno Marsudi and the foreign minister of South Korea, Yun Byung-se discussed further implementation of visa exemption agreements for Indonesians to travel to South Korea. Negotiation for the same agreements also discussed with her Russian counterpart, foreign minister of Russia, Sergei Lavrov for further implementation of visa exemption agreements for Indonesians to travel to Russia . 21 October 2015: In the Joint Commission for Bilateral Cooperation (JCBC) meeting between Indonesia and Mongolia in Jakarta, Indonesia's Foreign Affairs Deputy Minister, A.M. Fachir and Mongolia State Secretary/Acting Foreign Affairs Vice Minister, Damba Gankhuyag are planning to arrange a mutual reciprocal visa waiver for holders of ordinary passports of both countries. 24 October 2015: On the sidelines meeting of the Ocean Rim Association in Padang , West Sumatra , Indonesian Foreign Minister Retno Marsudi and Indian Minister of State for Foreign Affairs Vijay Kumar Singh are planning to arrange a mutual reciprocal visa waiver for holders of ordinary passport of both countries. 8 June 2016: The Taiwan government plans to extend its visa exemption scheme to Indonesian passport holders, as well as visa simplification to the rest 7 ASEAN nations. Visitors from Brunei, Cambodia, Indonesia, Laos, Myanmar, the Philippines, Thailand and Vietnam will be granted entry privileges such as visa waivers, landing visas or e-visas, according to the report. Visitors from three others ASEAN member nations, Malaysia, Singapore, and Thailand already enjoy visa exemptions for stays of up to 30 days in Taiwan. 19 February 2019: At Investment Summit 2019 in Kathmandu , Nepal, Indonesian Ambassador to Bangladesh , Rina Soemarno requests that Bangladesh grants Indonesian passport holder visa-free access to the country based on reciprocity. 10 July 2015: Foreign minister of Indonesia , Retno Marsudi and European Commission Vice President, Frans Timmermans are planning to have a mutual reciprocal visa waiver arrangements for holders of ordinary passport of Indonesia and the European Union . During her meeting with Federica Mogherini at 48th AMM that was held in Kuala Lumpur early August 2015, Minister Retno Marsudi requested support from the European Union counterpart for abolishing Schengen visa requirements for Indonesian citizens. July 27, 2015: During his visit in Indonesia, the prime minister of the United Kingdom, David Cameron and the president of Indonesia, Joko Widodo raised a possibility to abolish visa requirements for holders of diplomatic, service and ordinary passport of Indonesia. 31 July 2015: Indonesian Ambassador to Bulgaria and Albania and Bulgarian Vice Minister of Foreign Affairs have raised possibility of waiving visa requirements for holders of ordinary passports of both countries. 26 August 2015: In an interview to Indonesian media on 26 August 2015, Russian Ambassador to Indonesia , Mikhail Y Galuzin told that his government is ready to waive visa requirements to ordinary passport of Indonesia. Date of implementation is not determined yet because talks and negotiations are still on going. 28 September 2015: In the 70th UN General Assembly in New York, the foreign minister of Indonesia, Retno Marsudi requested support from her French and German counterparts to secure visa-free access to the Schengen Area for Indonesian citizens. Foreign minister of France, Laurent Fabius and foreign minister of Germany, Frank Walter Steinmeier are committed to support Indonesia's request by the time this issue is discussed at the EU Commission. Belgium , Denmark , Finland , Latvia , Lithuania , Luxembourg , Netherlands , Portugal and Romania also give their support for Indonesia to get a visa-free access to Schengen Area . 5 November 2015: On the sidelines of the EU-ASEAN ministerial meeting in Luxembourg, the European Commission has reportedly included Indonesia in a list of countries proposed for review by the European Council. Indonesia's proposal will be submitted to the council early next year. European Council then will ask three main entities ( Frontex , Europol and EASO ) to study and review Indonesia's eligibility. If the study results are positive then the Council and the European Commission will propose a new regulation regarding the status change of Indonesia to get visa-free Schengen. 27 April 2016: During his visit in Indonesia, the president of Serbia, Tomislav Nikolić and the president of Indonesia, Joko Widodo raised a possibility to abolish visa requirements for holders of diplomatic and service passports. 17 May 2017: President Grybauskaite, during her state visit to Indonesia, expressed Lithuania's readiness to support the negotiations on CEPA and the free-visa policy for EU member states as such cooperation will help to generate a revenue of €2.5 billion. 23 November 2018: Vice Chairman of Indonesia's People's Consultative Assembly , Ahmad Muzani requests Bosnia and Herzegovina to grant Indonesian passport holder visa-free travel to the Balkan nation. Many countries have entry restrictions on foreigners that go beyond the common requirement of having either a valid visa or a visa exemption. Such restrictions may be health related or impose additional documentation requirements on certain classes of people for diplomatic or political purposes. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa.

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Visa requirements for Chinese citizens

Visa requirements for Chinese citizens are administrative entry restrictions imposed on citizens of China by the authorities of other states. As of 2024, Chinese citizens had visa-free or visa on arrival access to 88 countries and territories, ranking the Chinese passport 63rd in the world according to the Henley Passport Index . Before February 2014, Chinese immigration authorities did not generally allow mainland Chinese citizens to board outbound flights without having a valid visa for the destination country, even if the destination country granted a visa on arrival to Chinese passport holders, unless the exit was approved by the Ministry of Public Security . Exceptions were possible if the traveller had a third country's visa and a connecting flight from the initial destination country to the third country. As of 10 June 2017 , [ update ] if the destination is a visa-on-arrival or e-visa issuing country this approval is no longer needed. [ citation needed ] Visa requirements for Chinese citizens were lifted by: Visas on arrival were introduced by: Chinese citizens were made eligible for eVisas by:90 days within any 180 day period. Although officially no visa is required, at least a Double Entry Schengen visa is required to enter Andorra since it has no own airport facility. Electronic Travel Authorization will only be issued to those who already possess a U.S. or Schengen visa. It must be approved before travel and is valid for tourism purposes. As of 1 October 2017, visas are issued with a 10-year validity period. Argentinian Ministry of Foreign Affairs website states that visa is required for Chinese citizens visiting Argentina. 90 days within any 180 day period. Holders of passports for public affairs do not require a visa for up to 30 days. Visa payment can be made by major credit cards. Visas valid for 30 days can be obtained on arrival or online. No transit visa is required if transiting through Calgary, Montreal Trudeau (Air Canada Flights only), Toronto Pearson (Terminal 1 only, cannot change terminal or transit through Terminal 3), Vancouver International or Winnipeg Airports to or from the United States within 24 hours of arrival while holding valid US visa and travelling on flights operated by Air Canada (including subsidiaries Air Canada Rouge and Jazz Air), Air China, Cathay Pacific, China Airlines, China Eastern Airlines, China Southern Airlines, Hainan Airlines, Philippine Airlines, WestJet, or Xiamen Airlines. Need to departure from Beijing, Chengdu, Fuzhou, Guangzhou, Harbin, Hong Kong, Manila, Nagoya, Osaka, Seoul, Shanghai, Shenyang, Taipei, Tokyo, or Xiamen if travelling to the United States. Need not to be under a removal or deportation order or staying in the United States longer than the authorized time if leaving the United States. Visa is not required for permanent residents of the United States. National visa may be substituted with a visa issued by Canada or the United States which is valid for a minimum of 6 months from the arrival date. Holders of passports for public affairs do not require a visa for stays up to 30 days. National visa may be substituted with a visa issued by Canada or the United States. Can be extended up to 90 days with a fee. Holders of passports for public affairs do not require a visa. Holders of a visa issued by Canada, United States, United Kingdom, Ireland, Cyprus and any Schengen Area country can obtain a Tourist Card on arrival for a maximum stay of 30 days. United Kingdom residents can obtain a Tourist Card on arrival for a maximum stay of 90 days. 90 days within any one-year period. Chinese citizens are eligible to apply for e-Visa. Per IATA, Chinese citizens are eligible to apply for visa on arrival for a maximum stay of one month with a Letter of Guarantee from a local travel agency. All non-Haitian passport holders must pay a tourist fee of US$10 on arrival. National visa may be substituted with a valid visa issued by Canada, the United States, or a Schengen Area member state, or a residence permit of the United Kingdom, Japan, Singapore, Australia and New Zealand. 90 days within any 180-day period. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. 90 days within any 12-month period. In the following cases, Chinese nationals can enter Korea without a visa. Visa is not required for direct or transit visitors to Jeju Island up to 30 days. Transit to or from third countries such as the United States, Canada, and New Zealand. Chinese group tourists departing from China (including Hong Kong and Macau) to Incheon, Gimpo, Gimhae, Cheongju, Muan, Daegu, and Yangyang International Airport in South Korea, travel within 5 days (10 days at Yangyang Airport) and then transfer to domestic flights in Korea Flight to Jeju Island. Chinese group tourists departing from China via South Korea to Japan with a Japanese group tourist visa, and Chinese group tourists departing from Japan via South Korea to China or a third country. Due to COVID-19, Kuwait government stops issuing the travel visas to the ordinary passport holders of Chinese citizens. Extendable for 2 additional months. National visa may be substituted with a valid visa (of any category except transit) or permanent residency issued by Canada, Japan, United Kingdom, United States, or a Schengen Area member state, may enter visa-free for 180 days. Holders of permanent residency of Chile, Peru, and Colombia may enter visa-free for 180 days. Note: Temporary residence cards, permits or other documents issued by those countries such as EU temporary residency card, Canadian study/work permit, or U.S. I-20 form, EAD card are NOT accepted for entering Mexico. Only valid visas (of any category, except transit visa) physically affixed in the passport are accepted. National visa may be substituted with a valid Schengen visa, a valid visa of Australia, Cyprus, Japan, Canada, New Zealand, Ireland, the United States of America and the United Kingdom. Also a residence permit in the countries of the Schengen zone, Australia, Cyprus, Japan, Canada, New Zealand, Ireland, the United States of America and the United Kingdom for up to 30 days per stay. Travelers must pay a fee of 650 MT upon entry. Can be extendable for another 30 days. Chinese national are also eligible for single / multiple entry electronic visa valid for 30 days. National visa may be substituted with a valid visa issued by Australia, Canada, the United States, Schengen (need to be valid for 6 months after entry) or the United Kingdom for up to 30 days. Holders of passports for public affairs do not require a visa. Holders of passports for public affairs do not require a visa. Chinese tourists traveling in registered and organized travel groups are eligible for a free 30-day single-entry visitor visa. Citizens of China may visit Russia without a visa for up to 15 days if traveling as part of a tour group from 5 to 50 persons that is accompanied by a representative of a tour operator registered in both countries. Although officially no visa is required, at least a Single Entry Schengen visa is required to enter San Marino since it does not have an own airport facility and no border controls. Holders of a visa issued by the United States and the Schengen Area do not require a visa. Holders of passports for public affairs do not require a visa. Holders of passports for public affairs do not require a visa up to 90 days within a six-month period. Pre-arranged visa can be picked up on arrival. Obtainable online. Printed visa authorization must be presented at the time of travel. Holders of passports for public affairs do not require a visa. The duration of stay is 30 days at a time, no more than 90 days within any 180 days. 30-day visa cannot be extended while in Thailand. National visa may be substituted with a valid visa issued by the United States, Canada or a European Union member state for stays up to 90 days when arriving via Montevideo airport or Montevideo and Colonia ports. Holders of passports for public affairs do not require a visa. Also eligible for a universal visa allowing access to Zimbabwe. Also eligible for a universal visa allowing access to Zambia.Taiwan and mainland China have been under separated governance since 1949, respectively ruled by the Government of the Republic of China and the Government of the People's Republic of China due to the Chinese Civil War . Even though neither party regards the people of the other as foreigner, movement of people between mainland China and Taiwan is subject to immigration restrictions impose by both parties, either for immigrants or visitors. Chinese Mainlanders are subject to Taiwan immigration requirements , and are also subject to Mainland exit permission requirements if they are boarding a ferry or flight directly heading to Taiwan departing from the Mainland. Exit-related restrictions include : Entry-related restrions include : For tourists residing overseas (including Hong Kong and Macau) since September 1, 2023, and medical, business and student purpose permit issuance has been resumed earlier.Taiwan and mainland China have been under separated governance since 1949, respectively ruled by the Government of the Republic of China and the Government of the People's Republic of China due to the Chinese Civil War . Even though neither party regards the people of the other as foreigner, movement of people between mainland China and Taiwan is subject to immigration restrictions impose by both parties, either for immigrants or visitors. Chinese Mainlanders are subject to Taiwan immigration requirements , and are also subject to Mainland exit permission requirements if they are boarding a ferry or flight directly heading to Taiwan departing from the Mainland. Exit-related restrictions include : Entry-related restrions include : For tourists residing overseas (including Hong Kong and Macau) since September 1, 2023, and medical, business and student purpose permit issuance has been resumed earlier.Holders of Chinese diplomatic or official / service passports may enter the following countries without a visa. Diplomatic passports only O - Official passports are limited to those traveling with a delegation of ministerial level or higher. Diplomatic and official / service passportsHolders of an APEC Business Travel Card (ABTC) travelling on business do not require a visa to the following countries: 1 - Up to 180 days 2 - Up to 90 days 3 - Up to 90 days in a period of 180 days 4 - Up to 60 days The card must be used in conjunction with a passport and has the following advantages: In addition to passports, Exit and Entry Permit were issued to citizens of the People's Republic of China for visiting certain land neighboring countries for trade, tourism purposes without a passport, and visa to the country of visiting and vice versa under the bilateral agreements. Such permit is issued by the police stations in the related border administrative divisions. By far, travelers from the administrative divisions that share borders with North Korea , Mongolia , Myanmar , Laos , Vietnam , India and Nepal could apply for the Exit-Entry Permit for crossing borders. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. These are the numbers of mainland Chinese visitors to various countries or territories:

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/An_American_Plague/html

An American Plague

An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793 is a 2003 nonfiction adolescent history by author Jim Murphy published by Clarion Books . An American Plague was one of the finalists in the 2003 National Book Award and was a 2004 Newbery Honor Book . It portrays the agony and pain this disease brought upon the American people marking its place in history in order to never be forgotten.The book takes place during the 1793 Philadelphia yellow fever epidemic . At this point Philadelphia is considered to be the largest city located in North America . The city is hit with an incurable and unknown disease which kills about 50% of the people affected. The author Jim Murphy describes a disease called the yellow fever and how it affected the residents of Philadelphia. In the novel he highlights the heroic roles and actions that the Philadelphia free blacks took in order to fight this deadly disease, and how it causes a constitutional crisis that leads president George Washington to leave the city of Philadelphia. The cure for the disease was not found until centuries later.Dr. Benjamin Rush : Developed a radical treatment process for the yellow fever disease which involved withdrawing blood from patients and giving patients mercury and the root of a poisonous plant. Mayor Matthew Clarkson : The only government leader who stayed to deal with the issues that were going on in Philadelphia when the plague was taking place. President George Washington : Was involved with foreign affairs when the plague struck and was out of touch with the government affairs for the time length of six weeks while the plague was taking over Philadelphia. Thomas Jefferson : Was the Secretary of State when the plague struck Philadelphia. Edmond-Charles Genêt : Was the French Ambassador who wanted the Americans to help France with their revolution . The Reverend J. Henry c. Helmuth : Believed that the plague was a punishment sent by god because there was an increase in gambling as well as in drinking among the people of Philadelphia. Absalom Jones : Was involved in the building of the St. George's United Methodist Church and, after participating and helping build the church, was told to sit in the back of the church by the church leaders. Mathew Carey : Wrote a book that was pronounced to be a best seller titled " A Short Account of the Malignant Fever " Dr. William Currie : Believed that the fever came from a shipment that came from the West Indies and claimed that it was not the yellow fever.Critics that were able to engage with the book found it to be very intriguing. It has been stated that Jim Murphy created an impeccable book that draws the reader in while at the same time creating fear. He is able to describe how horrid this period of time was for history with solid research and amazing facts. "In a lavishly illustrated book, containing maps, newspaper columns and period illustrations, Jim Murphy unflinchingly presents the horrors of the event as well as its heroes" states Anita Silvey. Kirkus Reviews named it Starred Review and found the book to be "A mesmerizing, macabre account...powerful evocative prose... compelling subject matter...fascinating discussion...valuable lesson in reading and writing history. Stellar." "Leisurely, lyrical tone...Murphy injects the events with immediacy...archival photographs...bring the story to life...comprehensive history." was Publishers Weekly' s opinion about the work. Murphy spotlights the heroic role of Philadelphia's free blacks in combating the disease, and the Constitutional crisis that President Washington faced when he was forced to leave the city — and all his papers — while escaping the deadly contagion. [ citation needed ]

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/George_Miller_Sternberg/html

George Miller Sternberg

Indian Wars Brigadier General George Miller Sternberg (June 8, 1838 – November 3, 1915) was a U.S. Army physician who is considered the first American bacteriologist , having written Manual of Bacteriology (1892). After he survived typhoid and yellow fever , Sternberg documented the cause of malaria (1881), discovered the cause of lobar pneumonia (1881), and confirmed the roles of the bacilli of tuberculosis and typhoid fever (1886). As the 18th U.S. Army Surgeon General , from 1893 to 1902, Sternberg led commissions to control typhoid and yellow fever, along with his subordinate Major Walter Reed . Sternberg also oversaw the establishment of the Army Medical School (1893; now the Walter Reed Army Institute of Research ) and of the U.S. Army Nurse Corps (1901). The pioneering German bacteriologist Robert Koch honored Sternberg with the sobriquet , "Father of American Bacteriology ". Sternberg was born at Hartwick Seminary , Otsego County, New York , where he spent most of his childhood. He was the eldest child of Levi Sternberg and Margaret Miller Sternberg. His father was a Lutheran clergyman, was descended from a German family from the Palatinate , which had settled in the Schoharie Valley in the early years of the 18th century. His father later became principal of Hartwick Seminary in Hartwick, New York, where he started his education. His mother, Margaret Levering (Miller) Sternberg, was the daughter of George B. Miller, also a Lutheran clergyman and professor of theology at the seminary, which was a Lutheran school. As an eldest child of a large family and he was given adult responsibilities from an early age. He interrupted his studies at the seminary with a year of work in a bookstore in Cooperstown and three years of teaching in nearby rural schools. During his last year at Hartwick he was an instructor in mathematics , chemistry , and natural philosophy . He was at the same time pursuing the study of medicine with Horace Lathrop of Cooperstown. For his formal medical training he went first to Buffalo , and later to the College of Physicians and Surgeons of New York ( M.D. degree, 1860). After graduation he settled in Elizabeth, New Jersey , to practice, remaining there until the outbreak of the Civil War. On May 28, 1861, he was appointed an Assistant Surgeon in the U.S. Army, and on July 21 of the same year was captured at the First Battle of Bull Run , while serving with General George Sykes ' division. He managed to escape and soon joined his command in the defense of Washington . He later participated in the Peninsular campaign and saw service in the battles of Gaines' Mill and Malvern Hill . During this campaign he contracted typhoid fever while at Harrison's Landing and was sent north on a transport. During the remainder of the war he performed hospital duty, mostly at Lovell Hospital at Portsmouth, Rhode Island , and at Cleveland, Ohio . On March 13, 1865, he was given the Brevets of captain and major for faithful and meritorious service. The years following the war followed the pattern of frequent moves typical of junior medical officers of the day. He married Louisa Russell, daughter of Robert Russell of Cooperstown, on October 19, 1865, and took his bride to Jefferson Barracks, Missouri , from where he was soon transferred to Fort Harker , near Ellsworth in Kansas . Louisa did not accompany him to the latter post, but joined him in 1867 just prior to an outbreak of cholera . She was one of the first civilians to develop the disease which killed her within a few hours on July 15 and soon claimed a toll of about 75 people at the fort. Sternberg was promoted to captain on May 28, 1866, and was soon sent to Fort Riley, Kansas (December 1867). With troops from this post he took part (1868–69) in several expeditions against hostile Cheyenne Indians along the upper Arkansas River in Indian Territory and in western Kansas. Besides his military duties, Sternberg was also interested in fossils and began collecting leaf imprints from the nearby Dakota Sandstone Formation . Some of his specimens went back East where they were studied by the famous paleobotanist, Leo Lesquereux . Sternberg also collected vertebrate fossils, including shark teeth, fish remains and mosasaur bones, from the Smoky Hill Chalk and Pierre Shale formations in western Kansas, and sent the specimens back to Washington, D.C., where they were eventually curated in the United States National Museum ( Smithsonian Institution ). There they were studied and later described in publications by Joseph Leidy . The type specimen of the giant Late Cretaceous fish, Xiphactinus audax , was collected by Dr. Sternberg. His work was also credited by Edward D. Cope and Samuel W. Williston . Sternberg was also responsible for getting his younger brother, Charles H. Sternberg , started in paleontology . Charles would later credit his older brother for getting many other paleontologists of the day interested in the fossil resources of Kansas. Sternberg served at Fort Riley until July 1870, when he was ordered to Governors Island, New York . In the meantime, he had remarried on September 1, 1869, at Indianapolis, Indiana , to Martha L. Pattison, a daughter of Thomas T. N. Pattison of that city. During two years at Governors Island and three (1872–75) at Fort Barrancas , Florida, Sternberg had frequent contacts with yellow fever patients, and at the latter post, he contracted the disease himself. He had earlier noted the efficiency of moving inhabitants out of an infested environment and successfully applied that method to the Barrancas garrison. At about this time, Sternberg published two articles in the New Orleans Medical and Surgical Journal ("An Inquiry into the Modus Operandi of the Yellow Fever Poison," July 1875, and "A Study of the Natural History of Yellow Fever," March 1877) which gained him status as an authority on yellow fever. While convalescing from his bout with the disease in 1877 he was ordered to Fort Walla Walla , Washington, and later that year he participated in a campaign against the Nez Perce Indians . The spent his spare hours in study and experimentation which laid a foundation for his later work. In 1870 he perfected an anemometer and patented an automatic heat regulator which later had wide negative use. On December 1, 1875, Sternberg was promoted major, and in April 1879, he was ordered to Washington, D. C., and detailed with the 1880 Havana Yellow Fever Commission . His medical colleagues on the Commission were Doctors Stanfard Chaille of New Orleans and Juan Guiteras of Havana . Sternberg was assigned to work on the problems relating to the nature and natural history of the disease and especially to its etiology (origins). This involved the microscopical examination of blood and tissues in which he was one of the first to employ the newly discovered process of photomicrography . He developed high efficiency in its use. In the course of this work, he spent three months in Havana closely associated with Dr. Carlos Finlay , the main proponent of the theory of mosquito transmission of yellow fever. In 1880, the Commission concluded that the solution of yellow fever causality must await further progress in the new science of bacteriology . Sternberg was soon sent to New Orleans to investigate the conflicting discoveries of Plasmodium malariae by Alphonse Laveran , and of Bacillus malariae by Edwin Klebs and Corrado Tommasi-Crudeli . His report (1881) declared that the Bacillus malariae had no part in the causation of malaria. The same year—simultaneously with Louis Pasteur —he announced the discovery of the pneumococcus , eventually recognized as the pathogenic agent of lobar pneumonia . He was the first in the United States to demonstrate the Plasmodium organism as cause of malaria (1885) and to confirm the causitive roles of the bacilli of tuberculosis and typhoid fever (1886). He was the first scientist to produce photomicrographs of the tubercule bacillus . He was also the earliest American pioneer in the related field of disinfection in which he began with experiments (1878) with putrefactive bacteria . This work was continued in Washington and in the laboratories of Johns Hopkins Hospital in Baltimore , under the auspices of the American Public Health Association . For his essay "Disinfection and Individual Prophylaxis against Infectious Diseases" (1886), later translated into several languages, he was awarded the Lomb Prize . He oversaw creation the US Army enlisted hospital corps ("medics") in 1887. During the Hamburg cholera epidemic of 1892 he was detailed for duty with the New York quarantine station as a consultant on disinfection as applied to ships, their personnel, and cargo. Although some cases of the disease reached United States shores, none developed within the country. Sternberg was promoted to lieutenant colonel on January 2, 1891. In 1892 he published his Manual of Bacteriology , the first exhaustive treatise on the subject produced in the United States. With the retirement of Surgeon General Sutherland (May 1893), Sternberg, along with many others, submitted his claims for consideration for the vacancy. Although hardly the seniormost officer in the Medical Corps , he was among the top dozen and was without question the most eminent professional scientist in the service. He received the appointment of Surgeon General by President Grover Cleveland on May 30, 1893, succeeding Charles Sutherland and receiving promotion to brigadier general. Sternberg's nine-year tenure (1893–1902) as Surgeon General coincided with immense professional progress in the field of bacteriology as well as the occurrence of the Spanish–American War . He was responsible for the 1893 establishment of the Army Medical School (precursor of today's Walter Reed Army Institute of Research ), the organization of a contract dental service, the creation of the tuberculosis hospital at Fort Bayard, New Mexico , and of a special surgical hospital at Washington Barracks . The equipment of the medical school included laboratories of chemistry and bacteriology, and a liberal-minded policy was adopted in the supply of laboratory supplies to the larger military hospitals. With the Spanish–American War and its epidemic of typhoid fever, the problem of field hospitalization was confronted with fair success. (He was subjected to much criticism for conditions at these hospitals, but made little reply.) Sternberg created the Typhoid Fever Board (1898), consisting of Majors Walter Reed , Victor C. Vaughan , and Edward O. Shakespeare , which established the facts of contact infection and fly carriage of the disease. In 1900 he organized the Yellow Fever Commission , headed by Reed, which ultimately fixed the transmission of yellow fever upon a particular species of mosquito. (These became celebrated as the " Walter Reed Boards "). On his recommendation the first tropical disease board was also established in Manila (January 1900) where it continued for about the next two years. In 1901, Sternberg oversaw the establishment of the U.S. Army Nurse Corps . In July 1900, Sternberg recognized Elizabeth Fleischman for her radiographic work with X-rays on the wounded soldiers during the Spanish–American War . Sternberg was retired on account of age on June 8, 1902, and devoted the later years of his life to social welfare activities in Washington, particularly to the sanitary improvement of dwellings and to the care of tuberculous patients. Sternberg died at his home in Washington, on November 3, 1915. He was buried at Arlington National Cemetery . Sternberg was born at Hartwick Seminary , Otsego County, New York , where he spent most of his childhood. He was the eldest child of Levi Sternberg and Margaret Miller Sternberg. His father was a Lutheran clergyman, was descended from a German family from the Palatinate , which had settled in the Schoharie Valley in the early years of the 18th century. His father later became principal of Hartwick Seminary in Hartwick, New York, where he started his education. His mother, Margaret Levering (Miller) Sternberg, was the daughter of George B. Miller, also a Lutheran clergyman and professor of theology at the seminary, which was a Lutheran school. As an eldest child of a large family and he was given adult responsibilities from an early age. He interrupted his studies at the seminary with a year of work in a bookstore in Cooperstown and three years of teaching in nearby rural schools. During his last year at Hartwick he was an instructor in mathematics , chemistry , and natural philosophy . He was at the same time pursuing the study of medicine with Horace Lathrop of Cooperstown. For his formal medical training he went first to Buffalo , and later to the College of Physicians and Surgeons of New York ( M.D. degree, 1860). After graduation he settled in Elizabeth, New Jersey , to practice, remaining there until the outbreak of the Civil War. On May 28, 1861, he was appointed an Assistant Surgeon in the U.S. Army, and on July 21 of the same year was captured at the First Battle of Bull Run , while serving with General George Sykes ' division. He managed to escape and soon joined his command in the defense of Washington . He later participated in the Peninsular campaign and saw service in the battles of Gaines' Mill and Malvern Hill . During this campaign he contracted typhoid fever while at Harrison's Landing and was sent north on a transport. During the remainder of the war he performed hospital duty, mostly at Lovell Hospital at Portsmouth, Rhode Island , and at Cleveland, Ohio . On March 13, 1865, he was given the Brevets of captain and major for faithful and meritorious service. The years following the war followed the pattern of frequent moves typical of junior medical officers of the day. He married Louisa Russell, daughter of Robert Russell of Cooperstown, on October 19, 1865, and took his bride to Jefferson Barracks, Missouri , from where he was soon transferred to Fort Harker , near Ellsworth in Kansas . Louisa did not accompany him to the latter post, but joined him in 1867 just prior to an outbreak of cholera . She was one of the first civilians to develop the disease which killed her within a few hours on July 15 and soon claimed a toll of about 75 people at the fort. Sternberg was promoted to captain on May 28, 1866, and was soon sent to Fort Riley, Kansas (December 1867). With troops from this post he took part (1868–69) in several expeditions against hostile Cheyenne Indians along the upper Arkansas River in Indian Territory and in western Kansas. Besides his military duties, Sternberg was also interested in fossils and began collecting leaf imprints from the nearby Dakota Sandstone Formation . Some of his specimens went back East where they were studied by the famous paleobotanist, Leo Lesquereux . Sternberg also collected vertebrate fossils, including shark teeth, fish remains and mosasaur bones, from the Smoky Hill Chalk and Pierre Shale formations in western Kansas, and sent the specimens back to Washington, D.C., where they were eventually curated in the United States National Museum ( Smithsonian Institution ). There they were studied and later described in publications by Joseph Leidy . The type specimen of the giant Late Cretaceous fish, Xiphactinus audax , was collected by Dr. Sternberg. His work was also credited by Edward D. Cope and Samuel W. Williston . Sternberg was also responsible for getting his younger brother, Charles H. Sternberg , started in paleontology . Charles would later credit his older brother for getting many other paleontologists of the day interested in the fossil resources of Kansas. Sternberg served at Fort Riley until July 1870, when he was ordered to Governors Island, New York . In the meantime, he had remarried on September 1, 1869, at Indianapolis, Indiana , to Martha L. Pattison, a daughter of Thomas T. N. Pattison of that city. On May 28, 1861, he was appointed an Assistant Surgeon in the U.S. Army, and on July 21 of the same year was captured at the First Battle of Bull Run , while serving with General George Sykes ' division. He managed to escape and soon joined his command in the defense of Washington . He later participated in the Peninsular campaign and saw service in the battles of Gaines' Mill and Malvern Hill . During this campaign he contracted typhoid fever while at Harrison's Landing and was sent north on a transport. During the remainder of the war he performed hospital duty, mostly at Lovell Hospital at Portsmouth, Rhode Island , and at Cleveland, Ohio . On March 13, 1865, he was given the Brevets of captain and major for faithful and meritorious service. The years following the war followed the pattern of frequent moves typical of junior medical officers of the day. He married Louisa Russell, daughter of Robert Russell of Cooperstown, on October 19, 1865, and took his bride to Jefferson Barracks, Missouri , from where he was soon transferred to Fort Harker , near Ellsworth in Kansas . Louisa did not accompany him to the latter post, but joined him in 1867 just prior to an outbreak of cholera . She was one of the first civilians to develop the disease which killed her within a few hours on July 15 and soon claimed a toll of about 75 people at the fort. Sternberg was promoted to captain on May 28, 1866, and was soon sent to Fort Riley, Kansas (December 1867). With troops from this post he took part (1868–69) in several expeditions against hostile Cheyenne Indians along the upper Arkansas River in Indian Territory and in western Kansas. Besides his military duties, Sternberg was also interested in fossils and began collecting leaf imprints from the nearby Dakota Sandstone Formation . Some of his specimens went back East where they were studied by the famous paleobotanist, Leo Lesquereux . Sternberg also collected vertebrate fossils, including shark teeth, fish remains and mosasaur bones, from the Smoky Hill Chalk and Pierre Shale formations in western Kansas, and sent the specimens back to Washington, D.C., where they were eventually curated in the United States National Museum ( Smithsonian Institution ). There they were studied and later described in publications by Joseph Leidy . The type specimen of the giant Late Cretaceous fish, Xiphactinus audax , was collected by Dr. Sternberg. His work was also credited by Edward D. Cope and Samuel W. Williston . Sternberg was also responsible for getting his younger brother, Charles H. Sternberg , started in paleontology . Charles would later credit his older brother for getting many other paleontologists of the day interested in the fossil resources of Kansas. Sternberg served at Fort Riley until July 1870, when he was ordered to Governors Island, New York . In the meantime, he had remarried on September 1, 1869, at Indianapolis, Indiana , to Martha L. Pattison, a daughter of Thomas T. N. Pattison of that city. During two years at Governors Island and three (1872–75) at Fort Barrancas , Florida, Sternberg had frequent contacts with yellow fever patients, and at the latter post, he contracted the disease himself. He had earlier noted the efficiency of moving inhabitants out of an infested environment and successfully applied that method to the Barrancas garrison. At about this time, Sternberg published two articles in the New Orleans Medical and Surgical Journal ("An Inquiry into the Modus Operandi of the Yellow Fever Poison," July 1875, and "A Study of the Natural History of Yellow Fever," March 1877) which gained him status as an authority on yellow fever. While convalescing from his bout with the disease in 1877 he was ordered to Fort Walla Walla , Washington, and later that year he participated in a campaign against the Nez Perce Indians . The spent his spare hours in study and experimentation which laid a foundation for his later work. In 1870 he perfected an anemometer and patented an automatic heat regulator which later had wide negative use. On December 1, 1875, Sternberg was promoted major, and in April 1879, he was ordered to Washington, D. C., and detailed with the 1880 Havana Yellow Fever Commission . His medical colleagues on the Commission were Doctors Stanfard Chaille of New Orleans and Juan Guiteras of Havana . Sternberg was assigned to work on the problems relating to the nature and natural history of the disease and especially to its etiology (origins). This involved the microscopical examination of blood and tissues in which he was one of the first to employ the newly discovered process of photomicrography . He developed high efficiency in its use. In the course of this work, he spent three months in Havana closely associated with Dr. Carlos Finlay , the main proponent of the theory of mosquito transmission of yellow fever. In 1880, the Commission concluded that the solution of yellow fever causality must await further progress in the new science of bacteriology . Sternberg was soon sent to New Orleans to investigate the conflicting discoveries of Plasmodium malariae by Alphonse Laveran , and of Bacillus malariae by Edwin Klebs and Corrado Tommasi-Crudeli . His report (1881) declared that the Bacillus malariae had no part in the causation of malaria. The same year—simultaneously with Louis Pasteur —he announced the discovery of the pneumococcus , eventually recognized as the pathogenic agent of lobar pneumonia . He was the first in the United States to demonstrate the Plasmodium organism as cause of malaria (1885) and to confirm the causitive roles of the bacilli of tuberculosis and typhoid fever (1886). He was the first scientist to produce photomicrographs of the tubercule bacillus . He was also the earliest American pioneer in the related field of disinfection in which he began with experiments (1878) with putrefactive bacteria . This work was continued in Washington and in the laboratories of Johns Hopkins Hospital in Baltimore , under the auspices of the American Public Health Association . For his essay "Disinfection and Individual Prophylaxis against Infectious Diseases" (1886), later translated into several languages, he was awarded the Lomb Prize . He oversaw creation the US Army enlisted hospital corps ("medics") in 1887. During the Hamburg cholera epidemic of 1892 he was detailed for duty with the New York quarantine station as a consultant on disinfection as applied to ships, their personnel, and cargo. Although some cases of the disease reached United States shores, none developed within the country. Sternberg was promoted to lieutenant colonel on January 2, 1891. In 1892 he published his Manual of Bacteriology , the first exhaustive treatise on the subject produced in the United States. With the retirement of Surgeon General Sutherland (May 1893), Sternberg, along with many others, submitted his claims for consideration for the vacancy. Although hardly the seniormost officer in the Medical Corps , he was among the top dozen and was without question the most eminent professional scientist in the service. He received the appointment of Surgeon General by President Grover Cleveland on May 30, 1893, succeeding Charles Sutherland and receiving promotion to brigadier general. Sternberg's nine-year tenure (1893–1902) as Surgeon General coincided with immense professional progress in the field of bacteriology as well as the occurrence of the Spanish–American War . He was responsible for the 1893 establishment of the Army Medical School (precursor of today's Walter Reed Army Institute of Research ), the organization of a contract dental service, the creation of the tuberculosis hospital at Fort Bayard, New Mexico , and of a special surgical hospital at Washington Barracks . The equipment of the medical school included laboratories of chemistry and bacteriology, and a liberal-minded policy was adopted in the supply of laboratory supplies to the larger military hospitals. With the Spanish–American War and its epidemic of typhoid fever, the problem of field hospitalization was confronted with fair success. (He was subjected to much criticism for conditions at these hospitals, but made little reply.) Sternberg created the Typhoid Fever Board (1898), consisting of Majors Walter Reed , Victor C. Vaughan , and Edward O. Shakespeare , which established the facts of contact infection and fly carriage of the disease. In 1900 he organized the Yellow Fever Commission , headed by Reed, which ultimately fixed the transmission of yellow fever upon a particular species of mosquito. (These became celebrated as the " Walter Reed Boards "). On his recommendation the first tropical disease board was also established in Manila (January 1900) where it continued for about the next two years. In 1901, Sternberg oversaw the establishment of the U.S. Army Nurse Corps . In July 1900, Sternberg recognized Elizabeth Fleischman for her radiographic work with X-rays on the wounded soldiers during the Spanish–American War . Sternberg was retired on account of age on June 8, 1902, and devoted the later years of his life to social welfare activities in Washington, particularly to the sanitary improvement of dwellings and to the care of tuberculous patients. Sternberg died at his home in Washington, on November 3, 1915. He was buried at Arlington National Cemetery . During two years at Governors Island and three (1872–75) at Fort Barrancas , Florida, Sternberg had frequent contacts with yellow fever patients, and at the latter post, he contracted the disease himself. He had earlier noted the efficiency of moving inhabitants out of an infested environment and successfully applied that method to the Barrancas garrison. At about this time, Sternberg published two articles in the New Orleans Medical and Surgical Journal ("An Inquiry into the Modus Operandi of the Yellow Fever Poison," July 1875, and "A Study of the Natural History of Yellow Fever," March 1877) which gained him status as an authority on yellow fever. While convalescing from his bout with the disease in 1877 he was ordered to Fort Walla Walla , Washington, and later that year he participated in a campaign against the Nez Perce Indians . The spent his spare hours in study and experimentation which laid a foundation for his later work. In 1870 he perfected an anemometer and patented an automatic heat regulator which later had wide negative use. On December 1, 1875, Sternberg was promoted major, and in April 1879, he was ordered to Washington, D. C., and detailed with the 1880 Havana Yellow Fever Commission . His medical colleagues on the Commission were Doctors Stanfard Chaille of New Orleans and Juan Guiteras of Havana . Sternberg was assigned to work on the problems relating to the nature and natural history of the disease and especially to its etiology (origins). This involved the microscopical examination of blood and tissues in which he was one of the first to employ the newly discovered process of photomicrography . He developed high efficiency in its use. In the course of this work, he spent three months in Havana closely associated with Dr. Carlos Finlay , the main proponent of the theory of mosquito transmission of yellow fever.In 1880, the Commission concluded that the solution of yellow fever causality must await further progress in the new science of bacteriology . Sternberg was soon sent to New Orleans to investigate the conflicting discoveries of Plasmodium malariae by Alphonse Laveran , and of Bacillus malariae by Edwin Klebs and Corrado Tommasi-Crudeli . His report (1881) declared that the Bacillus malariae had no part in the causation of malaria. The same year—simultaneously with Louis Pasteur —he announced the discovery of the pneumococcus , eventually recognized as the pathogenic agent of lobar pneumonia . He was the first in the United States to demonstrate the Plasmodium organism as cause of malaria (1885) and to confirm the causitive roles of the bacilli of tuberculosis and typhoid fever (1886). He was the first scientist to produce photomicrographs of the tubercule bacillus . He was also the earliest American pioneer in the related field of disinfection in which he began with experiments (1878) with putrefactive bacteria . This work was continued in Washington and in the laboratories of Johns Hopkins Hospital in Baltimore , under the auspices of the American Public Health Association . For his essay "Disinfection and Individual Prophylaxis against Infectious Diseases" (1886), later translated into several languages, he was awarded the Lomb Prize . He oversaw creation the US Army enlisted hospital corps ("medics") in 1887. During the Hamburg cholera epidemic of 1892 he was detailed for duty with the New York quarantine station as a consultant on disinfection as applied to ships, their personnel, and cargo. Although some cases of the disease reached United States shores, none developed within the country. Sternberg was promoted to lieutenant colonel on January 2, 1891. In 1892 he published his Manual of Bacteriology , the first exhaustive treatise on the subject produced in the United States. With the retirement of Surgeon General Sutherland (May 1893), Sternberg, along with many others, submitted his claims for consideration for the vacancy. Although hardly the seniormost officer in the Medical Corps , he was among the top dozen and was without question the most eminent professional scientist in the service. He received the appointment of Surgeon General by President Grover Cleveland on May 30, 1893, succeeding Charles Sutherland and receiving promotion to brigadier general. Sternberg's nine-year tenure (1893–1902) as Surgeon General coincided with immense professional progress in the field of bacteriology as well as the occurrence of the Spanish–American War . He was responsible for the 1893 establishment of the Army Medical School (precursor of today's Walter Reed Army Institute of Research ), the organization of a contract dental service, the creation of the tuberculosis hospital at Fort Bayard, New Mexico , and of a special surgical hospital at Washington Barracks . The equipment of the medical school included laboratories of chemistry and bacteriology, and a liberal-minded policy was adopted in the supply of laboratory supplies to the larger military hospitals. With the Spanish–American War and its epidemic of typhoid fever, the problem of field hospitalization was confronted with fair success. (He was subjected to much criticism for conditions at these hospitals, but made little reply.) Sternberg created the Typhoid Fever Board (1898), consisting of Majors Walter Reed , Victor C. Vaughan , and Edward O. Shakespeare , which established the facts of contact infection and fly carriage of the disease. In 1900 he organized the Yellow Fever Commission , headed by Reed, which ultimately fixed the transmission of yellow fever upon a particular species of mosquito. (These became celebrated as the " Walter Reed Boards "). On his recommendation the first tropical disease board was also established in Manila (January 1900) where it continued for about the next two years. In 1901, Sternberg oversaw the establishment of the U.S. Army Nurse Corps . In July 1900, Sternberg recognized Elizabeth Fleischman for her radiographic work with X-rays on the wounded soldiers during the Spanish–American War . Sternberg was retired on account of age on June 8, 1902, and devoted the later years of his life to social welfare activities in Washington, particularly to the sanitary improvement of dwellings and to the care of tuberculous patients. Sternberg died at his home in Washington, on November 3, 1915. He was buried at Arlington National Cemetery . Sternberg was a member of the Military Order of the Loyal Legion of the United States , the Society of the Army of the Potomac , the Sons of the American Revolution and the Association of Military Surgeons of the United States . He was awarded the Civil War Campaign Medal and the Indian Campaign Medal . He was posthumously eligible for the Spanish War Service Medal .On Sternberg's monument in Arlington National Cemetery is the inscription: Pioneer American Bacteriologist, distinguished by his studies of the causation and prevention of infectious diseases, by his discovery of the microorganism causing pneumonia, and scientific investigations of yellow fever, which paved the way for the experimental demonstration of the mode of transmission of this pestilence. Veteran of three wars, breveted for bravery in action in the Civil War and the Nez Perce Wars. Served as Surgeon General of United States Army for period of nine years including the Spanish War. Founder of the Army Medical School. Scientist, author and philanthropist. M. D., LL. D. Along with Pasteur and Koch, Sternberg is credited with first bringing the fundamental principles and techniques of the new science of bacteriology within the reach of the average physician. A collection of his papers is held at the National Library of Medicine in Bethesda, Maryland.

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Informed consent

Informed consent is a principle in medical ethics , medical law and media studies , that a patient must have sufficient information and understanding before making decisions about their medical care. Pertinent information may include risks and benefits of treatments, alternative treatments, the patient's role in treatment, and their right to refuse treatment . In most systems, healthcare providers have a legal and ethical responsibility to ensure that a patient's consent is informed. This principle applies more broadly than healthcare intervention, for example to conduct research and to disclose a person's medical information. Within the US, definitions of informed consent vary, and the standard required is generally determined by the state. Informed consent requires a clear appreciation and understanding of the facts, implications, and consequences of an action. To give informed consent, the individual concerned must have adequate reasoning faculties and possess all relevant facts. Impairments to reasoning and judgment that may preclude informed consent include intellectual or emotional immaturity, high levels of stress such as post-traumatic stress disorder or a severe intellectual disability , severe mental disorder , intoxication , severe sleep deprivation , dementia , or coma . Obtaining informed consent is not always required . If an individual is considered unable to give informed consent, another person is generally authorized to give consent on the individual's behalf—for example, the parents or legal guardians of a child (though in this circumstance the child may be required to provide informed assent ) and conservators for the mentally disordered . Alternatively, the doctrine of implied consent permits treatment in limited cases, for example when an unconscious person will die without immediate intervention. Cases in which an individual is provided insufficient information to form a reasoned decision raise serious ethical issues. When these issues occur, or are anticipated to occur, in a clinical trial , they are subject to review by an ethics committee or institutional review board . Informed consent is codified in both national and international law. 'Free consent' is a cognate term in the International Covenant on Civil and Political Rights , adopted in 1966 by the United Nations , and intended to be in force by 23 March 1976. Article 7 of the covenant prohibits experiments conducted without the "free consent to medical or scientific experimentation" of the subject. As of September 2019 [ update ] , the covenant has 173 parties and six more signatories without ratification. Informed consent can be complex to evaluate, because neither expressions of consent, nor expressions of understanding of implications, necessarily mean that full adult consent was in fact given, nor that full comprehension of relevant issues is internally digested. Consent may be implied within the usual subtleties of human communication, rather than explicitly negotiated verbally or in writing. If a doctor asks a patient to take their blood pressure, for example, a patient may demonstrate consent by offering their arm for a blood pressure cuff. In some cases consent cannot legally be possible, even if the person protests he does indeed understand and wish. There are also structured instruments for evaluating capacity to give informed consent, although no ideal instrument presently exists. Thus, there is always a degree to which informed consent must be assumed or inferred based upon observation, or knowledge, or legal reliance. This especially is the case in sexual or relational issues. In medical or formal circumstances, explicit agreement by means of signature—normally relied on legally—regardless of actual consent, is the norm. This is the case with certain procedures, such as a " do not resuscitate " directive that a patient signed before onset of their illness. Brief examples of each of the above:For an individual to give valid informed consent, three components must be present: disclosure, capacity and voluntariness. Disclosure requires the researcher to supply each prospective subject with the information necessary to make an autonomous decision and also to ensure that the subject adequately understands the information provided. This latter requirement implies that a written consent form be written in lay language suited for the comprehension skills of subject population, as well as assessing the level of understanding through conversation (to be informed). Capacity pertains to the ability of the subject to both understand the information provided and form a reasonable judgment based on the potential consequences of his/her decision. Voluntariness refers to the subject's right to freely exercise his/her decision making without being subjected to external pressure such as coercion, manipulation, or undue influence.As children often lack the decision-making ability or legal power (competence) to provide true informed consent for medical decisions, it often falls on parents or legal guardians to provide informed permission for medical decisions. This "consent by proxy" usually works reasonably well, but can lead to ethical dilemmas when the judgment of the parents or guardians and the medical professional differ with regard to what constitutes appropriate decisions "in the best interest of the child". Children who are legally emancipated , and certain situations such as decisions regarding sexually transmitted diseases or pregnancy, or for unemancipated minors who are deemed to have medical decision making capacity, may be able to provide consent without the need for parental permission depending on the laws of the jurisdiction the child lives in. The American Academy of Pediatrics encourages medical professionals also to seek the assent of older children and adolescents by providing age appropriate information to these children to help empower them in the decision-making process. Research on children has benefited society in many ways. The only effective way to establish normal patterns of growth and metabolism is to do research on infants and young children. When addressing the issue of informed consent with children, the primary response is parental consent. This is valid, although only legal guardians are able to consent for a child, not adult siblings. Additionally, parents may not order the termination of a treatment that is required to keep a child alive, even if they feel it is in the best interest. Guardians are typically involved in the consent of children, however a number of doctrines have developed that allow children to receive health treatments without parental consent. For example, emancipated minors may consent to medical treatment, and minors can also consent in an emergency. Waiver of the consent requirement may be applied in certain circumstances where no foreseeable harm is expected to result from the study or when permitted by law, federal regulations, or if an ethical review committee has approved the non-disclosure of certain information. Besides studies with minimal risk, waivers of consent may be obtained in a military setting. According to 10 USC 980, the United States Code for the Armed Forces, Limitations on the Use of Humans as Experimental Subjects, a waiver of advanced informed consent may be granted by the Secretary of Defense if a research project would: directly benefit subjects advance the development of a medical product necessary to the military and be carried out under all laws and regulations (i.e., Emergency Research Consent Waiver) including those pertinent to the FDA. While informed consent is a basic right and should be carried out effectively, if a patient is incapacitated due to injury or illness, it is still important that patients benefit from emergency experimentation. [ better source needed ] The Food and Drug Administration (FDA) and the Department of Health and Human Services (DHHS) joined [ when? ] to create federal guidelines to permit emergency research, without informed consent. However, they [ who? ] can only proceed with the research if they obtain a waiver of informed consent (WIC) or an emergency exception from informed consent (EFIC). The 21st Century Cures Act enacted by the 114th United States Congress in December 2016 allows researchers to waive the requirement for informed consent when clinical testing "poses no more than minimal risk" and "includes appropriate safeguards to protect the rights, safety, and welfare of the human subject." The 21st Century Cures Act enacted by the 114th United States Congress in December 2016 allows researchers to waive the requirement for informed consent when clinical testing "poses no more than minimal risk" and "includes appropriate safeguards to protect the rights, safety, and welfare of the human subject." Medical sociologists have studied informed consent as well bioethics more generally. Oonagh Corrigan, looking at informed consent for research in patients, argues that much of the conceptualization of informed consent comes from research ethics and bioethics with a focus on patient autonomy, and notes that this aligns with a neoliberal worldview. : 770 Corrigan argues that a model based solely around individual decision making does not accurately describe the reality of consent because of social processes: a view that has started to be acknowledged in bioethics. : 771 She feels that the liberal principles of informed consent are often in opposition with autocratic medical practices such that norms values and systems of expertise often shape and individuals ability to apply choice. : 789 Patients who agree to participate in trials often do so because they feel that the trial was suggested by a doctor as the best intervention. : 782 Patients may find being asked to consent within a limited time frame a burdensome intrusion on their care when it arises because a patient has to deal with a new condition. : 783 Patients involved in trials may not be fully aware of the alternative treatments, and an awareness that there is uncertainty in the best treatment can help make patients more aware of this. : 784 Corrigan notes that patients generally expect that doctors are acting exclusively in their interest in interactions and that this combined with "clinical equipose" where a healthcare practitioner does not know which treatment is better in a randomized control trial can be harmful to the doctor-patient relationship. : 780–781The doctrine of informed consent relates to professional negligence and establishes a breach of the duty of care owed to the patient (see duty of care , breach of the duty , and respect for persons ). The doctrine of informed consent also has significant implications for medical trials of medications, devices, or procedures. Until 2015 in the United Kingdom and in countries such as Malaysia and Singapore , informed consent in medical procedures requires proof as to the standard of care to expect as a recognised standard of acceptable professional practice (the Bolam Test ), that is, what risks would a medical professional usually disclose in the circumstances (see Loss of right in English law ). Arguably, this is "sufficient consent" rather than "informed consent." The UK has since departed from the Bolam test for judging standards of informed consent, due to the landmark ruling in Montgomery v Lanarkshire Health Board . This moves away from the concept of a reasonable physician and instead uses the standard of a reasonable patient , and what risks an individual would attach significance to. Medicine in the United States, Australia, and Canada takes this patient-centric approach to "informed consent." Informed consent in these jurisdictions requires healthcare providers to disclose significant risks, as well as risks of particular importance to that patient. This approach combines an objective (a hypothetical reasonable patient) and subjective (this particular patient) approach. [ citation needed ] The doctrine of informed consent should be contrasted [ according to whom? ] with the general doctrine of medical consent, which applies to assault or battery . The consent standard here is only that the person understands, in general terms, the nature of and purpose of the intended intervention. As the higher standard of informed consent applies to negligence, not battery, the other elements of negligence must be made out. Significantly, causation must be shown: That had the individual been made aware of the risk he would not have proceeded with the operation (or perhaps with that surgeon). [ original research? ] Optimal establishment of an informed consent requires adaptation to cultural or other individual factors of the patient. As of 2011, for example, people from Mediterranean and Arab appeared to rely more on the context of the delivery of the information, with the information being carried more by who is saying it and where, when, and how it is being said, rather than what is said, which is of relatively more importance in typical "Western" countries. [ better source needed ] The informed consent doctrine is generally implemented through good healthcare practice: pre-operation discussions with patients and the use of medical consent forms in hospitals. However, reliance on a signed form should not undermine the basis of the doctrine in giving the patient an opportunity to weigh and respond to the risk. In one British case, a doctor performing routine surgery on a woman noticed that she had cancerous tissue in her womb. He took the initiative to remove the woman's womb; however, as she had not given informed consent for this operation, the doctor was judged by the General Medical Council to have acted negligently. The council stated that the woman should have been informed of her condition, and allowed to make her own decision. [ citation needed ] To document that informed consent has been given for a procedure, healthcare organisations have traditionally used paper-based consent forms on which the procedure and its risks and benefits are noted, and is signed by both patient and clinician. In a number of healthcare organisations consent forms are scanned and maintained in an electronic document store. The paper consent process has been demonstrated to be associated with significant errors of omission, and therefore increasing numbers of organisations are using digital consent applications where the risk of errors can be minimised, a patient's decision making and comprehension can be supported by additional lay-friendly and accessible information, consent can be completed remotely, and the process can become paperless. One form of digital consent is dynamic consent , which invites participants to provide consent in a granular way, and makes it easier for them to withdraw consent if they wish. Electronic consent methods have been used to support indexing and retrieval of consent data, thus enhancing the ability to honor to patient intent and identify willing research participants. More recently, Health Sciences South Carolina , a statewide research collaborative focused on transforming healthcare quality, health information systems and patient outcomes, developed an open-source system called Research Permissions Management System (RPMS). The ability to give informed consent is governed by a general requirement of competency. In common law jurisdictions, adults are presumed competent to consent. This presumption can be rebutted, for instance, in circumstances of mental illness or other incompetence. This may be prescribed in legislation or based on a common-law standard of inability to understand the nature of the procedure. In cases of incompetent adults, a health care proxy makes medical decisions. In the absence of a proxy, the medical practitioner is expected to act in the patient's best interests until a proxy can be found. By contrast, ' minors ' (which may be defined differently in different jurisdictions) are generally presumed incompetent to consent, but depending on their age and other factors may be required to provide Informed assent . In some jurisdictions (e.g. much of the U.S.), this is a strict standard. In other jurisdictions (e.g. England, Australia, Canada), this presumption may be rebutted through proof that the minor is 'mature' (the ' Gillick standard '). In cases of incompetent minors, informed consent is usually required from the parent (rather than the 'best interests standard') although a parens patriae order may apply, allowing the court to dispense with parental consent in cases of refusal. Research involving deception is controversial given the requirement for informed consent. Deception typically arises in social psychology, when researching a particular psychological process requires that investigators deceive subjects. For example, in the Milgram experiment , researchers wanted to determine the willingness of participants to obey authority figures despite their personal conscientious objections. They had authority figures demand that participants deliver what they thought was an electric shock to another research participant. For the study to succeed, it was necessary to deceive the participants so they believed that the subject was a peer and that their electric shocks caused the peer actual pain. Nonetheless, research involving deception prevents subjects from exercising their basic right of autonomous informed decision-making and conflicts with the ethical principle of respect for persons . The Ethical Principles of Psychologists and Code of Conduct set by the American Psychological Association says that psychologists may conduct research that includes a deceptive compartment only if they can both justify the act by the value and importance of the study's results and show they could not obtain the results by some other way. Moreover, the research should bear no potential harm to the subject as an outcome of deception, either physical pain or emotional distress . Finally, the code requires a debriefing session in which the experimenter both tells the subject about the deception and gives subject the option of withdrawing the data. In some U.S. states, informed consent laws (sometimes called "right to know" laws) require that a woman seeking an elective abortion receive information from the abortion provider about her legal rights, alternatives to abortion (such as adoption ), available public and private assistance, and other information specified in the law, before the abortion is performed. Other countries with such laws (e.g. Germany ) require that the information giver be properly certified to make sure that no abortion is carried out for the financial gain of the abortion provider and to ensure that the decision to have an abortion is not swayed by any form of incentive. Some informed consent laws have been criticized for allegedly using "loaded language in an apparently deliberate attempt to 'personify' the fetus," but those critics acknowledge that "most of the information in the [legally mandated] materials about abortion comports with recent scientific findings and the principles of informed consent", although "some content is either misleading or altogether incorrect." Until 2015 in the United Kingdom and in countries such as Malaysia and Singapore , informed consent in medical procedures requires proof as to the standard of care to expect as a recognised standard of acceptable professional practice (the Bolam Test ), that is, what risks would a medical professional usually disclose in the circumstances (see Loss of right in English law ). Arguably, this is "sufficient consent" rather than "informed consent." The UK has since departed from the Bolam test for judging standards of informed consent, due to the landmark ruling in Montgomery v Lanarkshire Health Board . This moves away from the concept of a reasonable physician and instead uses the standard of a reasonable patient , and what risks an individual would attach significance to. Medicine in the United States, Australia, and Canada takes this patient-centric approach to "informed consent." Informed consent in these jurisdictions requires healthcare providers to disclose significant risks, as well as risks of particular importance to that patient. This approach combines an objective (a hypothetical reasonable patient) and subjective (this particular patient) approach. [ citation needed ] The doctrine of informed consent should be contrasted [ according to whom? ] with the general doctrine of medical consent, which applies to assault or battery . The consent standard here is only that the person understands, in general terms, the nature of and purpose of the intended intervention. As the higher standard of informed consent applies to negligence, not battery, the other elements of negligence must be made out. Significantly, causation must be shown: That had the individual been made aware of the risk he would not have proceeded with the operation (or perhaps with that surgeon). [ original research? ] Optimal establishment of an informed consent requires adaptation to cultural or other individual factors of the patient. As of 2011, for example, people from Mediterranean and Arab appeared to rely more on the context of the delivery of the information, with the information being carried more by who is saying it and where, when, and how it is being said, rather than what is said, which is of relatively more importance in typical "Western" countries. [ better source needed ] The informed consent doctrine is generally implemented through good healthcare practice: pre-operation discussions with patients and the use of medical consent forms in hospitals. However, reliance on a signed form should not undermine the basis of the doctrine in giving the patient an opportunity to weigh and respond to the risk. In one British case, a doctor performing routine surgery on a woman noticed that she had cancerous tissue in her womb. He took the initiative to remove the woman's womb; however, as she had not given informed consent for this operation, the doctor was judged by the General Medical Council to have acted negligently. The council stated that the woman should have been informed of her condition, and allowed to make her own decision. [ citation needed ]To document that informed consent has been given for a procedure, healthcare organisations have traditionally used paper-based consent forms on which the procedure and its risks and benefits are noted, and is signed by both patient and clinician. In a number of healthcare organisations consent forms are scanned and maintained in an electronic document store. The paper consent process has been demonstrated to be associated with significant errors of omission, and therefore increasing numbers of organisations are using digital consent applications where the risk of errors can be minimised, a patient's decision making and comprehension can be supported by additional lay-friendly and accessible information, consent can be completed remotely, and the process can become paperless. One form of digital consent is dynamic consent , which invites participants to provide consent in a granular way, and makes it easier for them to withdraw consent if they wish. Electronic consent methods have been used to support indexing and retrieval of consent data, thus enhancing the ability to honor to patient intent and identify willing research participants. More recently, Health Sciences South Carolina , a statewide research collaborative focused on transforming healthcare quality, health information systems and patient outcomes, developed an open-source system called Research Permissions Management System (RPMS). The ability to give informed consent is governed by a general requirement of competency. In common law jurisdictions, adults are presumed competent to consent. This presumption can be rebutted, for instance, in circumstances of mental illness or other incompetence. This may be prescribed in legislation or based on a common-law standard of inability to understand the nature of the procedure. In cases of incompetent adults, a health care proxy makes medical decisions. In the absence of a proxy, the medical practitioner is expected to act in the patient's best interests until a proxy can be found. By contrast, ' minors ' (which may be defined differently in different jurisdictions) are generally presumed incompetent to consent, but depending on their age and other factors may be required to provide Informed assent . In some jurisdictions (e.g. much of the U.S.), this is a strict standard. In other jurisdictions (e.g. England, Australia, Canada), this presumption may be rebutted through proof that the minor is 'mature' (the ' Gillick standard '). In cases of incompetent minors, informed consent is usually required from the parent (rather than the 'best interests standard') although a parens patriae order may apply, allowing the court to dispense with parental consent in cases of refusal.Research involving deception is controversial given the requirement for informed consent. Deception typically arises in social psychology, when researching a particular psychological process requires that investigators deceive subjects. For example, in the Milgram experiment , researchers wanted to determine the willingness of participants to obey authority figures despite their personal conscientious objections. They had authority figures demand that participants deliver what they thought was an electric shock to another research participant. For the study to succeed, it was necessary to deceive the participants so they believed that the subject was a peer and that their electric shocks caused the peer actual pain. Nonetheless, research involving deception prevents subjects from exercising their basic right of autonomous informed decision-making and conflicts with the ethical principle of respect for persons . The Ethical Principles of Psychologists and Code of Conduct set by the American Psychological Association says that psychologists may conduct research that includes a deceptive compartment only if they can both justify the act by the value and importance of the study's results and show they could not obtain the results by some other way. Moreover, the research should bear no potential harm to the subject as an outcome of deception, either physical pain or emotional distress . Finally, the code requires a debriefing session in which the experimenter both tells the subject about the deception and gives subject the option of withdrawing the data. In some U.S. states, informed consent laws (sometimes called "right to know" laws) require that a woman seeking an elective abortion receive information from the abortion provider about her legal rights, alternatives to abortion (such as adoption ), available public and private assistance, and other information specified in the law, before the abortion is performed. Other countries with such laws (e.g. Germany ) require that the information giver be properly certified to make sure that no abortion is carried out for the financial gain of the abortion provider and to ensure that the decision to have an abortion is not swayed by any form of incentive. Some informed consent laws have been criticized for allegedly using "loaded language in an apparently deliberate attempt to 'personify' the fetus," but those critics acknowledge that "most of the information in the [legally mandated] materials about abortion comports with recent scientific findings and the principles of informed consent", although "some content is either misleading or altogether incorrect." Informed consent is part of ethical clinical research as well, in which a human subject voluntarily confirms his or her willingness to participate in a particular clinical trial , after having been informed of all aspects of the trial that are relevant to the subject's decision to participate. Informed consent is documented by means of a written, signed, and dated informed consent form. In medical research , the Nuremberg Code set a base international standard in 1947, in response to the ethical violation in the Holocaust . Standards continued to develop. Nowadays, medical research is overseen by an ethics committee that also oversees the informed consent process. As the medical guidelines established in the Nuremberg Code were imported into the ethical guidelines for the social sciences , informed consent became a common part of the research procedure. However, while informed consent is the default in medical settings, it is not always required in the social sciences. Here, firstly, research often involves low or no risk for participants, unlike in many medical experiments. Secondly, the mere knowledge that they participate in a study can cause people to alter their behavior, as in the Hawthorne Effect : "In the typical lab experiment, subjects enter an environment in which they are keenly aware that their behavior is being monitored, recorded, and subsequently scrutinized." : 168 In such cases, seeking informed consent directly interferes with the ability to conduct the research, because the very act of revealing that a study is being conducted is likely to alter the behavior studied. Author J.A. List explains the potential dilemma that can result: "if one were interested in exploring whether, and to what extent, race or gender influences the prices that buyers pay for used cars, it would be difficult to measure accurately the degree of discrimination among used car dealers who know that they are taking part in an experiment." In a case where such interference is likely, and after careful consideration, a researcher may forgo the informed consent process. This may be done after the researcher(s) and an Ethics Committee and/or Institutional Review Board (IRB) weigh the risk to study participants against the benefits to society and whether participants participate voluntarily and are to be treated fairly. The birth of new online media, such as social media, has complicated the idea of informed consent. In an online environment people pay little attention to Terms of Use agreements and can subject themselves to research without thorough knowledge. This issue came to the public light following a study conducted by Facebook in 2014, and published by that company and Cornell University . Facebook conducted a study without consulting an Ethics Committee or IRB where they altered the Facebook News Feeds of roughly 700,000 users to reduce either the amount of positive or negative posts they saw for a week. The study then analyzed if the users' status updates changed during the different conditions. The study was published in the Proceedings of the National Academy of Sciences . The lack of informed consent led to outrage among many researchers and users. Many believed that by potentially altering the mood of users by altering what posts they see, Facebook put at-risk individuals at higher dangers for depression and suicide. However, supporters of Facebook claim that Facebook details that they have the right to use information for research in their terms of use. Others say the experiment is just a part of Facebook's current work, which alters News Feeds algorithms continually to keep people interested and coming back to the site. Others pointed out that this specific study is not unique but rather news organizations constantly try out different headlines using algorithms to elicit emotions and garner clicks or Facebook shares. They say this Facebook study is no different from things people already accept. Still, others say that Facebook broke the law when conducting the experiment on users that did not give informed consent. The Facebook study controversy raises numerous questions about informed consent and the differences in the ethical review process between publicly and privately funded research. Some say Facebook was within its limits and others see the need for more informed consent and/or the establishment of in-house private review boards. Some researchers and ethicists advocate for researchers to share experimental results with their subjects in a way they can understand, both as an ethical obligation and as a way to encourage more participation. In 2023, the government of the United Kingdom proposed making this a requirement. The Ethical, Legal, and Social Implications research program of the National Human Genome Research Institute in the United States has provided some funding for researchers to do this. Informed consent is part of ethical clinical research as well, in which a human subject voluntarily confirms his or her willingness to participate in a particular clinical trial , after having been informed of all aspects of the trial that are relevant to the subject's decision to participate. Informed consent is documented by means of a written, signed, and dated informed consent form. In medical research , the Nuremberg Code set a base international standard in 1947, in response to the ethical violation in the Holocaust . Standards continued to develop. Nowadays, medical research is overseen by an ethics committee that also oversees the informed consent process.As the medical guidelines established in the Nuremberg Code were imported into the ethical guidelines for the social sciences , informed consent became a common part of the research procedure. However, while informed consent is the default in medical settings, it is not always required in the social sciences. Here, firstly, research often involves low or no risk for participants, unlike in many medical experiments. Secondly, the mere knowledge that they participate in a study can cause people to alter their behavior, as in the Hawthorne Effect : "In the typical lab experiment, subjects enter an environment in which they are keenly aware that their behavior is being monitored, recorded, and subsequently scrutinized." : 168 In such cases, seeking informed consent directly interferes with the ability to conduct the research, because the very act of revealing that a study is being conducted is likely to alter the behavior studied. Author J.A. List explains the potential dilemma that can result: "if one were interested in exploring whether, and to what extent, race or gender influences the prices that buyers pay for used cars, it would be difficult to measure accurately the degree of discrimination among used car dealers who know that they are taking part in an experiment." In a case where such interference is likely, and after careful consideration, a researcher may forgo the informed consent process. This may be done after the researcher(s) and an Ethics Committee and/or Institutional Review Board (IRB) weigh the risk to study participants against the benefits to society and whether participants participate voluntarily and are to be treated fairly. The birth of new online media, such as social media, has complicated the idea of informed consent. In an online environment people pay little attention to Terms of Use agreements and can subject themselves to research without thorough knowledge. This issue came to the public light following a study conducted by Facebook in 2014, and published by that company and Cornell University . Facebook conducted a study without consulting an Ethics Committee or IRB where they altered the Facebook News Feeds of roughly 700,000 users to reduce either the amount of positive or negative posts they saw for a week. The study then analyzed if the users' status updates changed during the different conditions. The study was published in the Proceedings of the National Academy of Sciences . The lack of informed consent led to outrage among many researchers and users. Many believed that by potentially altering the mood of users by altering what posts they see, Facebook put at-risk individuals at higher dangers for depression and suicide. However, supporters of Facebook claim that Facebook details that they have the right to use information for research in their terms of use. Others say the experiment is just a part of Facebook's current work, which alters News Feeds algorithms continually to keep people interested and coming back to the site. Others pointed out that this specific study is not unique but rather news organizations constantly try out different headlines using algorithms to elicit emotions and garner clicks or Facebook shares. They say this Facebook study is no different from things people already accept. Still, others say that Facebook broke the law when conducting the experiment on users that did not give informed consent. The Facebook study controversy raises numerous questions about informed consent and the differences in the ethical review process between publicly and privately funded research. Some say Facebook was within its limits and others see the need for more informed consent and/or the establishment of in-house private review boards. Some researchers and ethicists advocate for researchers to share experimental results with their subjects in a way they can understand, both as an ethical obligation and as a way to encourage more participation. In 2023, the government of the United Kingdom proposed making this a requirement. The Ethical, Legal, and Social Implications research program of the National Human Genome Research Institute in the United States has provided some funding for researchers to do this. Other, long-standing controversies underscore the role for conflicts of interest among medical school faculty and researchers. For example, in 2014 coverage of University of California (UC) medical school faculty members has included news of ongoing corporate payments to researchers and practitioners from companies that market and produce the very devices and treatments they recommend to patients. Robert Pedowitz, the former chairman of UCLA's orthopedic surgery department, reported concern that his colleague's financial conflicts of interest could negatively affect patient care or research into new treatments. In a subsequent lawsuit about whistleblower retaliation, the university provided a $10 million settlement to Pedowitz while acknowledging no wrongdoing. Consumer Watchdog, an oversight group, observed that University of California policies were "either inadequate or unenforced...Patients in UC hospitals deserve the most reliable surgical devices and medication…and they shouldn't be treated as subjects in expensive experiments." Other UC incidents include taking the eggs of women for implantation into other women without consent and injecting live bacteria into human brains, resulting in potentially premature deaths. Informed consent is a technical term first used by attorney, Paul G. Gebhard, in a medical malpractice United States court case in 1957. In tracing its history, some scholars have suggested tracing the history of checking for any of these practices: : 54 A patient agrees to a health intervention based on an understanding of it. The patient has multiple choices and is not compelled to choose a particular one. The consent includes giving permission. These practices are part of what constitutes informed consent, and their history is the history of informed consent. : 60 They combine to form the modern concept of informed consent—which rose in response to particular incidents in modern research. : 60 Whereas various cultures in various places practiced informed consent, the modern concept of informed consent was developed by people who drew influence from Western tradition . : 60 Historians cite a series of medical guidelines to trace the history of informed consent in medical practice. The Hippocratic Oath , a Greek text dating to 500 B.C.E., was the first set of Western writings giving guidelines for the conduct of medical professionals. Consent by patients as well as several other, now considered fundamental issues, is not mentioned. The Hippocratic Corpus advises that physicians conceal most information from patients to give the patients the best care. : 61 The rationale is a beneficence model for care—the doctor knows better than the patient, and therefore should direct the patient's care, because the patient is not likely to have better ideas than the doctor. : 61 Henri de Mondeville , a French surgeon who in the 14th century, wrote about medical practice. He traced his ideas to the Hippocratic Oath. : 63 Among his recommendations were that doctors "promise a cure to every patient" in hopes that the good prognosis would inspire a good outcome to treatment. : 63 Mondeville never mentioned getting consent, but did emphasize the need for the patient to have confidence in the doctor. : 63 He also advised that when deciding therapeutically unimportant details the doctor should meet the patients' requests "so far as they do not interfere with treatment". In Ottoman Empire records there exists an agreement from 1539 in which negotiates details of a surgery, including fee and a commitment not to sue in case of death. This is the oldest identified written document in which a patient acknowledges risk of medical treatment and writes to express their willingness to proceed. Benjamin Rush was an 18th-century United States physician who was influenced by the Age of Enlightenment cultural movement. : 65 Because of this, he advised that doctors ought to share as much information as possible with patients. He recommended that doctors educate the public and respect a patient's informed decision to accept therapy. : 65 There is no evidence that he supported seeking a consent from patients. : 65 In a lecture titled "On the duties of patients to their physicians", he stated that patients should be strictly obedient to the physician's orders; this was representative of much of his writings. : 65 John Gregory, Rush's teacher, wrote similar views that a doctor could best practice beneficence by making decisions for the patients without their consent. : 66 Thomas Percival was a British physician who published a book called Medical Ethics in 1803. : 68 Percival was a student of the works of Gregory and various earlier Hippocratic physicians. : 68 Like all previous works, Percival's Medical Ethics makes no mention of soliciting for the consent of patients or respecting their decisions. : 68 Percival said that patients have a right to truth, but when the physician could provide better treatment by lying or withholding information, he advised that the physician do as he thought best. : 68 When the American Medical Association was founded they in 1847 produced a work called the first edition of the American Medical Association Code of Medical Ethics . : 69 Many sections of this book are verbatim copies of passages from Percival's Medical Ethics . : 69 A new concept in this book was the idea that physicians should fully disclose all patient details truthfully when talking to other physicians, but the text does not also apply this idea to disclosing information to patients. : 70 Through this text, Percival's ideas became pervasive guidelines throughout the United States as other texts were derived from them. : 70 Worthington Hooker was an American physician who in 1849 published Physician and Patient . : 70 This medical ethics book was radical demonstrating understanding of the AMA's guidelines and Percival's philosophy and soundly rejecting all directives that a doctor should lie to patients. : 70 In Hooker's view, benevolent deception is not fair to the patient, and he lectured widely on this topic. : 70 Hooker's ideas were not broadly influential. : 70 The US Canterbury v. Spence case established the principle of informed consent in US law. Earlier legal cases had created the underpinnings for informed consent, but his judgment gave a detailed and thought through discourse on the matter. The judgment cites cases going back to 1914 as precedent for informed consent. : 56 Historians cite a series of human subject research experiments to trace the history of informed consent in research. The U.S. Army Yellow Fever Commission "is considered the first research group in history to use consent forms." In 1900, Major Walter Reed was appointed head of the four man U.S. Army Yellow Fever Commission in Cuba that determined mosquitoes were the vector for yellow fever transmission. His earliest experiments were probably done without formal documentation of informed consent. In later experiments he obtained support from appropriate military and administrative authorities. He then drafted what is now "one of the oldest series of extant informed consent documents." The three surviving examples are in Spanish with English translations; two have an individual's signature and one is marked with an X. Tearoom Trade is the name of a book by American psychologist Laud Humphreys . In it he describes his research into male homosexual acts. In conducting this research he never sought consent from his research subjects and other researchers raised concerns that he violated the right to privacy for research participants . Henrietta Lacks on January 29, 1951, shortly after the birth of her son Joseph, Lacks entered Johns Hopkins Hospital in Baltimore with profuse bleeding. She was diagnosed with cervical cancer and was treated with inserts of radium tubes. During her radiation treatments for the tumor, two samples—one of healthy cells, the other of malignant cells—were removed from her cervix without her permission. Later that year, 31-year-old Henrietta Lacks died from the cancer. Her cells were cultured creating Hela cells, but the family was not informed until 1973, the family learned the truth when scientists asked for DNA samples after finding that HeLa had contaminated other samples. In 2013 researchers published the genome without the Lacks family consent. The Milgram experiment is the name of a 1961 experiment conducted by American psychologist Stanley Milgram . In the experiment Milgram had an authority figure order research participants to commit a disturbing act of harming another person. After the experiment he would reveal that he had deceived the participants and that they had not hurt anyone, but the research participants were upset at the experience of having participated in the research. The experiment raised broad discussion on the ethics of recruiting participants for research without giving them full information about the nature of the research. Chester M. Southam used HeLa cells to inject into cancer patients and Ohio State Penitentiary inmates without informed consent to determine if people could become immune to cancer and if cancer could be transmitted. Historians cite a series of medical guidelines to trace the history of informed consent in medical practice. The Hippocratic Oath , a Greek text dating to 500 B.C.E., was the first set of Western writings giving guidelines for the conduct of medical professionals. Consent by patients as well as several other, now considered fundamental issues, is not mentioned. The Hippocratic Corpus advises that physicians conceal most information from patients to give the patients the best care. : 61 The rationale is a beneficence model for care—the doctor knows better than the patient, and therefore should direct the patient's care, because the patient is not likely to have better ideas than the doctor. : 61 Henri de Mondeville , a French surgeon who in the 14th century, wrote about medical practice. He traced his ideas to the Hippocratic Oath. : 63 Among his recommendations were that doctors "promise a cure to every patient" in hopes that the good prognosis would inspire a good outcome to treatment. : 63 Mondeville never mentioned getting consent, but did emphasize the need for the patient to have confidence in the doctor. : 63 He also advised that when deciding therapeutically unimportant details the doctor should meet the patients' requests "so far as they do not interfere with treatment". In Ottoman Empire records there exists an agreement from 1539 in which negotiates details of a surgery, including fee and a commitment not to sue in case of death. This is the oldest identified written document in which a patient acknowledges risk of medical treatment and writes to express their willingness to proceed. Benjamin Rush was an 18th-century United States physician who was influenced by the Age of Enlightenment cultural movement. : 65 Because of this, he advised that doctors ought to share as much information as possible with patients. He recommended that doctors educate the public and respect a patient's informed decision to accept therapy. : 65 There is no evidence that he supported seeking a consent from patients. : 65 In a lecture titled "On the duties of patients to their physicians", he stated that patients should be strictly obedient to the physician's orders; this was representative of much of his writings. : 65 John Gregory, Rush's teacher, wrote similar views that a doctor could best practice beneficence by making decisions for the patients without their consent. : 66 Thomas Percival was a British physician who published a book called Medical Ethics in 1803. : 68 Percival was a student of the works of Gregory and various earlier Hippocratic physicians. : 68 Like all previous works, Percival's Medical Ethics makes no mention of soliciting for the consent of patients or respecting their decisions. : 68 Percival said that patients have a right to truth, but when the physician could provide better treatment by lying or withholding information, he advised that the physician do as he thought best. : 68 When the American Medical Association was founded they in 1847 produced a work called the first edition of the American Medical Association Code of Medical Ethics . : 69 Many sections of this book are verbatim copies of passages from Percival's Medical Ethics . : 69 A new concept in this book was the idea that physicians should fully disclose all patient details truthfully when talking to other physicians, but the text does not also apply this idea to disclosing information to patients. : 70 Through this text, Percival's ideas became pervasive guidelines throughout the United States as other texts were derived from them. : 70 Worthington Hooker was an American physician who in 1849 published Physician and Patient . : 70 This medical ethics book was radical demonstrating understanding of the AMA's guidelines and Percival's philosophy and soundly rejecting all directives that a doctor should lie to patients. : 70 In Hooker's view, benevolent deception is not fair to the patient, and he lectured widely on this topic. : 70 Hooker's ideas were not broadly influential. : 70 The US Canterbury v. Spence case established the principle of informed consent in US law. Earlier legal cases had created the underpinnings for informed consent, but his judgment gave a detailed and thought through discourse on the matter. The judgment cites cases going back to 1914 as precedent for informed consent. : 56Historians cite a series of human subject research experiments to trace the history of informed consent in research. The U.S. Army Yellow Fever Commission "is considered the first research group in history to use consent forms." In 1900, Major Walter Reed was appointed head of the four man U.S. Army Yellow Fever Commission in Cuba that determined mosquitoes were the vector for yellow fever transmission. His earliest experiments were probably done without formal documentation of informed consent. In later experiments he obtained support from appropriate military and administrative authorities. He then drafted what is now "one of the oldest series of extant informed consent documents." The three surviving examples are in Spanish with English translations; two have an individual's signature and one is marked with an X. Tearoom Trade is the name of a book by American psychologist Laud Humphreys . In it he describes his research into male homosexual acts. In conducting this research he never sought consent from his research subjects and other researchers raised concerns that he violated the right to privacy for research participants . Henrietta Lacks on January 29, 1951, shortly after the birth of her son Joseph, Lacks entered Johns Hopkins Hospital in Baltimore with profuse bleeding. She was diagnosed with cervical cancer and was treated with inserts of radium tubes. During her radiation treatments for the tumor, two samples—one of healthy cells, the other of malignant cells—were removed from her cervix without her permission. Later that year, 31-year-old Henrietta Lacks died from the cancer. Her cells were cultured creating Hela cells, but the family was not informed until 1973, the family learned the truth when scientists asked for DNA samples after finding that HeLa had contaminated other samples. In 2013 researchers published the genome without the Lacks family consent. The Milgram experiment is the name of a 1961 experiment conducted by American psychologist Stanley Milgram . In the experiment Milgram had an authority figure order research participants to commit a disturbing act of harming another person. After the experiment he would reveal that he had deceived the participants and that they had not hurt anyone, but the research participants were upset at the experience of having participated in the research. The experiment raised broad discussion on the ethics of recruiting participants for research without giving them full information about the nature of the research. Chester M. Southam used HeLa cells to inject into cancer patients and Ohio State Penitentiary inmates without informed consent to determine if people could become immune to cancer and if cancer could be transmitted. With the growth of bioethics in the 21st century to include environmental sustainability , some authors, such as Cristina Richie have proposed a "green consent". This would include information and education about the climate impact of pharmaceuticals (carbon cost of medications) and climate change health hazards.

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Yellow fever

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History of Jacksonville, Florida

The city of Jacksonville, Florida , began to grow in the late 18th century as Cow Ford , settled by British colonists. Its major development occurred in the late nineteenth century, when it became a winter vacation destination for tourists from the North and Midwest. Its development was halted or slowed by the Great Fire of 1901 , the Florida Land Bust of the 1920s , and the economic woes of the 1960s and 70s. Since the late 20th century, the city has experienced steady growth, with a new federal building constructed in downtown in 2003. Since 1940, Jacksonville has also been a major port for the United States Navy . The city is a thriving metropolis with over a million citizens. Due to its consolidated city-county government structure, it has the largest municipal population among Florida cities, as well as the largest land area of any city in the contiguous United States .Archaeological evidence indicates 6,000 years of human habitation in the area. Pottery has been found dating to 2500 BC, nearly the oldest in the United States and second to artifacts of the Savannah River area. In the 16th century, the beginning of the historical record period, the area was inhabited by the Mocama , a coastal subgroup of the Timucua indigenous Native Americans . At the time of contact with Europeans, most Mocama villages in present-day Jacksonville were part of the powerful chiefdom known as the Saturiwa , centered on Fort George Island near the mouth of the St. Johns River . They had a complex society, well-adapted to the environmental conditions of the area. In 1513, Spanish explorers landed in Florida and claimed their discovery for Spain (see Spanish Florida ). The first Europeans to visit the area were Spanish missionaries and explorers from this period. In February 1562, French naval officer Jean Ribault and 150 settlers arrived seeking land for a safe haven for the French Huguenots , Protestants suffering religious persecution in France. Ribault explored the mouth of the St. Johns River before moving north and establishing the colony of Charlesfort on what is now Parris Island, South Carolina . Ribault returned to France for supplies, but the French Wars of Religion had broken out during his absence. His return to Florida was delayed as a result. Without leadership or provisions, the colonists abandoned Charlesfort. In 1564 Ribault's former lieutenant, René Goulaine de Laudonnière , launched a new expedition to found a colony on the St. Johns River. On June 22, 1564, the settlers established Fort Caroline atop the St. Johns Bluff. Laudonnière made an alliance with the local tribe of Timucua Indians, the Saturiwa . He also forged friendly relations with their competitors, the Utina tribe, who lived upriver to the south (around what is now Palatka and the Lake George area). Ribault intended to resupply Fort Caroline in early 1565, but was again delayed. As a result, the colony faced famine , three mutinies , and eventually warfare with the Utina. Ribault finally reached the fort with a relief expedition in the summer, and assumed command of the settlement. In the meantime, the Spanish admiral Pedro Menéndez de Avilés had established the colony of St. Augustine 35 miles to the south, with the express mission to displace the French. When he arrived, Ribault launched a naval expedition of 200 sailors and 400 soldiers to dislodge the Spanish, but a storm at sea incapacitated them for several days and caused numerous deaths. On September 20, 1565, Menéndez marched his men overland to Fort Caroline, defended by 200 or 250 people, and killed everyone except for 50 women and children and 26 men who escaped. The Spanish picked up the survivors of Ribault's fleet, and summarily executed all but 20. The Spanish took over Fort Caroline, renaming it as San Matteo. In 1568 the French and Spanish confronted each other again here, when Dominique de Gourgues burned it to the ground. The Spanish rebuilt the fort, but abandoned it in 1569. The Spanish next built Fort San Nicolas further upriver to protect the rear flank of St. Augustine. "San Nicolas" served as their name for the Jacksonville area, a placename which survives in the neighborhood of St. Nicholas. The fort was located on the east side of the St. Johns, where Bishop Kenny High School now stands. The fort was abandoned in the late 17th century. France and Spain were defeated by the British in the French and Indian War . During the war the British had defeated the Spanish in Cuba and occupied the island, whereas Florida had hardly seen any fighting. As part of the negotiations between the two nations in the aftermath of the war, Spain would cede Florida to Great Britain in exchange for the return of Cuba. The British agreed and Florida was ceded to the United Kingdom in 1763. The British soon constructed the King's Road connecting St. Augustine to Georgia . The road crossed the St. Johns River at a narrow point, which the Seminole called Wacca Pilatka and the British named the "Cow Ford", both names ostensibly reflecting the fact that cattle were brought across the river there. The British divided Florida into the two colonies of British East Florida and British West Florida . The British government gave land grants to officers and soldiers who had fought in the French and Indian War in order to encourage settlement. In order to induce settlers to move to the two new colonies reports of Florida 's natural wealth were published in England . A large number of British colonists who were "energetic and of good character" moved to Florida , mostly coming from South Carolina , Georgia and England though there was also a group of settlers who came from the colony of Bermuda . This would be the first permanent English-speaking population in what is now Duval County , Baker County , St. Johns County and Nassau County . The British built good public roads and introduced the cultivation of sugar cane, indigo and fruits as well the export of lumber. As a result of these initiatives northeastern Florida prospered economically in a way it never did under Spanish rule. Furthermore, the British governors were directed to call general assemblies as soon as possible in order to make laws for the Floridas and in the meantime they were, with the advice of councils, to establish courts. This would be the first introduction of much of the English-derived legal system which Florida still has today including trial-by-jury , habeas corpus and county-based government. The British gave control of the territory back to Spain in 1783. Americans of English descent and Americans of Scots-Irish descent began moving into northern Florida from the backwoods of Georgia and South Carolina . Though technically not allowed by the Spanish authorities, the Spanish were never able to effectively police the border region and the backwoods settlers from the United States would continue to migrate into Florida unchecked. These migrants, mixing with the already present English-speaking settlers who had lived in Florida since the British period, would be the progenitors of the population known as Florida Crackers . The Spanish also accepted fugitive slaves from the newly-created United States if they accepted Catholic baptism. Between 1812 and 1814 during the War of 1812 between the US and Britain, the US Navy assisted American settlers in Florida in "The Patriot War", a covert attempt to seize control of Florida from the Spanish. They began with invasions of Fernandina and Amelia Island. Spain sold the Florida Territory to the United States in 1821 and, by 1822, Jacksonville's current name had come into use, to honor General Andrew Jackson . It first appears on a petition sent on June 15, 1822 to U.S. Secretary of State John Quincy Adams , asking that Jacksonville be named a port of entry . The city is named for Andrew Jackson , military governor of the Florida Territory and eventual President of the United States. U.S. settlers led by Isaiah D. Hart wrote a charter for a town government, which was approved by the Florida Legislative Council on February 9, 1832. Remembered as the city's most important founding father, Hart is memorialized with the Isaiah D. Hart Bridge over the St. Johns. Even before the outbreak of war, a militia unit was raised in Jacksonville in April 1859. The unit, called the Jacksonville Light Infantry, would become Company A of the 3rd Florida Infantry Regiment . The company carried a battle flag bearing the slogan "Let Us Alone" and was commanded by Dr. Holmes Steele, a former mayor of the city. During the American Civil War , Jacksonville was a key supply point for hogs and cattle leaving Florida and aiding the Confederate cause. Throughout most of the war, the US Navy maintained a blockade around Florida's ports, including Jacksonville. In October 1862 Union forces captured a Confederate battery in the Battle of St. Johns Bluff and occupied Jacksonville. Throughout the war Jacksonville changed hands several times, though never with a battle. On February 20, 1864, Union soldiers from Jacksonville marched inland and confronted the Confederate Army at the Battle of Olustee . The battle was a devastating loss for the Union and a decisive victory for the Confederacy. Soldiers on both sides were veterans of the great battles in the eastern and western theaters of war, but many of them remarked in letters and diaries that they had never experienced such terrible fighting. The Confederate dead were buried at Oaklawn Cemetery in nearby Lake City . The Union losses caused Northern authorities to question the necessity of further Union involvement in the militarily insignificant region of northern Florida. On the morning of 22 February, as the Union forces were still retreating to Jacksonville, the 54th Massachusetts was ordered to counter-march back to Ten-Mile Station. The locomotive of a train carrying wounded Union soldiers had broken down and the wounded were in danger of capture. When the 54th Massachusetts arrived, the men attached ropes to the engine and cars and manually pulled the train approximately three miles to Camp Finnegan, where horses were secured to help pull the train. After that, the train was pulled by both men and horses to Jacksonville for a total distance of ten miles. It took forty-two hours to pull the train that distance. The US Transport Maple Leaf was sunk at Jacksonville, April 1, 1864. The U.S. Transport General Hunter was sunk in the St. John's River, April 16, 1864, close to where the Maple Leaf was sunk. In the fall of 1865, a black enlisted man in the 3rd USCT was hung by his thumbs for stealing from a field kitchen. The punishment led to a riot and gunfire was exchanged between black enlisted men and their white officers. The riot was put down and several soldiers were put on trial for mutiny, with 6 of them being executed. By the end of the war in 1865, a Union commander commented that Jacksonville had become "pathetically dilapidated, a mere skeleton of its former self, a victim of war."Archaeological evidence indicates 6,000 years of human habitation in the area. Pottery has been found dating to 2500 BC, nearly the oldest in the United States and second to artifacts of the Savannah River area. In the 16th century, the beginning of the historical record period, the area was inhabited by the Mocama , a coastal subgroup of the Timucua indigenous Native Americans . At the time of contact with Europeans, most Mocama villages in present-day Jacksonville were part of the powerful chiefdom known as the Saturiwa , centered on Fort George Island near the mouth of the St. Johns River . They had a complex society, well-adapted to the environmental conditions of the area.In 1513, Spanish explorers landed in Florida and claimed their discovery for Spain (see Spanish Florida ). The first Europeans to visit the area were Spanish missionaries and explorers from this period. In February 1562, French naval officer Jean Ribault and 150 settlers arrived seeking land for a safe haven for the French Huguenots , Protestants suffering religious persecution in France. Ribault explored the mouth of the St. Johns River before moving north and establishing the colony of Charlesfort on what is now Parris Island, South Carolina . Ribault returned to France for supplies, but the French Wars of Religion had broken out during his absence. His return to Florida was delayed as a result. Without leadership or provisions, the colonists abandoned Charlesfort. In 1564 Ribault's former lieutenant, René Goulaine de Laudonnière , launched a new expedition to found a colony on the St. Johns River. On June 22, 1564, the settlers established Fort Caroline atop the St. Johns Bluff. Laudonnière made an alliance with the local tribe of Timucua Indians, the Saturiwa . He also forged friendly relations with their competitors, the Utina tribe, who lived upriver to the south (around what is now Palatka and the Lake George area). Ribault intended to resupply Fort Caroline in early 1565, but was again delayed. As a result, the colony faced famine , three mutinies , and eventually warfare with the Utina. Ribault finally reached the fort with a relief expedition in the summer, and assumed command of the settlement. In the meantime, the Spanish admiral Pedro Menéndez de Avilés had established the colony of St. Augustine 35 miles to the south, with the express mission to displace the French. When he arrived, Ribault launched a naval expedition of 200 sailors and 400 soldiers to dislodge the Spanish, but a storm at sea incapacitated them for several days and caused numerous deaths. On September 20, 1565, Menéndez marched his men overland to Fort Caroline, defended by 200 or 250 people, and killed everyone except for 50 women and children and 26 men who escaped. The Spanish picked up the survivors of Ribault's fleet, and summarily executed all but 20. The Spanish took over Fort Caroline, renaming it as San Matteo. In 1568 the French and Spanish confronted each other again here, when Dominique de Gourgues burned it to the ground. The Spanish rebuilt the fort, but abandoned it in 1569. The Spanish next built Fort San Nicolas further upriver to protect the rear flank of St. Augustine. "San Nicolas" served as their name for the Jacksonville area, a placename which survives in the neighborhood of St. Nicholas. The fort was located on the east side of the St. Johns, where Bishop Kenny High School now stands. The fort was abandoned in the late 17th century. France and Spain were defeated by the British in the French and Indian War . During the war the British had defeated the Spanish in Cuba and occupied the island, whereas Florida had hardly seen any fighting. As part of the negotiations between the two nations in the aftermath of the war, Spain would cede Florida to Great Britain in exchange for the return of Cuba. The British agreed and Florida was ceded to the United Kingdom in 1763. The British soon constructed the King's Road connecting St. Augustine to Georgia . The road crossed the St. Johns River at a narrow point, which the Seminole called Wacca Pilatka and the British named the "Cow Ford", both names ostensibly reflecting the fact that cattle were brought across the river there. The British divided Florida into the two colonies of British East Florida and British West Florida . The British government gave land grants to officers and soldiers who had fought in the French and Indian War in order to encourage settlement. In order to induce settlers to move to the two new colonies reports of Florida 's natural wealth were published in England . A large number of British colonists who were "energetic and of good character" moved to Florida , mostly coming from South Carolina , Georgia and England though there was also a group of settlers who came from the colony of Bermuda . This would be the first permanent English-speaking population in what is now Duval County , Baker County , St. Johns County and Nassau County . The British built good public roads and introduced the cultivation of sugar cane, indigo and fruits as well the export of lumber. As a result of these initiatives northeastern Florida prospered economically in a way it never did under Spanish rule. Furthermore, the British governors were directed to call general assemblies as soon as possible in order to make laws for the Floridas and in the meantime they were, with the advice of councils, to establish courts. This would be the first introduction of much of the English-derived legal system which Florida still has today including trial-by-jury , habeas corpus and county-based government. The British gave control of the territory back to Spain in 1783. Americans of English descent and Americans of Scots-Irish descent began moving into northern Florida from the backwoods of Georgia and South Carolina . Though technically not allowed by the Spanish authorities, the Spanish were never able to effectively police the border region and the backwoods settlers from the United States would continue to migrate into Florida unchecked. These migrants, mixing with the already present English-speaking settlers who had lived in Florida since the British period, would be the progenitors of the population known as Florida Crackers . The Spanish also accepted fugitive slaves from the newly-created United States if they accepted Catholic baptism. Between 1812 and 1814 during the War of 1812 between the US and Britain, the US Navy assisted American settlers in Florida in "The Patriot War", a covert attempt to seize control of Florida from the Spanish. They began with invasions of Fernandina and Amelia Island. Spain sold the Florida Territory to the United States in 1821 and, by 1822, Jacksonville's current name had come into use, to honor General Andrew Jackson . It first appears on a petition sent on June 15, 1822 to U.S. Secretary of State John Quincy Adams , asking that Jacksonville be named a port of entry . The city is named for Andrew Jackson , military governor of the Florida Territory and eventual President of the United States. U.S. settlers led by Isaiah D. Hart wrote a charter for a town government, which was approved by the Florida Legislative Council on February 9, 1832. Remembered as the city's most important founding father, Hart is memorialized with the Isaiah D. Hart Bridge over the St. Johns.Even before the outbreak of war, a militia unit was raised in Jacksonville in April 1859. The unit, called the Jacksonville Light Infantry, would become Company A of the 3rd Florida Infantry Regiment . The company carried a battle flag bearing the slogan "Let Us Alone" and was commanded by Dr. Holmes Steele, a former mayor of the city. During the American Civil War , Jacksonville was a key supply point for hogs and cattle leaving Florida and aiding the Confederate cause. Throughout most of the war, the US Navy maintained a blockade around Florida's ports, including Jacksonville. In October 1862 Union forces captured a Confederate battery in the Battle of St. Johns Bluff and occupied Jacksonville. Throughout the war Jacksonville changed hands several times, though never with a battle. On February 20, 1864, Union soldiers from Jacksonville marched inland and confronted the Confederate Army at the Battle of Olustee . The battle was a devastating loss for the Union and a decisive victory for the Confederacy. Soldiers on both sides were veterans of the great battles in the eastern and western theaters of war, but many of them remarked in letters and diaries that they had never experienced such terrible fighting. The Confederate dead were buried at Oaklawn Cemetery in nearby Lake City . The Union losses caused Northern authorities to question the necessity of further Union involvement in the militarily insignificant region of northern Florida. On the morning of 22 February, as the Union forces were still retreating to Jacksonville, the 54th Massachusetts was ordered to counter-march back to Ten-Mile Station. The locomotive of a train carrying wounded Union soldiers had broken down and the wounded were in danger of capture. When the 54th Massachusetts arrived, the men attached ropes to the engine and cars and manually pulled the train approximately three miles to Camp Finnegan, where horses were secured to help pull the train. After that, the train was pulled by both men and horses to Jacksonville for a total distance of ten miles. It took forty-two hours to pull the train that distance. The US Transport Maple Leaf was sunk at Jacksonville, April 1, 1864. The U.S. Transport General Hunter was sunk in the St. John's River, April 16, 1864, close to where the Maple Leaf was sunk. In the fall of 1865, a black enlisted man in the 3rd USCT was hung by his thumbs for stealing from a field kitchen. The punishment led to a riot and gunfire was exchanged between black enlisted men and their white officers. The riot was put down and several soldiers were put on trial for mutiny, with 6 of them being executed. By the end of the war in 1865, a Union commander commented that Jacksonville had become "pathetically dilapidated, a mere skeleton of its former self, a victim of war."Following the Civil War , during Reconstruction and afterward, Jacksonville and nearby St. Augustine became popular winter resorts for the rich and famous of the Gilded Age . Visitors arrived by steamboat and (beginning in the 1880s) by railroad , and wintered at dozens of hotels and boarding houses. The 1888 Subtropical Exposition was held in Jacksonville and attended by President Grover Cleveland , but the Florida-style world's fair did not lead to a lasting boost for tourism in Jacksonville. The area declined in importance as a resort destination after Henry Flagler extended the Florida East Coast Railroad to the south, reaching Palm Beach in 1894 and the Miami area in 1896. This drew tourism to the southern Atlantic Coast. [ citation needed ] Jacksonville's prominence as a winter resort was dealt another blow by major yellow fever epidemics in 1886 and 1888. During the second one, nearly ten percent of the more than 4,000 victims died, including the city's mayor. In the absence of scientific knowledge concerning the cause of yellow fever, nearly half (10,000 out of 25,000) of the city's panicked residents fled despite the imposition of quarantines . Inbound and outbound mail was fumigated in an effort to reduce contagion. Jacksonville's reputation as a healthful tourist destination suffered. The African-American population did not appear to catch the disease, leading the panicked population into erroneously believing that the black residents were "carriers" of the Yellow Fever. In fact, Black people had immunity from catching the disease earlier, as children. During the Spanish–American War , gunrunners helping the Cuban rebels used Jacksonville as the center for smuggling illegal arms and supplies to the island. Duval County sheriff and future state governor, Napoleon Bonaparte Broward , was one of the many gunrunners operating out of the city. Author Stephen Crane travelled to Jacksonville to cover the war. [ citation needed ]Following the Civil War , during Reconstruction and afterward, Jacksonville and nearby St. Augustine became popular winter resorts for the rich and famous of the Gilded Age . Visitors arrived by steamboat and (beginning in the 1880s) by railroad , and wintered at dozens of hotels and boarding houses. The 1888 Subtropical Exposition was held in Jacksonville and attended by President Grover Cleveland , but the Florida-style world's fair did not lead to a lasting boost for tourism in Jacksonville. The area declined in importance as a resort destination after Henry Flagler extended the Florida East Coast Railroad to the south, reaching Palm Beach in 1894 and the Miami area in 1896. This drew tourism to the southern Atlantic Coast. [ citation needed ]Jacksonville's prominence as a winter resort was dealt another blow by major yellow fever epidemics in 1886 and 1888. During the second one, nearly ten percent of the more than 4,000 victims died, including the city's mayor. In the absence of scientific knowledge concerning the cause of yellow fever, nearly half (10,000 out of 25,000) of the city's panicked residents fled despite the imposition of quarantines . Inbound and outbound mail was fumigated in an effort to reduce contagion. Jacksonville's reputation as a healthful tourist destination suffered. The African-American population did not appear to catch the disease, leading the panicked population into erroneously believing that the black residents were "carriers" of the Yellow Fever. In fact, Black people had immunity from catching the disease earlier, as children. During the Spanish–American War , gunrunners helping the Cuban rebels used Jacksonville as the center for smuggling illegal arms and supplies to the island. Duval County sheriff and future state governor, Napoleon Bonaparte Broward , was one of the many gunrunners operating out of the city. Author Stephen Crane travelled to Jacksonville to cover the war. [ citation needed ]On May 3, 1901, downtown Jacksonville was ravaged by the Great Fire—the largest-ever urban fire in the Southeastern United States , which started when hot ash from a shantyhouse's chimney landed on the drying moss at Cleaveland's Fiber Factory. At half past noon most of the Cleaveland workers were at lunch, but by the time they returned the entire city block was engulfed in flames. The fire destroyed the business district and rendered 10,000 residents homeless in the course of eight hours. Florida Governor William S. Jennings declared a state of martial law in Jacksonville and dispatched several state militia units to help. Reconstruction started immediately, and the city was returned to civil authority on May 17. Despite the widespread damage, only seven deaths were reported. Young architect Henry John Klutho had just returned to New York from a year in Europe when he read about the Jacksonville fire and, seeing a rare opportunity, he headed south. Klutho and other architects, enamored by the " Prairie Style " of architecture then being popularized by architect Frank Lloyd Wright in Chicago and other Midwestern cities, designed exuberant local buildings with a Florida flair. While many of Klutho's buildings were demolished by the 1980s, a number of his creations remain, including the St. James Building from 1911 (a former department store that is now Jacksonville's City Hall) and the Morocco Temple from 1910. The Klutho Apartments, in Springfield , were recently restored and converted into office space by local charity Fresh Ministries . Despite the losses of the last several decades, Jacksonville still has one of the largest collections of Prairie Style buildings (particularly residences) outside the Midwest. In the early 20th century, before Hollywood , the motion picture industry was based in Fort Lee, New Jersey#America's first motion picture industry . In need of a winter headquarters, moviemakers were attracted to Jacksonville due to its warm climate, exotic locations, excellent rail access, and cheaper labor, earning the city the title of "The Winter Film Capital of the World." In 1908, New York-based Kalem Studios was the first to open a permanent studio in Jacksonville. Over the course of the next decade, more than 30 silent film companies established studios in town, including Metro Pictures (later MGM ), Edison Studios , Majestic Films, King Bee Film Company , Vim Comedy Company , Norman Studios , Gaumont Studios and the Lubin Manufacturing Company . In 1914, Oliver "Babe" Hardy , a comedic actor and Georgia native, began his motion picture career in Jacksonville. He starred in over 36 short silent films his first year acting. With the closing of Lubin in early 1915, Oliver moved to New York then New Jersey to find film jobs. Acquiring a job with the Vim Company in early 1915, he returned to Jacksonville in the spring of 1917 before relocating to Los Angeles in October 1917. In 1915, Joseph Engel opened Metro Pictures in Jacksonville. In 1917, the first motion picture made in Technicolor and the first feature-length color movie produced in the United States, The Gulf Between , was filmed on location in Jacksonville. Jacksonville's mostly conservative residents, however, objected to the hallmarks of the early movie industry, such as car chases in the streets, simulated bank robberies and fire alarms in public places, and even the occasional riot. [ citation needed ] In 1917, conservative Democrat John W. Martin was elected mayor on the platform of taming the city's movie industry. By that time, southern California was emerging as the major movie production center, thanks in large part to the move of film pioneers like William Selig and D.W. Griffith to the area. These factors hastened the demise of Jacksonville as a place for film production. In 1920, Richard Norman, founder of Norman Film Manufacturing Company , a European American , purchased the bankrupt Eagle Film studios, on the Eagle Film City property in Jacksonville's rural Arlington section. and created a string of African American films starring black actors in the vein of Oscar Micheaux and the Lincoln Motion Picture Company. In contrast to the degrading parts offered in certain white films such as The Birth of a Nation , Norman and his contemporaries sought to create positive stories featuring African Americans in what he termed "splendidly assuming different roles." The 1920s brought significant real estate development and speculation to the city during the great Florida land boom (and bust). Hordes of train passengers passed through Jacksonville on their way south to the new tourist destinations of South Florida, as most of the passenger trains arriving from the population centers of the North were routed through Jacksonville. The Riverside Theater , which opened in 1927, was the first theater in Florida to show talking pictures . Completion of the Dixie Highway (portions of which became U.S. 1 ) in the 1920s began to draw significant automobile traffic as well. An important entry point to the state since the 1870s, Jacksonville now justifiably billed itself as the "Gateway to Florida." A significant part of Jacksonville's growth in the 20th century came from the presence of navy bases in the region. October 15, 1940, Naval Air Station Jacksonville ("NAS Jax") on the westside became the first navy installation in the city. This base was a major training center during World War II, with over 20,000 pilots and aircrewmen being trained there. After the war, the Navy's elite Blue Angels were established at NAS Jax. Today NAS Jax is the third largest navy installation in the country and employs over 23,000 civilian and active-duty personnel. In June 1941, land in the westernmost side of Duval County was earmarked for a second naval air facility. This became NAS Cecil Field, which during the Cold War was designated a Master Jet Base , the only one in the South. RF-8 Crusaders out of Cecil Field detected missiles in Cuba, precipitating the Cuban Missile Crisis . In 1993, the Navy decided to close NAS Cecil Field, and this was completed in 1999. The land once occupied by this installation is now known as the "Cecil Commerce Center" and contains one of the campuses of Florida Community College which now offers civil aeronautics classes. December 1942 saw the addition of a third naval installation to Jacksonville: Naval Station Mayport at the mouth of the St. Johns River. This port developed through World War II and today is the home port for many types of navy ships, most notably the aircraft carrier USS John F. Kennedy from 1995 to 26 July 2007, when Big John was towed away, eventually to be mothballed in Philadelphia. NS Mayport current employs about 14,000 personnel. Jacksonville is also not far from Naval Submarine Base Kings Bay in St. Marys, Georgia , which is home to part of the US Navy 's nuclear-powered ballistic missile submarine ( SSBN ) fleet. The naval base became a key training ground in the 1950s and 1960s and as such, the population of the city rose dramatically. More than half of the residents in Jacksonville had some tie to the naval base, whether it be a relative stationed there, or due to employment opportunities, by 1970, necessitating the opening of an international airport in the area. On December 29, 1963, a fire gutted the first couple of stories of the Hotel Roosevelt on Adams Street, killing 22 people, setting a record for the highest one-day death toll in Jacksonville history. The hotel was later abandoned, with most businesses inside moving to the nearby Hotel George Washington . Offshore Power Systems (OPS) was a 1970 joint venture between Westinghouse Electric Company , who constructed nuclear generating plants, and Newport News Shipbuilding and Drydock , who had recently merged with Tenneco , to create floating nuclear power plants at the Port of Jacksonville . Construction of the new facility was projected to cost $200 million and create 10,000 new jobs when completed in 1976. Contracts were signed by Public Service Electric and Gas Company with PSE&G paying for the startup costs for the manufacturing facility. Westinghouse named Zeke Zechella to be president of OPS in 1972. OPS obtained 850+ acres (3.4 km2) on Blount Island from the Jacksonville Port Authority (JPA) for $2,000/acre, then installed infrastructure using over 1,000 workers. A total of $125 million was invested in the property and facility, however; no plants were ever built. Because of its high visibility and patronage, the Hemming Park and surrounding stores were the site of numerous civil rights demonstrations in the 1960s. Black Sit-ins began on August 13, 1960 when students asked to be served at the segregated lunch counter at Woolworths , Morrison's Cafeteria and other eateries. They were denied service and kicked, spit at and addressed with racial slurs. This came to a head on "Ax Handle Saturday", August 27, 1960. A group of 200 middle aged and older white men (allegedly some were also members of the Ku Klux Klan ) gathered in Hemming Park armed with baseball bats and ax handles. They attacked the protesters conducting sit-ins. The violence spread, and the white mob started attacking all African-Americans in sight. Rumors were rampant on both sides that the unrest was spreading around the county (in reality, the violence stayed in relatively the same location, and did not spill over into the mostly-white, upper-class Cedar Hills neighborhood, for example). A black street gang called the "Boomerangs" attempted to protect the demonstrators. Police, who had not intervened when the protesters were attacked, now became involved, arresting members of the Boomerangs and other black residents who attempted to stop the beatings. Nat Glover , who worked in Jacksonville law enforcement for 37 years, including eight years as Sheriff of Jacksonville , recalled stumbling into the riot. Glover said he ran to the police, expecting them to arrest the thugs, but was told to leave town or risk being killed. Several whites had joined the black protesters on that day. Richard Charles Parker, a 25-year-old student attending Florida State University was among them. White protesters were the object of particular dislike by racists, so when the fracas began, Parker was hustled out of the area for his own protection. The police had been watching him and arrested him as an instigator, charging him with vagrancy, disorderly conduct and inciting a riot. After Parker stated that he was proud to be a member of the NAACP , Judge John Santora sentenced him to 90 days in jail. Jacksonville is has been largely spared from the impacts of hurricanes . Hurricane Dora made landfall near St. Augustine, Florida on September 11, 1964, with winds of 110 mph (175 km/h) , becoming the first on record to make landfall in the region. Despite the storm damage, over 20,000 fans attended a live concert the next day at the Gator Bowl Stadium by the British rock-and-roll band, " The Beatles ". The winds were blowing so hard that Ringo Starr 's drum set had to be nailed down to the stage. [ citation needed ] Dora was the only storm in recorded history to affect Jacksonville with hurricane-force winds, though the city has been affected by weaker storms as well as hurricanes that lost intensity before reaching the area. In September 1999, after Hurricane Floyd struck the Bahamas , over one million Floridians were evacuated from coastal areas, many of them from Jacksonville. Mayor John Delaney announced the mandatory evacuation of the Jacksonville Beaches and other low lying neighborhoods early on September 14; in total, nearly 80,000 Jacksonville residents left their homes. Ultimately the storm turned northward 125 miles off the coast, causing only minor damage in Jacksonville and the southeastern U.S. before making landfall in North Carolina . In September 2017, Jacksonville experienced record flooding from Hurricane Irma . Through the 1960s Jacksonville, like most other large cities in the US, suffered from the effects of urban sprawl . To compensate for the loss of population and tax revenue and end waste and corruption, voters elected to consolidate the government of Jacksonville with the government of Duval County . The move was carried out on October 1, 1968, and Hans Tanzler , elected mayor of Jacksonville the year before, became the first mayor of the consolidated government. Jacksonville became the largest city in Florida and the 13th largest in the United States, and has a greater land area than any other American city outside Alaska . All areas of Duval County are considered part of Jacksonville besides the four independent municipalities of Jacksonville Beach , Atlantic Beach , Neptune Beach , and Baldwin , although residents of these towns vote in city elections and are eligible for services provided by Jacksonville. Claude Yates began the "quiet revolution" with the Yates Manifesto and J. J. Daniel was chairman of the Local Government Study Commission . Lex Hester was Executive Director of the commission and the key architect of Jacksonville's consolidated government, transition coordinator and chief administrative officer following consolidation. On May 3, 1901, downtown Jacksonville was ravaged by the Great Fire—the largest-ever urban fire in the Southeastern United States , which started when hot ash from a shantyhouse's chimney landed on the drying moss at Cleaveland's Fiber Factory. At half past noon most of the Cleaveland workers were at lunch, but by the time they returned the entire city block was engulfed in flames. The fire destroyed the business district and rendered 10,000 residents homeless in the course of eight hours. Florida Governor William S. Jennings declared a state of martial law in Jacksonville and dispatched several state militia units to help. Reconstruction started immediately, and the city was returned to civil authority on May 17. Despite the widespread damage, only seven deaths were reported. Young architect Henry John Klutho had just returned to New York from a year in Europe when he read about the Jacksonville fire and, seeing a rare opportunity, he headed south. Klutho and other architects, enamored by the " Prairie Style " of architecture then being popularized by architect Frank Lloyd Wright in Chicago and other Midwestern cities, designed exuberant local buildings with a Florida flair. While many of Klutho's buildings were demolished by the 1980s, a number of his creations remain, including the St. James Building from 1911 (a former department store that is now Jacksonville's City Hall) and the Morocco Temple from 1910. The Klutho Apartments, in Springfield , were recently restored and converted into office space by local charity Fresh Ministries . Despite the losses of the last several decades, Jacksonville still has one of the largest collections of Prairie Style buildings (particularly residences) outside the Midwest.In the early 20th century, before Hollywood , the motion picture industry was based in Fort Lee, New Jersey#America's first motion picture industry . In need of a winter headquarters, moviemakers were attracted to Jacksonville due to its warm climate, exotic locations, excellent rail access, and cheaper labor, earning the city the title of "The Winter Film Capital of the World." In 1908, New York-based Kalem Studios was the first to open a permanent studio in Jacksonville. Over the course of the next decade, more than 30 silent film companies established studios in town, including Metro Pictures (later MGM ), Edison Studios , Majestic Films, King Bee Film Company , Vim Comedy Company , Norman Studios , Gaumont Studios and the Lubin Manufacturing Company . In 1914, Oliver "Babe" Hardy , a comedic actor and Georgia native, began his motion picture career in Jacksonville. He starred in over 36 short silent films his first year acting. With the closing of Lubin in early 1915, Oliver moved to New York then New Jersey to find film jobs. Acquiring a job with the Vim Company in early 1915, he returned to Jacksonville in the spring of 1917 before relocating to Los Angeles in October 1917. In 1915, Joseph Engel opened Metro Pictures in Jacksonville. In 1917, the first motion picture made in Technicolor and the first feature-length color movie produced in the United States, The Gulf Between , was filmed on location in Jacksonville. Jacksonville's mostly conservative residents, however, objected to the hallmarks of the early movie industry, such as car chases in the streets, simulated bank robberies and fire alarms in public places, and even the occasional riot. [ citation needed ] In 1917, conservative Democrat John W. Martin was elected mayor on the platform of taming the city's movie industry. By that time, southern California was emerging as the major movie production center, thanks in large part to the move of film pioneers like William Selig and D.W. Griffith to the area. These factors hastened the demise of Jacksonville as a place for film production. In 1920, Richard Norman, founder of Norman Film Manufacturing Company , a European American , purchased the bankrupt Eagle Film studios, on the Eagle Film City property in Jacksonville's rural Arlington section. and created a string of African American films starring black actors in the vein of Oscar Micheaux and the Lincoln Motion Picture Company. In contrast to the degrading parts offered in certain white films such as The Birth of a Nation , Norman and his contemporaries sought to create positive stories featuring African Americans in what he termed "splendidly assuming different roles."The 1920s brought significant real estate development and speculation to the city during the great Florida land boom (and bust). Hordes of train passengers passed through Jacksonville on their way south to the new tourist destinations of South Florida, as most of the passenger trains arriving from the population centers of the North were routed through Jacksonville. The Riverside Theater , which opened in 1927, was the first theater in Florida to show talking pictures . Completion of the Dixie Highway (portions of which became U.S. 1 ) in the 1920s began to draw significant automobile traffic as well. An important entry point to the state since the 1870s, Jacksonville now justifiably billed itself as the "Gateway to Florida."A significant part of Jacksonville's growth in the 20th century came from the presence of navy bases in the region. October 15, 1940, Naval Air Station Jacksonville ("NAS Jax") on the westside became the first navy installation in the city. This base was a major training center during World War II, with over 20,000 pilots and aircrewmen being trained there. After the war, the Navy's elite Blue Angels were established at NAS Jax. Today NAS Jax is the third largest navy installation in the country and employs over 23,000 civilian and active-duty personnel. In June 1941, land in the westernmost side of Duval County was earmarked for a second naval air facility. This became NAS Cecil Field, which during the Cold War was designated a Master Jet Base , the only one in the South. RF-8 Crusaders out of Cecil Field detected missiles in Cuba, precipitating the Cuban Missile Crisis . In 1993, the Navy decided to close NAS Cecil Field, and this was completed in 1999. The land once occupied by this installation is now known as the "Cecil Commerce Center" and contains one of the campuses of Florida Community College which now offers civil aeronautics classes. December 1942 saw the addition of a third naval installation to Jacksonville: Naval Station Mayport at the mouth of the St. Johns River. This port developed through World War II and today is the home port for many types of navy ships, most notably the aircraft carrier USS John F. Kennedy from 1995 to 26 July 2007, when Big John was towed away, eventually to be mothballed in Philadelphia. NS Mayport current employs about 14,000 personnel. Jacksonville is also not far from Naval Submarine Base Kings Bay in St. Marys, Georgia , which is home to part of the US Navy 's nuclear-powered ballistic missile submarine ( SSBN ) fleet. The naval base became a key training ground in the 1950s and 1960s and as such, the population of the city rose dramatically. More than half of the residents in Jacksonville had some tie to the naval base, whether it be a relative stationed there, or due to employment opportunities, by 1970, necessitating the opening of an international airport in the area.On December 29, 1963, a fire gutted the first couple of stories of the Hotel Roosevelt on Adams Street, killing 22 people, setting a record for the highest one-day death toll in Jacksonville history. The hotel was later abandoned, with most businesses inside moving to the nearby Hotel George Washington .Offshore Power Systems (OPS) was a 1970 joint venture between Westinghouse Electric Company , who constructed nuclear generating plants, and Newport News Shipbuilding and Drydock , who had recently merged with Tenneco , to create floating nuclear power plants at the Port of Jacksonville . Construction of the new facility was projected to cost $200 million and create 10,000 new jobs when completed in 1976. Contracts were signed by Public Service Electric and Gas Company with PSE&G paying for the startup costs for the manufacturing facility. Westinghouse named Zeke Zechella to be president of OPS in 1972. OPS obtained 850+ acres (3.4 km2) on Blount Island from the Jacksonville Port Authority (JPA) for $2,000/acre, then installed infrastructure using over 1,000 workers. A total of $125 million was invested in the property and facility, however; no plants were ever built. Because of its high visibility and patronage, the Hemming Park and surrounding stores were the site of numerous civil rights demonstrations in the 1960s. Black Sit-ins began on August 13, 1960 when students asked to be served at the segregated lunch counter at Woolworths , Morrison's Cafeteria and other eateries. They were denied service and kicked, spit at and addressed with racial slurs. This came to a head on "Ax Handle Saturday", August 27, 1960. A group of 200 middle aged and older white men (allegedly some were also members of the Ku Klux Klan ) gathered in Hemming Park armed with baseball bats and ax handles. They attacked the protesters conducting sit-ins. The violence spread, and the white mob started attacking all African-Americans in sight. Rumors were rampant on both sides that the unrest was spreading around the county (in reality, the violence stayed in relatively the same location, and did not spill over into the mostly-white, upper-class Cedar Hills neighborhood, for example). A black street gang called the "Boomerangs" attempted to protect the demonstrators. Police, who had not intervened when the protesters were attacked, now became involved, arresting members of the Boomerangs and other black residents who attempted to stop the beatings. Nat Glover , who worked in Jacksonville law enforcement for 37 years, including eight years as Sheriff of Jacksonville , recalled stumbling into the riot. Glover said he ran to the police, expecting them to arrest the thugs, but was told to leave town or risk being killed. Several whites had joined the black protesters on that day. Richard Charles Parker, a 25-year-old student attending Florida State University was among them. White protesters were the object of particular dislike by racists, so when the fracas began, Parker was hustled out of the area for his own protection. The police had been watching him and arrested him as an instigator, charging him with vagrancy, disorderly conduct and inciting a riot. After Parker stated that he was proud to be a member of the NAACP , Judge John Santora sentenced him to 90 days in jail. Jacksonville is has been largely spared from the impacts of hurricanes . Hurricane Dora made landfall near St. Augustine, Florida on September 11, 1964, with winds of 110 mph (175 km/h) , becoming the first on record to make landfall in the region. Despite the storm damage, over 20,000 fans attended a live concert the next day at the Gator Bowl Stadium by the British rock-and-roll band, " The Beatles ". The winds were blowing so hard that Ringo Starr 's drum set had to be nailed down to the stage. [ citation needed ] Dora was the only storm in recorded history to affect Jacksonville with hurricane-force winds, though the city has been affected by weaker storms as well as hurricanes that lost intensity before reaching the area. In September 1999, after Hurricane Floyd struck the Bahamas , over one million Floridians were evacuated from coastal areas, many of them from Jacksonville. Mayor John Delaney announced the mandatory evacuation of the Jacksonville Beaches and other low lying neighborhoods early on September 14; in total, nearly 80,000 Jacksonville residents left their homes. Ultimately the storm turned northward 125 miles off the coast, causing only minor damage in Jacksonville and the southeastern U.S. before making landfall in North Carolina . In September 2017, Jacksonville experienced record flooding from Hurricane Irma .Through the 1960s Jacksonville, like most other large cities in the US, suffered from the effects of urban sprawl . To compensate for the loss of population and tax revenue and end waste and corruption, voters elected to consolidate the government of Jacksonville with the government of Duval County . The move was carried out on October 1, 1968, and Hans Tanzler , elected mayor of Jacksonville the year before, became the first mayor of the consolidated government. Jacksonville became the largest city in Florida and the 13th largest in the United States, and has a greater land area than any other American city outside Alaska . All areas of Duval County are considered part of Jacksonville besides the four independent municipalities of Jacksonville Beach , Atlantic Beach , Neptune Beach , and Baldwin , although residents of these towns vote in city elections and are eligible for services provided by Jacksonville. Claude Yates began the "quiet revolution" with the Yates Manifesto and J. J. Daniel was chairman of the Local Government Study Commission . Lex Hester was Executive Director of the commission and the key architect of Jacksonville's consolidated government, transition coordinator and chief administrative officer following consolidation.

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Yellow fever

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World Health Day

World Health Day is a global health awareness day celebrated every year on 7 April, under the sponsorship of the World Health Organization (WHO), as well as other related organizations. In 1948, the WHO held the First World Health Assembly . The Assembly decided to celebrate 7 April of each year, with effect from 1950, as the World Health Day. The World Health Day is held to mark WHO's founding and is seen as an opportunity by the organization to draw worldwide attention to a subject of major importance to global health each year. The WHO organizes international, regional and local events on the Day related to a particular theme. World Health Day is acknowledged by various governments and non-governmental organizations with interests in public health issues, who also organize activities and highlight their support in media reports, such as the Global Health Council . World Health Day is one of 11 official global health campaigns marked by WHO, along with World Tuberculosis Day , World Immunization Week , World Malaria Day , World No Tobacco Day , World AIDS Day , World Blood Donor Day , World Chagas Disease Day , World Patient Safety Day , World Antimicrobial Awareness Week and World Hepatitis Day . 1991: Should Disaster Strike, be prepared 1992: Heart beat: A rhythm of Health 1993: Handle life with care: Prevent violence and Negligence 1994: Oral Health for a Healthy Life 1995: Global Polio Eradication 1996: Healthy Cities for better life 1997: Emerging infectious diseases 1998: Safe motherhood 1999: Active aging makes the difference 2000: Safe Blood starts with me 2001: Mental Health : stop exclusion, dare to care 2002: Move for health 2003: Shape the future of life: healthy environments for children 2004: Road safety 2005: Make every mother and child count 2006: Working together for health In 2006, World Health Day was devoted to the health workforce crisis, or chronic shortages of health workers around the world due to decades of underinvestment in their education, training, salaries, working environment and management. The day was also meant to celebrate individual health workers – the people who provide health care to those who need it, in other words those at the heart of health systems . The Day also marked the launch of the WHO's World Health Report 2006 , which focused on the same theme. The report contained an assessment of the current crisis in the global health workforce, revealing an estimated shortage of almost 4.3 million physicians, midwives, nurses and other health care providers worldwide, and further proposed a series of actions for countries and the international community to tackle it. In 2008, World Health Day focused on the need to protect health from the adverse effects of climate change and establish links between climate change and health and other development areas such as environment, food, energy, transport. The theme "protecting health from climate change" put health at the centre of the global dialogue about climate change. WHO selected this theme in recognition that climate change is posing ever growing threats to global public health security. World Health Day 2009 focused on the safety of health facilities and the readiness of health workers who treat those affected by emergencies. Health centres and staff are critical lifelines for vulnerable people in disasters – treating injuries , preventing illnesses and caring for people's health needs. Often, already fragile health systems are unable to keep functioning through a disaster, with immediate and future public health consequences. For this year's World Health Day campaign, WHO and international partners underscored the importance of investing in health infrastructure that can withstand hazards and serve people in immediate need, and urged health facilities to implement systems to respond to internal emergencies, such as fires, and ensure the continuity of care. With the campaign "1000 cities, 1000 lives", events were organized worldwide during the week starting 7 April 2010. The global goals of the campaign were: 1000 cities : to open up public spaces to health, whether it be activities in parks, town hall meetings, clean-up campaigns, or closing off portions of streets to motorized vehicles. 1000 lives : to collect 1000 stories of urban health champions who have taken action and had a significant impact on health in their cities. The theme of World Health Day 2011, marked on 7 April 2011, was " antimicrobial resistance and its global spread" and focused on the need for governments and stakeholders to implement the policies and practices needed to prevent and counter the emergence of highly resistant microorganisms . When infections caused by resistant microorganisms fail to respond to standard treatments, including antibiotics and other antimicrobial medicines – also known as drug resistance – this may result in prolonged illness and greater risk of death. On World Health Day 2011, WHO called for intensified global commitment to safeguard antimicrobial medicines for future generations. The organization introduced a six-point policy package to combat the spread of antimicrobial resistance: Commit to a comprehensive, financed national plan with accountability and civil society engagement. Strengthen surveillance and laboratory capacity. Ensure uninterrupted access to essential medicines of assured quality. Regulate and promote rational use of medicines, including in animal husbandry, and ensure proper patient care; reduce use of antimicrobials in food-producing animals. Enhance infection prevention and control. Foster innovations and research and development for new tools. World Health Day 2012 was marked with the slogan "Good health adds life to years". Life expectancy is going up in most countries, meaning more and more people live longer and enter an age when they may need health care . Meanwhile, birth rates are generally falling. Countries and health care systems need to find innovative and sustainable ways to cope with the demographic shift. As stated by John Beard, director of the WHO Department of Ageing and Life Course, "With the rapid ageing of populations, finding the right model for long-term care becomes more and more urgent". Different activities were organized by WHO as well as non-governmental and community organizations around the world to mark World Health Day 2012. The theme of World Health Day 2013, marked on 7 April 2013, was the need to control raised blood pressure (hypertension) as a "silent killer, global public health crisis". The slogan for the campaign was "Healthy Heart Beat, Healthy Blood Pressure". The WHO reports hypertension – which is both preventable and treatable – contributes to the burden of heart disease , stroke and kidney failure, and is an important cause of premature death and disability. The organization estimates one in 3 adults has raised blood pressure. Specific objectives of the World Health Day 2013 campaign were to: raise awareness of the causes and consequences of high blood pressure; provide information on how to prevent high blood pressure and related complications; encourage adults to check their blood pressure and follow the advice of healthcare professionals; encourage self care to prevent high blood pressure; to make blood pressure measurement affordable to all; to incite national and local authorities to create enabling environments for healthy behaviours . World Health Day 2014 put the spotlight on some of the most commonly known vectors – such as mosquitoes, sandflies, bugs, ticks and snails – responsible for transmitting a wide range of parasites and pathogens that can cause many different illnesses. Mosquitoes, for example, transmit malaria – the most deadly vector-borne disease, causing an estimated 660 000 deaths annually worldwide – as well as dengue fever , lymphatic filariasis , chikungunya , Japanese encephalitis , and yellow fever . More than half of the world's population is at risk of these diseases. The goal of the World Health Day 2014 campaign was better protection from vector-borne diseases, especially for families living in areas where diseases are transmitted by vectors, and travelers to countries where they pose a health threat. The campaign advocated for health authorities in countries where vector-borne diseases are a public health problem or emerging threat, to put in place measures to improve surveillance and protection. The WHO promoted improvement of food safety as part of the 2015 World Health Day campaign. Unsafe food — food containing harmful bacteria, viruses, parasites or chemical substances — is responsible for more than 200 diseases, and is linked to the deaths of some 2 million people annually, mostly children. Changes in food production , distribution and consumption ; changes to the environment; new and emerging pathogens; and antimicrobial resistance all pose challenges to food safety systems. The WHO works with countries and partners to strengthen efforts to prevent, detect and respond to foodborne disease outbreaks in line with the Codex Alimentarius , advocating that food safety is a shared responsibility — from farmers and manufacturers to vendors and consumers — and raising awareness about the importance of the part everyone can play in ensuring that the food on our plate is safe to eat. The WHO focused World Health Day 2016, on diabetes – a largely preventable and treatable non-communicable disease that is rapidly increasing in numbers in many countries, most dramatically in low- and middle-income countries . Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes, including maintaining normal body weight , engaging in regular physical activity, and eating a healthy diet. Diabetes can be controlled and managed to prevent complications through diagnosis, self-management education, and affordable treatment. The WHO estimates about 422 million people in the world have diabetes, with the disease the direct cause of some 1.5 million deaths. The goals of WHD 2016 are (1) scale up prevention, (2) strengthen care, and (3) enhance surveillance. World Health Day 2017, celebrated on 7 April, aims to mobilize action on depression . This condition affects people of all ages, from all walks of life, in all countries. It impacts on people's ability to carry out everyday tasks, with consequences for families, friends, and even communities, workplaces, and health care systems. At worst, depression can lead to self-inflicted injury and suicide . A better understanding of depression – which can be prevented and treated – will help reduce the stigma associated with the illness, and lead to more people seeking help. World Health Day 2018 theme, "Universal Health Coverage: Everyone, Everywhere", emphasized the idea that health is a fundamental human right, and that all people should be able to have access to health care. The slogan for the day was "Health For All". Several events were held including a panel discussion on universal health coverage which was live streamed . 2018 marked the 70th anniversary of the World Health Organization's founding. The 2019 World Health Day theme was "Universal Health Coverage: Everyone, Everywhere", a repeat of the 2018 theme, with an emphasis on the idea that "Universal Health Coverage is the WHO's number one goal". To commemorate the 2019 World Health Day theme, the World Health Organization launched a campaign to sign a petition for health for all, held a Facebook live event, and shared information about primary health care and universal health coverage "statistics and facts". The 2020 World Health Day theme took place in the context of the COVID-19 global pandemic and was therefore launched as 'Support Nurses and Midwives". Around the world, people spent the day thanking the nurses and health care workers on the frontlines battling the COVID-19 coronavirus. The US White House released a presidential message emphasizing the role public health plays in "building strong, prosperous, and free societies around the world". The celebration of 2020 World Health Day took place around the world in a mostly virtual environment through online press conferences, announcements, and social media due to the worldwide, broad based, "stay at home" order due to the COVID-19 coronavirus pandemic. Much of the efforts were focused on raising funds for the COVID-19 solidarity response fund. In 2006, World Health Day was devoted to the health workforce crisis, or chronic shortages of health workers around the world due to decades of underinvestment in their education, training, salaries, working environment and management. The day was also meant to celebrate individual health workers – the people who provide health care to those who need it, in other words those at the heart of health systems . The Day also marked the launch of the WHO's World Health Report 2006 , which focused on the same theme. The report contained an assessment of the current crisis in the global health workforce, revealing an estimated shortage of almost 4.3 million physicians, midwives, nurses and other health care providers worldwide, and further proposed a series of actions for countries and the international community to tackle it. In 2008, World Health Day focused on the need to protect health from the adverse effects of climate change and establish links between climate change and health and other development areas such as environment, food, energy, transport. The theme "protecting health from climate change" put health at the centre of the global dialogue about climate change. WHO selected this theme in recognition that climate change is posing ever growing threats to global public health security. World Health Day 2009 focused on the safety of health facilities and the readiness of health workers who treat those affected by emergencies. Health centres and staff are critical lifelines for vulnerable people in disasters – treating injuries , preventing illnesses and caring for people's health needs. Often, already fragile health systems are unable to keep functioning through a disaster, with immediate and future public health consequences. For this year's World Health Day campaign, WHO and international partners underscored the importance of investing in health infrastructure that can withstand hazards and serve people in immediate need, and urged health facilities to implement systems to respond to internal emergencies, such as fires, and ensure the continuity of care.With the campaign "1000 cities, 1000 lives", events were organized worldwide during the week starting 7 April 2010. The global goals of the campaign were: 1000 cities : to open up public spaces to health, whether it be activities in parks, town hall meetings, clean-up campaigns, or closing off portions of streets to motorized vehicles. 1000 lives : to collect 1000 stories of urban health champions who have taken action and had a significant impact on health in their cities.The theme of World Health Day 2011, marked on 7 April 2011, was " antimicrobial resistance and its global spread" and focused on the need for governments and stakeholders to implement the policies and practices needed to prevent and counter the emergence of highly resistant microorganisms . When infections caused by resistant microorganisms fail to respond to standard treatments, including antibiotics and other antimicrobial medicines – also known as drug resistance – this may result in prolonged illness and greater risk of death. On World Health Day 2011, WHO called for intensified global commitment to safeguard antimicrobial medicines for future generations. The organization introduced a six-point policy package to combat the spread of antimicrobial resistance: Commit to a comprehensive, financed national plan with accountability and civil society engagement. Strengthen surveillance and laboratory capacity. Ensure uninterrupted access to essential medicines of assured quality. Regulate and promote rational use of medicines, including in animal husbandry, and ensure proper patient care; reduce use of antimicrobials in food-producing animals. Enhance infection prevention and control. Foster innovations and research and development for new tools.World Health Day 2012 was marked with the slogan "Good health adds life to years". Life expectancy is going up in most countries, meaning more and more people live longer and enter an age when they may need health care . Meanwhile, birth rates are generally falling. Countries and health care systems need to find innovative and sustainable ways to cope with the demographic shift. As stated by John Beard, director of the WHO Department of Ageing and Life Course, "With the rapid ageing of populations, finding the right model for long-term care becomes more and more urgent". Different activities were organized by WHO as well as non-governmental and community organizations around the world to mark World Health Day 2012. The theme of World Health Day 2013, marked on 7 April 2013, was the need to control raised blood pressure (hypertension) as a "silent killer, global public health crisis". The slogan for the campaign was "Healthy Heart Beat, Healthy Blood Pressure". The WHO reports hypertension – which is both preventable and treatable – contributes to the burden of heart disease , stroke and kidney failure, and is an important cause of premature death and disability. The organization estimates one in 3 adults has raised blood pressure. Specific objectives of the World Health Day 2013 campaign were to: raise awareness of the causes and consequences of high blood pressure; provide information on how to prevent high blood pressure and related complications; encourage adults to check their blood pressure and follow the advice of healthcare professionals; encourage self care to prevent high blood pressure; to make blood pressure measurement affordable to all; to incite national and local authorities to create enabling environments for healthy behaviours .World Health Day 2014 put the spotlight on some of the most commonly known vectors – such as mosquitoes, sandflies, bugs, ticks and snails – responsible for transmitting a wide range of parasites and pathogens that can cause many different illnesses. Mosquitoes, for example, transmit malaria – the most deadly vector-borne disease, causing an estimated 660 000 deaths annually worldwide – as well as dengue fever , lymphatic filariasis , chikungunya , Japanese encephalitis , and yellow fever . More than half of the world's population is at risk of these diseases. The goal of the World Health Day 2014 campaign was better protection from vector-borne diseases, especially for families living in areas where diseases are transmitted by vectors, and travelers to countries where they pose a health threat. The campaign advocated for health authorities in countries where vector-borne diseases are a public health problem or emerging threat, to put in place measures to improve surveillance and protection.The WHO promoted improvement of food safety as part of the 2015 World Health Day campaign. Unsafe food — food containing harmful bacteria, viruses, parasites or chemical substances — is responsible for more than 200 diseases, and is linked to the deaths of some 2 million people annually, mostly children. Changes in food production , distribution and consumption ; changes to the environment; new and emerging pathogens; and antimicrobial resistance all pose challenges to food safety systems. The WHO works with countries and partners to strengthen efforts to prevent, detect and respond to foodborne disease outbreaks in line with the Codex Alimentarius , advocating that food safety is a shared responsibility — from farmers and manufacturers to vendors and consumers — and raising awareness about the importance of the part everyone can play in ensuring that the food on our plate is safe to eat. The WHO focused World Health Day 2016, on diabetes – a largely preventable and treatable non-communicable disease that is rapidly increasing in numbers in many countries, most dramatically in low- and middle-income countries . Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes, including maintaining normal body weight , engaging in regular physical activity, and eating a healthy diet. Diabetes can be controlled and managed to prevent complications through diagnosis, self-management education, and affordable treatment. The WHO estimates about 422 million people in the world have diabetes, with the disease the direct cause of some 1.5 million deaths. The goals of WHD 2016 are (1) scale up prevention, (2) strengthen care, and (3) enhance surveillance. World Health Day 2017, celebrated on 7 April, aims to mobilize action on depression . This condition affects people of all ages, from all walks of life, in all countries. It impacts on people's ability to carry out everyday tasks, with consequences for families, friends, and even communities, workplaces, and health care systems. At worst, depression can lead to self-inflicted injury and suicide . A better understanding of depression – which can be prevented and treated – will help reduce the stigma associated with the illness, and lead to more people seeking help. World Health Day 2018 theme, "Universal Health Coverage: Everyone, Everywhere", emphasized the idea that health is a fundamental human right, and that all people should be able to have access to health care. The slogan for the day was "Health For All". Several events were held including a panel discussion on universal health coverage which was live streamed . 2018 marked the 70th anniversary of the World Health Organization's founding. The 2019 World Health Day theme was "Universal Health Coverage: Everyone, Everywhere", a repeat of the 2018 theme, with an emphasis on the idea that "Universal Health Coverage is the WHO's number one goal". To commemorate the 2019 World Health Day theme, the World Health Organization launched a campaign to sign a petition for health for all, held a Facebook live event, and shared information about primary health care and universal health coverage "statistics and facts". The 2020 World Health Day theme took place in the context of the COVID-19 global pandemic and was therefore launched as 'Support Nurses and Midwives". Around the world, people spent the day thanking the nurses and health care workers on the frontlines battling the COVID-19 coronavirus. The US White House released a presidential message emphasizing the role public health plays in "building strong, prosperous, and free societies around the world". The celebration of 2020 World Health Day took place around the world in a mostly virtual environment through online press conferences, announcements, and social media due to the worldwide, broad based, "stay at home" order due to the COVID-19 coronavirus pandemic. Much of the efforts were focused on raising funds for the COVID-19 solidarity response fund.

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Yellow fever

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Lookout Mountain

Lookout Mountain is a mountain ridge located at the northwest corner of the U.S. state of Georgia , the northeast corner of Alabama , and along the southeastern Tennessee state line in Chattanooga . Lookout Mountain was the scene of the 18th-century "Last Battle of the Cherokees" in this area during the Nickajack Expedition . On November 24, 1863, during the American Civil War , the Battle of Lookout Mountain took place here.The name appears on maps as early as Mathew Carey 's 1795 "Map of The Tennassee Government." Lookout Mountain and Sand Mountain (to the southwest) make up a large portion of the southernmost end of the Cumberland Plateau . The area was lifted from an ancient sea, and worn down by erosion for millions of years. The summit, called "High Point", is located just east of Thompsonville in Walker County, Georgia , with an elevation of 2,392 feet (729 m) above sea level. The foothills of the mountain extend into Chickamauga and Chattanooga National Military Park . [ citation needed ] The caves of Ruby Falls are in Lookout Mountain, and the rock formations of the "City of Rocks" (or Rock City ) attraction are situated on the ridge. The area is home to the Lookout Mountain Incline Railway , Covenant College , and a hang-gliding school. Lookout Mountain is one of the Chattanooga area's most visited tourist attractions . Civil War-related landmarks include "Point Park", operated by the National Park Service, and the Cravens House . Nearby are Georgia's Cloudland Canyon and Cloudland Canyon State Park . [ citation needed ] The southwestern section of Lookout Mountain is in northeastern Alabama. The Little River flows over the mountain in Little River Canyon National Preserve and the DeSoto Falls in DeSoto State Park . The Noccalula Falls Park , featuring a pioneer village showcasing several nineteenth-century homes, is located at the southern terminus of Lookout Mountain, in Gadsden, Alabama . Local legend claims that the 90-foot falls' namesake, Noccalula, jumped to her death because she could not marry the man she loved. [ citation needed ] White water sports and rock-climbing (offering views of the Coosa River Basin ) are this area's key attractions. [ citation needed ] From the "Rock City" point, a marker claims that seven U.S. states can be seen: Tennessee , Kentucky , Virginia , South Carolina , North Carolina , Georgia , and Alabama . The claim is repeated on numerous barn roofs in the surrounding area. No scientific investigation has upheld this claim. Located on the northwest side of Lookout Mountain, Sunset Rock is a popular trailhead and tourist stop. It is part of the Chickamauga and Chattanooga Military State Park, the largest and oldest Civil War national park. Once known as Point Lookout, Sunset Rock provides a view of the Tennessee River , Signal Mountain and Prentice Cooper State Forest. The 100-foot cliff and moderate temperatures invite heavy traffic for its many climbing routes, which were completed in 1960. Sunset Rock is mainly sandstone, making for easier routing and climbing. Route development continued through the 1960s and 1970s. In the 1980s, routers pushed the grades ever higher. Climbing here is especially popular in the autumn months due to cooler weather. Sunset Rock is attractive to Civil War enthusiasts due to its history; it has a Tennessee Historical Commission Marker at the head of the trail, describing its Civil War battle history. Confederate Generals Braxton Bragg and James Longstreet used Sunset Rock as a lookout in 1863 where they were able to track the movement of the Union troops as they entered Lookout Valley. It is claimed that, unknown to Longstreet, the Union troops could see him on Sunset Rock from the valley, where they were able to decipher the Confederate code, giving them the ability to anticipate the next moves of the Confederates. This resulted in the Battle of Wauhatchie , in which the Confederate army attempted to remove the Union forces from the river and block their supply lines. The attempt was unsuccessful; with the consequence that the Union forces were able to lift the siege of Chattanooga. [ citation needed ]Lookout Mountain and Sand Mountain (to the southwest) make up a large portion of the southernmost end of the Cumberland Plateau . The area was lifted from an ancient sea, and worn down by erosion for millions of years. The summit, called "High Point", is located just east of Thompsonville in Walker County, Georgia , with an elevation of 2,392 feet (729 m) above sea level. The foothills of the mountain extend into Chickamauga and Chattanooga National Military Park . [ citation needed ] The caves of Ruby Falls are in Lookout Mountain, and the rock formations of the "City of Rocks" (or Rock City ) attraction are situated on the ridge. The area is home to the Lookout Mountain Incline Railway , Covenant College , and a hang-gliding school. Lookout Mountain is one of the Chattanooga area's most visited tourist attractions . Civil War-related landmarks include "Point Park", operated by the National Park Service, and the Cravens House . Nearby are Georgia's Cloudland Canyon and Cloudland Canyon State Park . [ citation needed ]The southwestern section of Lookout Mountain is in northeastern Alabama. The Little River flows over the mountain in Little River Canyon National Preserve and the DeSoto Falls in DeSoto State Park . The Noccalula Falls Park , featuring a pioneer village showcasing several nineteenth-century homes, is located at the southern terminus of Lookout Mountain, in Gadsden, Alabama . Local legend claims that the 90-foot falls' namesake, Noccalula, jumped to her death because she could not marry the man she loved. [ citation needed ] White water sports and rock-climbing (offering views of the Coosa River Basin ) are this area's key attractions. [ citation needed ]From the "Rock City" point, a marker claims that seven U.S. states can be seen: Tennessee , Kentucky , Virginia , South Carolina , North Carolina , Georgia , and Alabama . The claim is repeated on numerous barn roofs in the surrounding area. No scientific investigation has upheld this claim. Located on the northwest side of Lookout Mountain, Sunset Rock is a popular trailhead and tourist stop. It is part of the Chickamauga and Chattanooga Military State Park, the largest and oldest Civil War national park. Once known as Point Lookout, Sunset Rock provides a view of the Tennessee River , Signal Mountain and Prentice Cooper State Forest. The 100-foot cliff and moderate temperatures invite heavy traffic for its many climbing routes, which were completed in 1960. Sunset Rock is mainly sandstone, making for easier routing and climbing. Route development continued through the 1960s and 1970s. In the 1980s, routers pushed the grades ever higher. Climbing here is especially popular in the autumn months due to cooler weather. Sunset Rock is attractive to Civil War enthusiasts due to its history; it has a Tennessee Historical Commission Marker at the head of the trail, describing its Civil War battle history. Confederate Generals Braxton Bragg and James Longstreet used Sunset Rock as a lookout in 1863 where they were able to track the movement of the Union troops as they entered Lookout Valley. It is claimed that, unknown to Longstreet, the Union troops could see him on Sunset Rock from the valley, where they were able to decipher the Confederate code, giving them the ability to anticipate the next moves of the Confederates. This resulted in the Battle of Wauhatchie , in which the Confederate army attempted to remove the Union forces from the river and block their supply lines. The attempt was unsuccessful; with the consequence that the Union forces were able to lift the siege of Chattanooga. [ citation needed ]The Chickamauga people, a branch of Cherokee Native Americans , lived in the Chattanooga area. The Chickamauga called the mountain Chat-a-nu-ga; hence the name of the city. Research suggests the mountain was inhabited, although no physical evidence has been found. On top of the mountain, the pattern of boulders suggest lanes or walls were once there. During the Revolutionary War , a battle between forces of John Sevier 's Washington District Regiment and those of Chief Dragging Canoe of the Chickamauga Cherokee , may have taken place on Lookout Mountain on September 20, 1782. Archaeologist and ethno-historian, Raymond Evans, has asserted that such a battle could not have taken place. However, a battle between militia forces under Joseph Martin , at the time Superintendent for Indian Affairs for both Virginia and North Carolina , and those of Dragging Canoe did occur there in August 1788. It was reported that on August 28, 1823, Daniel S. Butrick and William Chamberlain arrived at Lookout Mountain to perform missionary work with Native Americans. [ citation needed ] After the Trail of Tears , land taken from the tribes was purchased by the highest bidder without a lottery of land parcels. This method of distributing land caused much of Lookout Mountain to be owned by a few wealthy Chattanooga families. [ citation needed ] The aptly named Summertown, located on top of the mountain, was barely accessible from a small rutted turnpike which had been built in 1852 by Colonel James A. Whiteside. Whiteside, a native of Danville, Kentucky , owned a summer home which he converted into a hotel with several cottages. Naturalists who came to the area and visited the summit, such as Bradford Torrey , thought the cottages spoiled the environment and made it look like a cheap resort. Whiteside had purchased much of the land on the mountain's summit. [ citation needed ] Another wealthy Chattanoogan, Robert Cravens, had purchased most of the land on the side of the mountain. Cravens was also instrumental in developing the area, and moved into the house he built (the Cravens House) in 1855. Within a few years, about 25 families regularly summered on the mountain. [ citation needed ] Lookout Mountain's Sunset Rock was once the home to the photo shop of JB Linn. After the Union forces under Major General Joseph Hooker took over the mountain, Linn gained access to Sunset Rock (then called Point Lookout). He built a small shack there and named it "Gallery Point Lookout". [ citation needed ] In December 1863, he and his brother began taking photographs of many war commanders and officers, as well as wealthy civilians in the area. They became very successful with these pictures. The Gallery Point Lookout House is no longer in existence, but many of Linn's photographs still exist. [ citation needed ] On November 24, 1863, the Battle of Lookout Mountain was fought on the slopes of the mountain. The majority of hand-to-hand combat took place near Cravens' house (about halfway to the summit). Lookout Mountain's shape and location can in some conditions cause a unique weather phenomenon in the area: after dawn, fog will sometimes descend from the cooler mountaintop and stop about halfway down. Such an event took place the day of the battle and is the reason for its romanticized name, the " Battle Above the Clouds ". The battle was won by Union forces, enabling them to lift the Confederate siege of Chattanooga. [ citation needed ] When cases of Yellow fever began to increase in the United States, the Chattanooga population believed that the city was immune to any possibility of an epidemic because of its mountain climate. In 1878, two local residents died of the disease, throwing the city into a panic that led some 12,000 people to flee. Many of these went up the mountain, believing the climate would offer some protection against the disease. After the epidemic passed, many people complained about the inconvenient and complicated travel up the mountain, and the St. Elmo Turnpike (Ochs Highway) was created to help with access to the mountain. Early in the 1900s, Lookout Mountain was incorporated as a town. [ citation needed ] The twentieth century saw some wealthy businessmen settle permanently on the mountain, but its attraction as a tourist destination also grew. Entrepreneurs — among them Garnet Carter , J.B. Pound, O.B. Andrews, and Leo Lambert — began developing, improving, and marketing attractions in the 1910s and 1920s. [ citation needed ] Today, tourist attractions include:The Chickamauga people, a branch of Cherokee Native Americans , lived in the Chattanooga area. The Chickamauga called the mountain Chat-a-nu-ga; hence the name of the city. Research suggests the mountain was inhabited, although no physical evidence has been found. On top of the mountain, the pattern of boulders suggest lanes or walls were once there. During the Revolutionary War , a battle between forces of John Sevier 's Washington District Regiment and those of Chief Dragging Canoe of the Chickamauga Cherokee , may have taken place on Lookout Mountain on September 20, 1782. Archaeologist and ethno-historian, Raymond Evans, has asserted that such a battle could not have taken place. However, a battle between militia forces under Joseph Martin , at the time Superintendent for Indian Affairs for both Virginia and North Carolina , and those of Dragging Canoe did occur there in August 1788. It was reported that on August 28, 1823, Daniel S. Butrick and William Chamberlain arrived at Lookout Mountain to perform missionary work with Native Americans. [ citation needed ] After the Trail of Tears , land taken from the tribes was purchased by the highest bidder without a lottery of land parcels. This method of distributing land caused much of Lookout Mountain to be owned by a few wealthy Chattanooga families. [ citation needed ] The aptly named Summertown, located on top of the mountain, was barely accessible from a small rutted turnpike which had been built in 1852 by Colonel James A. Whiteside. Whiteside, a native of Danville, Kentucky , owned a summer home which he converted into a hotel with several cottages. Naturalists who came to the area and visited the summit, such as Bradford Torrey , thought the cottages spoiled the environment and made it look like a cheap resort. Whiteside had purchased much of the land on the mountain's summit. [ citation needed ] Another wealthy Chattanoogan, Robert Cravens, had purchased most of the land on the side of the mountain. Cravens was also instrumental in developing the area, and moved into the house he built (the Cravens House) in 1855. Within a few years, about 25 families regularly summered on the mountain. [ citation needed ] Lookout Mountain's Sunset Rock was once the home to the photo shop of JB Linn. After the Union forces under Major General Joseph Hooker took over the mountain, Linn gained access to Sunset Rock (then called Point Lookout). He built a small shack there and named it "Gallery Point Lookout". [ citation needed ] In December 1863, he and his brother began taking photographs of many war commanders and officers, as well as wealthy civilians in the area. They became very successful with these pictures. The Gallery Point Lookout House is no longer in existence, but many of Linn's photographs still exist. [ citation needed ]On November 24, 1863, the Battle of Lookout Mountain was fought on the slopes of the mountain. The majority of hand-to-hand combat took place near Cravens' house (about halfway to the summit). Lookout Mountain's shape and location can in some conditions cause a unique weather phenomenon in the area: after dawn, fog will sometimes descend from the cooler mountaintop and stop about halfway down. Such an event took place the day of the battle and is the reason for its romanticized name, the " Battle Above the Clouds ". The battle was won by Union forces, enabling them to lift the Confederate siege of Chattanooga. [ citation needed ]When cases of Yellow fever began to increase in the United States, the Chattanooga population believed that the city was immune to any possibility of an epidemic because of its mountain climate. In 1878, two local residents died of the disease, throwing the city into a panic that led some 12,000 people to flee. Many of these went up the mountain, believing the climate would offer some protection against the disease. After the epidemic passed, many people complained about the inconvenient and complicated travel up the mountain, and the St. Elmo Turnpike (Ochs Highway) was created to help with access to the mountain. Early in the 1900s, Lookout Mountain was incorporated as a town. [ citation needed ] The twentieth century saw some wealthy businessmen settle permanently on the mountain, but its attraction as a tourist destination also grew. Entrepreneurs — among them Garnet Carter , J.B. Pound, O.B. Andrews, and Leo Lambert — began developing, improving, and marketing attractions in the 1910s and 1920s. [ citation needed ] Today, tourist attractions include:When cases of Yellow fever began to increase in the United States, the Chattanooga population believed that the city was immune to any possibility of an epidemic because of its mountain climate. In 1878, two local residents died of the disease, throwing the city into a panic that led some 12,000 people to flee. Many of these went up the mountain, believing the climate would offer some protection against the disease. After the epidemic passed, many people complained about the inconvenient and complicated travel up the mountain, and the St. Elmo Turnpike (Ochs Highway) was created to help with access to the mountain. Early in the 1900s, Lookout Mountain was incorporated as a town. [ citation needed ]The twentieth century saw some wealthy businessmen settle permanently on the mountain, but its attraction as a tourist destination also grew. Entrepreneurs — among them Garnet Carter , J.B. Pound, O.B. Andrews, and Leo Lambert — began developing, improving, and marketing attractions in the 1910s and 1920s. [ citation needed ] Today, tourist attractions include:

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History of malaria

The history of malaria extends from its prehistoric origin as a zoonotic disease in the primates of Africa through to the 21st century. A widespread and potentially lethal human infectious disease, at its peak malaria infested every continent except Antarctica . Its prevention and treatment have been targeted in science and medicine for hundreds of years. Since the discovery of the Plasmodium parasites which cause it, research attention has focused on their biology as well as that of the mosquitoes which transmit the parasites. References to its unique, periodic fevers are found throughout recorded history, beginning in the first millennium BC in Greece and China. For thousands of years, traditional herbal remedies have been used to treat malaria. The first effective treatment for malaria came from the bark of the cinchona tree , which contains quinine . After the link to mosquitos and their parasites was identified in the early twentieth century, mosquito control measures such as widespread use of the insecticide DDT , swamp drainage, covering or oiling the surface of open water sources, indoor residual spraying, and use of insecticide treated nets was initiated. Prophylactic quinine was prescribed in malaria endemic areas, and new therapeutic drugs, including chloroquine and artemisinins , were used to resist the scourge. Today, artemisinin is present in every remedy applied in the treatment of malaria. After introducing artemisinin as a cure administered together with other remedies, malaria mortality in Africa decreased by half, though it later partially rebounded. Malaria researchers have won multiple Nobel Prizes for their achievements, although the disease continues to afflict some 200 million patients each year, killing more than 600,000. Malaria was the most important health hazard encountered by U.S. troops in the South Pacific during World War II , where about 500,000 men were infected. According to Joseph Patrick Byrne, "Sixty thousand American soldiers died of malaria during the African and South Pacific campaigns." At the close of the 20th century, malaria remained endemic in more than 100 countries throughout the tropical and subtropical zones, including large areas of Central and South America, Hispaniola ( Haiti and the Dominican Republic ), Africa, the Middle East, the Indian subcontinent, Southeast Asia, and Oceania. Resistance of Plasmodium to anti-malaria drugs, as well as resistance of mosquitos to insecticides and the discovery of zoonotic species of the parasite have complicated control measures. One estimate, which has been published in a 2002 Nature article, claims that malaria may have killed 50-60 billion people throughout history, or about half of all humans that have ever lived. However, speaking on the BBC podcast More or Less , Emeritus Professor of Medical Statistics at Liverpool School of Tropical Medicine Brian Faragher voiced doubt about this estimate, noting that the Nature article in question did not reference the claim. Faragher gave a tentative estimate of about 4-5% of deaths being caused by malaria, lower than the claimed 50%. More or Less were unable to find any source for the original figure aside from works which made the claim without reference. The first evidence of malaria parasites was found in mosquitoes preserved in amber from the Palaeogene period that are approximately 30 million years old. Malaria protozoa are diversified into primate, rodent, bird, and reptile host lineages. The DNA of Plasmodium falciparum shows the same pattern of diversity as its human hosts, with greater diversity in Africa than in the rest of the world, showing that modern humans had had the disease before they left Africa. Humans may have originally caught P. falciparum from gorillas . P. vivax , another malarial Plasmodium species among the six that infect humans, also likely originated in African gorillas and chimpanzees . Another malarial species recently discovered to be transmissible to humans, P. knowlesi , originated in Asian macaque monkeys . While P. malariae is highly host specific to humans, there is some evidence that low level non-symptomatic infection persists among wild chimpanzees. About 10,000 years ago, malaria started having a major impact on human survival, coinciding with the start of agriculture in the Neolithic revolution . Consequences included natural selection for sickle-cell disease , thalassaemias , glucose-6-phosphate dehydrogenase deficiency , Southeast Asian ovalocytosis , elliptocytosis and loss of the Gerbich antigen ( glycophorin C ) and the Duffy antigen on the erythrocytes , because such blood disorders confer a selective advantage against malaria infection ( balancing selection ). The three major types of inherited genetic resistance (sickle-cell disease, thalassaemias, and glucose-6-phosphate dehydrogenase deficiency) were present in the Mediterranean world by the time of the Roman Empire , about 2000 years ago. Molecular methods have confirmed the high prevalence of P. falciparum malaria in ancient Egypt . The Ancient Greek historian Herodotus wrote that the builders of the Egyptian pyramids ( c. 2700 –1700 BC) were given large amounts of garlic , probably to protect them against malaria. The Pharaoh Sneferu , the founder of the Fourth dynasty of Egypt , who reigned from around 2613–2589 BC, used bed-nets as protection against mosquitoes. Cleopatra VII , the last Pharaoh of Ancient Egypt , similarly slept under a mosquito net. However, whether the mosquito nets were used for the purpose of malaria prevention, or for more mundane purpose of avoiding the discomfort of mosquito bites, is unknown. The presence of malaria in Egypt from circa 800 BC onwards has been confirmed using DNA -based methods. Malaria became widely recognized in ancient Greece by the 4th century BC and is implicated in the decline of many city-state populations. The term μίασμα (Greek for miasma : "stain" or "pollution") was coined by Hippocrates of Kos who used it to describe dangerous fumes from the ground that are transported by winds and can cause serious illnesses. Hippocrates (460–370 BC), the "father of medicine", related the presence of intermittent fevers with climatic and environmental conditions and classified the fever according to periodicity: Gk.: tritaios pyretos / L.: febris tertiana (fever every third day), and Gk.: tetartaios pyretos / L.: febris quartana (fever every fourth day). The Chinese Huangdi Neijing (The Inner Canon of the Yellow Emperor) dating from ~300 BC – 200 AD apparently refers to repeated paroxysmal fevers associated with enlarged spleens and a tendency to epidemic occurrence. Around 168 BC, the herbal remedy Qing-hao ( 青蒿 ) ( Artemisia annua ) came into use in China to treat female hemorrhoids ( Wushi'er bingfang translated as "Recipes for 52 kinds of diseases" unearthed from the Mawangdui ). Qing-hao was first recommended for acute intermittent fever episodes by Ge Hong as an effective medication in the 4th-century Chinese manuscript Zhou hou bei ji fang , usually translated as "Emergency Prescriptions kept in one's Sleeve". His recommendation was to soak fresh plants of the artemisia herb in cold water, wring them out, and ingest the expressed bitter juice in their raw state. "Roman fever" refers to a particularly deadly strain of malaria that affected the Roman Campagna and the city of Rome throughout various epochs in history. An epidemic of Roman fever during the fifth century AD may have contributed to the fall of the Roman empire . [ failed verification ] [ failed verification ] The many remedies to reduce the spleen in Pedanius Dioscorides 's De Materia Medica have been suggested to have been a response to chronic malaria in the Roman empire. Some so-called " vampire burials " in late antiquity may have been performed in response to malaria epidemics. For example, some children who died of malaria were buried in the necropolis at Lugnano in Teverina using rituals meant to prevent them from returning from the dead . Modern scholars hypothesize that communities feared that the dead would return and spread disease. In 835, the celebration of Hallowmas (All Saints Day) was moved from May to November at the behest of Pope Gregory IV , on the "practical grounds that Rome in summer could not accommodate the great number of pilgrims who flocked to it", and perhaps because of public health considerations regarding Roman Fever, which claimed a number of lives of pilgrims during the sultry summers of the region. During the Middle Ages , treatments for malaria (and other diseases) included blood-letting, inducing vomiting, limb amputations, and trepanning . Physicians and surgeons in the period used herbal medicines like belladonna to bring about pain relief in affected patients. The name malaria is derived from mal aria ('bad air' in Medieval Italian ). This idea came from the Ancient Romans, who thought that this disease came from pestilential fumes in the swamps. The word malaria has its roots in the miasma theory , as described by historian and chancellor of Florence Leonardo Bruni in his Historiarum Florentini populi libri XII , which was the first major example of Renaissance historical writing: Avuto i Fiorentini questo fortissimo castello e fornitolo di buone guardie, consigliavano fra loro medesimi fosse da fare. Erano alcuni a' quali pareva sommamente utile e necessario a ridurre lo esercito, e massimamente essendo affaticato per la infermità e per la mala aria e per lungo e difficile campeggiare nel tempo dell'autunno e in luoghi infermi, e vedendo ancora ch'egli era diminuito assai per la licenza conceduta a molti pel capitano di potersi partire: perocchè, nel tempo che eglino erano stati lungamente a quello assedio, molti, o per disagio del campo o per paura d'infermità , avevano domandato e ottenuto licenza da lui (Acciajuoli 1476). After the Florentines had conquered this stronghold, after putting good guardians on it they were discussing among themselves how to proceed. For some of them it appeared most useful and necessary to reduce the army, more so as it was extremely stressed by disease and bad air , and due to the long-lasting and difficult camps in unhealthy places during the autumn. They (the Florentines) further considered that the army was reduced in numbers due to the leave permits granted to many soldiers by their officers. In fact, during the siege, many soldiers had asked and obtained leave permits due to the camp hardships and fear of illness [translated from medieval Italian, Toscanic dialect]. The coastal plains of southern Italy fell from international prominence when malaria expanded in the sixteenth century. At roughly the same time, in the coastal marshes of England, mortality from "marsh fever" or "tertian ague" ( ague : via French from medieval Latin acuta ( febris ), acute fever) was comparable to that in sub-Saharan Africa today. William Shakespeare was born at the start of the especially cold period that climatologists call the " Little Ice Age ", yet he was aware enough of the ravages of the disease to mention it in eight of his plays. Malaria was commonplace beside the river Thames then and even into the mid-Victorian era. Medical accounts and ancient autopsy reports state that tertian malarial fevers caused the death of four members of the prominent Medici family of Florence [Note 1] . These claims have been confirmed with more modern methodologies. The name malaria is derived from mal aria ('bad air' in Medieval Italian ). This idea came from the Ancient Romans, who thought that this disease came from pestilential fumes in the swamps. The word malaria has its roots in the miasma theory , as described by historian and chancellor of Florence Leonardo Bruni in his Historiarum Florentini populi libri XII , which was the first major example of Renaissance historical writing: Avuto i Fiorentini questo fortissimo castello e fornitolo di buone guardie, consigliavano fra loro medesimi fosse da fare. Erano alcuni a' quali pareva sommamente utile e necessario a ridurre lo esercito, e massimamente essendo affaticato per la infermità e per la mala aria e per lungo e difficile campeggiare nel tempo dell'autunno e in luoghi infermi, e vedendo ancora ch'egli era diminuito assai per la licenza conceduta a molti pel capitano di potersi partire: perocchè, nel tempo che eglino erano stati lungamente a quello assedio, molti, o per disagio del campo o per paura d'infermità , avevano domandato e ottenuto licenza da lui (Acciajuoli 1476). After the Florentines had conquered this stronghold, after putting good guardians on it they were discussing among themselves how to proceed. For some of them it appeared most useful and necessary to reduce the army, more so as it was extremely stressed by disease and bad air , and due to the long-lasting and difficult camps in unhealthy places during the autumn. They (the Florentines) further considered that the army was reduced in numbers due to the leave permits granted to many soldiers by their officers. In fact, during the siege, many soldiers had asked and obtained leave permits due to the camp hardships and fear of illness [translated from medieval Italian, Toscanic dialect]. The coastal plains of southern Italy fell from international prominence when malaria expanded in the sixteenth century. At roughly the same time, in the coastal marshes of England, mortality from "marsh fever" or "tertian ague" ( ague : via French from medieval Latin acuta ( febris ), acute fever) was comparable to that in sub-Saharan Africa today. William Shakespeare was born at the start of the especially cold period that climatologists call the " Little Ice Age ", yet he was aware enough of the ravages of the disease to mention it in eight of his plays. Malaria was commonplace beside the river Thames then and even into the mid-Victorian era. Medical accounts and ancient autopsy reports state that tertian malarial fevers caused the death of four members of the prominent Medici family of Florence [Note 1] . These claims have been confirmed with more modern methodologies. Malaria was not referenced in the "medical books" of the Mayans or Aztecs . Despite this, antibodies against malaria have been detected in some South American mummies, indicating that some malaria strains in the Americas might have a pre-Columbian origin. European settlers and West African slaves could have brought other strains of malaria to the Americas in the 16th century. In the book 1493: Uncovering the New World Columbus Created , the author Charles Mann cites sources that speculate that the reason African slaves were brought to the British Americas was because of their resistance to malaria. The colonies needed low-paid agricultural labor, and large numbers of poor British were ready to emigrate. North of the Mason–Dixon line , where malaria-transmitting mosquitoes did not fare well, British indentured servants proved more profitable, as they would work toward their freedom. However, as malaria spread to places such as the tidewater of Virginia and South Carolina, the owners of large plantations came to rely on the enslavement of more malaria-resistant West Africans, while white small landholders risked ruin whenever they got sick. The disease also helped weaken the Native American population and made them more susceptible to other diseases. Malaria caused huge losses to British forces in the South during the Revolutionary War as well as to Union forces during the Civil War. Spanish missionaries found that fever was treated by Amerindians near Loxa ( Ecuador ) with powder from Peruvian bark (later established to be from any of several trees of genus Cinchona ). It was used by the Quechua Indians of Ecuador to reduce the shaking effects caused by severe chills. Jesuit Brother Agostino Salumbrino (1561–1642), who lived in Lima and was an apothecary by training, observed the Quechua using the bark of the cinchona tree for that purpose. While its effect in treating malaria (and hence malaria-induced shivering) was unrelated to its effect in controlling shivering from cold, it was nevertheless effective for malaria. The use of the "fever tree" bark was introduced into European medicine by Jesuit missionaries ( Jesuit's bark ). Jesuit Bernabé de Cobo (1582–1657), who explored Mexico and Peru, is credited with taking cinchona bark to Europe. He brought the bark from Lima to Spain, and then to Rome and other parts of Italy , in 1632. Francesco Torti wrote in 1712 that only "intermittent fever" was amenable to the fever tree bark. This work finally established the specific nature of cinchona bark and brought about its general use in medicine. It would be nearly 200 years before the active principles, quinine and other alkaloids , of cinchona bark were isolated. Quinine , a toxic plant alkaloid, is, in addition to its anti-malarial properties, moderately effective against nocturnal leg cramps . In 1717, the dark pigmentation of a postmortem spleen and brain was published by the epidemiologist Giovanni Maria Lancisi in his malaria textbook De noxiis paludum effluviis eorumque remediis . This was one of the earliest reports of the characteristic enlargement of the spleen and dark color of the spleen and brain, which are the most constant post-mortem indications of chronic malaria infection. He related the prevalence of malaria in swampy areas to the presence of flies and recommended swamp drainage to prevent it. Spanish missionaries found that fever was treated by Amerindians near Loxa ( Ecuador ) with powder from Peruvian bark (later established to be from any of several trees of genus Cinchona ). It was used by the Quechua Indians of Ecuador to reduce the shaking effects caused by severe chills. Jesuit Brother Agostino Salumbrino (1561–1642), who lived in Lima and was an apothecary by training, observed the Quechua using the bark of the cinchona tree for that purpose. While its effect in treating malaria (and hence malaria-induced shivering) was unrelated to its effect in controlling shivering from cold, it was nevertheless effective for malaria. The use of the "fever tree" bark was introduced into European medicine by Jesuit missionaries ( Jesuit's bark ). Jesuit Bernabé de Cobo (1582–1657), who explored Mexico and Peru, is credited with taking cinchona bark to Europe. He brought the bark from Lima to Spain, and then to Rome and other parts of Italy , in 1632. Francesco Torti wrote in 1712 that only "intermittent fever" was amenable to the fever tree bark. This work finally established the specific nature of cinchona bark and brought about its general use in medicine. It would be nearly 200 years before the active principles, quinine and other alkaloids , of cinchona bark were isolated. Quinine , a toxic plant alkaloid, is, in addition to its anti-malarial properties, moderately effective against nocturnal leg cramps . In 1717, the dark pigmentation of a postmortem spleen and brain was published by the epidemiologist Giovanni Maria Lancisi in his malaria textbook De noxiis paludum effluviis eorumque remediis . This was one of the earliest reports of the characteristic enlargement of the spleen and dark color of the spleen and brain, which are the most constant post-mortem indications of chronic malaria infection. He related the prevalence of malaria in swampy areas to the presence of flies and recommended swamp drainage to prevent it. In the nineteenth century, the first drugs were developed to treat malaria, and parasites were first identified as its source. French chemist Pierre Joseph Pelletier and French pharmacist Joseph Bienaimé Caventou separated in 1820 the alkaloids cinchonine and quinine from powdered fever tree bark, allowing for the creation of standardized doses of the active ingredients. Prior to 1820, the bark was simply dried, ground to a fine powder and mixed into a liquid (commonly wine) for drinking. Manuel Incra Mamani spent four years collecting cinchona seeds in the Andes in Bolivia , highly prized for their quinine but whose export was prohibited. He provided them to an English trader, Charles Ledger , who sent the seeds to his brother in England to sell. They sold them to the Dutch government, who cultivated 20,000 trees of the Cinchona ledgeriana in Java (Indonesia). By the end of the nineteenth century, the Dutch had established a world monopoly over its supply. In 1834, in British Guiana , a German physician, Carl Warburg , invented an antipyretic medicine: ' Warburg's Tincture '. This secret, proprietary remedy contained quinine and other herbs . Trials were held in Europe in the 1840s and 1850s. It was officially adopted by the Austrian Empire in 1847. It was considered by many eminent medical professionals to be a more efficacious antimalarial than quinine. It was also more economical. The British government supplied Warburg's Tincture to troops in India and other colonies. In 1876, methylene blue was synthesized by German chemist Heinrich Caro . Paul Ehrlich in 1880 described the use of "neutral" dyes—mixtures of acidic and basic dyes—for the differentiation of cells in peripheral blood smears. In 1891, Ernst Malachowski and Dmitri Leonidovich Romanowsky independently developed techniques using a mixture of Eosin Y and modified methylene blue (methylene azure) that produced a surprising hue unattributable to either staining component: a shade of purple. Malachowski used alkali-treated methylene blue solutions and Romanowsky used methylene blue solutions that were molded or aged. This new method differentiated blood cells and demonstrated the nuclei of malarial parasites. Malachowski's staining technique was one of the most significant technical advances in the history of malaria. In 1891, Paul Guttmann and Ehrlich noted that methylene blue had a high affinity for some tissues and that this dye had a slight antimalarial property. Methylene blue and its congeners may act by preventing the biocrystallization of heme . In 1848, German anatomist Johann Heinrich Meckel recorded black-brown pigment granules in the blood and spleen of a patient who had died in a mental hospital. Meckel was thought to have been looking at malaria parasites without realizing it; he did not mention malaria in his report. He hypothesized that the pigment was melanin . The causal relationship of pigment to the parasite was established in 1880, when French physician Charles Louis Alphonse Laveran , working in the military hospital of Constantine, Algeria , observed pigmented parasites inside the red blood cells of people with malaria. He witnessed the events of exflagellation and became convinced that the moving flagella were parasitic microorganisms . He noted that quinine removed the parasites from the blood. Laveran called this microscopic organism Oscillaria malariae and proposed that malaria was caused by this protozoan . This discovery remained controversial until the development of the oil immersion lens in 1884 and of superior staining methods in 1890–1891. In 1885, Ettore Marchiafava , Angelo Celli and Camillo Golgi studied the reproduction cycles in human blood (Golgi cycles). Golgi observed that all parasites present in the blood divided almost simultaneously at regular intervals and that division coincided with attacks of fever. In 1886 Golgi described the morphological differences that are still used to distinguish two malaria parasite species Plasmodium vivax and Plasmodium malariae . Shortly after this Sakharov in 1889 and Marchiafava & Celli in 1890 independently identified Plasmodium falciparum as a species distinct from P. vivax and P. malariae . In 1890, Grassi and Feletti reviewed the available information and named both P. malariae and P. vivax (although within the genus Haemamoeba .) By 1890, Laveran's germ was generally accepted, but most of his initial ideas had been discarded in favor of the taxonomic work and clinical pathology of the Italian school. Marchiafava and Celli called the new microorganism Plasmodium . H. vivax was soon renamed Plasmodium vivax . In 1892, Marchiafava and Bignami proved that the multiple forms seen by Laveran were from a single species. This species was eventually named P. falciparum . Laveran was awarded the 1907 Nobel Prize for Physiology or Medicine "in recognition of his work on the role played by protozoa in causing diseases". Dutch physician Pieter Pel first proposed a tissue stage of the malaria parasite in 1886, presaging its discovery by over 50 years. This suggestion was reiterated in 1893 when Golgi suggested that the parasites might have an undiscovered tissue phase (this time in endothelial cells). Golgi's latent phase theory was supported by Pel in 1896. The establishment of the scientific method from about the mid-19th century on demanded testable hypotheses and verifiable phenomena for causation and transmission. Anecdotal reports [Note 2] , and the discovery in 1881 that mosquitoes were the vector of yellow fever, eventually led to the investigation of mosquitoes in connection with malaria. An early effort at malaria prevention occurred in 1896 in Massachusetts. An Uxbridge outbreak prompted health officer Dr. Leonard White to write a report to the State Board of Health, which led to a study of mosquito-malaria links and the first efforts for malaria prevention. Massachusetts state pathologist, Theobald Smith, asked that White's son collect mosquito specimens for further analysis, and that citizens add screens to windows, and drain collections of water. Britain's Sir Ronald Ross , an army surgeon working in Secunderabad , India , proved in 1897 that malaria is transmitted by mosquitoes , an event now commemorated by World Mosquito Day . He was able to find pigmented malaria parasites in a mosquito that he artificially fed on a malaria patient who had crescents in his blood. He continued his research into malaria by showing that certain mosquito species ( Culex fatigans ) transmit malaria to sparrows and he isolated malaria parasites from the salivary glands of mosquitoes that had fed on infected birds. He reported this to the British Medical Association in Edinburgh in 1898. Giovanni Battista Grassi , professor of Comparative Anatomy at Rome University, showed that human malaria could only be transmitted by Anopheles (Greek anofelís : good-for-nothing) mosquitoes. Grassi, along with coworkers Amico Bignami , Giuseppe Bastianelli and Ettore Marchiafava, announced at the session of the Accademia dei Lincei on 4 December 1898 that a healthy man in a non-malarial zone had contracted tertian malaria after being bitten by an experimentally infected Anopheles claviger specimen. In 1898–1899, Bastianelli, Bignami and Grassi were the first to observe the complete transmission cycle of P. falciparum , P. vivax and P. malaria from mosquito to human and back in A. claviger . A dispute broke out between the British and Italian schools of malariology over priority, but Ross received the 1902 Nobel Prize for Physiology or Medicine for "his work on malaria, by which he has shown how it enters the organism and thereby has laid the foundation for successful research on this disease and methods of combating it." William Henry Perkin , a student of August Wilhelm von Hofmann at the Royal College of Chemistry in London, unsuccessfully tried in the 1850s to synthesize quinine in a commercial process. The idea was to take two equivalents of N-allyltoluidine ( C 10 H 13 N ) and three atoms of oxygen to produce quinine ( C 20 H 24 N 2 O 2 ) and water. Instead, Perkin's mauve was produced when attempting quinine total synthesis via the oxidation of N-allyltoluidine. Before Perkin's discovery, all dyes and pigments were derived from roots, leaves, insects, or, in the case of Tyrian purple , molluscs . Quinine wouldn't be successfully synthesized until 1918. Synthesis remains elaborate, expensive and low yield, with the additional problem of separation of the stereoisomers . Though quinine is not one of the major drugs used in treatment, modern production still relies on extraction from the cinchona tree.French chemist Pierre Joseph Pelletier and French pharmacist Joseph Bienaimé Caventou separated in 1820 the alkaloids cinchonine and quinine from powdered fever tree bark, allowing for the creation of standardized doses of the active ingredients. Prior to 1820, the bark was simply dried, ground to a fine powder and mixed into a liquid (commonly wine) for drinking. Manuel Incra Mamani spent four years collecting cinchona seeds in the Andes in Bolivia , highly prized for their quinine but whose export was prohibited. He provided them to an English trader, Charles Ledger , who sent the seeds to his brother in England to sell. They sold them to the Dutch government, who cultivated 20,000 trees of the Cinchona ledgeriana in Java (Indonesia). By the end of the nineteenth century, the Dutch had established a world monopoly over its supply. In 1834, in British Guiana , a German physician, Carl Warburg , invented an antipyretic medicine: ' Warburg's Tincture '. This secret, proprietary remedy contained quinine and other herbs . Trials were held in Europe in the 1840s and 1850s. It was officially adopted by the Austrian Empire in 1847. It was considered by many eminent medical professionals to be a more efficacious antimalarial than quinine. It was also more economical. The British government supplied Warburg's Tincture to troops in India and other colonies. In 1876, methylene blue was synthesized by German chemist Heinrich Caro . Paul Ehrlich in 1880 described the use of "neutral" dyes—mixtures of acidic and basic dyes—for the differentiation of cells in peripheral blood smears. In 1891, Ernst Malachowski and Dmitri Leonidovich Romanowsky independently developed techniques using a mixture of Eosin Y and modified methylene blue (methylene azure) that produced a surprising hue unattributable to either staining component: a shade of purple. Malachowski used alkali-treated methylene blue solutions and Romanowsky used methylene blue solutions that were molded or aged. This new method differentiated blood cells and demonstrated the nuclei of malarial parasites. Malachowski's staining technique was one of the most significant technical advances in the history of malaria. In 1891, Paul Guttmann and Ehrlich noted that methylene blue had a high affinity for some tissues and that this dye had a slight antimalarial property. Methylene blue and its congeners may act by preventing the biocrystallization of heme . French chemist Pierre Joseph Pelletier and French pharmacist Joseph Bienaimé Caventou separated in 1820 the alkaloids cinchonine and quinine from powdered fever tree bark, allowing for the creation of standardized doses of the active ingredients. Prior to 1820, the bark was simply dried, ground to a fine powder and mixed into a liquid (commonly wine) for drinking. Manuel Incra Mamani spent four years collecting cinchona seeds in the Andes in Bolivia , highly prized for their quinine but whose export was prohibited. He provided them to an English trader, Charles Ledger , who sent the seeds to his brother in England to sell. They sold them to the Dutch government, who cultivated 20,000 trees of the Cinchona ledgeriana in Java (Indonesia). By the end of the nineteenth century, the Dutch had established a world monopoly over its supply. In 1834, in British Guiana , a German physician, Carl Warburg , invented an antipyretic medicine: ' Warburg's Tincture '. This secret, proprietary remedy contained quinine and other herbs . Trials were held in Europe in the 1840s and 1850s. It was officially adopted by the Austrian Empire in 1847. It was considered by many eminent medical professionals to be a more efficacious antimalarial than quinine. It was also more economical. The British government supplied Warburg's Tincture to troops in India and other colonies. In 1876, methylene blue was synthesized by German chemist Heinrich Caro . Paul Ehrlich in 1880 described the use of "neutral" dyes—mixtures of acidic and basic dyes—for the differentiation of cells in peripheral blood smears. In 1891, Ernst Malachowski and Dmitri Leonidovich Romanowsky independently developed techniques using a mixture of Eosin Y and modified methylene blue (methylene azure) that produced a surprising hue unattributable to either staining component: a shade of purple. Malachowski used alkali-treated methylene blue solutions and Romanowsky used methylene blue solutions that were molded or aged. This new method differentiated blood cells and demonstrated the nuclei of malarial parasites. Malachowski's staining technique was one of the most significant technical advances in the history of malaria. In 1891, Paul Guttmann and Ehrlich noted that methylene blue had a high affinity for some tissues and that this dye had a slight antimalarial property. Methylene blue and its congeners may act by preventing the biocrystallization of heme . In 1848, German anatomist Johann Heinrich Meckel recorded black-brown pigment granules in the blood and spleen of a patient who had died in a mental hospital. Meckel was thought to have been looking at malaria parasites without realizing it; he did not mention malaria in his report. He hypothesized that the pigment was melanin . The causal relationship of pigment to the parasite was established in 1880, when French physician Charles Louis Alphonse Laveran , working in the military hospital of Constantine, Algeria , observed pigmented parasites inside the red blood cells of people with malaria. He witnessed the events of exflagellation and became convinced that the moving flagella were parasitic microorganisms . He noted that quinine removed the parasites from the blood. Laveran called this microscopic organism Oscillaria malariae and proposed that malaria was caused by this protozoan . This discovery remained controversial until the development of the oil immersion lens in 1884 and of superior staining methods in 1890–1891. In 1885, Ettore Marchiafava , Angelo Celli and Camillo Golgi studied the reproduction cycles in human blood (Golgi cycles). Golgi observed that all parasites present in the blood divided almost simultaneously at regular intervals and that division coincided with attacks of fever. In 1886 Golgi described the morphological differences that are still used to distinguish two malaria parasite species Plasmodium vivax and Plasmodium malariae . Shortly after this Sakharov in 1889 and Marchiafava & Celli in 1890 independently identified Plasmodium falciparum as a species distinct from P. vivax and P. malariae . In 1890, Grassi and Feletti reviewed the available information and named both P. malariae and P. vivax (although within the genus Haemamoeba .) By 1890, Laveran's germ was generally accepted, but most of his initial ideas had been discarded in favor of the taxonomic work and clinical pathology of the Italian school. Marchiafava and Celli called the new microorganism Plasmodium . H. vivax was soon renamed Plasmodium vivax . In 1892, Marchiafava and Bignami proved that the multiple forms seen by Laveran were from a single species. This species was eventually named P. falciparum . Laveran was awarded the 1907 Nobel Prize for Physiology or Medicine "in recognition of his work on the role played by protozoa in causing diseases". Dutch physician Pieter Pel first proposed a tissue stage of the malaria parasite in 1886, presaging its discovery by over 50 years. This suggestion was reiterated in 1893 when Golgi suggested that the parasites might have an undiscovered tissue phase (this time in endothelial cells). Golgi's latent phase theory was supported by Pel in 1896. The establishment of the scientific method from about the mid-19th century on demanded testable hypotheses and verifiable phenomena for causation and transmission. Anecdotal reports [Note 2] , and the discovery in 1881 that mosquitoes were the vector of yellow fever, eventually led to the investigation of mosquitoes in connection with malaria. An early effort at malaria prevention occurred in 1896 in Massachusetts. An Uxbridge outbreak prompted health officer Dr. Leonard White to write a report to the State Board of Health, which led to a study of mosquito-malaria links and the first efforts for malaria prevention. Massachusetts state pathologist, Theobald Smith, asked that White's son collect mosquito specimens for further analysis, and that citizens add screens to windows, and drain collections of water. Britain's Sir Ronald Ross , an army surgeon working in Secunderabad , India , proved in 1897 that malaria is transmitted by mosquitoes , an event now commemorated by World Mosquito Day . He was able to find pigmented malaria parasites in a mosquito that he artificially fed on a malaria patient who had crescents in his blood. He continued his research into malaria by showing that certain mosquito species ( Culex fatigans ) transmit malaria to sparrows and he isolated malaria parasites from the salivary glands of mosquitoes that had fed on infected birds. He reported this to the British Medical Association in Edinburgh in 1898. Giovanni Battista Grassi , professor of Comparative Anatomy at Rome University, showed that human malaria could only be transmitted by Anopheles (Greek anofelís : good-for-nothing) mosquitoes. Grassi, along with coworkers Amico Bignami , Giuseppe Bastianelli and Ettore Marchiafava, announced at the session of the Accademia dei Lincei on 4 December 1898 that a healthy man in a non-malarial zone had contracted tertian malaria after being bitten by an experimentally infected Anopheles claviger specimen. In 1898–1899, Bastianelli, Bignami and Grassi were the first to observe the complete transmission cycle of P. falciparum , P. vivax and P. malaria from mosquito to human and back in A. claviger . A dispute broke out between the British and Italian schools of malariology over priority, but Ross received the 1902 Nobel Prize for Physiology or Medicine for "his work on malaria, by which he has shown how it enters the organism and thereby has laid the foundation for successful research on this disease and methods of combating it." William Henry Perkin , a student of August Wilhelm von Hofmann at the Royal College of Chemistry in London, unsuccessfully tried in the 1850s to synthesize quinine in a commercial process. The idea was to take two equivalents of N-allyltoluidine ( C 10 H 13 N ) and three atoms of oxygen to produce quinine ( C 20 H 24 N 2 O 2 ) and water. Instead, Perkin's mauve was produced when attempting quinine total synthesis via the oxidation of N-allyltoluidine. Before Perkin's discovery, all dyes and pigments were derived from roots, leaves, insects, or, in the case of Tyrian purple , molluscs . Quinine wouldn't be successfully synthesized until 1918. Synthesis remains elaborate, expensive and low yield, with the additional problem of separation of the stereoisomers . Though quinine is not one of the major drugs used in treatment, modern production still relies on extraction from the cinchona tree.Relapses were first noted in 1897 by William S. Thayer, who recounted the experiences of a physician who relapsed 21 months after leaving an endemic area. He proposed the existence of a tissue stage. Relapses were confirmed by Patrick Manson, who allowed infected Anopheles mosquitoes to feed on his eldest son. The younger Manson then described a relapse nine months after his apparent cure with quinine. Also, in 1900 Amico Bignami and Giuseppe Bastianelli found that they could not infect an individual with blood containing only gametocytes . The possibility of the existence of a chronic blood stage infection was proposed by Ronald Ross and David Thompson in 1910. The existence of asexually-reproducing avian malaria parasites in cells of the internal organs was first demonstrated by Henrique de Beaurepaire Aragão in 1908. Three possible mechanisms of relapse were proposed by Marchoux in 1926 ( i ) parthenogenesis of macro gametocytes : ( ii ) persistence of schizonts in small numbers in the blood where immunity inhibits multiplication, but later disappears and/or ( iii ) reactivation of an encysted body in the blood. James in 1931 proposed that sporozoites are carried to internal organs, where they enter reticuloendothelial cells and undergo a cycle of development, based on quinine's lack of activity on them. Huff and Bloom in 1935 demonstrated stages of avian malaria that transpire outside blood cells (exoerythrocytic). In 1945 Fairley et al. reported that inoculation of blood from a patient with P. vivax may fail to induce malaria, although the donor may subsequently exhibit the condition. Sporozoites disappeared from the blood stream within one hour and reappeared eight days later. This suggests the presence of forms that persist in tissues. Using mosquitoes rather than blood, in 1946 Shute described a similar phenomenon and proposed the existence of an 'x-body' or resting form. The following year Sapero proposed a link between relapse and a tissue stage not yet discovered. Garnham in 1947 described exoerythrocytic schizogony in Hepatocystis (Plasmodium) kochi . In the following year, British biologists Henry Edward Shortt and Cyril Garnham described the liver stages of P. cynomolgi in monkeys. In the same year, a human volunteer consented to receive a massive dose of infected sporozoites of P. vivax and undergo a liver biopsy three months later, thus allowing Shortt et al. to demonstrate the tissue stage. The tissue form of Plasmodium ovale was described in 1954 and that of P. malariae in 1960 in experimentally infected chimpanzees. The latent or dormant liver form of the parasite ( hypnozoite ), apparently responsible for the relapses characteristic of P. vivax and P. ovale infections, was first observed in the 1980s. The term hypnozoite was coined by Miles B. Markus while a student. In 1976, he speculated: "If sporozoites of Isospora can behave in this fashion, then those of related Sporozoa, like malaria parasites, may have the ability to survive in the tissues in a similar way." In 1982, Krotoski et al reported identification of P. vivax hypnozoites in liver cells of infected chimpanzees. From 1980 onwards and until recently (even in 2022), recurrences of P. vivax malaria have been thought to be mostly hypnozoite-mediated. Between 2018 and 2021, however, it was reported that vast numbers of non-circulating, non-hypnozoite parasites occur unobtrusively in tissues of P. vivax -infected people, with only a small proportion of the total parasite biomass present in the peripheral bloodstream. This finding supports an intellectually insightful paradigm-shifting viewpoint, which has prevailed since 2011 (albeit not believed between 2011 and 2018 or later by most malariologists), that an unknown percentage of P. vivax recurrences are recrudescences (having a non-circulating or sequestered merozoite origin), and not relapses (which have a hypnozoite source). The recent discoveries did not give rise to this new theory, which was pre-existing. They merely confirmed the validity thereof. In the early twentieth century, before antibiotics , patients with tertiary syphilis were intentionally infected with malaria to induce a fever; this was called malariotherapy. In 1917, Julius Wagner-Jauregg , a Viennese psychiatrist , began to treat neurosyphilitics with induced Plasmodium vivax malaria. Three or four bouts of fever were enough to kill the temperature-sensitive syphilis bacteria ( Spirochaeta pallida also known as Treponema pallidum ). P. vivax infections were then terminated by quinine. By accurately controlling the fever with quinine, the effects of both syphilis and malaria could be minimized. While about 15% of patients died from malaria, this was preferable to the almost-certain death from syphilis. Therapeutic malaria opened up a wide field of chemotherapeutic research and was practiced until 1950. Wagner-Jauregg was awarded the 1927 Nobel Prize in Physiology or Medicine for his discovery of the therapeutic value of malaria inoculation in the treatment of dementia paralytica . Henry Heimlich advocated malariotherapy as a treatment for AIDS , and some studies of malariotherapy for HIV infection have been performed in China. The United States Centers for Disease Control and Prevention does not recommend the use of malariotherapy for HIV. In 1881, Dr. Carlos Finlay , a Cuban-born physician of Scottish ancestry, theorized that yellow fever was transmitted by a specific mosquito, later designated Aedes aegypti . The theory remained controversial for twenty years until it was confirmed in 1901 by Walter Reed . This was the first scientific proof of a disease being transmitted exclusively by an insect vector, and demonstrated that control of such diseases necessarily entailed control or eradication of their insect vector. Yellow fever and malaria among workers had seriously delayed construction of the Panama Canal . Mosquito control instituted by William C. Gorgas dramatically reduced this problem. Johann "Hans" Andersag and colleagues synthesized and tested some 12,000 compounds, eventually producing Resochin as a substitute for quinine in the 1930s. It is chemically related to quinine through the possession of a quinoline nucleus and the dialkylaminoalkylamino side chain. Resochin (7-chloro-4- 4- (diethylamino) – 1 – methylbutyl amino quinoline) and a similar compound Sontochin (3-methyl Resochin) were synthesized in 1934. In March 1946, the drug was officially named Chloroquine . Chloroquine is an inhibitor of hemozoin production through biocrystallization . Quinine and chloroquine affect malarial parasites only at life stages when the parasites are forming hematin-pigment (hemozoin) as a byproduct of hemoglobin degradation. Chloroquine-resistant forms of P. falciparum emerged only 19 years later. The first resistant strains were detected around the Cambodia ‐ Thailand border and in Colombia , in the 1950s. In 1989, chloroquine resistance in P. vivax was reported in Papua New Guinea. These resistant strains spread rapidly, producing a large mortality increase, particularly in Africa during the 1990s. Systematic screening of traditional Chinese medical herbs was carried out by Chinese research teams, consisting of hundreds of scientists in the 1960s and 1970s. Qinghaosu, later named artemisinin , was cold-extracted in a neutral milieu (pH 7.0) from the dried leaves of Artemisia annua . Artemisinin was isolated by pharmacologist Tu Youyou ( Nobel Prize in Physiology or Medicine , 2015). Tu headed a team tasked by the Chinese government with finding a treatment for chloroquine-resistant malaria. Their work was known as Project 523 , named after the date it was announced – 23 May 1967. The team investigated more than 2000 Chinese herb preparations and by 1971 had made 380 extracts from 200 herbs. An extract from qinghao ( Artemisia annua ) was effective, but the results were variable. Tu reviewed the literature, including Zhou hou bei ji fang (A handbook of prescriptions for emergencies) written in 340 BC by Chinese physician Ge Hong. This book contained the only useful reference to the herb: "A handful of qinghao immersed in two litres of water, wring out the juice and drink it all." Tu's team subsequently isolated a nontoxic, neutral extract that was 100% effective against parasitemia in animals. The first successful trials of artemisinin were in 1979. Artemisinin is a sesquiterpene lactone containing a peroxide group, which is believed to be essential for its anti-malarial activity. Its derivatives, artesunate and artemether , have been used in clinics since 1987 for the treatment of drug-resistant and drug-sensitive malaria, especially cerebral malaria. These drugs are characterized by fast action, high efficacy, and good tolerance. They kill the asexual forms of P. berghei and P. cynomolgi and have transmission-blocking activity. In 1985, Zhou Yiqing and his team combined artemether and lumefantrine into a single tablet, which was registered as a medicine in China in 1992. Later, it became known as "Coartem" . Artemisinin combination treatments (ACTs) are now widely used to treat uncomplicated falciparum malaria, but access to ACTs is still limited in most malaria-endemic countries, and only a minority of the patients who need artemisinin-based combination treatments receive them. In 2008, White predicted that improved agricultural practices, selection of high-yielding hybrids, microbial production, and the development of synthetic peroxides would lower prices. Efforts to control the spread of malaria had a major setback in 1930: entomologist Raymond Corbett Shannon discovered imported disease-bearing Anopheles gambiae mosquitoes living in Brazil (DNA analysis later revealed the actual species to be A. arabiensis ). This species of mosquito is a particularly efficient vector for malaria and is native to Africa. In 1938, the introduction of this vector caused the greatest epidemic of malaria ever seen in the New World . However, complete eradication of A. gambiae from northeast Brazil and thus from the New World was achieved in 1940 by the systematic application of the arsenic -containing compound Paris green to breeding places, and of pyrethrum spray-killing to adult resting places. The Austrian chemist Othmar Zeidler is credited with the first synthesis of DDT ( D ichloro D iphenyl T richloroethane) in 1874. The insecticidal properties of DDT were identified in 1939 by chemist Paul Hermann Müller of Geigy Pharmaceutical . For his discovery of DDT as a contact poison against several arthropods , he was awarded the 1948 Nobel Prize in Physiology or Medicine. In the fall of 1942, samples of the chemical were acquired by the United States, Britain and Germany. Laboratory tests demonstrated that it was highly effective against many insects. Rockefeller Foundation studies showed in Mexico that DDT remained effective for six to eight weeks if sprayed on the inside walls and ceilings of houses and other buildings. The first field test in which residual DDT was applied to the interior surfaces of all habitations and outbuildings was carried out in central Italy in the spring of 1944. The objective was to determine the residual effect of the spray on anopheline density in the absence of other control measures. Spraying began in Castel Volturno and, after a few months, in the delta of the Tiber . The unprecedented effectiveness of the chemical was confirmed: the new insecticide was able to eradicate malaria by eradicating mosquitoes. At the end of World War II, a massive malaria control program based on DDT spraying was carried out in Italy. In Sardinia – the second largest island in the Mediterranean – between 1946 and 1951, the Rockefeller Foundation conducted a large-scale experiment to test the feasibility of the strategy of "species eradication" in an endemic malaria vector. Malaria was effectively eliminated in the United States by the use of DDT in the National Malaria Eradication Program (1947–52). The concept of eradication prevailed in 1955 in the Eighth World Health Assembly : DDT was adopted as a primary tool in the fight against malaria. In 1953, the World Health Organization (WHO) launched an antimalarial program in parts of Liberia as a pilot project to determine the feasibility of malaria eradication in tropical Africa. However, these projects encountered difficulties that foreshadowed the general retreat from malaria eradication efforts across tropical Africa by the mid-1960s. DDT was banned for agricultural uses in the US in 1972 (DDT has never been banned for non-agricultural uses such as malaria control ) after the discussion opened in 1962 by Silent Spring , written by American biologist Rachel Carson , which launched the environmental movement in the West. The book catalogued the environmental impacts of indiscriminate DDT spraying and suggested that DDT and other pesticides cause cancer and that their agricultural use was a threat to wildlife . The U.S. Agency for International Development supports indoor DDT spraying as a vital component of malaria control programs and has initiated DDT and other insecticide spraying programs in tropical countries. Other insecticides are available for mosquito control, as well as physical measures, such as draining the wetland breeding grounds and the provision of better sanitation . Pyrethrum (from the flowering plant Chrysanthemum [or Tanacetum ] cinerariaefolium ) is an economically important source of natural insecticide. Pyrethrins attack the nervous systems of all insects. A few minutes after application, the insect cannot move or fly, while female mosquitoes are inhibited from biting. The use of pyrethrum in insecticide preparations dates to about 400 BCE . Pyrethrins are biodegradable and break down easily on exposure to light. The majority of the world's supply of pyrethrin and Chrysanthemum cinerariaefolium comes from Kenya . The flower was first introduced into Kenya and the highlands of Eastern Africa during the late 1920s. The flowers of the plant are harvested shortly after blooming; they are either dried and powdered, or the oils within the flowers are extracted with solvents . Until the 1950s, screening of anti-malarial drugs was carried out on avian malaria. Avian malaria species differ from those that infect humans. The discovery in 1948 of Plasmodium berghei in wild rodents in the Congo and later other rodent species that could infect laboratory rats transformed drug development. The short hepatic phase and life cycle of these parasites made them useful as animal models, a status they still retain. Plasmodium cynomolgi in rhesus monkeys ( Macaca mulatta ) was used in the 1960s to test drugs active against P. vivax . Growth of the liver stages in animal-free systems was achieved in the 1980s when pre-erythrocytic P. berghei stages were grown in wI38, a human embryonic lung cell line (cells cultured from one specimen). This was followed by their growth in the human hepatoma line HepG2. Both P. falciparum and P. vivax have been grown in human liver cells; partial development of P. ovale in human liver cells was achieved; and P. malariae was grown in chimpanzee and monkey liver cells. The first successful continuous malaria culture was established in 1976 by William Trager and James B. Jensen, which facilitated research into the molecular biology of the parasite and the development of new drugs. By using increasing volumes of culture medium, P.falciparum was grown to higher parasitemia levels (above 10%). The use of antigen-based malaria rapid diagnostic tests (RDTs) emerged in the 1980s. In the twenty-first century, Giemsa microscopy and RDTs became the two preferred diagnostic techniques. Malaria RDTs do not require special equipment and offer the potential to extend accurate malaria diagnosis to areas lacking microscopy services. Plasmodium knowlesi has been known since the 1930s in Asian macaque monkeys and as experimentally capable of infecting humans. In 1965, a natural human infection was reported in a U.S. soldier returning from the Pahang Jungle of the Malaysian peninsula. Relapses were first noted in 1897 by William S. Thayer, who recounted the experiences of a physician who relapsed 21 months after leaving an endemic area. He proposed the existence of a tissue stage. Relapses were confirmed by Patrick Manson, who allowed infected Anopheles mosquitoes to feed on his eldest son. The younger Manson then described a relapse nine months after his apparent cure with quinine. Also, in 1900 Amico Bignami and Giuseppe Bastianelli found that they could not infect an individual with blood containing only gametocytes . The possibility of the existence of a chronic blood stage infection was proposed by Ronald Ross and David Thompson in 1910. The existence of asexually-reproducing avian malaria parasites in cells of the internal organs was first demonstrated by Henrique de Beaurepaire Aragão in 1908. Three possible mechanisms of relapse were proposed by Marchoux in 1926 ( i ) parthenogenesis of macro gametocytes : ( ii ) persistence of schizonts in small numbers in the blood where immunity inhibits multiplication, but later disappears and/or ( iii ) reactivation of an encysted body in the blood. James in 1931 proposed that sporozoites are carried to internal organs, where they enter reticuloendothelial cells and undergo a cycle of development, based on quinine's lack of activity on them. Huff and Bloom in 1935 demonstrated stages of avian malaria that transpire outside blood cells (exoerythrocytic). In 1945 Fairley et al. reported that inoculation of blood from a patient with P. vivax may fail to induce malaria, although the donor may subsequently exhibit the condition. Sporozoites disappeared from the blood stream within one hour and reappeared eight days later. This suggests the presence of forms that persist in tissues. Using mosquitoes rather than blood, in 1946 Shute described a similar phenomenon and proposed the existence of an 'x-body' or resting form. The following year Sapero proposed a link between relapse and a tissue stage not yet discovered. Garnham in 1947 described exoerythrocytic schizogony in Hepatocystis (Plasmodium) kochi . In the following year, British biologists Henry Edward Shortt and Cyril Garnham described the liver stages of P. cynomolgi in monkeys. In the same year, a human volunteer consented to receive a massive dose of infected sporozoites of P. vivax and undergo a liver biopsy three months later, thus allowing Shortt et al. to demonstrate the tissue stage. The tissue form of Plasmodium ovale was described in 1954 and that of P. malariae in 1960 in experimentally infected chimpanzees. The latent or dormant liver form of the parasite ( hypnozoite ), apparently responsible for the relapses characteristic of P. vivax and P. ovale infections, was first observed in the 1980s. The term hypnozoite was coined by Miles B. Markus while a student. In 1976, he speculated: "If sporozoites of Isospora can behave in this fashion, then those of related Sporozoa, like malaria parasites, may have the ability to survive in the tissues in a similar way." In 1982, Krotoski et al reported identification of P. vivax hypnozoites in liver cells of infected chimpanzees. From 1980 onwards and until recently (even in 2022), recurrences of P. vivax malaria have been thought to be mostly hypnozoite-mediated. Between 2018 and 2021, however, it was reported that vast numbers of non-circulating, non-hypnozoite parasites occur unobtrusively in tissues of P. vivax -infected people, with only a small proportion of the total parasite biomass present in the peripheral bloodstream. This finding supports an intellectually insightful paradigm-shifting viewpoint, which has prevailed since 2011 (albeit not believed between 2011 and 2018 or later by most malariologists), that an unknown percentage of P. vivax recurrences are recrudescences (having a non-circulating or sequestered merozoite origin), and not relapses (which have a hypnozoite source). The recent discoveries did not give rise to this new theory, which was pre-existing. They merely confirmed the validity thereof. In the early twentieth century, before antibiotics , patients with tertiary syphilis were intentionally infected with malaria to induce a fever; this was called malariotherapy. In 1917, Julius Wagner-Jauregg , a Viennese psychiatrist , began to treat neurosyphilitics with induced Plasmodium vivax malaria. Three or four bouts of fever were enough to kill the temperature-sensitive syphilis bacteria ( Spirochaeta pallida also known as Treponema pallidum ). P. vivax infections were then terminated by quinine. By accurately controlling the fever with quinine, the effects of both syphilis and malaria could be minimized. While about 15% of patients died from malaria, this was preferable to the almost-certain death from syphilis. Therapeutic malaria opened up a wide field of chemotherapeutic research and was practiced until 1950. Wagner-Jauregg was awarded the 1927 Nobel Prize in Physiology or Medicine for his discovery of the therapeutic value of malaria inoculation in the treatment of dementia paralytica . Henry Heimlich advocated malariotherapy as a treatment for AIDS , and some studies of malariotherapy for HIV infection have been performed in China. The United States Centers for Disease Control and Prevention does not recommend the use of malariotherapy for HIV. In 1881, Dr. Carlos Finlay , a Cuban-born physician of Scottish ancestry, theorized that yellow fever was transmitted by a specific mosquito, later designated Aedes aegypti . The theory remained controversial for twenty years until it was confirmed in 1901 by Walter Reed . This was the first scientific proof of a disease being transmitted exclusively by an insect vector, and demonstrated that control of such diseases necessarily entailed control or eradication of their insect vector. Yellow fever and malaria among workers had seriously delayed construction of the Panama Canal . Mosquito control instituted by William C. Gorgas dramatically reduced this problem. Johann "Hans" Andersag and colleagues synthesized and tested some 12,000 compounds, eventually producing Resochin as a substitute for quinine in the 1930s. It is chemically related to quinine through the possession of a quinoline nucleus and the dialkylaminoalkylamino side chain. Resochin (7-chloro-4- 4- (diethylamino) – 1 – methylbutyl amino quinoline) and a similar compound Sontochin (3-methyl Resochin) were synthesized in 1934. In March 1946, the drug was officially named Chloroquine . Chloroquine is an inhibitor of hemozoin production through biocrystallization . Quinine and chloroquine affect malarial parasites only at life stages when the parasites are forming hematin-pigment (hemozoin) as a byproduct of hemoglobin degradation. Chloroquine-resistant forms of P. falciparum emerged only 19 years later. The first resistant strains were detected around the Cambodia ‐ Thailand border and in Colombia , in the 1950s. In 1989, chloroquine resistance in P. vivax was reported in Papua New Guinea. These resistant strains spread rapidly, producing a large mortality increase, particularly in Africa during the 1990s. Systematic screening of traditional Chinese medical herbs was carried out by Chinese research teams, consisting of hundreds of scientists in the 1960s and 1970s. Qinghaosu, later named artemisinin , was cold-extracted in a neutral milieu (pH 7.0) from the dried leaves of Artemisia annua . Artemisinin was isolated by pharmacologist Tu Youyou ( Nobel Prize in Physiology or Medicine , 2015). Tu headed a team tasked by the Chinese government with finding a treatment for chloroquine-resistant malaria. Their work was known as Project 523 , named after the date it was announced – 23 May 1967. The team investigated more than 2000 Chinese herb preparations and by 1971 had made 380 extracts from 200 herbs. An extract from qinghao ( Artemisia annua ) was effective, but the results were variable. Tu reviewed the literature, including Zhou hou bei ji fang (A handbook of prescriptions for emergencies) written in 340 BC by Chinese physician Ge Hong. This book contained the only useful reference to the herb: "A handful of qinghao immersed in two litres of water, wring out the juice and drink it all." Tu's team subsequently isolated a nontoxic, neutral extract that was 100% effective against parasitemia in animals. The first successful trials of artemisinin were in 1979. Artemisinin is a sesquiterpene lactone containing a peroxide group, which is believed to be essential for its anti-malarial activity. Its derivatives, artesunate and artemether , have been used in clinics since 1987 for the treatment of drug-resistant and drug-sensitive malaria, especially cerebral malaria. These drugs are characterized by fast action, high efficacy, and good tolerance. They kill the asexual forms of P. berghei and P. cynomolgi and have transmission-blocking activity. In 1985, Zhou Yiqing and his team combined artemether and lumefantrine into a single tablet, which was registered as a medicine in China in 1992. Later, it became known as "Coartem" . Artemisinin combination treatments (ACTs) are now widely used to treat uncomplicated falciparum malaria, but access to ACTs is still limited in most malaria-endemic countries, and only a minority of the patients who need artemisinin-based combination treatments receive them. In 2008, White predicted that improved agricultural practices, selection of high-yielding hybrids, microbial production, and the development of synthetic peroxides would lower prices. Johann "Hans" Andersag and colleagues synthesized and tested some 12,000 compounds, eventually producing Resochin as a substitute for quinine in the 1930s. It is chemically related to quinine through the possession of a quinoline nucleus and the dialkylaminoalkylamino side chain. Resochin (7-chloro-4- 4- (diethylamino) – 1 – methylbutyl amino quinoline) and a similar compound Sontochin (3-methyl Resochin) were synthesized in 1934. In March 1946, the drug was officially named Chloroquine . Chloroquine is an inhibitor of hemozoin production through biocrystallization . Quinine and chloroquine affect malarial parasites only at life stages when the parasites are forming hematin-pigment (hemozoin) as a byproduct of hemoglobin degradation. Chloroquine-resistant forms of P. falciparum emerged only 19 years later. The first resistant strains were detected around the Cambodia ‐ Thailand border and in Colombia , in the 1950s. In 1989, chloroquine resistance in P. vivax was reported in Papua New Guinea. These resistant strains spread rapidly, producing a large mortality increase, particularly in Africa during the 1990s. Systematic screening of traditional Chinese medical herbs was carried out by Chinese research teams, consisting of hundreds of scientists in the 1960s and 1970s. Qinghaosu, later named artemisinin , was cold-extracted in a neutral milieu (pH 7.0) from the dried leaves of Artemisia annua . Artemisinin was isolated by pharmacologist Tu Youyou ( Nobel Prize in Physiology or Medicine , 2015). Tu headed a team tasked by the Chinese government with finding a treatment for chloroquine-resistant malaria. Their work was known as Project 523 , named after the date it was announced – 23 May 1967. The team investigated more than 2000 Chinese herb preparations and by 1971 had made 380 extracts from 200 herbs. An extract from qinghao ( Artemisia annua ) was effective, but the results were variable. Tu reviewed the literature, including Zhou hou bei ji fang (A handbook of prescriptions for emergencies) written in 340 BC by Chinese physician Ge Hong. This book contained the only useful reference to the herb: "A handful of qinghao immersed in two litres of water, wring out the juice and drink it all." Tu's team subsequently isolated a nontoxic, neutral extract that was 100% effective against parasitemia in animals. The first successful trials of artemisinin were in 1979. Artemisinin is a sesquiterpene lactone containing a peroxide group, which is believed to be essential for its anti-malarial activity. Its derivatives, artesunate and artemether , have been used in clinics since 1987 for the treatment of drug-resistant and drug-sensitive malaria, especially cerebral malaria. These drugs are characterized by fast action, high efficacy, and good tolerance. They kill the asexual forms of P. berghei and P. cynomolgi and have transmission-blocking activity. In 1985, Zhou Yiqing and his team combined artemether and lumefantrine into a single tablet, which was registered as a medicine in China in 1992. Later, it became known as "Coartem" . Artemisinin combination treatments (ACTs) are now widely used to treat uncomplicated falciparum malaria, but access to ACTs is still limited in most malaria-endemic countries, and only a minority of the patients who need artemisinin-based combination treatments receive them. In 2008, White predicted that improved agricultural practices, selection of high-yielding hybrids, microbial production, and the development of synthetic peroxides would lower prices. Efforts to control the spread of malaria had a major setback in 1930: entomologist Raymond Corbett Shannon discovered imported disease-bearing Anopheles gambiae mosquitoes living in Brazil (DNA analysis later revealed the actual species to be A. arabiensis ). This species of mosquito is a particularly efficient vector for malaria and is native to Africa. In 1938, the introduction of this vector caused the greatest epidemic of malaria ever seen in the New World . However, complete eradication of A. gambiae from northeast Brazil and thus from the New World was achieved in 1940 by the systematic application of the arsenic -containing compound Paris green to breeding places, and of pyrethrum spray-killing to adult resting places. The Austrian chemist Othmar Zeidler is credited with the first synthesis of DDT ( D ichloro D iphenyl T richloroethane) in 1874. The insecticidal properties of DDT were identified in 1939 by chemist Paul Hermann Müller of Geigy Pharmaceutical . For his discovery of DDT as a contact poison against several arthropods , he was awarded the 1948 Nobel Prize in Physiology or Medicine. In the fall of 1942, samples of the chemical were acquired by the United States, Britain and Germany. Laboratory tests demonstrated that it was highly effective against many insects. Rockefeller Foundation studies showed in Mexico that DDT remained effective for six to eight weeks if sprayed on the inside walls and ceilings of houses and other buildings. The first field test in which residual DDT was applied to the interior surfaces of all habitations and outbuildings was carried out in central Italy in the spring of 1944. The objective was to determine the residual effect of the spray on anopheline density in the absence of other control measures. Spraying began in Castel Volturno and, after a few months, in the delta of the Tiber . The unprecedented effectiveness of the chemical was confirmed: the new insecticide was able to eradicate malaria by eradicating mosquitoes. At the end of World War II, a massive malaria control program based on DDT spraying was carried out in Italy. In Sardinia – the second largest island in the Mediterranean – between 1946 and 1951, the Rockefeller Foundation conducted a large-scale experiment to test the feasibility of the strategy of "species eradication" in an endemic malaria vector. Malaria was effectively eliminated in the United States by the use of DDT in the National Malaria Eradication Program (1947–52). The concept of eradication prevailed in 1955 in the Eighth World Health Assembly : DDT was adopted as a primary tool in the fight against malaria. In 1953, the World Health Organization (WHO) launched an antimalarial program in parts of Liberia as a pilot project to determine the feasibility of malaria eradication in tropical Africa. However, these projects encountered difficulties that foreshadowed the general retreat from malaria eradication efforts across tropical Africa by the mid-1960s. DDT was banned for agricultural uses in the US in 1972 (DDT has never been banned for non-agricultural uses such as malaria control ) after the discussion opened in 1962 by Silent Spring , written by American biologist Rachel Carson , which launched the environmental movement in the West. The book catalogued the environmental impacts of indiscriminate DDT spraying and suggested that DDT and other pesticides cause cancer and that their agricultural use was a threat to wildlife . The U.S. Agency for International Development supports indoor DDT spraying as a vital component of malaria control programs and has initiated DDT and other insecticide spraying programs in tropical countries. Other insecticides are available for mosquito control, as well as physical measures, such as draining the wetland breeding grounds and the provision of better sanitation . Pyrethrum (from the flowering plant Chrysanthemum [or Tanacetum ] cinerariaefolium ) is an economically important source of natural insecticide. Pyrethrins attack the nervous systems of all insects. A few minutes after application, the insect cannot move or fly, while female mosquitoes are inhibited from biting. The use of pyrethrum in insecticide preparations dates to about 400 BCE . Pyrethrins are biodegradable and break down easily on exposure to light. The majority of the world's supply of pyrethrin and Chrysanthemum cinerariaefolium comes from Kenya . The flower was first introduced into Kenya and the highlands of Eastern Africa during the late 1920s. The flowers of the plant are harvested shortly after blooming; they are either dried and powdered, or the oils within the flowers are extracted with solvents .The Austrian chemist Othmar Zeidler is credited with the first synthesis of DDT ( D ichloro D iphenyl T richloroethane) in 1874. The insecticidal properties of DDT were identified in 1939 by chemist Paul Hermann Müller of Geigy Pharmaceutical . For his discovery of DDT as a contact poison against several arthropods , he was awarded the 1948 Nobel Prize in Physiology or Medicine. In the fall of 1942, samples of the chemical were acquired by the United States, Britain and Germany. Laboratory tests demonstrated that it was highly effective against many insects. Rockefeller Foundation studies showed in Mexico that DDT remained effective for six to eight weeks if sprayed on the inside walls and ceilings of houses and other buildings. The first field test in which residual DDT was applied to the interior surfaces of all habitations and outbuildings was carried out in central Italy in the spring of 1944. The objective was to determine the residual effect of the spray on anopheline density in the absence of other control measures. Spraying began in Castel Volturno and, after a few months, in the delta of the Tiber . The unprecedented effectiveness of the chemical was confirmed: the new insecticide was able to eradicate malaria by eradicating mosquitoes. At the end of World War II, a massive malaria control program based on DDT spraying was carried out in Italy. In Sardinia – the second largest island in the Mediterranean – between 1946 and 1951, the Rockefeller Foundation conducted a large-scale experiment to test the feasibility of the strategy of "species eradication" in an endemic malaria vector. Malaria was effectively eliminated in the United States by the use of DDT in the National Malaria Eradication Program (1947–52). The concept of eradication prevailed in 1955 in the Eighth World Health Assembly : DDT was adopted as a primary tool in the fight against malaria. In 1953, the World Health Organization (WHO) launched an antimalarial program in parts of Liberia as a pilot project to determine the feasibility of malaria eradication in tropical Africa. However, these projects encountered difficulties that foreshadowed the general retreat from malaria eradication efforts across tropical Africa by the mid-1960s. DDT was banned for agricultural uses in the US in 1972 (DDT has never been banned for non-agricultural uses such as malaria control ) after the discussion opened in 1962 by Silent Spring , written by American biologist Rachel Carson , which launched the environmental movement in the West. The book catalogued the environmental impacts of indiscriminate DDT spraying and suggested that DDT and other pesticides cause cancer and that their agricultural use was a threat to wildlife . The U.S. Agency for International Development supports indoor DDT spraying as a vital component of malaria control programs and has initiated DDT and other insecticide spraying programs in tropical countries. Other insecticides are available for mosquito control, as well as physical measures, such as draining the wetland breeding grounds and the provision of better sanitation . Pyrethrum (from the flowering plant Chrysanthemum [or Tanacetum ] cinerariaefolium ) is an economically important source of natural insecticide. Pyrethrins attack the nervous systems of all insects. A few minutes after application, the insect cannot move or fly, while female mosquitoes are inhibited from biting. The use of pyrethrum in insecticide preparations dates to about 400 BCE . Pyrethrins are biodegradable and break down easily on exposure to light. The majority of the world's supply of pyrethrin and Chrysanthemum cinerariaefolium comes from Kenya . The flower was first introduced into Kenya and the highlands of Eastern Africa during the late 1920s. The flowers of the plant are harvested shortly after blooming; they are either dried and powdered, or the oils within the flowers are extracted with solvents .Until the 1950s, screening of anti-malarial drugs was carried out on avian malaria. Avian malaria species differ from those that infect humans. The discovery in 1948 of Plasmodium berghei in wild rodents in the Congo and later other rodent species that could infect laboratory rats transformed drug development. The short hepatic phase and life cycle of these parasites made them useful as animal models, a status they still retain. Plasmodium cynomolgi in rhesus monkeys ( Macaca mulatta ) was used in the 1960s to test drugs active against P. vivax . Growth of the liver stages in animal-free systems was achieved in the 1980s when pre-erythrocytic P. berghei stages were grown in wI38, a human embryonic lung cell line (cells cultured from one specimen). This was followed by their growth in the human hepatoma line HepG2. Both P. falciparum and P. vivax have been grown in human liver cells; partial development of P. ovale in human liver cells was achieved; and P. malariae was grown in chimpanzee and monkey liver cells. The first successful continuous malaria culture was established in 1976 by William Trager and James B. Jensen, which facilitated research into the molecular biology of the parasite and the development of new drugs. By using increasing volumes of culture medium, P.falciparum was grown to higher parasitemia levels (above 10%). The use of antigen-based malaria rapid diagnostic tests (RDTs) emerged in the 1980s. In the twenty-first century, Giemsa microscopy and RDTs became the two preferred diagnostic techniques. Malaria RDTs do not require special equipment and offer the potential to extend accurate malaria diagnosis to areas lacking microscopy services. Until the 1950s, screening of anti-malarial drugs was carried out on avian malaria. Avian malaria species differ from those that infect humans. The discovery in 1948 of Plasmodium berghei in wild rodents in the Congo and later other rodent species that could infect laboratory rats transformed drug development. The short hepatic phase and life cycle of these parasites made them useful as animal models, a status they still retain. Plasmodium cynomolgi in rhesus monkeys ( Macaca mulatta ) was used in the 1960s to test drugs active against P. vivax . Growth of the liver stages in animal-free systems was achieved in the 1980s when pre-erythrocytic P. berghei stages were grown in wI38, a human embryonic lung cell line (cells cultured from one specimen). This was followed by their growth in the human hepatoma line HepG2. Both P. falciparum and P. vivax have been grown in human liver cells; partial development of P. ovale in human liver cells was achieved; and P. malariae was grown in chimpanzee and monkey liver cells. The first successful continuous malaria culture was established in 1976 by William Trager and James B. Jensen, which facilitated research into the molecular biology of the parasite and the development of new drugs. By using increasing volumes of culture medium, P.falciparum was grown to higher parasitemia levels (above 10%). The use of antigen-based malaria rapid diagnostic tests (RDTs) emerged in the 1980s. In the twenty-first century, Giemsa microscopy and RDTs became the two preferred diagnostic techniques. Malaria RDTs do not require special equipment and offer the potential to extend accurate malaria diagnosis to areas lacking microscopy services. Plasmodium knowlesi has been known since the 1930s in Asian macaque monkeys and as experimentally capable of infecting humans. In 1965, a natural human infection was reported in a U.S. soldier returning from the Pahang Jungle of the Malaysian peninsula.

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Yellow fever

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National Doctors' Day

National Doctors' Day is a day celebrated to recognize the contributions of physicians to individual lives and communities . The date varies from nation to nation depending on the event of commemoration used to mark the day. In some nations the day is marked as a holiday . Although supposed to be celebrated by patients in and benefactors of the healthcare industry , it is usually celebrated by health care organizations . Staff may organize a lunch for doctors during which physicians are presented with tokens of recognition. Historically, a card or red carnation may be sent to physicians and their spouses, along with a flower being placed on the graves of deceased physicians .The first Doctors' Day observance was March 28, 1933, in Winder, Georgia , United States. This first observance included the mailing of cards to the physicians and their wives, flowers placed on graves of deceased doctors, including Dr. Long, and a formal dinner in the home of Dr. and Mrs. William T. Randolph. After the Barrow County Alliance adopted Mrs. Almond's resolution to pay tribute to the doctors, the plan was presented to the Georgia State Medical Alliance in 1933 by Mrs. E. R. Harris of Winder, president of the Barrow County Alliance. On May 10, 1934, the resolution was adopted at the annual state meeting in Augusta, Georgia. The resolution was introduced to the Women's Alliance of the Southern Medical Association at its 29th annual meeting held in St. Louis, Missouri, November 19–22, 1935, by the Alliance president, Mrs. J. Bonar White. Since then, Doctors' Day has become an integral part of and synonymous with, the Southern Medical Association Alliance. The United States Senate and House of Representatives passed S.J. RES. #366 during the 101st United States Congress , which President Bush signed on October 30, 1990 (creating Public Law 101-473), designating Doctors' Day as a national holiday to be celebrated on March 30. Dr. Marion Mass along with Dr. Kimberly Jackson and Dr. Christina Lang applied to officially have physicians day changed to physicians week. This was accepted in March 2017. In 2017 Physicians Working Together (PWT, founded by Dr. Kimberly Jackson) sponsored a series of articles in celebration of National Physicians week that were hosted on KevinMD. In 2018 PWT along with Openxmed sponsored a free online conference focusing on physician well being and advocacy. In 2019, PWT and Openxmed sponsored a scholarship program for medical students and residents. The week long event focuses on advocacy and supporting the physician community.

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Yellow fever

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Councilman body

In pathology , a Councilman body , also known as a Councilman hyaline body or apoptotic body , is an eosinophilic globule of apoptotic hepatocyte cell fragments. Ultimately, the fragments are taken up by macrophages or adjacent parenchymal cells. They are found in the liver of individuals suffering from acute viral hepatitis, yellow fever , and other viral syndromes. Councilman bodies were first identified in yellow fever, which characteristically shows a midzonal hepatic necrosis on biopsy. Similar inclusions are observed in other viral hemorrhagic fevers and all of the viral hepatitides. Liver biopsy of acute viral hepatitis shows panlobular lymphocytic infiltrates with ballooning hepatocytes.Councilman bodies are named after American pathologist William Thomas Councilman (1854–1933), who discovered them.

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Yellow fever

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Edward Nathaniel Bancroft

Edward Nathaniel Bancroft , M.D. (1772–1842) was an English physician, botanist, and zoologist, known for his writings on yellow fever .Bancroft was the son of Edward Bancroft . He was born in London and received his schooling under Charles Burney and Samuel Parr . He entered St. John's College, Cambridge , and graduated bachelor of medicine in 1794. In 1795 he was appointed a physician to the armed forces. He served in the Windward Islands , in Portugal, in the Mediterranean, and with Abercromby's expedition to Egypt in 1801. On his return to England he proceeded to the degree of M.D. in 1804, and began to practise as a physician in London, retaining half-pay rank in the army. He joined the College of Physicians in 1805, became a fellow in 1806, was appointed to give the Gulstonian lectures the same year, and was made a censor in 1808, at the comparatively early ago of thirty-six; he was a pamphleteer against the pretensions of army surgeons. In 1808 he was appointed a physician to St George's Hospital . In 1811 he gave up practice in London, owing to ill-health, and resumed his full-pay rank as physician to the forces, proceeding to Jamaica . He remained there for the rest of his life (thirty-one years), his ultimate rank being that of deputy inspector-general of army hospitals. He died at Kingston on 18 September 1842, in his seventy-first year; a mural tablet to his memory was placed in the cathedral church of Kingston 'by the physicians and surgeons of Jamaica'. Like many naval physicians of his time, Dr Bancroft was a naturalist . The genus name Manta was first published in his paper On the fish known in Jamaica as the sea-devil , 1829. Bancroft's earliest writings were two polemical pamphlets—"A Letter to the Commissioners of Military Enquiry, containing Animadversions on the Fifth Report", London, 1808, and "Exposure of Misrepresentations by Dr. McGrigor and Dr. Jackson to the Commissioners of Military Enquiry", London, 1808—on proposed changes in the army medical department in which he contended for the then existing artificial distinctions between physician to the forces and regimental surgeon, and for the precedence of the former. His opponents in the controversy were two army medical officers, James McGrigor and Robert Jackson . McGrigor charged Bancroft with want of accuracy, want of candour, and partiality. Jackson accused him of being "presumptuous in his professional rank, which he conceives to be superior to actual knowledge." Bancroft's best title to be remembered in medicine is his "Essay on the Disease called Yellow Fever, with Observations concerning Febrile Contagion, Typhus Fever, Dysentery, and the Plague, partly delivered as the Gulstonian Lectures before the College of Phvsicians in the years 1806 and 1807", London, 1811, with a "Sequel" to the same, London, 1817. "Never," says Charles Murchison ( Continued Fevers of Great Britain , 1st ed. 1862, p. 111), "has any work effected a greater revolution in professional opinion in this country." The spontaneous, autochthonous, or de novo origin of the contagia of pestilential diseases was then the generally accepted one, though the doctrine of the reproduction of a pathogen existing ab æterno had been stated, among others, by Alard Mauritius Eggerdes , a Prussian physician, for bubonic plague in 1720. Bancroft's skill in dialectic made the ab æterno doctrine popular. He argued, "There is no chance, nor even possibility, of thus generating anything so wonderful and so immutable as contagion, which, resembling animals and vegetables in the faculty of propagating itself, must, like them, have been the original work of our common Creator. ... As well might we revive the for-ever exploded doctrine of equivocal generation" ( Essay , p. 109). Bancroft explained away facts vouched for by observers such as John Pringle , Donald Monro , and Gilbert Blane . Yellow fever, he also argued, should be identified as a malarial fever . Murchison stated that "the doctrine of Bancroft was generally adopted, without investigation of the facts upon which it was founded."

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Yellow fever

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Travel visa

A visa ( from Latin charta visa 'paper that has been seen' ) is a conditional authorization granted by a polity to a foreigner that allows them to enter, remain within, or leave its territory. Visas typically include limits on the duration of the foreigner's stay, areas within the country they may enter, the dates they may enter, the number of permitted visits, or if the individual can work in the country in question. Visas are associated with the request for permission to enter a territory and thus are, in most countries, distinct from actual formal permission for an alien to enter and remain in the country. In each instance, a visa is subject to entry permission by an immigration official at the time of actual entry and can be revoked at any time. Visa evidence most commonly takes the form of a sticker endorsed in the applicant's passport or other travel document but may also exist electronically. Some countries no longer issue physical visa evidence, instead recording details only in immigration databases . Historically, immigration officials were empowered to permit or reject entry of visitors on arrival at the frontiers. If permitted entry, the official would issue a visa, when required, which would be a stamp in a passport. Today, travellers wishing to enter another country must often apply in advance for what is also called a visa, sometimes in person at a consular office , by post , or over the Internet . The modern visa may be a sticker or a stamp in the passport, an electronic record of the authorization, or a separate document which the applicant can print before entering and produce on entry to the visited polity. Some countries do not require visitors to apply for a visa in advance for short visits. Visa applications in advance of arrival give countries a chance to consider the applicant's circumstances, such as financial security, reason for travel, and details of previous visits to the country. Visitors may also be required to undergo and pass security or health checks upon arrival at the port of entry. Some polities which restrict emigration require individuals to possess an exit visa to leave the polity. These exit visas may be required for citizens , foreigners, or both, depending on the policies of the polity concerned. Unlike ordinary visas, exit visas are often seen as an illegitimate intrusion on individuals' right to freedom of movement . The imposition of an exit visa requirement may be seen to violate customary international law , as the right to leave any country is provided for in the Universal Declaration of Human Rights . Uniquely, the Norwegian special territory of Svalbard is an entirely visa-free zone under the terms of the Svalbard Treaty . Some countries—such as those in the Schengen Area —have agreements with other countries allowing each other's citizens to travel between them without visas. In 2015, the World Tourism Organization announced that the number of tourists requiring a visa before travelling was at its lowest level ever. In Western Europe in the late 19th century and early 20th century, passports and visas were not generally necessary for moving from one country to another. The relatively high speed and large movements of people travelling by train would have caused bottlenecks if regular passport controls had been used. Passports and visas became usually necessary as travel documents only after World War I . Up until that point in time, passports and visas were usually the same type of travel documents. In the modern world, visas have become separate secondary travel documents, with passports acting as the primary travel documents.Some visas can be granted on arrival or by prior application at the country's embassy or consulate , or through a private visa service specialist who is specialized in the issuance of international travel documents. These agencies are authorized by the foreign authority, embassy, or consulate to represent international travellers who are unable or unwilling to travel to the embassy and apply in person. Private visa and passport services collect an additional fee for verifying customer applications, supporting documents, and submitting them to the appropriate authority. If there is no embassy or consulate in one's home country, then one would have to travel to a third country (or apply by post) and try to get a visa issued there. Alternatively, in such cases visas may be pre-arranged for collection on arrival at the border. The need or absence of need of a visa generally depends on the citizenship of the applicant, the intended duration of the stay, and the activities that the applicant may wish to undertake in the country he or she visits; these may delineate different formal categories of visas, with different issue conditions. The issuing authority, usually a branch of the country's foreign ministry or department (e.g. U.S. State Department ), and typically consular affairs officers, may request appropriate documentation from the applicant. This may include proof that the applicant is able to support him or herself in the host country (lodging, food), proof that the person hosting the applicant in his or her home really exists and has sufficient room for hosting the applicant, proof that the applicant has obtained health and evacuation insurance, etc. Some countries ask for proof of health status, especially for long-term visas; some countries deny such visas to persons with certain illnesses, such as AIDS . The exact conditions depend on the country and category of visa. Notable examples of countries requiring HIV tests of long-term residents are Russia and Uzbekistan. In Uzbekistan, however, the HIV test requirement is sometimes not strictly enforced. Other countries require a medical test that includes an HIV test, even for a short-term tourism visa. For example, Cuban citizens and international exchange students require such a test approved by a medical authority to enter Chilean territory. The issuing authority may also require applicants to attest that they have no criminal convictions, or that they do not participate in certain activities (like prostitution or drug trafficking). Some countries will deny visas if passports show evidence of citizenship of, or travel to, a country that is considered hostile by that country. For example, some Arabic-oriented countries will not issue visas to nationals of Israel and those whose passports bear evidence of visiting Israel. Many countries frequently demand strong evidence of intent to return to the home country, if the visa is for a temporary stay, due to potential unwanted illegal immigration . Proof of ties to the visa applicant's country of residence is often demanded to demonstrate a sufficient incentive to return. This can include things such as documented evidence of employment, bank statements, property ownership, and family ties.Each country typically has a multitude of categories of visas with various names. The most common types and names of visas include: For passing through the country of issue to a destination outside that country. Validity of transit visas are usually limited by short terms such as several hours to ten days depending on the size of the country or the circumstances of a particular transit itinerary. Airside transit visa , required by some countries for passing through their airports even without going through passport control. Crew member, steward, or driver visa , issued to persons employed or trained on aircraft, vessels, trains, trucks, buses, and any other means of international transportation, or ships fishing in international waters. For short visits to the visited country. Many countries differentiate between different reasons for these visits, such as: Cultural exchange visa , usually issued to athletes and performing artists participating in a cultural exchange program. Visas valid for long term stays of a specific duration include: Granted for those intending to settle permanently in the issuing country (obtain the status of a permanent resident with a prospect of possible naturalization in the future): These are granted to officials doing jobs for their governments, or otherwise representing their countries in the host country, such as the personnel of diplomatic missions. Normally visa applications are made at and collected from a consulate, embassy, or other diplomatic mission. Also known as visas on arrival (VOA), they are granted at a port of entry. This is distinct from visa-free entry, where no visa is required, as the visitor must still obtain the visa on arrival before proceeding to immigration control. An electronic visa (e-Visa or eVisa) is stored in a computer and is linked to the passport number so no label, sticker, or stamp is placed in the passport before travel. The application is done over the internet, and the receipt acts as a visa, which can be printed or stored on a mobile device.For passing through the country of issue to a destination outside that country. Validity of transit visas are usually limited by short terms such as several hours to ten days depending on the size of the country or the circumstances of a particular transit itinerary. Airside transit visa , required by some countries for passing through their airports even without going through passport control. Crew member, steward, or driver visa , issued to persons employed or trained on aircraft, vessels, trains, trucks, buses, and any other means of international transportation, or ships fishing in international waters. For short visits to the visited country. Many countries differentiate between different reasons for these visits, such as: Cultural exchange visa , usually issued to athletes and performing artists participating in a cultural exchange program. Visas valid for long term stays of a specific duration include: Granted for those intending to settle permanently in the issuing country (obtain the status of a permanent resident with a prospect of possible naturalization in the future): These are granted to officials doing jobs for their governments, or otherwise representing their countries in the host country, such as the personnel of diplomatic missions.For passing through the country of issue to a destination outside that country. Validity of transit visas are usually limited by short terms such as several hours to ten days depending on the size of the country or the circumstances of a particular transit itinerary. Airside transit visa , required by some countries for passing through their airports even without going through passport control. Crew member, steward, or driver visa , issued to persons employed or trained on aircraft, vessels, trains, trucks, buses, and any other means of international transportation, or ships fishing in international waters.For short visits to the visited country. Many countries differentiate between different reasons for these visits, such as: Cultural exchange visa , usually issued to athletes and performing artists participating in a cultural exchange program.Visas valid for long term stays of a specific duration include:Granted for those intending to settle permanently in the issuing country (obtain the status of a permanent resident with a prospect of possible naturalization in the future):These are granted to officials doing jobs for their governments, or otherwise representing their countries in the host country, such as the personnel of diplomatic missions.Normally visa applications are made at and collected from a consulate, embassy, or other diplomatic mission. Also known as visas on arrival (VOA), they are granted at a port of entry. This is distinct from visa-free entry, where no visa is required, as the visitor must still obtain the visa on arrival before proceeding to immigration control. An electronic visa (e-Visa or eVisa) is stored in a computer and is linked to the passport number so no label, sticker, or stamp is placed in the passport before travel. The application is done over the internet, and the receipt acts as a visa, which can be printed or stored on a mobile device.Also known as visas on arrival (VOA), they are granted at a port of entry. This is distinct from visa-free entry, where no visa is required, as the visitor must still obtain the visa on arrival before proceeding to immigration control.An electronic visa (e-Visa or eVisa) is stored in a computer and is linked to the passport number so no label, sticker, or stamp is placed in the passport before travel. The application is done over the internet, and the receipt acts as a visa, which can be printed or stored on a mobile device.Visas can also be single-entry , which means the visa is cancelled as soon as the holder enters the country; double-entry , or multiple-entry , which permits double or multiple entries into the country with the same visa. Countries may also issue re-entry permits that allow temporarily leaving the country without invalidating the visa. Even a business visa will normally not allow the holder to work in the host country without an additional work permit . Once issued, a visa will typically have to be used within a certain period of time. In some countries, the validity of a visa is not the same as the authorized period of stay. The visa validity then indicates the time period when the entry is permitted into the country. For example, if a visa has been issued to begin on 1 January and to expire on 30 March, and the typical authorized period of stay in a country is 90 days, then the 90-day authorized stay starts on the day the passenger enters the country (entrance has to be between 1 January and 30 March). Thus, the latest day the traveller could conceivably stay in the issuing country is 1 July (if the traveller entered on 30 March). This interpretation of visas is common in the Americas. With other countries, a person may not stay beyond the period of validity of their visa, which is usually set within the period of validity of their passport. The visa may also limit the total number of days the visitor may spend in the applicable territory within the period of validity. This interpretation of visa periods is common in Europe. Once in the country, the validity period of a visa or authorized stay can often be extended for a fee at the discretion of immigration authorities. Overstaying a period of authorized stay given by the immigration officers is considered illegal immigration even if the visa validity period is not over (i.e., for multiple entry visas) and a form of being "out of status" and the offender may be fined , prosecuted, deported , or even blacklisted from entering the country again. Entering a country without a valid visa or visa exemption may result in detention and removal (deportation or exclusion) from the country. Undertaking activities that are not authorized by the status of entry (for example, working while possessing a non-worker tourist status) can result in the individual being deemed liable for deportation—commonly referred to as an illegal alien . Such violation is not a violation of a visa, despite the common misuse of the phrase, but a violation of status; hence the term "out of status". Even having a visa does not guarantee entry to the host country. The border crossing authorities make the final determination to allow entry, and may even cancel a visa at the border if the alien cannot demonstrate to their satisfaction that they will abide by the status their visa grants them. Some countries that do not require visas for short stays may require a long-stay visa for those who intend to apply for a residence permit . For example, the EU does not require a visa of citizens of many countries for stays under 90 days, but its member states require a long-stay visa of such citizens for longer stays.Many countries have a mechanism to allow the holder of a visa to apply to extend a visa. In Denmark, a visa holder can apply to the Danish Immigration Service for a Residence Permit after they have arrived in the country. In the United Kingdom, applications can be made to UK Visas and Immigration . In certain circumstances, it is impossible for the holder of the visa to do this, either because the country does not have a mechanism to prolong visas or, most likely, because the holder of the visa is using a short stay visa to live in a country. Some foreign visitors sometimes engage in what is known as a visa run : leaving a country—usually to a neighboring country—for a short period just before the permitted length of stay expires, then returning to the first country to get a new entry stamp in order to extend their stay ("reset the clock"). Despite the name, a visa run is usually done with a passport that can be used for entry without a visa. Visa runs are frowned upon by immigration authorities as such acts may signify that the foreigner wishes to reside permanently and might also work in that country; purposes that visitors are prohibited from engaging in and usually require an immigrant visa or a work visa. Immigration officers may deny re-entry to visitors suspected of engaging in prohibited activities, especially when they have done repeated visa runs and have no evidence of spending reasonable time in their home countries or countries where they have the right to reside and work. To combat visa runs, some countries have limits on how long visitors can spend in the country without a visa, as well as how much time they have to stay out before "resetting the clock". For example, Schengen countries impose a maximum limit for visitors of 90 days in any 180-day period. Some countries do not "reset the clock" when a visitor comes back after visiting a neighboring country. For example, the United States does not give visitors a new period of stay when they come back from visiting Canada, Mexico, or the Caribbean; instead they are readmitted to the United States for the remaining days granted on their initial entry. Some other countries, e.g. Thailand, allow visitors who arrive by land from neighboring countries a shorter length of stay than those who arrive by air. In some cases, a visa run is necessary to activate new visas or change the immigration status of a person. An example would be leaving a country and then returning immediately to activate a newly issued work visa before a person can legally work.Some foreign visitors sometimes engage in what is known as a visa run : leaving a country—usually to a neighboring country—for a short period just before the permitted length of stay expires, then returning to the first country to get a new entry stamp in order to extend their stay ("reset the clock"). Despite the name, a visa run is usually done with a passport that can be used for entry without a visa. Visa runs are frowned upon by immigration authorities as such acts may signify that the foreigner wishes to reside permanently and might also work in that country; purposes that visitors are prohibited from engaging in and usually require an immigrant visa or a work visa. Immigration officers may deny re-entry to visitors suspected of engaging in prohibited activities, especially when they have done repeated visa runs and have no evidence of spending reasonable time in their home countries or countries where they have the right to reside and work. To combat visa runs, some countries have limits on how long visitors can spend in the country without a visa, as well as how much time they have to stay out before "resetting the clock". For example, Schengen countries impose a maximum limit for visitors of 90 days in any 180-day period. Some countries do not "reset the clock" when a visitor comes back after visiting a neighboring country. For example, the United States does not give visitors a new period of stay when they come back from visiting Canada, Mexico, or the Caribbean; instead they are readmitted to the United States for the remaining days granted on their initial entry. Some other countries, e.g. Thailand, allow visitors who arrive by land from neighboring countries a shorter length of stay than those who arrive by air. In some cases, a visa run is necessary to activate new visas or change the immigration status of a person. An example would be leaving a country and then returning immediately to activate a newly issued work visa before a person can legally work.In general, an applicant may be refused a visa if they do not meet the requirements for admission or entry under that country's immigration laws. More specifically, a visa may be denied or refused when the applicant: has committed fraud, deception, or misrepresentation in his or her current application as well as in a previous application has obtained a criminal record, has been arrested, or has criminal charges pending is considered to be a threat to national security does not have a good moral character has previous visa/immigration violations (even if the violations did not happen in the country the applicant is seeking a visa for) had their previous visa application(s) or application for immigration benefits refused and cannot prove that the reasons for the previous refusals no longer exist or are not applicable any more (even if the refusals did not previously happen in the country the applicant is seeking a visa for) cannot prove to have strong ties to their current country of nationality or residence (for those who are applying for temporary or non-immigrant visas) intends to reside or work permanently in the country she/he will visit if not applying for an immigrant or work visa respectively fails to demonstrate intent to return (for non-immigrants) fails to provide sufficient evidence/documents to prove eligibility for the visa sought after does not have a legitimate reason for the journey does not have adequate means of financial support for themselves or family does not have adequate medical insurance, especially if engaging in high risk activities (e.g. rock climbing, skiing, etc.) does not have travel arrangements (i.e. transport and lodging) in the destination country does not have health/travel insurance valid for the destination and the duration of stay is a citizen of a country to which the destination country is hostile or at war with has previously visited, or intends to visit, a country to which the destination country is hostile has a communicable disease, such as tuberculosis or ebola , or a sexually transmitted disease has a passport that expires too soon Even if a traveller does not need a visa, the aforementioned criteria can also be used by border control officials to refuse the traveller's entry into the country in question.The main reasons states impose visa restrictions on foreign nationals are to curb illegal immigration, security concerns, and reciprocity for visa restrictions imposed on their own nationals. Typically, nations impose visa restrictions on citizens of poorer countries, along with politically unstable and undemocratic ones, as it is considered more likely that people from these countries will seek to illegally immigrate. Visa restrictions may also be imposed when nationals of another country are perceived as likelier to be terrorists or criminals, or by autocratic regimes that perceive foreign influence to be a threat to their rule. According to Professor Eric Neumayer of the London School of Economics : The poorer, the less democratic, and the more exposed to armed political conflict the target country is, the more likely that visa restrictions are in place against its passport holders. The same is true for countries whose nationals have been major perpetrators of terrorist acts in the past. Some countries apply the principle of reciprocity in their visa policy. A country's visa policy is called 'reciprocal' if it imposes visa requirement against citizens of all the countries that impose visa requirements against its own citizens. The opposite is rarely true: a country rarely lifts visa requirements against citizens of all the countries that also lift visa requirements against its own citizens, unless a prior bilateral agreement has been made. A fee may be charged for issuing a visa; these are often also reciprocal—hence, if country A charges country B's citizens US$50 for a visa, country B will often also charge the same amount for country A's visitors. The fee charged may also be at the discretion of each embassy. A similar reciprocity often applies to the duration of the visa (the period in which one is permitted to request entry of the country) and the number of entries one can attempt with the visa. Other restrictions, such as requiring fingerprints and photographs, may also be reciprocated. Expedited processing of the visa application for some countries will generally incur additional charges. Government authorities usually impose administrative entry restrictions on foreign citizens in three ways - countries whose nationals may enter without a visa, countries whose nationals may obtain a visa on arrival, and countries whose nationals require a visa in advance. Nationals who require a visa in advance are usually advised to obtain them at a diplomatic mission of their destination country. Several countries allow nationals of countries that require a visa to obtain them online. The following table lists visa policies of all countries by the number of foreign nationalities that may enter that country for tourism without a visa or by obtaining a visa on arrival with normal passport. It also notes countries that issue electronic visas to certain nationalities. Symbol "+" indicates a country that limits the visa-free regime negatively by only listing nationals who require a visa, thus the number represents the number of UN member states reduced by the number of nationals who require a visa and "+" stands for all possible non-UN member state nationals that might also not require a visa. "N/A" indicates countries that have contradictory information on its official websites or information supplied by the Government to IATA . Some countries that allow visa on arrival do so only at a limited number of entry points. Some countries such as the European Union member states have a qualitatively different visa regime between each other as it also includes freedom of movement. The following table is current as of 3 October 2019 [ update ] . Source: Possession of a valid visa is a condition for entry into many countries, and exemption schemes exist. In some cases visa-free entry may be granted to holders of diplomatic passports even as visas are required by normal passport holders ( see: Passport ). Some countries have reciprocal agreements such that a visa is not needed under certain conditions, e.g., when the visit is for tourism and for a relatively short period. Such reciprocal agreements may stem from common membership in international organizations or a shared heritage: Other countries may unilaterally grant visa-free entry to nationals of certain countries to facilitate tourism, promote business, or even to cut expenses on maintaining consular posts abroad. Some of the considerations for a country to grant visa-free entry to another country include (but are not limited to): [ citation needed ] being a low security risk for the country potentially granting visa-free entry diplomatic relationship between two countries conditions in the visitor's home country as compared to the host country having a low risk of overstaying or violating visa terms in the country potentially granting visa-free entry To have a smaller worldwide diplomatic staff, some countries rely on other country's (or countries') judgments when issuing visas. For example, Mexico allows citizens of all countries to enter without Mexican visas if they possess a valid American visa that has already been used. Costa Rica accepts valid visas of Schengen /EU countries, Canada , Japan , South Korea , and the United States (if valid for at least three months on date of arrival). The ultimate example of such reliance is the microstate of Andorra , which imposes no visa requirements of its own because it has no international airport and is inaccessible by land without passing through the territory of either France or Spain and is thus "protected" by the Schengen visa system. Visa-free travel between countries also occurs in all cases where passports (or passport-replacing documents such as laissez-passer) are not needed for such travel. ( For examples of passport-free travel, see International travel without passports .) As of 2019, the Henley & Partners passport index ranks the Japanese, Singaporean, and South Korean passports as the ones with the most visa exemptions by other nations, allowing holders of those passports to visit 189 countries without obtaining a visa in advance of arrival. However, as of 6 June 2019 , [ update ] the Passport Index ranks the United Arab Emirates passport as the one with the most visa exemptions by other nations, allowing holders of this passport to visit 173 countries without obtaining a visa in advance of arrival.Normally, visas are valid for entry only into the country that issued the visa. Countries that are members of regional organizations or party to regional agreements may, however, issue visas valid for entry into some or all of the member states of the organization or agreement: Potentially, there are new common visa schemes: These schemes no longer operate.Potentially, there are new common visa schemes:These schemes no longer operate.Exit visas may be required to leave some countries. Many countries limit the ability of individuals to leave in certain circumstances, such as those with outstanding legal proceedings or large government debts. Despite this, the term exit visa is generally limited to countries that systematically restrict departure, where the right to leave is not automatic. Imposing a systematic requirement for exit permission may be seen to violate the right to freedom of movement , which is found in the UDHR and forms part of customary international law . Countries implementing exit visas vary in who they require to obtain one. Some countries permit the free movement of foreign nationals while restricting their own citizens. Others may limit the exit visa requirement to resident foreigners in the country on work visas , such as in the Kafala system . Iraq, Kuwait, Lebanon, Oman , Saudi Arabia, and the United Arab Emirates all have an exit visa requirement for alien foreign workers. This is part of their kafala work visa sponsorship system. Consequently, at the end of a foreign worker's employment period, the worker must secure clearance from their employer stating that the worker has satisfactorily fulfilled the terms of their employment contract or that the worker's services are no longer needed. The exit visa can also be withheld if there are pending court charges that need to be settled or penalties that have to be meted out. In September 2018, Qatar lifted the exit visa requirement for most workers. Persons are generally free to leave Israel, except for those who are subject to a stay of exit order. Nepal requires its citizens emigrating to the United States on an H-1B visa to present an exit permit issued by the Nepali Ministry of Labour. This document is called a work permit and needs to be presented to Nepali immigration to leave Nepal. Uzbekistan was the last remaining country of the former USSR that required an exit visa , which was valid for a two-year period. The practice was abolished in 2019. There had been an explicit United Nations complaint about this practice. North Korea requires that its citizens obtain an exit visa stating the traveller's destination country and time to be spent abroad before leaving the country. [ citation needed ] Additionally, North Korean authorities also require North Korean citizens to obtain a re-entry visa from a North Korean embassy or North Korean mission abroad before being allowed back into North Korea. [ citation needed ] The government of the People's Republic of China requires its citizens to obtain a two-way permit (visiting), or one-way permit (emigrating) issued by the People's Republic of China's authorities, prior to visiting Hong Kong or Macau. The two-way permit and one-way permit are a de facto exit visa for Hong Kong- or Macau-bound trips for citizens of the People's Republic of China. Singapore operates an Exit Permit scheme in order to enforce the national service obligations of its male citizens and permanent residents. Requirements vary according to age and status: Iran, Taiwan and South Korea also require male citizens who are older than a certain age but have not fulfilled their military duties to register with local Military Manpower Administration office before they pursue international travels, studies, business trips, and/or performances. Failure to do so is a felony in those countries and violators would face up to three years of imprisonment. During the Fascist period in Italy , an exit visa was required from 1922 to 1943. Nazi Germany required exit visas from 1933 to 1945 . The Soviet Union and its Warsaw Pact allies required exit visas both for emigration and for those who wanted to leave the Soviet Union for a shorter period. Some countries, including the Czech Republic , require that an alien who needs a visa on entry be in possession of a valid visa upon exit. To satisfy this formal requirement, exit visas sometimes need to be issued. Russia requires an exit visa if a visitor stays past the expiration date of their visa. They must then extend their visa or apply for an exit visa and are not allowed to leave the country until they show a valid visa or have a permissible excuse for overstaying their visa (e.g., a note from a doctor or a hospital explaining an illness, missed flight, lost or stolen visa). In some cases, the Ministry of Foreign Affairs can issue a return-Home certificate that is valid for ten days from the embassy of the visitor's native country, thus eliminating the need for an exit visa. A foreign citizen granted a temporary residence permit in Russia needs a temporary resident visa to take a trip abroad (valid for both exit and return). It is also colloquially called an exit visa . Not all foreign citizens are subject to that requirement. Citizens of Germany, for example, do not require this exit visa. In March 2021, during the COVID-19 pandemic , the United Kingdom required everyone leaving England to fill out an exit form detailing their address, passport number, destination, and reason to travel. Permitted reasons to travel included for work or volunteering, education, medical or compassionate reasons such as weddings and funerals. Travellers may be required to carry evidence to support their reason to travel. Cuba dropped its exit visa requirement in January 2013. Guatemala requires any foreigner who is a permanent resident to apply for a multiple 5-year exit visa. The United States of America does not require exit visas. Since 1 October 2007, however, the U.S. government requires all foreign and U.S. nationals departing the United States by air to hold a valid passport (or certain specific passport-replacing documents). Even though travellers might not require a passport to enter a certain country, they will require a valid passport booklet (booklet only, U.S. Passport Card not accepted) to depart the United States in order to satisfy the U.S. immigration authorities. Exemptions to this requirement to hold a valid passport include: U.S. Permanent Resident/Resident Alien Card (Form I-551); U.S. Military ID Cards when travelling on official orders; U.S. Merchant Mariner Card; NEXUS Card ; U.S. travel document: Refugee Travel Document (Form I-571); or Permit to Re-Enter (Form I-327) Emergency Travel Document (e.g. Consular Letter) issued by a foreign embassy or consulate specifically for the purpose of travel to the bearer's home country. Nationals of Mexico holding one of the following documents: (expired) "Matricula Consular"; or Birth certificate with consular registration; or Certificate of Nationality issued by a Mexican consulate abroad; or Certificate of Military Duty ( Cartilla Militar ); or Voter's Certificate ( Credencial IFE or Credencial para Votar ). Refugee Travel Document (Form I-571); or Permit to Re-Enter (Form I-327) (expired) "Matricula Consular"; or Birth certificate with consular registration; or Certificate of Nationality issued by a Mexican consulate abroad; or Certificate of Military Duty ( Cartilla Militar ); or Voter's Certificate ( Credencial IFE or Credencial para Votar ). In addition, green card holders and certain other aliens must obtain a certificate of compliance (also known as a "sailing permit" or "departure permit") from the Internal Revenue Service proving that they are up-to-date with their US income tax obligations before they may leave the country. While the requirement has been in effect since 1921, it has not been stringently enforced, but in 2014 the House Ways and Means Committee has considered beginning to enforce the requirement as a way to increase tax revenues. Australia, citing COVID-19 concerns, in 2020 banned outward travel by both Australian citizens and permanent residents, unless they requested and were granted an exemption. In August 2021 this ban was extended to people who are ordinarily resident in countries other than Australia as well. Exceptions apply to business travel and travel for "compelling reasons" for three months or longer, among others. On 1 November 2021, after 20 months, the exit permit system was scrapped and New South Wales and Victoria officially re-opened their borders in addition to ending quarantine requirements on arrival for fully vaccinated individuals. However, on 27 November 2021, 72-hour quarantine requirements were reinstated over concerns about the SARS-CoV-2 Omicron variant .Iraq, Kuwait, Lebanon, Oman , Saudi Arabia, and the United Arab Emirates all have an exit visa requirement for alien foreign workers. This is part of their kafala work visa sponsorship system. Consequently, at the end of a foreign worker's employment period, the worker must secure clearance from their employer stating that the worker has satisfactorily fulfilled the terms of their employment contract or that the worker's services are no longer needed. The exit visa can also be withheld if there are pending court charges that need to be settled or penalties that have to be meted out. In September 2018, Qatar lifted the exit visa requirement for most workers. Persons are generally free to leave Israel, except for those who are subject to a stay of exit order. Nepal requires its citizens emigrating to the United States on an H-1B visa to present an exit permit issued by the Nepali Ministry of Labour. This document is called a work permit and needs to be presented to Nepali immigration to leave Nepal. Uzbekistan was the last remaining country of the former USSR that required an exit visa , which was valid for a two-year period. The practice was abolished in 2019. There had been an explicit United Nations complaint about this practice. North Korea requires that its citizens obtain an exit visa stating the traveller's destination country and time to be spent abroad before leaving the country. [ citation needed ] Additionally, North Korean authorities also require North Korean citizens to obtain a re-entry visa from a North Korean embassy or North Korean mission abroad before being allowed back into North Korea. [ citation needed ] The government of the People's Republic of China requires its citizens to obtain a two-way permit (visiting), or one-way permit (emigrating) issued by the People's Republic of China's authorities, prior to visiting Hong Kong or Macau. The two-way permit and one-way permit are a de facto exit visa for Hong Kong- or Macau-bound trips for citizens of the People's Republic of China. Singapore operates an Exit Permit scheme in order to enforce the national service obligations of its male citizens and permanent residents. Requirements vary according to age and status: Iran, Taiwan and South Korea also require male citizens who are older than a certain age but have not fulfilled their military duties to register with local Military Manpower Administration office before they pursue international travels, studies, business trips, and/or performances. Failure to do so is a felony in those countries and violators would face up to three years of imprisonment.During the Fascist period in Italy , an exit visa was required from 1922 to 1943. Nazi Germany required exit visas from 1933 to 1945 . The Soviet Union and its Warsaw Pact allies required exit visas both for emigration and for those who wanted to leave the Soviet Union for a shorter period. Some countries, including the Czech Republic , require that an alien who needs a visa on entry be in possession of a valid visa upon exit. To satisfy this formal requirement, exit visas sometimes need to be issued. Russia requires an exit visa if a visitor stays past the expiration date of their visa. They must then extend their visa or apply for an exit visa and are not allowed to leave the country until they show a valid visa or have a permissible excuse for overstaying their visa (e.g., a note from a doctor or a hospital explaining an illness, missed flight, lost or stolen visa). In some cases, the Ministry of Foreign Affairs can issue a return-Home certificate that is valid for ten days from the embassy of the visitor's native country, thus eliminating the need for an exit visa. A foreign citizen granted a temporary residence permit in Russia needs a temporary resident visa to take a trip abroad (valid for both exit and return). It is also colloquially called an exit visa . Not all foreign citizens are subject to that requirement. Citizens of Germany, for example, do not require this exit visa. In March 2021, during the COVID-19 pandemic , the United Kingdom required everyone leaving England to fill out an exit form detailing their address, passport number, destination, and reason to travel. Permitted reasons to travel included for work or volunteering, education, medical or compassionate reasons such as weddings and funerals. Travellers may be required to carry evidence to support their reason to travel. Cuba dropped its exit visa requirement in January 2013. Guatemala requires any foreigner who is a permanent resident to apply for a multiple 5-year exit visa. The United States of America does not require exit visas. Since 1 October 2007, however, the U.S. government requires all foreign and U.S. nationals departing the United States by air to hold a valid passport (or certain specific passport-replacing documents). Even though travellers might not require a passport to enter a certain country, they will require a valid passport booklet (booklet only, U.S. Passport Card not accepted) to depart the United States in order to satisfy the U.S. immigration authorities. Exemptions to this requirement to hold a valid passport include: U.S. Permanent Resident/Resident Alien Card (Form I-551); U.S. Military ID Cards when travelling on official orders; U.S. Merchant Mariner Card; NEXUS Card ; U.S. travel document: Refugee Travel Document (Form I-571); or Permit to Re-Enter (Form I-327) Emergency Travel Document (e.g. Consular Letter) issued by a foreign embassy or consulate specifically for the purpose of travel to the bearer's home country. Nationals of Mexico holding one of the following documents: (expired) "Matricula Consular"; or Birth certificate with consular registration; or Certificate of Nationality issued by a Mexican consulate abroad; or Certificate of Military Duty ( Cartilla Militar ); or Voter's Certificate ( Credencial IFE or Credencial para Votar ). Refugee Travel Document (Form I-571); or Permit to Re-Enter (Form I-327) (expired) "Matricula Consular"; or Birth certificate with consular registration; or Certificate of Nationality issued by a Mexican consulate abroad; or Certificate of Military Duty ( Cartilla Militar ); or Voter's Certificate ( Credencial IFE or Credencial para Votar ). In addition, green card holders and certain other aliens must obtain a certificate of compliance (also known as a "sailing permit" or "departure permit") from the Internal Revenue Service proving that they are up-to-date with their US income tax obligations before they may leave the country. While the requirement has been in effect since 1921, it has not been stringently enforced, but in 2014 the House Ways and Means Committee has considered beginning to enforce the requirement as a way to increase tax revenues. The United States of America does not require exit visas. Since 1 October 2007, however, the U.S. government requires all foreign and U.S. nationals departing the United States by air to hold a valid passport (or certain specific passport-replacing documents). Even though travellers might not require a passport to enter a certain country, they will require a valid passport booklet (booklet only, U.S. Passport Card not accepted) to depart the United States in order to satisfy the U.S. immigration authorities. Exemptions to this requirement to hold a valid passport include: U.S. Permanent Resident/Resident Alien Card (Form I-551); U.S. Military ID Cards when travelling on official orders; U.S. Merchant Mariner Card; NEXUS Card ; U.S. travel document: Refugee Travel Document (Form I-571); or Permit to Re-Enter (Form I-327) Emergency Travel Document (e.g. Consular Letter) issued by a foreign embassy or consulate specifically for the purpose of travel to the bearer's home country. Nationals of Mexico holding one of the following documents: (expired) "Matricula Consular"; or Birth certificate with consular registration; or Certificate of Nationality issued by a Mexican consulate abroad; or Certificate of Military Duty ( Cartilla Militar ); or Voter's Certificate ( Credencial IFE or Credencial para Votar ). Refugee Travel Document (Form I-571); or Permit to Re-Enter (Form I-327) (expired) "Matricula Consular"; or Birth certificate with consular registration; or Certificate of Nationality issued by a Mexican consulate abroad; or Certificate of Military Duty ( Cartilla Militar ); or Voter's Certificate ( Credencial IFE or Credencial para Votar ). In addition, green card holders and certain other aliens must obtain a certificate of compliance (also known as a "sailing permit" or "departure permit") from the Internal Revenue Service proving that they are up-to-date with their US income tax obligations before they may leave the country. While the requirement has been in effect since 1921, it has not been stringently enforced, but in 2014 the House Ways and Means Committee has considered beginning to enforce the requirement as a way to increase tax revenues. Australia, citing COVID-19 concerns, in 2020 banned outward travel by both Australian citizens and permanent residents, unless they requested and were granted an exemption. In August 2021 this ban was extended to people who are ordinarily resident in countries other than Australia as well. Exceptions apply to business travel and travel for "compelling reasons" for three months or longer, among others. On 1 November 2021, after 20 months, the exit permit system was scrapped and New South Wales and Victoria officially re-opened their borders in addition to ending quarantine requirements on arrival for fully vaccinated individuals. However, on 27 November 2021, 72-hour quarantine requirements were reinstated over concerns about the SARS-CoV-2 Omicron variant .The Henley Passport index ranks passports according to the number of destinations that can be reached using a particular country's ordinary passport without the need of a prior visa ("visa-free"). The survey ranks 199 passports against 227 destination countries, territories, and micro-states. The IATA maintains a database of travel information worldwide and all destinations that are in the IATA database are considered by the index. However, because not all territories issue passports, there are far fewer passports ranked than destinations about which queries are made. As of 8 December 2023, the Singaporean passport offers holders visa-free or visa-on-arrival access to a total of 195 countries and territories, followed by the Japanese with 193 and the Finnish , French , German , Italian , South Korean , Spanish and Swedish passports, each offering 190 visa-free or visa-on-arrival countries and territories to its holders. These rankings were subsequently followed by the Austrian , Danish , Irish , Luxembourgeois and British passports, each offering visa-free or visa-on-arrival travel to 189 countries and territories. The World Tourism Organization (UNWTO) of the United Nations has issued various Visa Openness Report s.The Henley Passport index ranks passports according to the number of destinations that can be reached using a particular country's ordinary passport without the need of a prior visa ("visa-free"). The survey ranks 199 passports against 227 destination countries, territories, and micro-states. The IATA maintains a database of travel information worldwide and all destinations that are in the IATA database are considered by the index. However, because not all territories issue passports, there are far fewer passports ranked than destinations about which queries are made. As of 8 December 2023, the Singaporean passport offers holders visa-free or visa-on-arrival access to a total of 195 countries and territories, followed by the Japanese with 193 and the Finnish , French , German , Italian , South Korean , Spanish and Swedish passports, each offering 190 visa-free or visa-on-arrival countries and territories to its holders. These rankings were subsequently followed by the Austrian , Danish , Irish , Luxembourgeois and British passports, each offering visa-free or visa-on-arrival travel to 189 countries and territories.The World Tourism Organization (UNWTO) of the United Nations has issued various Visa Openness Report s.Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints.

Wiki

Yellow fever

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Hideyo Noguchi

Hideyo Noguchi ( 野口 英世 , Noguchi Hideyo , November 9, 1876 – May 21, 1928) , also known as Seisaku Noguchi ( 野口 æ¸ ä½œ , Noguchi Seisaku ) , was a prominent Japanese bacteriologist who in 1911 discovered the agent of syphilis as the cause of progressive paralytic disease.Noguchi Hideyo, whose childhood name was Seisaku Noguchi, was born to a family of farmers for generations in Inawashiro , Fukushima prefecture in 1876. When he was one and a half years old, he fell into a fireplace and suffered a burn injury on his left hand. There was no doctor in the small village, but one of the men examined the boy. "The fingers of the left hand are mostly gone," he said, "and the left arm, the left foot, and the right hand are burned; I don't know how badly." In 1883, Noguchi entered Mitsuwa elementary school. Thanks to generous contributions from his teacher Kobayashi and his friends, he was able to receive surgery on his badly burned hand. He recovered about 70% mobility and functionality in his left hand through the operation. Noguchi decided to become a doctor to help those in need. He apprenticed himself to Dr. Kanae Watanabe ( 渡部 鼎 , Watanabe Kanae ) , the same doctor who had performed the surgery. He entered Saisei Gakusha, which later became Nippon Medical School . He passed the examinations to practice medicine when he was twenty years old in 1897. He showed signs of great talent and was supported in his studies by Dr. Morinosuke Chiwaki . In 1898, he changed his first name to Hideyo after reading a Tsubouchi Shōyō novel of college students whose character had the same name—Seisaku—as him. The character in the story was an intelligent medical student like Noguchi but became lazy and ruined his life. In 1900 Noguchi travelled on the America Maru to the United States , where he obtained a job as a research assistant with Dr. Simon Flexner at the University of Pennsylvania and later at the Rockefeller Institute of Medical Research . He thrived in this environment. At this time his work concerned venomous snakes . In part, his move was motivated by difficulties in obtaining a medical position in Japan, as prospective employers were concerned that his hand deformity would discourage potential patients. In a research setting, he did not such an issue. He and his peers learned from their work and from each other. In this period, a fellow research assistant in Flexner's lab was Frenchman Alexis Carrel , who would go on to win a Nobel Prize in 1912. Noguchi's work later attracted the Prize committee's scrutiny. In the 21st century, the Nobel Foundation archives were opened for public inspection and research. Historians found that Noguchi was nominated several times for the Nobel Prize in Physiology or Medicine : in 1913–1915, 1920, 1921 and 1924–1927. During the 1920s, his work was being increasingly criticized for inaccuracies. [ citation needed ] In 1921, he was elected as a member of the American Philosophical Society . While working at the Rockefeller Institute of Medical Research in 1911, he was accused of inoculating orphan children with syphilis in the course of a clinical study. He was acquitted of any wrongdoing at the time but, since the late 20th century, his conduct of the study has come to be considered an early instance of unethical human experimentation . At the time, society had not developed a consensus about how to conduct human experimentation and feelings varied about the medical research community. Antivivisectionists linked their concerns for animals with concerns about humans. The American Society for the Prevention of Cruelty to Children was founded in the late 19th century after the American Society for the Prevention of Cruelty to Animals. In 1913, Noguchi demonstrated the presence of Treponema pallidum (syphilitic spirochete) in the brain of a progressive paralysis patient, proving that the spirochete was the cause of the disease. Dr. Noguchi's name is remembered in the binomial attached to another spirochete, Leptospira noguchii . In 1918, Noguchi traveled extensively in Central America and South America working with the International Health Board to conduct research to develop a vaccine for yellow fever , and to research Oroya fever , poliomyelitis and trachoma . He believed that yellow fever was caused by spirochaete bacteria instead of a virus . He worked for much of the next ten years trying to prove this theory. His work on yellow fever was widely criticized as taking an inaccurate approach that was contradictory to contemporary research, and confusing yellow fever with other pathogens. In 1927-28 three different papers appeared in medical journals that discredited his theories. It turned out he had confused yellow fever with leptospirosis . The vaccine he developed against "yellow fever" was successfully used to treat the latter disease.In 1911 and 1912 at the Rockefeller Institute in New York City, Noguchi was working to develop a syphilis skin test similar to the tuberculin skin test. The subjects were recruited from clinics and hospitals in New York. In the experiment, Noguchi injected an extract of syphilis, called luetin, under the subjects' upper arm skin. Skin reactions were studied, as they varied among healthy subjects and syphilis patients, based on the disease's stage and its treatment. Of the 571 subjects, 315 had syphilis. The remaining subjects were "controls;" they were orphans or hospital patients who did not have syphilis. The hospital patients were already being treated for various non-syphilitic diseases, such as malaria, leprosy, tuberculosis, and pneumonia. Finally, the controls were normal individuals, mostly children between the ages of 2 and 18 years. Critics at the time, mainly from the anti-vivisectionist movement, noted that Noguchi violated the rights of vulnerable orphans and hospital patients. There was concern on the part of anti-vivisectionists that the children would get syphilis from Noguchi's experiments. It became a public scandal and the media discussed it. The editor of Life pointed out: If the researcher had said to these patients: "Have I your permission to inject into your system a concoction more or less related to a hideous disease?" — the invalids might have declined. In Noguchi's defense, Rockefeller Institute business manager Jerome D. Greene wrote a letter to the anti- vivisection society, which had protested the experiment. Greene pointed out that Noguchi had tested the extract on himself before administering it to subjects, and his fellow researchers had done the same, so it was impossible that the injections could cause syphilis. However, Noguchi himself was diagnosed with untreated syphilis in 1913, for which he refused treatment from Rockefeller Hospital. At the time, Greene's explanation was considered a demonstration of the importance of the studies and care the doctors were taking in research. In May 1912 the New York Society for the Prevention for Cruelty to Children asked the New York district attorney to press charges against Noguchi; he declined. In the United States, it was not until the late 20th century that sufficient consensus developed about human experimentation to gain passage of laws to protect subjects. Along the way, more protocols were developed about informed consent and rights of patients/subjects. Following the death of British pathologist Adrian Stokes of yellow fever in September 1927, it became increasingly evident that yellow fever was caused by a virus, not by the bacillus Leptospira icteroides , as Noguchi believed. [ citation needed ] Feeling his reputation was at stake, Noguchi hastened to Lagos to carry out additional research. However, he found the working conditions in Lagos did not suit him. At the invitation of Dr. William Alexander Young , the young director of the British Medical Research Institute, Accra , Gold Coast (modern-day Ghana ), he moved to Accra and made this his base in 1927. However, Noguchi proved a very difficult guest and by May 1928 Young regretted his invitation. Noguchi was secretive and volatile, working almost entirely at night to avoid contact with fellow researchers. The diaries of Oskar Klotz, another researcher with the Rockefeller Foundation, describe Noguchi's temper and behavior as erratic and bordering on the paranoid. His methods were haphazard. According to Klotz, he inoculated huge numbers of monkeys with yellow fever, but failed to keep proper records. He may have believed himself immune to yellow fever, having been inoculated with a vaccine of his own development. Possibly his erratic and irresponsible behavior was caused by the untreated syphilis with which he was diagnosed in 1913, and which may have progressed to neurosyphilis . [ citation needed ] Despite repeated promises to Young, Noguchi failed to keep infected mosquitoes in their specially designed secure housing. In May 1928, having failed to find evidence for his theories, Noguchi was set to return to New York, but was taken ill in Lagos. He boarded his ship to sail home, but on 12 May was put ashore at Accra and taken to a hospital with yellow fever. After lingering for some days, he died on 21 May. In a letter home, Young states, "He died suddenly noon Monday. I saw him Sunday afternoon – he smiled – and amongst other things, said, "Are you sure you are quite well?" "Quite." I said, and then he said "I don't understand." Seven days later, despite exhaustive sterilisation of the site and most particularly of Noguchi's laboratory, Young himself died of yellow fever. While Noguchi was influential during his lifetime, later research was not able to reproduce many of his claims, including having discovered the causes of polio, rabies, syphilis, trachoma, and yellow fever. His finding that Noguchia granulosis causes trachoma was questioned within a year of his death, and overturned shortly thereafter. His identification of the rabies pathogen was wrong, because the medium he invented to cultivate bacteria was seriously prone to contamination. A fellow Rockefeller Institute researcher said that Noguchi "knew nothing about the pathology of yellow fever" and criticized him for being unwilling to issue retractions for false claims, saying, "I don't think that Noguchi was an honest scientist". Noguchi's failures have often been attributed to his tendency to work in isolation without the skeptical eye of fellow researchers. What are considered flaws in the Rockefeller Institute's system of peer review is also a frequent subject of criticism. Noguchi's most famous contribution is his identification of the causative agent of syphilis (the bacteria Treponema pallidum ) in the brain tissues of patients with partial paralysis due to meningoencephalitis. Other lasting contributions include the use of snake venom in serums, the identification of the leishmaniasis pathogen and of Carrion's disease with Oroya fever. His claim to have grown a culture of syphilis is considered irreproducible . [ citation needed ]Noguchi was honored with Japanese and foreign decorations. He received honorary degrees from a number of universities. He was self-effacing in his public life, and he often referred to himself as "funny Noguchi." Those who knew him well said that he "gloated in honors." When Noguchi was awarded an honorary doctorate at Yale, William Lyon Phelps observed that the kings of Spain, Denmark and Sweden had conferred awards, but "perhaps he appreciates even more than royal honors the admiration and the gratitude of the people." Noguchi's remains were returned to the United States and buried in Woodlawn Cemetery in the Bronx , New York City. In 1928, the Japanese government awarded Noguchi the Order of the Rising Sun, Gold and Silver Star , which represents the second highest of eight classes associated with the award. In 1979, the Noguchi Memorial Institute for Medical Research (NMIMR) was founded with funds donated by the Japanese government at the University of Ghana in Legon, a suburb north of Accra . In 1981, the Instituto Nacional de Salud Mental (National Institute of Mental Health) "Honorio Delgado - Hideyo Noguchi" was founded with founds of the Peruvian Government and the JICA (Japan International Cooperation Agency) in Lima - Perú. Dr. Noguchi's portrait has been printed on Japanese 1000- yen banknotes since 2004. In addition, the house near Inawashiro where he was born and brought up is preserved. It is operated as part of a museum to his life and achievements. Noguchi's name is honored at the Centro de Investigaciones Regionales Dr. Hideyo Noguchi at the Universidad Autónoma de Yucatán . A 2.1 km street in Guayaquil, Ecuador downtown is named after Dr. Hideyo Noguchi.The Japanese Government established the Hideyo Noguchi Africa Prize in July 2006 as a new international medical research and services award to mark the official visit by Prime Minister Jun'ichirō Koizumi to Africa in May 2006 and the 80th anniversary of Dr. Noguchi's death. The Prize is awarded to individuals with outstanding achievements in combating various infectious diseases in Africa or in establishing innovative medical service systems. The presentation ceremony and laureate lectures coincided with the Fourth Tokyo International Conference on African Development in late April 2008. In 2009, the conference venue was moved from Tokyo to Yokohama as another way of honoring the man after whom the prize was named. In 1899, Dr. Noguchi worked at the Yokohama Port Quarantine Office as an assistant quarantine doctor. The Prize is expected to be awarded every five years. The prize has been made possible through a combination of government funding and private donations.

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Yellow fever

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Vaccine-preventable disease

A vaccine-preventable disease is an infectious disease for which an effective preventive vaccine exists. If a person acquires a vaccine-preventable disease and dies from it, the death is considered a vaccine-preventable death . [ citation needed ] The most common and serious vaccine-preventable diseases tracked by the World Health Organization (WHO) are: diphtheria , Haemophilus influenzae serotype b infection , hepatitis B , measles , meningitis , mumps , pertussis , poliomyelitis , rubella , tetanus , tuberculosis , and yellow fever . The WHO reports licensed vaccines being available to prevent, or contribute to the prevention and control of, 31 vaccine-preventable infections. In 2012, the World Health Organization estimated that vaccination prevents 2.5 million deaths each year. With 100% immunization, and 100% efficacy of the vaccines, one out of seven deaths among young children could be prevented, mostly in developing countries, making this an important global health issue. Four diseases were responsible for 98% of vaccine-preventable deaths: measles , Haemophilus influenzae serotype b , pertussis , and neonatal tetanus . The Immunization Surveillance, Assessment and Monitoring program of the WHO monitors and assesses the safety and effectiveness of programs and vaccines at reducing illness and deaths from diseases that could be prevented by vaccines. Vaccine-preventable deaths are usually caused by a failure to obtain the vaccine in a timely manner. This may be due to financial constraints or to lack of access to the vaccine. A vaccine that is generally recommended may be medically inappropriate for a small number of people due to severe allergies or a damaged immune system . In addition, a vaccine against a given disease may not be recommended for general use in a given country, or may be recommended only to certain populations, such as young children or older adults. Every country makes its own immunization recommendations, based on the diseases that are common in its area and its healthcare priorities. If a vaccine-preventable disease is uncommon in a country, then residents of that country are unlikely to receive a vaccine against it. For example, residents of Canada and the United States do not routinely receive vaccines against yellow fever , which leaves them vulnerable to infection if travelling to areas where risk of yellow fever is highest (endemic or transitional regions). The WHO lists 25 diseases for which vaccines are available:

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Yellow fever

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Visa requirements for Philippine citizens

Visa requirements for Filipino citizens are administrative entry restrictions imposed on citizens of the Philippines by the authorities of other territories. As of February 9, 2024, Filipino citizens had visa-free or visa on arrival access to 69 countries and territories, ranking the Philippine passport 75th in the world according to the Henley Passport Index . Women of all nationalities must cover their body with clothing, except for their face, hands and feet. Philippine passport holders who have a valid, multiple-entry Schengen visa, which has been previously used in one of the Schengen states, or foreign citizens who have a valid permit of stay in one of the Schengen states, can enter visa-free. Philippine passport holders who have a valid, multiple-entry U.S. or UK visa, which has been previously used in the respective country of issuance, or have valid permit of stay in the U.S. or UK, can enter visa-free. There are no visa requirements for entry into Andorra, but it can only be accessed by passing through France or Spain. A multiple entry visa is required to re-enter either France or Spain when leaving Andorra. All visitors can stay for 3 months. Visa on arrival for Filipinos with valid visa or resident card from Canada, the United Kingdom, and the United States, or a Schengen visa. Those with valid B2 or B1 / B2 visa issued by the U.S. are eligible to apply for Electronic Travel Authorization (eTA) prior to arrival (eTA fee is 50 USD and processing time is 20 working days). Visa on arrival for holders of valid sticker visa or resident card issued by Australia, Canada, GCC countries, Japan, New Zealand, Russia, South Korea, EU or Schengen Area member states, United Kingdom or United States. May apply online (Online Visitor e600 visa). Transit visa is not required. Filipinos with existing Saudi Iqama (valid for at least 3 months) and Saudi Exit-ReEntry visa can enter Bahrain visa-free via King Fahad Causeway Bridge. As of 2018, individuals with valid U.S. or Schengen Treaty Visas in their passports, as well as individuals with valid U.S. residency, do not require a visa to travel to Belize. Must have an international vaccination certificate. Visa free for up to 30 days for valid UK or Schengen visa holders. 90 days on arrival, can extend another 90 days for 180 days total. 30 days upon arrival, can extend for total of 90 days. Visa free for a maximum stay of 90 days for valid visa holders or residents of the Schengen member states. Eligible to travel to Cuba for up to 30 days, provided that the Philippine passport holder has a tourist card and also holds a valid visa or permanent residence permit issued by Canada, the United States or an EU member state. Visa on arrival with a valid Schengen visa or residence permit. The passport must be valid for at least 6 months beyond the return date. Visa is not required for a maximum stay of 90 days within 180 days for valid visa holders or residents of Canada, the European Union member states, or the United States. Must obtain an entry clearance from the Gambian Immigration prior to travel. Visa is not required for a maximum stay of 90 days within 180 days for valid visa holders or residents of Canada, the European Union member states, or the United States. Visa is not required for a maximum stay of 90 days within 180 days for valid visa holders or residents of Canada, the European Union member states, or the United States. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. 90 days within any 12-month period. Visa free transit (up to 30 days) provided holding a valid U.S., Canada, Australia, New Zealand visa, and arriving from or departing to those countries. Visa-free access for 30 days to Jeju Island . Group tourists from the Philippines can travel visa-free through Yangyang International Airport until May 2024. Group tourists can only travel to the Gangwon-do region and the metropolitan area of South Korea, and the maximum stay is 15 days. According to the Article 7 para 1 of the Regulation on Visa Regime Published on: May 13, 2021 9:07 AM of Montenegro, "holders of valid foreign travel documents containing a valid Schengen visa, a valid visa of Commonwealth of Australia, the Republic of Bulgaria, the Republic of Croatia, Japan, Canada, New Zealand, Ireland, Romania, the United States of America and the United Kingdom of Great Britain and Northern Ireland may enter, pass through the territory and stay in Montenegro up to 30 days, and not longer than the expiry of visa if the period of validity of the visa is less than 30 days." Those with a valid Canadian, UK or U.S. visa with a validity date at least 5 days beyond the intended period of stay in the Republic of Macedonia can stay for up to 15 days at any given entry on the territory of the Republic of Macedonia while the total duration of consecutive stays in the Republic of Macedonia must not exceed 3 months in any six-month period calculated from the day of first entry. Travelers can enter the country with a valid Schengen visa. Filipinos who hold a valid multiple-entry visa or resident permit issued by the United States, the United Kingdom, Canada, Australia, Japan, the European Union, Singapore or South Korea can travel to Panama visa-free for stays of up to 30 days. Philippine passport holders with already used but still valid US, UK, Schengen visas can avail visa-on-arrival at any port of entry in Saudi Arabia. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. Electronic Travel Authorization can also be obtained on arrival. 30 days extendable to 6 months. Maximum 2 visits annually if not arriving by air. e-Visa (30 days) is currently suspended following the Russian invasion of Ukraine . Visas are valid for tourism and business purposes for 30 days. From January 1, 2019, electronic visas will also be available for the following purposes: treatment, activities in the field of culture, science, education, sports, in order to perform official duties of a foreign correspondent or representative of a foreign media. Starting November 1, 2020, visa cost will be reduced to 20 USD for visa with single entry and 30 USD for double-entry visa with decision within 3 business days. Urgent visa processing will be available for double visa fee (40/60 USD) and decision within 1 business day. Certain countries allow Filipino citizens to enter without a visa if they are in a possession of a valid visa or resident permit for Canada , Ireland , the Schengen area , the United States or the United Kingdom . Visa requirements for Filipino citizens for entry to various territories, disputed areas, partially recognized countries and restricted zones: 3 months within any year period. Filipino citizens may enter the Moroccan controlled zone of Western Sahara without obtaining a visa. May stay up to 14 days. In possession of a long-stay visa or hold a valid residence permit issued by a Schengen member state. Holding a residence permit for Andorra or Monaco. A flight crew in the performance of your duties, to travel only in the airport or surrounding areas for the duration of the stopover. A seafarer, holding a "seaman's book" recognised by the French authorities, in order to go ashore in the authorised area for the duration of the stopover. (By authorised area, we mean the port area, the commune of the port of call, the neighbouring communes as defined by the Prefect or the State Representative for certain overseas territories), A passenger of a vessel who will remain on board during the stop. A passenger on a cruise ship and you plan to enter and stay during the period of the stopover, and you hold a valid residence permit issued by a Member State of the European Union, the European Economic Area or Switzerland, or issued by Andorra, Monaco, San Marino, Canada, Japan or the United States of America authorising readmission to these States, or if you hold a valid visa issued by a French authority for another part of the territory of France. Visa is not required if you are: In possession of a long-stay visa or hold a valid residence permit issued by a Schengen member state Holding a residence permit for Andorra or Monaco. A flight crew in the performance of your duties, to travel only in the airport or surrounding areas for the duration of the stopover. A seafarer, holding a "seaman's book" recognised by the French authorities, in order to go ashore in the authorised area for the duration of the stopover. (By authorised area, we mean the port area, the commune of the port of call, the neighbouring communes as defined by the Prefect or the State Representative for certain overseas territories), A passenger of a vessel who will remain on board during the stop. A passenger on a cruise ship and you plan to enter and stay during the period of the stopover, and you hold a valid residence permit issued by a Member State of the European Union, the European Economic Area or Switzerland, or issued by Andorra, Monaco, San Marino, Canada, Japan or the United States of America authorising readmission to these States, or if you hold a valid visa issued by a French authority for another part of the territory of France. US Tourist or Resident Visa (including an H-1B work visa or green card). UK Tourist or Resident Visa. Canadian Tourist or Resident Visa.Visa requirements for Filipino citizens for entry to various territories, disputed areas, partially recognized countries and restricted zones: 3 months within any year period. Filipino citizens may enter the Moroccan controlled zone of Western Sahara without obtaining a visa. May stay up to 14 days. In possession of a long-stay visa or hold a valid residence permit issued by a Schengen member state. Holding a residence permit for Andorra or Monaco. A flight crew in the performance of your duties, to travel only in the airport or surrounding areas for the duration of the stopover. A seafarer, holding a "seaman's book" recognised by the French authorities, in order to go ashore in the authorised area for the duration of the stopover. (By authorised area, we mean the port area, the commune of the port of call, the neighbouring communes as defined by the Prefect or the State Representative for certain overseas territories), A passenger of a vessel who will remain on board during the stop. A passenger on a cruise ship and you plan to enter and stay during the period of the stopover, and you hold a valid residence permit issued by a Member State of the European Union, the European Economic Area or Switzerland, or issued by Andorra, Monaco, San Marino, Canada, Japan or the United States of America authorising readmission to these States, or if you hold a valid visa issued by a French authority for another part of the territory of France. Visa is not required if you are: In possession of a long-stay visa or hold a valid residence permit issued by a Schengen member state Holding a residence permit for Andorra or Monaco. A flight crew in the performance of your duties, to travel only in the airport or surrounding areas for the duration of the stopover. A seafarer, holding a "seaman's book" recognised by the French authorities, in order to go ashore in the authorised area for the duration of the stopover. (By authorised area, we mean the port area, the commune of the port of call, the neighbouring communes as defined by the Prefect or the State Representative for certain overseas territories), A passenger of a vessel who will remain on board during the stop. A passenger on a cruise ship and you plan to enter and stay during the period of the stopover, and you hold a valid residence permit issued by a Member State of the European Union, the European Economic Area or Switzerland, or issued by Andorra, Monaco, San Marino, Canada, Japan or the United States of America authorising readmission to these States, or if you hold a valid visa issued by a French authority for another part of the territory of France. US Tourist or Resident Visa (including an H-1B work visa or green card). UK Tourist or Resident Visa. Canadian Tourist or Resident Visa.Holders of an APEC Business Travel Card (ABTC) travelling on business do not require a visa to the following countries: 1 - Up to 180 days 2 - Up to 90 days 3 - Up to 90 days in a period of 180 days 4 - Up to 60 days The card must be used in conjunction with a passport and has the following advantages: Many countries have entry restrictions on foreigners that go beyond the common requirement of having either a valid visa or a visa exemption. Such restrictions may be health related or impose additional documentation requirements on certain classes of people for diplomatic or political purposes. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa.

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Yellow_Jack_(flag)/html

Yellow Jack (flag)

The Yellow Jack (" Quebec ") signal flag, is a plain yellow banner that was historically used to signify a vessel was, or might be, harboring a dangerous disease and needed to be quarantined (the flag represents the letter "Q"). A ship flying two Quebecs ("QQ"), or "Double Quebec", is signaling: "I require health clearance." In both cases, if and when free pratique is granted, the vessel may lower the Quebec(s), raise the national ensign of the port, and do business there. In the event that, for health reasons, the vessel is not granted free pratique, it continues to fly the Quebec, in effect indicating that it is in quarantine until such time as any health concern is resolved. In international maritime signal flags , plain yellow, green, and black flags have been used to symbolize disease in ships and ports. The color yellow has a longer history. It was used to mark houses of infection prior to its maritime use. Yellow jack also became a name for yellow fever . Cholera -infected ships also used a yellow flag. The plain yellow flag ("Q" or "Quebec" in international maritime signal flags), may derive its letter symbol from its initial use in "quarantine". In some Indonesian cities such as Jakarta , plain yellow flags are commonly used to mark a recent death, regardless of cause. They are placed in intersections leading to the home of the recently deceased as direction markers for mourners, and to mark the funeral convoy , so that it is given the right of way .

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Yellow fever

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Yellow Fever (play)

Yellow Fever is a play by R. A. Shiomi , which takes place on Powell Street in Japantown, Vancouver , a gathering place for the local Japanese-Canadian culture. Set in the 1970s, the Sam Spade -like main character, Sam Shikaze, must work to unravel the mysteries that surround him. First produced by the Pan Asian Repertory Theatre in 1982, it received positive reviews and had a successful run off-Broadway.Sam Shikaze, a smooth private eye, narrates his own story about what happened when he was hired to find the missing Cherry Blossom Queen. He is soon trapped in a web of racism and political intrigue that seems to lead back to the Hong Kong tongs. Chuck Chan is a lawyer who tried to help solve the case, while Nancy Wing is a beautiful reporter who is searching for a story. Captain Kadota, an old friend of Sam's, offers his aid as a member of the police force, although Sam and Kadota do not see eye-to-eye on politics. Sam Shikaze ( Donald Li ) Rosie (Carol Honda) Goldberg (James Jenner) Chuck Chan (Henry Yuk) Nancy Wing ( Freda Foh Shen ) Sergeant Mackenzie (Jeffrey Spolan) Capt. Kenji Kadota ( Ernest Abuba ) Superintendent Jameson (James Jenner) Presented by the Pan Asian Repertory Theater: Raul Aranasm, stage director Tisa Chang , artistic director Susan Socolowski, administrative director

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Yellow fever

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History of virology

The history of virology – the scientific study of viruses and the infections they cause – began in the closing years of the 19th century. Although Edward Jenner and Louis Pasteur developed the first vaccines to protect against viral infections, they did not know that viruses existed. The first evidence of the existence of viruses came from experiments with filters that had pores small enough to retain bacteria. In 1892, Dmitri Ivanovsky used one of these filters to show that sap from a diseased tobacco plant remained infectious to healthy tobacco plants despite having been filtered. Martinus Beijerinck called the filtered, infectious substance a "virus" and this discovery is considered to be the beginning of virology . The subsequent discovery and partial characterization of bacteriophages by Frederick Twort and Félix d'Herelle further catalyzed the field, and by the early 20th century many viruses had been discovered. In 1926, Thomas Milton Rivers defined viruses as obligate parasites. Viruses were demonstrated to be particles, rather than a fluid, by Wendell Meredith Stanley , and the invention of the electron microscope in 1931 allowed their complex structures to be visualised.Despite his other successes, Louis Pasteur (1822–1895) was unable to find a causative agent for rabies and speculated about a pathogen too small to be detected using a microscope. In 1884, the French microbiologist Charles Chamberland (1851–1931) invented a filter – known today as the Chamberland filter – that had pores smaller than bacteria. Thus, he could pass a solution containing bacteria through the filter and completely remove them from the solution. In 1876, Adolf Mayer , who directed the Agricultural Experimental Station in Wageningen , was the first to show that what he called "Tobacco Mosaic Disease" was infectious. He thought that it was caused by either a toxin or a very small bacterium. Later, in 1892, the Russian biologist Dmitry Ivanovsky (1864–1920) used a Chamberland filter to study what is now known as the tobacco mosaic virus . His experiments showed that crushed leaf extracts from infected tobacco plants remain infectious after filtration. Ivanovsky suggested the infection might be caused by a toxin produced by bacteria, but did not pursue the idea. In 1898, the Dutch microbiologist Martinus Beijerinck (1851–1931), a microbiology teacher at the Agricultural School in Wageningen repeated experiments by Adolf Mayer and became convinced that filtrate contained a new form of infectious agent. He observed that the agent multiplied only in cells that were dividing and he called it a contagium vivum fluidum (soluble living germ) and re-introduced the word virus . Beijerinck maintained that viruses were liquid in nature, a theory later discredited by the American biochemist and virologist Wendell Meredith Stanley (1904–1971), who proved that they were in fact, particles. In the same year, 1898, Friedrich Loeffler (1852–1915) and Paul Frosch (1860–1928) passed the first animal virus through a similar filter and discovered the cause of foot-and-mouth disease . The first human virus to be identified was the yellow fever virus . In 1881, Carlos Finlay (1833–1915), a Cuban physician, first conducted and published research that indicated that mosquitoes were carrying the cause of yellow fever, a theory proved in 1900 by commission headed by Walter Reed (1851–1902). During 1901 and 1902, William Crawford Gorgas (1854–1920) organised the destruction of the mosquitoes' breeding habitats in Cuba, which dramatically reduced the prevalence of the disease. Gorgas later organised the elimination of the mosquitoes from Panama, which allowed the Panama Canal to be opened in 1914. The virus was finally isolated by Max Theiler (1899–1972) in 1932 who went on to develop a successful vaccine. By 1928 enough was known about viruses to enable the publication of Filterable Viruses , a collection of essays covering all known viruses edited by Thomas Milton Rivers (1888–1962). Rivers, a survivor of typhoid fever contracted at the age of twelve, went on to have a distinguished career in virology. In 1926, he was invited to speak at a meeting organised by the Society of American Bacteriology where he said for the first time, "Viruses appear to be obligate parasites in the sense that their reproduction is dependent on living cells." The notion that viruses were particles was not considered unnatural and fitted in nicely with the germ theory . It is assumed that Dr. J. Buist of Edinburgh was the first person to see virus particles in 1886, when he reported seeing "micrococci" in vaccine lymph, though he had probably observed clumps of vaccinia . In the years that followed, as optical microscopes were improved "inclusion bodies" were seen in many virus-infected cells, but these aggregates of virus particles were still too small to reveal any detailed structure. It was not until the invention of the electron microscope in 1931 by the German engineers Ernst Ruska (1906–1988) and Max Knoll (1887–1969), that virus particles, especially bacteriophages , were shown to have complex structures. The sizes of viruses determined using this new microscope fitted in well with those estimated by filtration experiments. Viruses were expected to be small, but the range of sizes came as a surprise. Some were only a little smaller than the smallest known bacteria, and the smaller viruses were of similar sizes to complex organic molecules. In 1935, Wendell Stanley examined the tobacco mosaic virus and found it was mostly made of protein. In 1939, Stanley and Max Lauffer (1914) separated the virus into protein and nucleic acid , which was shown by Stanley's postdoctoral fellow Hubert S. Loring to be specifically RNA . The discovery of RNA in the particles was important because in 1928, Fred Griffith ( c. 1879 –1941) provided the first evidence that its "cousin", DNA , formed genes . In Pasteur's day, and for many years after his death, the word "virus" was used to describe any cause of infectious disease. Many bacteriologists soon discovered the cause of numerous infections. However, some infections remained, many of them horrendous, for which no bacterial cause could be found. These agents were invisible and could only be grown in living animals. The discovery of viruses paved the way to understanding these mysterious infections. And, although Koch's postulates could not be fulfilled for many of these infections, this did not stop the pioneer virologists from looking for viruses in infections for which no other cause could be found. Bacteriophages are the viruses that infect and replicate in bacteria. They were discovered in the early 20th century, by the English bacteriologist Frederick Twort (1877–1950). But before this time, in 1896, the bacteriologist Ernest Hanbury Hankin (1865–1939) reported that something in the waters of the River Ganges could kill Vibrio cholerae – the cause of cholera . The agent in the water could be passed through filters that remove bacteria but was destroyed by boiling. Twort discovered the action of bacteriophages on staphylococci bacteria. He noticed that when grown on nutrient agar some colonies of the bacteria became watery. He collected some of these watery colonies and passed them through a Chamberland filter to remove the bacteria and discovered that when the filtrate was added to fresh cultures of bacteria, they in turn became watery. He proposed that the agent might be "an amoeba, an ultramicroscopic virus, a living protoplasm, or an enzyme with the power of growth". Félix d'Herelle (1873–1949) was a mainly self-taught French-Canadian microbiologist. In 1917 he discovered that "an invisible antagonist", when added to bacteria on agar , would produce areas of dead bacteria. The antagonist, now known to be a bacteriophage, could pass through a Chamberland filter. He accurately diluted a suspension of these viruses and discovered that the highest dilutions (lowest virus concentrations), rather than killing all the bacteria, formed discrete areas of dead organisms. Counting these areas and multiplying by the dilution factor allowed him to calculate the number of viruses in the original suspension. He realised that he had discovered a new form of virus and later coined the term "bacteriophage". Between 1918 and 1921 d'Herelle discovered different types of bacteriophages that could infect several other species of bacteria including Vibrio cholerae . Bacteriophages were heralded as a potential treatment for diseases such as typhoid and cholera , but their promise was forgotten with the development of penicillin . Since the early 1970s, bacteria have continued to develop resistance to antibiotics such as penicillin , and this has led to a renewed interest in the use of bacteriophages to treat serious infections . D'Herelle travelled widely to promote the use of bacteriophages in the treatment of bacterial infections. In 1928, he became professor of biology at Yale and founded several research institutes. He was convinced that bacteriophages were viruses despite opposition from established bacteriologists such as the Nobel Prize winner Jules Bordet (1870–1961). Bordet argued that bacteriophages were not viruses but just enzymes released from "lysogenic" bacteria. He said "the invisible world of d'Herelle does not exist". But in the 1930s, the proof that bacteriophages were viruses was provided by Christopher Andrewes (1896–1988) and others. They showed that these viruses differed in size and in their chemical and serological properties. In 1940, the first electron micrograph of a bacteriophage was published and this silenced sceptics who had argued that bacteriophages were relatively simple enzymes and not viruses. Numerous other types of bacteriophages were quickly discovered and were shown to infect bacteria wherever they are found. Early research was interrupted by World War II . d'Herelle, despite his Canadian citizenship, was interned by the Vichy Government until the end of the war. Knowledge of bacteriophages increased in the 1940s following the formation of the Phage Group by scientists throughout the US. Among the members were Max Delbrück (1906–1981) who founded a course on bacteriophages at Cold Spring Harbor Laboratory . Other key members of the Phage Group included Salvador Luria (1912–1991) and Alfred Hershey (1908–1997). During the 1950s, Hershey and Chase made important discoveries on the replication of DNA during their studies on a bacteriophage called T2 . Together with Delbruck they were jointly awarded the 1969 Nobel Prize in Physiology or Medicine "for their discoveries concerning the replication mechanism and the genetic structure of viruses". Since then, the study of bacteriophages has provided insights into the switching on and off of genes, and a useful mechanism for introducing foreign genes into bacteria and many other fundamental mechanisms of molecular biology . Bacteriophages are the viruses that infect and replicate in bacteria. They were discovered in the early 20th century, by the English bacteriologist Frederick Twort (1877–1950). But before this time, in 1896, the bacteriologist Ernest Hanbury Hankin (1865–1939) reported that something in the waters of the River Ganges could kill Vibrio cholerae – the cause of cholera . The agent in the water could be passed through filters that remove bacteria but was destroyed by boiling. Twort discovered the action of bacteriophages on staphylococci bacteria. He noticed that when grown on nutrient agar some colonies of the bacteria became watery. He collected some of these watery colonies and passed them through a Chamberland filter to remove the bacteria and discovered that when the filtrate was added to fresh cultures of bacteria, they in turn became watery. He proposed that the agent might be "an amoeba, an ultramicroscopic virus, a living protoplasm, or an enzyme with the power of growth". Félix d'Herelle (1873–1949) was a mainly self-taught French-Canadian microbiologist. In 1917 he discovered that "an invisible antagonist", when added to bacteria on agar , would produce areas of dead bacteria. The antagonist, now known to be a bacteriophage, could pass through a Chamberland filter. He accurately diluted a suspension of these viruses and discovered that the highest dilutions (lowest virus concentrations), rather than killing all the bacteria, formed discrete areas of dead organisms. Counting these areas and multiplying by the dilution factor allowed him to calculate the number of viruses in the original suspension. He realised that he had discovered a new form of virus and later coined the term "bacteriophage". Between 1918 and 1921 d'Herelle discovered different types of bacteriophages that could infect several other species of bacteria including Vibrio cholerae . Bacteriophages were heralded as a potential treatment for diseases such as typhoid and cholera , but their promise was forgotten with the development of penicillin . Since the early 1970s, bacteria have continued to develop resistance to antibiotics such as penicillin , and this has led to a renewed interest in the use of bacteriophages to treat serious infections . D'Herelle travelled widely to promote the use of bacteriophages in the treatment of bacterial infections. In 1928, he became professor of biology at Yale and founded several research institutes. He was convinced that bacteriophages were viruses despite opposition from established bacteriologists such as the Nobel Prize winner Jules Bordet (1870–1961). Bordet argued that bacteriophages were not viruses but just enzymes released from "lysogenic" bacteria. He said "the invisible world of d'Herelle does not exist". But in the 1930s, the proof that bacteriophages were viruses was provided by Christopher Andrewes (1896–1988) and others. They showed that these viruses differed in size and in their chemical and serological properties. In 1940, the first electron micrograph of a bacteriophage was published and this silenced sceptics who had argued that bacteriophages were relatively simple enzymes and not viruses. Numerous other types of bacteriophages were quickly discovered and were shown to infect bacteria wherever they are found. Early research was interrupted by World War II . d'Herelle, despite his Canadian citizenship, was interned by the Vichy Government until the end of the war. Knowledge of bacteriophages increased in the 1940s following the formation of the Phage Group by scientists throughout the US. Among the members were Max Delbrück (1906–1981) who founded a course on bacteriophages at Cold Spring Harbor Laboratory . Other key members of the Phage Group included Salvador Luria (1912–1991) and Alfred Hershey (1908–1997). During the 1950s, Hershey and Chase made important discoveries on the replication of DNA during their studies on a bacteriophage called T2 . Together with Delbruck they were jointly awarded the 1969 Nobel Prize in Physiology or Medicine "for their discoveries concerning the replication mechanism and the genetic structure of viruses". Since then, the study of bacteriophages has provided insights into the switching on and off of genes, and a useful mechanism for introducing foreign genes into bacteria and many other fundamental mechanisms of molecular biology . In 1882, Adolf Mayer (1843–1942) described a condition of tobacco plants, which he called "mosaic disease" ("mozaïkziekte"). The diseased plants had variegated leaves that were mottled . He excluded the possibility of a fungal infection and could not detect any bacterium and speculated that a "soluble, enzyme-like infectious principle was involved". He did not pursue his idea any further, and it was the filtration experiments of Ivanovsky and Beijerinck that suggested the cause was a previously unrecognised infectious agent. After tobacco mosaic was recognized as a virus disease, virus infections of many other plants were discovered. The importance of tobacco mosaic virus in the history of viruses cannot be overstated. It was the first virus to be discovered, and the first to be crystallised and its structure shown in detail. The first X-ray diffraction pictures of the crystallised virus were obtained by Bernal and Fankuchen in 1941. On the basis of her pictures, Rosalind Franklin discovered the full structure of the virus in 1955. In the same year, Heinz Fraenkel-Conrat and Robley Williams showed that purified tobacco mosaic virus RNA and its coat protein can assemble by themselves to form functional viruses, suggesting that this simple mechanism was probably the means through which viruses were created within their host cells. By 1935, many plant diseases were thought to be caused by viruses. In 1922, John Kunkel Small (1869–1938) discovered that insects could act as vectors and transmit virus to plants. In the following decade many diseases of plants were shown to be caused by viruses that were carried by insects and in 1939, Francis Holmes , a pioneer in plant virology, described 129 viruses that caused disease of plants. Modern, intensive agriculture provides a rich environment for many plant viruses. In 1948, in Kansas, US, 7% of the wheat crop was destroyed by wheat streak mosaic virus . The virus was spread by mites called Aceria tulipae . In 1970, the Russian plant virologist Joseph Atabekov discovered that many plant viruses only infect a single species of host plant. The International Committee on Taxonomy of Viruses now recognises over 900 plant viruses. By the end of the 19th century, viruses were defined in terms of their infectivity , their ability to be filtered, and their requirement for living hosts. Up until this time, viruses had only been grown in plants and animals, but in 1906, Ross Granville Harrison (1870–1959) invented a method for growing tissue in lymph , and, in 1913, E Steinhardt, C Israeli, and RA Lambert used this method to grow vaccinia virus in fragments of guinea pig corneal tissue. In 1928, HB and MC Maitland grew vaccinia virus in suspensions of minced hens' kidneys. Their method was not widely adopted until the 1950s, when poliovirus was grown on a large scale for vaccine production. In 1941–42, George Hirst (1909–94) developed assays based on haemagglutination to quantify a wide range of viruses as well as virus-specific antibodies in serum. Although the influenza virus that caused the 1918–1919 influenza pandemic was not discovered until the 1930s, the descriptions of the disease and subsequent research has proved it was to blame. The pandemic killed 40–50 million people in less than a year, but the proof that it was caused by a virus was not obtained until 1933. Haemophilus influenzae is an opportunistic bacterium which commonly follows influenza infections; this led the eminent German bacteriologist Richard Pfeiffer (1858–1945) to incorrectly conclude that this bacterium was the cause of influenza. A major breakthrough came in 1931, when the American pathologist Ernest William Goodpasture grew influenza and several other viruses in fertilised chickens' eggs. Hirst identified an enzymic activity associated with the virus particle, later characterised as the neuraminidase , the first demonstration that viruses could contain enzymes. Frank Macfarlane Burnet showed in the early 1950s that the virus recombines at high frequencies, and Hirst later deduced that it has a segmented genome. In 1949, John F. Enders (1897–1985) Thomas Weller (1915–2008), and Frederick Robbins (1916–2003) grew polio virus for the first time in cultured human embryo cells, the first virus to be grown without using solid animal tissue or eggs. Infections by poliovirus most often cause the mildest of symptoms. This was not known until the virus was isolated in cultured cells and many people were shown to have had mild infections that did not lead to poliomyelitis. But, unlike other viral infections, the incidence of polio – the rarer severe form of the infection – increased in the 20th century and reached a peak around 1952. The invention of a cell culture system for growing the virus enabled Jonas Salk (1914–1995) to make an effective polio vaccine . Denis Parsons Burkitt (1911–1993) was born in Enniskillen, County Fermanagh, Ireland. He was the first to describe a type of cancer that now bears his name Burkitt's lymphoma . This type of cancer was endemic in equatorial Africa and was the commonest malignancy of children in the early 1960s. In an attempt to find a cause for the cancer, Burkitt sent cells from the tumour to Anthony Epstein (b. 1921) a British virologist, who along with Yvonne Barr and Bert Achong (1928–1996), and after many failures, discovered viruses that resembled herpes virus in the fluid that surrounded the cells. The virus was later shown to be a previously unrecognised herpes virus, which is now called Epstein–Barr virus . Surprisingly, Epstein–Barr virus is a very common but relatively mild infection of Europeans. Why it can cause such a devastating illness in Africans is not fully understood, but reduced immunity to virus caused by malaria might be to blame. Epstein–Barr virus is important in the history of viruses for being the first virus shown to cause cancer in humans. The second half of the 20th century was the golden age of virus discovery and most of the 2,000 recognised species of animal, plant, and bacterial viruses were discovered during these years. In 1946, bovine virus diarrhea was discovered, which is still possibly the most common pathogen of cattle throughout the world and in 1957, equine arterivirus was discovered. In the 1950s, improvements in virus isolation and detection methods resulted in the discovery of several important human viruses including varicella zoster virus , the paramyxoviruses – which include measles virus and respiratory syncytial virus – and the rhinoviruses that cause the common cold . In the 1960s more viruses were discovered. In 1963, the hepatitis B virus was discovered by Baruch Blumberg (b. 1925). Reverse transcriptase , the key enzyme that retroviruses use to translate their RNA into DNA, was first described in 1970, independently by Howard Temin and David Baltimore (b. 1938). This was important to the development of antiviral drugs – a key turning-point in the history of viral infections. In 1983, Luc Montagnier (b. 1932) and his team at the Pasteur Institute in France first isolated the retrovirus now called HIV. In 1989 Michael Houghton 's team at Chiron Corporation discovered hepatitis C . New viruses and strains of viruses were discovered in every decade of the second half of the 20th century. These discoveries have continued in the 21st century as new viral diseases such as SARS and nipah virus have emerged. Despite scientists' achievements over the past one hundred years, viruses continue to pose new threats and challenges. Although the influenza virus that caused the 1918–1919 influenza pandemic was not discovered until the 1930s, the descriptions of the disease and subsequent research has proved it was to blame. The pandemic killed 40–50 million people in less than a year, but the proof that it was caused by a virus was not obtained until 1933. Haemophilus influenzae is an opportunistic bacterium which commonly follows influenza infections; this led the eminent German bacteriologist Richard Pfeiffer (1858–1945) to incorrectly conclude that this bacterium was the cause of influenza. A major breakthrough came in 1931, when the American pathologist Ernest William Goodpasture grew influenza and several other viruses in fertilised chickens' eggs. Hirst identified an enzymic activity associated with the virus particle, later characterised as the neuraminidase , the first demonstration that viruses could contain enzymes. Frank Macfarlane Burnet showed in the early 1950s that the virus recombines at high frequencies, and Hirst later deduced that it has a segmented genome. In 1949, John F. Enders (1897–1985) Thomas Weller (1915–2008), and Frederick Robbins (1916–2003) grew polio virus for the first time in cultured human embryo cells, the first virus to be grown without using solid animal tissue or eggs. Infections by poliovirus most often cause the mildest of symptoms. This was not known until the virus was isolated in cultured cells and many people were shown to have had mild infections that did not lead to poliomyelitis. But, unlike other viral infections, the incidence of polio – the rarer severe form of the infection – increased in the 20th century and reached a peak around 1952. The invention of a cell culture system for growing the virus enabled Jonas Salk (1914–1995) to make an effective polio vaccine . Denis Parsons Burkitt (1911–1993) was born in Enniskillen, County Fermanagh, Ireland. He was the first to describe a type of cancer that now bears his name Burkitt's lymphoma . This type of cancer was endemic in equatorial Africa and was the commonest malignancy of children in the early 1960s. In an attempt to find a cause for the cancer, Burkitt sent cells from the tumour to Anthony Epstein (b. 1921) a British virologist, who along with Yvonne Barr and Bert Achong (1928–1996), and after many failures, discovered viruses that resembled herpes virus in the fluid that surrounded the cells. The virus was later shown to be a previously unrecognised herpes virus, which is now called Epstein–Barr virus . Surprisingly, Epstein–Barr virus is a very common but relatively mild infection of Europeans. Why it can cause such a devastating illness in Africans is not fully understood, but reduced immunity to virus caused by malaria might be to blame. Epstein–Barr virus is important in the history of viruses for being the first virus shown to cause cancer in humans. The second half of the 20th century was the golden age of virus discovery and most of the 2,000 recognised species of animal, plant, and bacterial viruses were discovered during these years. In 1946, bovine virus diarrhea was discovered, which is still possibly the most common pathogen of cattle throughout the world and in 1957, equine arterivirus was discovered. In the 1950s, improvements in virus isolation and detection methods resulted in the discovery of several important human viruses including varicella zoster virus , the paramyxoviruses – which include measles virus and respiratory syncytial virus – and the rhinoviruses that cause the common cold . In the 1960s more viruses were discovered. In 1963, the hepatitis B virus was discovered by Baruch Blumberg (b. 1925). Reverse transcriptase , the key enzyme that retroviruses use to translate their RNA into DNA, was first described in 1970, independently by Howard Temin and David Baltimore (b. 1938). This was important to the development of antiviral drugs – a key turning-point in the history of viral infections. In 1983, Luc Montagnier (b. 1932) and his team at the Pasteur Institute in France first isolated the retrovirus now called HIV. In 1989 Michael Houghton 's team at Chiron Corporation discovered hepatitis C . New viruses and strains of viruses were discovered in every decade of the second half of the 20th century. These discoveries have continued in the 21st century as new viral diseases such as SARS and nipah virus have emerged. Despite scientists' achievements over the past one hundred years, viruses continue to pose new threats and challenges.

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Yellow fever

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Absalom Jones

Absalom Jones (November 7, 1746 – February 13, 1818) was an African-American abolitionist and clergyman who became prominent in Philadelphia , Pennsylvania . Disappointed at the racial discrimination he experienced in a local Methodist church, he founded the Free African Society with Richard Allen in 1787, a mutual aid society for African Americans in the city. The Free African Society included many people newly freed from slavery after the American Revolutionary War . In 1794, Jones founded the first Black Episcopal congregation, and in 1802, he was the first African American to be ordained as a priest in the Episcopal Church of the United States. He is listed on the Episcopal calendar of saints . He is remembered liturgically on the date of his death, February 13, in the 1979 Book of Common Prayer as "Absalom Jones, Priest, 1818".Absalom Jones was born into slavery in Sussex County , Delaware , in 1746. When he was sixteen, his enslaver sold him, his mother, and his siblings to a neighboring farmer. That year, the farmer kept Absalom but sold his mother and siblings and moved to Philadelphia, Pennsylvania , where he became a merchant. Absalom was allowed to attend Benezet's School , where he learned to read and write. While still enslaved by Mr. Wynkop (who was a vestryman of Christ Church and later St. Peter's ), Absalom married Mary King (an enslaved woman owned by S. King, a neighbor to the Wynkoops), on January 4, 1770. Rev. Jacob Duché performed the wedding ceremony. By 1778, Absalom had purchased his wife's freedom so their children would be free; he asked for aid by donations and loans. (According to colonial law, children took the status of their mother, so children born to enslaved women were enslaved from birth.) Absalom also wrote to his enslaver seeking his freedom but was initially denied. In 1784, however, Wynkoop manumitted him, inspired by revolutionary ideals. Absalom took the surname "Jones" as an indication of his American identity. Later, Jones applied for his freedom for the second time. He was released from slavery on October 1, 1784. After being released from slavery, Absalom was ordained as a priest in September 1802. This made him the first Black person to be ordained in America by a well-known religion. Around 1780, a Methodist movement was sweeping through the colonies as part of the Second Great Awakening . It came at a time of revolutionary ferment in the closing period of the American Revolutionary War. The movement was especially popular in New York, Baltimore, and Philadelphia. Methodists had developed in Great Britain as evangelicals within the Church of England . In December 1784, Thomas Coke and Francis Asbury established the Methodist Episcopal Church as a new denomination, separate from the Church of England. Pennsylvania abolished slavery and became a free state in the new United States. Jones became a lay minister of the interracial congregation of St. George's Methodist Episcopal Church in Philadelphia. The Methodist church admitted persons of all races and allowed African Americans to preach. Together with Richard Allen , Jones was one of the first African Americans licensed to preach by the Methodist Episcopal Church. However, members of the church still practiced racial discrimination. In 1792, while at St. George's Methodist Episcopal Church, Absalom Jones and other African American members were told that they could not join the rest of the congregation in seating and kneeling on the first floor and instead had to be segregated first sitting against the wall and then in the gallery or balcony. After their prayer, Jones and most of the church's African-American members got up and walked out. Jones and Allen founded the Free African Society (FAS), first conceived as a non-denominational mutual aid society, to help newly freed people in Philadelphia. Jones and Allen later separated, as their religious lives took different directions after 1794. They remained lifelong friends and collaborators. As 1791 began, Jones started holding religious services at FAS, which became the core of his African Church in Philadelphia the following year. Jones wanted to establish an African-American congregation independent of Caucasian control while remaining part of the Episcopal Church . After a successful petition, the African Episcopal Church of St. Thomas , the first Black church in Philadelphia, opened its doors on July 17, 1794. Jones was ordained as a deacon in 1795 and as a priest in 1802, became the first African-American priest in the Episcopal Church. A month after St. Thomas church opened, the Founders and Trustees published "The Causes and Motives for Establishing St. Thomas's African Church of Philadelphia," saying their intent was "to arise out of the dust and shake ourselves, and throw off that servile fear, that the habit of oppression and bondage trained us up in." Famous for his oratory, Jones helped establish the tradition of anti-slavery sermons on New Year's Day. His sermon for January 1, 1808, the date on which the U.S. Constitution mandated the end of the African slave trade , was called "A Thanksgiving Sermon" and published in pamphlet form. It became famous. Rumors persisted that Jones had supernatural abilities to influence the minds of assembled congregations. Caucasian observers failed to recognize his oratory skills, perhaps because they believed rhetoric to be beyond the capabilities of people of African descent. Numerous other African-American leaders were similarly said to have supernatural abilities. In 1775, the state of North Carolina had made it illegal to free enslaved people unless approved by a county court, a provision largely ignored by members of the Society of Friends (Quakers). They not only continued to free the people they enslaved but, in some cases, bought enslaved people from other men to free them. In 1788, the North Carolina legislature passed a law allowing the capture and sale of any formerly enslaved person freed without court approval, with twenty percent of the sale price going as a reward to the person who reported the illegal manumission. Many freed African Americans fled the state to avoid being captured and sold back into slavery. After becoming the first Black and freedman to be ordained as a priest, and as the Constitution's deadline for abolition of the slave trade passed, Jones took part in the first group of African Americans to petition the U.S. Congress . Their petition related to the Fugitive Slave Act of 1793 , which they criticized for encouraging cruelty and brutality, as well as supporting the continuing criminal practice of kidnapping free Bl acks and selling them into slavery. Jones drafted a petition on behalf of four formerly enslaved people and asked Congress to adopt "some remedy for an evil of such magnitude." The petition was presented on 30 January 1797 by U.S. Representative John Swanwick of Pennsylvania. Jones used moral suasion: trying to convince whites that slavery was immoral, offensive to God, and contrary to the nation's ideal. Although U.S. Representative George Thatcher of Massachusetts argued that the petition should be accepted and referred to the Committee on the Fugitive Law, the House of Representatives declined to accept the petition by a vote of 50 to 33. Jones submitted a similar petition two years later, which was also declined.On a parallel path, Richard Allen (1760–1831) founded the African Methodist Episcopal Church (AME), the first independent Black church within the Methodist tradition. He and his followers converted a building and opened it on July 29, 1794, as Mother Bethel A.M.E. Church . In 1799, Allen was ordained as the first Black minister in the Methodist Church by Bishop Francis Asbury . In 1816, Allen gathered other B lack congregations in the region to create a new and fully independent denomination, the African Methodist Episcopal Church. In 1816, Allen was elected as the AME's first bishop.Yellow fever repeatedly struck Philadelphia and other coastal cities in the 1790s, until sanitary improvements advocated by Dr. Benjamin Rush were adopted and completed. In the meantime, Allen and Jones assisted Rush in helping people afflicted by the plague, for people of African descent were initially rumored to be immune. Many Caucasians (including most doctors except for Rush and his assistants, some of whom died) fled the city, hoping to escape infection. Allen and Jones' corps of African-American Philadelphians helped nurse the sick, as well as bury the dead. Jones, in particular, sometimes worked through the night. However, Rush's reliance on bleeding and purging as a medical treatment proved misplaced. When Mathew Carey published a popular pamphlet accusing African Americans of profiting from nursing sick Caucasian citizens, Jones and Allen published a protest pamphlet in response. They described sacrifices that they and the Free African Society members made for the city's health. Philadelphia Mayor Matthew Clarkson , who had called upon them for help, publicly recognized that Jones and Allen acted upon their desires to improve the entire community. Jones' responses to the overall crisis strengthened ties between 'free' African Americans and many progressive Caucasians, aiding him later on when he established St. Thomas' Episcopal Church. Almost twenty times more black people helped the plague-struck than whites, which proved crucial in helping St. Thomas Church gain social acceptance. Jones died on February 13, 1818, in Philadelphia. He was initially interred in the St. Thomas Churchyard in Philadelphia, Pennsylvania. His body was relocated to Lebanon Cemetery and then to Eden Cemetery . In 1991, his remains were exhumed, cremated and placed in a reliquary in the Absalom Jones altar of the current African Episcopal Church of St. Thomas (now located at 6361 Lancaster Avenue in Philadelphia). The chapel is named in his honor, as is the church's rectory. The national Episcopal Church remembers his life and service annually with a Lesser Feast on the anniversary of his death, February 13 . The Diocese of Pennsylvania honors his memory with an annual celebration and award.

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Yellow fever

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Wilmington, North Carolina

Wilmington is a port city in and the county seat of New Hanover County in coastal southeastern North Carolina , United States. With a population of 115,451 in the 2020 census , it is the eighth-most populous city in the state . Wilmington is the principal city of the Wilmington, NC Metropolitan Statistical Area , which includes the Pender , and Brunswick counties in southeastern North Carolina as well as New Hanover county. Its metropolitan statistical area had an estimated population of 467,337 in 2020. Wilmington's historic downtown has a 1.75-mile (2.82 km) riverwalk, developed as a tourist attraction in the late 20th century. In 2014, Wilmington's riverfront was ranked as the "Best American Riverfront" by readers of USA Today . The National Trust for Historic Preservation selected Wilmington as one of its 2008 Dozen Distinctive Destinations. City residents live between the Cape Fear River and the Atlantic Ocean , with four nearby beach communities just outside Wilmington: Fort Fisher , Wrightsville Beach , Carolina Beach , and Kure Beach , all within half-hour drives from downtown Wilmington. The city is home to the University of North Carolina Wilmington (UNCW), which provides a wide variety of programs for undergraduates, graduate students, and adult learners, in addition to cultural and sports events open to the community. Toward the end of the 19th century, Wilmington was a majority-black, racially integrated, prosperous city, and the largest city in North Carolina. In the Wilmington massacre of 1898 , white supremacists launched a coup that overthrew the legitimately elected local Fusionist government. They expelled opposition black and white leaders from the city, destroyed the property and businesses of black citizens built up since the Civil War , including the only black newspaper in the city, and killed an estimated 60 to more than 300 people. This coincided with broader efforts of disenfranchisement at the state level. Whereas North Carolina had 125,000 registered black voters in 1896, it had 6,000 black voters by 1902. By 1910, Charlotte overtook Wilmington as North Carolina's largest city. In 2003, the city was designated by the U.S. Congress as a "Coast Guard City", one of 29 cities that currently bear that designation, and was the home port for the USCGC Diligence , a United States Coast Guard medium-endurance cutter until 2020. On September 2, 2020, then-President Donald Trump officially declared Wilmington as the first World War II Heritage City in the country. The World War II battleship USS North Carolina , now a war memorial, is moored across from the downtown port area, and is open to the public for tours. Other attractions include the Cape Fear Museum of History and Science and the Children's Museum of Wilmington Wilmington is also the home of Cinespace Wilmington , [lower-alpha 1] the largest domestic television and movie production facility outside California. Dream Stage 10, the facility's newest sound stage, is the third-largest in the United States. It houses the largest special-effects water tank in North America. After the studio complex's opening in 1984, Wilmington became a major center of American film and television production. Numerous movies and television shows , in a range of genres, have been produced here, including Iron Man 3 , Super Mario Bros. , The Conjuring , A Walk to Remember , The Crow , Sleepy Hollow , Dawson's Creek , One Tree Hill , and The Summer I Turned Pretty . The city was founded in the 1730s, and after going through a series of different names (New Carthage, New London, Newton), its name became Wilmington in 1740, named after Spencer Compton, 1st Earl of Wilmington . The area along the river had been inhabited by various successive cultures of indigenous peoples for thousands of years. At the time of European encounter, historic Native Americans were members of tribes belonging to the Eastern Siouan family. In the early 16th century, Italian explorer Giovanni da Verrazzano , commissioned by the king of France with a French crew, was reportedly the first European to see this area, including the city's present site. The first permanent colonial settlement in the area was established in the 1720s by European settlers . In September 1732, a community was founded on land owned by John Watson on the Cape Fear River , at the confluence of its northwest and northeast branches. The settlement, founded by the first royal governor, George Burrington , was called New Carthage, and then New Liverpool; it gradually took on the name New Town or Newton. Governor Gabriel Johnston soon after established his government there for the North Carolina colony . In 1739 or 1740, the town was incorporated with a new name, Wilmington, in honor of Spencer Compton, Earl of Wilmington . Some early settlers of Wilmington came from the Albemarle and Pamlico regions, as well as from the colonies of Virginia and South Carolina , but most new settlers migrated from the northern colonies , the West Indies , and Northern Europe . Many of the early settlers were indentured servants from Northern Europe. As the indentured servants gained their freedom and fewer could be persuaded to travel to North America because of improving conditions back home, the settlers imported an increasing number of slaves to satisfy the labor demand. By 1767, African slaves accounted for more than 62% of the population of the Lower Cape Fear region. Many worked in the port as laborers, and some in ship-related trades. Naval stores and lumber fueled the region's economy, both before and after the American Revolution . During the Revolutionary War, the British maintained a garrison at Fort Johnston near Wilmington. Due to Wilmington's commercial importance as a major port, it had a critical role in opposition to the British in the years leading up to the revolution. The city had outspoken political leaders who influenced and led the resistance movement in North Carolina. The foremost of these was Wilmington resident Cornelius Harnett , who was serving in the General Assembly at the time, and where he rallied opposition to the Sugar Act in 1764. When the British Parliament passed the Stamp Act the following year, designed to raise revenue for the Crown with a kind of tax on shipping, Wilmington was the site of an elaborate demonstration against it. On October 19, 1765, several hundred townspeople gathered in protest of the new law, burned an effigy of one town resident who favored the act, and toasted to "Liberty, Property, and No Stamp Duty." On October 31, another crowd gathered in a symbolic funeral of "Liberty". Before the effigy was buried, though, Liberty was found to have a pulse, and celebration ensued. William Houston of Duplin County was appointed stamp receiver for Cape Fear. When Houston visited Wilmington on business, still unaware of his appointment, he recounted, "The Inhabitants immediately assembled about me & demanded a Categorical Answer whether I intended to put the Act relating [to] the Stamps in force. The Town Bell was rung[,] Drums [were] beating, Colours [were] flying and [a] great concourse of People [were] gathered together." For the sake of his own life, and "to quiet the Minds of the inraged [ sic ] and furious Mobb...," Houston resigned his position at the courthouse. Governor William Tryon made attempts to mitigate the opposition, to no avail. On November 18, 1765, he pleaded his case directly to prominent residents of the area. They said the law restricted their rights. When the stamps arrived on November 28 on HMS Diligence , Tryon ordered them to be kept on board. Shipping on the Cape Fear River was stopped, as were the functions of the courts. Tryon, after having received his official commission as governor (a position he had assumed only after the death of Arthur Dobbs ), was brought to Wilmington by Captain Constantine Phipps on a barge from the Diligence , and "was received cordially by the gentlemen of the borough." He was greeted with the firing of seventeen pieces of artillery , and the New Hanover County Regiment of the North Carolina militia , who had lined the streets. This "warm welcome" was spoiled, however, after a dispute arose between Captain Phipps and captains of ships in the harbor regarding the display of their colors. The townspeople became infuriated with Phipps and threats were made against both sides. After Tryon harangued them for their actions, the townspeople gathered around the barrels of punch and ox he had brought as refreshments. The barrels were broken open, letting the punch spill into the streets; they threw the head of the ox into the pillory , and gave its body to the enslaved population. Because of the unrest, Tryon moved his seat of government to New Bern instead of Wilmington. On February 18, 1766, two merchant ships arrived without stamped papers at Brunswick Town . Each ship provided signed statements from the collectors at their respective ports of origin that no were stamps available, but Captain Jacob Lobb of the British cruiser Viper seized the vessels. In response, numerous residents from southern counties met in Wilmington. The group organized as the Sons of Liberty and pledged to block implementation of the Stamp Act. The following day, as many as a thousand men, including the mayor and aldermen of Wilmington, were led by Cornelius Harnett to Brunswick to confront Tryon. The governor was unyielding, but a mob retrieved the seized ships. They forced royal customs officers and public officials in the region to swear never to issue stamped paper. The Westminster Parliament repealed the Stamp Act in March 1766 In the 1830s, citizens of Wilmington became eager to take advantage of railroad transportation . At this time, the shipping tonnage registered at Wilmington was 9,035. Plans were developed to build a railroad line from the capital, Raleigh , to Wilmington. When Raleigh citizens declined to subscribe in sufficient number to stock to raise money for the project, organizers changed the terminus to Weldon . When the railroad line was completed in 1840, it was the longest single line of railroad track in the world. The railroad also controlled a fleet of steamboats that ran between Wilmington and Charleston ; these were used both for passenger travel and freight. Regular boat lines served Fayetteville , and packet lines traveled to northern ports. The city was a main stopover point, contributing greatly to its commerce. By mid-century, the churchyard of St. James Episcopal Church and other town cemeteries had become filled with graves. On November 16, 1853, a group of citizens, organized as "the Proprietors of the Wilmington Cemetery", was formed to develop a new cemetery . Sixty-five acres of land around Burnt Mill Creek were chosen as the site for what would be called Oakdale Cemetery . It was the first rural cemetery in North Carolina. The cemetery's first interment, on February 6, 1855, was six-year-old Annie deRosset. Many remains from St. James churchyard were relocated to the new cemetery. The Wilmington Gas Light Company was established in 1854. Soon after, streetlights were powered by gas made from lightwood and rosin , replacing the old street oil lamps. On December 27, 1855, the first cornerstone was laid, and construction began on a new city hall. A grant from the Thalian Association funded the attached opera house, named Thalian Hall. In 1857, the city opened its first public school, named the Union Free School, on 6th Street between Nun and Church Streets, serving White students. Wilmington had a Black majority population before the Civil War. While most were slaves, the city had a significant community of free people of color , who developed businesses and trades. For a period up to Nat Turner 's rebellion, they had been allowed to vote, carry arms, and serve in the militia. Fears after the rebellion resulted in the state legislature passing laws to restrict the rights of free Blacks. During the Civil War , the port was the major base for Confederate and privately owned blockade runners , which delivered badly needed supplies from England. The Union mounted a blockade to reduce the goods received by the South. The city was captured by Union forces in the Battle of Wilmington in February 1865, about one month after the fall of Fort Fisher had closed the port. Wilmington was the last Confederate port to be captured. As nearly all the military action took place some distance from the city, numerous antebellum houses and other buildings survived the war years. In mid-August of 1862, Wilmington was devastated by a deadly outbreak of yellow fever . This fever outbreak was brought about by a blockade runner named Kate. Sources suggest that the runner had crew members who were sick before the ship landed, but Dr. W.T. Wragg would later write an article in the New York Journal of Medicine that there were at least five cases in the city before the ship arrived. Dr. Wragg treated many of the yellow fever victims during the outbreak and claimed that the dirtiness of the city and the fumes of the dirty water left by heavy rains caused the disease. By the end of the outbreak at least 1,500 and perhaps as many as 2,000, contracted yellow fever. Of those, between 650 and 800 died, a mortality rate approximately 40 percent Walter Reed would later discover in 1900 that yellow fever was transmitted by mosquitoes, so Wilmington's outbreak had to be introduced by a third party and spread by mosquitoes in the city. During the Reconstruction era , former free Blacks and newly emancipated freedmen built a community in the city. About 55% of its residents were Black people. At the time, Wilmington was the largest city and the economic capital of the state. Three of the city's aldermen were Black. Black people were also in positions of justice of the peace, deputy clerk of court, street superintendent, coroners, policemen, mail clerks, and mail carriers. At the time, Black people accounted for over 30% of Wilmington's skilled craftsmen, such as mechanics, carpenters, jewelers, watchmakers, painters, plasterers, plumbers, stevedores, blacksmiths, masons, and wheelwrights. In addition, they owned 10 of the city's 11 restaurants and were 90% of the city's 22 barbers. The city had more Black bootmakers/shoemakers than White ones, and half of the city's tailors were Black. Lastly, two brothers, Alexander and Frank Manly, owned the Wilmington Daily Record , one of the few Black-owned newspapers in the state, which was reported to be the only one in the country. In the 1890s, a coalition of Republicans and Populists had gained state and federal offices. The Democrats were determined to reassert their control. Violence increased around elections in this period, as armed White paramilitary insurgents, known as Red Shirts , worked to suppress Black and Republican voting. White Democrats regained control of the state legislature and sought to impose white supremacy , but some Blacks continued to be elected to local offices. The Wilmington Insurrection of 1898 (also known as the Wilmington Race Riot) occurred as a result of the racially charged political conflict that had occurred in the decades after the Civil War and efforts by White Democrats to re-establish white supremacy and overturn Black voting. In 1898, a cadre of White Democrats, professionals, and businessmen planned to overthrow the city government if their candidates were not elected. Two days after the election, in which a White Republican was elected mayor and both White and Black aldermen were elected, more than 1500 White men (led by Democrat Alfred M. Waddell , an unsuccessful gubernatorial candidate in 1896) attacked and burned the only Black-owned daily newspaper in the state and ran off the new officers. They overthrew the legitimately elected municipal government. Waddell and his men forced the elected Republican city officials to resign at gunpoint and replaced them with men selected by leading White Democrats. Waddell was elected mayor by the newly seated board of aldermen that day. Prominent Black Americans and White Republicans were banished from the city in the following days. This is the only such coup d'état in United States history. Whites attacked and killed an estimated 10–100 Blacks; no Whites died in the violence. As a result of the attacks, more than 2100 Blacks permanently left the city, leaving a hole among its professional and middle classes. The demographic change was so large that the city became majority White, rather than the majority Black it was before the coup. Following these events, the North Carolina legislature passed a new constitution that raised barriers to voter registration , imposing requirements for poll taxes and literacy tests that effectively disfranchised most Black voters, following the example of Mississippi. Blacks were essentially excluded from the political system until after the enactment of the federal Voting Rights Act of 1965 . Wilmington is home to the Bijou Theater, which began as a tent in 1904 and progressed to a permanent structure in 1906. It operated until 1956, making it the oldest movie theater in the state and one of the oldest, continuously running theaters in the country. In 1910, Charlotte passed Wilmington to become North Carolina's largest city. In the mid-20th century, efforts to preserve many historic building began. Due to this, many historic buildings were listed as National Register of Historic Places . Starting in the 1980s, the city has been used for filming many horror films, such as Blue Velvet in 1985 and I Know What You Did Last Summer in 1997. In 1990, the extension of Interstate 40 to New Hanover County was opened and officially connected the region to the Interstate Highway System . During World War II , Wilmington was the home of the North Carolina Shipbuilding Company . The shipyard was created as part of the U.S. government's Emergency Shipbuilding Program . Workers built 243 ships in Wilmington during the five years the company operated. Three prisoner-of-war (POW) camps operated in the city from February 1944 through April 1946. At their peak, the camps held 550 German prisoners. The first camp was located on the corner of Shipyard Boulevard and Carolina Beach Road; it was moved downtown to Ann Street, between 8th and 10th Avenues, when it outgrew the original location. A smaller contingent of prisoners was assigned to a third site, working in the officers' mess and doing groundskeeping at Bluethenthal Army Air Base, which is now Wilmington International Airport . During the 1990s, and all the way to the late-2000s, Wilmington began to grow rapidly, partially due to the film industry and the completion of I-40. The city successfully annexed the areas of Seagate in 1998 and Masonboro in 2000. The annexation of Monkey Junction was stopped in 2012 by the North Carolina House of Representatives after local backlash. In 2017, a chemical compound called GenX , discharged by a Chemours plant near Fayetteville, North Carolina , was first found to be present in the Cape Fear River , a major water source for the region. It was also revealed that the same plant had been discharging the chemical compound since 1980. In 2020, then-President Donald Trump designated Wilmington as the first World War II Heritage City in the country due to the city's contributions during the war. The Audubon Trolley Station , Brookwood Historic District , Carolina Heights Historic District , Carolina Place Historic District , City Hall/Thalian Hall , Delgrado School , Federal Building and Courthouse , Fort Fisher , Gabriel's Landing , James Walker Nursing School Quarters , Market Street Mansion District , Masonboro Sound Historic District , Moores Creek National Battlefield , Sunset Park Historic District , USS North Carolina (BB-55) National Historic Landmark , Westbrook-Ardmore Historic District , William Hooper School (Former) , Wilmington Historic District , and Wilmington National Cemetery are listed on the National Register of Historic Places . The city was founded in the 1730s, and after going through a series of different names (New Carthage, New London, Newton), its name became Wilmington in 1740, named after Spencer Compton, 1st Earl of Wilmington . The area along the river had been inhabited by various successive cultures of indigenous peoples for thousands of years. At the time of European encounter, historic Native Americans were members of tribes belonging to the Eastern Siouan family. In the early 16th century, Italian explorer Giovanni da Verrazzano , commissioned by the king of France with a French crew, was reportedly the first European to see this area, including the city's present site. The first permanent colonial settlement in the area was established in the 1720s by European settlers . In September 1732, a community was founded on land owned by John Watson on the Cape Fear River , at the confluence of its northwest and northeast branches. The settlement, founded by the first royal governor, George Burrington , was called New Carthage, and then New Liverpool; it gradually took on the name New Town or Newton. Governor Gabriel Johnston soon after established his government there for the North Carolina colony . In 1739 or 1740, the town was incorporated with a new name, Wilmington, in honor of Spencer Compton, Earl of Wilmington . Some early settlers of Wilmington came from the Albemarle and Pamlico regions, as well as from the colonies of Virginia and South Carolina , but most new settlers migrated from the northern colonies , the West Indies , and Northern Europe . Many of the early settlers were indentured servants from Northern Europe. As the indentured servants gained their freedom and fewer could be persuaded to travel to North America because of improving conditions back home, the settlers imported an increasing number of slaves to satisfy the labor demand. By 1767, African slaves accounted for more than 62% of the population of the Lower Cape Fear region. Many worked in the port as laborers, and some in ship-related trades. Naval stores and lumber fueled the region's economy, both before and after the American Revolution . During the Revolutionary War, the British maintained a garrison at Fort Johnston near Wilmington. Due to Wilmington's commercial importance as a major port, it had a critical role in opposition to the British in the years leading up to the revolution. The city had outspoken political leaders who influenced and led the resistance movement in North Carolina. The foremost of these was Wilmington resident Cornelius Harnett , who was serving in the General Assembly at the time, and where he rallied opposition to the Sugar Act in 1764. When the British Parliament passed the Stamp Act the following year, designed to raise revenue for the Crown with a kind of tax on shipping, Wilmington was the site of an elaborate demonstration against it. On October 19, 1765, several hundred townspeople gathered in protest of the new law, burned an effigy of one town resident who favored the act, and toasted to "Liberty, Property, and No Stamp Duty." On October 31, another crowd gathered in a symbolic funeral of "Liberty". Before the effigy was buried, though, Liberty was found to have a pulse, and celebration ensued. William Houston of Duplin County was appointed stamp receiver for Cape Fear. When Houston visited Wilmington on business, still unaware of his appointment, he recounted, "The Inhabitants immediately assembled about me & demanded a Categorical Answer whether I intended to put the Act relating [to] the Stamps in force. The Town Bell was rung[,] Drums [were] beating, Colours [were] flying and [a] great concourse of People [were] gathered together." For the sake of his own life, and "to quiet the Minds of the inraged [ sic ] and furious Mobb...," Houston resigned his position at the courthouse. Governor William Tryon made attempts to mitigate the opposition, to no avail. On November 18, 1765, he pleaded his case directly to prominent residents of the area. They said the law restricted their rights. When the stamps arrived on November 28 on HMS Diligence , Tryon ordered them to be kept on board. Shipping on the Cape Fear River was stopped, as were the functions of the courts. Tryon, after having received his official commission as governor (a position he had assumed only after the death of Arthur Dobbs ), was brought to Wilmington by Captain Constantine Phipps on a barge from the Diligence , and "was received cordially by the gentlemen of the borough." He was greeted with the firing of seventeen pieces of artillery , and the New Hanover County Regiment of the North Carolina militia , who had lined the streets. This "warm welcome" was spoiled, however, after a dispute arose between Captain Phipps and captains of ships in the harbor regarding the display of their colors. The townspeople became infuriated with Phipps and threats were made against both sides. After Tryon harangued them for their actions, the townspeople gathered around the barrels of punch and ox he had brought as refreshments. The barrels were broken open, letting the punch spill into the streets; they threw the head of the ox into the pillory , and gave its body to the enslaved population. Because of the unrest, Tryon moved his seat of government to New Bern instead of Wilmington. On February 18, 1766, two merchant ships arrived without stamped papers at Brunswick Town . Each ship provided signed statements from the collectors at their respective ports of origin that no were stamps available, but Captain Jacob Lobb of the British cruiser Viper seized the vessels. In response, numerous residents from southern counties met in Wilmington. The group organized as the Sons of Liberty and pledged to block implementation of the Stamp Act. The following day, as many as a thousand men, including the mayor and aldermen of Wilmington, were led by Cornelius Harnett to Brunswick to confront Tryon. The governor was unyielding, but a mob retrieved the seized ships. They forced royal customs officers and public officials in the region to swear never to issue stamped paper. The Westminster Parliament repealed the Stamp Act in March 1766In the 1830s, citizens of Wilmington became eager to take advantage of railroad transportation . At this time, the shipping tonnage registered at Wilmington was 9,035. Plans were developed to build a railroad line from the capital, Raleigh , to Wilmington. When Raleigh citizens declined to subscribe in sufficient number to stock to raise money for the project, organizers changed the terminus to Weldon . When the railroad line was completed in 1840, it was the longest single line of railroad track in the world. The railroad also controlled a fleet of steamboats that ran between Wilmington and Charleston ; these were used both for passenger travel and freight. Regular boat lines served Fayetteville , and packet lines traveled to northern ports. The city was a main stopover point, contributing greatly to its commerce. By mid-century, the churchyard of St. James Episcopal Church and other town cemeteries had become filled with graves. On November 16, 1853, a group of citizens, organized as "the Proprietors of the Wilmington Cemetery", was formed to develop a new cemetery . Sixty-five acres of land around Burnt Mill Creek were chosen as the site for what would be called Oakdale Cemetery . It was the first rural cemetery in North Carolina. The cemetery's first interment, on February 6, 1855, was six-year-old Annie deRosset. Many remains from St. James churchyard were relocated to the new cemetery. The Wilmington Gas Light Company was established in 1854. Soon after, streetlights were powered by gas made from lightwood and rosin , replacing the old street oil lamps. On December 27, 1855, the first cornerstone was laid, and construction began on a new city hall. A grant from the Thalian Association funded the attached opera house, named Thalian Hall. In 1857, the city opened its first public school, named the Union Free School, on 6th Street between Nun and Church Streets, serving White students. Wilmington had a Black majority population before the Civil War. While most were slaves, the city had a significant community of free people of color , who developed businesses and trades. For a period up to Nat Turner 's rebellion, they had been allowed to vote, carry arms, and serve in the militia. Fears after the rebellion resulted in the state legislature passing laws to restrict the rights of free Blacks.During the Civil War , the port was the major base for Confederate and privately owned blockade runners , which delivered badly needed supplies from England. The Union mounted a blockade to reduce the goods received by the South. The city was captured by Union forces in the Battle of Wilmington in February 1865, about one month after the fall of Fort Fisher had closed the port. Wilmington was the last Confederate port to be captured. As nearly all the military action took place some distance from the city, numerous antebellum houses and other buildings survived the war years. In mid-August of 1862, Wilmington was devastated by a deadly outbreak of yellow fever . This fever outbreak was brought about by a blockade runner named Kate. Sources suggest that the runner had crew members who were sick before the ship landed, but Dr. W.T. Wragg would later write an article in the New York Journal of Medicine that there were at least five cases in the city before the ship arrived. Dr. Wragg treated many of the yellow fever victims during the outbreak and claimed that the dirtiness of the city and the fumes of the dirty water left by heavy rains caused the disease. By the end of the outbreak at least 1,500 and perhaps as many as 2,000, contracted yellow fever. Of those, between 650 and 800 died, a mortality rate approximately 40 percent Walter Reed would later discover in 1900 that yellow fever was transmitted by mosquitoes, so Wilmington's outbreak had to be introduced by a third party and spread by mosquitoes in the city. During the Reconstruction era , former free Blacks and newly emancipated freedmen built a community in the city. About 55% of its residents were Black people. At the time, Wilmington was the largest city and the economic capital of the state. Three of the city's aldermen were Black. Black people were also in positions of justice of the peace, deputy clerk of court, street superintendent, coroners, policemen, mail clerks, and mail carriers. At the time, Black people accounted for over 30% of Wilmington's skilled craftsmen, such as mechanics, carpenters, jewelers, watchmakers, painters, plasterers, plumbers, stevedores, blacksmiths, masons, and wheelwrights. In addition, they owned 10 of the city's 11 restaurants and were 90% of the city's 22 barbers. The city had more Black bootmakers/shoemakers than White ones, and half of the city's tailors were Black. Lastly, two brothers, Alexander and Frank Manly, owned the Wilmington Daily Record , one of the few Black-owned newspapers in the state, which was reported to be the only one in the country. In the 1890s, a coalition of Republicans and Populists had gained state and federal offices. The Democrats were determined to reassert their control. Violence increased around elections in this period, as armed White paramilitary insurgents, known as Red Shirts , worked to suppress Black and Republican voting. White Democrats regained control of the state legislature and sought to impose white supremacy , but some Blacks continued to be elected to local offices. The Wilmington Insurrection of 1898 (also known as the Wilmington Race Riot) occurred as a result of the racially charged political conflict that had occurred in the decades after the Civil War and efforts by White Democrats to re-establish white supremacy and overturn Black voting. In 1898, a cadre of White Democrats, professionals, and businessmen planned to overthrow the city government if their candidates were not elected. Two days after the election, in which a White Republican was elected mayor and both White and Black aldermen were elected, more than 1500 White men (led by Democrat Alfred M. Waddell , an unsuccessful gubernatorial candidate in 1896) attacked and burned the only Black-owned daily newspaper in the state and ran off the new officers. They overthrew the legitimately elected municipal government. Waddell and his men forced the elected Republican city officials to resign at gunpoint and replaced them with men selected by leading White Democrats. Waddell was elected mayor by the newly seated board of aldermen that day. Prominent Black Americans and White Republicans were banished from the city in the following days. This is the only such coup d'état in United States history. Whites attacked and killed an estimated 10–100 Blacks; no Whites died in the violence. As a result of the attacks, more than 2100 Blacks permanently left the city, leaving a hole among its professional and middle classes. The demographic change was so large that the city became majority White, rather than the majority Black it was before the coup. Following these events, the North Carolina legislature passed a new constitution that raised barriers to voter registration , imposing requirements for poll taxes and literacy tests that effectively disfranchised most Black voters, following the example of Mississippi. Blacks were essentially excluded from the political system until after the enactment of the federal Voting Rights Act of 1965 . Wilmington is home to the Bijou Theater, which began as a tent in 1904 and progressed to a permanent structure in 1906. It operated until 1956, making it the oldest movie theater in the state and one of the oldest, continuously running theaters in the country. In 1910, Charlotte passed Wilmington to become North Carolina's largest city. In the mid-20th century, efforts to preserve many historic building began. Due to this, many historic buildings were listed as National Register of Historic Places . Starting in the 1980s, the city has been used for filming many horror films, such as Blue Velvet in 1985 and I Know What You Did Last Summer in 1997. In 1990, the extension of Interstate 40 to New Hanover County was opened and officially connected the region to the Interstate Highway System . During World War II , Wilmington was the home of the North Carolina Shipbuilding Company . The shipyard was created as part of the U.S. government's Emergency Shipbuilding Program . Workers built 243 ships in Wilmington during the five years the company operated. Three prisoner-of-war (POW) camps operated in the city from February 1944 through April 1946. At their peak, the camps held 550 German prisoners. The first camp was located on the corner of Shipyard Boulevard and Carolina Beach Road; it was moved downtown to Ann Street, between 8th and 10th Avenues, when it outgrew the original location. A smaller contingent of prisoners was assigned to a third site, working in the officers' mess and doing groundskeeping at Bluethenthal Army Air Base, which is now Wilmington International Airport . During World War II , Wilmington was the home of the North Carolina Shipbuilding Company . The shipyard was created as part of the U.S. government's Emergency Shipbuilding Program . Workers built 243 ships in Wilmington during the five years the company operated. Three prisoner-of-war (POW) camps operated in the city from February 1944 through April 1946. At their peak, the camps held 550 German prisoners. The first camp was located on the corner of Shipyard Boulevard and Carolina Beach Road; it was moved downtown to Ann Street, between 8th and 10th Avenues, when it outgrew the original location. A smaller contingent of prisoners was assigned to a third site, working in the officers' mess and doing groundskeeping at Bluethenthal Army Air Base, which is now Wilmington International Airport . During the 1990s, and all the way to the late-2000s, Wilmington began to grow rapidly, partially due to the film industry and the completion of I-40. The city successfully annexed the areas of Seagate in 1998 and Masonboro in 2000. The annexation of Monkey Junction was stopped in 2012 by the North Carolina House of Representatives after local backlash. In 2017, a chemical compound called GenX , discharged by a Chemours plant near Fayetteville, North Carolina , was first found to be present in the Cape Fear River , a major water source for the region. It was also revealed that the same plant had been discharging the chemical compound since 1980. In 2020, then-President Donald Trump designated Wilmington as the first World War II Heritage City in the country due to the city's contributions during the war. The Audubon Trolley Station , Brookwood Historic District , Carolina Heights Historic District , Carolina Place Historic District , City Hall/Thalian Hall , Delgrado School , Federal Building and Courthouse , Fort Fisher , Gabriel's Landing , James Walker Nursing School Quarters , Market Street Mansion District , Masonboro Sound Historic District , Moores Creek National Battlefield , Sunset Park Historic District , USS North Carolina (BB-55) National Historic Landmark , Westbrook-Ardmore Historic District , William Hooper School (Former) , Wilmington Historic District , and Wilmington National Cemetery are listed on the National Register of Historic Places . Wilmington is the eastern terminus of Interstate 40 , an east-west freeway that ends 2,554 miles away at Barstow, California , where it joins I-15, the gateway to Southern California. This road passes through many major cities and state capitals along the way. According to the United States Census Bureau , the city has a total area of 52.97 square miles (137.2 km 2 ) , of which 51.41 square miles (133.2 km 2 ) is land and 1.56 square miles (4.0 km 2 ) (2.95%) is water. Wrightsville Beach is a common destination in the Wilmington area. Carolina Beach and Kure Beach also add to the city's attractions. Wilmington has a humid subtropical climate ( Köppen Cfa ), with these characteristics:Wilmington has a humid subtropical climate ( Köppen Cfa ), with these characteristics:Wilmington boasts a large historic district encompassing nearly 300 blocks. Abandoned warehouses on downtown's northern end have been recently demolished making room for multimillion dollar projects, such as what was the world headquarters of Pharmaceutical Product Development and current tallest building in Wilmington at 228 feet (69 m) . (The building was then bought by Thermo Fisher Scientific . In 2023, it was bought by the City of Wilmington and renamed "Skyline Center". It is now the main building for city government operations. ) Other completed projects include: a state-of-the-art convention center, Live Oak Bank Pavilion, Pier 33 Apartments, and The Cove houseboat community in Port City Marina. Downtown / Old WilmingtonBetween 2006 and 2008, crime rates, as reported through the Federal Bureau of Investigation 's Uniform Crime Reports , decreased in 6 of the 8 reported categories. Wilmington has an increasing problem with gang violence and on October 15, 2013, the WPD and NHC sheriff's department created a joint task force to combat gang violence. Just a day later the city council approved $142,000 in funding for a gang investigative unit. As of the 2020 census , there were 115,451 people, 54,673 households, and 27,131 families residing in the city. At the 2013 census estimate , there were 112,067 people and 47,003 households in the city. The population density was 2,067.8 inhabitants per square mile (798.4/km 2 ) and there were 53,400 housing units. The racial composition of the city was: 73.5% White , 19.9% Black or African American , 6.1% Hispanic or Latino American , 1.2% Asian American , 0.5% Native American , 0.1% Native Hawaiian or other Pacific Islander . There were 34,359 households, out of which 20.4% had children under the age of 18 living with them, 33.5% were married couples living together, 14.0% had a female householder with no husband present, and 49.5% were non-families. 36.6% of all households were made up of individuals, and 11.3% had someone living alone who was 65 years of age or older. The average household size was 2.10 and the average family size was 2.77. In the city, the population was spread out, with 18.4% under the age of 18, 17.2% from 18 to 24, 28.5% from 25 to 44, 20.6% from 45 to 64, and 15.3% who were 65 years of age or older. The median age was 34 years. For every 100 females, there were 87.5 males. For every 100 females age 18 and over, there were 85.0 males. The median income for a household in the city was $31,099, and the median income for a family was $41,891. Males had a median income of $30,803 versus $23,423 for females. The per capita income for the city was $21,503. About 13.3% of families and 19.6% of the population were below the poverty line , including 25.9% of those under age 18 and 12.0% of those age 65 or over. Less than half of Wilmington's population is religiously affiliated (47.30%), with the majority of practitioners being Christian . The two largest Christian denominations in Wilmington are Protestant: Baptists (14.66%) and Methodists (8.29%), followed by Roman Catholics (7.42%). There are also a significant number of Presbyterians (3.19%), Episcopalians (2.30%), Pentecostals (1.45%), and Lutherans (1.32%). Other Christian denominations make up 7.02%, and the Latter-Day Saints have 0.90%. Much smaller is the proportion of residents who follow Islam (0.46%), and Judaism (0.25%). A small percentage of people practice Eastern religions (0.04%). Wilmington has significant historical religious buildings, such as the Basilica Shrine of St. Mary and the Temple of Israel .As of the 2020 census , there were 115,451 people, 54,673 households, and 27,131 families residing in the city.At the 2013 census estimate , there were 112,067 people and 47,003 households in the city. The population density was 2,067.8 inhabitants per square mile (798.4/km 2 ) and there were 53,400 housing units. The racial composition of the city was: 73.5% White , 19.9% Black or African American , 6.1% Hispanic or Latino American , 1.2% Asian American , 0.5% Native American , 0.1% Native Hawaiian or other Pacific Islander . There were 34,359 households, out of which 20.4% had children under the age of 18 living with them, 33.5% were married couples living together, 14.0% had a female householder with no husband present, and 49.5% were non-families. 36.6% of all households were made up of individuals, and 11.3% had someone living alone who was 65 years of age or older. The average household size was 2.10 and the average family size was 2.77. In the city, the population was spread out, with 18.4% under the age of 18, 17.2% from 18 to 24, 28.5% from 25 to 44, 20.6% from 45 to 64, and 15.3% who were 65 years of age or older. The median age was 34 years. For every 100 females, there were 87.5 males. For every 100 females age 18 and over, there were 85.0 males. The median income for a household in the city was $31,099, and the median income for a family was $41,891. Males had a median income of $30,803 versus $23,423 for females. The per capita income for the city was $21,503. About 13.3% of families and 19.6% of the population were below the poverty line , including 25.9% of those under age 18 and 12.0% of those age 65 or over.Less than half of Wilmington's population is religiously affiliated (47.30%), with the majority of practitioners being Christian . The two largest Christian denominations in Wilmington are Protestant: Baptists (14.66%) and Methodists (8.29%), followed by Roman Catholics (7.42%). There are also a significant number of Presbyterians (3.19%), Episcopalians (2.30%), Pentecostals (1.45%), and Lutherans (1.32%). Other Christian denominations make up 7.02%, and the Latter-Day Saints have 0.90%. Much smaller is the proportion of residents who follow Islam (0.46%), and Judaism (0.25%). A small percentage of people practice Eastern religions (0.04%). Wilmington has significant historical religious buildings, such as the Basilica Shrine of St. Mary and the Temple of Israel .The Wilmington International Airport (ILM) serves the area with commercial air service provided by American Airlines , Delta Air Lines , United Airlines and Avelo Airlines . American Airlines carries a large share of the airport's traffic, and therefore flies the largest of the aircraft in and out of the airport. The airport serves over 930,000 travelers per year. The airport is also home to two fixed-base operations (FBOs) that currently house over 100 private aircraft. The airport maintains a separate International Terminal providing a full service Federal Inspection Station to clear international flights. This includes U.S. Customs and Border Protection, U.S. Department of Agriculture and the U.S. Department of Immigration. The airport is 4 miles from downtown and is served by Wave Transit buses. Public transit in the area is provided by the Cape Fear Public Transportation Authority , which operates fixed bus routes, shuttles, and a free downtown trolley under the brand name Wave Transit. A daily intercity bus service to Raleigh is provided by Greyhound Lines . Wilmington is also served by Amtrak Thruway bus connections to Wilson, North Carolina where connections can be made with Amtrak's Carolinian and Palmetto . The city's Union Station last had passenger train service in 1968 with the Seaboard Coast Line 's predecessor version of the Palmetto. The Seaboard Air Line 's station last had service in 1958, with a daily train to Charlotte via Hamlet . The NCDOT Cape Fear Run bicycle route connects Apex to Wilmington and closely parallels the RUSA 600 km brevet route. The city of Wilmington offers transient docking facilities in the center of downtown Wilmington along the Cape Fear River approximately 12.5 miles (20 km) from the Intracoastal Waterway . The river depth in the run up from the ICW is in excess of 40 feet (12 m) . Taxicab services are available from several vendors, however, the City's Taxi Commission keeps meter rates artificially low. In 2021, regulations were eased to help the taxi industry compete with other companies like Uber and Lyft . The Gary Shell Cross-City Trail is primarily a multi-use trail that provides bicycle and pedestrian access to numerous recreational, cultural and educational destinations in Wilmington. The Gary Shell Cross-City Trail provides bicycle and pedestrian connection from Wade Park, Halyburton Park and Empie Park to the Heide-Trask Drawbridge at the Intracoastal Waterway. It also connects to the River to Sea Bikeway and the under-construction Central College Trail and Greenville Loop Trail.The Wilmington International Airport (ILM) serves the area with commercial air service provided by American Airlines , Delta Air Lines , United Airlines and Avelo Airlines . American Airlines carries a large share of the airport's traffic, and therefore flies the largest of the aircraft in and out of the airport. The airport serves over 930,000 travelers per year. The airport is also home to two fixed-base operations (FBOs) that currently house over 100 private aircraft. The airport maintains a separate International Terminal providing a full service Federal Inspection Station to clear international flights. This includes U.S. Customs and Border Protection, U.S. Department of Agriculture and the U.S. Department of Immigration. The airport is 4 miles from downtown and is served by Wave Transit buses.Public transit in the area is provided by the Cape Fear Public Transportation Authority , which operates fixed bus routes, shuttles, and a free downtown trolley under the brand name Wave Transit. A daily intercity bus service to Raleigh is provided by Greyhound Lines . Wilmington is also served by Amtrak Thruway bus connections to Wilson, North Carolina where connections can be made with Amtrak's Carolinian and Palmetto . The city's Union Station last had passenger train service in 1968 with the Seaboard Coast Line 's predecessor version of the Palmetto. The Seaboard Air Line 's station last had service in 1958, with a daily train to Charlotte via Hamlet . The NCDOT Cape Fear Run bicycle route connects Apex to Wilmington and closely parallels the RUSA 600 km brevet route. The city of Wilmington offers transient docking facilities in the center of downtown Wilmington along the Cape Fear River approximately 12.5 miles (20 km) from the Intracoastal Waterway . The river depth in the run up from the ICW is in excess of 40 feet (12 m) . Taxicab services are available from several vendors, however, the City's Taxi Commission keeps meter rates artificially low. In 2021, regulations were eased to help the taxi industry compete with other companies like Uber and Lyft . The Gary Shell Cross-City Trail is primarily a multi-use trail that provides bicycle and pedestrian access to numerous recreational, cultural and educational destinations in Wilmington. The Gary Shell Cross-City Trail provides bicycle and pedestrian connection from Wade Park, Halyburton Park and Empie Park to the Heide-Trask Drawbridge at the Intracoastal Waterway. It also connects to the River to Sea Bikeway and the under-construction Central College Trail and Greenville Loop Trail.Wilmington's industrial base includes electrical, medical, electronic and telecommunications equipment; clothing and apparel; food processing; paper products; nuclear fuel; and pharmaceuticals. Wilmington is part of North Carolina's Research coast, adjacent to the Research Triangle Park in Durham . Also important to Wilmington's economy is tourism due to its close proximity to the ocean and vibrant nightlife. Located on the Cape Fear River , which flows into the Atlantic Ocean, Wilmington is a sizable seaport , including private marine terminals and the North Carolina State Ports Authority 's Port of Wilmington. Wilmington is home to the Greater Wilmington Chamber of Commerce, the oldest Chamber in North Carolina, organized in 1853. Companies with their headquarters in Wilmington include Live Oak Bank and HomeInsurance.com . According to the city's 2014 Comprehensive Annual Financial Report, the top employers in the city are: According to the city's 2014 Comprehensive Annual Financial Report, the top employers in the city are: Wilmington adopted a council–manager form of government in 1941. List of mayors of Wilmington:List of mayors of Wilmington:Public schools in Wilmington are operated by the New Hanover County School System . Holly Shelter Middle School Lake Forest Academy MCS Noble Middle School Murray Middle School Myrtle Grove Middle School Roland-Grise Middle School Trask Middle School Williston Middle School Alderman Anderson Bellamy Blair Bradley Creek Castle Hayne Codington College Park Eaton Forest Hills Freeman School of Engineering Gregory School of Science, Mathematics and Technology Holly Tree Lake Forest Academy Mary C. Williams Masonboro (formerly called Walter L. Parsley Elementary) Murrayville Ogden Pine Valley Snipes Academy of Arts and Design Sunset Park Winter Park Wrightsboro Wrightsville Beach Cape Fear Academy Cape Fear Center for Inquiry Friends School of Wilmington The Lyceum Academy New Horizons Elementary School St. Mark Catholic School St. Mary Catholic Church Wilmington Academy of Arts and SciencesPublic schools in Wilmington are operated by the New Hanover County School System . Holly Shelter Middle School Lake Forest Academy MCS Noble Middle School Murray Middle School Myrtle Grove Middle School Roland-Grise Middle School Trask Middle School Williston Middle School Alderman Anderson Bellamy Blair Bradley Creek Castle Hayne Codington College Park Eaton Forest Hills Freeman School of Engineering Gregory School of Science, Mathematics and Technology Holly Tree Lake Forest Academy Mary C. Williams Masonboro (formerly called Walter L. Parsley Elementary) Murrayville Ogden Pine Valley Snipes Academy of Arts and Design Sunset Park Winter Park Wrightsboro Wrightsville Beach Cape Fear Academy Cape Fear Center for Inquiry Friends School of Wilmington The Lyceum Academy New Horizons Elementary School St. Mark Catholic School St. Mary Catholic Church Wilmington Academy of Arts and SciencesHolly Shelter Middle School Lake Forest Academy MCS Noble Middle School Murray Middle School Myrtle Grove Middle School Roland-Grise Middle School Trask Middle School Williston Middle SchoolAlderman Anderson Bellamy Blair Bradley Creek Castle Hayne Codington College Park Eaton Forest Hills Freeman School of Engineering Gregory School of Science, Mathematics and Technology Holly Tree Lake Forest Academy Mary C. Williams Masonboro (formerly called Walter L. Parsley Elementary) Murrayville Ogden Pine Valley Snipes Academy of Arts and Design Sunset Park Winter Park Wrightsboro Wrightsville BeachCape Fear Academy Cape Fear Center for Inquiry Friends School of Wilmington The Lyceum Academy New Horizons Elementary School St. Mark Catholic School St. Mary Catholic Church Wilmington Academy of Arts and SciencesNew Hanover Regional Medical Center is a hospital in Wilmington. It was established in 1967 as a public hospital , and it was the first hospital in the city to admit patients of all races. It was operated by New Hanover County. In February 2021 Novant Health , a nonprofit private organization, acquired the hospital. The city supports a very active calendar with its showcase theater, Thalian Hall , hosting about 250 events annually. The complex has been in continuous operation since it opened in 1858 and houses three performance venues, the Main Stage, the Grand Ballroom, and the Studio Theater. The Hannah Block Historic USO/Community Arts Center, 120 South Second Street in the Wilmington Historic District , is a multiuse facility owned by the City of Wilmington and managed by the Thalian Association, the Official Community Theater of North Carolina. Here, five studios are available to nonprofit organizations for theatrical performances, rehearsals, musicals, recitals and art classes. For more than half a century, the Hannah Block Historic USO Building has facilitated the coming together of generations, providing children with programs that challenge them creatively, and enhance the quality of life for residents throughout the region. The Hannah Block Second Street Stage is home to the Thalian Association Children's Theater. It is one of the main attractions at the Hannah Block Community Arts Center. The theater seats 200 and is used as a performance venue by community theater groups and other entertainment productions. The University of North Carolina at Wilmington College of Arts and Science departments of Theatre, Music and Art share a state-of-the-art, $34 million Cultural Arts Building, which opened in December 2006. The production area consists of a music recital hall, art gallery, and two theaters. Sponsored events include 4 theater productions a year. The Brooklyn Arts Center at St. Andrews is a 125-year-old building on the corner of North 4th and Campbell St in downtown Wilmington. The Brooklyn Arts Center at Saint Andrews (BAC) is on the National Register of Historic Places. The BAC is used for weddings, concerts, fundraisers, art shows, vintage flea markets, and other community-driven events. Wilmington is home to the Wilmington Conservatory of Fine Arts, a studio for foundlings. The Wilmington Conservatory of Fine Arts is the only studio in the region to offer Progressing Ballet Technique instruction from two certified instructors. The Conservatory is also host to Turning Pointe Dance Company, a faith-based dance company, which performs artistic pieces such as "Pinocchio" for the Wilmington Community. Wilmington is home to Cinespace Wilmington . The city's prominent place in cinema throughout the 1980s and 1990s earned the city the moniker "Hollywood East". Popular television series like Dawson's Creek , One Tree Hill , Sleepy Hollow , SIX , Good Behavior , Eastbound and Down and Under The Dome were filmed at the studio complex and on location throughout the city. Movies shot in Wilmington include Maximum Overdrive (1986), Crimes of the Heart (1986), Year of the Dragon (1985), Blue Velvet (1986), King Kong Lives (1986), Hiding Out (1987), Raw Deal (1986), Track 29 (1988), Weeds (1987), Teenage Mutant Ninja Turtles (1990), The Crow (1994), Silver Bullet (1985), Firestarter (1984), Iron Man 3 , A Walk to Remember , We're the Millers , The Longest Ride and The Choice . Actor Brandon Lee was killed after an accidental shooting during the filming of The Crow . Since 1995, Wilmington hosts an annual, nationally recognized, independent film festival called "Cucalorus." It is the keystone event of The Cucalorus Film Foundation, a non-profit organization. The Foundation also sponsors weekly screenings, several short documentary projects, and the annual Kids Festival, with hands on film-making workshops. The Cape Fear Independent Film Network also hosts a film festival annually, and the Wilmington Jewish Film Festival also takes place yearly. For several years Wilmington was also the location of fan conventions for One Tree Hill , reuniting the cast and drawing tourists to the city. In 2014, Governor Pat McCrory decided not to renew the film incentives, which ended up taking a massive toll on not just Wilmington's but North Carolina's entire film industry. As a result, most productions and film businesses moved to other cities, especially to Atlanta, Georgia . For the years following, were many attempts to bring the industry back to North Carolina via the North Carolina Film and Entertainment Grant. This grant designates $31 million per fiscal year (Jul 1–Jun 30) in film incentives. In the early 2020s, after the COVID-19 lockdowns and changes to state legislation, filming in the city began to increase again, with 2021 being the biggest year to date for both the city's film industry as well as the whole film industry at large in North Carolina. In 2022, Dark Horse Studios , which became Wilmington's second film studio in 2020, planned a 20 million dollar expansion to their studio complex in Wilmington, set to be complete in 2024. On September 27, 2023, Cinespace Studios announced it had purchased the EUE/Screen Gems Studios location in Wilmington. Birthplace of Johnson Jones Hooper (1815–1862), Author of the Simon Suggs Series. Birthplace of Robert Ruark (1915–1965) Now rare, an early edition of the Scottish poet Robert Burns 's " Poems, Chiefly in the Scottish Dialect " was printed by Bonsal and Niles of Market Street, Baltimore in 1804. Chamber Music Wilmington was founded in 1995 and presents its four-concert "Simply Classical" series every season. The concerts are performed by world-class chamber musicians and are held at UNCW's Beckwith Recital Hall. The Wilmington Symphony Orchestra was established in 1971 and offers throughout the year a series of five classical performances, and a Free Family Concert. Wilmington is also home to numerous music festivals. One of the largest DIY festivals, the Wilmington Exchange Festival, occurs over a period of 5 days around Memorial Day each year. It is currently in its 13th year. Celebrating its 37th year, February 2 thru 4, 2017, the North Carolina Jazz Festival is a three-day traditional jazz festival that features world-renowned jazz musicians. The Cape Fear Blues Society is a driving force behind blues music in Wilmington. The organization manages, staffs and sponsors weekly Cape Fear Blues Jams and the annual Cape Fear Blues Challenge talent competition (winners travel to Memphis TN for the International Blues Challenge). Its largest endeavor is the Cape Fear Blues Festival, an annual celebration that showcases local, regional and national touring blues artists performing at a variety of events and venues, including the Cape Fear Blues Cruise, Blues Workshops, an All-Day Blues Jam, and numerous live club shows. Membership in the CFBS is open to listeners and musicians alike. The Second and Orange Street USO Club was erected by the Army Corps of Engineers at a cost of $80,000. Along with an identical structure on Nixon Street for African-American servicemen, it opened in December 1941, the same month that the Japanese attacked Pearl Harbor . From 1941 to 1945, the USO hosted 35,000 uniformed visitors a week. Recently renovated with sensitivity to its historic character, the Hannah Block Historic USO (HBHUSO) lobby serves as a museum where World War II memorabilia and other artifacts are displayed. The building itself was rededicated in Ms. Block's name in 2006 and restored to its 1943 wartime character in 2008. The building is listed in the National Register of Historic Places. The World War II Wilmington Home Front Heritage Coalition, an all volunteer 501(c)(3) preservation organization, is the de facto preservationist of the building's history and maintains the home front museum. Wilmington is host to many annual festivals, including, most notably, the Azalea Festival . The Azalea Festival, sponsored by the Cape Fear Garden Club, features a garden tour, historic home tour, garden party, musical performances, a parade, and a fireworks show. It takes places every year in April. The city supports a very active calendar with its showcase theater, Thalian Hall , hosting about 250 events annually. The complex has been in continuous operation since it opened in 1858 and houses three performance venues, the Main Stage, the Grand Ballroom, and the Studio Theater. The Hannah Block Historic USO/Community Arts Center, 120 South Second Street in the Wilmington Historic District , is a multiuse facility owned by the City of Wilmington and managed by the Thalian Association, the Official Community Theater of North Carolina. Here, five studios are available to nonprofit organizations for theatrical performances, rehearsals, musicals, recitals and art classes. For more than half a century, the Hannah Block Historic USO Building has facilitated the coming together of generations, providing children with programs that challenge them creatively, and enhance the quality of life for residents throughout the region. The Hannah Block Second Street Stage is home to the Thalian Association Children's Theater. It is one of the main attractions at the Hannah Block Community Arts Center. The theater seats 200 and is used as a performance venue by community theater groups and other entertainment productions. The University of North Carolina at Wilmington College of Arts and Science departments of Theatre, Music and Art share a state-of-the-art, $34 million Cultural Arts Building, which opened in December 2006. The production area consists of a music recital hall, art gallery, and two theaters. Sponsored events include 4 theater productions a year. The Brooklyn Arts Center at St. Andrews is a 125-year-old building on the corner of North 4th and Campbell St in downtown Wilmington. The Brooklyn Arts Center at Saint Andrews (BAC) is on the National Register of Historic Places. The BAC is used for weddings, concerts, fundraisers, art shows, vintage flea markets, and other community-driven events. Wilmington is home to the Wilmington Conservatory of Fine Arts, a studio for foundlings. The Wilmington Conservatory of Fine Arts is the only studio in the region to offer Progressing Ballet Technique instruction from two certified instructors. The Conservatory is also host to Turning Pointe Dance Company, a faith-based dance company, which performs artistic pieces such as "Pinocchio" for the Wilmington Community. Wilmington is home to Cinespace Wilmington . The city's prominent place in cinema throughout the 1980s and 1990s earned the city the moniker "Hollywood East". Popular television series like Dawson's Creek , One Tree Hill , Sleepy Hollow , SIX , Good Behavior , Eastbound and Down and Under The Dome were filmed at the studio complex and on location throughout the city. Movies shot in Wilmington include Maximum Overdrive (1986), Crimes of the Heart (1986), Year of the Dragon (1985), Blue Velvet (1986), King Kong Lives (1986), Hiding Out (1987), Raw Deal (1986), Track 29 (1988), Weeds (1987), Teenage Mutant Ninja Turtles (1990), The Crow (1994), Silver Bullet (1985), Firestarter (1984), Iron Man 3 , A Walk to Remember , We're the Millers , The Longest Ride and The Choice . Actor Brandon Lee was killed after an accidental shooting during the filming of The Crow . Since 1995, Wilmington hosts an annual, nationally recognized, independent film festival called "Cucalorus." It is the keystone event of The Cucalorus Film Foundation, a non-profit organization. The Foundation also sponsors weekly screenings, several short documentary projects, and the annual Kids Festival, with hands on film-making workshops. The Cape Fear Independent Film Network also hosts a film festival annually, and the Wilmington Jewish Film Festival also takes place yearly. For several years Wilmington was also the location of fan conventions for One Tree Hill , reuniting the cast and drawing tourists to the city. In 2014, Governor Pat McCrory decided not to renew the film incentives, which ended up taking a massive toll on not just Wilmington's but North Carolina's entire film industry. As a result, most productions and film businesses moved to other cities, especially to Atlanta, Georgia . For the years following, were many attempts to bring the industry back to North Carolina via the North Carolina Film and Entertainment Grant. This grant designates $31 million per fiscal year (Jul 1–Jun 30) in film incentives. In the early 2020s, after the COVID-19 lockdowns and changes to state legislation, filming in the city began to increase again, with 2021 being the biggest year to date for both the city's film industry as well as the whole film industry at large in North Carolina. In 2022, Dark Horse Studios , which became Wilmington's second film studio in 2020, planned a 20 million dollar expansion to their studio complex in Wilmington, set to be complete in 2024. On September 27, 2023, Cinespace Studios announced it had purchased the EUE/Screen Gems Studios location in Wilmington. Birthplace of Johnson Jones Hooper (1815–1862), Author of the Simon Suggs Series. Birthplace of Robert Ruark (1915–1965) Now rare, an early edition of the Scottish poet Robert Burns 's " Poems, Chiefly in the Scottish Dialect " was printed by Bonsal and Niles of Market Street, Baltimore in 1804.Chamber Music Wilmington was founded in 1995 and presents its four-concert "Simply Classical" series every season. The concerts are performed by world-class chamber musicians and are held at UNCW's Beckwith Recital Hall. The Wilmington Symphony Orchestra was established in 1971 and offers throughout the year a series of five classical performances, and a Free Family Concert. Wilmington is also home to numerous music festivals. One of the largest DIY festivals, the Wilmington Exchange Festival, occurs over a period of 5 days around Memorial Day each year. It is currently in its 13th year. Celebrating its 37th year, February 2 thru 4, 2017, the North Carolina Jazz Festival is a three-day traditional jazz festival that features world-renowned jazz musicians. The Cape Fear Blues Society is a driving force behind blues music in Wilmington. The organization manages, staffs and sponsors weekly Cape Fear Blues Jams and the annual Cape Fear Blues Challenge talent competition (winners travel to Memphis TN for the International Blues Challenge). Its largest endeavor is the Cape Fear Blues Festival, an annual celebration that showcases local, regional and national touring blues artists performing at a variety of events and venues, including the Cape Fear Blues Cruise, Blues Workshops, an All-Day Blues Jam, and numerous live club shows. Membership in the CFBS is open to listeners and musicians alike. The Second and Orange Street USO Club was erected by the Army Corps of Engineers at a cost of $80,000. Along with an identical structure on Nixon Street for African-American servicemen, it opened in December 1941, the same month that the Japanese attacked Pearl Harbor . From 1941 to 1945, the USO hosted 35,000 uniformed visitors a week. Recently renovated with sensitivity to its historic character, the Hannah Block Historic USO (HBHUSO) lobby serves as a museum where World War II memorabilia and other artifacts are displayed. The building itself was rededicated in Ms. Block's name in 2006 and restored to its 1943 wartime character in 2008. The building is listed in the National Register of Historic Places. The World War II Wilmington Home Front Heritage Coalition, an all volunteer 501(c)(3) preservation organization, is the de facto preservationist of the building's history and maintains the home front museum.Wilmington is host to many annual festivals, including, most notably, the Azalea Festival . The Azalea Festival, sponsored by the Cape Fear Garden Club, features a garden tour, historic home tour, garden party, musical performances, a parade, and a fireworks show. It takes places every year in April. The Star-News is Wilmington's daily newspaper; read widely throughout the Lower Cape Fear region and now owned by Gannett, following its merger with the Star's previous owner, GateHouse Media . A daily online newspaper, Port City Daily , is owned by Local Daily Media. Two historically black newspapers are distributed and published weekly: The Wilmington Journal and The Challenger Newspapers. Encore Magazine is a weekly arts and entertainment publication. The Wilmington television market is ranked 130 in the United States, and is the smallest DMA in North Carolina. The broadcast stations are as follows: Cable news station News 14 Carolina also maintains its coastal bureau in Wilmington. On September 8, 2008, at noon, WWAY, WECT, WSFX, WILM-LP and W51CW all turned off their analog signals, making Wilmington the first market in the nation to go digital-only as part of a test by the Federal Communications Commission (FCC) to iron out transition and reception concerns before the nationwide shutoff . Wilmington was chosen as the test market because the area's digital channel positions will remain unchanged after the transition. As the area's official conduit of emergency information, WUNJ did not participate in the early analog switchoff, and kept their analog signal on until the national digital switchover date of June 12, 2009. W47CK did not participate due to its low-power status; FCC rules currently exempt low-powered stations from the 2009 analog shutdown. WILM-LP and W51CW chose to participate, even though they are exempt as LPTV stations. Despite Tropical Storm Hanna making landfall southwest of Wilmington two days before (September 6), the switchover continued as scheduled. The ceremony was marked by governmental and television representatives flipping a large switch (marked with the slogan "First in Flight, First in Digital") from analog to digital. The Star-News is Wilmington's daily newspaper; read widely throughout the Lower Cape Fear region and now owned by Gannett, following its merger with the Star's previous owner, GateHouse Media . A daily online newspaper, Port City Daily , is owned by Local Daily Media. Two historically black newspapers are distributed and published weekly: The Wilmington Journal and The Challenger Newspapers. Encore Magazine is a weekly arts and entertainment publication.The Wilmington television market is ranked 130 in the United States, and is the smallest DMA in North Carolina. The broadcast stations are as follows: Cable news station News 14 Carolina also maintains its coastal bureau in Wilmington. On September 8, 2008, at noon, WWAY, WECT, WSFX, WILM-LP and W51CW all turned off their analog signals, making Wilmington the first market in the nation to go digital-only as part of a test by the Federal Communications Commission (FCC) to iron out transition and reception concerns before the nationwide shutoff . Wilmington was chosen as the test market because the area's digital channel positions will remain unchanged after the transition. As the area's official conduit of emergency information, WUNJ did not participate in the early analog switchoff, and kept their analog signal on until the national digital switchover date of June 12, 2009. W47CK did not participate due to its low-power status; FCC rules currently exempt low-powered stations from the 2009 analog shutdown. WILM-LP and W51CW chose to participate, even though they are exempt as LPTV stations. Despite Tropical Storm Hanna making landfall southwest of Wilmington two days before (September 6), the switchover continued as scheduled. The ceremony was marked by governmental and television representatives flipping a large switch (marked with the slogan "First in Flight, First in Digital") from analog to digital. The Wilmington Sharks are a Coastal Plain League (CPL) baseball team in Wilmington that was founded in 1997 and was among the charter organizations when the CPL was formed that same year. The roster is made up of top collegiate baseball players fine-tuning their skills using wood bats to prepare for professional baseball. Their stadium is located at Buck Hardee Field at Legion Stadium. The Wilmington Sea Dawgs are a Tobacco Road Basketball League (TRBL) team that began its inaugural season with the American Basketball Association (ABA) in November 2006 and have also played in the Premier Basketball League , and the Continental Basketball League . The Wilmington Hammerheads were a professional soccer team based in Wilmington. They were founded in 1996 and played in the United Soccer Leagues Second Division. Their stadium was Legion Stadium , however, UNCW Soccer Stadium for their 2017 season. After the 2009 season, the USL discontinued their relationship with the franchise owner Chuck Sullivan . The Hammerheads franchise returned in 2011, but was disbanded again in 2017. Currently, the organization only manages its youth team under the name Wilmington Hammerheads Youth FC. The University of North Carolina Wilmington sponsors 19 intercollegiate sports and has held Division 1 membership in the NCAA since 1977. UNCW competes in the Colonial Athletic Association and has been a member since 1984. The University of North Carolina Wilmington is also home to the Seamen Ultimate Frisbee team. The team won the National Championship in 1993 and most recently qualified for the USA Ultimate College Nationals tournament in 2014 The Cape Fear Rugby Football Club is an amateur rugby club playing in USA Rugby South Division II. They were founded in 1974 and hosts the annual Cape Fear Sevens Tournament held over July 4 weekend; hosting teams from all over the world. They own their own rugby pitch located at 21st and Chestnut St. Off and on, from 1900 to 2001, Wilmington has been home to a professional minor league baseball team. The Wilmington Pirates , a Cincinnati Reds farm team, were one of the top clubs in the Tobacco State League from 1946–50. Most recently the Wilmington Waves, a Class A affiliate of the Los Angeles Dodgers , played in the South Atlantic League. Former All Star catcher Jason Varitek played for Wilmington's Port City Roosters in 1995 and 1996. In 1914 the Philadelphia Phillies held spring training in Wilmington. The beach near Wilmington, NC is home to the annual O'Neil/Sweetwater Pro-Am and Music Festival, the second largest surfing contest on the East Coast. Chandler's Wharf Cotton Exchange of Wilmington Front Street Center Hanover Center Shopping Mall Independence Mall Long Leaf Mall Mayfaire Town Center The Point at BarclayWilmington is a sister city with the following cities:

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Yellow fever

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Vachellia xanthophloea

Acacia xanthophloea Benth. Vachellia xanthophloea is a tree in the family Fabaceae , commonly known in English as the fever tree . This species of Vachellia is native to eastern and southern Africa (Botswana, Kenya, Malawi, Mozambique, Somalia, South Africa, Eswatini, Tanzania, Zambia, Zimbabwe). It has also become a landscape tree in other warm climates, outside of its natural range.The trees grow to a height of 15–25 m (49–82 ft) . The characteristic bark is smooth, powdery and greenish yellow, although new twigs are purple, flaking later to reveal the characteristic yellow. It is one of the few trees where photosynthesis takes place in the bark . Straight, white spines grow from the branch nodes in pairs. The leaves are twice compound, with small leaflets ( 8 mm × 2 mm or 0.3 in × 0.1 in ). The flowers are produced in scented pale cream spherical inflorescences, clustered at the nodes and towards the ends of the branches. The pale brown pods contain 5–10 elliptical, flattened green seeds and are 5–19 cm (2.0–7.5 in) long, straight, flat and rather papery, the segments are mostly longer than they are wide, often breaking up to form small clusters of segments each containing an individual seed. As the pods mature they change colour from green to pale greyish brown. Fever trees are fast growing and short lived. They have a tendency to occur as single-aged stands, and are subject to stand-level diebacks that have been variously attributed to elephants, water tables, and synchronous senescence. The name xanthophloea is derived from Greek and means "yellow bark" (ξανθός "yellow, golden"; φλοιός "bark"). The common name, fever tree , comes from its tendency to grow in swampy areas: early European settlers in the region noted that malarial fever was contracted in areas with these trees. It is now understood that malarial fever is spread by mosquitos living in the swampy areas that often support this tree species, and not by the tree species itself. This is because mosquitos often lay eggs in moist swampy areas, which they need blood to do. Vachellia xanthophloea is found growing near swamps, riverine forests or on lake shores, in semi-evergreen bush land and woodland where there is a high groundwater table. In seasonally flooded areas it often forms dense single species stands. The leaves and pods are used to provide food for livestock while the young branches and foliage are eaten by African elephants while giraffe and vervet monkeys eat the pods and leaves. The flowers are used for foraging by bees and provides favoured nesting sites for birds. Like other acacias and Fabaceae it is a nitrogen fixer, so improves soil fertility. The gum is part of the diet of the Senegal bushbaby ( Galago senegalensis ) especially in the dry season. Butterflies recorded as feeding on Vachellia xanthophloea in Kenya included the Kikuyu ciliate blue ( Anthene kikuyu ), Pitman's hairtail ( Anthene pitmani ), common ciliate blue ( Anthene definita ), African babul blue ( Azanus jesous ), Victoria's bar ( Cigaritis victoriae ) and common zebra blue ( Leptotes pirithous ). In addition 30 species of larger moths have been recorded as feeding on this tree. Vachellia xanthophloea are planted next to dams and streams on farms to control soil erosion, as a live fence or hedge and in ornamental planting for shade and shelter in amenity areas. Vachellia xanthophloea is often planted as a source of firewood, but its gummy sap leaves a thick, black, tarlike residue when burnt. The valuable timber of Vachellia xanthophloea is pale reddish brown with a hard, heavy texture, and, because it is liable to crack, it should be seasoned before use. The timber is used to make poles and posts. In Australia, Vachellia xanthophlea is a prohibited invasive plant in the state of Queensland under the Biosecurity Act 2014, under which it must not be given away, sold, or released into the environment without a permit. The act further requires that all sightings of Vachellia xanthophlea are to be reported to the appropriate authorities within 24 hours and that within Queensland everyone is obliged to take all reasonable and practical steps to minimise the risk of Vachellia xanthophlea spreading until they have received advice from an authorised officer. Although so far, it has only been found in a few gardens and not in the "wild". It is also a "declared pest" in Western Australia . These trees are immortalized by Rudyard Kipling in one of his Just So Stories , " The Elephant's Child ", wherein he repeatedly refers to "the great grey-green, greasy Limpopo River , all set about with fever-trees." This tree has been used for thousands of years by African tribes as a divination tool. Bark from this tree and four other herbs including Silene capensis (African dream root) and Synaptolepis kirkii are boiled into a brew. This is taken to induce lucid dreams, which they call "white paths". Before going to sleep a question is asked that will be answered in their dreams. Medicinally, the roots and a powder made from bark stripped from the trunk are used as an emetic and as a prophylactic against malaria.

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Yellow fever

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Visa requirements for Malaysian citizens

Visa requirements for Malaysian citizens are administrative entry restrictions by the authorities of other states placed on citizens of Malaysia . As of 2024, Malaysian citizens had visa-free or visa on arrival access to 183 countries and territories, ranking the Malaysian passport 12th in the world according to the Henley Passport Index . Although Malaysian passports bear the inscription "This passport is valid for all countries except Israel" and the Malaysian government officially allows travel to Israel for Christian pilgrims only, Israel still issues visas to Malaysian citizens according to its rules. In September 2017, Malaysia announced a ban on all Malaysian citizens from travelling to North Korea , in the wake of strained Malaysia–North Korea relations following the assassination of Kim Jong-nam at Kuala Lumpur International Airport . e-Visa may be obtained online prior to departure. 3 months on each visit in 12-month period if granted. e-Visa may be obtained online prior to departure. Fee of USD 51. Must have an international vaccination certificate. Fee EUR 25. Visa-free starting from December 1, 2023 until November 30, 2024. Must be arriving at Port Bouet Airport and hold an International Certificate of Vaccination. Fee is 73 EURO. 90 days within any 180 day period. Travel officially restricted by Malaysian government to pilgrims only. Confirmation from Israeli Foreign Ministry is required before a visa is issued. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. Fee KWD 3. e-Visa may be obtained online prior to departure. Granted free of charge at Beirut International Airport . Must not have Israeli visa or stamp in the passport. Must be in possession of phone number & address to be visited in Lebanon, and a non-refundable onward ticket. According to the e-Visa site, citizens of Malaysia are exempt from visa. Must have hotel reservation. 90 days within any 180 day period. At Beira (BEW), Nampula (APL), Maputo (MPM), Pemba (POL), Tete (TET) and Vilankulo (VNX). Must have onward ticket. Visa holders issued by USA or a Schengen Member State may enter São Tomé and Príncipe for stay up to a maximum stay of 15 days. Valid Schengen, UK, US, Switzerland or EEA Member State Visa holder may enter Serbia without Serbian tourist visa. Application can be submitted up to 30 days before travel. Visitors must upload a reservation confirmation(s) for each visitor's location of stay in Seychelles. Yellow fever vaccination certificate is required if coming from endemic countries. Payment of the fee (EUR 10) by credit or debit card. Valid for one journey only and it expires once exit the country. Obtainable online. Printed visa authorization must be presented at the time of travel. Must hold return / onward ticket. Fee of USD 30 to be paid in cash only. 90 days within any 180 days period in Turkiye. Malaysian citizens who do receive a visa are normally issued with 10-years multiple-entry combination B1 / B2 visas, and each entry can stay for a maximum of 6 months (the period of stay is subject to the border immigration officer). Barbados Brunei Ireland Schengen Area Singapore United KingdomVisa requirements for Malaysia citizens for visits to various territories, disputed areas, partially recognized countries and restricted zones:Holders of an APEC Business Travel Card (ABTC) travelling on business do not require a visa to the following countries: 1 - Up to 180 days 2 - Up to 90 days 3 - Up to 90 days in a period of 180 days 4 - Up to 60 days The card must be used in conjunction with a passport and has the following advantages: Many countries have entry restrictions on foreigners that go beyond the common requirement of having either a valid visa or a visa exemption. Such restrictions may be health related or impose additional documentation requirements on certain classes of people for diplomatic or political purposes. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa.

Wiki

Yellow fever

https://api.wikimedia.org/core/v1/wikipedia/en/page/Visa_requirements_for_Brazilian_citizens/html

Visa requirements for Brazilian citizens

Visa requirements for Brazilian citizens are administrative entry restrictions by the authorities of other states placed on citizens of Brazil . As of 2024, Brazilian citizens had visa-free or visa on arrival access to 173 countries and territories, ranking the Brazilian passport 18th in the world according to the Henley Passport Index . The Mercosur member states of Argentina, Brazil, Paraguay, and Uruguay, together with most other South American countries (as shown below) do not even require a Brazilian passport; a national or state-issued Brazilian identity card is enough for entry into all Mercosur member and associate states (with the exception of Guyana and Suriname). Nevertheless, the identity card must be in good condition, must not have expired, and the holder must be clearly recognizable in the photograph. Brazilians within Mercosur have unlimited access to any of the full members ( Argentina , Paraguay , Uruguay ) and associated members ( Bolivia , Chile , Peru , Colombia , Ecuador ) with the right to residence and work, with no requirement other than nationality. Citizens of these nine countries (including Brazil) may apply for the grant of "temporary residence" for up to two years in another country of the bloc. Then, they may apply for "permanent residence" just before the term of their "temporary residence" expires. Brazilians may request lawful permanent resident status in Argentina and Uruguay at any time. No prior temporary resident status is needed. May apply online (Online Visitor e600 visa). 90 days within any year period. Must have an international vaccination certificate. Entry is allowed with a valid ID card that is less than 10 years old. Brazilians can live and work legally in Bolivia under the Mercosur (and Associated Countries) immigration agreement with no requirement other than being a citizen at birth or a naturalized citizen for over 5 years, and passing a background check. 90 days within any 6-month period. Visa is also obtainable online. Entry is allowed with a valid ID card that is less than 10 years old. Brazilians can live and work legally in Chile under the Mercosur (and Associated Countries) immigration agreement with no requirement other than being a citizen at birth or a naturalized citizen for over 5 years, and passing a background check. Hong Kong, Macau, and Taiwan count as third countries under the 24, 72 and 144-hours transit without visa (TWOV) policies. Entry is allowed with a valid ID card that is less than 10 years old. Brazilians can live and work legally in Colombia under the Mercosur (and Associated Countries) immigration agreement with no requirement other than being a citizen at birth or a naturalized citizen for over 5 years, and passing a background check. Can be extended up to 90 days with a fee. 90 days within any 180 day period. Entry is allowed with a valid ID card that is less than 10 years old. Brazilians can live and work legally in Ecuador under the Mercosur (and Associated Countries) immigration agreement with no requirement other than being a citizen at birth or a naturalized citizen for over 5 years, and passing a background check. An entry clearance must be obtained from the Gambian Immigration prior to travel. As of April 2023, a visa can be obtained at the border with Senegal for 100 USD. Valid for three months and multiple entries. 90 days (business), 6 months (tourist). 30 days within any year period. Applications can be submitted up to 90 days prior to travel and must be submitted at least 3 days in advance. eTA fee is USD 32.50. Proof of reservation at the hotel where visitors plan to stay is required (if staying with friends, an invitation letter is also acceptable). Yellow fever vaccination certificate is required if coming from endemic countries. 90 days within any 12-month period. 90 days within any 180 day period. 90 days within any 180 day period. Entry is allowed with a valid ID card that is less than 10 years old. Brazilians can live and work legally in Paraguay under the Mercosur (and Associated Countries) immigration agreement with no requirement other than being a citizen at birth or a naturalized citizen for over 5 years, and passing a background check. Entry is allowed with a valid ID card that is less than 10 years old. Brazilians can live and work legally in Peru under the Mercosur (and Associated Countries) immigration agreement with no requirement other than being a citizen at birth or a naturalized citizen for over 5 years, and passing a background check. 90 days within any 180 day period. Obtainable online. Printed visa authorization must be presented at the time of travel. The standard visitor visa allows a stay of 60 days within any 6 month period. Visa fees (for Standard visitor visa): SAARC - USD 35 Non SAARC - USD 75 e-Visa categories will be charged an additional USD 18.50 service fee. If transiting from any of the Sri Lankan airports, An e-Visa is exempted (2 day transit period). e-Visa holders can enter through all border points. Determined at the port of entry. Tourist visas are issued with validity of up to 10 years. e-Visa is valid for 90 days and multiple entry. For tourism purposes also eligible for a universal visa allowing access to Zimbabwe. For tourism purposes also eligible for a universal visa allowing access to Zambia.Visas for Cambodia, Myanmar, Rwanda, São Tomé and Príncipe , Senegal, Sri Lanka and Turkey are obtainable online. Visas for Cambodia, Myanmar, Rwanda, São Tomé and Príncipe , Senegal, Sri Lanka and Turkey are obtainable online. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available. Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa. Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence. The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old. Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints. Many countries require a minimum number of blank pages to be available in the passport being presented, typically one or two pages. Endorsement pages, which often appear after the visa pages, are not counted as being valid or available.Many African countries, including Angola , Benin , Burkina Faso , Burundi , Cameroon , Central African Republic , Chad , Democratic Republic of the Congo , Republic of the Congo , Côte d'Ivoire , Equatorial Guinea , Gabon , Gambia , Ghana , Guinea-Bissau , Kenya , Liberia , Mali , Mauritania , Niger , Rwanda , Senegal , Sierra Leone and Togo , South Sudan , Uganda , and Zambia , require all incoming passengers older than nine months to one year to have a current International Certificate of Vaccination or Prophylaxis , as does the South American territory of French Guiana . Some other countries require vaccination only if the passenger is coming from an infected area or has visited one recently or has transited for 12 hours in those countries: Algeria, Botswana, Cabo Verde, Chad, Djibouti, Egypt, Eswatini, Ethiopia, Gambia, Ghana, Guinea, Lesotho, Libya, Equatorial Guinea, Eritrea, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Papua New Guinea, Seychelles, Somalia, South Africa, Sudan, Tunisia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Very few countries, such as Paraguay, just require a valid passport on arrival. However many countries and groupings now require only an identity card – especially from their neighbours. Other countries may have special bilateral arrangements that depart from the generality of their passport validity length policies to shorten the period of passport validity required for each other's citizens or even accept passports that have already expired (but not been cancelled). Some countries, such as Japan, Ireland and the United Kingdom, require a passport valid throughout the period of the intended stay. In the absence of specific bilateral agreements, countries requiring passports to be valid for at least 6 more months on arrival include Afghanistan, Algeria, Anguilla, Bahrain, Bhutan, Botswana, British Virgin Islands, Brunei, Cambodia, Cameroon, Cape Verde, Cayman Islands, Central African Republic, Chad, Comoros, Costa Rica, Côte d'Ivoire, Curaçao, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, Gabon, Guinea Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Israel, Jordan, Kenya, Kiribati, Kuwait, Laos, Madagascar, Malaysia, Marshall Islands, Mongolia, Myanmar, Namibia, Nepal, Nicaragua, Nigeria, Oman, Palau, Papua New Guinea, Peru, Philippines, Qatar, Rwanda, Samoa, Saudi Arabia, Singapore, Solomon Islands, Somalia, Sri Lanka, Sudan, Suriname, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Turkey, Tuvalu, Uganda, United Arab Emirates, Vanuatu, Venezuela, and Vietnam. Countries requiring passports valid for at least 4 months on arrival include Micronesia and Zambia. Countries requiring passports with a validity of at least 3 months beyond the date of intended departure include Azerbaijan, Bosnia and Herzegovina, Honduras, Montenegro, Nauru, Moldova and New Zealand. Similarly, the EEA countries of Iceland, Liechtenstein, Norway, all European Union countries (except Ireland) together with Switzerland also require 3 months validity beyond the date of the bearer's intended departure unless the bearer is an EEA or Swiss national. Countries requiring passports valid for at least 3 months on arrival include Albania, North Macedonia, Panama, and Senegal. Bermuda requires passports to be valid for at least 45 days upon entry. Countries that require a passport validity of at least one month beyond the date of intended departure include Eritrea, Hong Kong, Lebanon, Macau, the Maldives and South Africa.Some countries, including Australia, Canada, Fiji, New Zealand and the United States, routinely deny entry to non-citizens who have a criminal record while others impose restrictions depending on the type of conviction and the length of the sentence.The government of a country can declare a diplomat persona non grata , banning entry into that country. In non-diplomatic use, the authorities of a country may also declare a foreigner persona non grata permanently or temporarily, usually because of unlawful activity. Kuwait, Lebanon, Libya, Syria, and Yemen do not allow entry to people with passport stamps from Israel or whose passports have either a used or an unused Israeli visa, or where there is evidence of previous travel to Israel such as entry or exit stamps from neighbouring border posts in transit countries such as Jordan and Egypt. To circumvent this Arab League boycott of Israel , the Israeli immigration services have now mostly ceased to stamp foreign nationals' passports on either entry to or exit from Israel (unless the entry is for some work-related purposes). Since 15 January 2013, Israel no longer stamps foreign passports at Ben Gurion Airport . Passports are still (as of 22 June 2017 [ update ] ) stamped at Erez when passing into and out of Gaza . [ citation needed ] Iran refuses admission to holders of passports containing an Israeli visa or stamp that is less than 12 months old.Several countries mandate that all travellers, or all foreign travellers, be fingerprinted on arrival and will refuse admission to or even arrest travellers who refuse to comply. In some countries, such as the United States, this may apply even to transit passengers who merely wish to change planes rather than go landside . Fingerprinting countries/regions include Afghanistan, Argentina, Brunei, Cambodia, China, Ethiopia, Ghana, Guinea, India, Japan, Kenya (both fingerprints and a photo are taken), Malaysia upon entry and departure, Mongolia, Saudi Arabia, Singapore, South Korea, Taiwan, Thailand, Uganda, the United Arab Emirates and the United States. Many countries also require a photo be taken of people entering the country. The United States, which does not fully implement exit control formalities at its land frontiers (although long mandated by domestic legislation), intends to implement facial recognition for passengers departing from international airports to identify people who overstay their visa. Together with fingerprint and face recognition, iris scanning is one of three biometric identification technologies internationally standardised since 2006 by the International Civil Aviation Organization (ICAO) for use in e-passports and the United Arab Emirates conducts iris scanning on visitors who need to apply for a visa. The United States Department of Homeland Security has announced plans to greatly increase the biometric data it collects at US borders. In 2018, Singapore began trials of iris scanning at three land and maritime immigration checkpoints.

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Yellow fever

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Demographics of Nigeria

Nigeria is the most populous country in Africa and the sixth in the world . It is also one of the most densely populated countries in Africa , with approximately 218.5 million people in an area of 923,768 km 2 (356,669 sq mi) . 54.3% of Nigerians are urban dwellers, with the annual rate of urbanisation being estimated at 3.92%. [lower-alpha 1] Nigeria is home to 371 ethnic groups speaking over 500 languages and the variety of customs and traditions among them gives the country great cultural diversity. The three largest ethnic groups are the Hausa , who make up 25% of the population; the Yoruba , who make up 21%; and the Igbo , who make up 18%. The Ijaw , Efik , Ibibio , Annang , and Ogoni are other Southern populations. Meanwhile, the Tiv , Urhobo-Isoko , Edo and Itsekiri inhabit Nigerian's Midwest. Over 1.2 million people living in Nigeria (0.5% of its total population, or 1 in every 200 people living in Nigeria) are from a continent other than Africa. There are 100,000 people from the United States, 75,000 are from Lebanon , 60,000 are from China and 16,000 are from the United Kingdom. Nigeria has a young population overall, with 42.54% of inhabitants between the ages of 0–14. There is also a very high dependency ratio at 88.2 dependants per 100 non-dependants. The three main religious groups are Muslims (estimated to be 53.5% of the total population), Christians (estimated at 45.9%), and adherents of indigenous religions (estimated at 0.6%). The predominantly Christian Igbo are found in the southeast. Roman Catholicism is the largest Christian denomination in Igboland , but Anglicanism is also strong, as are Pentecostalism and other Evangelical denominations. Persons of different ethnic backgrounds most commonly communicate in English, although knowledge of two or more Nigerian languages is widespread. Hausa , Igbo and Yoruba are the most widely used Nigerian languages. Nigerian Pidgin is used widely as an unofficial medium of communication, especially in the Nigerian cities of Warri , Sapele , Ughelli , Benin and Port Harcourt . Nigeria's population has been increasing rapidly for at least the last 5 decades due to very high birth rates, quadrupling its population during this time. Growth was fastest in the 1980s, after child mortality dropped rapidly. It has slowed slightly since then as both the birth rate and total fertility, rate have declined marginally since a 1978 peak. According to the 2017 revision of the World Population Prospects the total population was 257,541,212 in 2016, compared to only 88,992,220 in 1950. The proportion of children under the age of 15 in 2010 was 44.0%, 53.2% were between 15 and 65 years of age, while 2.7% were 65 years or older. There is a large degree of population momentum , with 3.2 per cent growth leading to the projected population of 546 million by 2100. The federal government has not elected to implement the type of controversial family planning programs that have reduced population growth of other developing nations, a result of low political support for these programs and a cultural preference for large families as well as high levels of social instability. Rising educational levels and health care improvements may enable future parents to plan for smaller families. The former Nigeria's chairman of National Population Commission , Eze Duruiheoma, delivering Nigeria's statement in New York City on sustainable cities , human mobility and international migration in the 51st session of Commission on Population and Development, said that "Nigeria remains the most populous in Africa, the seventh globally with an estimated population of over 198 million. The World Population Prospects predicts that by 2050, Nigeria will become the third most populated country in the world. Over the last 50 years, Nigeria's urban population has grown at an average annual growth rate of more than 6.5% without commensurate increases in social amenities and infrastructure." He also stated that the population "grew substantially from 17.3% in 1967 to 49.4% in 2017." Population by sex and age group (Census 21.III.2006) Population by age group (estimates 1.VII.2016) (Data are projections based on the 2006 Population Census.) Population by age group (estimates 1.VII.2020) (Source: National Population Commission.) Total fertility rate (TFR) (Wanted TFR) and crude birth rate (CBR): Fertility data as of 2013 (DHS Program): Source: Demographic and Health Surveys (DHS) ∗ MICS surveys Contraceptive prevalence , any methods (% of women ages 15–49) ∗ UNICEFs state of the worlds children and child info, United Nations population divisions world contraceptive use, household surveys including demographic and health surveys and multiple indicator cluster surveys. ∗ MICS surveysContraceptive prevalence , any methods (% of women ages 15–49) ∗ UNICEFs state of the worlds children and child info, United Nations population divisions world contraceptive use, household surveys including demographic and health surveys and multiple indicator cluster surveys. The total population in sub-Saharan Africa is projected to increase to almost one billion people, making it the most populated region outside of South-Central Asia. According to the United Nations, the population of Nigeria will reach 375 million by 2050. Nigeria might then be the 3rd most populous country in the world. In 2100, the population of Nigeria may reach 541 million. While the overall population is expected to increase, the growth rate is estimated to decrease from 1.2 per cent per year in 2010 to 0.4 per cent per year in 2050. The birth rate is also projected to decrease from 20.7 to 13.7, while the death rate is projected to increase from 8.5 in 2010 to 9.8 in 2050. By 2050, 69.6% of the population is estimated to be living in urban areas compared to 50.6% in 2010. Registration of vital events in Nigeria is not complete. The Population Department of the United Nations prepared the following estimates ( UN World Population Prospects 2022 ). Life expectancy from 1950 to 2015 ( UN World Population Prospects ): Life expectancy from 1950 to 2015 ( UN World Population Prospects ): The following demographic statistics of Nigeria in 2022 are from the World Population Review. One birth every 4 seconds One death every 13 seconds One net migrant every 9 minutes Net gain of one person every 6 seconds The following demographic statistics are from The World Factbook , unless otherwise indicated. Note 1: on 30 September 2021, the Centers for Disease Control and Prevention issued a Travel Health Notice for a Yellow Fever outbreak in Nigeria; a large, ongoing outbreak of yellow fever in Nigeria began in September 2017; the outbreak is now spread throughout the country with the Nigerian Ministry of Health reporting cases of the disease in multiple states (Bauchi, Benue, Delta, Ebonyi, and Enugu); the CDC recommends travellers going to Nigeria should receive vaccination against yellow fever at least 10 days before travel and should take steps to prevent mosquito bites while there; those never vaccinated against yellow fever should avoid travel to Nigeria during the outbreak Note 2: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Nigeria; as of 6 June 2022, Nigeria has reported a total of 256,148 cases of COVID-19 or 124.3 cumulative cases of COVID-19 per 100,000 population with a total of 3,148 cumulative deaths or a rate of 1.5 cumulative death per 100,000 population; as of 22 May 2022, 12.97% of the population has received at least one dose of COVID-19 vaccine Note 3: on 21 March 2022, the US Centers for Disease Control and Prevention (CDC) issued a Travel Alert for polio in Africa; Nigeria is currently considered a high risk to travellers for circulating vaccine-derived polioviruses (cVDPV); vaccine-derived poliovirus (VDPV) is a strain of the weakened poliovirus that was initially included in oral polio vaccine (OPV) and that has changed over time and behaves more like the wild or naturally occurring virus; this means it can be spread more easily to people who are unvaccinated against polio and who come in contact with the stool or respiratory secretions, such as from a sneeze, of an "infected" person who received oral polio vaccine; the CDC recommends that before any international travel, anyone unvaccinated, incompletely vaccinated, or with an unknown polio vaccination status should complete the routine polio vaccine series; before travel to any high-risk destination, CDC recommends that adults who previously completed the full, routine polio vaccine series receive a single, lifetime booster dose of polio vaccine Definition: age 15 and over can read and write Nigeria is Africa's most populous country. Significant population clusters are scattered throughout the country, with the highest density areas being in the south and southwest.Note 1: on 30 September 2021, the Centers for Disease Control and Prevention issued a Travel Health Notice for a Yellow Fever outbreak in Nigeria; a large, ongoing outbreak of yellow fever in Nigeria began in September 2017; the outbreak is now spread throughout the country with the Nigerian Ministry of Health reporting cases of the disease in multiple states (Bauchi, Benue, Delta, Ebonyi, and Enugu); the CDC recommends travellers going to Nigeria should receive vaccination against yellow fever at least 10 days before travel and should take steps to prevent mosquito bites while there; those never vaccinated against yellow fever should avoid travel to Nigeria during the outbreak Note 2: widespread ongoing transmission of a respiratory illness caused by the novel coronavirus (COVID-19) is occurring throughout Nigeria; as of 6 June 2022, Nigeria has reported a total of 256,148 cases of COVID-19 or 124.3 cumulative cases of COVID-19 per 100,000 population with a total of 3,148 cumulative deaths or a rate of 1.5 cumulative death per 100,000 population; as of 22 May 2022, 12.97% of the population has received at least one dose of COVID-19 vaccine Note 3: on 21 March 2022, the US Centers for Disease Control and Prevention (CDC) issued a Travel Alert for polio in Africa; Nigeria is currently considered a high risk to travellers for circulating vaccine-derived polioviruses (cVDPV); vaccine-derived poliovirus (VDPV) is a strain of the weakened poliovirus that was initially included in oral polio vaccine (OPV) and that has changed over time and behaves more like the wild or naturally occurring virus; this means it can be spread more easily to people who are unvaccinated against polio and who come in contact with the stool or respiratory secretions, such as from a sneeze, of an "infected" person who received oral polio vaccine; the CDC recommends that before any international travel, anyone unvaccinated, incompletely vaccinated, or with an unknown polio vaccination status should complete the routine polio vaccine series; before travel to any high-risk destination, CDC recommends that adults who previously completed the full, routine polio vaccine series receive a single, lifetime booster dose of polio vaccineDefinition: age 15 and over can read and writeNigeria is Africa's most populous country. Significant population clusters are scattered throughout the country, with the highest density areas being in the south and southwest.Today millions of ethnic Nigerians live abroad, the largest communities can be found in the United Kingdom (500,000–3,000,000) and the United States (600,000–1,000,000 Nigerians), other countries that followed closely are South Africa, Gambia , and Canada respectively. There are also large groups in Ireland, Portugal and many other countries. Inspiration for emigration is based heavily on socio-economical issues such as warfare, insecurity, economical instability and civil unrest. Between 1400 and 1900, of 1.4 million of 2 million emigrants were slaves sent to the Americas with the other 600,000 being sent to other destinations via the trans-Saharan, Red Sea and Indian Ocean routes. This is due to the fact that the land now known as Nigeria was a central point for 4 slave trades during the 19th century. Though bondage represented a great deal, an estimated 30,000 Nigerian inhabitants would relocate to Kano City and Gambia to take advantage of financial opportunities afforded by fertile land and available natural resources. What's more, the presence of gold mines and rail lines along the Gold Coast, present-day Ghana, attracted an estimated 6,500 Nigerian citizens to attain financial gain and opportunity. The population of Nigerians in Ghana rose to roughly 149,000 before the 1969 alien expulsion order would displace nearly the entire population to surrounding countries. Nigeria is nearly equally divided between Islam and Christianity. The majority of Nigerian Muslims are Sunni and mostly live in the northern, central and south-western states of the country, while Christians dominate in some central states (especially Plateau and Benue states), and the south-east and south-south regions. Other religions practised in Nigeria include African Traditional Religion , Hinduism , Bahá'í Faith , Judaism, The Grail Movement , and the Reformed Ògbóni Fraternity, one of the traditional socio-religious institutions of the Yorùbá people and their Òrìṣà religion known as Ẹ̀sìn Òrìṣà Ìbílẹ̀ in the Yorùbá language . According to a 2009 Pew survey, 50.4% of Nigeria's population were Muslims . A later Pew study in 2011 calculated that Christians now formed 50.8% of the population. Adherents of other religions made up 1% of the population. The shift of population balance between Muslims and Christians is a result of northern and southern Nigeria being in different stages of demographic transition. The Muslim-dominated north is in an earlier stage of the demographic transition with much higher fertility rates than the south, whose split Christian/Muslim population is further along in the transition, and whose fertility rates are declining. Decreasing fertility can be linked to more access to education, use of contraceptives, and differing beliefs regarding family planning. The 1999 introduction of Sharia law in twelve northern Nigerian states led to massive violence and unrest and caused an ethnic and religious rift between Sharia and Non-Sharia states, a divide that has deepened with time. Nigeria is home to a substantial network of organised crime , active especially in drug trafficking. Nigerian criminal groups are heavily involved in drug trafficking, shipping heroin from Asian countries to Europe and America; and cocaine from South America to Europe and South Africa. The various Nigerian confraternities or "campus cults" are active in both organised crime and in political violence as well as providing a network of corruption within Nigeria. As confraternities have extensive connections with political and military figures, they offer excellent alumni networking opportunities. The Supreme Vikings Confraternity, for example, boasts that twelve members of the Rivers State House of Assembly are cult members. On lower levels of society, there are the " area boys ", these are organised gangs mostly active in Lagos who specialise in mugging and small-scale drug dealing. According to official statistics, gang violence in Lagos resulted in 273 civilians and 84 policemen killed in the period of August 2000 to May 2001. "The result of factors such as endemic local corruption, which facilitates illicit trafficking ; the Nigerian Civil War , which contributed to a proliferation of firearms; the oil boom of the 1970s, which led to the embezzlement of public funds; and the economic crisis of the 1980s, which was accompanied by a rise in robberies. The expansion of the Nigerian diaspora and organized crime went hand in hand. Global migration boosted prostitution, drug trafficking and fraud, the three main activities of Nigerian syndicates. The smuggling of Nigerian sex workers became a whole industry that now extends from Switzerland to France and Italy (where black prostitutes are called "fireflies"), and has even reached the Prudish Kingdom of Saudi Arabia , from which 1,000 women are said to be deported every month by the authorities." The high crime rate among Nigerian migrants also leads to stereotyping Nigerians as criminals; thus, in Cameroon, Nigerian migrants are perceived collectively by the inhabitants of Cameroon as likely to be oil smugglers or dealers in stolen cars. In the Netherlands , the debate on Nigerian crime reached an intensity described as a " moral panic " by one scholar. In Switzerland , the crime rate of Nigerian young males was reported as 620% that of Swiss males in same age group (2009 data), the second highest crime rate of any nationality, just below that of Angolan nationals (at 630%). Nigeria is also pervaded by political corruption . It is ranked 136 out of 168 countries in Transparency International 's 2015 Corruption Perceptions Index .

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West Nile

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West Nile

West Nile may refer to:

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West Nile

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West Nile virus

West Nile virus ( WNV ) is a single-stranded RNA virus that causes West Nile fever . It is a member of the family Flaviviridae , from the genus Flavivirus , which also contains the Zika virus , dengue virus , and yellow fever virus. The virus is primarily transmitted by mosquitoes , mostly species of Culex . The primary hosts of WNV are birds, so that the virus remains within a "bird–mosquito–bird" transmission cycle. The virus is genetically related to the Japanese encephalitis family of viruses. Humans and horses both exhibit disease symptoms from the virus, and symptoms rarely occur in other animals.Contrary to popular belief, West Nile virus was not named after the Nile River , rather, the West Nile district of Uganda where the virus was first isolated in 1937. After its original discovery in this region, it was found in many other parts of the world. Most likely, it spread from the original West Nile district.Like most other flaviviruses, WNV is an enveloped virus with icosahedral symmetry . Electron microscope studies reveal a 45–50 nm virion covered with a relatively smooth protein shell; this structure is similar to the dengue fever virus, another Flavivirus . The protein shell is made of two structural proteins: the glycoprotein E and the small membrane protein M. Protein E has numerous functions including receptor binding, viral attachment, and entry into the cell through membrane fusion . The outer protein shell is covered by a host-derived lipid membrane , the viral envelope . The flavivirus lipid membrane has been found to contain cholesterol and phosphatidylserine , but other elements of the membrane have yet to be identified. The lipid membrane has many roles in viral infection , including acting as signaling molecules and enhancing entry into the cell. Cholesterol, in particular, plays an integral part in WNV entering a host cell. The two viral envelope proteins, E and M, are inserted into the membrane. The RNA genome is bound to capsid (C) proteins, which are 105 amino-acid residues long, to form the nucleocapsid . The capsid proteins are one of the first proteins created in an infected cell; the capsid protein is a structural protein whose main purpose is to package RNA into the developing viruses. The capsid has been found to prevent apoptosis by affecting the Akt pathway. WNV is a positive-sense, single-stranded RNA virus . Its genome is approximately 11,000 nucleotides long and is flanked by 5′ and 3′ non-coding stem loop structures. The coding region of the genome codes for three structural proteins and seven nonstructural (NS) proteins , proteins that are not incorporated into the structure of new viruses. The WNV genome is first translated into a polyprotein and later cleaved by virus and host proteases into separate proteins (i.e. NS1, C, E). Structural proteins (C, prM/M, E) are capsid, precursor membrane proteins, and envelope proteins, respectively. The structural proteins are located at the 5′ end of the genome and are cleaved into mature proteins by both host and viral proteases. [ citation needed ] Nonstructural proteins consist of NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5. These proteins mainly assist with viral replication or act as proteases. The nonstructural proteins are located near the 3′ end of the genome.WNV is a positive-sense, single-stranded RNA virus . Its genome is approximately 11,000 nucleotides long and is flanked by 5′ and 3′ non-coding stem loop structures. The coding region of the genome codes for three structural proteins and seven nonstructural (NS) proteins , proteins that are not incorporated into the structure of new viruses. The WNV genome is first translated into a polyprotein and later cleaved by virus and host proteases into separate proteins (i.e. NS1, C, E). Structural proteins (C, prM/M, E) are capsid, precursor membrane proteins, and envelope proteins, respectively. The structural proteins are located at the 5′ end of the genome and are cleaved into mature proteins by both host and viral proteases. [ citation needed ]Nonstructural proteins consist of NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5. These proteins mainly assist with viral replication or act as proteases. The nonstructural proteins are located near the 3′ end of the genome.Once WNV has successfully entered the bloodstream of a host animal, the envelope protein, E, binds to attachment factors called glycosaminoglycans on the host cell. These attachment factors aid entry into the cell, however, binding to primary receptors is also necessary. Primary receptors include DC-SIGN , DC-SIGN-R, and the integrin α v β 3 . By binding to these primary receptors, WNV enters the cell through clathrin-mediated endocytosis . As a result of endocytosis, WNV enters the cell within an endosome . [ citation needed ] The acidity of the endosome catalyzes the fusion of the endosomal and viral membranes, allowing the genome to be released into the cytoplasm. Translation of the positive-sense single-stranded RNA occurs at the endoplasmic reticulum ; the RNA is translated into a polyprotein which is then cleaved by both host and viral proteases NS2B-NS3 to produce mature proteins. In order to replicate its genome, NS5, a RNA polymerase , forms a replication complex with other nonstructural proteins to produce an intermediary negative-sense single-stranded RNA ; the negative-sense strand serves as a template for synthesis of the final positive-sense RNA. Once the positive-sense RNA has been synthesized, the capsid protein, C, encloses the RNA strands into immature virions. The rest of the virus is assembled along the endoplasmic reticulum and through the Golgi apparatus , and results in non-infectious immature virions. The E protein is then glycosylated and prM is cleaved by furin , a host cell protease, into the M protein, thereby producing an infectious mature virion. The mature viruses are then secreted out of the cell. [ citation needed ]WNV is one of the Japanese encephalitis antigenic serocomplex of viruses, together with Japanese encephalitis virus, Murray Valley encephalitis virus , Saint Louis encephalitis virus and some other flaviviruses. Studies of phylogenetic lineages have determined that WNV emerged as a distinct virus around 1000 years ago. This initial virus developed into two distinct lineages. Lineage 1 and its multiple profiles is the source of the epidemic transmission in Africa and throughout the world. Lineage 2 was considered an African zoonosis . However, in 2008, lineage 2, previously only seen in horses in sub-Saharan Africa and Madagascar, began to appear in horses in Europe, where the first known outbreak affected 18 animals in Hungary. Lineage 1 West Nile virus was detected in South Africa in 2010 in a mare and her aborted fetus ; previously, only lineage 2 West Nile virus had been detected in horses and humans in South Africa. Kunjin virus is a subtype of West Nile virus endemic to Oceania . A 2007 fatal case in a killer whale in Texas broadened the known host range of West Nile virus to include cetaceans . Since the first North American cases in 1999, the virus has been reported throughout the United States, Canada, Mexico, the Caribbean, and Central America. There have been human cases and equine cases, and many birds are infected. The Barbary macaque , Macaca sylvanus , was the first nonhuman primate to contract WNV. Both the American and Israeli strains are marked by high mortality rates in infected avian populations; the presence of dead birds—especially Corvidae —can be an early indicator of the arrival of the virus. [ citation needed ]The natural hosts for WNV are birds and mosquitoes. Over 300 different species of bird have been shown to be infected with the virus. Some birds, including the American crow ( Corvus brachyrhynchos ), blue jay ( Cyanocitta cristata ) and greater sage-grouse ( Centrocercus urophasianus ), are killed by the infection, but others survive. The American robin ( Turdus migratorius ) and house sparrow ( Passer domesticus ) are thought to be among the most important reservoir species in N. American and European cities. Brown thrashers ( Toxostoma rufum ), gray catbirds ( Dumetella carolinensis ), northern cardinals ( Cardinalis cardinalis ), northern mockingbirds ( Mimus polyglottos ), wood thrushes ( Hylocichla mustelina ) and the dove family are among the other common N. American birds in which high levels of antibodies against WNV have been found. WNV has been demonstrated in a large number of mosquito species, but the most significant for viral transmission are Culex species that feed on birds, including Culex pipiens , C. restuans , C. salinarius , C. quinquefasciatus , C. nigripalpus , C. erraticus and C. tarsalis . Experimental infection has also been demonstrated with soft tick vectors, but is unlikely to be important in natural transmission. WNV has a broad host range, and is also known to be able to infect at least 30 mammalian species, including humans, some non-human primates, horses, dogs and cats. Some infected humans and horses experience disease but dogs and cats rarely show symptoms. Reptiles and amphibians can also be infected, including some species of crocodiles, alligators, snakes, lizards and frogs. Mammals are considered incidental or dead-end hosts for the virus: they do not usually develop a high enough level of virus in the blood ( viremia ) to infect another mosquito feeding on them and carry on the transmission cycle; some birds are also dead-end hosts. In the normal rural or enzootic transmission cycle, the virus alternates between the bird reservoir and the mosquito vector. It can also be transmitted between birds via direct contact, by eating an infected bird carcass or by drinking infected water. Vertical transmission between female and offspring is possible in mosquitoes, and might potentially be important in overwintering. In the urban or spillover cycle, infected mosquitoes that have fed on infected birds transmit the virus to humans. This requires mosquito species that bite both birds and humans, which are termed bridge vectors. The virus can also rarely be spread through blood transfusions, organ transplants, or from mother to baby during pregnancy, delivery, or breastfeeding. Unlike in birds, it does not otherwise spread directly between people. West Nile fever is an infection by the West Nile virus, which is typically spread by mosquitoes . In about 80% of infections people have few or no symptoms . About 20% of people develop a fever , headache, vomiting, or a rash. In less than 1% of people, encephalitis or meningitis occurs, with associated neck stiffness, confusion, or seizures. Recovery may take weeks to months. The risk of death among those in whom the nervous system is affected is about 10 percent. West Nile virus (WNV) is usually spread by mosquitoes that become infected when they feed on infected birds, which often carry the disease . Rarely the virus is spread through blood transfusions, organ transplants, or from mother to baby during pregnancy, delivery, or breastfeeding, but it otherwise does not spread directly between people. Risks for severe disease include being over 60 years old and having other health problems. Diagnosis is typically based on symptoms and blood tests. There is no human vaccine . The best way to reduce the risk of infection is to avoid mosquito bites. Mosquito populations may be reduced by eliminating standing pools of water, such as in old tires, buckets, gutters, and swimming pools. When mosquitoes cannot be avoided, mosquito repellent , window screens , and mosquito nets reduce the likelihood of being bitten. There is no specific treatment for the disease; pain medications may reduce symptoms. Severe disease may also occur in horses. Several vaccines for these animals are now available. Before the availability of veterinary vaccines, around 40% of horses infected in North America died. West Nile fever is an infection by the West Nile virus, which is typically spread by mosquitoes . In about 80% of infections people have few or no symptoms . About 20% of people develop a fever , headache, vomiting, or a rash. In less than 1% of people, encephalitis or meningitis occurs, with associated neck stiffness, confusion, or seizures. Recovery may take weeks to months. The risk of death among those in whom the nervous system is affected is about 10 percent. West Nile virus (WNV) is usually spread by mosquitoes that become infected when they feed on infected birds, which often carry the disease . Rarely the virus is spread through blood transfusions, organ transplants, or from mother to baby during pregnancy, delivery, or breastfeeding, but it otherwise does not spread directly between people. Risks for severe disease include being over 60 years old and having other health problems. Diagnosis is typically based on symptoms and blood tests. There is no human vaccine . The best way to reduce the risk of infection is to avoid mosquito bites. Mosquito populations may be reduced by eliminating standing pools of water, such as in old tires, buckets, gutters, and swimming pools. When mosquitoes cannot be avoided, mosquito repellent , window screens , and mosquito nets reduce the likelihood of being bitten. There is no specific treatment for the disease; pain medications may reduce symptoms. Severe disease may also occur in horses. Several vaccines for these animals are now available. Before the availability of veterinary vaccines, around 40% of horses infected in North America died. According to the Center for Disease Control , infection with West Nile Virus is seasonal in temperate zones. Climates that are temperate, such as those in the United States and Europe, see peak season from July to October. Peak season changes depending on geographic region and warmer and humid climates can see longer peak seasons. All ages are equally likely to be infected but there is a higher amount of death and neuroinvasive West Nile Virus in people 60–89 years old. People of older age are more likely to have adverse effects. [ citation needed ] There are several modes of transmission, but the most common cause of infection in humans is by being bitten by an infected mosquito. Other modes of transmission include blood transfusion, organ transplantation, breast-feeding, transplacental transmission, and laboratory acquisition. These alternative modes of transmission are extremely rare. Prevention efforts against WNV mainly focus on preventing human contact with and being bitten by infected mosquitoes. This is twofold, first by personal protective actions and second by mosquito-control actions. When a person is in an area that has WNV, it is important to avoid outdoor activity, and if they go outside they should use a mosquito repellent with DEET. A person can also wear clothing that covers more skin, such as long sleeves and pants. Mosquito control can be done at the community level and include surveillance programs and control programs including pesticides and reducing mosquito habitats. This includes draining standing water. Surveillance systems in birds is particularly useful. If dead birds are found in a neighborhood, the event should be reported to local authorities. This may help health departments do surveillance and determine if the birds are infected with West Nile Virus. Despite the commercial availability of four veterinary vaccines for horses, no human vaccine has progressed beyond phase II clinical trials . Efforts have been made to produce a vaccine for human use and several candidates have been produced but none are licensed to use. The best method to reduce the risk of infections is avoiding mosquito bites. This may be done by eliminating standing pools of water, such as in old tires, buckets, gutters, and swimming pools. Mosquito repellent , window screens , mosquito nets , and avoiding areas where mosquitoes occur may also be useful. Like other tropical diseases which are expected to have increased spread due to climate change, there is concern that changing weather conditions will increase West Nile Virus spread. Climate change will affect disease rates, ranges, and seasonality and affects the distribution of West Nile Virus. Projected changes in flood frequency and severity can bring new challenges in flood risk management , allowing for increased mosquito populations in urban areas. Weather conditions affected by climate change including temperature, precipitation and wind may affect the survival and reproduction rates of mosquitoes, suitable habitats, distribution, and abundance. Ambient temperatures drive mosquito replication rates and transmission of WNV by affecting the peak season of mosquitoes and geographic variations. For example, increased temperatures can affect the rate of virus replication, speed up the virus evolution rate, and viral transmission efficiency. Furthermore, higher winter temperatures and warmer spring may lead to larger summer mosquito populations, increasing the risk for WNV. Similarly, rainfall may also drive mosquito replication rates and affect the seasonality and geographic variations of the virus. Studies show an association between heavy precipitation and higher incidence of reported WNV. Likewise, wind is another environmental factor that serves as a dispersal mechanism for mosquitoes. Mosquitoes have extremely wide environmental tolerances and a nearly ubiquitous geographical distribution, being present on all major land masses except Antarctica and Iceland. Nevertheless, changes in climate and land use on ecological timescales can variously expand or fragment their distribution patterns, raising consequent concerns for human health.

Wiki

West Nile

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West Nile fever

West Nile fever is an infection by the West Nile virus , which is typically spread by mosquitoes . In about 80% of infections people have few or no symptoms . About 20% of people develop a fever , headache, vomiting, or a rash. In less than 1% of people, encephalitis or meningitis occurs, with associated neck stiffness, confusion, or seizures. Recovery may take weeks to months. The risk of death among those in whom the nervous system is affected is about 10 percent. West Nile virus (WNV) is usually spread by mosquitoes that become infected when they feed on infected birds, which often carry the disease . Rarely the virus is spread through blood transfusions, organ transplants, or from mother to baby during pregnancy, delivery, or breastfeeding, but it otherwise does not spread directly between people. Risks for severe disease include being over 60 years old and having other health problems. Diagnosis is typically based on symptoms and blood tests. There is no human vaccine . The best way to reduce the risk of infection is to avoid mosquito bites. Mosquito populations may be reduced by eliminating standing pools of water, such as in old tires, buckets, gutters, and swimming pools. When mosquitoes cannot be avoided, mosquito repellent , window screens , and mosquito nets reduce the likelihood of being bitten. There is no specific treatment for the disease; pain medications may reduce symptoms. The virus was discovered in Uganda in 1937, and was first detected in North America in 1999. WNV has occurred in Europe, Africa, Asia, Australia, and North America. In the United States thousands of cases are reported a year, with most occurring in August and September. It can occur in outbreaks of disease. Severe disease may also occur in horses, for which a vaccine is available. A surveillance system in birds is useful for early detection of a potential human outbreak. About 80% of those infected with West Nile virus (WNV) show no symptoms and go unreported. About 20% of infected people develop symptoms. These vary in severity, and begin 3 to 14 days after being bitten. Most people with mild symptoms of WNV recover completely, though fatigue and weakness may last for weeks or months. Symptoms may range from mild, such as fever , to severe, such as paralysis and meningitis . A severe infection can last weeks and can, rarely, cause permanent brain damage . Death may ensue if the central nervous system is affected. Medical conditions such as cancer and diabetes , and age over 60 years, increase the risk of developing severe symptoms. Headache can be a prominent symptom of WNV fever, meningitis, encephalitis, meningoencephalitis, and it may or may not be present in poliomyelitis-like syndrome. Thus, headache is not a useful indicator of neuroinvasive disease.WNV is one of the Japanese encephalitis antigenic serocomplex of viruses. Image reconstructions and cryoelectron microscopy reveal a 45–50 nm virion covered with a relatively smooth protein surface. This structure is similar to the dengue fever virus; both belong to the genus Flavivirus within the family Flaviviridae . The genetic material of WNV is a positive-sense , single strand of RNA , which is between 11,000 and 12,000 nucleotides long; these genes encode seven nonstructural proteins and three structural proteins. The RNA strand is held within a nucleocapsid formed from 12- kDa protein blocks; the capsid is contained within a host-derived membrane altered by two viral membrane proteins. West Nile virus has been seen to replicate faster and spread more easily to birds at higher temperatures; one of several ways climate change could affect the epidemiology of this disease. The prime method of spread of the West Nile virus (WNV) is the female mosquito. In Europe, cats were identified as being hosts for West Nile virus . The important mosquito vectors vary according to area; in the United States, Culex pipiens (Eastern United States, and urban and residential areas of the United States north of 36–39°N), Culex tarsalis (Midwest and West), and Culex quinquefasciatus (Southeast) are the main vector species. The mosquito species that are most frequently infected with WNV feed primarily on birds. Different species of mosquitos take a blood meal from different types of vertebrate hosts , Mosquitoes show further selectivity, exhibiting preference for different species of birds. In the United States, WNV mosquito vectors feed preferentially on members of the Corvidae and thrush family . Among the preferred species within these families are the American crow , a corvid, and the American robin ( Turdus migratorius ). Some species of birds develop sufficient viral levels (>~10 4.2 log PFU/ml; ) after being infected to transmit the infection to biting mosquitoes that in turn go on to infect other birds. In birds that die from WNV, death usually occurs after 4 to 6 days. In mammals and several species of birds, the virus does not multiply as readily and so does not develop high viremia during infection. Mosquitoes biting such hosts are not believed to ingest sufficient virus to become infected, making them so-called dead-end hosts . As a result of the differential infectiousness of hosts, the feeding patterns of mosquitoes play an important role in WNV transmission, and they are partly genetically controlled, even within a species. Direct human-to-human transmission initially was believed to be caused only by occupational exposure, such as in a laboratory setting, or conjunctival exposure to infected blood. The US outbreak identified additional transmission methods through blood transfusion, organ transplant, intrauterine exposure, and breast feeding. Since 2003, blood banks in the United States routinely screen for the virus among their donors. As a precautionary measure, the UK's National Blood Service initially ran a test for this disease in donors who donate within 28 days of a visit to the United States, Canada, or the northeastern provinces of Italy, and the Scottish National Blood Transfusion Service asks prospective donors to wait 28 days after returning from North America or the northeastern provinces of Italy before donating. There also have been reports of possible transmission of the virus from mother to child during pregnancy or breastfeeding or exposure to the virus in a lab, but these are rare cases and not conclusively confirmed. Recently, the potential for mosquito saliva to affect the course of WNV disease was demonstrated. Mosquitoes inoculate their saliva into the skin while obtaining blood. Mosquito saliva is a pharmacological cocktail of secreted molecules, principally proteins, that can affect vascular constriction, blood coagulation , platelet aggregation , inflammation , and immunity . It clearly alters the immune response in a manner that may be advantageous to a virus. Studies have shown it can specifically modulate the immune response during early virus infection, and mosquito feeding can exacerbate WNV infection, leading to higher viremia and more severe forms of disease. Vertical transmission , the transmission of a viral or bacterial disease from the female of the species to her offspring, has been observed in various West Nile virus studies, amongst different species of mosquitoes in both the laboratory and in nature. Mosquito progeny infected vertically in autumn may potentially serve as a mechanism for WNV to overwinter and initiate enzootic horizontal transmission the following spring, although it likely plays little role in transmission in the summer and fall. Risk factors independently associated with developing a clinical infection with WNV include a suppressed immune system and a patient history of organ transplantation. For neuroinvasive disease the additional risk factors include older age (>50+), male sex, hypertension , and diabetes mellitus . A genetic factor also appears to increase susceptibility to West Nile disease. A mutation of the gene CCR5 gives some protection against HIV but leads to more serious complications of WNV infection. Carriers of two mutated copies of CCR5 made up 4.0 to 4.5% of a sample of people with West Nile disease, while the incidence of the gene in the general population is only 1.0%. The most at risk occupations in the U.S. are outdoor workers, for example farmers, loggers, landscapers/groundskeepers, construction workers, painters, summer camp workers and pavers. Two reports of accidental exposure by laboratory personnel working with infected fluids or tissues have been received. While this appears to be a rare occurrence, it highlights the need for proper handling of infected materials. The World Health Organization states that there are no known cases of health care workers acquiring the virus from infected patients when the appropriate infection control precautions are observed. WNV is one of the Japanese encephalitis antigenic serocomplex of viruses. Image reconstructions and cryoelectron microscopy reveal a 45–50 nm virion covered with a relatively smooth protein surface. This structure is similar to the dengue fever virus; both belong to the genus Flavivirus within the family Flaviviridae . The genetic material of WNV is a positive-sense , single strand of RNA , which is between 11,000 and 12,000 nucleotides long; these genes encode seven nonstructural proteins and three structural proteins. The RNA strand is held within a nucleocapsid formed from 12- kDa protein blocks; the capsid is contained within a host-derived membrane altered by two viral membrane proteins. West Nile virus has been seen to replicate faster and spread more easily to birds at higher temperatures; one of several ways climate change could affect the epidemiology of this disease. The prime method of spread of the West Nile virus (WNV) is the female mosquito. In Europe, cats were identified as being hosts for West Nile virus . The important mosquito vectors vary according to area; in the United States, Culex pipiens (Eastern United States, and urban and residential areas of the United States north of 36–39°N), Culex tarsalis (Midwest and West), and Culex quinquefasciatus (Southeast) are the main vector species. The mosquito species that are most frequently infected with WNV feed primarily on birds. Different species of mosquitos take a blood meal from different types of vertebrate hosts , Mosquitoes show further selectivity, exhibiting preference for different species of birds. In the United States, WNV mosquito vectors feed preferentially on members of the Corvidae and thrush family . Among the preferred species within these families are the American crow , a corvid, and the American robin ( Turdus migratorius ). Some species of birds develop sufficient viral levels (>~10 4.2 log PFU/ml; ) after being infected to transmit the infection to biting mosquitoes that in turn go on to infect other birds. In birds that die from WNV, death usually occurs after 4 to 6 days. In mammals and several species of birds, the virus does not multiply as readily and so does not develop high viremia during infection. Mosquitoes biting such hosts are not believed to ingest sufficient virus to become infected, making them so-called dead-end hosts . As a result of the differential infectiousness of hosts, the feeding patterns of mosquitoes play an important role in WNV transmission, and they are partly genetically controlled, even within a species. Direct human-to-human transmission initially was believed to be caused only by occupational exposure, such as in a laboratory setting, or conjunctival exposure to infected blood. The US outbreak identified additional transmission methods through blood transfusion, organ transplant, intrauterine exposure, and breast feeding. Since 2003, blood banks in the United States routinely screen for the virus among their donors. As a precautionary measure, the UK's National Blood Service initially ran a test for this disease in donors who donate within 28 days of a visit to the United States, Canada, or the northeastern provinces of Italy, and the Scottish National Blood Transfusion Service asks prospective donors to wait 28 days after returning from North America or the northeastern provinces of Italy before donating. There also have been reports of possible transmission of the virus from mother to child during pregnancy or breastfeeding or exposure to the virus in a lab, but these are rare cases and not conclusively confirmed. Recently, the potential for mosquito saliva to affect the course of WNV disease was demonstrated. Mosquitoes inoculate their saliva into the skin while obtaining blood. Mosquito saliva is a pharmacological cocktail of secreted molecules, principally proteins, that can affect vascular constriction, blood coagulation , platelet aggregation , inflammation , and immunity . It clearly alters the immune response in a manner that may be advantageous to a virus. Studies have shown it can specifically modulate the immune response during early virus infection, and mosquito feeding can exacerbate WNV infection, leading to higher viremia and more severe forms of disease. Vertical transmission , the transmission of a viral or bacterial disease from the female of the species to her offspring, has been observed in various West Nile virus studies, amongst different species of mosquitoes in both the laboratory and in nature. Mosquito progeny infected vertically in autumn may potentially serve as a mechanism for WNV to overwinter and initiate enzootic horizontal transmission the following spring, although it likely plays little role in transmission in the summer and fall. Vertical transmission , the transmission of a viral or bacterial disease from the female of the species to her offspring, has been observed in various West Nile virus studies, amongst different species of mosquitoes in both the laboratory and in nature. Mosquito progeny infected vertically in autumn may potentially serve as a mechanism for WNV to overwinter and initiate enzootic horizontal transmission the following spring, although it likely plays little role in transmission in the summer and fall. Risk factors independently associated with developing a clinical infection with WNV include a suppressed immune system and a patient history of organ transplantation. For neuroinvasive disease the additional risk factors include older age (>50+), male sex, hypertension , and diabetes mellitus . A genetic factor also appears to increase susceptibility to West Nile disease. A mutation of the gene CCR5 gives some protection against HIV but leads to more serious complications of WNV infection. Carriers of two mutated copies of CCR5 made up 4.0 to 4.5% of a sample of people with West Nile disease, while the incidence of the gene in the general population is only 1.0%. The most at risk occupations in the U.S. are outdoor workers, for example farmers, loggers, landscapers/groundskeepers, construction workers, painters, summer camp workers and pavers. Two reports of accidental exposure by laboratory personnel working with infected fluids or tissues have been received. While this appears to be a rare occurrence, it highlights the need for proper handling of infected materials. The World Health Organization states that there are no known cases of health care workers acquiring the virus from infected patients when the appropriate infection control precautions are observed. Preliminary diagnosis is often based on the patient's clinical symptoms, places and dates of travel (if patient is from a non endemic country or area), activities, and epidemiologic history of the location where infection occurred. A recent history of mosquito bites and an acute febrile illness associated with neurologic signs and symptoms should cause clinical suspicion of WNV. Diagnosis of West Nile virus infections is generally accomplished by serologic testing of blood serum or cerebrospinal fluid (CSF), which is obtained via a lumbar puncture . Initial screening could be done using the ELISA technique detecting immunoglobulins in the sera of the tested individuals. Typical findings of WNV infection include lymphocytic pleocytosis , elevated protein level, reference glucose and lactic acid levels, and no erythrocytes . Definitive diagnosis of WNV is obtained through detection of virus-specific antibody IgM and neutralizing antibodies . Cases of West Nile virus meningitis and encephalitis that have been serologically confirmed produce similar degrees of CSF pleocytosis and are often associated with substantial CSF neutrophilia . Specimens collected within eight days following onset of illness may not test positive for West Nile IgM, and testing should be repeated. A positive test for West Nile IgG in the absence of a positive West Nile IgM is indicative of a previous flavivirus infection and is not by itself evidence of an acute West Nile virus infection. If cases of suspected West Nile virus infection, sera should be collected on both the acute and convalescent phases of the illness. Convalescent specimens should be collected 2–3 weeks after acute specimens. It is common in serologic testing for cross-reactions to occur among flaviviruses such as dengue virus (DENV) and tick-borne encephalitis virus ; this necessitates caution when evaluating serologic results of flaviviral infections. Four FDA -cleared WNV IgM ELISA kits are commercially available from different manufacturers in the U.S., each of these kits is indicated for use on serum to aid in the presumptive laboratory diagnosis of WNV infection in patients with clinical symptoms of meningitis or encephalitis. Positive WNV test results obtained via use of these kits should be confirmed by additional testing at a state health department laboratory or CDC. In fatal cases, nucleic acid amplification, histopathology with immunohistochemistry , and virus culture of autopsy tissues can also be useful. Only a few state laboratories or other specialized laboratories, including those at CDC, are capable of doing this specialized testing. A number of various diseases may present with symptoms similar to those caused by a clinical West Nile virus infection. Those causing neuroinvasive disease symptoms include the enterovirus infection and bacterial meningitis. Accounting for differential diagnoses is a crucial step in the definitive diagnosis of WNV infection. Consideration of a differential diagnosis is required when a patient presents with unexplained febrile illness, extreme headache, encephalitis or meningitis. Diagnostic and serologic laboratory testing using polymerase chain reaction (PCR) testing and viral culture of CSF to identify the specific pathogen causing the symptoms, is the only currently available means of differentiating between causes of encephalitis and meningitis. A number of various diseases may present with symptoms similar to those caused by a clinical West Nile virus infection. Those causing neuroinvasive disease symptoms include the enterovirus infection and bacterial meningitis. Accounting for differential diagnoses is a crucial step in the definitive diagnosis of WNV infection. Consideration of a differential diagnosis is required when a patient presents with unexplained febrile illness, extreme headache, encephalitis or meningitis. Diagnostic and serologic laboratory testing using polymerase chain reaction (PCR) testing and viral culture of CSF to identify the specific pathogen causing the symptoms, is the only currently available means of differentiating between causes of encephalitis and meningitis. Many of the guidelines for preventing occupational West Nile virus exposure are common to all mosquito-borne diseases . Public health measures include taking steps to reduce mosquito populations. Personal recommendations are to reduce the likelihood of being bitten. General measures to avoid bites include: West Nile virus can be sampled from the environment by the pooling of trapped mosquitoes via ovitraps , carbon dioxide -baited light traps, and gravid traps, testing blood samples drawn from wild birds, dogs, and sentinel monkeys, and testing brains of dead birds found by various animal control agencies and the public. [ citation needed ] Testing of the mosquito samples requires the use of reverse-transcriptase PCR ( RT-PCR ) to directly amplify and show the presence of virus in the submitted samples. When using the blood sera of wild birds and sentinel chickens, samples must be tested for the presence of WNV antibodies by use of immunohistochemistry (IHC) or enzyme-linked immunosorbent assay (ELISA). Dead birds, after necropsy , or their oral swab samples collected on specific RNA-preserving filter paper card, can have their virus presence tested by either RT-PCR or IHC, where virus shows up as brown-stained tissue because of a substrate- enzyme reaction. West Nile control is achieved through mosquito control , by elimination of mosquito breeding sites such as abandoned pools, applying larvacide to active breeding areas, and targeting the adult population via lethal ovitraps and aerial spraying of pesticides . [ citation needed ] Environmentalists have condemned attempts to control the transmitting mosquitoes by spraying pesticide, saying the detrimental health effects of spraying outweigh the relatively few lives that may be saved, and more environmentally friendly ways of controlling mosquitoes are available. They also question the effectiveness of insecticide spraying, as they believe mosquitoes that are resting or flying above the level of spraying will not be killed; the most common vector in the northeastern United States, Culex pipiens , is a canopy feeder. [ citation needed ]West Nile virus can be sampled from the environment by the pooling of trapped mosquitoes via ovitraps , carbon dioxide -baited light traps, and gravid traps, testing blood samples drawn from wild birds, dogs, and sentinel monkeys, and testing brains of dead birds found by various animal control agencies and the public. [ citation needed ] Testing of the mosquito samples requires the use of reverse-transcriptase PCR ( RT-PCR ) to directly amplify and show the presence of virus in the submitted samples. When using the blood sera of wild birds and sentinel chickens, samples must be tested for the presence of WNV antibodies by use of immunohistochemistry (IHC) or enzyme-linked immunosorbent assay (ELISA). Dead birds, after necropsy , or their oral swab samples collected on specific RNA-preserving filter paper card, can have their virus presence tested by either RT-PCR or IHC, where virus shows up as brown-stained tissue because of a substrate- enzyme reaction. West Nile control is achieved through mosquito control , by elimination of mosquito breeding sites such as abandoned pools, applying larvacide to active breeding areas, and targeting the adult population via lethal ovitraps and aerial spraying of pesticides . [ citation needed ] Environmentalists have condemned attempts to control the transmitting mosquitoes by spraying pesticide, saying the detrimental health effects of spraying outweigh the relatively few lives that may be saved, and more environmentally friendly ways of controlling mosquitoes are available. They also question the effectiveness of insecticide spraying, as they believe mosquitoes that are resting or flying above the level of spraying will not be killed; the most common vector in the northeastern United States, Culex pipiens , is a canopy feeder. [ citation needed ]No specific treatment is available for WNV infection. Most people recover without treatment. In mild cases, over-the-counter pain relievers can help ease mild headaches and muscle aches in adults. In severe cases supportive care is provided, often in hospital, with intravenous fluids , pain medication, respiratory support, and prevention of secondary infections. While the general prognosis is favorable, current studies indicate that West Nile Fever can often be more severe than previously recognized, with studies of various recent outbreaks indicating that it may take as long as 60 to 90 days to recover. Patients with milder WNF are just as likely as those with more severe manifestations of neuroinvasive disease to experience multiple somatic complaints such as tremor, and dysfunction in motor skills and executive functions for over a year. People with milder symptoms are just as likely as people with more severe symptoms to experience adverse outcomes. Recovery is marked by a long convalescence with fatigue . One study found that neuroinvasive WNV infection was associated with an increased risk for subsequent kidney disease. WNV was first isolated from a feverish 37-year-old woman at Omogo in the West Nile District of Uganda in 1937 during research on yellow fever virus . A series of serosurveys in 1939 in central Africa found anti-WNV positive results ranging from 1.4% (Congo) to 46.4% (White Nile region, Sudan). It was subsequently identified in Egypt (1942) and India (1953), a 1950 serosurvey in Egypt found 90% of those over 40 years in age had WNV antibodies. The ecology was characterized in 1953 with studies in Egypt and Israel . The virus became recognized as a cause of severe human meningoencephalitis in elderly patients during an outbreak in Israel in 1957. The disease was first noted in horses in Egypt and France in the early 1960s and found to be widespread in southern Europe, southwest Asia and Australia. [ citation needed ] The first appearance of WNV in the Western Hemisphere was in 1999 with encephalitis reported in humans, dogs, cats, and horses, and the subsequent spread in the United States may be an important milestone in the evolving history of this virus. The American outbreak began in College Point, Queens in New York City and was later spread to the neighboring states of New Jersey and Connecticut . The virus is believed to have entered in an infected bird or mosquito, although there is no clear evidence. West Nile virus is now endemic in Africa, Europe, the Middle East, west and central Asia, Oceania (subtype Kunjin ), and most recently, North America and is spreading into Central and South America. Outbreaks of West Nile virus encephalitis in humans have occurred in Algeria (1994), Romania (1996 to 1997), the Czech Republic (1997), Congo (1998), Russia (1999), the United States (1999 to 2009), Canada (1999–2007), Israel (2000) and Greece (2010). Epizootics of disease in horses occurred in Morocco (1996), Italy (1998), the United States (1999 to 2001), and France (2000), Mexico (2003) and Sardinia (2011). [ citation needed ] Outdoor workers (including biological fieldworkers, construction workers, farmers, landscapers, and painters), healthcare personnel, and laboratory personnel who perform necropsies on animals are at risk of contracting WNV. In 2012, the US experienced one of its worst epidemics in which 286 people died, with the state of Texas being hard hit by this virus. Drought has been associated with a higher number of West Nile virus cases in the following year. As drought can decrease fish and other populations that eat mosquito eggs, higher numbers of mosquitoes can result. Higher temperatures are linked to decreased time for replication and increased viral load in birds and mosquitoes. Drought has been associated with a higher number of West Nile virus cases in the following year. As drought can decrease fish and other populations that eat mosquito eggs, higher numbers of mosquitoes can result. Higher temperatures are linked to decreased time for replication and increased viral load in birds and mosquitoes. A vaccine for horses ( ATCvet code: QI05AA10 ( WHO ) ) based on killed viruses exists; some zoos have given this vaccine to their birds, although its effectiveness is unknown. Dogs and cats show few if any signs of infection. There have been no known cases of direct canine-human or feline-human transmission; although these pets can become infected, it is unlikely they are, in turn, capable of infecting native mosquitoes and thus continuing the disease cycle. AMD3100 , which had been proposed as an antiretroviral drug for HIV, has shown promise against West Nile encephalitis. Morpholino antisense oligos conjugated to cell penetrating peptides have been shown to partially protect mice from WNV disease. There have also been attempts to treat infections using ribavirin , intravenous immunoglobulin , or alpha interferon . GenoMed, a U.S. biotech company, has found that blocking angiotensin II can treat the " cytokine storm " of West Nile virus encephalitis as well as other viruses. As of 2019, six vaccines had progressed to human trials but none had been licensed in the United States. Only the two live attenuated vaccines produced strong immunity after a single dose.

Wiki

West Nile

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Spread of West Nile Fever in Europe

West Nile Fever (WNF) is a mosquito-borne viral infection caused by the West Nile virus (WNV), a member of the Flaviviridae family. The virus primarily incubates in a bird-mosquito transmission cycle, with humans and other mammals serving as incidental hosts .The West Nile virus was first identified in 1937 in the West Nile region of Uganda . It is primarily transmitted to humans through the bite of infected mosquitoes , which acquire the virus by feeding on infected birds. In urban environments, mosquitoes are often the primary vectors of WNV transmission. Additionally, WNV can be transmitted through blood transfusions , organ transplantation , and from mother to fetus during pregnancy or through breastfeeding , although these modes of transmission are less common. Most individuals infected with WNV remain asymptomatic, while approximately 20% develop West Nile fever, characterized by flu-like symptoms such as fever, headache, body aches, and fatigue. However, in a small percentage of cases (less than 1%), WNV infection can lead to severe neuroinvasive diseases such as West Nile encephalitis , meningitis , or acute flaccid paralysis. These neurological complications can result in long-term disabilities or, in severe cases, death. Elderly individuals and those with weakened immune systems are at higher risk of developing severe forms of WNV disease. West Nile virus is endemic in many parts of the world. The virus has demonstrated an ability to cause sporadic outbreaks and endemic transmission in previously unaffected regions. In recent decades, there has been a significant increase in the frequency and geographic distribution of WNV outbreaks globally. This expansion is attributed to various factors, including climate change, globalization, increased human and bird populations, and the movement of infected birds and mosquitoes through trade and travel routes. The epidemiology of WNV varies regionally, with seasonal fluctuations in transmission intensity influenced by environmental factors such as temperature, rainfall, and mosquito population dynamics. Understanding the global distribution and epidemiology of WNV is essential for implementing effective surveillance, prevention, and control measures to mitigate the impact of the disease on public health.The West Nile virus was first identified in 1937 in the West Nile region of Uganda . It is primarily transmitted to humans through the bite of infected mosquitoes , which acquire the virus by feeding on infected birds. In urban environments, mosquitoes are often the primary vectors of WNV transmission. Additionally, WNV can be transmitted through blood transfusions , organ transplantation , and from mother to fetus during pregnancy or through breastfeeding , although these modes of transmission are less common. Most individuals infected with WNV remain asymptomatic, while approximately 20% develop West Nile fever, characterized by flu-like symptoms such as fever, headache, body aches, and fatigue. However, in a small percentage of cases (less than 1%), WNV infection can lead to severe neuroinvasive diseases such as West Nile encephalitis , meningitis , or acute flaccid paralysis. These neurological complications can result in long-term disabilities or, in severe cases, death. Elderly individuals and those with weakened immune systems are at higher risk of developing severe forms of WNV disease. West Nile virus is endemic in many parts of the world. The virus has demonstrated an ability to cause sporadic outbreaks and endemic transmission in previously unaffected regions. In recent decades, there has been a significant increase in the frequency and geographic distribution of WNV outbreaks globally. This expansion is attributed to various factors, including climate change, globalization, increased human and bird populations, and the movement of infected birds and mosquitoes through trade and travel routes. The epidemiology of WNV varies regionally, with seasonal fluctuations in transmission intensity influenced by environmental factors such as temperature, rainfall, and mosquito population dynamics. Understanding the global distribution and epidemiology of WNV is essential for implementing effective surveillance, prevention, and control measures to mitigate the impact of the disease on public health.The documented history of West Nile Virus (WNV) traces back to its initial identification in Camargue , France , during the 1960s. Subsequent to its discovery, the European Union (EU) witnessed the emergence of West Nile Fever outbreaks, notably in Algeria in 1994 and Romania in 1996, with the latter experiencing a significant toll of 393 hospitalized cases and 17 fatalities in Bucharest. In 1999, Volgograd, Astrakhan, and Rostov in Russia collectively reported 318 human cases and 40 deaths attributed to WNV. The virus further manifested in Italy in 1998 and southern France in 2000, where cases of encephalitis linked to WNV were reported in horses. By 2008, Italy documented human cases associated with neurological complications. The spread of WNV extended to Spain and Portugal in 2010, marking the first recorded instances of the virus affecting horses and humans in these regions, subsequently impacting horses, humans, and birds. In the United Kingdom, WNV was identified in birds beginning in 2003. Human epidemics were recorded in the Balkan region during 2011 and 2012, with Italy and Hungary also experiencing spread during the latter year. The most substantial human outbreak in the EU occurred in 2018, affecting 11 countries and resulting in 1548 individuals contracting the disease via mosquito bites, a phenomenon attributed to elevated regional temperatures. Additionally, in 2020, outbreaks of WNV were observed in the EU, including in Spain and the Netherlands. During summer and early fall, the prevalence of West Nile Virus (WNV) infections peaks, constituting the primary period of transmission. The virus is more commonly found in tropical and temperate regions, where environmental conditions favor mosquito breeding and viral replication. Ambient temperature plays a crucial role in shaping the dynamics of WNV transmission, influencing mosquito reproduction rates and the duration of the virus within mosquito populations, thereby impacting its spread. Higher temperatures contribute to accelerated growth rates in mosquito populations, reduce the interval between blood meals, and enhance the rate of virus evolution. Additionally, elevated ambient temperatures expedite the replication cycle of the virus itself. The interplay between weather patterns and climate directly affects vector competence, determining the availability of suitable habitats for both vectors and hosts. The phenomenon of climate change exacerbates the spread of WNV by raising ambient temperatures, facilitating its dissemination into new regions and expanding its geographical range. Furthermore, increased precipitation resulting from climate change creates more standing water, providing conducive breeding sites for mosquitoes and subsequently increasing mosquito populations. Conversely, decreased precipitation can also lead to higher mosquito populations and WNV transmission due to alterations in the food web and reduced predation pressure, leading to heightened vector-host interactions. Climate change-induced precipitation anomalies further contribute to the ease of WNV spread. Outbreaks of WNV typically initiate in rural areas, particularly wetlands, where birds and mosquitoes establish an endemic cycle, before spreading to organic-rich water sources in urban areas. Additionally, higher vegetation opacity is positively correlated with increased mosquito activity, further influencing the dynamics of WNV transmission. These ecological and climatic factors collectively contribute to the complexity of WNV transmission dynamics and underscore the importance of comprehensive surveillance and mitigation strategies. Ecological factors, encompassing the presence of hosts including both birds and mosquitoes, and the intricate interactions between the pathogen and its vector and environmental milieu, are pivotal in understanding the transmission dynamics of West Nile Virus (WNV). WNV outbreaks consistently coincide with the annual arrival of migratory birds in Europe, typically occurring during late summer and early fall. This temporal correlation strongly suggests a significant role for bird migration in the dissemination of the virus across regions. Moreover, investigations have revealed the presence of analogous viruses to WNV, such as Eastern and Western equine encephalomyelitis alphaviruses, within migrating bird populations. These findings underscore the importance of avian migration pathways in the global spread of arboviruses and highlight the potential for intercontinental transmission facilitated by migratory bird movements. In 2020, significant hotspots of West Nile Virus (WNV) activity were identified across various regions, with southwest Spain, northern Italy, and northern Greece emerging as major focal points. Additionally, notable outbreaks occurred in Hungary, Romania, and Germany, contributing to the overall dissemination of the virus within Europe. These regions experienced heightened WNV transmission, leading to increased human infections and necessitating intensified surveillance and control measures. Furthermore, Italy, Greece, Russia, and Romania have consistently been recognized as hotspots for WNV activity, underscoring the persistent challenge posed by the virus in these areas. The recurrence of WNV outbreaks in these countries emphasizes the need for sustained efforts in monitoring and management to mitigate the public health impact of the disease. The potential impact of the 2020 Covid-19 pandemic on West Nile Virus (WNV) surveillance cannot be overlooked, as attention and resources were redirected towards addressing the novel virus, possibly leading to decreased surveillance efforts in some nations. Within the European Union (EU), surveillance of WNV is conducted through the European Surveillance System operated by the European Center for Disease Prevention and Control (ECDC). The ECDC collaborates closely with organizations such as the World Organization for Animal Health and the European Food Safety Authority to enhance monitoring and response capabilities. Reports of WNV outbreaks in horses within the EU are channeled through the Animal Disease Notification System to the European Commission for further action. In countries like Austria, France, Greece, and Italy, surveillance efforts are specifically tailored towards the early detection of West Nile Fever. Serosurveys play a crucial role in identifying the presence of the virus in horses, while surveillance of birds and mosquitoes is conducted to enable early detection and response measures. Furthermore, in response to the 2018 outbreaks, countries like Slovenia, Italy, Serbia, and Greece implemented After Action Reviews and adopted a One Health approach to effectively address the challenges posed by WNV. These collaborative efforts underscore the importance of coordinated surveillance and response strategies in combating the spread of WNV within Europe.The documented history of West Nile Virus (WNV) traces back to its initial identification in Camargue , France , during the 1960s. Subsequent to its discovery, the European Union (EU) witnessed the emergence of West Nile Fever outbreaks, notably in Algeria in 1994 and Romania in 1996, with the latter experiencing a significant toll of 393 hospitalized cases and 17 fatalities in Bucharest. In 1999, Volgograd, Astrakhan, and Rostov in Russia collectively reported 318 human cases and 40 deaths attributed to WNV. The virus further manifested in Italy in 1998 and southern France in 2000, where cases of encephalitis linked to WNV were reported in horses. By 2008, Italy documented human cases associated with neurological complications. The spread of WNV extended to Spain and Portugal in 2010, marking the first recorded instances of the virus affecting horses and humans in these regions, subsequently impacting horses, humans, and birds. In the United Kingdom, WNV was identified in birds beginning in 2003. Human epidemics were recorded in the Balkan region during 2011 and 2012, with Italy and Hungary also experiencing spread during the latter year. The most substantial human outbreak in the EU occurred in 2018, affecting 11 countries and resulting in 1548 individuals contracting the disease via mosquito bites, a phenomenon attributed to elevated regional temperatures. Additionally, in 2020, outbreaks of WNV were observed in the EU, including in Spain and the Netherlands. During summer and early fall, the prevalence of West Nile Virus (WNV) infections peaks, constituting the primary period of transmission. The virus is more commonly found in tropical and temperate regions, where environmental conditions favor mosquito breeding and viral replication. Ambient temperature plays a crucial role in shaping the dynamics of WNV transmission, influencing mosquito reproduction rates and the duration of the virus within mosquito populations, thereby impacting its spread. Higher temperatures contribute to accelerated growth rates in mosquito populations, reduce the interval between blood meals, and enhance the rate of virus evolution. Additionally, elevated ambient temperatures expedite the replication cycle of the virus itself. The interplay between weather patterns and climate directly affects vector competence, determining the availability of suitable habitats for both vectors and hosts. The phenomenon of climate change exacerbates the spread of WNV by raising ambient temperatures, facilitating its dissemination into new regions and expanding its geographical range. Furthermore, increased precipitation resulting from climate change creates more standing water, providing conducive breeding sites for mosquitoes and subsequently increasing mosquito populations. Conversely, decreased precipitation can also lead to higher mosquito populations and WNV transmission due to alterations in the food web and reduced predation pressure, leading to heightened vector-host interactions. Climate change-induced precipitation anomalies further contribute to the ease of WNV spread. Outbreaks of WNV typically initiate in rural areas, particularly wetlands, where birds and mosquitoes establish an endemic cycle, before spreading to organic-rich water sources in urban areas. Additionally, higher vegetation opacity is positively correlated with increased mosquito activity, further influencing the dynamics of WNV transmission. These ecological and climatic factors collectively contribute to the complexity of WNV transmission dynamics and underscore the importance of comprehensive surveillance and mitigation strategies. Ecological factors, encompassing the presence of hosts including both birds and mosquitoes, and the intricate interactions between the pathogen and its vector and environmental milieu, are pivotal in understanding the transmission dynamics of West Nile Virus (WNV). WNV outbreaks consistently coincide with the annual arrival of migratory birds in Europe, typically occurring during late summer and early fall. This temporal correlation strongly suggests a significant role for bird migration in the dissemination of the virus across regions. Moreover, investigations have revealed the presence of analogous viruses to WNV, such as Eastern and Western equine encephalomyelitis alphaviruses, within migrating bird populations. These findings underscore the importance of avian migration pathways in the global spread of arboviruses and highlight the potential for intercontinental transmission facilitated by migratory bird movements.During summer and early fall, the prevalence of West Nile Virus (WNV) infections peaks, constituting the primary period of transmission. The virus is more commonly found in tropical and temperate regions, where environmental conditions favor mosquito breeding and viral replication. Ambient temperature plays a crucial role in shaping the dynamics of WNV transmission, influencing mosquito reproduction rates and the duration of the virus within mosquito populations, thereby impacting its spread. Higher temperatures contribute to accelerated growth rates in mosquito populations, reduce the interval between blood meals, and enhance the rate of virus evolution. Additionally, elevated ambient temperatures expedite the replication cycle of the virus itself. The interplay between weather patterns and climate directly affects vector competence, determining the availability of suitable habitats for both vectors and hosts. The phenomenon of climate change exacerbates the spread of WNV by raising ambient temperatures, facilitating its dissemination into new regions and expanding its geographical range. Furthermore, increased precipitation resulting from climate change creates more standing water, providing conducive breeding sites for mosquitoes and subsequently increasing mosquito populations. Conversely, decreased precipitation can also lead to higher mosquito populations and WNV transmission due to alterations in the food web and reduced predation pressure, leading to heightened vector-host interactions. Climate change-induced precipitation anomalies further contribute to the ease of WNV spread. Outbreaks of WNV typically initiate in rural areas, particularly wetlands, where birds and mosquitoes establish an endemic cycle, before spreading to organic-rich water sources in urban areas. Additionally, higher vegetation opacity is positively correlated with increased mosquito activity, further influencing the dynamics of WNV transmission. These ecological and climatic factors collectively contribute to the complexity of WNV transmission dynamics and underscore the importance of comprehensive surveillance and mitigation strategies.Ecological factors, encompassing the presence of hosts including both birds and mosquitoes, and the intricate interactions between the pathogen and its vector and environmental milieu, are pivotal in understanding the transmission dynamics of West Nile Virus (WNV). WNV outbreaks consistently coincide with the annual arrival of migratory birds in Europe, typically occurring during late summer and early fall. This temporal correlation strongly suggests a significant role for bird migration in the dissemination of the virus across regions. Moreover, investigations have revealed the presence of analogous viruses to WNV, such as Eastern and Western equine encephalomyelitis alphaviruses, within migrating bird populations. These findings underscore the importance of avian migration pathways in the global spread of arboviruses and highlight the potential for intercontinental transmission facilitated by migratory bird movements.In 2020, significant hotspots of West Nile Virus (WNV) activity were identified across various regions, with southwest Spain, northern Italy, and northern Greece emerging as major focal points. Additionally, notable outbreaks occurred in Hungary, Romania, and Germany, contributing to the overall dissemination of the virus within Europe. These regions experienced heightened WNV transmission, leading to increased human infections and necessitating intensified surveillance and control measures. Furthermore, Italy, Greece, Russia, and Romania have consistently been recognized as hotspots for WNV activity, underscoring the persistent challenge posed by the virus in these areas. The recurrence of WNV outbreaks in these countries emphasizes the need for sustained efforts in monitoring and management to mitigate the public health impact of the disease. The potential impact of the 2020 Covid-19 pandemic on West Nile Virus (WNV) surveillance cannot be overlooked, as attention and resources were redirected towards addressing the novel virus, possibly leading to decreased surveillance efforts in some nations. Within the European Union (EU), surveillance of WNV is conducted through the European Surveillance System operated by the European Center for Disease Prevention and Control (ECDC). The ECDC collaborates closely with organizations such as the World Organization for Animal Health and the European Food Safety Authority to enhance monitoring and response capabilities. Reports of WNV outbreaks in horses within the EU are channeled through the Animal Disease Notification System to the European Commission for further action. In countries like Austria, France, Greece, and Italy, surveillance efforts are specifically tailored towards the early detection of West Nile Fever. Serosurveys play a crucial role in identifying the presence of the virus in horses, while surveillance of birds and mosquitoes is conducted to enable early detection and response measures. Furthermore, in response to the 2018 outbreaks, countries like Slovenia, Italy, Serbia, and Greece implemented After Action Reviews and adopted a One Health approach to effectively address the challenges posed by WNV. These collaborative efforts underscore the importance of coordinated surveillance and response strategies in combating the spread of WNV within Europe.In 2020, significant hotspots of West Nile Virus (WNV) activity were identified across various regions, with southwest Spain, northern Italy, and northern Greece emerging as major focal points. Additionally, notable outbreaks occurred in Hungary, Romania, and Germany, contributing to the overall dissemination of the virus within Europe. These regions experienced heightened WNV transmission, leading to increased human infections and necessitating intensified surveillance and control measures. Furthermore, Italy, Greece, Russia, and Romania have consistently been recognized as hotspots for WNV activity, underscoring the persistent challenge posed by the virus in these areas. The recurrence of WNV outbreaks in these countries emphasizes the need for sustained efforts in monitoring and management to mitigate the public health impact of the disease.The potential impact of the 2020 Covid-19 pandemic on West Nile Virus (WNV) surveillance cannot be overlooked, as attention and resources were redirected towards addressing the novel virus, possibly leading to decreased surveillance efforts in some nations. Within the European Union (EU), surveillance of WNV is conducted through the European Surveillance System operated by the European Center for Disease Prevention and Control (ECDC). The ECDC collaborates closely with organizations such as the World Organization for Animal Health and the European Food Safety Authority to enhance monitoring and response capabilities. Reports of WNV outbreaks in horses within the EU are channeled through the Animal Disease Notification System to the European Commission for further action. In countries like Austria, France, Greece, and Italy, surveillance efforts are specifically tailored towards the early detection of West Nile Fever. Serosurveys play a crucial role in identifying the presence of the virus in horses, while surveillance of birds and mosquitoes is conducted to enable early detection and response measures. Furthermore, in response to the 2018 outbreaks, countries like Slovenia, Italy, Serbia, and Greece implemented After Action Reviews and adopted a One Health approach to effectively address the challenges posed by WNV. These collaborative efforts underscore the importance of coordinated surveillance and response strategies in combating the spread of WNV within Europe.West Nile virus (WNV) infection typically manifests with most individuals remaining asymptomatic, while approximately 20-40% of those infected develop symptoms ranging from mild flu-like illness to severe West Nile encephalitis. The incidence of severe neurologic disease is less than 1%. However, there are public health concerns regarding the prevalence of the disease in blood donors due to the potential for transmission through blood transfusions. Early detection of outbreaks is crucial as it can accelerate the public health response, aiding in containment and mitigation efforts. In Europe, the disease burden of WNV fluctuates, with notable peaks and troughs in reported cases. The highest number of cases was recorded in 2018, with 1,548 human cases reported across European Union countries. In other years, the number of cases has been significantly lower but a notable increase has still been observed. This variability underscores the importance of robust surveillance and reporting mechanisms to accurately track the prevalence of WNV and implement timely interventions to prevent further transmission and mitigate clinical outcomes. Diagnosis of West Nile Virus (WNV) primarily relies on detecting viral RNA in serum or cerebrospinal fluid. Although specific therapeutic treatments for WNV infections are lacking, severe cases, notably West Nile encephalitis, may necessitate intensive care unit interventions, life support therapy, and rehabilitation. Supportive care forms the cornerstone of management to alleviate symptoms and manage complications. Prevention strategies, including mosquito control measures and public health awareness campaigns, are vital in curbing virus transmission and minimizing its impact. Severe illness tends to be more prevalent among the elderly population, particularly those over 50 years old, who face a tenfold higher risk of developing neurologic symptoms. This risk escalates dramatically for patients older than 80 years. The IgM antibody test, especially the IgM-capture enzyme-linked immunosorbent assay, is commonly employed for diagnosis. This test exhibits high sensitivity (95-100%) in both serum and spinal fluid. However, WNV-specific IgM antibodies may not be detectable until around the fourth day of illness. The incubation period in humans ranges from 3 to 15 days. Symptoms often commence with a mild febrile illness, including fever, headache, and myalgias. Some individuals may develop a roseolar or maculopapular rash. Limited data suggest that immunocompromised patients may face an increased risk of severe disease. Transmission of WNV can also occur through blood transfusions, necessitating screening among blood donors. While serious non-neurologic complications such as myocarditis, pancreatitis, and fulminant hepatitis are rare, they may occur. Patients with profound muscle weakness may require intubation and mechanical ventilation for support. West Nile Virus (WNV) surveillance and recording mechanisms vary in quality between countries in Europe, leading to inconsistencies in data detection. Furthermore, there is a lack of surveillance systems and health policies in place to effectively manage outbreaks. To address these challenges, there is a critical need for precise definitions of viral circulation, standardized surveillance protocols, and coordinated efforts among public health agencies to enhance monitoring and response capabilities. Such measures are essential for early detection, containment, and mitigation of West Nile Virus outbreaks. Surveillance efforts often focus on monitoring the avian population, as birds serve as primary hosts for the virus. The most common route of infection to humans is through the bite of infected Culicine mosquitoes. Mosquitoes become infected when they feed on infected birds that have high levels of WNV in their blood. Birds of the family Corvidae are particularly susceptible to WNV infection. West Nile Virus is not transmitted from person to person by mosquitoes. However, transmission of WNV can occur via red blood cell, plasma, and platelet transfusions, highlighting the need for stringent screening measures among blood donors to prevent iatrogenic transmission. Coordinated surveillance efforts targeting both avian populations and mosquito vectors are crucial for early detection and containment of WNV transmission, thus mitigating the impact of outbreaks on human health. Vector control measures are a primary strategy for preventing the spread of West Nile Virus (WNV). The virus, transmitted mainly by mosquitoes, can travel long distances through bird populations. Integrated Vector Management (IVM), endorsed by the World Health Organization, is a key approach that involves rational decision-making to optimize resources for vector control. Strategies include reducing vector density and human-vector contact. However, the complex transmission cycle of WNV presents challenges, requiring comprehensive surveillance and targeted interventions. Larval control, aimed at containing mosquito populations by managing immature stages, is a crucial aspect. Efforts focus on mapping breeding sites, eliminating standing water, and using larvicides. While specific larval population thresholds are lacking, methods such as bacterial larvicides have shown high efficacy. Additionally, personal protection measures, including repellents and window screens, play a role in minimizing human-mosquito contact and reducing the risk of infection. As of the current date, there are no licensed vaccination options available for West Nile Virus (WNV). While some vaccine candidates are under evaluation, efforts to develop a licensed human vaccine have faced challenges and stalled progress. Despite ongoing research and clinical trials, the absence of a licensed vaccine underscores the need for continued investment and innovation in vaccine development to mitigate the impact of WNV on public health.West Nile virus (WNV) infection typically manifests with most individuals remaining asymptomatic, while approximately 20-40% of those infected develop symptoms ranging from mild flu-like illness to severe West Nile encephalitis. The incidence of severe neurologic disease is less than 1%. However, there are public health concerns regarding the prevalence of the disease in blood donors due to the potential for transmission through blood transfusions. Early detection of outbreaks is crucial as it can accelerate the public health response, aiding in containment and mitigation efforts. In Europe, the disease burden of WNV fluctuates, with notable peaks and troughs in reported cases. The highest number of cases was recorded in 2018, with 1,548 human cases reported across European Union countries. In other years, the number of cases has been significantly lower but a notable increase has still been observed. This variability underscores the importance of robust surveillance and reporting mechanisms to accurately track the prevalence of WNV and implement timely interventions to prevent further transmission and mitigate clinical outcomes.West Nile virus (WNV) infection typically manifests with most individuals remaining asymptomatic, while approximately 20-40% of those infected develop symptoms ranging from mild flu-like illness to severe West Nile encephalitis. The incidence of severe neurologic disease is less than 1%. However, there are public health concerns regarding the prevalence of the disease in blood donors due to the potential for transmission through blood transfusions. Early detection of outbreaks is crucial as it can accelerate the public health response, aiding in containment and mitigation efforts. In Europe, the disease burden of WNV fluctuates, with notable peaks and troughs in reported cases. The highest number of cases was recorded in 2018, with 1,548 human cases reported across European Union countries. In other years, the number of cases has been significantly lower but a notable increase has still been observed. This variability underscores the importance of robust surveillance and reporting mechanisms to accurately track the prevalence of WNV and implement timely interventions to prevent further transmission and mitigate clinical outcomes.Diagnosis of West Nile Virus (WNV) primarily relies on detecting viral RNA in serum or cerebrospinal fluid. Although specific therapeutic treatments for WNV infections are lacking, severe cases, notably West Nile encephalitis, may necessitate intensive care unit interventions, life support therapy, and rehabilitation. Supportive care forms the cornerstone of management to alleviate symptoms and manage complications. Prevention strategies, including mosquito control measures and public health awareness campaigns, are vital in curbing virus transmission and minimizing its impact. Severe illness tends to be more prevalent among the elderly population, particularly those over 50 years old, who face a tenfold higher risk of developing neurologic symptoms. This risk escalates dramatically for patients older than 80 years. The IgM antibody test, especially the IgM-capture enzyme-linked immunosorbent assay, is commonly employed for diagnosis. This test exhibits high sensitivity (95-100%) in both serum and spinal fluid. However, WNV-specific IgM antibodies may not be detectable until around the fourth day of illness. The incubation period in humans ranges from 3 to 15 days. Symptoms often commence with a mild febrile illness, including fever, headache, and myalgias. Some individuals may develop a roseolar or maculopapular rash. Limited data suggest that immunocompromised patients may face an increased risk of severe disease. Transmission of WNV can also occur through blood transfusions, necessitating screening among blood donors. While serious non-neurologic complications such as myocarditis, pancreatitis, and fulminant hepatitis are rare, they may occur. Patients with profound muscle weakness may require intubation and mechanical ventilation for support. West Nile Virus (WNV) surveillance and recording mechanisms vary in quality between countries in Europe, leading to inconsistencies in data detection. Furthermore, there is a lack of surveillance systems and health policies in place to effectively manage outbreaks. To address these challenges, there is a critical need for precise definitions of viral circulation, standardized surveillance protocols, and coordinated efforts among public health agencies to enhance monitoring and response capabilities. Such measures are essential for early detection, containment, and mitigation of West Nile Virus outbreaks. Surveillance efforts often focus on monitoring the avian population, as birds serve as primary hosts for the virus. The most common route of infection to humans is through the bite of infected Culicine mosquitoes. Mosquitoes become infected when they feed on infected birds that have high levels of WNV in their blood. Birds of the family Corvidae are particularly susceptible to WNV infection. West Nile Virus is not transmitted from person to person by mosquitoes. However, transmission of WNV can occur via red blood cell, plasma, and platelet transfusions, highlighting the need for stringent screening measures among blood donors to prevent iatrogenic transmission. Coordinated surveillance efforts targeting both avian populations and mosquito vectors are crucial for early detection and containment of WNV transmission, thus mitigating the impact of outbreaks on human health.Diagnosis of West Nile Virus (WNV) primarily relies on detecting viral RNA in serum or cerebrospinal fluid. Although specific therapeutic treatments for WNV infections are lacking, severe cases, notably West Nile encephalitis, may necessitate intensive care unit interventions, life support therapy, and rehabilitation. Supportive care forms the cornerstone of management to alleviate symptoms and manage complications. Prevention strategies, including mosquito control measures and public health awareness campaigns, are vital in curbing virus transmission and minimizing its impact. Severe illness tends to be more prevalent among the elderly population, particularly those over 50 years old, who face a tenfold higher risk of developing neurologic symptoms. This risk escalates dramatically for patients older than 80 years. The IgM antibody test, especially the IgM-capture enzyme-linked immunosorbent assay, is commonly employed for diagnosis. This test exhibits high sensitivity (95-100%) in both serum and spinal fluid. However, WNV-specific IgM antibodies may not be detectable until around the fourth day of illness. The incubation period in humans ranges from 3 to 15 days. Symptoms often commence with a mild febrile illness, including fever, headache, and myalgias. Some individuals may develop a roseolar or maculopapular rash. Limited data suggest that immunocompromised patients may face an increased risk of severe disease. Transmission of WNV can also occur through blood transfusions, necessitating screening among blood donors. While serious non-neurologic complications such as myocarditis, pancreatitis, and fulminant hepatitis are rare, they may occur. Patients with profound muscle weakness may require intubation and mechanical ventilation for support. Severe illness tends to be more prevalent among the elderly population, particularly those over 50 years old, who face a tenfold higher risk of developing neurologic symptoms. This risk escalates dramatically for patients older than 80 years. The IgM antibody test, especially the IgM-capture enzyme-linked immunosorbent assay, is commonly employed for diagnosis. This test exhibits high sensitivity (95-100%) in both serum and spinal fluid. However, WNV-specific IgM antibodies may not be detectable until around the fourth day of illness. The incubation period in humans ranges from 3 to 15 days. Symptoms often commence with a mild febrile illness, including fever, headache, and myalgias. Some individuals may develop a roseolar or maculopapular rash. Limited data suggest that immunocompromised patients may face an increased risk of severe disease. Transmission of WNV can also occur through blood transfusions, necessitating screening among blood donors. While serious non-neurologic complications such as myocarditis, pancreatitis, and fulminant hepatitis are rare, they may occur. Patients with profound muscle weakness may require intubation and mechanical ventilation for support. West Nile Virus (WNV) surveillance and recording mechanisms vary in quality between countries in Europe, leading to inconsistencies in data detection. Furthermore, there is a lack of surveillance systems and health policies in place to effectively manage outbreaks. To address these challenges, there is a critical need for precise definitions of viral circulation, standardized surveillance protocols, and coordinated efforts among public health agencies to enhance monitoring and response capabilities. Such measures are essential for early detection, containment, and mitigation of West Nile Virus outbreaks. Surveillance efforts often focus on monitoring the avian population, as birds serve as primary hosts for the virus. The most common route of infection to humans is through the bite of infected Culicine mosquitoes. Mosquitoes become infected when they feed on infected birds that have high levels of WNV in their blood. Birds of the family Corvidae are particularly susceptible to WNV infection. West Nile Virus is not transmitted from person to person by mosquitoes. However, transmission of WNV can occur via red blood cell, plasma, and platelet transfusions, highlighting the need for stringent screening measures among blood donors to prevent iatrogenic transmission. Coordinated surveillance efforts targeting both avian populations and mosquito vectors are crucial for early detection and containment of WNV transmission, thus mitigating the impact of outbreaks on human health.Vector control measures are a primary strategy for preventing the spread of West Nile Virus (WNV). The virus, transmitted mainly by mosquitoes, can travel long distances through bird populations. Integrated Vector Management (IVM), endorsed by the World Health Organization, is a key approach that involves rational decision-making to optimize resources for vector control. Strategies include reducing vector density and human-vector contact. However, the complex transmission cycle of WNV presents challenges, requiring comprehensive surveillance and targeted interventions. Larval control, aimed at containing mosquito populations by managing immature stages, is a crucial aspect. Efforts focus on mapping breeding sites, eliminating standing water, and using larvicides. While specific larval population thresholds are lacking, methods such as bacterial larvicides have shown high efficacy. Additionally, personal protection measures, including repellents and window screens, play a role in minimizing human-mosquito contact and reducing the risk of infection. As of the current date, there are no licensed vaccination options available for West Nile Virus (WNV). While some vaccine candidates are under evaluation, efforts to develop a licensed human vaccine have faced challenges and stalled progress. Despite ongoing research and clinical trials, the absence of a licensed vaccine underscores the need for continued investment and innovation in vaccine development to mitigate the impact of WNV on public health.Vector control measures are a primary strategy for preventing the spread of West Nile Virus (WNV). The virus, transmitted mainly by mosquitoes, can travel long distances through bird populations. Integrated Vector Management (IVM), endorsed by the World Health Organization, is a key approach that involves rational decision-making to optimize resources for vector control. Strategies include reducing vector density and human-vector contact. However, the complex transmission cycle of WNV presents challenges, requiring comprehensive surveillance and targeted interventions. Larval control, aimed at containing mosquito populations by managing immature stages, is a crucial aspect. Efforts focus on mapping breeding sites, eliminating standing water, and using larvicides. While specific larval population thresholds are lacking, methods such as bacterial larvicides have shown high efficacy. Additionally, personal protection measures, including repellents and window screens, play a role in minimizing human-mosquito contact and reducing the risk of infection. As of the current date, there are no licensed vaccination options available for West Nile Virus (WNV). While some vaccine candidates are under evaluation, efforts to develop a licensed human vaccine have faced challenges and stalled progress. Despite ongoing research and clinical trials, the absence of a licensed vaccine underscores the need for continued investment and innovation in vaccine development to mitigate the impact of WNV on public health.2010 Outbreak in Greece In 2010, Greece experienced a significant outbreak of West Nile Virus, marking one of the earliest large-scale incidents in Europe. The outbreak primarily affected the region of Central Macedonia, with numerous cases reported in both humans and animals. According to the European Centre for Disease Prevention and Control (ECDC), Greece reported 262 confirmed human cases and 35 deaths during this outbreak, drawing attention to the emergence of WNV as a public health threat in Europe. 2018 Outbreak in Southern Europe In 2018, Southern Europe faced another notable outbreak of West Nile Virus, with multiple countries reporting increased activity of the virus. Italy, in particular, experienced a surge in human cases, with regions like Lombardy and Veneto being heavily affected. According to the Italian Ministry of Health, there were 123 confirmed cases and 11 deaths related to WNV in Italy during 2018, highlighting the severity of the outbreak. 2019 Outbreak in Serbia Serbia encountered a significant outbreak of West Nile Virus in 2019, with the virus spreading across various regions of the country. According to the Serbian Institute of Public Health, there were 356 confirmed cases of WNV infection and 35 fatalities reported during this outbreak. The outbreak raised concerns among public health authorities in Europe regarding the increasing geographical spread and impact of WNV in the continent. 2020 Outbreak in Spain Spain witnessed a notable outbreak of West Nile Virus in 2020, particularly in the regions of Andalusia and Extremadura. The Spanish Ministry of Health confirmed a total of 77 human cases and 6 deaths attributed to WNV during this period. The outbreak prompted coordinated efforts by health authorities to implement mosquito control measures and raise awareness among the population about the risks of WNV transmission. 2021 Outbreak in Greece and Romania In 2021, Greece and Romania experienced significant outbreaks of West Nile Virus, underscoring the continued threat posed by the virus in Europe. Greece reported 315 confirmed cases and 48 deaths, while Romania recorded 63 confirmed cases and 9 deaths during the outbreak. The outbreaks prompted enhanced surveillance and control measures in affected areas to mitigate further transmission of the virus. 1. Vector Control and Surveillance: Effective vector control measures and surveillance systems are fundamental for dengue prevention and control. Strategies such as larval source reduction, insecticide spraying, and biological control have shown efficacy in reducing mosquito populations and interrupting west nile transmission cycles. Surveillance systems for monitoring mosquito abundance and west nile cases enable early detection of outbreaks, facilitating timely intervention. 2. Integrated Vector Management (IVM): Integrated vector management, which integrates multiple control methods and emphasizes community participation, has emerged as a cornerstone of west nile control efforts. IVM approaches encompass environmental management, chemical control, biological control, and community mobilization, aiming to reduce mosquito breeding sites and limit west nile transmission. Studies have demonstrated the effectiveness of IVM in reducing dengue vector populations and disease incidence. 3. Early Detection and Diagnosis: Early detection and accurate diagnosis of dengue cases are crucial for timely outbreak response and patient management. Advances in diagnostic tools, including rapid diagnostic tests and molecular assays, have improved the capacity for early dengue detection. Enhanced surveillance systems, coupled with syndromic surveillance and outbreak investigations, enable public health authorities to identify and respond to dengue outbreaks promptly. 4. Community Engagement and Education: Engaging communities in west nile prevention and control efforts through education and community-based interventions is essential for sustainable disease control. Community participation in vector control activities, such as source reduction campaigns and clean-up drives, can effectively reduce mosquito breeding sites. Health education initiatives aimed at raising awareness about west nile transmission, symptoms, and preventive measures empower individuals to protect themselves and their communities from West Nile. 5. Climate Change and Urbanization : The impacts of climate change and urbanization influence the epidemiology of West Nile Virus, exacerbating disease transmission dynamics. Climate factors, such as temperature and precipitation patterns, influence mosquito breeding habitats and west nile vector distribution. Urbanization and population growth create conducive environments for mosquito proliferation, increasing the risk of west nile transmission in urban areas. Addressing the environmental and social determinants of dengue risk is critical for mitigating the impact of climate change and urbanization on dengue outbreaks. California's vector control program has implemented a comprehensive strategy to monitor and control mosquito populations, reducing the incidence of WNF in the state. This includes targeted surveillance, larval habitat reduction, and community outreach efforts. Main efforts include reducing nonessential water, vegetation management, and public awareness measures. Chicago's Public Health Response Following an outbreak of WNF, Chicago implemented an aggressive public health response, including enhanced mosquito surveillance, community-based interventions, and public awareness campaigns. These efforts led to a significant reduction in WNV cases. France developed a national plan for the prevention and control of vector-borne diseases, including WNF. This plan focuses on early detection, targeted control measures, and coordination among public health authorities to minimize the spread of WNV. Clinical surveillance of human non-neuroinvasive cases is also implemented. Uganda implemented a community-based surveillance program to detect and respond to outbreaks of WNV. Through active involvement of local communities, this program has improved early detection of cases and facilitated rapid response interventions. 2010 Outbreak in Greece In 2010, Greece experienced a significant outbreak of West Nile Virus, marking one of the earliest large-scale incidents in Europe. The outbreak primarily affected the region of Central Macedonia, with numerous cases reported in both humans and animals. According to the European Centre for Disease Prevention and Control (ECDC), Greece reported 262 confirmed human cases and 35 deaths during this outbreak, drawing attention to the emergence of WNV as a public health threat in Europe. 2018 Outbreak in Southern Europe In 2018, Southern Europe faced another notable outbreak of West Nile Virus, with multiple countries reporting increased activity of the virus. Italy, in particular, experienced a surge in human cases, with regions like Lombardy and Veneto being heavily affected. According to the Italian Ministry of Health, there were 123 confirmed cases and 11 deaths related to WNV in Italy during 2018, highlighting the severity of the outbreak. 2019 Outbreak in Serbia Serbia encountered a significant outbreak of West Nile Virus in 2019, with the virus spreading across various regions of the country. According to the Serbian Institute of Public Health, there were 356 confirmed cases of WNV infection and 35 fatalities reported during this outbreak. The outbreak raised concerns among public health authorities in Europe regarding the increasing geographical spread and impact of WNV in the continent. 2020 Outbreak in Spain Spain witnessed a notable outbreak of West Nile Virus in 2020, particularly in the regions of Andalusia and Extremadura. The Spanish Ministry of Health confirmed a total of 77 human cases and 6 deaths attributed to WNV during this period. The outbreak prompted coordinated efforts by health authorities to implement mosquito control measures and raise awareness among the population about the risks of WNV transmission. 2021 Outbreak in Greece and Romania In 2021, Greece and Romania experienced significant outbreaks of West Nile Virus, underscoring the continued threat posed by the virus in Europe. Greece reported 315 confirmed cases and 48 deaths, while Romania recorded 63 confirmed cases and 9 deaths during the outbreak. The outbreaks prompted enhanced surveillance and control measures in affected areas to mitigate further transmission of the virus. 1. Vector Control and Surveillance: Effective vector control measures and surveillance systems are fundamental for dengue prevention and control. Strategies such as larval source reduction, insecticide spraying, and biological control have shown efficacy in reducing mosquito populations and interrupting west nile transmission cycles. Surveillance systems for monitoring mosquito abundance and west nile cases enable early detection of outbreaks, facilitating timely intervention. 2. Integrated Vector Management (IVM): Integrated vector management, which integrates multiple control methods and emphasizes community participation, has emerged as a cornerstone of west nile control efforts. IVM approaches encompass environmental management, chemical control, biological control, and community mobilization, aiming to reduce mosquito breeding sites and limit west nile transmission. Studies have demonstrated the effectiveness of IVM in reducing dengue vector populations and disease incidence. 3. Early Detection and Diagnosis: Early detection and accurate diagnosis of dengue cases are crucial for timely outbreak response and patient management. Advances in diagnostic tools, including rapid diagnostic tests and molecular assays, have improved the capacity for early dengue detection. Enhanced surveillance systems, coupled with syndromic surveillance and outbreak investigations, enable public health authorities to identify and respond to dengue outbreaks promptly. 4. Community Engagement and Education: Engaging communities in west nile prevention and control efforts through education and community-based interventions is essential for sustainable disease control. Community participation in vector control activities, such as source reduction campaigns and clean-up drives, can effectively reduce mosquito breeding sites. Health education initiatives aimed at raising awareness about west nile transmission, symptoms, and preventive measures empower individuals to protect themselves and their communities from West Nile. 5. Climate Change and Urbanization : The impacts of climate change and urbanization influence the epidemiology of West Nile Virus, exacerbating disease transmission dynamics. Climate factors, such as temperature and precipitation patterns, influence mosquito breeding habitats and west nile vector distribution. Urbanization and population growth create conducive environments for mosquito proliferation, increasing the risk of west nile transmission in urban areas. Addressing the environmental and social determinants of dengue risk is critical for mitigating the impact of climate change and urbanization on dengue outbreaks. California's vector control program has implemented a comprehensive strategy to monitor and control mosquito populations, reducing the incidence of WNF in the state. This includes targeted surveillance, larval habitat reduction, and community outreach efforts. Main efforts include reducing nonessential water, vegetation management, and public awareness measures. Chicago's Public Health Response Following an outbreak of WNF, Chicago implemented an aggressive public health response, including enhanced mosquito surveillance, community-based interventions, and public awareness campaigns. These efforts led to a significant reduction in WNV cases. France developed a national plan for the prevention and control of vector-borne diseases, including WNF. This plan focuses on early detection, targeted control measures, and coordination among public health authorities to minimize the spread of WNV. Clinical surveillance of human non-neuroinvasive cases is also implemented. Uganda implemented a community-based surveillance program to detect and respond to outbreaks of WNV. Through active involvement of local communities, this program has improved early detection of cases and facilitated rapid response interventions. California's vector control program has implemented a comprehensive strategy to monitor and control mosquito populations, reducing the incidence of WNF in the state. This includes targeted surveillance, larval habitat reduction, and community outreach efforts. Main efforts include reducing nonessential water, vegetation management, and public awareness measures. Chicago's Public Health Response Following an outbreak of WNF, Chicago implemented an aggressive public health response, including enhanced mosquito surveillance, community-based interventions, and public awareness campaigns. These efforts led to a significant reduction in WNV cases. France developed a national plan for the prevention and control of vector-borne diseases, including WNF. This plan focuses on early detection, targeted control measures, and coordination among public health authorities to minimize the spread of WNV. Clinical surveillance of human non-neuroinvasive cases is also implemented. Uganda implemented a community-based surveillance program to detect and respond to outbreaks of WNV. Through active involvement of local communities, this program has improved early detection of cases and facilitated rapid response interventions. Within the European Union (EU), surveillance of West Nile Virus (WNV) is conducted through the European Surveillance System managed by the European Center for Disease Prevention and Control (ECDC). This system serves as a vital platform for monitoring and reporting WNV cases, facilitating early detection and response efforts across member states. In addition to its role in WNV surveillance, the ECDC collaborates closely with international organizations such as the World Organization for Animal Health and the European Food Safety Authority. These collaborations enhance the exchange of information and expertise, bolstering the EU's capacity to effectively address the public health challenges posed by WNV and other emerging infectious diseases. Such coordinated efforts underscore the importance of international cooperation in mitigating the spread of vector-borne diseases within Europe and beyond. Intersectoral collaboration plays a crucial role in coordinating response plans to combat West Nile Virus (WNV) outbreaks. While efforts to mitigate the spread of WNV primarily occur at the national level, there is a growing recognition of the need for a more extensive collaborative response. Such collaboration facilitates the sharing of resources, expertise, and best practices among countries, thereby enhancing the effectiveness of response efforts. Moreover, coordination of methodologies across Europe would be advantageous in establishing standardized virus response protocols. By aligning methodologies, countries can streamline surveillance, diagnostic, and intervention strategies, fostering a more cohesive and efficient approach to WNV management across the continent. This emphasizes the importance of cross-border cooperation and harmonization in addressing the public health challenges posed by WNV within Europe. Integrative surveillance efforts, coupled with economic and social disparities, pose challenges in establishing standardized data on the spread of West Nile Virus (WNV) across Europe. These factors contribute to variations in surveillance methodologies, data collection practices, and reporting systems among European countries, hindering efforts to compile comprehensive and uniform datasets on WNV transmission. Despite the recognition of the need for a coordinated response, the majority of mitigation efforts remain country-based, with limited collaboration on a larger scale. This fragmented approach underscores the complexity of addressing WNV within a diverse European landscape and highlights the importance of fostering cross-border cooperation to effectively combat the spread of the virus across the continent.Within the European Union (EU), surveillance of West Nile Virus (WNV) is conducted through the European Surveillance System managed by the European Center for Disease Prevention and Control (ECDC). This system serves as a vital platform for monitoring and reporting WNV cases, facilitating early detection and response efforts across member states. In addition to its role in WNV surveillance, the ECDC collaborates closely with international organizations such as the World Organization for Animal Health and the European Food Safety Authority. These collaborations enhance the exchange of information and expertise, bolstering the EU's capacity to effectively address the public health challenges posed by WNV and other emerging infectious diseases. Such coordinated efforts underscore the importance of international cooperation in mitigating the spread of vector-borne diseases within Europe and beyond.Intersectoral collaboration plays a crucial role in coordinating response plans to combat West Nile Virus (WNV) outbreaks. While efforts to mitigate the spread of WNV primarily occur at the national level, there is a growing recognition of the need for a more extensive collaborative response. Such collaboration facilitates the sharing of resources, expertise, and best practices among countries, thereby enhancing the effectiveness of response efforts. Moreover, coordination of methodologies across Europe would be advantageous in establishing standardized virus response protocols. By aligning methodologies, countries can streamline surveillance, diagnostic, and intervention strategies, fostering a more cohesive and efficient approach to WNV management across the continent. This emphasizes the importance of cross-border cooperation and harmonization in addressing the public health challenges posed by WNV within Europe.Integrative surveillance efforts, coupled with economic and social disparities, pose challenges in establishing standardized data on the spread of West Nile Virus (WNV) across Europe. These factors contribute to variations in surveillance methodologies, data collection practices, and reporting systems among European countries, hindering efforts to compile comprehensive and uniform datasets on WNV transmission. Despite the recognition of the need for a coordinated response, the majority of mitigation efforts remain country-based, with limited collaboration on a larger scale. This fragmented approach underscores the complexity of addressing WNV within a diverse European landscape and highlights the importance of fostering cross-border cooperation to effectively combat the spread of the virus across the continent.In combating the spread of West Nile Virus (WNV) in Europe, prioritizing research initiatives is essential for effective prevention and control strategies. A primary focus must be on the development of vaccines, given the severe long-term effects and health threats posed by WNV. Research efforts should aim to create vaccines that not only provide robust immunity against WNV but also address the unique challenges posed by the virus, such as its ability to cause neurological complications. To achieve this, it is crucial to investigate the most effective ways to target different cells based on factors like longevity, duration, and persistence of antibodies. Understanding these dynamics will inform the design of vaccines that offer durable protection against WNV infection. Furthermore, research on the use of platforms for vaccine research and development is imperative. Exploring diverse technological approaches and methodologies can expedite the vaccine development process while ensuring safety and efficacy. Additionally, addressing safety issues associated with vaccine candidates is paramount to instill public confidence and facilitate widespread vaccination programs. Rigorous evaluation of vaccine safety profiles through preclinical and clinical studies is essential to mitigate potential risks and ensure the deployment of safe and effective vaccines against WNV, especially towards susceptible populations. Research efforts should focus on understanding the unique immune responses and vulnerabilities of these populations to tailor vaccination strategies accordingly. Moreover, advancements in diagnostic testing methodologies are crucial for early detection and surveillance of WNV outbreaks. Improving testing accuracy and accessibility can facilitate prompt intervention and containment measures to curb the spread of the virus. Additionally, comprehensive mosquito control strategies are essential for reducing vector populations and interrupting WNV transmission cycles. Research should explore innovative approaches for mosquito control, considering environmental factors and social settings that influence mosquito habitats and human-mosquito interactions. Enhancing surveillance and risk assessment of mosquitoes in Europe is also critical for proactive disease management. Integrating social and environmental data into surveillance systems can enhance our understanding of WNV transmission dynamics and inform targeted interventions to mitigate the risk of outbreaks. In confronting the spread of West Nile Virus (WNV) across Europe, bolstering public health infrastructure emerges as a critical imperative to effectively combat this emerging threat. While surveillance remains the cornerstone of WNV prevention, it is also recognized as being costly and time-consuming. However, it remains the most effective tool for early detection and intervention. Despite this, there is a concerning trend of increased demand coupled with reduced resources for the health sector. This disjuncture underscores the urgent need for governments and stakeholders to prioritize investment in public health infrastructure to fortify surveillance capabilities and response mechanisms. The escalating healthcare costs associated with addressing WNV and other non-communicable diseases (NCDs) and vector-borne illnesses highlight the urgency of proactive measures to strengthen public health infrastructure. These diseases not only exact a toll on individual health but also exert significant economic burdens, affecting poverty levels and productivity within communities. Recognizing the multifaceted impact of human activity on disease incidence, it becomes evident that a comprehensive approach is required to mitigate the spread of WNV. This entails addressing risk factors for geographic expansion, including human mobility, population growth, trade, and climate change. Collaboration across different levels of governance – local, regional, national, and global – as well as across diverse disciplines such as veterinary medicine, public health, and technology, is paramount. This collaboration is a perspective commonly known as "One Health." By fostering these synergistic partnerships through the One Health perspective, Europe can effectively confront the challenges posed by WNV and safeguard the health and well-being of its populations for generations to come. Implementing sound policy measures is paramount for effective prevention and control of West Nile Virus (WNV) transmission in Europe. Proper allocation of resources, collaboration within a One Health approach, and vaccination research would make great strides in tackling the issue of prevention and control first within Europe, then worldwide eradication. In tackling the spread of WNV in Europe, policymakers must prioritize a comprehensive approach that integrates robust surveillance and proactive mosquito control measures. Governments should allocate resources towards strengthening surveillance systems, investing in advanced technologies for early detection and rapid response to outbreaks. Collaborative efforts between public health agencies, veterinary services, and research institutions are crucial for sharing information and coordinating efforts in disease surveillance and vector control. The importance of community engagement and reporting would play an extremely important role in surveillance, and promoting awareness would help decrease the spread of the virus through things like mosquito spray and vaccination. Furthermore, policymakers should adopt a One Health approach to address the broader social determinants of WNV transmission. This approach recognizes the interconnectedness of human, animal, and environmental health and advocates for interdisciplinary collaboration. Integrating One Health principles into public health agendas can strengthen resilience against WNV and enhance overall health outcomes. Enhanced collaboration between health sectors, including human and veterinary medicine, environmental science, and agriculture, is essential for effective One Health implementation. Policymakers should facilitate interdisciplinary partnerships, data sharing, and joint surveillance efforts to identify and mitigate WNV risks at the human-animal-environment interface. By fostering collaboration across sectors and implementing evidence-based policies, policymakers can develop holistic solutions to prevent and control WNV transmission while addressing the underlying determinants of disease emergence and spread. Vaccination Finally, vaccination programs should be prioritized as a cornerstone of WNV prevention policies. Governments should work towards facilitating access to safe and effective vaccines, particularly for vulnerable populations such as the elderly and immunocompromised individuals. Implementing comprehensive vaccination campaigns, along with robust surveillance to monitor vaccine coverage and efficacy, can significantly reduce the burden of WNV-related morbidity and mortality.In combating the spread of West Nile Virus (WNV) in Europe, prioritizing research initiatives is essential for effective prevention and control strategies. A primary focus must be on the development of vaccines, given the severe long-term effects and health threats posed by WNV. Research efforts should aim to create vaccines that not only provide robust immunity against WNV but also address the unique challenges posed by the virus, such as its ability to cause neurological complications. To achieve this, it is crucial to investigate the most effective ways to target different cells based on factors like longevity, duration, and persistence of antibodies. Understanding these dynamics will inform the design of vaccines that offer durable protection against WNV infection. Furthermore, research on the use of platforms for vaccine research and development is imperative. Exploring diverse technological approaches and methodologies can expedite the vaccine development process while ensuring safety and efficacy. Additionally, addressing safety issues associated with vaccine candidates is paramount to instill public confidence and facilitate widespread vaccination programs. Rigorous evaluation of vaccine safety profiles through preclinical and clinical studies is essential to mitigate potential risks and ensure the deployment of safe and effective vaccines against WNV, especially towards susceptible populations. Research efforts should focus on understanding the unique immune responses and vulnerabilities of these populations to tailor vaccination strategies accordingly. Moreover, advancements in diagnostic testing methodologies are crucial for early detection and surveillance of WNV outbreaks. Improving testing accuracy and accessibility can facilitate prompt intervention and containment measures to curb the spread of the virus. Additionally, comprehensive mosquito control strategies are essential for reducing vector populations and interrupting WNV transmission cycles. Research should explore innovative approaches for mosquito control, considering environmental factors and social settings that influence mosquito habitats and human-mosquito interactions. Enhancing surveillance and risk assessment of mosquitoes in Europe is also critical for proactive disease management. Integrating social and environmental data into surveillance systems can enhance our understanding of WNV transmission dynamics and inform targeted interventions to mitigate the risk of outbreaks.In combating the spread of West Nile Virus (WNV) in Europe, prioritizing research initiatives is essential for effective prevention and control strategies. A primary focus must be on the development of vaccines, given the severe long-term effects and health threats posed by WNV. Research efforts should aim to create vaccines that not only provide robust immunity against WNV but also address the unique challenges posed by the virus, such as its ability to cause neurological complications. To achieve this, it is crucial to investigate the most effective ways to target different cells based on factors like longevity, duration, and persistence of antibodies. Understanding these dynamics will inform the design of vaccines that offer durable protection against WNV infection. Furthermore, research on the use of platforms for vaccine research and development is imperative. Exploring diverse technological approaches and methodologies can expedite the vaccine development process while ensuring safety and efficacy. Additionally, addressing safety issues associated with vaccine candidates is paramount to instill public confidence and facilitate widespread vaccination programs. Rigorous evaluation of vaccine safety profiles through preclinical and clinical studies is essential to mitigate potential risks and ensure the deployment of safe and effective vaccines against WNV, especially towards susceptible populations. Research efforts should focus on understanding the unique immune responses and vulnerabilities of these populations to tailor vaccination strategies accordingly.Moreover, advancements in diagnostic testing methodologies are crucial for early detection and surveillance of WNV outbreaks. Improving testing accuracy and accessibility can facilitate prompt intervention and containment measures to curb the spread of the virus. Additionally, comprehensive mosquito control strategies are essential for reducing vector populations and interrupting WNV transmission cycles. Research should explore innovative approaches for mosquito control, considering environmental factors and social settings that influence mosquito habitats and human-mosquito interactions. Enhancing surveillance and risk assessment of mosquitoes in Europe is also critical for proactive disease management. Integrating social and environmental data into surveillance systems can enhance our understanding of WNV transmission dynamics and inform targeted interventions to mitigate the risk of outbreaks.In confronting the spread of West Nile Virus (WNV) across Europe, bolstering public health infrastructure emerges as a critical imperative to effectively combat this emerging threat. While surveillance remains the cornerstone of WNV prevention, it is also recognized as being costly and time-consuming. However, it remains the most effective tool for early detection and intervention. Despite this, there is a concerning trend of increased demand coupled with reduced resources for the health sector. This disjuncture underscores the urgent need for governments and stakeholders to prioritize investment in public health infrastructure to fortify surveillance capabilities and response mechanisms. The escalating healthcare costs associated with addressing WNV and other non-communicable diseases (NCDs) and vector-borne illnesses highlight the urgency of proactive measures to strengthen public health infrastructure. These diseases not only exact a toll on individual health but also exert significant economic burdens, affecting poverty levels and productivity within communities. Recognizing the multifaceted impact of human activity on disease incidence, it becomes evident that a comprehensive approach is required to mitigate the spread of WNV. This entails addressing risk factors for geographic expansion, including human mobility, population growth, trade, and climate change. Collaboration across different levels of governance – local, regional, national, and global – as well as across diverse disciplines such as veterinary medicine, public health, and technology, is paramount. This collaboration is a perspective commonly known as "One Health." By fostering these synergistic partnerships through the One Health perspective, Europe can effectively confront the challenges posed by WNV and safeguard the health and well-being of its populations for generations to come.Implementing sound policy measures is paramount for effective prevention and control of West Nile Virus (WNV) transmission in Europe. Proper allocation of resources, collaboration within a One Health approach, and vaccination research would make great strides in tackling the issue of prevention and control first within Europe, then worldwide eradication. In tackling the spread of WNV in Europe, policymakers must prioritize a comprehensive approach that integrates robust surveillance and proactive mosquito control measures. Governments should allocate resources towards strengthening surveillance systems, investing in advanced technologies for early detection and rapid response to outbreaks. Collaborative efforts between public health agencies, veterinary services, and research institutions are crucial for sharing information and coordinating efforts in disease surveillance and vector control. The importance of community engagement and reporting would play an extremely important role in surveillance, and promoting awareness would help decrease the spread of the virus through things like mosquito spray and vaccination. Furthermore, policymakers should adopt a One Health approach to address the broader social determinants of WNV transmission. This approach recognizes the interconnectedness of human, animal, and environmental health and advocates for interdisciplinary collaboration. Integrating One Health principles into public health agendas can strengthen resilience against WNV and enhance overall health outcomes. Enhanced collaboration between health sectors, including human and veterinary medicine, environmental science, and agriculture, is essential for effective One Health implementation. Policymakers should facilitate interdisciplinary partnerships, data sharing, and joint surveillance efforts to identify and mitigate WNV risks at the human-animal-environment interface. By fostering collaboration across sectors and implementing evidence-based policies, policymakers can develop holistic solutions to prevent and control WNV transmission while addressing the underlying determinants of disease emergence and spread. Vaccination Finally, vaccination programs should be prioritized as a cornerstone of WNV prevention policies. Governments should work towards facilitating access to safe and effective vaccines, particularly for vulnerable populations such as the elderly and immunocompromised individuals. Implementing comprehensive vaccination campaigns, along with robust surveillance to monitor vaccine coverage and efficacy, can significantly reduce the burden of WNV-related morbidity and mortality.

Wiki

West Nile

https://api.wikimedia.org/core/v1/wikipedia/en/page/West_Nile_sub-region/html

West Nile sub-region

West Nile sub-region , previously known as West Nile Province and West Nile District , is a sub-region in north-western Uganda , in the Northern Region of Uganda. The sub-region is bordered by the Democratic Republic of the Congo to the south and west, by South Sudan to the north and by the Albert Nile to the east. The town of Arua , is the largest town in the sub-region. Arua lies approximately 475 kilometres (295 mi) , by road, northwest of Kampala , the capital of Uganda , and the largest city in that country. West Nile sub-region consists of the following districts, as of July 1, 2021: The sub-region received its name from being located on the western side of the Albert Nile . Military leader and former president of Uganda, Idi Amin , first gained prominence in the West Nile region before staging a military coup and usurping Milton Obote in 1971.As of May 2019, West Nile is supplied by the 3.5 megawatts Nyagak Hydroelectric Power Station , located at Nyapea , Zombo District . This is boosted by the newly installed 4.6 megawatt Yumbe Thermal Power Station, operated by Electromaxx. Another 8 megawatts thermal installation is expected in June 2019. Meantime, construction of the 6.6 megawatts Nyagak III Hydroelectric Power Station , is ongoing, with commissioning expected in 2022. With 16 megawatts to the sub-region now, the current power shortage can be mitigated until the national grid connections arrive in the next 2 to 3 years. Electromaxx has received authorization to transfer 12.6 megawatts of its installation at Tororo to West Nile, to alleviate the acute power shortage there.

Wiki

West Nile

https://api.wikimedia.org/core/v1/wikipedia/en/page/White_Nile/html

White Nile

The White Nile ( Arabic : النيل الأبيض an-nīl al-'abyaḍ ) is a river in Africa, the minor of the two main tributaries of the Nile , the larger being the Blue Nile . The name "White" comes from the clay sediment carried in the water that changes the water to a pale color. In the strict meaning, "White Nile" refers to the river formed at Lake No , at the confluence of the Bahr al Jabal and Bahr el Ghazal Rivers. In the wider sense, "White Nile" refers to all the stretches of river draining from Lake Victoria through to the merger with the Blue Nile: the "Victoria Nile" from Lake Victoria via Lake Kyoga to Lake Albert , then the "Albert Nile" to the South Sudan border, and then the "Mountain Nile" or "Bahr-al-Jabal" down to Lake No. "White Nile" may sometimes include the headwaters of Lake Victoria, the most remote of which being 3,700 km (2,300 mi) from the Blue Nile. The 19th-century search by Europeans for the source of the Nile was mainly focused on the White Nile, which disappeared into the depths of what was then known as "Darkest Africa".The Kagera River , which flows into Lake Victoria near the Tanzanian town of Bukoba , is the longest feeder river for Lake Victoria, although sources do not agree on which is the longest tributary of the Kagera, and hence the most distant source of the Nile . The source of the Nile can be considered to be either the Ruvyironza , which emerges in Bururi Province , Burundi (near Bukirasaz), or the Nyabarongo , which flows from Nyungwe Forest in Rwanda. These two feeder rivers meet near Rusumo Falls on the border between Rwanda and Tanzania. These waterfalls are known for an event on 28–29 April 1994, when 250,000 Rwandans crossed the bridge at Rusumo Falls into Ngara , Tanzania , in 24 hours, in what the United Nations High Commissioner for Refugees called "the largest and fastest refugee exodus in modern times". The Kagera forms part of the Rwanda–Tanzania and Tanzania–Uganda borders before flowing into Lake Victoria. The White Nile in Uganda goes under the name of "Victoria Nile" from Lake Victoria via Lake Kyoga to Lake Albert, and then as the "Albert Nile" from there to the border with South Sudan. The Victoria Nile starts at the outlet of Lake Victoria, at Jinja, Uganda , on the northern shore of the lake. Downstream from the Nalubaale Power Station and the Kiira Power Station at the outlet of the lake, the river goes over Bujagali Falls (the location of the Bujagali Power Station ) about 15 km (9.3 mi) downstream from Jinja. The river then flows northwest through Uganda to Lake Kyoga in the centre of the country, thence west to Lake Albert. At Karuma Falls , the river flows under Karuma Bridge ( 2°14′45.40″N 32°15′9.05″E / 2.2459444°N 32.2525139°E / 2.2459444; 32.2525139 ) at the southeastern corner of Murchison Falls National Park . During much of the insurgency of the Lord's Resistance Army , Karuma Bridge, built in 1963 to help the cotton industry, was the key stop on the way to Gulu , where vehicles gathered in convoys before being provided with a military escort for the final run north. In 2009, the government of Uganda announced plans to construct a 750-megawatt hydropower project several kilometres north of the bridge, which was scheduled for completion in 2016. The World Bank had approved funding a smaller 200-megawatt power plant, but Uganda opted for a larger project, which the Ugandans will fund internally if necessary. Just before entering Lake Albert, the river is compressed into a passage just seven meters wide at Murchison Falls , marking its entry into the western branch of the East African Rift . The river then flows into Lake Albert opposite the Blue Mountains in the Democratic Republic of the Congo . The stretch of river from Lake Kyoga to Lake Albert is sometimes called the "Kyoga Nile". The river draining from Lake Albert to the north is called the "Albert Nile". It separates the West Nile sub-region of Uganda from the rest of the country. A bridge passes over the Albert Nile near its inlet in Nebbi District , but no other bridge over this section has been built. A ferry connects the roads between Adjumani and Moyo , and navigation of the river is otherwise done by small boat or canoe. From the point at which the river enters South Sudan from Uganda, the river goes under the name of "Mountain Nile". From Lake No in South Sudan the river becomes the "White Nile" in its strictest sense, and so continues northwards into Sudan where it ends at its confluence with the Blue Nile. From Nimule in South Sudan, close to the border with Uganda, the river becomes known as the "Mountain Nile" or "Baḥr al-Jabal" (also "Baḥr el-Jebel", بحر الجبل ), literally Mountain River" or "River of the Mountain". The Southern Sudanese state of Central Equatoria through which the river flows was known as Bahr al-Jabal until 2006. The southern stretch of the river encounters several rapids before reaching the Sudan plain and the vast swamp of the Sudd . It makes its way to Lake No, where it merges with the Bahr el Ghazal and there forms the White Nile. An anabranch river called Bahr el Zeraf flows out of the Bahr al-Jabal at and flows through the Sudd, to eventually join the White Nile. The Mountain Nile cascades through narrow gorges and over a series of rapids that includes the Fula (Fola) Rapids. To some people, the White Nile starts at the confluence of the Mountain Nile with the Bahr el Ghazal at Lake No. The 120 kilometers of White Nile that flow east from Lake No to the mouth of the Sobat are very gently sloping and hold many swamps and lagoons. When in flood, the Sobat River tributary carries a large amount of sediment , adding greatly to the White Nile's pale color. From South Sudan's second city Malakal , the river runs slowly but swamp-free into Sudan and north to Khartoum. Downstream from Malakal lies Kodok , the site of the 1898 Fashoda Incident that marked an end to the Scramble for Africa . In Sudan the river lends its name to the Sudanese state of White Nile , before merging with the larger Blue Nile at Khartoum and forming the River Nile.The Kagera River , which flows into Lake Victoria near the Tanzanian town of Bukoba , is the longest feeder river for Lake Victoria, although sources do not agree on which is the longest tributary of the Kagera, and hence the most distant source of the Nile . The source of the Nile can be considered to be either the Ruvyironza , which emerges in Bururi Province , Burundi (near Bukirasaz), or the Nyabarongo , which flows from Nyungwe Forest in Rwanda. These two feeder rivers meet near Rusumo Falls on the border between Rwanda and Tanzania. These waterfalls are known for an event on 28–29 April 1994, when 250,000 Rwandans crossed the bridge at Rusumo Falls into Ngara , Tanzania , in 24 hours, in what the United Nations High Commissioner for Refugees called "the largest and fastest refugee exodus in modern times". The Kagera forms part of the Rwanda–Tanzania and Tanzania–Uganda borders before flowing into Lake Victoria.The White Nile in Uganda goes under the name of "Victoria Nile" from Lake Victoria via Lake Kyoga to Lake Albert, and then as the "Albert Nile" from there to the border with South Sudan. The Victoria Nile starts at the outlet of Lake Victoria, at Jinja, Uganda , on the northern shore of the lake. Downstream from the Nalubaale Power Station and the Kiira Power Station at the outlet of the lake, the river goes over Bujagali Falls (the location of the Bujagali Power Station ) about 15 km (9.3 mi) downstream from Jinja. The river then flows northwest through Uganda to Lake Kyoga in the centre of the country, thence west to Lake Albert. At Karuma Falls , the river flows under Karuma Bridge ( 2°14′45.40″N 32°15′9.05″E / 2.2459444°N 32.2525139°E / 2.2459444; 32.2525139 ) at the southeastern corner of Murchison Falls National Park . During much of the insurgency of the Lord's Resistance Army , Karuma Bridge, built in 1963 to help the cotton industry, was the key stop on the way to Gulu , where vehicles gathered in convoys before being provided with a military escort for the final run north. In 2009, the government of Uganda announced plans to construct a 750-megawatt hydropower project several kilometres north of the bridge, which was scheduled for completion in 2016. The World Bank had approved funding a smaller 200-megawatt power plant, but Uganda opted for a larger project, which the Ugandans will fund internally if necessary. Just before entering Lake Albert, the river is compressed into a passage just seven meters wide at Murchison Falls , marking its entry into the western branch of the East African Rift . The river then flows into Lake Albert opposite the Blue Mountains in the Democratic Republic of the Congo . The stretch of river from Lake Kyoga to Lake Albert is sometimes called the "Kyoga Nile". The river draining from Lake Albert to the north is called the "Albert Nile". It separates the West Nile sub-region of Uganda from the rest of the country. A bridge passes over the Albert Nile near its inlet in Nebbi District , but no other bridge over this section has been built. A ferry connects the roads between Adjumani and Moyo , and navigation of the river is otherwise done by small boat or canoe.The Victoria Nile starts at the outlet of Lake Victoria, at Jinja, Uganda , on the northern shore of the lake. Downstream from the Nalubaale Power Station and the Kiira Power Station at the outlet of the lake, the river goes over Bujagali Falls (the location of the Bujagali Power Station ) about 15 km (9.3 mi) downstream from Jinja. The river then flows northwest through Uganda to Lake Kyoga in the centre of the country, thence west to Lake Albert. At Karuma Falls , the river flows under Karuma Bridge ( 2°14′45.40″N 32°15′9.05″E / 2.2459444°N 32.2525139°E / 2.2459444; 32.2525139 ) at the southeastern corner of Murchison Falls National Park . During much of the insurgency of the Lord's Resistance Army , Karuma Bridge, built in 1963 to help the cotton industry, was the key stop on the way to Gulu , where vehicles gathered in convoys before being provided with a military escort for the final run north. In 2009, the government of Uganda announced plans to construct a 750-megawatt hydropower project several kilometres north of the bridge, which was scheduled for completion in 2016. The World Bank had approved funding a smaller 200-megawatt power plant, but Uganda opted for a larger project, which the Ugandans will fund internally if necessary. Just before entering Lake Albert, the river is compressed into a passage just seven meters wide at Murchison Falls , marking its entry into the western branch of the East African Rift . The river then flows into Lake Albert opposite the Blue Mountains in the Democratic Republic of the Congo . The stretch of river from Lake Kyoga to Lake Albert is sometimes called the "Kyoga Nile". The river draining from Lake Albert to the north is called the "Albert Nile". It separates the West Nile sub-region of Uganda from the rest of the country. A bridge passes over the Albert Nile near its inlet in Nebbi District , but no other bridge over this section has been built. A ferry connects the roads between Adjumani and Moyo , and navigation of the river is otherwise done by small boat or canoe.From the point at which the river enters South Sudan from Uganda, the river goes under the name of "Mountain Nile". From Lake No in South Sudan the river becomes the "White Nile" in its strictest sense, and so continues northwards into Sudan where it ends at its confluence with the Blue Nile. From Nimule in South Sudan, close to the border with Uganda, the river becomes known as the "Mountain Nile" or "Baḥr al-Jabal" (also "Baḥr el-Jebel", بحر الجبل ), literally Mountain River" or "River of the Mountain". The Southern Sudanese state of Central Equatoria through which the river flows was known as Bahr al-Jabal until 2006. The southern stretch of the river encounters several rapids before reaching the Sudan plain and the vast swamp of the Sudd . It makes its way to Lake No, where it merges with the Bahr el Ghazal and there forms the White Nile. An anabranch river called Bahr el Zeraf flows out of the Bahr al-Jabal at and flows through the Sudd, to eventually join the White Nile. The Mountain Nile cascades through narrow gorges and over a series of rapids that includes the Fula (Fola) Rapids. To some people, the White Nile starts at the confluence of the Mountain Nile with the Bahr el Ghazal at Lake No. The 120 kilometers of White Nile that flow east from Lake No to the mouth of the Sobat are very gently sloping and hold many swamps and lagoons. When in flood, the Sobat River tributary carries a large amount of sediment , adding greatly to the White Nile's pale color. From South Sudan's second city Malakal , the river runs slowly but swamp-free into Sudan and north to Khartoum. Downstream from Malakal lies Kodok , the site of the 1898 Fashoda Incident that marked an end to the Scramble for Africa . In Sudan the river lends its name to the Sudanese state of White Nile , before merging with the larger Blue Nile at Khartoum and forming the River Nile.From Nimule in South Sudan, close to the border with Uganda, the river becomes known as the "Mountain Nile" or "Baḥr al-Jabal" (also "Baḥr el-Jebel", بحر الجبل ), literally Mountain River" or "River of the Mountain". The Southern Sudanese state of Central Equatoria through which the river flows was known as Bahr al-Jabal until 2006. The southern stretch of the river encounters several rapids before reaching the Sudan plain and the vast swamp of the Sudd . It makes its way to Lake No, where it merges with the Bahr el Ghazal and there forms the White Nile. An anabranch river called Bahr el Zeraf flows out of the Bahr al-Jabal at and flows through the Sudd, to eventually join the White Nile. The Mountain Nile cascades through narrow gorges and over a series of rapids that includes the Fula (Fola) Rapids. To some people, the White Nile starts at the confluence of the Mountain Nile with the Bahr el Ghazal at Lake No. The 120 kilometers of White Nile that flow east from Lake No to the mouth of the Sobat are very gently sloping and hold many swamps and lagoons. When in flood, the Sobat River tributary carries a large amount of sediment , adding greatly to the White Nile's pale color. From South Sudan's second city Malakal , the river runs slowly but swamp-free into Sudan and north to Khartoum. Downstream from Malakal lies Kodok , the site of the 1898 Fashoda Incident that marked an end to the Scramble for Africa . In Sudan the river lends its name to the Sudanese state of White Nile , before merging with the larger Blue Nile at Khartoum and forming the River Nile.The White Nile is a navigable waterway from the Lake Albert to Khartoum through Jebel Aulia Dam , only between Juba and Uganda requires the river upgrade or channel to make it navigable. During part of the year the rivers are navigable up to Gambela, Ethiopia , and Wau, South Sudan .

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West Nile

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West Nile rebellion

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West Nile

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Nile

The Nile [lower-alpha 2] is a major north-flowing river in northeastern Africa . It flows into the Mediterranean Sea . The Nile is the longest river in Africa and has historically been considered the longest river in the world , though this has been contested by research suggesting that the Amazon River is slightly longer. Of the world's major rivers, the Nile is one of the smallest, as measured by annual flow in cubic metres of water. About 6,650 km (4,130 mi) [lower-alpha 1] long, its drainage basin covers eleven countries: the Democratic Republic of the Congo , Tanzania , Burundi , Rwanda , Uganda , Kenya , Ethiopia , Eritrea , South Sudan , Sudan , and Egypt . In particular, the Nile is the primary water source of Egypt, Sudan and South Sudan. Additionally, the Nile is an important economic river, supporting agriculture and fishing. The Nile has two major tributaries : the White Nile and the Blue Nile . The White Nile is traditionally considered to be the headwaters stream . However, the Blue Nile is the source of most of the water of the Nile downstream, containing 80% of the water and silt . The White Nile is longer and rises in the Great Lakes region. It begins at Lake Victoria and flows through Uganda and South Sudan. The Blue Nile begins at Lake Tana in Ethiopia and flows into Sudan from the southeast. The two rivers meet at the Sudanese capital of Khartoum . The northern section of the river flows north almost entirely through the Nubian Desert to Cairo and its large delta , and the river flows into the Mediterranean Sea at Alexandria . Egyptian civilization and Sudanese kingdoms have depended on the river and its annual flooding since ancient times. Most of the population and cities of Egypt lie along those parts of the Nile valley north of the Aswan Dam . Nearly all the cultural and historical sites of Ancient Egypt developed and are found along river banks. The Nile is, with the Rhône and Po , one of the three Mediterranean rivers with the largest water discharge . The standard English names "White Nile" and "Blue Nile" refer to the river's source, derived from Arabic names formerly applied to only the Sudanese stretches that meet at Khartoum . In the ancient Egyptian language , the Nile is called Ḥꜥpy (Hapy) or Jtrw (Iteru), meaning "river". In Coptic , the word ⲫⲓⲁⲣⲟ , pronounced piaro ( Sahidic ) or phiaro ( Bohairic ), means "the river" (lit. p(h).iar-o "the.canal-great"), and comes from the same ancient name. In Nobiin , the river is called Áman DawÅ« , meaning "the great water". In Luganda , the river is called Kiira or Kiyira . In Runyoro , it is called Kihiira . In Egyptian Arabic , the Nile is called en-NÄ«l , while in Standard Arabic it is called an-NÄ«l . In Biblical Hebrew , it is הַיְאוֹר ‎ , Ha-Ye'or or הַשִׁיחוֹר ‎ , Ha-Shiḥor . The English name Nile and the Arabic names en-Nîl and an-Nîl both derive from the Latin Nilus and the Ancient Greek Νεῖλος . Beyond that, however, the etymology is disputed. Homer called the river Î‘á¼´Î³Ï Ï€Ï„Î¿Ï‚ , Aiguptos , but in subsequent periods, Greek authors referred to its lower course as Neilos ; this term became generalised for the entire river system. Thus, the name may derive from Ancient Egyptian expression n ꜣ r ꜣ w-ḥ ꜣ w(t) (lit. 'the mouths of the front parts'), which referred specifically to the branches of the Nile transversing the Delta, and would have been pronounced ni-lo-he in the area around Memphis in the 8th century BCE. Hesiod at his Theogony refers to Nilus (Νεῖλος) as one of the Potamoi (river gods), son of Oceanus and Tethys . Another derivation of Nile might be related to the term Nil ( Sanskrit : नील , romanized : nila ; Egyptian Arabic : نيلة ), which refers to Indigofera tinctoria , one of the original sources of indigo dye . Another may be Nymphaea caerulea , known as "The Sacred Blue Lily of the Nile", which was found scattered over Tutankhamun 's corpse when it was excavated in 1922. [ citation needed ] Another possible etymology derives from the Semitic term Nahal , meaning "river". Old Libyan has the term lilu , meaning water (in modern Berber ilel ⵉⵍⴻⵍ means sea ). With a total length of about 6,650 km (4,130 mi) [lower-alpha 1] between the region of Lake Victoria and the Mediterranean Sea , the Nile is among the longest rivers on Earth. The drainage basin of the Nile covers 3,254,555 square kilometers (1,256,591 sq mi) , about 10% of the area of Africa. Compared to other major rivers, though, the Nile carries little water (5% of that of the Congo River , for example). The Nile basin is complex, and because of this, the discharge at any given point along the main stem depends on many factors including weather, diversions, evaporation and evapotranspiration , and groundwater flow. Upstream from Khartoum (to the south), the river is known as the White Nile , a term also used in a limited sense to describe the section between Lake No and Khartoum. At Khartoum, the river is joined by the Blue Nile . The White Nile starts in equatorial East Africa , and the Blue Nile begins in Ethiopia. Both branches are on the western flanks of the East African Rift . The source of the Blue Nile is Lake Tana in the Gish Abay region in the Ethiopian Highlands . The source of the White Nile, even after centuries of exploration, remains in dispute. The most remote source that is indisputably a source for the White Nile is the Kagera River ; however, the Kagera has tributaries that are in contention for the farthest source of the White Nile. Two start in Burundi: the Ruvyironza River (also known as the Luvironza) and the Rurubu River . In addition, in 2010, an exploration party in Rwanda went to a place described as the source of the Rukarara tributary, and by hacking a path up steep jungle-choked mountain slopes in the Nyungwe Forest found (in the dry season ) an appreciable incoming surface flow for many kilometres upstream, and found a new source, giving the Nile a length of 6,758 km (4,199 mi) . [ citation needed ] The White Nile leaves Lake Victoria at Ripon Falls near Jinja, Uganda , as the "Victoria Nile." It flows north for some 130 kilometers (81 mi) to Lake Kyoga . The last part of the approximately 200 kilometers (120 mi) river section starts from the western shores of the lake and flows at first to the west until just south of Masindi Port , where the river turns north, then makes a great half circle to the east and north to Karuma Falls . For the remaining part, it flows westerly through the Murchison Falls until it reaches the northern shores of Lake Albert where it forms a significant river delta. Lake Albert is on the border of the Democratic Republic of the Congo , but the Nile is not a border river at this point. After leaving Lake Albert, the river continues north through Uganda and is known as the Albert Nile . The White Nile flows into South Sudan just south of Nimule , where it is known as the Bahr al Jabal ("Mountain River" ). Just south of the town is the confluence with the Achwa River . The Bahr al Ghazal , 716 kilometers (445 mi) long, joins the Bahr al Jabal at a small lagoon called Lake No , after which the Nile becomes known as the Bahr al Abyad , or the White Nile, from the whitish clay suspended in its waters. When the Nile floods it leaves a rich silty deposit which fertilizes the soil. The Nile no longer floods in Egypt since the completion of the Aswan Dam in 1970. An anabranch river, the Bahr el Zeraf , flows out of the Nile's Bahr al Jabal section and rejoins the White Nile. The flow rate of the Bahr al Jabal at Mongalla is almost constant throughout the year and averages 1,048 m 3 /s (37,000 cu ft/s) . After Mongalla, the Bahr Al Jabal enters the enormous swamps of the Sudd region. More than half of the Nile's water is lost in this swamp to evaporation and transpiration . The average flow rate of the White Nile at the tails of the swamps is about 510 m 3 /s (18,000 cu ft/s) . From here it meets with the Sobat River at Malakal . On an annual basis, the White Nile upstream of Malakal contributes about 15% of the total outflow of the Nile. The average flow of the White Nile at Lake Kawaki Malakal, just below the Sobat River, is 924 m 3 /s (32,600 cu ft/s) ; the peak flow is approximately 1,218 m 3 /s (43,000 cu ft/s) in October and minimum flow is about 609 m 3 /s (21,500 cu ft/s) in April. This fluctuation is caused by the substantial variation in the flow of the Sobat, which has a minimum flow of about 99 m 3 /s (3,500 cu ft/s) in March and a peak flow of over 680 m 3 /s (24,000 cu ft/s) in October. During the dry season (January to June) the White Nile contributes between 70% and 90% of the total discharge from the Nile. Below Renk , the White Nile enters Sudan, it flows north to Khartoum and meets the Blue Nile. The course of the Nile in Sudan is distinctive. It flows over six groups of cataracts , from the sixth at Sabaloka just north of Khartoum northward to Abu Hamad . The tectonic uplift of the Nubian Swell diverts the river south-west for over 300 km, following the structure of the Central African Shear Zone embracing the Bayuda Desert . At Al Dabbah it resumes its northward course towards the first cataract at Aswan forming the S-shaped Great Bend of the Nile mentioned by Eratosthenes . In the north of Sudan, the river enters Lake Nasser (known in Sudan as Lake Nubia), the larger part of which is in Egypt. Below the Aswan Dam , at the northern limit of Lake Nasser, the Nile resumes its historic course. North of Cairo , the Nile splits into two branches (or distributaries) that feed the Mediterranean: the Rosetta Branch to the west and the Damietta to the east, forming the Nile Delta . The annual sediment transport by the Nile in Egypt has been quantified. The source of the Blue Nile is Lake Tana in the Gish Abay region in the Ethiopian Highlands . The source of the White Nile, even after centuries of exploration, remains in dispute. The most remote source that is indisputably a source for the White Nile is the Kagera River ; however, the Kagera has tributaries that are in contention for the farthest source of the White Nile. Two start in Burundi: the Ruvyironza River (also known as the Luvironza) and the Rurubu River . In addition, in 2010, an exploration party in Rwanda went to a place described as the source of the Rukarara tributary, and by hacking a path up steep jungle-choked mountain slopes in the Nyungwe Forest found (in the dry season ) an appreciable incoming surface flow for many kilometres upstream, and found a new source, giving the Nile a length of 6,758 km (4,199 mi) . [ citation needed ]The White Nile leaves Lake Victoria at Ripon Falls near Jinja, Uganda , as the "Victoria Nile." It flows north for some 130 kilometers (81 mi) to Lake Kyoga . The last part of the approximately 200 kilometers (120 mi) river section starts from the western shores of the lake and flows at first to the west until just south of Masindi Port , where the river turns north, then makes a great half circle to the east and north to Karuma Falls . For the remaining part, it flows westerly through the Murchison Falls until it reaches the northern shores of Lake Albert where it forms a significant river delta. Lake Albert is on the border of the Democratic Republic of the Congo , but the Nile is not a border river at this point. After leaving Lake Albert, the river continues north through Uganda and is known as the Albert Nile .The White Nile flows into South Sudan just south of Nimule , where it is known as the Bahr al Jabal ("Mountain River" ). Just south of the town is the confluence with the Achwa River . The Bahr al Ghazal , 716 kilometers (445 mi) long, joins the Bahr al Jabal at a small lagoon called Lake No , after which the Nile becomes known as the Bahr al Abyad , or the White Nile, from the whitish clay suspended in its waters. When the Nile floods it leaves a rich silty deposit which fertilizes the soil. The Nile no longer floods in Egypt since the completion of the Aswan Dam in 1970. An anabranch river, the Bahr el Zeraf , flows out of the Nile's Bahr al Jabal section and rejoins the White Nile. The flow rate of the Bahr al Jabal at Mongalla is almost constant throughout the year and averages 1,048 m 3 /s (37,000 cu ft/s) . After Mongalla, the Bahr Al Jabal enters the enormous swamps of the Sudd region. More than half of the Nile's water is lost in this swamp to evaporation and transpiration . The average flow rate of the White Nile at the tails of the swamps is about 510 m 3 /s (18,000 cu ft/s) . From here it meets with the Sobat River at Malakal . On an annual basis, the White Nile upstream of Malakal contributes about 15% of the total outflow of the Nile. The average flow of the White Nile at Lake Kawaki Malakal, just below the Sobat River, is 924 m 3 /s (32,600 cu ft/s) ; the peak flow is approximately 1,218 m 3 /s (43,000 cu ft/s) in October and minimum flow is about 609 m 3 /s (21,500 cu ft/s) in April. This fluctuation is caused by the substantial variation in the flow of the Sobat, which has a minimum flow of about 99 m 3 /s (3,500 cu ft/s) in March and a peak flow of over 680 m 3 /s (24,000 cu ft/s) in October. During the dry season (January to June) the White Nile contributes between 70% and 90% of the total discharge from the Nile.Below Renk , the White Nile enters Sudan, it flows north to Khartoum and meets the Blue Nile. The course of the Nile in Sudan is distinctive. It flows over six groups of cataracts , from the sixth at Sabaloka just north of Khartoum northward to Abu Hamad . The tectonic uplift of the Nubian Swell diverts the river south-west for over 300 km, following the structure of the Central African Shear Zone embracing the Bayuda Desert . At Al Dabbah it resumes its northward course towards the first cataract at Aswan forming the S-shaped Great Bend of the Nile mentioned by Eratosthenes . In the north of Sudan, the river enters Lake Nasser (known in Sudan as Lake Nubia), the larger part of which is in Egypt.Below the Aswan Dam , at the northern limit of Lake Nasser, the Nile resumes its historic course. North of Cairo , the Nile splits into two branches (or distributaries) that feed the Mediterranean: the Rosetta Branch to the west and the Damietta to the east, forming the Nile Delta .The annual sediment transport by the Nile in Egypt has been quantified. Below the confluence with the Blue Nile the only major tributary is the Atbarah River , also known as the Red Nile. Roughly halfway to the sea, it originates in Ethiopia north of Lake Tana , and is around 800 kilometers (500 mi) long. The Atbarah flows only while there is rain in Ethiopia and dries very rapidly. During the dry period of January to June, it typically dries up north of Khartoum . The Blue Nile ( Amharic : ዓባይ , ʿĀbay ) springs from Lake Tana in the Ethiopian Highlands. The Blue Nile flows about 1,400 kilometres to Khartoum, where the Blue Nile and White Nile join to form the Nile. Ninety percent of the water and ninety-six percent of the transported sediment carried by the Nile originates in Ethiopia, with fifty-nine percent of the water from the Blue Nile (the rest being from the Tekezé , Atbarah, Sobat , and small tributaries). The erosion and transportation of silt only occurs during the Ethiopian rainy season when rainfall is especially high in the Ethiopian Highlands ; the rest of the year, the great rivers draining Ethiopia into the Nile have a weaker flow. In harsh and arid seasons and droughts, the Blue Nile dries out completely. The flow of the Blue Nile varies considerably over its yearly cycle and is the main contribution to the large natural variation of the Nile flow. During the dry season the natural discharge of the Blue Nile can be as low as 113 m 3 /s (4,000 cu ft/s) , although upstream dams regulate the flow of the river. During the wet season, the peak flow of the Blue Nile often exceeds 5,663 m 3 /s (200,000 cu ft/s) in late August (a difference of a factor of 50). Before the placement of dams on the river the yearly discharge varied by a factor of 15 at Aswan. Peak flows of over 8,212 m 3 /s (290,000 cu ft/s) occurred during late August and early September, and minimum flows of about 552 m 3 /s (19,500 cu ft/s) occurred during late April and early May. The Bahr al Ghazal and the Sobat River are the two most important tributaries of the White Nile in terms of discharge. The Bahr al Ghazal's drainage basin is the largest of any of the Nile's sub-basins, measuring 520,000 square kilometers (200,000 sq mi) in size, but it contributes a relatively small amount of water, about 2 m 3 /s (71 cu ft/s) annually, because tremendous volumes of water are lost in the Sudd wetlands. The Sobat River, which joins the Nile a short distance below Lake No, drains about half as much land, 225,000 km 2 (86,900 sq mi) , but contributes 412 cubic meters per second (14,500 cu ft/s) annually to the Nile. When in flood the Sobat carries a large amount of sediment, adding greatly to the White Nile's color. The Yellow Nile is a former tributary that connected the Ouaddaï highlands of eastern Chad to the Nile River Valley c. 8000 to c. 1000 BCE . Its remains are known as the Wadi Howar . The wadi passes through Gharb Darfur near the northern border with Chad and meets up with the Nile near the southern point of the Great Bend.Below the confluence with the Blue Nile the only major tributary is the Atbarah River , also known as the Red Nile. Roughly halfway to the sea, it originates in Ethiopia north of Lake Tana , and is around 800 kilometers (500 mi) long. The Atbarah flows only while there is rain in Ethiopia and dries very rapidly. During the dry period of January to June, it typically dries up north of Khartoum .The Blue Nile ( Amharic : ዓባይ , ʿĀbay ) springs from Lake Tana in the Ethiopian Highlands. The Blue Nile flows about 1,400 kilometres to Khartoum, where the Blue Nile and White Nile join to form the Nile. Ninety percent of the water and ninety-six percent of the transported sediment carried by the Nile originates in Ethiopia, with fifty-nine percent of the water from the Blue Nile (the rest being from the Tekezé , Atbarah, Sobat , and small tributaries). The erosion and transportation of silt only occurs during the Ethiopian rainy season when rainfall is especially high in the Ethiopian Highlands ; the rest of the year, the great rivers draining Ethiopia into the Nile have a weaker flow. In harsh and arid seasons and droughts, the Blue Nile dries out completely. The flow of the Blue Nile varies considerably over its yearly cycle and is the main contribution to the large natural variation of the Nile flow. During the dry season the natural discharge of the Blue Nile can be as low as 113 m 3 /s (4,000 cu ft/s) , although upstream dams regulate the flow of the river. During the wet season, the peak flow of the Blue Nile often exceeds 5,663 m 3 /s (200,000 cu ft/s) in late August (a difference of a factor of 50). Before the placement of dams on the river the yearly discharge varied by a factor of 15 at Aswan. Peak flows of over 8,212 m 3 /s (290,000 cu ft/s) occurred during late August and early September, and minimum flows of about 552 m 3 /s (19,500 cu ft/s) occurred during late April and early May.The Bahr al Ghazal and the Sobat River are the two most important tributaries of the White Nile in terms of discharge. The Bahr al Ghazal's drainage basin is the largest of any of the Nile's sub-basins, measuring 520,000 square kilometers (200,000 sq mi) in size, but it contributes a relatively small amount of water, about 2 m 3 /s (71 cu ft/s) annually, because tremendous volumes of water are lost in the Sudd wetlands. The Sobat River, which joins the Nile a short distance below Lake No, drains about half as much land, 225,000 km 2 (86,900 sq mi) , but contributes 412 cubic meters per second (14,500 cu ft/s) annually to the Nile. When in flood the Sobat carries a large amount of sediment, adding greatly to the White Nile's color. The Yellow Nile is a former tributary that connected the Ouaddaï highlands of eastern Chad to the Nile River Valley c. 8000 to c. 1000 BCE . Its remains are known as the Wadi Howar . The wadi passes through Gharb Darfur near the northern border with Chad and meets up with the Nile near the southern point of the Great Bend.The Nile has been the lifeline of civilization in Egypt since the Stone Age , with most of the population and all of the cities of Egypt developing along those parts of the Nile valley lying north of Aswan. However, the Nile used to run much more westerly through what is now Wadi Hamim and Wadi al Maqar in Libya and flow into the Gulf of Sidra . As the sea level rose at the end of the most recent ice age , the stream which is now the northern Nile captured the ancestral Nile near Asyut . This change in climate also led to the current extents of the Sahara desert, around 3400 BCE. The Giza pyramid complex originally overlooked a branch of the Nile that no longer exists. This branch was highest during the African Humid Period . The existing Nile has five earlier phases: Flowing north from the Ethiopian Highlands, satellite imagery was used to identify dry watercourses in the desert to the west of the Nile. A canyon, now filled by surface drift, represents the Eonile that flowed during 23–5.3 million years before present. The Eonile transported clastic sediments to the Mediterranean; several natural gas fields have been discovered within these sediments. During the late- Miocene Messinian salinity crisis , when the Mediterranean Sea was a closed basin and evaporated to the point of being empty or nearly so, the Nile cut its course down to the new base level until it was several hundred metres below world ocean level at Aswan and 2,400 m (7,900 ft) below Cairo. This created a very long and deep canyon which was filled with sediment after the Mediterranean was recreated. At some point the sediments raised the riverbed sufficiently for the river to overflow westward into a depression to create Lake Moeris . Lake Tanganyika drained northwards into the Nile until the Virunga Volcanoes blocked its course in Rwanda. The Nile was much longer at that time, with its furthest headwaters in northern Zambia . The currently existing Nile first flowed during the former parts of the Würm glaciation period. Affad 23 is an archaeological site located in alluvial deposits formed by an ancient channel of the Nile in the Affad region of southern Dongola Reach , Sudan . There are two theories about the age of the integrated Nile. One is that the integrated drainage of the Nile is of young age and that the Nile basin was formerly broken into series of separate basins, only the most northerly of which fed a river following the present course of the Nile in Egypt and Sudan. Rushdi Said postulates that Egypt supplied most of the waters of the Nile during the early part of its history. The other theory is that the drainage from Ethiopia via rivers equivalent to the Blue Nile, the Atbara and the Takazze flowed to the Mediterranean via the Egyptian Nile since well back into Tertiary times. Salama suggests that during the Paleogene and Neogene Periods (66 million to 2.588 million years ago) a series of separate closed continental basins each occupied one of the major parts of the Sudanese Rift System: Mellut rift , White Nile rift , Blue Nile rift , Atbara rift and Sag El Naam rift . The Mellut Basin is nearly 12 kilometers (7.5 mi) deep at its central part. This rift is possibly still active, with reported tectonic activity in its northern and southern boundaries. The Sudd swamp which forms the central part of the basin may still be subsiding. The White Nile Rift system, although shallower than the Bahr el Arab rift , is about 9 kilometers (5.6 mi) deep. Geophysical exploration of the Blue Nile Rift System estimated the depth of the sediments to be 5–9 kilometers (3.1–5.6 mi) . These basins were not interconnected until their subsidence ceased, and the rate of sediment deposition was enough to fill and connect them. The Egyptian Nile connected to the Sudanese Nile, which captures the Ethiopian and Equatorial headwaters during the current stages of tectonic activity in the Eastern, Central and Sudanese Rift systems. The connection of the different Niles occurred during cyclic wet periods. The Atbarah overflowed its closed basin during the wet periods that occurred about 100,000 to 120,000 years ago. The Blue Nile connected to the main Nile during the 70,000–80,000 years B.P. wet period. The White Nile system in Bahr El Arab and White Nile Rifts remained a closed lake until the connection of the Victoria Nile to the main system some 12,500 years ago during the African humid period . The Greek historian Herodotus wrote that "Egypt was the gift of the Nile". An unending source of sustenance, it played a crucial role in the development of Egyptian civilization. Because the river overflowed its banks annually and deposited new layers of silt, the surrounding land was very fertile. The Ancient Egyptians cultivated and traded wheat , flax , papyrus and other crops around the Nile. Wheat was a crucial crop in the famine-plagued Middle East . This trading system secured Egypt's diplomatic relationships with other countries and contributed to economic stability. Far-reaching trade has been carried on along the Nile since ancient times. [ citation needed ] A tune, Hymn to the Nile , was created and sung by the ancient Egyptian peoples about the flooding of the Nile River and all of the miracles it brought to Ancient Egyptian civilization. Water buffalo were introduced from Asia, and the Assyrians introduced camels in the 7th century BCE. These animals were raised for meat and were domesticated and used for ploughing—or in the camels' case, carriage. Water was vital to both people and livestock. The Nile was also a convenient and efficient means of transportation for people and goods. The Nile was also an important part of ancient Egyptian spiritual life. Hapi was the god of the annual floods, and both he and the pharaoh were thought to control the flooding. The Nile was considered to be a causeway from life to death and the afterlife. The east was thought of as a place of birth and growth, and the west was considered the place of death, as the god Ra , the Sun, underwent birth, death, and resurrection each day as he crossed the sky. Thus, all tombs were west of the Nile, because the Egyptians believed that in order to enter the afterlife, they had to be buried on the side that symbolized death. [ citation needed ] As the Nile was such an important factor in Egyptian life, the ancient calendar was even based on the three cycles of the Nile. These seasons, each consisting of four months of thirty days each, were called Akhet , Peret , and Shemu . Akhet, which means inundation, was the time of the year when the Nile flooded, leaving several layers of fertile soil behind, aiding in agricultural growth. Peret was the growing season, and Shemu, the last season, was the harvest season when there were no rains. Owing to their failure to penetrate the Sudd wetlands of South Sudan, the upper reaches of the White Nile remained largely unknown to the ancient Greeks and Romans. Vitruvius thought that source of the Nile was in Mauritania, on the "other" (south) side of the Atlas Mountains . Various expeditions failed to determine the river's source. Agatharchides records that in the time of Ptolemy II Philadelphus , a military expedition had penetrated far enough along the course of the Blue Nile to determine that the summer floods were caused by heavy seasonal rainstorms in the Ethiopian Highlands, but no European of antiquity is known to have reached Lake Tana. The Tabula Rogeriana depicted the source as three lakes in 1154. Europeans began to learn about the origins of the Nile in the 14th century when the Pope sent monks as emissaries to Mongolia who passed India, the Middle East and Africa, and described being told of the source of the Nile in Abyssinia (Ethiopia). Later in the 15th and 16th centuries, travelers to Ethiopia visited Lake Tana and the source of the Blue Nile in the mountains south of the lake. Supposedly, Paolo Trevisani (circa 1452–1483), a Venetian traveller in Ethiopia, wrote a journal of his travels to the origin of the Nile that has since been lost. Although James Bruce claimed to be the first European to have visited the headwaters, modern writers give the credit to the Jesuit Pedro Páez . Páez's account of the source of the Nile is a long and vivid account of Ethiopia. It was published in full only in the early 20th century, although it was featured in works of Páez's contemporaries, including Baltazar Téllez, Athanasius Kircher and Johann Michael Vansleb . Europeans had been resident in Ethiopia since the late 15th century, and one of them may have visited the headwaters even earlier without leaving a written trace. The Portuguese João Bermudes published the first description of the Tis Issat Falls in his 1565 memoirs, compared them to the Nile Falls alluded to in Cicero 's De Republica . Jerónimo Lobo describes the source of the Blue Nile, visiting shortly after Pedro Páez. Telles also uses his account. The White Nile was even less understood. The ancients mistakenly believed that the Niger River represented the upper reaches of the White Nile. For example, Pliny the Elder writes that the Nile had its origins "in a mountain of lower Mauretania ", flowed above ground for "many days" distance, then went underground, reappeared as a large lake in the territories of the Masaesyli , then sank again below the desert to flow underground "for a distance of 20 days' journey till it reaches the nearest Ethiopians." Modern exploration of the Nile basin began with the conquest of the northern and central Sudan by the Ottoman viceroy of Egypt, Muhammad Ali , and his sons from 1821 onward. As a result of this, the Blue Nile was known as far as its exit from the Ethiopian foothills and the White Nile as far as the mouth of the Sobat River. Three expeditions under a Turkish officer, Selim Bimbashi, were made between 1839 and 1842, and two got to the point about 30 kilometres (20 miles) beyond the present port of Juba , where the country rises and rapids make navigation very difficult. Lake Victoria was first sighted by Europeans in 1858 when British explorer John Hanning Speke reached its southern shore while traveling with Richard Francis Burton to explore central Africa and locate the great lakes. Believing he had found the source of the Nile on seeing this "vast expanse of open water" for the first time, Speke named the lake after Queen Victoria . Burton, recovering from illness and resting further south on the shores of Lake Tanganyika , was outraged that Speke claimed to have proven his discovery to be the true source of the Nile when Burton regarded this as still unsettled. A quarrel ensued which sparked intense debate within the scientific community and interest by other explorers keen to either confirm or refute Speke's discovery. British explorer and missionary David Livingstone pushed too far west and entered the Congo River system instead. It was ultimately Welsh-American explorer Henry Morton Stanley who confirmed Speke's discovery, circumnavigating Lake Victoria and reporting the great outflow at Ripon Falls on the lake's northern shore. The Nile has long been used to transport goods along its length. Winter winds blow south, up river, so ships could sail up river using sails and down river using the flow of the river. While most Egyptians still live in the Nile valley, the 1970 completion of the Aswan Dam ended the summer floods and their renewal of the fertile soil, fundamentally changing farming practices. The Nile supports much of the population living along its banks, enabling Egyptians to live in otherwise inhospitable regions of the Sahara. The river's flow is disturbed at several points by the Cataracts of the Nile which form an obstacle to navigation by boats. The Sudd also forms a formidable navigation obstacle and impedes water flow, to the extent that Sudan had once attempted to build the Jonglei Canal to bypass the swamp. Nile cities include Khartoum, Aswan, Luxor (Thebes), and the Giza – Cairo conurbation . The first cataract, the closest to the mouth of the river, is at Aswan, north of the Aswan Dam. This part of the river is a regular tourist route, with cruise ships and traditional wooden sailing boats known as feluccas . Many cruise ships ply the route between Luxor and Aswan, stopping at Edfu and Kom Ombo along the way. Security concerns have limited cruising on the northernmost portion for many years. A computer simulation study to plan the economic development of the Nile was directed by H.A.W. Morrice and W.N. Allan, for the Ministry of Hydro-power of Sudan, during 1955–57 Morrice was their hydrological adviser, and Allan his predecessor. The calculations were enabled by accurate monthly inflow data collected for 50 years. The underlying principle was the use of over-year storage, to conserve water from rainy years for use in dry years. Irrigation, navigation and other needs were considered. Each computer run postulated a set of reservoirs and operating equations for the release of water as a function of the month and the levels upstream. The behavior that would have resulted given the inflow data was modeled. Over 600 models were run. Recommendations were made to the Sudanese authorities. The calculations were run on an IBM 650 computer. Simulation studies to design water resources are discussed further in the article on hydrology transport models , which have been used since the 1980s to analyze water quality. Despite the development of many reservoirs, drought during the 1980s led to widespread starvation in Ethiopia and Sudan, but Egypt was nourished by water impounded in Lake Nasser. Drought has proven to be a major cause of fatality in the Nile river basin. According to a report by the Strategic Foresight Group around 170 million people have been affected by droughts in the last century with half a million lives lost. From the 70 incidents of drought which took place between 1900 and 2012, 55 incidents took place in Ethiopia, Sudan, South Sudan, Kenya and Tanzania. The Giza pyramid complex originally overlooked a branch of the Nile that no longer exists. This branch was highest during the African Humid Period . The existing Nile has five earlier phases: Flowing north from the Ethiopian Highlands, satellite imagery was used to identify dry watercourses in the desert to the west of the Nile. A canyon, now filled by surface drift, represents the Eonile that flowed during 23–5.3 million years before present. The Eonile transported clastic sediments to the Mediterranean; several natural gas fields have been discovered within these sediments. During the late- Miocene Messinian salinity crisis , when the Mediterranean Sea was a closed basin and evaporated to the point of being empty or nearly so, the Nile cut its course down to the new base level until it was several hundred metres below world ocean level at Aswan and 2,400 m (7,900 ft) below Cairo. This created a very long and deep canyon which was filled with sediment after the Mediterranean was recreated. At some point the sediments raised the riverbed sufficiently for the river to overflow westward into a depression to create Lake Moeris . Lake Tanganyika drained northwards into the Nile until the Virunga Volcanoes blocked its course in Rwanda. The Nile was much longer at that time, with its furthest headwaters in northern Zambia . The currently existing Nile first flowed during the former parts of the Würm glaciation period. Affad 23 is an archaeological site located in alluvial deposits formed by an ancient channel of the Nile in the Affad region of southern Dongola Reach , Sudan . There are two theories about the age of the integrated Nile. One is that the integrated drainage of the Nile is of young age and that the Nile basin was formerly broken into series of separate basins, only the most northerly of which fed a river following the present course of the Nile in Egypt and Sudan. Rushdi Said postulates that Egypt supplied most of the waters of the Nile during the early part of its history. The other theory is that the drainage from Ethiopia via rivers equivalent to the Blue Nile, the Atbara and the Takazze flowed to the Mediterranean via the Egyptian Nile since well back into Tertiary times. Salama suggests that during the Paleogene and Neogene Periods (66 million to 2.588 million years ago) a series of separate closed continental basins each occupied one of the major parts of the Sudanese Rift System: Mellut rift , White Nile rift , Blue Nile rift , Atbara rift and Sag El Naam rift . The Mellut Basin is nearly 12 kilometers (7.5 mi) deep at its central part. This rift is possibly still active, with reported tectonic activity in its northern and southern boundaries. The Sudd swamp which forms the central part of the basin may still be subsiding. The White Nile Rift system, although shallower than the Bahr el Arab rift , is about 9 kilometers (5.6 mi) deep. Geophysical exploration of the Blue Nile Rift System estimated the depth of the sediments to be 5–9 kilometers (3.1–5.6 mi) . These basins were not interconnected until their subsidence ceased, and the rate of sediment deposition was enough to fill and connect them. The Egyptian Nile connected to the Sudanese Nile, which captures the Ethiopian and Equatorial headwaters during the current stages of tectonic activity in the Eastern, Central and Sudanese Rift systems. The connection of the different Niles occurred during cyclic wet periods. The Atbarah overflowed its closed basin during the wet periods that occurred about 100,000 to 120,000 years ago. The Blue Nile connected to the main Nile during the 70,000–80,000 years B.P. wet period. The White Nile system in Bahr El Arab and White Nile Rifts remained a closed lake until the connection of the Victoria Nile to the main system some 12,500 years ago during the African humid period .The Greek historian Herodotus wrote that "Egypt was the gift of the Nile". An unending source of sustenance, it played a crucial role in the development of Egyptian civilization. Because the river overflowed its banks annually and deposited new layers of silt, the surrounding land was very fertile. The Ancient Egyptians cultivated and traded wheat , flax , papyrus and other crops around the Nile. Wheat was a crucial crop in the famine-plagued Middle East . This trading system secured Egypt's diplomatic relationships with other countries and contributed to economic stability. Far-reaching trade has been carried on along the Nile since ancient times. [ citation needed ] A tune, Hymn to the Nile , was created and sung by the ancient Egyptian peoples about the flooding of the Nile River and all of the miracles it brought to Ancient Egyptian civilization. Water buffalo were introduced from Asia, and the Assyrians introduced camels in the 7th century BCE. These animals were raised for meat and were domesticated and used for ploughing—or in the camels' case, carriage. Water was vital to both people and livestock. The Nile was also a convenient and efficient means of transportation for people and goods. The Nile was also an important part of ancient Egyptian spiritual life. Hapi was the god of the annual floods, and both he and the pharaoh were thought to control the flooding. The Nile was considered to be a causeway from life to death and the afterlife. The east was thought of as a place of birth and growth, and the west was considered the place of death, as the god Ra , the Sun, underwent birth, death, and resurrection each day as he crossed the sky. Thus, all tombs were west of the Nile, because the Egyptians believed that in order to enter the afterlife, they had to be buried on the side that symbolized death. [ citation needed ] As the Nile was such an important factor in Egyptian life, the ancient calendar was even based on the three cycles of the Nile. These seasons, each consisting of four months of thirty days each, were called Akhet , Peret , and Shemu . Akhet, which means inundation, was the time of the year when the Nile flooded, leaving several layers of fertile soil behind, aiding in agricultural growth. Peret was the growing season, and Shemu, the last season, was the harvest season when there were no rains. Owing to their failure to penetrate the Sudd wetlands of South Sudan, the upper reaches of the White Nile remained largely unknown to the ancient Greeks and Romans. Vitruvius thought that source of the Nile was in Mauritania, on the "other" (south) side of the Atlas Mountains . Various expeditions failed to determine the river's source. Agatharchides records that in the time of Ptolemy II Philadelphus , a military expedition had penetrated far enough along the course of the Blue Nile to determine that the summer floods were caused by heavy seasonal rainstorms in the Ethiopian Highlands, but no European of antiquity is known to have reached Lake Tana. The Tabula Rogeriana depicted the source as three lakes in 1154. Europeans began to learn about the origins of the Nile in the 14th century when the Pope sent monks as emissaries to Mongolia who passed India, the Middle East and Africa, and described being told of the source of the Nile in Abyssinia (Ethiopia). Later in the 15th and 16th centuries, travelers to Ethiopia visited Lake Tana and the source of the Blue Nile in the mountains south of the lake. Supposedly, Paolo Trevisani (circa 1452–1483), a Venetian traveller in Ethiopia, wrote a journal of his travels to the origin of the Nile that has since been lost. Although James Bruce claimed to be the first European to have visited the headwaters, modern writers give the credit to the Jesuit Pedro Páez . Páez's account of the source of the Nile is a long and vivid account of Ethiopia. It was published in full only in the early 20th century, although it was featured in works of Páez's contemporaries, including Baltazar Téllez, Athanasius Kircher and Johann Michael Vansleb . Europeans had been resident in Ethiopia since the late 15th century, and one of them may have visited the headwaters even earlier without leaving a written trace. The Portuguese João Bermudes published the first description of the Tis Issat Falls in his 1565 memoirs, compared them to the Nile Falls alluded to in Cicero 's De Republica . Jerónimo Lobo describes the source of the Blue Nile, visiting shortly after Pedro Páez. Telles also uses his account. The White Nile was even less understood. The ancients mistakenly believed that the Niger River represented the upper reaches of the White Nile. For example, Pliny the Elder writes that the Nile had its origins "in a mountain of lower Mauretania ", flowed above ground for "many days" distance, then went underground, reappeared as a large lake in the territories of the Masaesyli , then sank again below the desert to flow underground "for a distance of 20 days' journey till it reaches the nearest Ethiopians." Modern exploration of the Nile basin began with the conquest of the northern and central Sudan by the Ottoman viceroy of Egypt, Muhammad Ali , and his sons from 1821 onward. As a result of this, the Blue Nile was known as far as its exit from the Ethiopian foothills and the White Nile as far as the mouth of the Sobat River. Three expeditions under a Turkish officer, Selim Bimbashi, were made between 1839 and 1842, and two got to the point about 30 kilometres (20 miles) beyond the present port of Juba , where the country rises and rapids make navigation very difficult. Lake Victoria was first sighted by Europeans in 1858 when British explorer John Hanning Speke reached its southern shore while traveling with Richard Francis Burton to explore central Africa and locate the great lakes. Believing he had found the source of the Nile on seeing this "vast expanse of open water" for the first time, Speke named the lake after Queen Victoria . Burton, recovering from illness and resting further south on the shores of Lake Tanganyika , was outraged that Speke claimed to have proven his discovery to be the true source of the Nile when Burton regarded this as still unsettled. A quarrel ensued which sparked intense debate within the scientific community and interest by other explorers keen to either confirm or refute Speke's discovery. British explorer and missionary David Livingstone pushed too far west and entered the Congo River system instead. It was ultimately Welsh-American explorer Henry Morton Stanley who confirmed Speke's discovery, circumnavigating Lake Victoria and reporting the great outflow at Ripon Falls on the lake's northern shore.The Nile has long been used to transport goods along its length. Winter winds blow south, up river, so ships could sail up river using sails and down river using the flow of the river. While most Egyptians still live in the Nile valley, the 1970 completion of the Aswan Dam ended the summer floods and their renewal of the fertile soil, fundamentally changing farming practices. The Nile supports much of the population living along its banks, enabling Egyptians to live in otherwise inhospitable regions of the Sahara. The river's flow is disturbed at several points by the Cataracts of the Nile which form an obstacle to navigation by boats. The Sudd also forms a formidable navigation obstacle and impedes water flow, to the extent that Sudan had once attempted to build the Jonglei Canal to bypass the swamp. Nile cities include Khartoum, Aswan, Luxor (Thebes), and the Giza – Cairo conurbation . The first cataract, the closest to the mouth of the river, is at Aswan, north of the Aswan Dam. This part of the river is a regular tourist route, with cruise ships and traditional wooden sailing boats known as feluccas . Many cruise ships ply the route between Luxor and Aswan, stopping at Edfu and Kom Ombo along the way. Security concerns have limited cruising on the northernmost portion for many years. A computer simulation study to plan the economic development of the Nile was directed by H.A.W. Morrice and W.N. Allan, for the Ministry of Hydro-power of Sudan, during 1955–57 Morrice was their hydrological adviser, and Allan his predecessor. The calculations were enabled by accurate monthly inflow data collected for 50 years. The underlying principle was the use of over-year storage, to conserve water from rainy years for use in dry years. Irrigation, navigation and other needs were considered. Each computer run postulated a set of reservoirs and operating equations for the release of water as a function of the month and the levels upstream. The behavior that would have resulted given the inflow data was modeled. Over 600 models were run. Recommendations were made to the Sudanese authorities. The calculations were run on an IBM 650 computer. Simulation studies to design water resources are discussed further in the article on hydrology transport models , which have been used since the 1980s to analyze water quality. Despite the development of many reservoirs, drought during the 1980s led to widespread starvation in Ethiopia and Sudan, but Egypt was nourished by water impounded in Lake Nasser. Drought has proven to be a major cause of fatality in the Nile river basin. According to a report by the Strategic Foresight Group around 170 million people have been affected by droughts in the last century with half a million lives lost. From the 70 incidents of drought which took place between 1900 and 2012, 55 incidents took place in Ethiopia, Sudan, South Sudan, Kenya and Tanzania. The Nile's water has affected the politics of East Africa and the Horn of Africa for many decades. The dispute between Egypt and Ethiopia over the $4.5 billion Grand Ethiopian Renaissance Dam has become a national preoccupation in both countries, stoking patriotism, deep-seated fears and even murmurs of war. Countries including Uganda, Sudan, Ethiopia and Kenya have complained about Egyptian domination of its water resources. The Nile Basin Initiative promotes a peaceful cooperation among those states. Several attempts have been made to establish agreements between the countries sharing the Nile waters. On 14 May 2010 at Entebbe , Uganda, Ethiopia, Rwanda, and Tanzania signed a new agreement on sharing the Nile water even though this agreement raised strong opposition from Egypt and Sudan. Ideally, such international agreements should promote equitable and efficient usage of the Nile basin's water resources. Without a better understanding about the availability of the future water resources of the Nile, it is possible that conflicts could arise between these countries relying on the Nile for their water supply, economic and social developments. In 1951, American John Goddard together with two French explorers became the first to successfully navigate the entire Nile from its source in Burundi at the potential headsprings of the Kagera River in Burundi to its mouth on the Mediterranean Sea, a journey of approximately 6,800 km (4,200 mi) . Their 9-month journey is described in the book Kayaks down the Nile . The White Nile Expedition, led by South African national Hendrik Coetzee , navigated the White Nile's entire length of approximately 3,700 kilometres (2,300 mi) . The expedition began at the White Nile's beginning at Lake Victoria in Uganda, on 17 January 2004 and arrived at the Mediterranean in Rosetta, four and a half months later. The Blue Nile Expedition, led by geologist Pasquale Scaturro and his partner, kayaker and documentary filmmaker Gordon Brown became the first known people to descend the entire Blue Nile, from Lake Tana in Ethiopia to the beaches of Alexandria on the Mediterranean. Their approximately 5,230-kilometre (3,250 mi) journey took 114 days, from 25 December 2003 to 28 April 2004. Though their expedition included others, Brown and Scaturro were the only ones to complete the entire journey. Although they descended whitewater manually, the team used outboard motors for much of their journey. On 29 January 2005, Canadian Les Jickling and New Zealander Mark Tanner completed the first human-powered transit of Ethiopia's Blue Nile. Their journey of over 5,000 kilometres (3,100 mi) took five months. They recount that they paddled through two war zones, regions notorious for bandits, and were arrested at gunpoint. In 1951, American John Goddard together with two French explorers became the first to successfully navigate the entire Nile from its source in Burundi at the potential headsprings of the Kagera River in Burundi to its mouth on the Mediterranean Sea, a journey of approximately 6,800 km (4,200 mi) . Their 9-month journey is described in the book Kayaks down the Nile . The White Nile Expedition, led by South African national Hendrik Coetzee , navigated the White Nile's entire length of approximately 3,700 kilometres (2,300 mi) . The expedition began at the White Nile's beginning at Lake Victoria in Uganda, on 17 January 2004 and arrived at the Mediterranean in Rosetta, four and a half months later. The Blue Nile Expedition, led by geologist Pasquale Scaturro and his partner, kayaker and documentary filmmaker Gordon Brown became the first known people to descend the entire Blue Nile, from Lake Tana in Ethiopia to the beaches of Alexandria on the Mediterranean. Their approximately 5,230-kilometre (3,250 mi) journey took 114 days, from 25 December 2003 to 28 April 2004. Though their expedition included others, Brown and Scaturro were the only ones to complete the entire journey. Although they descended whitewater manually, the team used outboard motors for much of their journey. On 29 January 2005, Canadian Les Jickling and New Zealander Mark Tanner completed the first human-powered transit of Ethiopia's Blue Nile. Their journey of over 5,000 kilometres (3,100 mi) took five months. They recount that they paddled through two war zones, regions notorious for bandits, and were arrested at gunpoint. [ clarification needed ] The following bridges cross the Blue Nile and connect Khartoum to Khartoum North: The following bridges cross the White Nile and connect Khartoum to Omdurman: The following bridges cross from Omdurman: to Khartoum North: The following bridges cross to Tuti from Khartoum state's three cities Other bridges[ clarification needed ] The following bridges cross the Blue Nile and connect Khartoum to Khartoum North: The following bridges cross the White Nile and connect Khartoum to Omdurman: The following bridges cross from Omdurman: to Khartoum North: The following bridges cross to Tuti from Khartoum state's three cities Other bridges

Wiki

West Nile

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Ugandan Bush War

NRM victory Ugandan government Tanzania (until 1985) North Korea (1981–1985) Supported by: Commonwealth of Nations National Resistance Movement (NRM) West Nile rebels: UFM (1980–83) FEDEMU (1983–85) ULM UNLF-AD Supported by: Libya Soviet Union Cuba China Saudi Arabia (West Nile Rebels only) Mozambique (alleged) Tanzania (from 1985) National Resistance Army : Yoweri Museveni Salim Saleh Sam Magara †Steven Kashaka Joram Mugume Pecos Kuteesa Fred Rwigyema Yusuf Lule West Nile rebels : Moses Ali Amin Onzi Felix Onama Isaac Lumago Elly Hassan Ugandan military Uganda National Liberation Army Conciliated rebel groups Pro-government militias People's Militia National Youth Army Tribal militias UPC youth paramilitaries Uganda Army: c. 7,100 (1980) The Ugandan Bush War was a civil war fought in Uganda by the official Ugandan government and its armed wing, the Uganda National Liberation Army (UNLA), against a number of rebel groups, most importantly the National Resistance Army (NRA), from 1980 to 1986. The unpopular President Milton Obote was overthrown in a coup d'état in 1971 by General Idi Amin , who established a military dictatorship . Amin was overthrown in 1979 following the Uganda-Tanzania War , but his loyalists started the Bush War by launching an insurgency in the West Nile region in 1980. Subsequent elections saw Obote return to power in a UNLA-ruled government. Several opposition groups claimed the elections were rigged , and united as the NRA under the leadership of Yoweri Museveni to start an armed uprising against Obote's government on 6 February 1981. Obote was overthrown and replaced as president by his general Tito Okello in 1985 during the closing months of the conflict. Okello formed a coalition government consisting of his followers and several armed opposition groups, which agreed to a peace deal. In contrast, the NRA refused to compromise with the government, and conquered much of western and southern Uganda in a number of offensives from August to December 1985. The NRA captured Kampala , Uganda's capital, in January 1986. It subsequently established a new government with Museveni as president, while the UNLA fully disintegrated in March 1986. Obote and Okello went into exile. Despite the nominal end of the civil war, numerous anti-NRA rebel factions and militias remained active, and would continue to fight Museveni's government in the next decades.The Ugandan Bush War is also known by a variety of other names. For instance, Ugandan Civil War has also been used, though this title as also been employed for other military conflicts such as the Lord's Resistance Army insurgency . As a result of the eventual victory of the NRM, several alternate titles for the 1980–1986 conflict reference the rebel group and its main theater of operations, the Luwero Triangle : These include Luwero War , National Resistance Movement revolution , or Resistance War . In 1971, the President of Uganda Milton Obote was overthrown in a coup d'état by parts of the Uganda Army which put Idi Amin in power. Obote had been president since Uganda's independence from the United Kingdom in 1962, and his regime saw a general decline in living standards in the country, with growing corruption, factional violence, and persecution of ethnic groups. Obote's increasing unpopularity led him to believe rivals were beginning to plot against him, particularly Amin and arranged a purge to occur while he was outside of the country. As Amin was popular in sections of the military, his loyalists responded by acting first and overthrowing the government, forcing Obote into exile in Tanzania . Despite initial popularity, Amin quickly turned to despotism and established a military dictatorship which accelerated the decline of Obote's regime, destroying the country's economy and political system. As time went on, Amin's regime was increasingly destabilized by factionalism and economic decline, while opposition groups as well as dissatisfied elements of the Uganda Army repeatedly attempted to organize uprisings or to overthrow his regime by other means. Several opposition factions, including Obote's loyalists, were supported by Tanzania under President Julius Nyerere . In 1978, parts of the Uganda Army launched an invasion of Tanzania under unclear circumstances, resulting in open war with the neighboring country. Tanzania halted the assault, mobilised anti-Amin opposition groups, and launched a counter-offensive. Amin's forces and his Libyan allies were defeated by Tanzanian troops and the Uganda National Liberation Front (UNLF), a political coalition formed by exiled anti-Amin Ugandans under the leadership of Obote, whose armed wing was known as Uganda National Liberation Army (UNLA). Amin was overthrown during the fall of Kampala and then fled the country, and UNLF was installed by Tanzania to replace him. The unstable UNLF government ruled the country provisionally from April 1979 until December 1980. Meanwhile, the ousted Amin loyalists who had fled into Zaire and Sudan reorganised, and prepared to renew war in order to regain control of Uganda. Obote planned to regain power, even though he remained widely unpopular in Uganda. War correspondent Al J Venter stated that in case of Obote's return to the presidency "Uganda will be assured of another war, many times as intense as the current struggle [i.e. the Uganda–Tanzania War]. Only, the next one will be a guerrilla conflict". Meanwhile, Uganda's northeast was destabilized by large-scale banditry and communal violence. Karamojong groups, Uganda Army remnants, and foreign raiders [lower-alpha 1] used the political instability to raid cattle and other foodstock. These events caused a famine in Karamojong Province which killed 50,000 out of the 360,000 inhabintants of the northeastern highlands. The first group to initiate hostilities were the Amin loyalists who launched a rebellion against the UNLF government in the autumn of 1980. Their 7,100-strong force never adopted an official name, but is generally called "Uganda Army" as it consisted for the most part of old troops of Amin's Uganda Army (it was also known as "West Front" or "Western Nile Front"). The rebels were not truly unified but split into several bands [lower-alpha 2] that were loyal to numerous officers who had previously served under Amin such as Emilio Mondo , Isaac Lumago , Isaac Maliyamungu , Elly Hassan , Christopher Mawadri , and Moses Ali . Amin arranged for the group to receive money from Saudi Arabia in preparation for a large-scale attack across the border against the West Nile sub-region . On 6 October, one week before the offensive was to commence, about 500 rebels crossed the border and attacked the town of Koboko . The 200-strong UNLA garrison was on parade at the time and was unarmed; the rebels massacred the soldiers. Word of the attack spread to other UNLA garrisons in West Nile, who quickly fled to the Nile River, leaving the Uganda Army's advance unopposed. They were welcomed by the local population, which had tense relations with the UNLA. As the rebels knew that they could not hold the captured territory against a full UNLA counter-offensive, they mostly retreated back into Sudan after a few days with a large amount of loot. The UNLA began its counterattack on 12 October accompanied by Tanzanian forces. The only significant resistance they encountered was in Bondo , where six Tanzanians were killed. The UNLA forces, considering the local population hostile, engaged in a campaign of destruction and looting across the West Nile, as Tanzanian officers tried in vain to restrain them. They leveled the town of Arua , killed over 1,000 civilians, and provoked the flight of over 250,000 refugees to Sudan and Zaire. The brutality of the UNLA inspired further unrest, as peasants and ex-soldiers took up arms to defend their lands from the government forces. The Uganda Army launched its next offensive just before the Ugandan national elections in December 1980 . In one of their most daring actions, the rebels ambushed Obote as he was touring the West Nile region. They almost killed him and Tito Okello , a high-ranking UNLA commander. This time, the Uganda Army also held the areas it captured in West Nile, and set up a parallel government after retaking Koboko. After about one month of combat, the insurgents had captured most of West Nile, leaving only some towns under UNLA control. However, many rebels focused more on looting the area and taking the plunder back to Zaire and Sudan than on fighting the UNLA. The West Nile rebellion was weakened by internal divisions as parts of the Uganda Army remained loyal to Idi Amin, whereas others wanted to distance themselves from the unpopular old dictator. [lower-alpha 3] The latter part of the insurgent army split off, forming the " Uganda National Rescue Front " (UNRF) under Moses Ali, whereas the remaining Amin loyalists were still called the "Ugandan Army" until becoming known as "Former Uganda National Army" (FUNA). The West Nile rebels soon started to fight each other. Furthermore, southwestern Uganda experienced a resurgence of the Rwenzururu movement which wanted self-determination for the Konjo and Amba peoples . The movement had been largely dormant since the 1960s, but managed to take control of weapon stockpiles that had been left unguarded when Amin's government collapsed in 1979. They thus resumed their insurgency, and the security situation in the mountainous border areas of the southwest quickly deteriorated in 1980. Meanwhile, the UNLF government experienced its own divisions. As the UNLA was being transformed from a loose alliance of various anti-Amin insurgent groups into a regular army, the different political factions attempted to ensure that their own loyalists would be present and dominant in the new military. Obote outmaneuvered his rivals, most importantly Yoweri Museveni , and made his 5,000-strong Kikosi Maalum group the core of the UNLA. In contrast, just 4,000 out of Museveni's 9,000 FRONASA fighters were allowed to join the new army, and these were distributed across several units. Furthermore, FRONASA was forced to give up its own weaponry. At the same time, the UNLA was rapidly expanded; most of the new recruits came from ethnic groups that supported Obote. As result, power shifted to pro-Obote elements in the government and the army. The elections of December 1980 were officially won by Milton Obote's Uganda People's Congress , effectively making him president of Uganda again. [lower-alpha 4] However, the results were strongly disputed by other candidates, resulting in increasing strife. Several political factions claimed electoral fraud , and believed themselves to be proven correct when Obote immediately launched a campaign of political repression. As the UNLA was dominated by pro-Obote forces, a coup was impossible, so the opposition instead launched armed rebellions against Obote's government: Museveni's followers created the Popular Resistance Army (PRA), Yusuf Lule formed the Uganda Freedom Fighters (UFF), Andrew Kayiira armed his Uganda Freedom Movement (UFM), and the Communist " Gang of Four " organized an armed group known as the Uganda National Liberation Front – Anti-Dictatorship (UNLF-AD). On 6 February 1981, hostilities began in the south with a PRA attack on the Kabamba Military Barracks in the central Mubende District . The attack aimed at capturing weaponry; although the operation failed to capture the armoury, Museveni's group of fighters managed to take a few guns and several vehicles before retreating. The PRA had more success during a series of attacks on police stations during the next days. Regardless, the small rebel group also came under pressure from UNLA and TPDF counter-insurgency operations, and still lacked a proper base. Museveni was familiar with guerrilla warfare , having fought with the Mozambican Liberation Front in Mozambique. He also had commanded his own Front for National Salvation to fight the Amin regime and had continued to campaign in rural areas hostile to Obote's government, especially central and western Buganda and in the western regions of Ankole and Bunyoro . As a result, he employed the tactics of a people's war to keep his small force active. In this regard, the PRA succeeded, as it won over many locals in the area around Kampala who considered Obote's government a regime which solely served the northerners. Without extensive support by sympathetic civilians during their early insurgency, Museveni's troops would have been easily crushed in 1981. The PRA also enjoyed very limited foreign support. Some believed that Museveni was aided by his old Mozambican allies, resulting in tensions between Obote's government and Mozambique. Most attacks by Museveni's force involved small mobile units called "coys" under the command of Fred Rwigyema , and Museveni's brother, Salim Saleh , with "A" Coy led by Steven Kashaka, "B" Coy by Joram Mugume , and "C" Coy by Pecos Kuteesa. There were three small zonal forces: the Lutta Unit operating in Kapeeka , the Kabalega Unit operating near Kiwoko , and the Nkrumah Unit operating in the areas of Ssingo. Many of the early members of the PRA like Rwigyema and Paul Kagame were actually Rwandan refugees living in Uganda. They later organized the Rwandan Patriotic Front . In contrast to Museveni's forces and the West Nile rebels, Andrew Kayira's UFM mostly consisted of relatively well-trained ex-soldiers and was focused on high-profile urban operations. The group hoped to destabilize Obote's government through direct attacks, a strategy which "doomed it to fail from the beginning" according to historians Tom Cooper and Adrien Fontanellaz. The UFM was not strong enough to challenge the UNLA head-on, suffered from leadership rivalries, lacked a firm organization, and was prone to being infiltrated by pro-government spies. As the war escalated, foreign support became vital for the survival of Obote's government. The Tanzanians initially helped to defend his regime and kept some order through the presence of about 10,000 Tanzania People's Defence Force soldiers and 1,000 policemen. Nevertheless, the unsustainable costs of these troops led Tanzanian President Julius Nyerere to gradually withdraw most of his forces from Uganda. By June 1981, just 800 to 1,000 Tanzanian advisors remained in the country. These advisors remained of crucial importance for the UNLA, but the Tanzanian withdrawal greatly weakened Obote's position. To compensate, he tried to enlist further foreign aid: He hired a British private military company , and convinced the Commonwealth of Nations as well as the United States to send small teams of security advisors. One of Obote's most important allies was North Korea . The Ugandan President visited the country in late 1981 and signed a cooperation agreement which included military support for his regime. At least 30 North Korean officers were subsequently sent to Gulu in northern Uganda, where they trained UNLA soldiers and repaired military equipment. By 1984, the number had risen to about 50 North Koreans who acted as security, intelligence, and military advisors. Museveni claimed that over 700 North Koreans were ultimately used by the UNLA; Obote maintained that only about 170 were present in Uganda. According to one study, the North Korean officers actively participated in and even led counter-insurgency operations for Obote. A Central Intelligence Agency report stated, however, that the North Koreans refused to actually venture to the frontlines. The Ugandan military also sent some officers and non-commissioned officer to North Korea for advanced trainings. Obote's government also organized various paramilitary groups to assist the UNLA. The "People's Militia" consisted of Langi , Acholi and Teso tribesmen, and was mostly loyal to UNLA chief of staff David Oyite-Ojok . It became increasingly powerful, and garnered a reputation as a fierce and brutal force. In addition, there was the "National Youth Army" (NYA), various tribal militias, and the UPC youth paramilitaries. Meanwhile, the conflict in the south became more serious. Another rebel group emerged, the so-called "Uganda Liberation Movement" which threatened to kidnap and kill United Nations personnel, as the latter was supporting Obote's attempts at restabilizing Uganda. The threats worked, and the U.N. stopped its training programme for the Ugandan police. The PRA also continued its hit-and-run operations with mixed successes: It overran a UNLA outpost at Kakiri on 5 April 1981, and captured important weaponry, but had to hastily retreat when a TPDF unit responded to the attack. The Tanzanian forces consequently conducted a counter-insurgency sweep, catching a PRA column under Elly Tumwine off-guard and recapturing some of the captured guns. Despite this, the PRA successfully recruited more volunteers, growing to about 200 fighters by early May. In the next month, Museveni travelled to Nairobi where he met with Lule; the two agreed to unite the PRA and UFF into a unified opposition group. The umbrella organization was dubbed the " National Resistance Movement " (NRM) and its armed wing was termed the " National Resistance Army " (NRA). Lule was appointed overall NRM Chairman, while Museveni became vice-chairman of the National Resistance Council and Chairman of the High Command of the NRA. The merger profited both sides: The UFF was extremely weak, and Lule finally gained an actual armed following, while Museveni was provided with important legitimacy, as Lule remained much respected among Uganda's southern population. This was especially important because a strategically important region near Kampala, known as Luwero Triangle , was mostly inhabited by Baganda . So far, the PRA had mostly consisted of non-Baganda, but Lule provided the newly formed NRA with backing from the Baganda, allowing Museveni to expand his envisioned "people's war". The Luwero Triangle consequently became the NRA's main operations area, although the group's center of recruitment remained Ankole in the west. Soon after the merger, Museveni implemented a strict code of conduct for fighters, allowing the NRA to remain highly disciplined and focused despite gradually growing in numbers and absorbing other insurgent factions such as the remnants of the "Gang of Four". By December 1981, the NRA had grown to about 900 militants. Libya's leader Muammar Gaddafi also opted to provide support to the NRA, although it was made up of forces which had overthrown his old ally Amin. Gaddafi believed that Libya could gain greater influence in central Africa through the NRA than it had previously with Amin. The Libyan support remained very limited, however, with about 800 rifles, a few machine guns and land mines being provided to the NRA in August 1981. Gaddafi demanded that the NRA merge with the UFM and UNRF to receive more substantial support, but the rebels remained rivals and refused to unite. Libya consequently cancelled its support to the NRA in 1982. While the rebellion in the south grew in intensity, most of the West Nile region remained under rebel control. A local administration began to emerge, and the remaining UNLA garrisons had great difficulties in holding out. The insurgents proved better trained and more effective fighters, and often captured supply convoys coming from the south. In addition, the UNLA garrisons suffered from indiscipline and internal rivalries, sometimes clashing in their barracks. Despite these advantages, the West Nile rebellion was crippled by infighting, high corruption, and lack of actual strategy among the rebel leadership. As the UNRF and FUNA fought each other, the former gained the upper hand and mostly evicted FUNA from West Nile by July 1981. FUNA commander Elly Hassan fled to Sudan, where he was eventually arrested by local authorities. Regardless, the inter-rebel struggle only resulted in the overall weakening of the West Nile insurgents. By 1981, four different insurgent factions were active in northwestern Uganda, all of which claimed to have no direct links with Amin. One West Nile rebel group, the so-called "Nile Regiment" (NR) was set up by Felix Onama , a former follower of Obote. As result of its inability to reduce corruption or provide true stability, the UNRF gradually lost the support of local civilians. The Ugandan government exploited the divisions and chaos among the rebels by launching counter-attacks into Western Nile from 1981, where its regular military and "People's Militia" committed numerous atrocities. By December 1981, the UNLA had retaken much of West Nile while encountering little resistance. Thousands of civilians fled to Sudan in response to the UNLA offensive. However, the UNLA failed to permanently dislodge the West Nile insurgents. In contrast, Obote opted for a more conciliatory approach with the Rwenzururu movement. Following negotiations, the Ugandan government signed a peace agreement with the rebel group's leadership in return for payments and other benefits to the latter. Furthermore, Obote granted the Rwenzururu region some limited autonomy. By late 1981, the UNLA was already in a critical situation. Its rapid expansion to over 15,000 troops by December 1981 resulted in a majority of its troops being untrained, badly armed and often unpaid. Corruption became rampant, and great differences emerged between UNLA units. Some, like those that were active in northern Uganda, were given preferential treatment and became relatively reliable. In contrast, the Central Brigade which mostly fought the NRA mostly consisted of barely-trained militiamen. These troops were considered to be "cannon-fodder" by their own commanders. The counter-insurgency operations against the West Nile rebels were thus much more successful than those against the NRA. Overall, the UNLA already showed signs of great strain at this point, and would have probably collapsed without Tanzanian support by the end of 1981. Regardless, UNLA continued to hold the rebels at bay and even scored several major victories. On 23 February 1982, UNLA fended off a large-scale raid by UFM on Kampala, and then managed to inflict high casualties on the routed insurgents. The UFM attempted to reorganize, but retreated into NRA-held areas. It hoped to convince some of Museveni's followers to defect. Instead, a UFM commander defected with a significant stock of weaponry to the NRA, further weakening the UFM. Fighting in the West Nile region occasionally spilled over into Sudan as UNLA troops pursued rebels over the border. This first occurred in April 1982, when UNLA troops crossed the frontier near Nimule and opened fire on a Sudanese Army unit; the Sudanese troops subsequently detained about 20 Ugandan soldiers. In contrast to other belligerents in the area, the Sudanese Army garrisons in south-eastern Sudan were generally well-disciplined and refrained from attacking civilians. By November 1982, the National Resistance Army, Uganda Freedom Movement, Uganda National Rescue Front, and the Nile Regiment had formed an alliance, called the "Uganda Popular Front" (UPF). Exiled politician Godfrey Binaisa was appointed head of the UPF. While being based in London , Binaisa decided to organize an invasion from Zaire to topple Obote. He attempted to enlist the aid of white mercenaries for this plot, but his plans fell through and were revealed when he was unable to pay for the operation. The entire plot discredited Binaisa. In December 1982, John Charles Ogole was appointed new commander of the UNLA's 11th Battalion in Arua. Ogole reorganized his troops, strengthened morale and discipline, and then launched another counter-insurgency campaign against the West Nile rebels. Ogole's tactics proved highly successful, and ousted most insurgents from the West Nile Region within months. Rebel leader Barnabas Kili was also captured. However, the operation also included widespread destruction and massacres at the hands of the UNLA, whereupon 260,000 people fled the area for Zaire and Sudan. This in turn destroyed the "insurgent infrastructure" of UNRF and FUNA, further weakening them. The UNRF was left mostly destroyed following Ogole's offensive, and relocated from West Nile. The group moved its bases in southern Sudan to northern Uganda, where it attempted to rally the Karamojong people to its cause. In the south, the UNLA under chief of staff Oyite-Ojok waged a counter-insurgency campaign against the NRA in the Luwero Triangle which resulted in the "genocidal killings" of thousands of Baganda civilians. Many government troops deployed in the Luwero Triangle belonged to the Acholi people who became widely hated by the southerners. On 16 June 1983, the Obote government launched Operation Bonanza , an extensive military expedition utilizing up to half of the UNLA forces, that alone claimed tens of thousands of lives and displaced a significant portion of the population. The operation was intended to be, as Amaza writes, a "typical encirclement and suppression campaign". The blame for the massacres was placed on the people of northern Uganda for supporting the actions of the NRA, which increased the existing regional tensions in the country. [ citation needed ] The UNLA also defeated the UFM in 1983, destroying its main camps during a coordinated counter-insurgency operation. The UFM suffered another setback when its exiled leadership was scattered during a crackdown in Kenya in July 1983; its leader Kirya was repatriated to Uganda and imprisoned. The group never recovered. Remnants of the UFM, possibly a few hundred militants strong, subsequently formed the Federal Democratic Movement of Uganda (FEDEMU). Up to late 1983, Obote's government had remained relatively stable and in control of most of Uganda thanks to the efforts of chief of staff David Oyite-Ojok. Though it could not defeat the NRA, the military was able to contain it. Despite this, Obote's forces suffered from tribalism, corruption, and internal rivalries. The UNLA and its allied militias had been expanded too quickly in an attempt to defeat the insurgency: By 1984, Obote had 35,000 to 40,000 men under arms, but just 15,000 had received basic training. As a result, the soldiers were undisciplined, unreliable, and prone to harass, steal from, and murder civilians due to a lack of proper pay and supplies. Although the Ugandan government knew that it could not even feed its large army, let alone properly train or arm it, Obote was unwilling to demobilize troops out of fear that the soldiers could behave even worse if they were no longer employed. Despite its massive military and militia support, the government was also unable to fully suppress violence in the northeast, where Karamojong raiders continued to operate. Obote's forces were at least able to contain the Karamojong cattle raiding, keeping the raiders out of other regions. The situation began to change with Oyite-Ojok's death under suspicious circumstances in a plane crash in December 1983. At first, people believed that the chief of staff had been killed by rebels who consequently assumed responsibility. Oyite-Ojok's loyal troops, most importantly the People's Militia and National Youth Army responded by carrying out revenge killings against suspected rebel supporters. After one week, however, rumours spread among the military according to which Obote had arranged the death of his chief of staff due to developing rifts between them. Although Obote's responsibility could not be proven, the rumours damaged Obote's reputation among the military. The CIA determined that Oyite-Ojok had been crucial for keeping the Ugandan government afloat, and had been responsible for "maintaining some semblance of security and order" in the country. With him gone, the UNLA began to unravel. An increasing number of Acholi soldiers believed that Obote was using them as cannon-fodder, while filling the country's leadership with Langi. At the same time, the NRA became more successful at spreading its propaganda, and attracting dissatisfied Acholi army officers to their cause. Foreign support for Obote had also diminished. Besides the still significant North Korean aid, just 50 Tanzanian, 12 British and six U.S. advisors remained in the country. However, the government initially remained relatively successful in battling the rebels. With Oyite-Ojok dead, Obote appointed Ogole new head of the anti-NRA operations in the Luwero Triangle. Ogole improved his troops' training and included other security as well as civil agencies in his anti-rebel strategy. In a series of operations, he managed to mostly oust the NRA from the region, forcing it to retreat west into the Rwenzori Mountains and Zaire. In addition, the Ugandan government decided "to teach the Karamojong a lesson" after raiders had taken advantage of Oyite-Ojok's death to attack his farm and kill over 100 militiamen in the northeast. In cooperation with the Kenyan government, UNLA and allied militias launched a campaign which largely destroyed or seized the Karamojong's food sources in the form of cattle and fields. This left the nomads almost totally dependent on international aid agencies like the World Food Programme and UNICEF for survival. However, the unrest in the UNLA eventually escalated when Acholi troops mutinied in Jinja and other locations in June 1985. Rifts subsequently erupted in the government and some political groups such as the Democratic Party attempted to exploit the chaos by gaining control over the military. The news also reached Gulu , where Lieutenant General Bazilio Olara-Okello , an Acholi, was stationed. Fearing that a new government in Kampala might purge the Acholi, he revolted. Olara-Okello gathered a force dominated by Acholi mutineers, and won the support of ex-Amin loyalists from the West Nile and Sudan. Using these troops, he conquered Lira , and then marched on Kampala. The capital fell after a short battle in July 1985, but Obote had already fled to Tanzania. He later relocated to Kenya and finally Zambia . After the successful coup, General Tito Okello was installed as president; this marked the first time in Uganda's history when Acholi had achieved state power. The coup had catastrophic consequences for the UNLA. The new Acholi leadership promptly began to use their new power to disempower and exploit other ethnic groups including Langi, resulting in the collapse of discipline and order among many military units. From then on, the UNLA gradually devolved into "marauding bands" and declined in numbers to about 15,000 troops by late 1985. Some commanders such as Ogole fled into exile. On 23 August, the 196 North Korean military advisers to the UNLA were flown out of Uganda. Regardless, Okello's government was successful in opening negotiations with several rebel groups, arguing that Obote – their common enemy – had been overthrown. The government reached an agreement with the FUNA, UNRF (I), FEDEMU, and the reactivated UFM. These rebel groups agreed to join a new National Unity government, officially integrated their militias into the government army, and their commanders became part of the ruling military council. Despite this, the ex-insurgents maintained autonomy. Kampala was carved up among the government coalition: UNLA held the center, FEDEMU the south, and FUNA the north. The situation consequently remained volatile, as the government proved fragile, while soldiers and other militants acted with impunity in the capital. Okello also attempted to bolster the UNLA by recruiting large numbers of Karamojong, even though this meant potentially arming cattle raiders. In addition, Okello's government suffered from a lack of respect among the country's elite, as most of its members were uneducated and considered ill-prepared to actually rule Uganda. In contrast to the other insurgents, the NRA refused to compromise with Okello's regime out of ideological reasons. It only agreed to peace talks in Nairobi after international pressure, but never intended to honor any ceasefire or power-sharing deal. Taking advantage of the chaos following Obote's fall, the NRA took full control of the Luwero Triangle as well as much of Uganda's west and south. It also received fresh weapons shipments from Libya and Tanzania. Museveni's group was thus in a position of strength, and used the Nairobi peace talks to stall for time. It even ostensibly agreed to a power-sharing deal. In truth, however, the NRA prepared its force for a decisive offensive. In August 1985, the NRA launched a series of coordinated attacks that resulted in the capture of significant amounts of territory in central and western Uganda. It besieged and captured the crucial garrison towns of Masaka and Mbarara, greatly weakening the UNLA. In course of these operations, the NRA greatly expanded by recruiting new troops in captured territories and absorbing defected government soldiers. In a few months, it enlisted around 9,000 fighters, growing to about 10,000 troops overall by December 1985. That month, a peace agreement was signed by Okello's government and the NRA, but the deal broke down almost immediately as both parties violated the agreed truce. By January 1986, the UNLA was starting to collapse as the rebels gained ground from the south and southwest. Okello's regime effectively ended when Kampala was captured by the NRA on 26 January 1986. Yoweri Museveni was subsequently sworn in as president on 29 January, and the NRA became the new regular army of Uganda. Tito Okello fled to Sudan. Despite this massive defeat, the UNLA attempted to rally once more, and intended to defend its remaining holdings in northern Uganda. These holdouts were led by Bazilio Olara-Okello, who ordered a mass mobilization in Gulu and Kitgum . Everyone who could hold a rifle, including women and girls, was armed and provided with an ad hoc training. Meanwhile, the NRA continued its offensive, capturing Jinja by late January, followed by Tororo in early February. At this point, the UNLA attempted one last time to stem the rebel advance. It counter-attacked at Tororo, but was repelled. The NRA proceeded to assault the fortified crossings of the Nile, encountering particularly heavy resistance by the UNLA and allied West Nile militias at Karuma and Kamdini . After bitter fighting, the NRA overcame the UNLA's defenses, inflicting "catastrophic losses" on the Acholi troops. With effective resistance no longer possible, the UNLA disintegrated and its remnants fled into exile, along with many former government officials. The NRA captured Gulu and Kitgum in March 1986, while the defeated Acholi soldiers mostly returned to their villages. The war appeared to be over. The first group to initiate hostilities were the Amin loyalists who launched a rebellion against the UNLF government in the autumn of 1980. Their 7,100-strong force never adopted an official name, but is generally called "Uganda Army" as it consisted for the most part of old troops of Amin's Uganda Army (it was also known as "West Front" or "Western Nile Front"). The rebels were not truly unified but split into several bands [lower-alpha 2] that were loyal to numerous officers who had previously served under Amin such as Emilio Mondo , Isaac Lumago , Isaac Maliyamungu , Elly Hassan , Christopher Mawadri , and Moses Ali . Amin arranged for the group to receive money from Saudi Arabia in preparation for a large-scale attack across the border against the West Nile sub-region . On 6 October, one week before the offensive was to commence, about 500 rebels crossed the border and attacked the town of Koboko . The 200-strong UNLA garrison was on parade at the time and was unarmed; the rebels massacred the soldiers. Word of the attack spread to other UNLA garrisons in West Nile, who quickly fled to the Nile River, leaving the Uganda Army's advance unopposed. They were welcomed by the local population, which had tense relations with the UNLA. As the rebels knew that they could not hold the captured territory against a full UNLA counter-offensive, they mostly retreated back into Sudan after a few days with a large amount of loot. The UNLA began its counterattack on 12 October accompanied by Tanzanian forces. The only significant resistance they encountered was in Bondo , where six Tanzanians were killed. The UNLA forces, considering the local population hostile, engaged in a campaign of destruction and looting across the West Nile, as Tanzanian officers tried in vain to restrain them. They leveled the town of Arua , killed over 1,000 civilians, and provoked the flight of over 250,000 refugees to Sudan and Zaire. The brutality of the UNLA inspired further unrest, as peasants and ex-soldiers took up arms to defend their lands from the government forces. The Uganda Army launched its next offensive just before the Ugandan national elections in December 1980 . In one of their most daring actions, the rebels ambushed Obote as he was touring the West Nile region. They almost killed him and Tito Okello , a high-ranking UNLA commander. This time, the Uganda Army also held the areas it captured in West Nile, and set up a parallel government after retaking Koboko. After about one month of combat, the insurgents had captured most of West Nile, leaving only some towns under UNLA control. However, many rebels focused more on looting the area and taking the plunder back to Zaire and Sudan than on fighting the UNLA. The West Nile rebellion was weakened by internal divisions as parts of the Uganda Army remained loyal to Idi Amin, whereas others wanted to distance themselves from the unpopular old dictator. [lower-alpha 3] The latter part of the insurgent army split off, forming the " Uganda National Rescue Front " (UNRF) under Moses Ali, whereas the remaining Amin loyalists were still called the "Ugandan Army" until becoming known as "Former Uganda National Army" (FUNA). The West Nile rebels soon started to fight each other. Furthermore, southwestern Uganda experienced a resurgence of the Rwenzururu movement which wanted self-determination for the Konjo and Amba peoples . The movement had been largely dormant since the 1960s, but managed to take control of weapon stockpiles that had been left unguarded when Amin's government collapsed in 1979. They thus resumed their insurgency, and the security situation in the mountainous border areas of the southwest quickly deteriorated in 1980. Meanwhile, the UNLF government experienced its own divisions. As the UNLA was being transformed from a loose alliance of various anti-Amin insurgent groups into a regular army, the different political factions attempted to ensure that their own loyalists would be present and dominant in the new military. Obote outmaneuvered his rivals, most importantly Yoweri Museveni , and made his 5,000-strong Kikosi Maalum group the core of the UNLA. In contrast, just 4,000 out of Museveni's 9,000 FRONASA fighters were allowed to join the new army, and these were distributed across several units. Furthermore, FRONASA was forced to give up its own weaponry. At the same time, the UNLA was rapidly expanded; most of the new recruits came from ethnic groups that supported Obote. As result, power shifted to pro-Obote elements in the government and the army. The elections of December 1980 were officially won by Milton Obote's Uganda People's Congress , effectively making him president of Uganda again. [lower-alpha 4] However, the results were strongly disputed by other candidates, resulting in increasing strife. Several political factions claimed electoral fraud , and believed themselves to be proven correct when Obote immediately launched a campaign of political repression. As the UNLA was dominated by pro-Obote forces, a coup was impossible, so the opposition instead launched armed rebellions against Obote's government: Museveni's followers created the Popular Resistance Army (PRA), Yusuf Lule formed the Uganda Freedom Fighters (UFF), Andrew Kayiira armed his Uganda Freedom Movement (UFM), and the Communist " Gang of Four " organized an armed group known as the Uganda National Liberation Front – Anti-Dictatorship (UNLF-AD). On 6 February 1981, hostilities began in the south with a PRA attack on the Kabamba Military Barracks in the central Mubende District . The attack aimed at capturing weaponry; although the operation failed to capture the armoury, Museveni's group of fighters managed to take a few guns and several vehicles before retreating. The PRA had more success during a series of attacks on police stations during the next days. Regardless, the small rebel group also came under pressure from UNLA and TPDF counter-insurgency operations, and still lacked a proper base. Museveni was familiar with guerrilla warfare , having fought with the Mozambican Liberation Front in Mozambique. He also had commanded his own Front for National Salvation to fight the Amin regime and had continued to campaign in rural areas hostile to Obote's government, especially central and western Buganda and in the western regions of Ankole and Bunyoro . As a result, he employed the tactics of a people's war to keep his small force active. In this regard, the PRA succeeded, as it won over many locals in the area around Kampala who considered Obote's government a regime which solely served the northerners. Without extensive support by sympathetic civilians during their early insurgency, Museveni's troops would have been easily crushed in 1981. The PRA also enjoyed very limited foreign support. Some believed that Museveni was aided by his old Mozambican allies, resulting in tensions between Obote's government and Mozambique. Most attacks by Museveni's force involved small mobile units called "coys" under the command of Fred Rwigyema , and Museveni's brother, Salim Saleh , with "A" Coy led by Steven Kashaka, "B" Coy by Joram Mugume , and "C" Coy by Pecos Kuteesa. There were three small zonal forces: the Lutta Unit operating in Kapeeka , the Kabalega Unit operating near Kiwoko , and the Nkrumah Unit operating in the areas of Ssingo. Many of the early members of the PRA like Rwigyema and Paul Kagame were actually Rwandan refugees living in Uganda. They later organized the Rwandan Patriotic Front . In contrast to Museveni's forces and the West Nile rebels, Andrew Kayira's UFM mostly consisted of relatively well-trained ex-soldiers and was focused on high-profile urban operations. The group hoped to destabilize Obote's government through direct attacks, a strategy which "doomed it to fail from the beginning" according to historians Tom Cooper and Adrien Fontanellaz. The UFM was not strong enough to challenge the UNLA head-on, suffered from leadership rivalries, lacked a firm organization, and was prone to being infiltrated by pro-government spies. As the war escalated, foreign support became vital for the survival of Obote's government. The Tanzanians initially helped to defend his regime and kept some order through the presence of about 10,000 Tanzania People's Defence Force soldiers and 1,000 policemen. Nevertheless, the unsustainable costs of these troops led Tanzanian President Julius Nyerere to gradually withdraw most of his forces from Uganda. By June 1981, just 800 to 1,000 Tanzanian advisors remained in the country. These advisors remained of crucial importance for the UNLA, but the Tanzanian withdrawal greatly weakened Obote's position. To compensate, he tried to enlist further foreign aid: He hired a British private military company , and convinced the Commonwealth of Nations as well as the United States to send small teams of security advisors. One of Obote's most important allies was North Korea . The Ugandan President visited the country in late 1981 and signed a cooperation agreement which included military support for his regime. At least 30 North Korean officers were subsequently sent to Gulu in northern Uganda, where they trained UNLA soldiers and repaired military equipment. By 1984, the number had risen to about 50 North Koreans who acted as security, intelligence, and military advisors. Museveni claimed that over 700 North Koreans were ultimately used by the UNLA; Obote maintained that only about 170 were present in Uganda. According to one study, the North Korean officers actively participated in and even led counter-insurgency operations for Obote. A Central Intelligence Agency report stated, however, that the North Koreans refused to actually venture to the frontlines. The Ugandan military also sent some officers and non-commissioned officer to North Korea for advanced trainings. Obote's government also organized various paramilitary groups to assist the UNLA. The "People's Militia" consisted of Langi , Acholi and Teso tribesmen, and was mostly loyal to UNLA chief of staff David Oyite-Ojok . It became increasingly powerful, and garnered a reputation as a fierce and brutal force. In addition, there was the "National Youth Army" (NYA), various tribal militias, and the UPC youth paramilitaries. Meanwhile, the conflict in the south became more serious. Another rebel group emerged, the so-called "Uganda Liberation Movement" which threatened to kidnap and kill United Nations personnel, as the latter was supporting Obote's attempts at restabilizing Uganda. The threats worked, and the U.N. stopped its training programme for the Ugandan police. The PRA also continued its hit-and-run operations with mixed successes: It overran a UNLA outpost at Kakiri on 5 April 1981, and captured important weaponry, but had to hastily retreat when a TPDF unit responded to the attack. The Tanzanian forces consequently conducted a counter-insurgency sweep, catching a PRA column under Elly Tumwine off-guard and recapturing some of the captured guns. Despite this, the PRA successfully recruited more volunteers, growing to about 200 fighters by early May. In the next month, Museveni travelled to Nairobi where he met with Lule; the two agreed to unite the PRA and UFF into a unified opposition group. The umbrella organization was dubbed the " National Resistance Movement " (NRM) and its armed wing was termed the " National Resistance Army " (NRA). Lule was appointed overall NRM Chairman, while Museveni became vice-chairman of the National Resistance Council and Chairman of the High Command of the NRA. The merger profited both sides: The UFF was extremely weak, and Lule finally gained an actual armed following, while Museveni was provided with important legitimacy, as Lule remained much respected among Uganda's southern population. This was especially important because a strategically important region near Kampala, known as Luwero Triangle , was mostly inhabited by Baganda . So far, the PRA had mostly consisted of non-Baganda, but Lule provided the newly formed NRA with backing from the Baganda, allowing Museveni to expand his envisioned "people's war". The Luwero Triangle consequently became the NRA's main operations area, although the group's center of recruitment remained Ankole in the west. Soon after the merger, Museveni implemented a strict code of conduct for fighters, allowing the NRA to remain highly disciplined and focused despite gradually growing in numbers and absorbing other insurgent factions such as the remnants of the "Gang of Four". By December 1981, the NRA had grown to about 900 militants. Libya's leader Muammar Gaddafi also opted to provide support to the NRA, although it was made up of forces which had overthrown his old ally Amin. Gaddafi believed that Libya could gain greater influence in central Africa through the NRA than it had previously with Amin. The Libyan support remained very limited, however, with about 800 rifles, a few machine guns and land mines being provided to the NRA in August 1981. Gaddafi demanded that the NRA merge with the UFM and UNRF to receive more substantial support, but the rebels remained rivals and refused to unite. Libya consequently cancelled its support to the NRA in 1982. While the rebellion in the south grew in intensity, most of the West Nile region remained under rebel control. A local administration began to emerge, and the remaining UNLA garrisons had great difficulties in holding out. The insurgents proved better trained and more effective fighters, and often captured supply convoys coming from the south. In addition, the UNLA garrisons suffered from indiscipline and internal rivalries, sometimes clashing in their barracks. Despite these advantages, the West Nile rebellion was crippled by infighting, high corruption, and lack of actual strategy among the rebel leadership. As the UNRF and FUNA fought each other, the former gained the upper hand and mostly evicted FUNA from West Nile by July 1981. FUNA commander Elly Hassan fled to Sudan, where he was eventually arrested by local authorities. Regardless, the inter-rebel struggle only resulted in the overall weakening of the West Nile insurgents. By 1981, four different insurgent factions were active in northwestern Uganda, all of which claimed to have no direct links with Amin. One West Nile rebel group, the so-called "Nile Regiment" (NR) was set up by Felix Onama , a former follower of Obote. As result of its inability to reduce corruption or provide true stability, the UNRF gradually lost the support of local civilians. The Ugandan government exploited the divisions and chaos among the rebels by launching counter-attacks into Western Nile from 1981, where its regular military and "People's Militia" committed numerous atrocities. By December 1981, the UNLA had retaken much of West Nile while encountering little resistance. Thousands of civilians fled to Sudan in response to the UNLA offensive. However, the UNLA failed to permanently dislodge the West Nile insurgents. In contrast, Obote opted for a more conciliatory approach with the Rwenzururu movement. Following negotiations, the Ugandan government signed a peace agreement with the rebel group's leadership in return for payments and other benefits to the latter. Furthermore, Obote granted the Rwenzururu region some limited autonomy. By late 1981, the UNLA was already in a critical situation. Its rapid expansion to over 15,000 troops by December 1981 resulted in a majority of its troops being untrained, badly armed and often unpaid. Corruption became rampant, and great differences emerged between UNLA units. Some, like those that were active in northern Uganda, were given preferential treatment and became relatively reliable. In contrast, the Central Brigade which mostly fought the NRA mostly consisted of barely-trained militiamen. These troops were considered to be "cannon-fodder" by their own commanders. The counter-insurgency operations against the West Nile rebels were thus much more successful than those against the NRA. Overall, the UNLA already showed signs of great strain at this point, and would have probably collapsed without Tanzanian support by the end of 1981. Regardless, UNLA continued to hold the rebels at bay and even scored several major victories. On 23 February 1982, UNLA fended off a large-scale raid by UFM on Kampala, and then managed to inflict high casualties on the routed insurgents. The UFM attempted to reorganize, but retreated into NRA-held areas. It hoped to convince some of Museveni's followers to defect. Instead, a UFM commander defected with a significant stock of weaponry to the NRA, further weakening the UFM. Fighting in the West Nile region occasionally spilled over into Sudan as UNLA troops pursued rebels over the border. This first occurred in April 1982, when UNLA troops crossed the frontier near Nimule and opened fire on a Sudanese Army unit; the Sudanese troops subsequently detained about 20 Ugandan soldiers. In contrast to other belligerents in the area, the Sudanese Army garrisons in south-eastern Sudan were generally well-disciplined and refrained from attacking civilians. By November 1982, the National Resistance Army, Uganda Freedom Movement, Uganda National Rescue Front, and the Nile Regiment had formed an alliance, called the "Uganda Popular Front" (UPF). Exiled politician Godfrey Binaisa was appointed head of the UPF. While being based in London , Binaisa decided to organize an invasion from Zaire to topple Obote. He attempted to enlist the aid of white mercenaries for this plot, but his plans fell through and were revealed when he was unable to pay for the operation. The entire plot discredited Binaisa. In December 1982, John Charles Ogole was appointed new commander of the UNLA's 11th Battalion in Arua. Ogole reorganized his troops, strengthened morale and discipline, and then launched another counter-insurgency campaign against the West Nile rebels. Ogole's tactics proved highly successful, and ousted most insurgents from the West Nile Region within months. Rebel leader Barnabas Kili was also captured. However, the operation also included widespread destruction and massacres at the hands of the UNLA, whereupon 260,000 people fled the area for Zaire and Sudan. This in turn destroyed the "insurgent infrastructure" of UNRF and FUNA, further weakening them. The UNRF was left mostly destroyed following Ogole's offensive, and relocated from West Nile. The group moved its bases in southern Sudan to northern Uganda, where it attempted to rally the Karamojong people to its cause. In the south, the UNLA under chief of staff Oyite-Ojok waged a counter-insurgency campaign against the NRA in the Luwero Triangle which resulted in the "genocidal killings" of thousands of Baganda civilians. Many government troops deployed in the Luwero Triangle belonged to the Acholi people who became widely hated by the southerners. On 16 June 1983, the Obote government launched Operation Bonanza , an extensive military expedition utilizing up to half of the UNLA forces, that alone claimed tens of thousands of lives and displaced a significant portion of the population. The operation was intended to be, as Amaza writes, a "typical encirclement and suppression campaign". The blame for the massacres was placed on the people of northern Uganda for supporting the actions of the NRA, which increased the existing regional tensions in the country. [ citation needed ] The UNLA also defeated the UFM in 1983, destroying its main camps during a coordinated counter-insurgency operation. The UFM suffered another setback when its exiled leadership was scattered during a crackdown in Kenya in July 1983; its leader Kirya was repatriated to Uganda and imprisoned. The group never recovered. Remnants of the UFM, possibly a few hundred militants strong, subsequently formed the Federal Democratic Movement of Uganda (FEDEMU). Up to late 1983, Obote's government had remained relatively stable and in control of most of Uganda thanks to the efforts of chief of staff David Oyite-Ojok. Though it could not defeat the NRA, the military was able to contain it. Despite this, Obote's forces suffered from tribalism, corruption, and internal rivalries. The UNLA and its allied militias had been expanded too quickly in an attempt to defeat the insurgency: By 1984, Obote had 35,000 to 40,000 men under arms, but just 15,000 had received basic training. As a result, the soldiers were undisciplined, unreliable, and prone to harass, steal from, and murder civilians due to a lack of proper pay and supplies. Although the Ugandan government knew that it could not even feed its large army, let alone properly train or arm it, Obote was unwilling to demobilize troops out of fear that the soldiers could behave even worse if they were no longer employed. Despite its massive military and militia support, the government was also unable to fully suppress violence in the northeast, where Karamojong raiders continued to operate. Obote's forces were at least able to contain the Karamojong cattle raiding, keeping the raiders out of other regions. The situation began to change with Oyite-Ojok's death under suspicious circumstances in a plane crash in December 1983. At first, people believed that the chief of staff had been killed by rebels who consequently assumed responsibility. Oyite-Ojok's loyal troops, most importantly the People's Militia and National Youth Army responded by carrying out revenge killings against suspected rebel supporters. After one week, however, rumours spread among the military according to which Obote had arranged the death of his chief of staff due to developing rifts between them. Although Obote's responsibility could not be proven, the rumours damaged Obote's reputation among the military. The CIA determined that Oyite-Ojok had been crucial for keeping the Ugandan government afloat, and had been responsible for "maintaining some semblance of security and order" in the country. With him gone, the UNLA began to unravel. An increasing number of Acholi soldiers believed that Obote was using them as cannon-fodder, while filling the country's leadership with Langi. At the same time, the NRA became more successful at spreading its propaganda, and attracting dissatisfied Acholi army officers to their cause. Foreign support for Obote had also diminished. Besides the still significant North Korean aid, just 50 Tanzanian, 12 British and six U.S. advisors remained in the country. However, the government initially remained relatively successful in battling the rebels. With Oyite-Ojok dead, Obote appointed Ogole new head of the anti-NRA operations in the Luwero Triangle. Ogole improved his troops' training and included other security as well as civil agencies in his anti-rebel strategy. In a series of operations, he managed to mostly oust the NRA from the region, forcing it to retreat west into the Rwenzori Mountains and Zaire. In addition, the Ugandan government decided "to teach the Karamojong a lesson" after raiders had taken advantage of Oyite-Ojok's death to attack his farm and kill over 100 militiamen in the northeast. In cooperation with the Kenyan government, UNLA and allied militias launched a campaign which largely destroyed or seized the Karamojong's food sources in the form of cattle and fields. This left the nomads almost totally dependent on international aid agencies like the World Food Programme and UNICEF for survival. However, the unrest in the UNLA eventually escalated when Acholi troops mutinied in Jinja and other locations in June 1985. Rifts subsequently erupted in the government and some political groups such as the Democratic Party attempted to exploit the chaos by gaining control over the military. The news also reached Gulu , where Lieutenant General Bazilio Olara-Okello , an Acholi, was stationed. Fearing that a new government in Kampala might purge the Acholi, he revolted. Olara-Okello gathered a force dominated by Acholi mutineers, and won the support of ex-Amin loyalists from the West Nile and Sudan. Using these troops, he conquered Lira , and then marched on Kampala. The capital fell after a short battle in July 1985, but Obote had already fled to Tanzania. He later relocated to Kenya and finally Zambia . After the successful coup, General Tito Okello was installed as president; this marked the first time in Uganda's history when Acholi had achieved state power. The coup had catastrophic consequences for the UNLA. The new Acholi leadership promptly began to use their new power to disempower and exploit other ethnic groups including Langi, resulting in the collapse of discipline and order among many military units. From then on, the UNLA gradually devolved into "marauding bands" and declined in numbers to about 15,000 troops by late 1985. Some commanders such as Ogole fled into exile. On 23 August, the 196 North Korean military advisers to the UNLA were flown out of Uganda. Regardless, Okello's government was successful in opening negotiations with several rebel groups, arguing that Obote – their common enemy – had been overthrown. The government reached an agreement with the FUNA, UNRF (I), FEDEMU, and the reactivated UFM. These rebel groups agreed to join a new National Unity government, officially integrated their militias into the government army, and their commanders became part of the ruling military council. Despite this, the ex-insurgents maintained autonomy. Kampala was carved up among the government coalition: UNLA held the center, FEDEMU the south, and FUNA the north. The situation consequently remained volatile, as the government proved fragile, while soldiers and other militants acted with impunity in the capital. Okello also attempted to bolster the UNLA by recruiting large numbers of Karamojong, even though this meant potentially arming cattle raiders. In addition, Okello's government suffered from a lack of respect among the country's elite, as most of its members were uneducated and considered ill-prepared to actually rule Uganda. In contrast to the other insurgents, the NRA refused to compromise with Okello's regime out of ideological reasons. It only agreed to peace talks in Nairobi after international pressure, but never intended to honor any ceasefire or power-sharing deal. Taking advantage of the chaos following Obote's fall, the NRA took full control of the Luwero Triangle as well as much of Uganda's west and south. It also received fresh weapons shipments from Libya and Tanzania. Museveni's group was thus in a position of strength, and used the Nairobi peace talks to stall for time. It even ostensibly agreed to a power-sharing deal. In truth, however, the NRA prepared its force for a decisive offensive. In August 1985, the NRA launched a series of coordinated attacks that resulted in the capture of significant amounts of territory in central and western Uganda. It besieged and captured the crucial garrison towns of Masaka and Mbarara, greatly weakening the UNLA. In course of these operations, the NRA greatly expanded by recruiting new troops in captured territories and absorbing defected government soldiers. In a few months, it enlisted around 9,000 fighters, growing to about 10,000 troops overall by December 1985. That month, a peace agreement was signed by Okello's government and the NRA, but the deal broke down almost immediately as both parties violated the agreed truce. By January 1986, the UNLA was starting to collapse as the rebels gained ground from the south and southwest. Okello's regime effectively ended when Kampala was captured by the NRA on 26 January 1986. Yoweri Museveni was subsequently sworn in as president on 29 January, and the NRA became the new regular army of Uganda. Tito Okello fled to Sudan. Despite this massive defeat, the UNLA attempted to rally once more, and intended to defend its remaining holdings in northern Uganda. These holdouts were led by Bazilio Olara-Okello, who ordered a mass mobilization in Gulu and Kitgum . Everyone who could hold a rifle, including women and girls, was armed and provided with an ad hoc training. Meanwhile, the NRA continued its offensive, capturing Jinja by late January, followed by Tororo in early February. At this point, the UNLA attempted one last time to stem the rebel advance. It counter-attacked at Tororo, but was repelled. The NRA proceeded to assault the fortified crossings of the Nile, encountering particularly heavy resistance by the UNLA and allied West Nile militias at Karuma and Kamdini . After bitter fighting, the NRA overcame the UNLA's defenses, inflicting "catastrophic losses" on the Acholi troops. With effective resistance no longer possible, the UNLA disintegrated and its remnants fled into exile, along with many former government officials. The NRA captured Gulu and Kitgum in March 1986, while the defeated Acholi soldiers mostly returned to their villages. The war appeared to be over. It has been estimated that approximately 100,000 to 500,000 people, including combatants and civilians, died across Uganda as a result of the Ugandan Bush War. Overall, Obote's regime proved to be even more brutal and killed more people than Amin's. The NRM's rise to power was initially met by a large portion of Ugandan's population with trepidation and confusion. Most knew little of the NRM, and it was feared that the new government might prove equally incapable and unstable as the previous regimes. After a few months, however, many Ugandans began to view the NRM with approval, as the party actually succeeded in improving stability and restoring order throughout many parts of Uganda. Regardless, Museveni's government quickly faced significant armed opposition. In fact, the NRA had formally won the civil war, but fighting had not stopped in the north. Various anti-NRA rebel groups and remnants of UNLA remained active, with major insurgencies affecting Acholiland and West Nile in particular. The UNLA's Acholi soldiers had never been disarmed, and many had grown accustomed to their lives as soldiers. They were no longer willing to live as peasants, and were dissatisfied with the new government as well as the traditional rule of the tribal elders. Many were extremely poor, and economic and political chaos was widespread in northern Uganda in the Bush War's wake. As time went on, groups of ex-soldiers began to band together as bandits, and violence gradually grew worse in the north. Some NRA garrisons in the region mishandled the crisis by responding with extreme brutality. Though many NRA troops actually behaved well, the army's undisciplined elements tarnished the reputation of Museveni's government. Rumours began to spread that the government was planning to kill all male Acholi. Many Acholi feared that the NRA sought revenge for the mass murders in the Luwero Triangle during the Bush War. In fact, many southerners blamed not just the violence of the Bush War on the Acholi, but even the brutal regime of Idi Amin – even though the Acholi had been marginalized by Amin. The Karamojong ex-UNLA soldiers also took large quantities of weaponry to their home territories after the collapse of Okello's regime, subsequently increasing their raids in scale and numbers. This general unrest contributed to the return of open war to northern Uganda . Over time, the NRM-led government would face more rebellions than both the Amin as well as the Obote regimes, yet survived all of them. Milton Obote never returned to Uganda following his second overthrow and exile, despite repeated rumors he planned to return to Ugandan politics. Obote resigned as leader of the Ugandan Peoples Congress and was succeeded by his wife, Miria Obote, shortly before his death on 10 October 2005 in South Africa . Tito Okello remained in exile in Kenya until 1993, when he was granted an amnesty by Museveni and returned to Uganda, where he died in Kampala in 1996. Despite its support for Obote during the civil war, North Korea quickly developed amicable relations with Museveni's government. Cooperation was restored as soon as 1986, and the new Ugandan military consequently received weaponry as well as training by North Korea. The country's involvement in the Bush War had other long-lasting repercussions, however, as North Koreans became a symbol for mystical military power in northern Uganda. As result, rebel groups such as the Holy Spirit Movement went on to claim that they were aided by North Korean spirits in their war against Museveni's government. The ranks of the UNLA included many ethnic Acholi and Langi, who had themselves been the victims of Idi Amin's genocidal purges in northern Uganda. Despite this, like Amin, the UNLA under Obote targeted and abused civilians. These abuses included the forced removal of 750,000 civilians from the area of the then Luweero District , including present-day Kiboga , Kyankwanzi , Nakaseke , and others. They were moved into refugee camps controlled by the military. Many civilians outside the camps, in what came to be known as the " Luweero triangle ", [lower-alpha 5] were continuously abused as "guerrilla sympathizers". The International Committee of the Red Cross has estimated that by July 1985, the Obote regime had been responsible for more than 300,000 civilian deaths across Uganda. The NRA also committed atrocities, as land mines were used against civilians, and child soldiers were widespread in the NRA's ranks, and continued to be after the NRA had become the regular Ugandan army. In the early stages of the war the NRA also executed some government-aligned chiefs and directed its civilian supporters to murder UPC activists. UPC members alleged that the NRA massacred civilians, though NRA leaders denied this. The ranks of the UNLA included many ethnic Acholi and Langi, who had themselves been the victims of Idi Amin's genocidal purges in northern Uganda. Despite this, like Amin, the UNLA under Obote targeted and abused civilians. These abuses included the forced removal of 750,000 civilians from the area of the then Luweero District , including present-day Kiboga , Kyankwanzi , Nakaseke , and others. They were moved into refugee camps controlled by the military. Many civilians outside the camps, in what came to be known as the " Luweero triangle ", [lower-alpha 5] were continuously abused as "guerrilla sympathizers". The International Committee of the Red Cross has estimated that by July 1985, the Obote regime had been responsible for more than 300,000 civilian deaths across Uganda. The NRA also committed atrocities, as land mines were used against civilians, and child soldiers were widespread in the NRA's ranks, and continued to be after the NRA had become the regular Ugandan army. In the early stages of the war the NRA also executed some government-aligned chiefs and directed its civilian supporters to murder UPC activists. UPC members alleged that the NRA massacred civilians, though NRA leaders denied this. The Ugandan Bush War was depicted in the 2018 film 27 Guns . It was written and directed by Natasha Museveni Karugire, Yoweri Museveni's eldest daughter.

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West Nile

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West Nile campaign

West Nile campaign may refer to:

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West Nile

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American crow

The American crow ( Corvus brachyrhynchos ) is a large passerine bird species of the family Corvidae . It is a common bird found throughout much of North America . American crows are the New World counterpart to the carrion crow and the hooded crow of Eurasia ; they all occupy the same ecological niche . Although the American crow and the hooded crow are very similar in size, structure and behavior, their calls and visual appearance are different. From beak to tail, an American crow measures 40–50 cm (16–20 in) , almost half of which is tail. Its wingspan is 85–100 cm (33–39 in) . Mass varies from about 300 to 600 g (11 to 21 oz) , with males tending to be larger than females. Plumage is all black, with iridescent feathers. It looks much like other all-black corvids. They are very intelligent, and adaptable to human environments. The most usual call is CaaW!-CaaW!-CaaW! They can be distinguished from the common raven ( C. corax ) because American crows are smaller and the beak is slightly less pronounced; from the fish crow ( C. ossifragus ) because American crows do not hunch and fluff their throat feathers when they call; and from the carrion crow ( C. corone ) by size, as the carrion crow is larger and of a stockier build. American crows are common, widespread, and susceptible to the West Nile virus , making them useful as a bioindicator to track the virus's spread. Direct transmission of the virus from crows to humans is impossible. They are considered an agricultural pest, and are subject to hunting and management.The American crow was described by German ornithologist Christian Ludwig Brehm in 1822. Its scientific name means literally 'short-billed crow', from Ancient Greek Î²ÏÎ±Ï‡Ï - brachy- ('short-') and ÏÏ Î½Ï‡Î¿Ï‚ rhynchos ('billed'). A 2012 genetic analysis of the genus Corvus by Knud A Jønsson and colleagues using nuclear and mitochondrial DNA calculated that the American crow diverged from a lineage that gave rise to the collared, carrion and hooded crows around 5 million years ago. "American crow" has been designated the official name by the International Ornithologists' Union (IOC). The number of subspecies varies by authority, ranging between three and five. The unclear taxonomy of the northwestern crow, previously its own species, has complicated subspecies determinations. Subspecies differ in bill proportion and form a rough NE–SW clinal in size across North America . Birds are smallest in the far west and on the southern coast. The number of subspecies varies by authority, ranging between three and five. The unclear taxonomy of the northwestern crow, previously its own species, has complicated subspecies determinations. Subspecies differ in bill proportion and form a rough NE–SW clinal in size across North America . Birds are smallest in the far west and on the southern coast. The American crow is a large, distinctive bird with iridescent black feathers all over. Its legs, feet and bill are also black. They measure 40–53 cm (16–21 in) in length, of which the tail makes up about 40%. The wing chord is 24.5 to 33 cm (9.6 to 13.0 in) , with the wingspan ranging from 85 to 100 cm (33 to 39 in) . The bill length can be from 3 to 5.5 cm (1.2 to 2.2 in) , varying strongly according to location. The tarsus is 5.5 to 6.5 cm (2.2 to 2.6 in) and the tail is 13.5 to 19 cm (5.3 to 7.5 in) . The body mass can vary from 316 to 620 g (11.1 to 21.9 oz) . Males tend to be larger than females. The most usual call is a loud, short, and rapid caaw-caaw-caaw . Usually the birds thrust their heads up and down as they utter this call. American crows can also produce a wide variety of sounds and sometimes mimic noises made by other animals, including other birds, such as barred owls. Visual differentiation from the fish crow ( C. ossifragus ) is extremely difficult and often inaccurate. Nonetheless, differences apart from size do exist. Fish crows tend to have more slender bills and feet. There may also be a small sharp hook at the end of the fish crow's upper bill. Fish crows also appear as if they have shorter legs when walking. More dramatically, when calling, fish crows tend to hunch and fluff their throat feathers. If seen flying at a distance from where size estimates are unreliable, the distinctly larger common ravens ( C. corax ) can be distinguished by their almost lozenge -shaped tail and their larger-looking heads. They also fluff their throat feathers when calling – like fish crows, only more so. Ravens also soar for extended periods, unlike crows, which rarely fly more than a few seconds without flapping their wings. Crows have been noted to be intelligent. They have the same brain-weight-to-body ratio as humans. This has led to some studies that have identified that crows are self-aware and that young crows take time to learn from tolerant parents. While a human has a neocortex , the crow has a different area in their brain that is equally complex. The average lifespan of the American crow in the wild is 7–8 years. Captive birds are known to have lived up to 30 years. The range of the American crow now extends from the Pacific Ocean to the Atlantic Ocean in Canada, on the French islands of Saint-Pierre and Miquelon , south through the United States, and into northern Mexico. The increase in trees throughout the Great Plains during the past century due to fire suppression and tree planting facilitated range expansions of the American crow as well as range expansions of many other species of birds. Virtually all types of country from wilderness, farmland, parks, open woodland to towns and major cities are inhabited; it is absent only from tundra habitat, where it is replaced by the common raven . This crow is a permanent resident in most of the US, but most Canadian birds migrate some distances southward in winter. Outside of the nesting season these birds often gather in large (thousands or even millions ) communal roosts at night. The American crow was recorded in Bermuda from 1876 onwards. Studying the behavior of American crows is laborious due to the difficulty in catching them to band them, let alone catching them again. Thus much of their behavior, including daily routine, migration, molting, survivorship, age of first breeding, nestling development, and the nature of nesting helpers, remains poorly studied. The American crow is omnivorous . It will feed on invertebrates of all types, carrion , scraps of human food, fruits, nuts such as walnuts and almonds , seeds , eggs and nestlings, stranded fish on the shore and various grains . American crows are active hunters and will prey on mice , young rabbits , frogs , and other small animals. In the winter and autumn, the diet of American crows is more dependent on nuts and acorns. Occasionally, they will visit bird feeders . The American crow is one of only a few species of bird that has been observed modifying and using tools to obtain food. Like most crows, they will scavenge at landfills , scattering garbage in the process. Where available, corn , wheat and other crops are a favorite food. These habits have historically caused the American crow to be considered a nuisance. However, it is suspected that the harm to crops is offset by the service the American crow provides by eating insect pests. American crows are socially monogamous cooperative breeding birds. Mated pairs form large families of up to 15 individuals from several breeding seasons that remain together for many years. Offspring from a previous nesting season will usually remain with the family to assist in rearing new nestlings. American crows do not reach breeding age for at least two years. Most do not leave the nest to breed for four to five years. The nesting season starts early, with some birds incubating eggs by early April. American crows build bulky stick nests , nearly always in trees but sometimes also in large bushes and, very rarely, on the ground. They will nest in a wide variety of trees, including large conifers , although oaks are most often used. Three to six eggs are laid and incubated for 18 days. The young are usually fledged by about 36 days after hatching. Predation primarily occurs at the nest site and eggs and nestlings are frequently eaten by snakes , raccoons , ravens and domestic cats . Adults are less frequently predated, but face potential attack from great horned owls , red-tailed hawks , peregrine falcons and eagles . They may be attacked by predators such as coyotes or bobcats at carrion when incautious, although this is even rarer. American crows succumb easily to West Nile virus infection. This was originally a mosquito -borne African virus causing encephalitis in humans and livestock since about 1000 AD, and was accidentally introduced to North America in 1999, apparently by an infected air traveller who got bitten by a mosquito after arrival. It is estimated that the American crow population has dropped by up to 45% since 1999. Despite this decline, the crow is considered a species of least concern. The disease runs most rampant in the subtropical conditions which encourage reproduction of its mosquito vectors among which Culex tarsalis is most significant. Mortality rates appear to be higher than those in other birds, causing local population losses of up to 72% in a single season. Because of this, American crows are a sentinel species indicating the presence of West Nile virus in an area. Crows cannot transmit the virus to humans directly. American crows, like other corvids, are highly cunning and inquisitive. They are able to steal food from other species, often in creative ways. One example shows a group of crows stealing a fish from a Northern river otter : one bird pecked the otter's tail to distract it while other birds swooped in and stole the fish. They are able to use and modify tools. The American crow is omnivorous . It will feed on invertebrates of all types, carrion , scraps of human food, fruits, nuts such as walnuts and almonds , seeds , eggs and nestlings, stranded fish on the shore and various grains . American crows are active hunters and will prey on mice , young rabbits , frogs , and other small animals. In the winter and autumn, the diet of American crows is more dependent on nuts and acorns. Occasionally, they will visit bird feeders . The American crow is one of only a few species of bird that has been observed modifying and using tools to obtain food. Like most crows, they will scavenge at landfills , scattering garbage in the process. Where available, corn , wheat and other crops are a favorite food. These habits have historically caused the American crow to be considered a nuisance. However, it is suspected that the harm to crops is offset by the service the American crow provides by eating insect pests. American crows are socially monogamous cooperative breeding birds. Mated pairs form large families of up to 15 individuals from several breeding seasons that remain together for many years. Offspring from a previous nesting season will usually remain with the family to assist in rearing new nestlings. American crows do not reach breeding age for at least two years. Most do not leave the nest to breed for four to five years. The nesting season starts early, with some birds incubating eggs by early April. American crows build bulky stick nests , nearly always in trees but sometimes also in large bushes and, very rarely, on the ground. They will nest in a wide variety of trees, including large conifers , although oaks are most often used. Three to six eggs are laid and incubated for 18 days. The young are usually fledged by about 36 days after hatching. Predation primarily occurs at the nest site and eggs and nestlings are frequently eaten by snakes , raccoons , ravens and domestic cats . Adults are less frequently predated, but face potential attack from great horned owls , red-tailed hawks , peregrine falcons and eagles . They may be attacked by predators such as coyotes or bobcats at carrion when incautious, although this is even rarer. American crows succumb easily to West Nile virus infection. This was originally a mosquito -borne African virus causing encephalitis in humans and livestock since about 1000 AD, and was accidentally introduced to North America in 1999, apparently by an infected air traveller who got bitten by a mosquito after arrival. It is estimated that the American crow population has dropped by up to 45% since 1999. Despite this decline, the crow is considered a species of least concern. The disease runs most rampant in the subtropical conditions which encourage reproduction of its mosquito vectors among which Culex tarsalis is most significant. Mortality rates appear to be higher than those in other birds, causing local population losses of up to 72% in a single season. Because of this, American crows are a sentinel species indicating the presence of West Nile virus in an area. Crows cannot transmit the virus to humans directly. American crows, like other corvids, are highly cunning and inquisitive. They are able to steal food from other species, often in creative ways. One example shows a group of crows stealing a fish from a Northern river otter : one bird pecked the otter's tail to distract it while other birds swooped in and stole the fish. They are able to use and modify tools. Crows are used as a motif in some human cultures, often associated with death, thieves, graveyards, bad luck, and other negative connotations. Conversely, they are seen by some neo-pagan and indigenous cultures as signs of good luck, or even signs of certain gods, such as Apollo , Odin , and others. The intelligence and adaptability of the American crow has insulated it from threats, and it is instead considered an agricultural pest. In 2012, BirdLife International estimated the American crow population to be around 31 million. The large population and vast range result in the least concern status for the American crow, meaning that the species is not threatened with extinction. Crows have been killed in large numbers by humans, both for recreation and as part of organized campaigns of extermination. In Canada, American crows have no protections, aside from Quebec, which bans their hunting during the nesting season. Laws on their hunting vary throughout the United States. New Jersey allows for a limited hunting season, unless they are agricultural pests, in which case they may be killed. Oklahoma allows hunting even during the nesting season. In the first half of the 20th century, state-sponsored campaigns dynamited roosting areas, taking large numbers of crows. A campaign in Oklahoma from 1934 to 1945 dynamited 3.8 million birds. The effect on populations was negligible and damage to agricultural crops did not decrease, and thus the campaign was halted due to its ineffectiveness. In a study taking data from 1917 to 1999, intentional killings were the overwhelming cause of death for crows, accounting for 68% of all recovered bird bands . Non-deadly methods of managing crows are varied but usually limited in their effectiveness. High value crops may be netted, but this is cost prohibitive for most other crops. Frightening may be used to disperse crows, including loud noises from guns, fake hawks flown from balloons, fake owls that move with the wind, strips of reflective tape on fences, or recordings of crow distress calls. Poisoned baits are of limited effectiveness, as only the most toxic baits work, and those are generally unacceptable for use. Crows quickly learn to avoid the less-toxic baits, as the baits make crows sick. The actual effect of crows on agriculture has been poorly studied. There is some suggestion that they may be a benefit to farmers, by eating insect pests and chasing off livestock predators like hawks.

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West Nile

https://api.wikimedia.org/core/v1/wikipedia/en/page/West_Nile_Bank_Front/html

West Nile Bank Front

The West Nile Bank Front ( WNBF ) was an Ugandan rebel group under the command of Juma Oris .Formed by ex- Uganda Army soldiers who remained loyal to Idi Amin , the group's exact foundation is unclear. Its first reported activity was in 1988. It became active as proper insurgent force from 1994. However, one ex-fighter of the group stated that the WNBF was founded in 1995. It appears to have been a West Nile offshoot of the Uganda People's Democratic Army and recruited primarily in Koboko County, Arua and Obongi , Moyo . One prominent associate of the WNBF was Isaac Lumago . It was active up through the end of the First Congo War in 1997, fighting from Sudan and the Democratic Republic of Congo against the Uganda People's Defense Force . The WNBF worked at destabilizing northern Uganda. It was responsible for many kidnappings and violent raids, and had similar goals and tactics to the Lord's Resistance Army . While it had initially recruited with promises of generous pay, which proved to be false, it eventually turned to forced recruitment to replenish its ranks. The brutal tactics of the WNBF, including the laying of landmines , made it lose popular support in the region. They were in competition for popular support with the rebel Uganda National Rescue Front II that was operating in the same region simultaneously. The fortunes of the WNBF did not really change until UPDF Major General Katumba Wamala arrived in 1996 and initiated a policy of civil-military cooperation. He has stated: By working through local and traditional authority structures and enforcing a measured approach to the counter-insurgency, Wamala earned the trust of much of the populace and was able to arrange for numerous rebels to return to their former lives. This diplomatic initiative was coupled by military pressure upon WNBF bases in Southern Sudan by the Ugandan-backed Sudan People's Liberation Army . Amid Operation Thunderbolt (1997) , the last WNBF bases in Sudan were destroyed at a major battle at Kaya in which the SPLA, UPDF and several Congolese armed groups took part. Its leader Juma Oris was wounded, and the group splintered. By late 1997, the WNBF was no longer capable of significant activity.

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West Nile

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West Nile virus in the United States

The West Nile virus quickly spread across the United States after the first reported cases in Queens, New York , in 1999. The virus is believed to have entered in an infected bird or mosquito, although there is no clear evidence. The disease spread quickly through infected birds. Mosquitoes spread the disease to mammals. It was mainly noted in horses but also appeared in a number of other species. The first human cases usually followed within three months of the first appearance of infected birds in the area except where cold weather interrupted the mosquito vectors . Since the virus has become widely established in the U.S., an average of 130 deaths a year occurred. Differences in surveillance and reporting between health departments and generally increased surveillance as the disease spread cause some problems in direct comparison of the number of cases and the mortality rate. The reported number of infected in 2009 was 720, but the estimated total number of infected the same year was 54,000 . The true mortality rate is thought to be much lower because most cases are so mild they go undiagnosed. Some estimates put severe cases at only 1% of all cases. It is believed that the elderly or people with weak immune systems are most vulnerable to serious illness or death if bitten by a mosquito infected by West Nile. [ unreliable medical source? ] Most mild cases go undiagnosed. In addition, some more severe but non-neuroinvasive cases are not reported to the CDC. Some mild cases are discovered during blood donation screening. 1,039 West Nile-tainted blood donations were discovered between 2003 and mid-2005. 30 cases of West Nile from blood transfusion were known, the majority from 2002 before blood screening was instituted. In the first ten years since the virus arrived in the U.S., over 1,100 deaths occurred with human cases reported from every U.S. state except Maine , Alaska and Hawaii . (Animal cases have been occasionally found in Maine and in Puerto Rico .) In 2012, there was a widespread outbreak with the highest death toll and second-highest total case numbers. Maine and Puerto Rico reported one case each, the first time the disease was reported in those places. In August 1999, the New York State Department of Environmental Conservation (NYSDEC) began receiving reports of large die-offs of crows in parks across New York City. On August 9, dead wild crows were discovered outside both the Queens Zoo and the Bronx Zoo, prompting head pathologist Dr. Tracey McNamara to begin investigating what was going on. At the same time, Dr. Deborah Asnis , an infectious disease specialist at Flushing Hospital Medical Center in Queens , noticed two male patients who were suffering from similar, unusual symptoms. The two patients, aged 60 and 75 respectively, were exhibiting sudden paralysis in their arms and legs, as well as disorientation and high fevers. Lab testing also showed elevated numbers of white blood cells within the spinal fluid of both males. Neither of the patients were responding to antiviral drugs. Possible early hypothesizes included botulism , viral encephalitis , Guillain–Barré syndrome , or meningitis , but none of these illnesses exactly matched the symptoms. Asnis decided to pursue a more concrete diagnosis by contacting authorities and other colleagues. Dr. Asnis contacted Dr. Marcelle Layton , the New York City Department of Health 's chief epidemiologist , on Monday, August 23, 1999, to report her patients' symptoms. Layton advised Asnis to send samples of the patients' blood and spinal fluid to the New York State Department of Health in Albany for further analysis. Around the same time, Dr. McNamara identified a potential viral encephalitis in brain tissue from the dead crows and sent samples off for further testing. Meanwhile, by Friday, August 27, just four days after Asnis had contacted Layton, two additional patients had been identified in Queens. The number rose to eight by Sunday, August 29, at Flushing Hospital Medical Center and other hospitals in Queens. All of the early patients resided within a few miles of one another. They were also frequent gardeners in the evenings. The Centers for Disease Control and Prevention (C.D.C.) initially identified the mystery illness as St. Louis encephalitis on September 3, 1999. The city of New York began widespread spraying for mosquitos later that same day. However, laboratory testing continued to determine a definitive cause of the symptoms. [ citation needed ] On September 9, Dr. McNamara contacted the C.D.C. with concerns that the epidemiologic pattern of this outbreak were not consistent with St. Louis encephalitis, which does not cause bird die-offs. Additionally, she reported that other known avian viral diseases would have resulted in the deaths of other bird species in the zoos (avian influenza and Newcastle disease would have killed chickens in the petting zoo and eastern equine encephalitis would have killed emus on exhibit). Since only corvids appeared to be dying, she suggested the possibility of a novel pathogen. The C.D.C. disagreed that the epidemiologic pattern was inconsistent and declined to test tissue samples from animal species. Instead, Dr. McNamara sent tissue samples to the National Veterinary Services Laboratory . On September 11, they reported that the samples she submitted were positive for a flavivirus , marking the first time a virus in this genus was implicated in an animal disease. The U.S. federal government eventually revised its diagnosis from St. Louis encephalitis to West Nile virus on September 27, 1999, based on research by Dr. Duane J. Gubler, a C.D.C. expert on arborviruses , and their own testing on samples submitted by Dr. McNamara. Both Dr. McNamara and Dr. Asnis have been credited by health experts with the early identification of West Nile virus in the United States. Their actions likely prevented a more widespread outbreak. In their 2003 book, The New Killer Diseases: How the Alarming Evolution of Germs Threatens Us All , authors Elinor Levy and Mark Fischetti praised Dr. Asnis' response to the symptoms, writing that, "Asnis did something other doctors might not have bothered to do." They elaborated that, "One of the worst problems with our disease-detection system is that many doctors never report cases of strange symptoms, either because they are unsure of the disease they are facing, they're ignorant of the reporting requirement, or they simply never get around to it. Deborah Asnis was highly conscientious." During the years between 1999 and 2010, an estimate of 3 million people have been infected in the United States. Highest incidence rates are observed in states of the central great plains, with South Dakota , Wyoming and North Dakota leading in incidence. During the 2012 West Nile virus outbreak in Texas , 1,868 cases were reported. Male patients, persons >65 years of age, and minorities were at highest risk for neuroinvasive disease. At total of 1,868 cases including 844 (45%) WNND (West Nile neuroinvasive disease) cases and 89 deaths (case-fatality rate 5%). Dates of onset ranged from May 1, 2012, through December 6, 2012. The outbreak peaked during week 33 (mid-August) with 225 reported cases, which is historically the same peak for all reported WNV cases in Texas during 2002–2011. The median time from date of symptom onset to date of official report to TxDSHS was 27 days (range 6–274 days). Of the 254 counties in Texas, 135 (53%) reported a WNV case. The overall incidence rate for the state was 7.8 cases per 100,000 population. Almost half of the cases were reported from the northeastern quadrant of the state, including the Dallas/Fort Worth metroplex (902 [48%] cases): Dallas (396 [21%]), Tarrant (259 [14%]), Collin (64 [3%]), and Denton (183 [10%]) counties. These 4 counties had a combined incidence rate of 16 cases per 100,000 population. Sources: Final Cumulative Maps & Data for 1999–2018 , Preliminary Maps & Data for 2019 , and West Nile Virus Disease Cases by State 2020 , Centers for Disease Control and Prevention *2019 also had 104 presumptive cases observed in blood donors ** as of December 15, 2020, also 127 presumptive cases observed in blood donorsThe following maps show the progress of human cases of West Nile across the United States. States are colored according to the percentage of all U.S. West Nile cases they represented in that year. Zero percent (no cases) is colored white; less than 1% is blue; between 1% and 5% is green; between 5% and 10% is yellow, and greater than 10% of cases in a year is red.

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West Nile

https://api.wikimedia.org/core/v1/wikipedia/en/page/West_African_Nile_monitor/html

West African Nile monitor

The West African Nile monitor ( Varanus niloticus stellatus ) is a subspecies of monitor lizard that is native to West African forests and adjacent savannah (east to northern Cameroon ). It has also been introduced to Florida , United States, where it is considered invasive . This cryptic species has traditionally been included in the Nile monitor ( V. niloticus ), but from 1997 to 2015 it was often considered as the western population of the ornate monitor ( V. ornatus ). Compared to the other members of the Nile monitor species complex (which also includes the ornate monitor of Central Africa), the West African Nile monitor has a genetic sequence divergence of more than 8%, meaning that they separated about 7.7 million years ago. This is a larger divergence than between humans and chimpanzees . Despite this, the Reptile Database continues to place it within the Nile monitor, but do note that this broad species definition includes distinctive clades .

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West Nile

https://api.wikimedia.org/core/v1/wikipedia/en/page/List_of_West_Nile_virus_outbreaks/html

List of West Nile virus outbreaks

The West Nile virus has caused outbreaks of West Nile fever in countries on a number of different continents since its discovery in 1937 in Uganda .The first cases of West Nile disease in the United States occurred in 1999 in New York. In the first three years only a small number of human cases were diagnosed, all in the Eastern or Southern U.S. (149 cases and 19 deaths, 1999–2001). In 2002, the disease exploded to most of the lower 48 states, causing 4,156 diagnosed cases of which 284 died. The disease continued to spread, reaching all but three states by 2006. The first case detected in Maine occurred in 2012. The single cases detected in Hawaii in 2014 and in Alaska in 2018 were likely imported. In the period from 1999 to 2018, the United States had 2,330 total deaths out of 50,830 diagnosed cases, giving a case fatality rate of 5%. The worst years were 2003 for the most cases with 9,862 and 2012 for the most deaths with 286. Most cases are thought to go undiagnosed. The WHO claims that about 80% of cases are asymptomatic. Half of all cases (48.5%) diagnosed in the U.S. lead to neuroinvasive symptoms. Over 90% of deaths occurred in cases with neuroinvasive disease. After several cases of West Nile disease transmitted by blood transfusion, the U.S. began testing all blood donations and dozens of presumed cases are found each year. Some West Nile cases resulted from organ transplants and some but not all organs/donors are tested. As of 2020, the disease outbreak is considered ongoing and essentially endemic. As well as humans, countless birds and over 27,000 horses have been infected, providing additional reservoirs for the virus. One human death occurred in 1999. In 2002, ten human deaths out of 416 confirmed and probable cases were reported by Canadian health officials. In 2003, 14 deaths and 1,494 confirmed and probable cases were reported. Cases were reported in 2003 in Nova Scotia , Quebec , Ontario , Manitoba , Saskatchewan , Alberta , British Columbia , and the Yukon . In 2004, only 26 cases were reported and two deaths; however, 2005 saw 239 cases and 12 deaths. By October 28, 2006, 127 cases and no deaths had been reported. One case was asymptomatic and only discovered through a blood donation. In 2007, 445 Manitobans had confirmed cases of WNV and two people died with a third unconfirmed but suspected. Summer of 2012 saw widespread viral penetration in Canada, coast to coast. 17 people have either tested positive or are suspected of having the virus in Saskatchewan, and only one person has tested positive in Alberta. Saskatchewan has reported 826 cases of WNV plus three deaths. The spread of West Nile Virus infected mosquitoes to British Columbia for the first time was reported in 2009

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West Nile

https://api.wikimedia.org/core/v1/wikipedia/en/page/Mosquito-borne_disease/html

Mosquito-borne disease

Mosquito-borne diseases or mosquito-borne illnesses are diseases caused by bacteria, viruses or parasites transmitted by mosquitoes . Nearly 700 million people get a mosquito-borne illness each year, resulting in over 725,000 deaths. Diseases transmitted by mosquitoes include malaria , dengue , West Nile virus , chikungunya , yellow fever , filariasis , tularemia , dirofilariasis , Japanese encephalitis , Saint Louis encephalitis , Western equine encephalitis , Eastern equine encephalitis , Venezuelan equine encephalitis , Ross River fever , Barmah Forest fever , La Crosse encephalitis , and Zika fever , as well as newly detected Keystone virus and Rift Valley fever . In January 2024, an Australian research group proved that Mycobacterium ulcerans , the causative pathogen of Buruli ulcer is transmitted by mosquitos. This is the first described mosquito-borne transmission of a bacterial disease. There is no evidence as of April 2020 that COVID-19 can be transmitted by mosquitoes, and it is extremely unlikely this could occur. The female mosquito of the genus Anopheles may carry the malaria parasite . Four different species of protozoa cause malaria: Plasmodium falciparum , Plasmodium malariae , Plasmodium ovale and Plasmodium vivax (see Plasmodium ). Worldwide, malaria is a leading cause of premature mortality, particularly in children under the age of five, with an estimated 207 million cases and more than half a million deaths in 2012, according to the World Malaria Report 2013 published by the World Health Organization (WHO). The death toll increased to one million as of 2018 according to the American Mosquito Control Association. In January 2024, a publication by an Australian research group demonstrated significant genetic similarity between Mycobacterium ulcerans in humans and possums, compared to PCR screening of M. ulcerans from trapped Aedes notoscriptus mosquitoes, and concluded that Mycobacterium ulcerans , the causative pathogen of Buruli ulcer , is transmitted by mosquitos. Botflies are known to parasitize humans or other mammalians, causing myiasis , and to use mosquitoes as intermediate vector agents to deposit eggs on a host. The human botfly Dermatobia hominis attaches its eggs to the underside of a mosquito, and when the mosquito takes a blood meal from a human or an animal, the body heat of the mammalian host induces hatching of the larvae. [ citation needed ] Some species of mosquito can carry the filariasis worm, a parasite that causes a disfiguring condition (often referred to as elephantiasis ) characterized by a great swelling of several parts of the body; worldwide, around 40 million people are living with a filariasis disability. [ citation needed ] The viral diseases yellow fever , dengue fever , Zika fever and chikungunya are transmitted mostly by Aedes aegypti mosquitoes. [ citation needed ] Other viral diseases like epidemic polyarthritis , Rift Valley fever , Ross River fever , St. Louis encephalitis , West Nile fever , Japanese encephalitis , La Crosse encephalitis and several other encephalitic diseases are carried by several different mosquitoes. Eastern equine encephalitis (EEE) and Western equine encephalitis (WEE) occur in the United States where they cause disease in humans, horses, and some bird species. Because of the high mortality rate, EEE and WEE are regarded as two of the most serious mosquito-borne diseases in the United States. Symptoms range from mild flu-like illness to encephalitis, coma, and death. Viruses carried by arthropods such as mosquitoes or ticks are known collectively as arboviruses . West Nile virus was accidentally introduced into the US in 1999 and by 2003 had spread to almost every state with over 3,000 cases in 2006. Other species of Aedes as well as Culex and Culiseta are also involved in the transmission of disease. [ citation needed ] Myxomatosis is spread by biting insects, including mosquitoes. The female mosquito of the genus Anopheles may carry the malaria parasite . Four different species of protozoa cause malaria: Plasmodium falciparum , Plasmodium malariae , Plasmodium ovale and Plasmodium vivax (see Plasmodium ). Worldwide, malaria is a leading cause of premature mortality, particularly in children under the age of five, with an estimated 207 million cases and more than half a million deaths in 2012, according to the World Malaria Report 2013 published by the World Health Organization (WHO). The death toll increased to one million as of 2018 according to the American Mosquito Control Association. In January 2024, a publication by an Australian research group demonstrated significant genetic similarity between Mycobacterium ulcerans in humans and possums, compared to PCR screening of M. ulcerans from trapped Aedes notoscriptus mosquitoes, and concluded that Mycobacterium ulcerans , the causative pathogen of Buruli ulcer , is transmitted by mosquitos. Botflies are known to parasitize humans or other mammalians, causing myiasis , and to use mosquitoes as intermediate vector agents to deposit eggs on a host. The human botfly Dermatobia hominis attaches its eggs to the underside of a mosquito, and when the mosquito takes a blood meal from a human or an animal, the body heat of the mammalian host induces hatching of the larvae. [ citation needed ]Some species of mosquito can carry the filariasis worm, a parasite that causes a disfiguring condition (often referred to as elephantiasis ) characterized by a great swelling of several parts of the body; worldwide, around 40 million people are living with a filariasis disability. [ citation needed ]The viral diseases yellow fever , dengue fever , Zika fever and chikungunya are transmitted mostly by Aedes aegypti mosquitoes. [ citation needed ] Other viral diseases like epidemic polyarthritis , Rift Valley fever , Ross River fever , St. Louis encephalitis , West Nile fever , Japanese encephalitis , La Crosse encephalitis and several other encephalitic diseases are carried by several different mosquitoes. Eastern equine encephalitis (EEE) and Western equine encephalitis (WEE) occur in the United States where they cause disease in humans, horses, and some bird species. Because of the high mortality rate, EEE and WEE are regarded as two of the most serious mosquito-borne diseases in the United States. Symptoms range from mild flu-like illness to encephalitis, coma, and death. Viruses carried by arthropods such as mosquitoes or ticks are known collectively as arboviruses . West Nile virus was accidentally introduced into the US in 1999 and by 2003 had spread to almost every state with over 3,000 cases in 2006. Other species of Aedes as well as Culex and Culiseta are also involved in the transmission of disease. [ citation needed ] Myxomatosis is spread by biting insects, including mosquitoes. A mosquito's period of feeding is often undetected; the bite only becomes apparent because of the immune reaction it provokes. When a mosquito bites a human, it injects saliva and anti-coagulants . With the initial bite to an individual, there is no reaction, but with subsequent bites, the body's immune system develops antibodies . The bites become inflamed and itchy within 24 hours. This is the usual reaction in young children. With more bites, the sensitivity of the human immune system increases, and an itchy red hive appears in minutes where the immune response has broken capillary blood vessels and fluid has collected under the skin. This type of reaction is common in older children and adults. Some adults can become desensitized to mosquitoes and have little or no reaction to their bites, while others can become hyper-sensitive with bites causing blistering, bruising, and large inflammatory reactions, a response known as skeeter syndrome . One study found Dengue virus and Zika virus altered the skin bacteria of rats in a way that caused their body odor to be more attractive to mosquitoes. Symptoms of illness are specific to the type of viral infection and vary in severity, based on the individuals infected. Symptoms vary in severity, from mild unnoticeable symptoms to more common symptoms like fever, rash, headache, achy muscle and joints, and conjunctivitis. Symptoms can last several days to weeks, but death resulting from this infection is rare. Most people infected with the West Nile virus usually do not develop symptoms. However, some individuals can develop cases of severe fatigue, weakness, headaches, body aches, joint and muscle pain, vomiting, diarrhea, and rash, which can last for weeks or months. More serious symptoms have a greater risk of appearing in people over 60 years of age, or those with cancer, diabetes, hypertension, and kidney disease. Dengue fever is mostly characterized by high fever, headaches, joint pain, and rash. However, more severe instances can lead to hemorrhagic fever, internal bleeding, and breathing difficulty, which can be fatal. People infected with this virus can develop sudden onset fever along with debilitating joint and muscle pain, rash, headache, nausea, and fatigue. Symptoms can last a few days or be prolonged to weeks and months. Although patients can recover completely, there have been cases in which joint pain has persisted for several months and can extend beyond that for years. Other people can develop heart complications, eye problems, and even neurological complications. Symptoms vary in severity, from mild unnoticeable symptoms to more common symptoms like fever, rash, headache, achy muscle and joints, and conjunctivitis. Symptoms can last several days to weeks, but death resulting from this infection is rare. Most people infected with the West Nile virus usually do not develop symptoms. However, some individuals can develop cases of severe fatigue, weakness, headaches, body aches, joint and muscle pain, vomiting, diarrhea, and rash, which can last for weeks or months. More serious symptoms have a greater risk of appearing in people over 60 years of age, or those with cancer, diabetes, hypertension, and kidney disease. Dengue fever is mostly characterized by high fever, headaches, joint pain, and rash. However, more severe instances can lead to hemorrhagic fever, internal bleeding, and breathing difficulty, which can be fatal. People infected with this virus can develop sudden onset fever along with debilitating joint and muscle pain, rash, headache, nausea, and fatigue. Symptoms can last a few days or be prolonged to weeks and months. Although patients can recover completely, there have been cases in which joint pain has persisted for several months and can extend beyond that for years. Other people can develop heart complications, eye problems, and even neurological complications. Mosquitoes carrying such arboviruses stay healthy because their immune systems recognizes the virions as foreign particles and "chop off" the virus' genetic coding, rendering it inert. Human infection with a mosquito-borne virus occurs when a female mosquito bites someone while its immune system is still in the process of destroying the virus's harmful coding. [ clarification needed ] It is not completely known how mosquitoes handle eukaryotic parasites to carry them without being harmed. Data has shown that the malaria parasite Plasmodium falciparum alters the mosquito vector's feeding behavior by increasing frequency of biting in infected mosquitoes, thus increasing the chance of transmitting the parasite. The mechanism of transmission of this disease starts with the injection of the parasite into the victim's blood when malaria-infected female Anopheles mosquitoes bite into a human being. The parasite uses human liver cells as hosts for maturation where it will continue to replicate and grow, moving into other areas of the body via the bloodstream. The spread of this infection cycle then continues when other mosquitoes bite the same individual. The result will cause that mosquito to ingest the parasite and allow it to transmit the Malaria disease into another person through the same mode of bite injection. Flaviviridae viruses transmissible via vectors like mosquitoes include West Nile virus and yellow fever virus, which are single stranded, positive-sense RNA viruses enveloped in a protein coat. Once inside the host's body, the virus will attach itself to a cell's surface through receptor-mediated endocytosis. This essentially means that the proteins and DNA material of the virus are ingested into the host cell. The viral RNA material will undergo several changes and processes inside the host's cell so that it can release more viral RNA that can then be replicated and assembled to infect neighboring host cells. Mosquito-borne flaviviruses also encode viral antagonists to the innate immune system in order to cause persistent infection in mosquitoes and a broad spectrum of diseases in humans. The data on transmissibility via insect vectors of hepatitis C virus, also belonging to family Flaviviridae (as well as for hepatitis B virus, belonging to family Hepadnaviridae ) are inconclusive. WHO states that "There is no insect vector or animal reservoir for HCV", while there are experimental data supporting at least the presence of [PCR]-detectable hepatitis C viral RNA in Culex mosquitoes for up to 13 days. Currently, there are no specific vaccine therapies for West Nile virus approved for humans; however, vaccines are available and some show promise for animals, as a means to intervene with the mechanism of spreading such pathogens. Doctors can typically identify a mosquito bite by sight. A doctor will perform a physical examination and ask about medical history as well as any travel history. Be ready to give details on any international trips, including the dates you were traveling, the countries you visited and any contact you had with mosquitoes. Diagnosing dengue fever can be difficult, as its symptoms often overlap with many other diseases such as malaria and typhoid fever . Laboratory tests can detect evidence of the dengue viruses, however the results often come back too late to assist in directing treatment. Medical testing can confirm the presence of West Nile fever or a West Nile-related illness, such as meningitis or encephalitis. If infected, a blood test may show a rising level of antibodies to the West Nile virus. A lumbar puncture (spinal tap) is the most common way to diagnose meningitis, by analyzing the cerebrospinal fluid surrounding your brain and spinal cord. The fluid sample may show an elevated white cell count and antibodies to the West Nile virus if you were exposed. In some cases, an electroencephalography (EEG) or magnetic resonance imaging (MRI) scan can help detect brain inflammation. A Zika virus infection might be suspected if symptoms are present and an individual has traveled to an area with known Zika virus transmission. Zika virus can only be confirmed by a laboratory test of body fluids, such as urine or saliva, or by blood test. Laboratory blood tests can identify evidence of chikungunya or other similar viruses such as dengue and Zika. Blood test may confirm the presence of IgM and IgG anti-chikungunya antibodies. IgM antibodies are highest 3 to 5 weeks after the beginning of symptoms and will continue be present for about 2 months. Diagnosing dengue fever can be difficult, as its symptoms often overlap with many other diseases such as malaria and typhoid fever . Laboratory tests can detect evidence of the dengue viruses, however the results often come back too late to assist in directing treatment. Medical testing can confirm the presence of West Nile fever or a West Nile-related illness, such as meningitis or encephalitis. If infected, a blood test may show a rising level of antibodies to the West Nile virus. A lumbar puncture (spinal tap) is the most common way to diagnose meningitis, by analyzing the cerebrospinal fluid surrounding your brain and spinal cord. The fluid sample may show an elevated white cell count and antibodies to the West Nile virus if you were exposed. In some cases, an electroencephalography (EEG) or magnetic resonance imaging (MRI) scan can help detect brain inflammation. A Zika virus infection might be suspected if symptoms are present and an individual has traveled to an area with known Zika virus transmission. Zika virus can only be confirmed by a laboratory test of body fluids, such as urine or saliva, or by blood test. Laboratory blood tests can identify evidence of chikungunya or other similar viruses such as dengue and Zika. Blood test may confirm the presence of IgM and IgG anti-chikungunya antibodies. IgM antibodies are highest 3 to 5 weeks after the beginning of symptoms and will continue be present for about 2 months. There is a re-emergence of mosquito vectored viruses (arthropod-borne viruses) called arboviruses carried by the Aedes aegypti mosquito. Examples are the Zika virus, chikungunya virus, yellow fever and dengue fever. The re-emergence of the viruses has been at a faster rate, and over a wider geographic area, than in the past. The rapid re-emergence is due to expanding global transportation networks, the mosquito's increasing ability to adapt to urban settings, the disruption of traditional land use and the inability to control expanding mosquito populations. Like malaria, arboviruses do not have a vaccine. (The only exception is yellow fever.) Prevention is focused on reducing the adult mosquito populations, controlling mosquito larvae and protecting individuals from mosquito bites. Depending on the mosquito vector, and the affected community, a variety of prevention methods may be deployed at one time. The use of insecticide treated mosquito nets (ITNs) are at the forefront of preventing mosquito bites that cause malaria. The prevalence of ITNs in sub-Saharan Africa has grown from 3% of households to 50% of households from 2000 to 2010 with over 254 million insecticide treated nets distributed throughout sub-Saharan Africa for use against the mosquito vectors Anopheles gambiae and Anopheles funestus which carry malaria. Because the Anopheles gambiae feeds indoors (endophagic) and rests indoors after feeding (endophilic), insecticide treated nets (ITNs) interrupt the mosquito's feeding pattern. The ITNs continue to offer protection, even after there are holes in the nets, because of their excito-repellency properties which reduce the number of mosquitoes that enter the home. The World Health Organization (WHO) recommends treating ITNs with the pyrethroid class of insecticides. There is an emerging concern of mosquito resistance to insecticides used in ITNs. Twenty-seven (27) sub-Saharan African countries have reported Anopheles vector resistance to pyrethroid insecticides. Indoor spraying of insecticides is another prevention method widely used to control mosquito vectors. To help control the Aedes aegypti mosquito, homes are sprayed indoors with residual insecticide applications. Indoor residual spraying (IRS) reduces the female mosquito population and mitigates the risk of dengue virus transmission. Indoor residual spraying is completed usually once or twice a year. Mosquitoes rest on walls and ceilings after feeding and are killed by the insecticide. Indoor spraying can be combined with spraying the exterior of the building to help reduce the number of mosquito larvae and subsequently, the number of adult mosquitoes. There are other methods that an individual can use to protect themselves from mosquito bites. Limiting exposure to mosquitoes from dusk to dawn when the majority of mosquitoes are active and wearing long sleeves and long pants during the period mosquitoes are most active. Placing screens on windows and doors is a simple and effective means of reducing the number of mosquitoes indoors. Anticipating mosquito contact and using a topical mosquito repellant with icaridin or DEET is also recommended. Draining or covering water receptacles, both indoor and outdoors, is also a simple but effective prevention method. Removing debris and tires, cleaning drains, and cleaning gutters help larval control and reduce the number of adult mosquitoes. There is a vaccine for yellow fever which was developed in the 1930s, the yellow 17D vaccine , and it is still in use today. The initial yellow fever vaccination provides lifelong protection for most people and provides immunity within 30 days of the vaccine. Reactions to the yellow fever vaccine have included mild headache and fever, and muscle aches. There are rare cases of individuals presenting with symptoms that mirror the disease itself. The risk of complications from the vaccine are greater for individuals over 60 years of age. In addition, the vaccine is not usually administered to babies under nine months of age, pregnant women, people with allergies to egg protein, and individuals living with AIDS/HIV . The World Health Organization (WHO) reports that 105 million people have been vaccinated for yellow fever in West Africa from 2000 to 2015. To date, there are relatively few vaccines against mosquito-borne diseases, this is due to the fact that most viruses and bacteria caused by mosquitos are highly mutatable. The National Institute of Allergy and Infectious Disease (NIAID) began Phase 1 clinical trials of a new vaccine that would be nearly universal in protecting against the majority of mosquito-borne diseases. The arboviruses have expanded their geographic range and infected populations that had no recent community knowledge of the diseases carried by the Aedes aegypti mosquito. Education and community awareness campaigns are necessary for prevention to be effective. Communities are educated on how the disease is spread, how they can protect themselves from infection and the symptoms of infection. Community health education programs can identify and address the social/economic and cultural issues that can hinder preventative measures. Community outreach and education programs can identify which preventative measures a community is most likely to employ. Leading to a targeted prevention method that has a higher chance of success in that particular community. Community outreach and education includes engaging community health workers and local healthcare providers, local schools and community organizations to educate the public on mosquito vector control and disease prevention. The use of insecticide treated mosquito nets (ITNs) are at the forefront of preventing mosquito bites that cause malaria. The prevalence of ITNs in sub-Saharan Africa has grown from 3% of households to 50% of households from 2000 to 2010 with over 254 million insecticide treated nets distributed throughout sub-Saharan Africa for use against the mosquito vectors Anopheles gambiae and Anopheles funestus which carry malaria. Because the Anopheles gambiae feeds indoors (endophagic) and rests indoors after feeding (endophilic), insecticide treated nets (ITNs) interrupt the mosquito's feeding pattern. The ITNs continue to offer protection, even after there are holes in the nets, because of their excito-repellency properties which reduce the number of mosquitoes that enter the home. The World Health Organization (WHO) recommends treating ITNs with the pyrethroid class of insecticides. There is an emerging concern of mosquito resistance to insecticides used in ITNs. Twenty-seven (27) sub-Saharan African countries have reported Anopheles vector resistance to pyrethroid insecticides. Indoor spraying of insecticides is another prevention method widely used to control mosquito vectors. To help control the Aedes aegypti mosquito, homes are sprayed indoors with residual insecticide applications. Indoor residual spraying (IRS) reduces the female mosquito population and mitigates the risk of dengue virus transmission. Indoor residual spraying is completed usually once or twice a year. Mosquitoes rest on walls and ceilings after feeding and are killed by the insecticide. Indoor spraying can be combined with spraying the exterior of the building to help reduce the number of mosquito larvae and subsequently, the number of adult mosquitoes. There are other methods that an individual can use to protect themselves from mosquito bites. Limiting exposure to mosquitoes from dusk to dawn when the majority of mosquitoes are active and wearing long sleeves and long pants during the period mosquitoes are most active. Placing screens on windows and doors is a simple and effective means of reducing the number of mosquitoes indoors. Anticipating mosquito contact and using a topical mosquito repellant with icaridin or DEET is also recommended. Draining or covering water receptacles, both indoor and outdoors, is also a simple but effective prevention method. Removing debris and tires, cleaning drains, and cleaning gutters help larval control and reduce the number of adult mosquitoes. There is a vaccine for yellow fever which was developed in the 1930s, the yellow 17D vaccine , and it is still in use today. The initial yellow fever vaccination provides lifelong protection for most people and provides immunity within 30 days of the vaccine. Reactions to the yellow fever vaccine have included mild headache and fever, and muscle aches. There are rare cases of individuals presenting with symptoms that mirror the disease itself. The risk of complications from the vaccine are greater for individuals over 60 years of age. In addition, the vaccine is not usually administered to babies under nine months of age, pregnant women, people with allergies to egg protein, and individuals living with AIDS/HIV . The World Health Organization (WHO) reports that 105 million people have been vaccinated for yellow fever in West Africa from 2000 to 2015. To date, there are relatively few vaccines against mosquito-borne diseases, this is due to the fact that most viruses and bacteria caused by mosquitos are highly mutatable. The National Institute of Allergy and Infectious Disease (NIAID) began Phase 1 clinical trials of a new vaccine that would be nearly universal in protecting against the majority of mosquito-borne diseases. The arboviruses have expanded their geographic range and infected populations that had no recent community knowledge of the diseases carried by the Aedes aegypti mosquito. Education and community awareness campaigns are necessary for prevention to be effective. Communities are educated on how the disease is spread, how they can protect themselves from infection and the symptoms of infection. Community health education programs can identify and address the social/economic and cultural issues that can hinder preventative measures. Community outreach and education programs can identify which preventative measures a community is most likely to employ. Leading to a targeted prevention method that has a higher chance of success in that particular community. Community outreach and education includes engaging community health workers and local healthcare providers, local schools and community organizations to educate the public on mosquito vector control and disease prevention. Numerous drugs have been used to treat yellow fever disease with minimal satisfaction to date. Patients with multisystem organ involvement will require critical care support such as possible hemodialysis or mechanical ventilation . Rest, fluids, and acetaminophen are also known to relieve milder symptoms of fever and muscle pain. Due to hemorrhagic complications, aspirin should be avoided. Infected individuals should avoid mosquito exposure by staying indoors or using a mosquito net . Dengue infection's therapeutic management is simple, cost effective and successful in saving lives by adequately performing timely institutionalized interventions. Treatment options are restricted, while no effective antiviral drugs for this infection have been accessible to date. Patients in the early phase of the dengue virus may recover without hospitalization. However, ongoing clinical research is in the works to find specific anti-dengue drugs. Dengue fever occurs via Aedes aegypti mosquito (it acts as a vector). Zika virus vaccine clinical trials are to be conducted and established. There are efforts being put toward advancing antiviral therapeutics against zika virus for swift control. Present day Zika virus treatment is symptomatic through antipyretics and analgesics . Currently there are no publications regarding viral drug screening. Nevertheless, therapeutics for this infection have been used. There are no treatment modalities for acute and chronic chikungunya that currently exist. Most treatment plans use supportive and symptomatic care like analgesics for pain and anti-inflammatories for inflammation caused by arthritis . In acute stages of this virus, rest, antipyretics and analgesics are used to subside symptoms. Most use non-steroidal anti-inflammatory drugs (NSAIDs). In some cases, joint pain may resolve from treatment but stiffness remains. The sterile insect technique (SIT) uses irradiation to sterilize insect pests before releasing them in large numbers to mate with wild females. Since they do not produce any offspring, the population, and consequently the disease incidence, is reduced over time. Used successfully for decades to combat fruit flies and livestock pests such as screwworm and tsetse flies , the technique can be adapted also for some disease-transmitting mosquito species. Pilot projects are being initiated or are under way in different parts of the world. Numerous drugs have been used to treat yellow fever disease with minimal satisfaction to date. Patients with multisystem organ involvement will require critical care support such as possible hemodialysis or mechanical ventilation . Rest, fluids, and acetaminophen are also known to relieve milder symptoms of fever and muscle pain. Due to hemorrhagic complications, aspirin should be avoided. Infected individuals should avoid mosquito exposure by staying indoors or using a mosquito net . Dengue infection's therapeutic management is simple, cost effective and successful in saving lives by adequately performing timely institutionalized interventions. Treatment options are restricted, while no effective antiviral drugs for this infection have been accessible to date. Patients in the early phase of the dengue virus may recover without hospitalization. However, ongoing clinical research is in the works to find specific anti-dengue drugs. Dengue fever occurs via Aedes aegypti mosquito (it acts as a vector).Zika virus vaccine clinical trials are to be conducted and established. There are efforts being put toward advancing antiviral therapeutics against zika virus for swift control. Present day Zika virus treatment is symptomatic through antipyretics and analgesics . Currently there are no publications regarding viral drug screening. Nevertheless, therapeutics for this infection have been used. There are no treatment modalities for acute and chronic chikungunya that currently exist. Most treatment plans use supportive and symptomatic care like analgesics for pain and anti-inflammatories for inflammation caused by arthritis . In acute stages of this virus, rest, antipyretics and analgesics are used to subside symptoms. Most use non-steroidal anti-inflammatory drugs (NSAIDs). In some cases, joint pain may resolve from treatment but stiffness remains. The sterile insect technique (SIT) uses irradiation to sterilize insect pests before releasing them in large numbers to mate with wild females. Since they do not produce any offspring, the population, and consequently the disease incidence, is reduced over time. Used successfully for decades to combat fruit flies and livestock pests such as screwworm and tsetse flies , the technique can be adapted also for some disease-transmitting mosquito species. Pilot projects are being initiated or are under way in different parts of the world. Mosquito-borne diseases, such as dengue fever and malaria , typically affect developing countries and areas with tropical climates. Mosquito vectors are sensitive to climate changes and tend to follow seasonal patterns. Between years there are often dramatic shifts in incidence rates. The occurrence of this phenomenon in endemic areas makes mosquito-borne viruses difficult to treat. Dengue fever is caused by infection through viruses of the family Flaviviridae. The illness is most commonly transmitted by Aedes aegypti mosquitoes in tropical and subtropical regions. Dengue virus has four different serotypes, each of which are antigenically related but have limited cross-immunity to reinfection. Although dengue fever has a global incidence of 50–100 million cases, only several hundreds of thousands of these cases are life-threatening. The geographic prevalence of the disease can be examined by the spread of Aedes aegypti . Over the last twenty years, there has been a geographic spread of the disease. Dengue incidence rates have risen sharply within urban areas which have recently become endemic hot spots for the disease. The recent spread of Dengue can also be attributed to rapid population growth, increased coagulation in urban areas, and global travel. Without sufficient vector control, the dengue virus has evolved rapidly over time, posing challenges to both government and public health officials. [ citation needed ] Malaria is caused by a protozoan called Plasmodium falciparum . P. falciparum parasites are transmitted mainly by the Anopheles gambiae complex in rural Africa. In just this area, P. falciparum infections comprise an estimated 200 million clinical cases and 1 million annual deaths. 75% of individuals affected in this region are children. As with dengue, changing environmental conditions have led to novel disease characteristics. Due to increased illness severity, treatment complications, and mortality rates, many public health officials concede that malaria patterns are rapidly transforming in Africa. Scarcity of health services, rising instances of drug resistance, and changing vector migration patterns are factors that public health officials believe contribute to malaria's dissemination. Climate heavily affects mosquito vectors of malaria and dengue. Climate patterns influence the lifespan of mosquitos as well as the rate and frequency of reproduction. Climate change impacts have been of great interest to those studying these diseases and their vectors. Additionally, climate impacts mosquito blood feeding patterns as well as extrinsic incubation periods. Climate consistency gives researchers an ability to accurately predict annual cycling of the disease but recent climate unpredictability has eroded researchers' ability to track the disease with such precision.In many insect species, such as Drosophila melanogaster , researchers found that a natural infection with the bacteria strain Wolbachia pipientis increases the fitness of the host by increasing resistance to RNA viral infections. Robert L. Glaser and Mark A. Meola investigated Wolbachia -induced resistance to West Nile virus (WNV) in Drosophila melanogaster (fruit flies). Two groups of fruit flies were naturally infected with Wolbachia . Glaser and Meola then cured one group of fruit flies of Wolbachia using tetracycline. Both the infected group and the cured groups were then infected with WNV. Flies infected with Wolbachia were found to have a changed phenotype that caused resistance to WNV. The phenotype was found to be caused by a "dominant, maternally transmitted, cytoplasmic factor". The WNV-resistance phenotype was then reversed by curing the fruit flies of Wolbachia . Since Wolbachia is also maternally transmitted, it was found that the WNV-resistant phenotype is directly related to the Wolbachia infection. West Nile virus is transmitted to humans and animals through the Southern house mosquito, Culex quinquefasciatus . Glaser and Meola knew vector compatibility could be reduced through Wolbachia infection due to studies done with other species of mosquitoes, mainly, Aedes aegypti . Their goal was to transfer WNV resistance to Cx. quinquefasciatus by inoculating the embryos of the mosquito with the same strain of Wolbachia that naturally occurred in the fruit flies. Upon infection, Cx. quinquefasciatus showed an increased resistance to WNV that was transferable to offspring. The ability to genetically modify mosquitoes in the lab and then have the infected mosquitoes transmit it to their offspring showed that it was possible to transmit the bacteria to wild populations to decrease human infections. [ citation needed ] In 2011, Ary Hoffmann and associates produced the first case of Wolbachia -induced arbovirus resistance in wild populations of Aedes aegypti through a small project called Eliminate Dengue: Our Challenge. This was made possible by an engineered strain of Wolbachia termed w Mel that came from D. melanogaster . The transfer of w Mel from D. melanogaster into field-caged populations of the mosquito Aedes aegypti induced resistance to dengue, yellow fever, and chikungunya viruses. Although other strains of Wolbachia also reduced susceptibility to dengue infection, they also put a greater demand on the fitness of Ae. aegypti . w Mel was different in that it was thought to only cost the organism a small portion of its fitness. w Mel-infected Ae. aegypti were released into two residential areas in the city of Cairns, Australia over a 14-week period. Hoffmann and associates, released a total of 141,600 infected adult mosquitoes in Yorkeys Knob suburb and 157,300 in Gordonvale suburb. After release, the populations were monitored for three years to record the spread of w Mel. Population monitoring was gauged by measuring larvae laid in traps. At the beginning of the monitoring period but still within the release period, it was found that w Mel-infected Ae. aegypti had doubled in Yorkeys Knob and increased 1.5-fold in Gordonvale. Uninfected Ae. aegypti populations were in decline. By the end of the three years, w Mel-infected Ae. aegypti had stable populations of about 90%. However, these populations were isolated to the Yorkeys Knob and Gordonvale suburbs due to unsuitable habitat surrounding the neighborhoods. Although populations flourished in these areas with nearly 100% transmission, no signs of spread were noted, proving disappointing for some. Following this experiment, Tom L. Schmidt and his colleagues conducted an experiment releasing Wolbachia -infected Aedes aegypti using different site selection methods occurred in different areas of Cairns during 2013. The release sites were monitored over two years. This time the release was done in urban areas that were adjacent to adequate habitat to encourage mosquito dispersal. Over the two years, the population doubled, and spatial spread was also increased, unlike the first release, giving ample satisfactory results. By increasing the spread of the Wolbachia -infected mosquitoes, the researchers were able to establish that population of a large city was possible if the mosquitoes were given adequate habitat to spread into upon release in different local locations throughout the city. In both of these studies, no adverse effects on public health or the natural ecosystem occurred. This made it an extremely attractive alternative to traditional insecticide methods given the increased pesticide resistance occurring from heavy use. From the success seen in Australia, the researchers were able to begin operating in more threatened portions of the world. The Eliminate Dengue program spread to 10 countries throughout Asia, Latin America, and the Western Pacific blooming into the non-profit organization, World Mosquito Program, as of September 2017. They still use the same technique of infecting wild populations of Ae. aegypti as they did in Australia, but their target diseases now include Zika, chikungunya and yellow fever as well as dengue. Although not alone in their efforts to use Wolbachia- infected mosquitoes to reduce mosquito-borne disease, the World Mosquito Program method is praised for being self-sustaining in that it causes permanent phenotype change rather than reducing mosquito populations through cytoplasmic incompatibility through male-only dispersal.

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West Nile

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Death of Alexander the Great

The death of Alexander the Great and subsequent related events have been the subjects of debates. According to a Babylonian astronomical diary , Alexander died in the palace of Nebuchadnezzar II in Babylon between the evening of 10 June and the evening of 11 June 323 BC, at the age of 32. Macedonians and local residents wept at the news of the death, while Achaemenid subjects were forced to shave their heads. The mother of Darius III , Sisygambis , having learned of Alexander's death, became depressed and killed herself later. Historians vary in their assessments of primary sources about Alexander's death, which has resulted in different views about its cause and circumstances.In February 323 BC, Alexander ordered his armies to prepare for the march to Babylon . According to Arrian , after crossing the Tigris Alexander was met by Chaldeans , who advised him not to enter the city because their deity Bel had warned them that to do so at that time would be fatal for Alexander. The Chaldeans also warned Alexander against marching westwards as he would then look to the setting sun, a symbol of decline. It was suggested that he enter Babylon via the Royal Gate, in the western wall, where he would face to the east. Alexander followed this advice, but the route turned out to be unfavorable because of swampy terrain. According to Jona Lendering , "it seems that in May 323" the Babylonian astrologers tried to avert the misfortune by substituting Alexander with an ordinary person on the Babylonian throne, who would take the brunt of the omen. The Greeks, however, did not understand that ritual. Calanus was likely to be a Hindu Naga sadhu , whom Greeks called gymnosophists . He had accompanied the Greek army back from Punjab , upon request by Alexander. He was 73 years of age at that time. However, when Persian weather and travel fatigue weakened him, he informed Alexander that he would rather die than live disabled. He decided to take his life by self-immolation . Alexander tried to dissuade him from doing so but upon the insistence of Calanus, Alexander relented and the job of building a pyre was entrusted to Ptolemy (son of Seleucus) . The place where this incident took place was Susa in 323 BC. Calanus is mentioned also by Alexander's admiral, Nearchus and Chares of Mytilene . He did not flinch as he burnt to the astonishment of those who watched. Before immolating himself alive on the pyre, his last words to Alexander were "We shall meet in Babylon". Thus he is said to have prophesied the death of Alexander in Babylon. At the time of the death of Calanus, Alexander, however, did not have any plan to go to Babylon. No one understood the meaning of his words "We shall meet in Babylon". It was only after Alexander fell sick and died in Babylon, that the Greeks came to realize what Calanus intended to convey.Calanus was likely to be a Hindu Naga sadhu , whom Greeks called gymnosophists . He had accompanied the Greek army back from Punjab , upon request by Alexander. He was 73 years of age at that time. However, when Persian weather and travel fatigue weakened him, he informed Alexander that he would rather die than live disabled. He decided to take his life by self-immolation . Alexander tried to dissuade him from doing so but upon the insistence of Calanus, Alexander relented and the job of building a pyre was entrusted to Ptolemy (son of Seleucus) . The place where this incident took place was Susa in 323 BC. Calanus is mentioned also by Alexander's admiral, Nearchus and Chares of Mytilene . He did not flinch as he burnt to the astonishment of those who watched. Before immolating himself alive on the pyre, his last words to Alexander were "We shall meet in Babylon". Thus he is said to have prophesied the death of Alexander in Babylon. At the time of the death of Calanus, Alexander, however, did not have any plan to go to Babylon. No one understood the meaning of his words "We shall meet in Babylon". It was only after Alexander fell sick and died in Babylon, that the Greeks came to realize what Calanus intended to convey.According to historical accounts, Alexander's body began to decompose six days after his death. Proposed causes of Alexander's death include alcoholic liver disease, fever, and strychnine poisoning, but little data support those versions. According to the University of Maryland School of Medicine report of 1998, Alexander probably died of typhoid fever (which, along with malaria , was common in ancient Babylon). In the week before his death, historical accounts mention chills, sweats, exhaustion and high fever, typical symptoms of infectious diseases, including typhoid fever. According to David W. Oldach from the University of Maryland Medical Center , Alexander also had "severe abdominal pain , causing him to cry out in agony". The associated account, however, comes from the unreliable Alexander Romance . According to Andrew N. Williams and Robert Arnott, in his last days Alexander was unable to speak, which was due to a previous injury to his neck during the Siege of Cyropolis . Other popular theories contend that Alexander either died of malaria or was poisoned. Other retrodiagnoses include noninfectious diseases as well. According to author Andrew Chugg, there is evidence Alexander died of malaria, having contracted it two weeks before the onset of illness while sailing in the marshes to inspect flood defences. Chugg based his argument on the Ephemerides (Journal) compiled by Alexander's secretary, Eumenes of Cardia. Chugg also showed in a paper in the Ancient History Bulletin that the Ephemerides are probably authentic. Chugg further noted that Arrian states that Alexander "No longer had any rest from the fever" halfway through his fatal illness. This is evidence that the fever had initially been intermittent, which is the signature fever curve of Plasmodium falciparum (the expected malarial parasite, given Alexander's travel history and the severity of the illness), thus enhancing the likelihood of malaria. The malaria version was also supported by Paul Cartledge . [ citation needed ] Throughout the centuries suspicions of possible poisoning have fallen on a number of alleged perpetrators, including one of Alexander's wives, his generals, his illegitimate half-brother or the royal cup-bearer. The poisoning version is featured particularly in the politically motivated Liber de Morte Testamentoque Alexandri ( The Book On the Death and Testament of Alexander ), which tries to discredit the family of Antipater . It was argued that the book was compiled in Polyperchon 's circle, not before c. 317 BC. This theory was also advanced by Justin in his Historia Philippicae et Totius Mundi Origines et Terrae Situs where he stated that Antipater murdered Alexander by feeding him a poison so strong that it "could be conveyed [only] in the hoof of a horse.". In Alexander the Great: The Death of a God , Paul C. Doherty claimed that Alexander was poisoned with arsenic by his possibly illegitimate half-brother Ptolemy I Soter . However, this was disputed by New Zealand National Poisons Centre toxicologist Dr. Leo Schep, who discounted arsenic poisoning and instead suggested that he could have been poisoned by a wine made from the plant Veratrum album , known as white hellebore. This poisonous plant can produce prolonged poisoning symptoms that match the course of events as described in the Alexander Romance , and was known to the Ancient Greeks. The article was published in the peer-reviewed medical journal Clinical Toxicology and suggested that if Alexander was poisoned, Veratrum album offers the most plausible cause. This theory is backed by the writings of the Ancient Greek historian Diodorus , who had recorded Alexander becoming "stricken with pain after drinking a large bowl of wine." Epidemiologist John Marr and Charles Calisher put forward the West Nile fever as the possible cause of Alexander's death. This version was deemed "fairly compelling" by University of Rhode Island epidemiologist Thomas Mather, who nonetheless noted that the West Nile virus tends to kill the elderly or those with weakened immune systems . The version of Marr and Calisher was also criticized by Burke A. Cunha from Winthrop University Hospital . According to analysis of other authors in response to Marr and Calisher, the West Nile virus could not have infected humans before the 8th century AD. Other causes that have been put forward include acute pancreatitis provoked by "heavy alcohol consumption and a very rich meal", acute endocarditis , schistosomiasis brought on by Schistosoma haematobium , porphyria , and Guillain-Barré syndrome . Fritz Schachermeyr proposed leukemia and malaria. When Alexander's symptoms were entered into databases of the Global Infectious Disease Epidemiology Network , influenza gained the highest probability (41.2%) on the list of differential diagnoses . However, according to Cunha, the symptoms and course of Alexander's disease are inconsistent with influenza, as well as with malaria, schistosomiasis, and poisoning in particular. Another theory moves away from disease and hypothesizes that Alexander's death was related to a congenital scoliotic syndrome . It has been discussed that Alexander had structural neck deformities and oculomotor deficits, which could be associated with Klippel–Feil syndrome , a rare congenital scoliotic disorder. His physical deformities and symptoms leading up to his death are what lead experts to believe this. Some believe that as Alexander fell ill in his final days, he suffered from progressive epidural spinal cord compression, which left him quadriplegic . However, this hypothesis cannot be proven without a full analysis of Alexander's body. Some have speculated that he suffered from Guillain-Barré syndrome , which typhoid fever can lead to when complicated with other maladies. He may have contracted this disease from a Helicobacter pylori infection after his lung wound during the siege of Multan , where it was common at the time. Proponents say this would explain why Alexander's body reportedly did not decompose for 6 days following his 'death' as he may well have been still alive but in a deep coma. One ancient account reports that the planning and construction of an appropriate funerary cart to convey the body out from Babylon took two years from the time of Alexander's death. It is not known exactly how the body was preserved for about two years before it was moved from Babylon. In 1889, E. A. Wallis Budge suggested that the body was submerged in a vat of honey, while Plutarch reported treatment by Egyptian embalmers . Egyptian and Chaldean embalmers who arrived on 16 June are said to have attested to Alexander's lifelike appearance. This was interpreted as a complication of typhoid fever , known as ascending paralysis , which causes a person to appear dead prior to death. On its way back to Macedonia , the funerary cart with Alexander's body was met in Syria by one of Alexander's generals, the future ruler Ptolemy I Soter . In late 322 or early 321 BC Ptolemy diverted the body to Egypt where it was interred in Memphis, Egypt . In the late 4th or early 3rd century BC Alexander's body was transferred from the Memphis tomb to Alexandria for reburial (by Ptolemy Philadelphus in c. 280 BC , according to Pausanias ). Later Ptolemy Philopator placed Alexander's body in Alexandria's communal mausoleum. Shortly after the death of Cleopatra , Alexander's resting place was visited by Augustus , who is said to have placed flowers on the tomb and a golden diadem upon Alexander's head. By the 4th century AD, the resting place of Alexander was no longer known; later authors, such as Ibn Abd al-Hakam , Al-Masudi and Leo the African , report having seen Alexander's tomb. Leo the African in 1491 and George Sandys in 1611 reportedly saw the tomb in Alexandria . According to one legend, the body lies in a crypt beneath an early Christian church.

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West Nile

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Nile crocodile

The Nile crocodile ( Crocodylus niloticus ) is a large crocodilian native to freshwater habitats in Africa, where it is present in 26 countries. It is widely distributed in sub-Saharan Africa , occurring mostly in the eastern, southern, and central regions of the continent, and lives in different types of aquatic environments such as lakes, rivers, swamps , and marshlands . Although capable of living in saline environments, this species is rarely found in saltwater, but occasionally inhabits deltas and brackish lakes. The range of this species once stretched northward throughout the Nile River, as far north as the Nile Delta . Generally, the adult male Nile crocodile is between 3.5 and 5 m (11 ft 6 in and 16 ft 5 in) in length and weighs 225 to 750 kg (500 to 1,650 lb) . However, specimens exceeding 6.1 m (20 ft) in length and 1,000 kg (2,200 lb) in weight have been recorded. It is the largest freshwater predator in Africa, and may be considered the second-largest extant reptile in the world, after the saltwater crocodile ( Crocodylus porosus ). Size is sexually dimorphic , with females usually about 30% smaller than males. The crocodile has thick, scaly, heavily armoured skin. Nile crocodiles are opportunistic apex predators ; a very aggressive crocodile, they are capable of taking almost any animal within their range. They are generalists , taking a variety of prey, with a diet consisting mostly of different species of fish, reptiles, birds, and mammals . As ambush predators , they can wait for hours, days, and even weeks for the suitable moment to attack. They are agile predators and wait for the opportunity for a prey item to come well within attack range. Even swift prey are not immune to attack. Like other crocodiles, Nile crocodiles have a powerful bite that is unique among all animals, and sharp, conical teeth that sink into flesh, allowing a grip that is almost impossible to loosen. They can apply high force for extended periods of time, a great advantage for holding down large prey underwater to drown. Nile crocodiles are relatively social. They share basking spots and large food sources, such as schools of fish and big carcasses . Their strict hierarchy is determined by size. Large, old males are at the top of this hierarchy and have first access to food and the best basking spots. Crocodiles tend to respect this order; when it is infringed, the results are often violent and sometimes fatal. Like most other reptiles, Nile crocodiles lay eggs ; these are guarded by the females and males, making the Nile crocodiles one of few reptile species whose males contribute to parental care. The hatchlings are also protected for a period of time, but hunt by themselves and are not fed by the parents. The Nile crocodile is one of the most dangerous species of crocodile and is responsible for hundreds of human deaths every year. It is common and is not endangered, despite some regional declines or extirpations in Maghreb .The binomial name Crocodylus niloticus is derived from the Greek κρόκη, kroke ("pebble"), δρῖλος, drilos ("worm"), referring to its rough skin; and niloticus , meaning "from the Nile River". The Nile crocodile is called timsah al-nil in Arabic , mamba in Swahili , garwe in Shona , ngwenya in Ndebele , ngwena in Venda , kwena in Sotho and Tswana , and tanin ha-yeor in Hebrew . It also sometimes referred to as the African crocodile , Ethiopian crocodile , and common crocodile . Although no subspecies are currently formally recognized, as many as seven have been proposed, mostly due to variations in appearance and size noted in various populations throughout Africa. These have consisted of C. n. africanus (informally named the East African Nile crocodile), C. n. chamses (the West African Nile crocodile), C. n. cowiei (the South African Nile crocodile), C. n. madagascariensis (the Malagasy or Madagascar Nile crocodile, regionally also known as the croco Mada , which translates to Malagasy crocodile), C. n. niloticus (the Ethiopian Nile crocodile; this would be the nominate subspecies), C. n. pauciscutatus (the Kenyan Nile crocodile) and C. (n.) suchus (now widely considered a separate species). In a study of the morphology of the various populations, including C. (n.) suchus , the appearance of the Nile crocodile sensu lato was found to be more variable than that of any other currently recognized crocodile species, and at least some of these variations were related to locality. For example, a study on Lake Turkana in Kenya (informally this population would be placed in C. n. pauciscutatus ) found that the local crocodiles have more osteoderms in their ventral surface than other known populations, and thus are of lesser value in leather trading, accounting for an exceptionally large (possibly overpopulated) local population there in the late 20th century. The segregation of the West African crocodile ( C. suchus ) from the Nile crocodile has been supported by morphological characteristics, studies of genetic materials and habitat preferences. The separation of the two is not recognized by the IUCN as their last evaluations of the group was in 2008 and 2009, years before the primary publications supporting the distinctiveness of the West African crocodiles. Although originally thought to be the same species as the West African crocodile , genetic studies using DNA sequencing have revealed that the Nile crocodile is actually more closely related to the crocodiles of the Americas, namely the American ( C. acutus ), Cuban ( C. rhombifer ), Morelet's ( C. moreletii ), and Orinoco crocodiles ( C. intermedius ). The fossil species C. checchiai from the Miocene in Kenya was about the same size as the extant African Nile crocodiles and shared similar physical characteristics to this specific species. At one time, the fossil species Rimasuchus lloydi was thought to be the closest relative of the Nile crocodile, but more recent research has indicated that Rimasuchus , despite its very large size (about 20–30% bigger than a Nile crocodile with a skull length estimated up to 97 cm (38 in) ), is more closely related to the dwarf crocodile ( Osteolaemus tetraspis ) among living species. Two other fossil species from Africa retained in the genus Crocodylus appear to be closely related to the Nile crocodile: C. anthropophagus from Plio-Pleistocene Tanzania and C. thorbjarnarsoni from Plio-Pleistocene Kenya . C. anthropophagus and C. thorbjarnarsoni were both somewhat larger, with projected total lengths up to 7.5–7.6 m (24 ft 7 in – 24 ft 11 in) . As well as being larger, C. anthropophagus and C. thorbjarnarsoni , as well as Rimasuchus spp., were all relatively broad-snouted, indicating a specialization at hunting sizeable prey, such as large mammals and freshwater turtles, the latter much larger than any in present-day Africa. Studies have since shown these other African crocodiles to be only more distantly related to the Nile crocodile. Below is a cladogram based on a 2018 tip dating study by Lee & Yates simultaneously using morphological , molecular ( DNA sequencing ), and stratigraphic ( fossil age) data, as revised by the 2021 Hekkala et al. paleogenomics study using DNA extracted from the extinct Voay . Voay †Crocodylus anthropophagus †Crocodylus thorbjarnarsoni †Crocodylus palaeindicus †Crocodylus Tirari Desert †Crocodylus johnstoni Freshwater crocodile Crocodylus novaeguineae New Guinea crocodile Crocodylus mindorensis Philippine crocodile Crocodylus porosus Saltwater crocodile Crocodylus siamensis Siamese crocodile Crocodylus palustris Mugger crocodile Crocodylus checchiai †Crocodylus falconensis †Crocodylus suchus West African crocodile Crocodylus niloticus Nile crocodile Crocodylus moreletii Morelet's crocodile Crocodylus rhombifer Cuban crocodile Crocodylus intermedius Orinoco crocodile Crocodylus acutus American crocodileAdult Nile crocodiles have a dark bronze colouration above, with faded blackish spots and stripes variably appearing across the back and a dingy off-yellow on the belly, although mud can often obscure the crocodile's actual colour. The flanks, which are yellowish-green in colour, have dark patches arranged in oblique stripes in highly variable patterns. Some variation occurs relative to environment; specimens from swift-flowing waters tend to be lighter in colour than those dwelling in murkier lakes or swamps, which provides camouflage that suits their environment, an example of clinal variation. Nile crocodiles have green eyes. The colouration also helps to camouflage them; juveniles are grey, multicoloured, or brown, with dark cross-bands on the tail and body. The underbelly of young crocodiles is yellowish green. As they mature, Nile crocodiles become darker and the cross-bands fade, especially those on the upper-body. A similar tendency in coloration change during maturation has been noted in most crocodile species. Most morphological attributes of Nile crocodiles are typical of crocodilians as a whole. Like all crocodilians, for example, the Nile crocodile is a quadruped with four short, splayed legs, a long, powerful tail , a scaly hide with rows of ossified scutes running down its back and tail, and powerful, elongated jaws . Their skin has a number of poorly understood integumentary sense organs that may react to changes in water pressure , presumably allowing them to track prey movements in the water. The Nile crocodile has fewer osteoderms on the belly, which are much more conspicuous on some of the more modestly sized crocodilians. The species, however, also has small, oval osteoderms on the sides of the body, as well as the throat. The Nile crocodile shares with all crocodilians a nictitating membrane to protect the eyes and lachrymal glands to cleanse its eyes with tears. The nostrils , eyes, and ears are situated on the top of the head, so the rest of the body can remain concealed under water. They have a four-chambered heart , although modified for their ectothermic nature due to an elongated cardiac septum, physiologically similar to the heart of a bird, which is especially efficient at oxygenating their blood. As in all crocodilians, Nile crocodiles have exceptionally high levels of lactic acid in their blood, which allows them to sit motionless in water for up to 2 hours. Levels of lactic acid as high as they are in a crocodile would kill most vertebrates. However, exertion by crocodilians can lead to death due to increasing lactic acid to lethal levels, which in turn leads to failure of the animal's internal organs. This is rarely recorded in wild crocodiles, normally having been observed in cases where humans have mishandled crocodiles and put them through overly extended periods of physical struggling and stress. The mouths of Nile crocodiles are filled with 64 to 68 sharply pointed, cone-shaped teeth (about a dozen less than alligators have). For most of a crocodile's life, broken teeth can be replaced. On each side of the mouth, five teeth are in the front of the upper jaw ( premaxilla ), 13 or 14 are in the rest of the upper jaw ( maxilla ), and 14 or 15 are on either side of the lower jaw ( mandible ). The enlarged fourth lower tooth fits into the notch on the upper jaw and is visible when the jaws are closed, as is the case with all true crocodiles. Hatchlings quickly lose a hardened piece of skin on the top of their mouths called the egg tooth , which they use to break through their eggshells at hatching. Among crocodilians, the Nile crocodile possesses a relatively long snout, which is about 1.6 to 2.0 times as long as broad at the level of the front corners of the eyes. As is the saltwater crocodile, the Nile crocodile is considered a species with medium-width snout relative to other extant crocodilian species. In a search for the largest crocodilian skulls in museums, the largest verifiable Nile crocodile skulls found were several housed in Arba Minch , Ethiopia , sourced from nearby Lake Chamo , which apparently included several specimens with a skull length more than 65 cm (26 in) , with the largest one being 68.6 cm (27.0 in) in length with a mandibular length of 87 cm (34 in) . Nile crocodiles with skulls this size are likely to measure in the range of 5.4 to 5.6 m (17 ft 9 in to 18 ft 4 in) , which is also the length of the animals according to the museum where they were found. However, larger skulls may exist, as this study largely focused on crocodilians from Asia. The detached head of an exceptionally large Nile crocodile (killed in 1968 and measuring 5.87 m (19 ft 3 in) in length) was found to have weighed 166 kg (366 lb) , including the large tendons used to shut the jaw. The bite force exerted by an adult Nile crocodile has been shown by Brady Barr to measure 22 kN (5,000 lbf) . However, the muscles responsible for opening the mouth are exceptionally weak, allowing a person to easily hold them shut, and even larger crocodiles can be brought under control by the use of duct tape to bind the jaws together. The broadest snouted modern crocodilians are alligators and larger caimans . For example, a 3.9 m (12 ft 10 in) black caiman ( Melanosuchus niger ) was found to have a notably broader and heavier skull than that of a Nile crocodile measuring 4.8 m (15 ft 9 in) . However, despite their robust skulls, alligators and caimans appear to be proportionately equal in biting force to true crocodiles, as the muscular tendons used to shut the jaws are similar in proportional size. Only the gharial ( Gavialis gangeticus ) (and perhaps some of the few very thin-snouted crocodilians) is likely to have noticeably diminished bite force compared to other living species due to its exceptionally narrow, fragile snout. More or less, the size of the tendons used to impart bite force increases with body size and the larger the crocodilian gets, the stronger its bite is likely to be. Therefore, a male saltwater crocodile, which had attained a length around 4.59 m (15 ft 1 in) , was found to have the most powerful biting force ever tested in a lab setting for any type of animal. The Nile crocodile is the largest crocodilian in Africa, and is generally considered the second-largest crocodilian after the saltwater crocodile . Typical size has been reported to be as much as 4.5 to 5.5 m (14 ft 9 in to 18 ft 1 in) , but this is excessive for actual average size per most studies and represents the upper limit of sizes attained by the largest animals in a majority of populations. Alexander and Marais (2007) give the typical mature size as 2.8 to 3.5 m (9 ft 2 in to 11 ft 6 in) ; Garrick and Lang (1977) put it at from 3.0 to 4.5 m (9 ft 10 in to 14 ft 9 in) . According to Cott (1961), the average length and weight of Nile crocodiles from Uganda and Zambia in breeding maturity was 3.16 m (10 ft 4 in) and 137.5 kg (303 lb) . Per Graham (1968), the average length and weight of a large sample of adult crocodiles from Lake Turkana (formerly known as Lake Rudolf), Kenya was 3.66 m (12 ft 0 in) and body mass of 201.6 kg (444 lb) . Similarly, adult crocodiles from Kruger National Park reportedly average 3.65 m (12 ft 0 in) in length. In comparison, the saltwater crocodile and gharial reportedly both average around 4 m (13 ft 1 in) , so are about 30 cm (12 in) longer on average, and the false gharial ( Tomistoma schlegelii ) may average about 3.75 m (12 ft 4 in) , so may be slightly longer, as well. However, compared to the narrow-snouted, streamlined gharial and false gharial, the Nile crocodile is more robust and ranks second to the saltwater crocodile in total average body mass among living crocodilians, and is considered to be the second-largest extant reptile. The largest accurately measured male, shot near Mwanza, Tanzania, measured 6.45 m (21 ft 2 in) and weighed about 1,043–1,089 kg (2,300–2,400 lb) . Another large male measuring 5.8 m (19 ft 0 in) in total length (Cott 1961) was among the largest Nile crocodiles ever recorded. It was estimated to weigh 1,082 kg (2,385 lb) . Like all crocodiles, they are sexually dimorphic , with the males up to 30% larger than the females, though the difference is considerably less compared to some species, like the saltwater crocodile. Male Nile crocodiles are about 30 to 50 cm (12 to 20 in) longer on average at sexual maturity and grow more so than females after becoming sexually mature, especially expanding in bulk after exceeding 4 m (13 ft 1 in) in length. Adult male Nile crocodiles usually range in length from 3.3 to 5.0 m (10 ft 10 in to 16 ft 5 in) long; at these lengths, an average sized male may weigh from 150 to 750 kg (330 to 1,650 lb) . Very old, mature ones can grow to 5.5 m (18 ft 1 in) or more in length (all specimens over 5.5 m (18 ft 1 in) from 1900 onward are cataloged later). Large mature males can reach 1,000 kg (2,200 lb) or more in weight. Mature female Nile crocodiles typically measure 2.2 to 3.8 m (7 ft 3 in to 12 ft 6 in) , at which lengths the average female specimen would weigh 40 to 250 kg (88 to 551 lb) . An old male individual, named "Big Daddy", housed at Mamba Village Centre, Mombasa , Kenya is considered to be one of the largest living Nile crocodiles in captivity. It measures 5 m (16 ft 5 in) in length and weighs 800 kg (1,800 lb) . In 2007, at the Katavi National Park , Brady Barr captured a specimen measuring 5.36 m (17 ft 7 in) in total length (with a considerable portion of its tail tip missing). The weight of this specimen was estimated to be 838 kg (1,847 lb) , making it one of the largest crocodiles ever to be captured and released alive. The bulk and mass of individual crocodiles can be fairly variable, some animals being relatively slender, while others being very robust; females are often bulkier than males of a similar length. As an example of the body mass increase undergone by mature crocodiles, one of the larger crocodiles handled firsthand by Cott (1961) was 4.4 m (14 ft 5 in) and weighed 414.5 kg (914 lb) , while the largest specimen measured by Graham and Beard (1973) was 4.8 m (15 ft 9 in) and weighed more than 680 kg (1,500 lb) . One of the largest known specimens from South Africa , caught by J.G Kuhlmann in Venda , which was 5.5 m (18 ft 1 in) long weighed 905.7 kg (1,997 lb) . On the other hand, another individual measuring 5.87 m (19 ft 3 in) in length was estimated to weigh between 770–820 kg (1,700–1,800 lb) . In attempts to parse the mean male and female lengths across the species, the mean adult length was estimated to be reportedly 4 m (13 ft 1 in) in males, at which males would average about 280 kg (620 lb) in weight, while that of the female is 3.05 m (10 ft 0 in) , at which females would average about 116 kg (256 lb) . This gives the Nile crocodile somewhat of a size advantage over the next largest non-marine predator on the African continent, the lion ( Panthera leo ), which averages 188 kg (414 lb) in males and 124 kg (273 lb) in females, and attains a maximum known weight of 313 kg (690 lb) , far less than that of large male crocodiles. Nile crocodiles from cooler climates, like the southern tip of Africa, may be smaller, reaching maximum lengths of only 4 m (13 ft 1 in) . A crocodile population from Mali , the Sahara Desert , and elsewhere in West Africa reaches only 2 to 3 m (6 ft 7 in to 9 ft 10 in) in length, but it is now largely recognized as a separate species, the West African crocodile . The mouths of Nile crocodiles are filled with 64 to 68 sharply pointed, cone-shaped teeth (about a dozen less than alligators have). For most of a crocodile's life, broken teeth can be replaced. On each side of the mouth, five teeth are in the front of the upper jaw ( premaxilla ), 13 or 14 are in the rest of the upper jaw ( maxilla ), and 14 or 15 are on either side of the lower jaw ( mandible ). The enlarged fourth lower tooth fits into the notch on the upper jaw and is visible when the jaws are closed, as is the case with all true crocodiles. Hatchlings quickly lose a hardened piece of skin on the top of their mouths called the egg tooth , which they use to break through their eggshells at hatching. Among crocodilians, the Nile crocodile possesses a relatively long snout, which is about 1.6 to 2.0 times as long as broad at the level of the front corners of the eyes. As is the saltwater crocodile, the Nile crocodile is considered a species with medium-width snout relative to other extant crocodilian species. In a search for the largest crocodilian skulls in museums, the largest verifiable Nile crocodile skulls found were several housed in Arba Minch , Ethiopia , sourced from nearby Lake Chamo , which apparently included several specimens with a skull length more than 65 cm (26 in) , with the largest one being 68.6 cm (27.0 in) in length with a mandibular length of 87 cm (34 in) . Nile crocodiles with skulls this size are likely to measure in the range of 5.4 to 5.6 m (17 ft 9 in to 18 ft 4 in) , which is also the length of the animals according to the museum where they were found. However, larger skulls may exist, as this study largely focused on crocodilians from Asia. The detached head of an exceptionally large Nile crocodile (killed in 1968 and measuring 5.87 m (19 ft 3 in) in length) was found to have weighed 166 kg (366 lb) , including the large tendons used to shut the jaw. The bite force exerted by an adult Nile crocodile has been shown by Brady Barr to measure 22 kN (5,000 lbf) . However, the muscles responsible for opening the mouth are exceptionally weak, allowing a person to easily hold them shut, and even larger crocodiles can be brought under control by the use of duct tape to bind the jaws together. The broadest snouted modern crocodilians are alligators and larger caimans . For example, a 3.9 m (12 ft 10 in) black caiman ( Melanosuchus niger ) was found to have a notably broader and heavier skull than that of a Nile crocodile measuring 4.8 m (15 ft 9 in) . However, despite their robust skulls, alligators and caimans appear to be proportionately equal in biting force to true crocodiles, as the muscular tendons used to shut the jaws are similar in proportional size. Only the gharial ( Gavialis gangeticus ) (and perhaps some of the few very thin-snouted crocodilians) is likely to have noticeably diminished bite force compared to other living species due to its exceptionally narrow, fragile snout. More or less, the size of the tendons used to impart bite force increases with body size and the larger the crocodilian gets, the stronger its bite is likely to be. Therefore, a male saltwater crocodile, which had attained a length around 4.59 m (15 ft 1 in) , was found to have the most powerful biting force ever tested in a lab setting for any type of animal. The bite force exerted by an adult Nile crocodile has been shown by Brady Barr to measure 22 kN (5,000 lbf) . However, the muscles responsible for opening the mouth are exceptionally weak, allowing a person to easily hold them shut, and even larger crocodiles can be brought under control by the use of duct tape to bind the jaws together. The broadest snouted modern crocodilians are alligators and larger caimans . For example, a 3.9 m (12 ft 10 in) black caiman ( Melanosuchus niger ) was found to have a notably broader and heavier skull than that of a Nile crocodile measuring 4.8 m (15 ft 9 in) . However, despite their robust skulls, alligators and caimans appear to be proportionately equal in biting force to true crocodiles, as the muscular tendons used to shut the jaws are similar in proportional size. Only the gharial ( Gavialis gangeticus ) (and perhaps some of the few very thin-snouted crocodilians) is likely to have noticeably diminished bite force compared to other living species due to its exceptionally narrow, fragile snout. More or less, the size of the tendons used to impart bite force increases with body size and the larger the crocodilian gets, the stronger its bite is likely to be. Therefore, a male saltwater crocodile, which had attained a length around 4.59 m (15 ft 1 in) , was found to have the most powerful biting force ever tested in a lab setting for any type of animal. The Nile crocodile is the largest crocodilian in Africa, and is generally considered the second-largest crocodilian after the saltwater crocodile . Typical size has been reported to be as much as 4.5 to 5.5 m (14 ft 9 in to 18 ft 1 in) , but this is excessive for actual average size per most studies and represents the upper limit of sizes attained by the largest animals in a majority of populations. Alexander and Marais (2007) give the typical mature size as 2.8 to 3.5 m (9 ft 2 in to 11 ft 6 in) ; Garrick and Lang (1977) put it at from 3.0 to 4.5 m (9 ft 10 in to 14 ft 9 in) . According to Cott (1961), the average length and weight of Nile crocodiles from Uganda and Zambia in breeding maturity was 3.16 m (10 ft 4 in) and 137.5 kg (303 lb) . Per Graham (1968), the average length and weight of a large sample of adult crocodiles from Lake Turkana (formerly known as Lake Rudolf), Kenya was 3.66 m (12 ft 0 in) and body mass of 201.6 kg (444 lb) . Similarly, adult crocodiles from Kruger National Park reportedly average 3.65 m (12 ft 0 in) in length. In comparison, the saltwater crocodile and gharial reportedly both average around 4 m (13 ft 1 in) , so are about 30 cm (12 in) longer on average, and the false gharial ( Tomistoma schlegelii ) may average about 3.75 m (12 ft 4 in) , so may be slightly longer, as well. However, compared to the narrow-snouted, streamlined gharial and false gharial, the Nile crocodile is more robust and ranks second to the saltwater crocodile in total average body mass among living crocodilians, and is considered to be the second-largest extant reptile. The largest accurately measured male, shot near Mwanza, Tanzania, measured 6.45 m (21 ft 2 in) and weighed about 1,043–1,089 kg (2,300–2,400 lb) . Another large male measuring 5.8 m (19 ft 0 in) in total length (Cott 1961) was among the largest Nile crocodiles ever recorded. It was estimated to weigh 1,082 kg (2,385 lb) . Like all crocodiles, they are sexually dimorphic , with the males up to 30% larger than the females, though the difference is considerably less compared to some species, like the saltwater crocodile. Male Nile crocodiles are about 30 to 50 cm (12 to 20 in) longer on average at sexual maturity and grow more so than females after becoming sexually mature, especially expanding in bulk after exceeding 4 m (13 ft 1 in) in length. Adult male Nile crocodiles usually range in length from 3.3 to 5.0 m (10 ft 10 in to 16 ft 5 in) long; at these lengths, an average sized male may weigh from 150 to 750 kg (330 to 1,650 lb) . Very old, mature ones can grow to 5.5 m (18 ft 1 in) or more in length (all specimens over 5.5 m (18 ft 1 in) from 1900 onward are cataloged later). Large mature males can reach 1,000 kg (2,200 lb) or more in weight. Mature female Nile crocodiles typically measure 2.2 to 3.8 m (7 ft 3 in to 12 ft 6 in) , at which lengths the average female specimen would weigh 40 to 250 kg (88 to 551 lb) . An old male individual, named "Big Daddy", housed at Mamba Village Centre, Mombasa , Kenya is considered to be one of the largest living Nile crocodiles in captivity. It measures 5 m (16 ft 5 in) in length and weighs 800 kg (1,800 lb) . In 2007, at the Katavi National Park , Brady Barr captured a specimen measuring 5.36 m (17 ft 7 in) in total length (with a considerable portion of its tail tip missing). The weight of this specimen was estimated to be 838 kg (1,847 lb) , making it one of the largest crocodiles ever to be captured and released alive. The bulk and mass of individual crocodiles can be fairly variable, some animals being relatively slender, while others being very robust; females are often bulkier than males of a similar length. As an example of the body mass increase undergone by mature crocodiles, one of the larger crocodiles handled firsthand by Cott (1961) was 4.4 m (14 ft 5 in) and weighed 414.5 kg (914 lb) , while the largest specimen measured by Graham and Beard (1973) was 4.8 m (15 ft 9 in) and weighed more than 680 kg (1,500 lb) . One of the largest known specimens from South Africa , caught by J.G Kuhlmann in Venda , which was 5.5 m (18 ft 1 in) long weighed 905.7 kg (1,997 lb) . On the other hand, another individual measuring 5.87 m (19 ft 3 in) in length was estimated to weigh between 770–820 kg (1,700–1,800 lb) . In attempts to parse the mean male and female lengths across the species, the mean adult length was estimated to be reportedly 4 m (13 ft 1 in) in males, at which males would average about 280 kg (620 lb) in weight, while that of the female is 3.05 m (10 ft 0 in) , at which females would average about 116 kg (256 lb) . This gives the Nile crocodile somewhat of a size advantage over the next largest non-marine predator on the African continent, the lion ( Panthera leo ), which averages 188 kg (414 lb) in males and 124 kg (273 lb) in females, and attains a maximum known weight of 313 kg (690 lb) , far less than that of large male crocodiles. Nile crocodiles from cooler climates, like the southern tip of Africa, may be smaller, reaching maximum lengths of only 4 m (13 ft 1 in) . A crocodile population from Mali , the Sahara Desert , and elsewhere in West Africa reaches only 2 to 3 m (6 ft 7 in to 9 ft 10 in) in length, but it is now largely recognized as a separate species, the West African crocodile . Like all crocodiles, they are sexually dimorphic , with the males up to 30% larger than the females, though the difference is considerably less compared to some species, like the saltwater crocodile. Male Nile crocodiles are about 30 to 50 cm (12 to 20 in) longer on average at sexual maturity and grow more so than females after becoming sexually mature, especially expanding in bulk after exceeding 4 m (13 ft 1 in) in length. Adult male Nile crocodiles usually range in length from 3.3 to 5.0 m (10 ft 10 in to 16 ft 5 in) long; at these lengths, an average sized male may weigh from 150 to 750 kg (330 to 1,650 lb) . Very old, mature ones can grow to 5.5 m (18 ft 1 in) or more in length (all specimens over 5.5 m (18 ft 1 in) from 1900 onward are cataloged later). Large mature males can reach 1,000 kg (2,200 lb) or more in weight. Mature female Nile crocodiles typically measure 2.2 to 3.8 m (7 ft 3 in to 12 ft 6 in) , at which lengths the average female specimen would weigh 40 to 250 kg (88 to 551 lb) . An old male individual, named "Big Daddy", housed at Mamba Village Centre, Mombasa , Kenya is considered to be one of the largest living Nile crocodiles in captivity. It measures 5 m (16 ft 5 in) in length and weighs 800 kg (1,800 lb) . In 2007, at the Katavi National Park , Brady Barr captured a specimen measuring 5.36 m (17 ft 7 in) in total length (with a considerable portion of its tail tip missing). The weight of this specimen was estimated to be 838 kg (1,847 lb) , making it one of the largest crocodiles ever to be captured and released alive. The bulk and mass of individual crocodiles can be fairly variable, some animals being relatively slender, while others being very robust; females are often bulkier than males of a similar length. As an example of the body mass increase undergone by mature crocodiles, one of the larger crocodiles handled firsthand by Cott (1961) was 4.4 m (14 ft 5 in) and weighed 414.5 kg (914 lb) , while the largest specimen measured by Graham and Beard (1973) was 4.8 m (15 ft 9 in) and weighed more than 680 kg (1,500 lb) . One of the largest known specimens from South Africa , caught by J.G Kuhlmann in Venda , which was 5.5 m (18 ft 1 in) long weighed 905.7 kg (1,997 lb) . On the other hand, another individual measuring 5.87 m (19 ft 3 in) in length was estimated to weigh between 770–820 kg (1,700–1,800 lb) . In attempts to parse the mean male and female lengths across the species, the mean adult length was estimated to be reportedly 4 m (13 ft 1 in) in males, at which males would average about 280 kg (620 lb) in weight, while that of the female is 3.05 m (10 ft 0 in) , at which females would average about 116 kg (256 lb) . This gives the Nile crocodile somewhat of a size advantage over the next largest non-marine predator on the African continent, the lion ( Panthera leo ), which averages 188 kg (414 lb) in males and 124 kg (273 lb) in females, and attains a maximum known weight of 313 kg (690 lb) , far less than that of large male crocodiles. Nile crocodiles from cooler climates, like the southern tip of Africa, may be smaller, reaching maximum lengths of only 4 m (13 ft 1 in) . A crocodile population from Mali , the Sahara Desert , and elsewhere in West Africa reaches only 2 to 3 m (6 ft 7 in to 9 ft 10 in) in length, but it is now largely recognized as a separate species, the West African crocodile . The Nile crocodile is presently the most common crocodilian in Africa. Among crocodilians today, only the saltwater crocodile occurs over a broader geographic area, although other species, especially the spectacled caiman ( Caiman crocodilus ) (due to its small size and extreme adaptability in habitat and flexibility in diet), seem to actually be more abundant. This species' historic range, however, was even wider. They were found as far north as the Mediterranean coast in Libya , Tunisia , Algeria , Morocco , the Nile Delta of Egypt and across the Red Sea in Israel , Palestine and Syria . The Nile crocodile has historically been recorded in areas where they are now regionally extinct. For example, Herodotus recorded the species inhabiting Lake Moeris in Egypt. They are thought to have become extinct in the Seychelles in the early 19th century (1810–1820). Today, Nile crocodiles are widely found in, among others, Somalia , Ethiopia , Uganda , Kenya, Egypt, the Central African Republic , the Democratic Republic of the Congo , Equatorial Guinea , Tanzania, Rwanda , Burundi , Zambia, Zimbabwe , Gabon , Angola , South Africa, Malawi , Mozambique , Namibia , Sudan , South Sudan , Botswana , and Cameroon . The Nile crocodile's current range of distribution extends from the regional tributaries of the Nile in Sudan and Lake Nasser in Egypt to the Cunene river of Angola, the Okavango Delta of Botswana, and the Olifants River in South Africa. Isolated populations also exist in Madagascar , which were supposed to have likely colonized the island very recently, after the extinction of the endemic crocodile Voay within the last 2000 years . However in 2022 a skull of Crocodylus from Madagascar was found to be around 7,500 years old based on radiocarbon dating, suggesting that the extinction of Voay post-dates the arrival of Nile crocodiles on Madagascar. Nile Crocodiles occur in the western and southern parts of Madagascar from Sambirano to Tôlanaro . They have been spotted in Zanzibar and the Comoros in modern times, but occur very rarely. The species was previously thought to extend in range into the whole of West and Central Africa, but these populations are now typically recognized as a distinct species, the West African (or desert) crocodile. The distributional boundaries between these species were poorly understood, but following several studies, they are now better known. West African crocodiles are found throughout much of West and Central Africa, ranging east to South Sudan and Uganda where the species may come into contact with the Nile crocodile. Nile crocodiles are absent from most of West and Central Africa, but range into the latter region in eastern and southern Democratic Republic of Congo, and along the Central African coastal Atlantic region (as far north to Cameroon). Likely a level of habitat segregation occurs between the two species, but this remains to be confirmed. Nile crocodiles may be able to tolerate an extremely broad range of habitat types, including small brackish streams, fast-flowing rivers, swamps , dams, and tidal lakes and estuaries . In East Africa, they are found mostly in rivers, lakes, marshes , and dams, favoring open, broad bodies of water over smaller ones. They are often found in waters adjacent to various open habitats such as savanna or even semi-desert but can also acclimate to well-wooded swamps, extensively wooded riparian zones , waterways of other woodlands and the perimeter of forests. In Madagascar, the remnant population of Nile crocodiles has adapted to living within caves. Nile crocodiles may make use of ephemeral watering holes on occasion. Although not a regular sea-going species as is the American crocodile , and especially the saltwater crocodile , the Nile crocodile possesses salt glands like all true crocodiles (i.e., excluding alligators and caimans), and does on occasion enter coastal and even marine waters . They have been known to enter the sea in some areas, with one specimen having been recorded 11 km (6.8 mi) off St. Lucia Bay in 1917. Nile crocodiles have been recently captured in South Florida , though no signs that the population is reproducing in the wild have been found. Genetic studies of Nile crocodiles captured in the wild in Florida have revealed that the specimens are all closely related to each other, suggesting a single source of the introduction. This source remains unclear, as their genetics do not match samples collected from captives at various zoos and theme parks in Florida. When compared to Nile crocodiles from their native Africa, the Florida wild specimens are most closely related to South African Nile crocodiles. It is unknown how many Nile crocodiles are currently at large in Florida. The animals likely were either brought there to be released or are escapees. Nile crocodiles have been recently captured in South Florida , though no signs that the population is reproducing in the wild have been found. Genetic studies of Nile crocodiles captured in the wild in Florida have revealed that the specimens are all closely related to each other, suggesting a single source of the introduction. This source remains unclear, as their genetics do not match samples collected from captives at various zoos and theme parks in Florida. When compared to Nile crocodiles from their native Africa, the Florida wild specimens are most closely related to South African Nile crocodiles. It is unknown how many Nile crocodiles are currently at large in Florida. The animals likely were either brought there to be released or are escapees. Generally, Nile crocodiles are relatively inert creatures, as are most crocodilians and other large, cold-blooded creatures. More than half of the crocodiles observed by Cott (1961), if not disturbed, spent the hours from 9:00 a.m. to 4:00 p.m. continuously basking with their jaws open if conditions were sunny. If their jaws are bound together in the extreme midday heat, Nile crocodiles may easily die from overheating. Although they can remain practically motionless for hours on end, whether basking or sitting in shallows, Nile crocodiles are said to be constantly aware of their surroundings and aware of the presence of other animals. However, mouth-gaping (while essential to thermoregulation) may also serve as a threat display to other crocodiles. For example, some specimens have been observed mouth-gaping at night, when overheating is not a risk. In Lake Turkana , crocodiles rarely bask at all through the day, unlike crocodiles from most other areas, for unknown reasons, usually sitting motionless partially exposed at the surface in shallows, with no apparent ill effects from the lack of basking on land. In South Africa, Nile crocodiles are more easily observed in winter because of the extensive amount of time they spend basking at this time of year. More time is spent in water on overcast, rainy, or misty days. In the southern reaches of their range, as a response to dry, cool conditions that they cannot survive externally, crocodiles may dig and take refuge in tunnels and engage in aestivation . Pooley found in Royal Natal National Park that during aestivation, young crocodiles of 60 to 90 cm (24 to 35 in) total length would dig tunnels around 1.2 to 1.8 m (3 ft 11 in to 5 ft 11 in) in depth for most, with some tunnels measuring more than 2.7 m (8 ft 10 in) , the longest there being 3.65 m (12 ft 0 in) . Crocodiles in aestivation are lethargic, entering a state similar to animals that hibernate . Only the largest individuals engaging in aestivation leave the burrow to sun on the warmest days; otherwise, these crocodiles rarely left their burrows. Aestivation has been recorded from May to August. Nile crocodiles usually dive for only a few minutes at a time, but can swim under water up to 30 minutes if threatened. If they remain fully inactive, they can hold their breath for up to 2 hours (which, as aforementioned, is due to the high levels of lactic acid in their blood). They have a rich vocal range and good hearing . Nile crocodiles normally crawl along on their bellies, but they can also "high walk" with their trunks raised above the ground. Smaller specimens can gallop , and even larger individuals are capable of occasional, surprising bursts of speed, briefly reaching up to 14 km/h (8.7 mph) . They can swim much faster, moving their bodies and tails in a sinuous fashion, and they can sustain this form of movement much longer than on land, with a maximum known swimming speed of 30 to 35 km/h (19 to 22 mph) , more than three times faster than any human. Nile crocodiles have been widely known to have gastroliths in their stomachs, which are stones swallowed by animals for various purposes. Although this is clearly a deliberate behaviour for the species, the purpose is not definitively known. Gastroliths are not present in hatchlings, but increase quickly in presence within most crocodiles examined at 2–3.1 m (6 ft 7 in – 10 ft 2 in) and yet normally become extremely rare again in very large specimens, meaning that some animals may eventually expel them. However, large specimens can have a large number of gastroliths. One crocodile measuring 3.84 m (12 ft 7 in) and weighing 239 kg (527 lb) had 5.1 kg (11 lb) of stones in its stomach, perhaps a record gastrolith weight for a crocodile. Specimens shot near Mpondwe on the Semliki River had gastroliths in their stomach despite being shot miles away from any sources for the stones; the same holds true for specimens from Kafue Flats , Upper Zambesi and Bangweulu Swamp , all of which often had stones inside them despite being nowhere near stony regions. Cott (1961) felt that gastroliths were most likely serving as ballast to provide stability and additional weight to sink in water, this bearing great probability over the theories that they assist in digestion and staving off hunger. However, Alderton (1998) stated that a study using radiology found that gastroliths were seen to internally aid the grinding of food during digestion for a small Nile crocodile. Herodotus claimed that Nile crocodiles have a symbiotic relationship with a bird named the Trochilus which enter the crocodile's mouth and pick leeches feeding on the crocodile's blood. Guggisberg (1972) had seen examples of birds picking scraps of meat from the teeth of basking crocodiles (without entering the mouth) and prey from soil very near basking crocodiles, so felt it was not impossible that a bold, hungry bird may occasionally nearly enter a crocodile's mouth, but not likely as a habitual behaviour. MacFarland and Reeder, reviewing the evidence in 1974, found that: "Extensive observations of Nile crocodiles in regular or occasional association with various species of potential cleaners (e.g. Plovers , Sandpipers , water dikkop ) ... have resulted in only a few reports of sandpipers removing leeches from the mouth and gular scutes and snapping at insects along the reptile's body." Matching Herodotus' description.Nile crocodiles are apex predators throughout their range. In the water, this species is an agile and rapid hunter relying on both movement and pressure sensors to catch any prey unfortunate enough to present itself inside or near the waterfront. Out of water, however, the Nile crocodile can only rely on its limbs, as it gallops on solid ground, to chase prey. No matter where they attack prey, this and other crocodilians take practically all of their food by ambush, needing to grab their prey in a matter of seconds to succeed. They have an ectothermic metabolism, so can survive for long periods between meals. However, for such large animals, their stomachs are relatively small, not much larger than a basketball in an average-sized adult, so as a rule, they are anything but voracious eaters. Young crocodiles feed more actively than their elders, according to studies in Uganda and Zambia. In general, at the smallest sizes ( 0.3–1 m (1 ft 0 in – 3 ft 3 in) ), Nile crocodiles were most likely to have full stomachs (17.4% full per Cott); adults at 3–4 m (9 ft 10 in – 13 ft 1 in) in length were most likely to have empty stomachs (20.2%). In the largest size range studied by Cott, 4–5 m (13 ft 1 in – 16 ft 5 in) , they were the second most likely to either have full stomachs (10%) or empty stomachs (20%). Other studies have also shown a large number of adult Nile crocodiles with empty stomachs. For example, in Lake Turkana , Kenya, 48.4% of crocodiles had empty stomachs. The stomachs of brooding females are always empty, meaning that they can survive several months without food. The Nile crocodile mostly hunts within the confines of waterways, attacking aquatic prey or terrestrial animals when they come to the water to drink or to cross. The crocodile mainly hunts land animals by almost fully submerging its body under water. Occasionally, a crocodile quietly surfaces so that only its eyes (to check positioning) and nostrils are visible, and swims quietly and stealthily toward its mark. The attack is sudden and unpredictable. The crocodile lunges its body out of water and grasps its prey. On other occasions, more of its head and upper body is visible, especially when the terrestrial prey animal is on higher ground, to get a sense of the direction of the prey item at the top of an embankment or on a tree branch. Crocodile teeth are not used for tearing up flesh, but to sink deep into it and hold on to the prey item. The immense bite force , which may be as high as 5,000 lbf (22,000 N) in large adults, ensures that the prey item cannot escape the grip. Prey taken is often much smaller than the crocodile itself, and such prey can be overpowered and swallowed with ease. When it comes to larger prey, success depends on the crocodile's body power and weight to pull the prey item back into the water, where it is either drowned or killed by sudden thrashes of the head or by tearing it into pieces with the help of other crocodiles. Subadult and smaller adult Nile crocodiles use their bodies and tails to herd groups of fish toward a bank, and eat them with quick sideways jerks of their heads. Some crocodiles of the species may habitually use their tails to sweep terrestrial prey off balance, sometimes forcing the prey specimen into the water, where it can be more easily drowned. They also cooperate, blocking migrating fish by forming a semicircle across the river. The most dominant crocodile eats first. Their ability to lie concealed with most of their bodies under water, combined with their speed over short distances, makes them effective opportunistic hunters of larger prey. They grab such prey in their powerful jaws, drag it into the water, and hold it underneath until it drowns. They also scavenge or steal kills from other predators, such as lions and leopards ( Panthera pardus ). Groups of Nile crocodiles may travel hundreds of meters from a waterway to feast on a carcass. They also feed on dead hippopotamuses ( Hippopotamus amphibius ) as a group (sometimes including three or four dozen crocodiles), tolerating each other. Much of the food from crocodile stomachs may come from scavenging carrion, and the crocodiles could be viewed as performing a similar function at times as do vultures or hyenas on land. Once their prey is dead, they rip off and swallow chunks of flesh. When groups are sharing a kill, they use each other for leverage, biting down hard and then twisting their bodies to tear off large pieces of meat in a "death roll". They may also get the necessary leverage by lodging their prey under branches or stones, before rolling and ripping. The Nile crocodile possesses unique predation behavior characterized by the ability of preying both within water, where it is best adapted, and out of it, which often results in unpredictable attacks on almost any other animal up to twice its size. Most hunting on land is done at night by lying in ambush near forest trails or roadsides, up to 50 m (170 ft) from the water's edge. Since their speed and agility on land is rather outmatched by most terrestrial animals, they must use obscuring vegetation or terrain to have a chance of succeeding during land-based hunts. In one case, an adult crocodile charged from the water up a bank to kill a bushbuck ( Tragelaphus scriptus ) and instead of dragging it into the water, was observed to pull the kill further on land into the cover of the bush. Two subadult crocodiles were once seen carrying the carcass of a nyala ( Tragelaphus angasii ) across land in unison. In South Africa, a game warden far from water sources in a savannah-scrub area reported that he saw a crocodile jump up and grab a donkey by the neck and then drag the prey off. Small carnivores are readily taken opportunistically, including African clawless otters ( Aonyx capensis ) Living in the rich biosphere of Africa south of the Sahara, the Nile crocodile may come into contact with other large predators. Its place in the ecosystems it inhabits is unique, as it is the only large tetrapod carnivore that spends the majority of its life in water and hunting prey associated with aquatic zones. Large mammalian predators in Africa are often social animals and obligated to feed almost exclusively on land. The Nile crocodile is a strong example of an apex predator . Outside water, crocodiles can meet competition from other dominant savannah predators, notably big cats , which in Africa are represented by lions, cheetahs , and leopards. In general, big cats and crocodiles have a relationship of mutual avoidance. Occasionally, if regular food becomes scarce, both lions and the crocodile will steal kills on land from each other and, depending on size, will be dominant over one another. Both species may be attracted to carrion, and may occasionally fight over both kills or carrion. Most conflicts over food occur near the water and can literally lead to a tug-of-war over a carcass that can end either way, although seldom is there any serious fighting or bloodshed between the large carnivores. Intimidation displays may also resolve these conflicts. However, when size differences are prominent, the predators may prey on each other.Living in the rich biosphere of Africa south of the Sahara, the Nile crocodile may come into contact with other large predators. Its place in the ecosystems it inhabits is unique, as it is the only large tetrapod carnivore that spends the majority of its life in water and hunting prey associated with aquatic zones. Large mammalian predators in Africa are often social animals and obligated to feed almost exclusively on land. The Nile crocodile is a strong example of an apex predator . Outside water, crocodiles can meet competition from other dominant savannah predators, notably big cats , which in Africa are represented by lions, cheetahs , and leopards. In general, big cats and crocodiles have a relationship of mutual avoidance. Occasionally, if regular food becomes scarce, both lions and the crocodile will steal kills on land from each other and, depending on size, will be dominant over one another. Both species may be attracted to carrion, and may occasionally fight over both kills or carrion. Most conflicts over food occur near the water and can literally lead to a tug-of-war over a carcass that can end either way, although seldom is there any serious fighting or bloodshed between the large carnivores. Intimidation displays may also resolve these conflicts. However, when size differences are prominent, the predators may prey on each other.On average, sexual maturity is obtained from 12 to 16 years of age. For males, the onset of sexual maturity occurs when they are about 3.3 m (10 ft 10 in) long and mass of 155 kg (342 lb) , being fairly consistent. On the other hand, that for females is rather more variable, and may be indicative of the health of a regional population based on size at sexual maturity. On average, according to Cott (1961), female sexual maturity occurs when they reach 2.2 to 3 m (7 ft 3 in to 9 ft 10 in) in length. Similarly, a wide range of studies from southern Africa found that the average length for females at the onset of sexual maturity was 2.33 m (7 ft 8 in) . However, stunted sexual maturity appears to occur in populations at opposite extremes, both where crocodiles are thought to be overpopulated and where they are overly reduced to heavy hunting, sometimes with females laying eggs when they measure as small as 1.5 m (4 ft 11 in) although it is questionable whether such clutches would bear healthy hatchlings. According to Bourquin (2008), the average breeding female in southern Africa is between 3 and 3.6 m (9 ft 10 in and 11 ft 10 in) . Earlier studies support that breeding is often inconsistent in females less than 3 m (9 ft 10 in) and clutch size is smaller, a female at 2.75 m (9 ft 0 in) reportedly never lays more than 35 eggs, while a female measuring 3.64 m (11 ft 11 in) can expect a clutch of up to 95 eggs. In "stunted" newly mature females from Lake Turkana measuring 1.83 m (6 ft 0 in) , the average clutch size was only 15. Graham and Beard (1968) hypothesized that, while females do continue to grow as do males throughout life, that past a certain age and size that females much over 3.2 m (10 ft 6 in) in length in Lake Turkana no longer breed (supported by the physiology of the females examined here); however, subsequent studies in Botswana and South Africa have found evidence of nesting females at least 4.1 m (13 ft 5 in) in length. In the Olifants River in South Africa, rainfall influenced the size of nesting females as only larger females (greater than 3 m (9 ft 10 in) ) nested during the driest years. Breeding females along the Olifants were overall larger than those in Zimbabwe . Most females nest only every two to three years while mature males may breed every year. During the mating season , males attract females by bellowing, slapping their snouts in the water, blowing water out of their noses, and making a variety of other noises. Among the larger males of a population, territorial clashes can lead to physical fighting between males especially if they are near the same size. Such clashes can be brutal affairs and can end in mortality but typically end with victor and loser still alive, the latter withdrawing into deep waters. Once a female has been attracted, the pair warble and rub the undersides of their jaws together. Compared to the tender behaviour of the female accepting the male, copulation is rather rough (even described as "rape"-like by Graham & Beard (1968)) in which the male often roars and pins the female underwater. Cott noted little detectable discrepancy in the mating habits of Nile crocodiles and American alligators. In some regions, males have reportedly mated with several females, perhaps any female that enters his claimed territory, though in most regions annual monogamy appears to be most common in this species. Females lay their eggs about one to two months after mating. The nesting season can fall in nearly every month of the year. In the northern extremes of the distribution (i.e. Somalia or Egypt ), the nesting season is December through February while in the southern limits (i.e. South Africa or Tanzania ) is in August through December. In crocodiles between these distributions egg-laying is in intermediate months, often focused between April and July. The dates correspond to about a month or two into the dry season within that given region. The benefits of this are presumably that nest flooding risk is considerably reduced at this time and the stage at which hatchlings begin their lives out of the egg falls roughly at the beginning of the rainy season , when water levels are still relatively low but insect prey is in recovery. Preferred nesting locations are sandy shores , dry stream beds , or riverbanks. The female digs a hole a few metres from the bank and up to 0.5 m (20 in) deep, and lays on average between 25 and 80 eggs. The number of eggs varies and depends partially on the size of the female. The most significant prerequisites to a nesting site are soil with the depth to permit the female to dig out the nest mound, shading to which mother can retire during the heat of the day and access to water. She finds a spot soft enough to allow her to dig a sideways slanted burrow. The mother Nile crocodile deposits the eggs in the terminal chamber and packs the sand or earth back over the nest pit. While, like all crocodilians, the Nile crocodile digs out a hole for a nest site, unlike most other modern crocodilians, female Nile crocodiles bury their eggs in sand or soil rather than incubate them in rotting vegetation. The female may urinate sporadically on the soil to keep it moist, which prevents soil from hardening excessively. After burying the eggs, the female then guards them for the three-month incubation period. Nests have been recorded seldom in concealed positions such as under a bush or in grasses, but normally in open spots on the bank. It is thought the Nile crocodile cannot nest under heavy forest cover as can two of the three other African crocodiles because they do not use rotting leaves (a very effective method of producing heat for the eggs) and thus require sunlight on sand or soil the surface of the egg chamber to provide the appropriate warmth for embryo development. In South Africa, the invasive plant Chromolaena odorata has recently exploded along banks traditionally used by crocodiles as nesting sites and caused nest failures by blocking sunlight over the nest chamber. When Nile crocodiles have been entirely free from disturbance in the past, they may nest gregariously with the nest lying so close together that after hatching time the rims of craters are almost contiguous. These communal nesting sites are not known to exist today, perhaps being most recently recorded at Ntoroko peninsula, Uganda where two such sites remaining until 1952. In one area, 17 craters were found in an area of 25 yd × 22 yd (75 ft × 66 ft) , in another 24 in an area of 26 yd × 24 yd (78 ft × 72 ft) . Communal nesting areas also reported from Lake Victoria (up until the 1930s) and also in the 20th century at Rahad River , Lake Turkana and Malawi . The behaviour of the female Nile crocodile is considered unpredictable and may be driven by the regional extent of prior human disturbance and human persecution rather than natural variability. In some areas, the mother crocodiles will only leave the nest if she needs to cool off ( thermoregulation ) by taking a quick dip or seeking out a patch of shade. Females will not leave nest site even if rocks are thrown at her back and several authors note her trance-like state while standing near nest, similar to that of crocodiles in aestivation but not like any other stage in their life-cycle. In such a trance, some mother Nile crocodiles may show no discernable reaction even if pelted with stones. At other times, the female will fiercely attack anything approaching their eggs, sometimes joined by another crocodile which may be the sire of the young. In other areas, the nesting female may disappear upon potential disturbance which may allow the presence of both the female and her buried nest to escape unwanted detection by predators. Despite the attentive care of both parents, the nests are often raided by humans and monitor lizards or other animals while she is temporarily absent. At a reported incubation period of about 90 days, the stage is notably shorter than that of the American alligator (110–120 days) but slightly longer than that of the mugger crocodile . Nile crocodiles have temperature-dependent sex determination (TSD), which means the sex of their hatchlings is determined not by genetics as is the case in mammals and birds, but by the average temperature during the middle third of their incubation period. If the temperature inside the nest is below 31.7 °C (89.1 °F), or above 34.5 °C (94.1 °F), the offspring will be female. Males can only be born if the temperature is within that narrow range. The hatchlings start to make a high-pitched chirping noise before hatching, which is the signal for the mother to rip open the nest. It is thought to be either difficult or impossible for hatchlings to escape the nest burrow without assistance, as the surface may become very heavy and packed above them. The mother crocodile may pick up the eggs in her mouth, and roll them between their tongue and the upper palate to help crack the shell and release her offspring. Once the eggs hatch, the female may lead the hatchlings to water, or even carry them there in her mouth, as female American alligators have been observed doing. Hatchling Nile crocodiles are between 280 and 300 mm (11 and 12 in) long at first and weigh around 70 g (2.5 oz) . The hatchlings grow approximately that length each year for the first several years. The new mother will protect her offspring for up to two years, and if there are multiple nests in the same area, the mothers may form a crèche . During this time, the mothers may pick up their offspring either in their mouths or gular fold (throat pouch) to keep the babies safe. The mother will sometimes carry her young on her back to avoid natural predators of the small crocodiles, which can be surprisingly bold even with the mother around. Nile crocodiles of under two years are much more rarely observed than larger specimens, and more seldom seen than the same age young in several other types of crocodilian. Young crocodiles are shy and evasive due to the formidable array of predators that they must face in sub-Saharan Africa, spending little time sunning and moving about nocturnally whenever possible. Crocodiles two years old and younger may spend a surprising amount of time on land, as evidenced by the range of terrestrial insects found in their stomachs, and their lifestyle may resemble that of a semi-aquatic mid-sized lizard more so than the very aquatic lives of older crocodiles. At the end of the two years, the hatchlings will be about 1.2 m (3 ft 11 in) long, and will naturally depart the nest area, avoiding the territories of older and larger crocodiles. After this stage, crocodiles may loosely associate with similarly sized crocodiles and many enter feeding congregations of crocodiles once they attain 2 m (6 ft 7 in) , at which size predators and cannibal crocodiles become much less of a concern. Crocodile longevity is not well established, but larger species like the Nile crocodile live longer, and may have a potential average life span of 70 to 100 years, though no crocodilian species commonly exceeds a lifespan of 50 to 60 years in captivity. An estimated 10% of eggs will survive to hatch and a mere 1% of young that hatch will successfully reach adulthood. The full range of causes for mortality of young Nile crocodiles is not well understood, as very young and small Nile crocodiles or well-concealed nests are only sporadically observed. Unseasonable flooding (during nesting which corresponds with the regional dry season) is not uncommon and has probably destroyed several nests, although statistical likelihood of such an event is not known. The only aspect of mortality in this age range that is well studied is predation and this is most likely the primary cause of death while the saurians are still diminutive. The single most virulent predator of nests is almost certainly the Nile monitor . This predator can destroy about 50% of studied Nile crocodile eggs on its own, often being successful (as are other nest predators) in light of the trance-like state that the mother crocodile enters while brooding or taking advantage of moments where she is distracted or needs to leave the nest. In comparison, perenties ( Varanus giganteus ) (the Australian ecological equivalent of the Nile monitor) succeeds in depredating about 90% of freshwater crocodile ( Crocodylus johnsoni ) eggs and about 25% of saltwater crocodile nests. Mammalian predators can take nearly as heavy of a toll, especially large mongooses such the Egyptian mongoose ( Herpestes ichneumon ) in the north and the water mongoose in the south of crocodile's range. Opportunistic mammals who attack Nile crocodile nests have included wild pigs, medium-sized wild cats and baboon troops. Like Nile monitors, mammalian predators probably locate crocodile nests by scent as the padded-down mound is easy to miss visually. Marabou storks sometimes follow monitors to pirate crocodile eggs for themselves to consume, although can also dig out nests on their own with their massive, awl-like bills if they can visually discern the nest mound. Predators of Nile crocodiles eggs have ranged from insects such as the red flour beetle ( Tribolium castaneum ) to predators as large and formidable as spotted hyenas ( Crocuta crocuta ). Unsurprisingly, once exposed to the elements as hatchlings, the young, small Nile crocodiles are even more vulnerable. Most of the predators of eggs also opportunistically eat young crocodiles, including monitors and marabous, plus almost all co-existing raptorial birds, including vultures, eagles , and large owls and buzzards . Many "large waders" are virulent predators of crocodile hatchlings, from dainty little egrets ( Egretta garzetta ) and compact hamerkops ( Scopus umbretta ) to towering saddle-billed storks ( Ephippiorhynchus senegalensis ), goliath herons and shoebills ( Balaeniceps rex ). Larger corvids and some non-wading water birds (i.e. pelicans ) can also take some young Nile crocodiles. Mammalian carnivores take many hatchlings as well as large turtles and snakes, large predatory freshwater fish, such as the African tigerfish , the introduced largemouth bass , and possibly bull sharks , when they enter river systems. When crocodile nests are dug out and the young placed in water by the mother, in areas such as Royal Natal National Park predators can essentially enter a feeding frenzy. It may take a few years before predation is no longer a major cause of mortality for young crocodiles. African fish eagles can take crocodile hatchlings up to a few months of age and honey badgers can prey on yearlings. Once they reach their juvenile stage, large African rock pythons and big cats remain as the only predatory threat to young crocodiles. Perhaps no predator is more deadly to young Nile crocodiles than larger crocodiles of their own species, as, like most crocodilians, they are cannibalistic. This species may be particularly dangerous to their own kind considering their aggressive dispositions. While the mother crocodile will react aggressively toward potential predators and has been recorded chasing and occasionally catching and killing such interlopers into her range, due to the sheer number of animals who feed on baby crocodiles and the large number of hatchlings, she is more often unsuccessful at deflecting such predators. An estimated 10% of eggs will survive to hatch and a mere 1% of young that hatch will successfully reach adulthood. The full range of causes for mortality of young Nile crocodiles is not well understood, as very young and small Nile crocodiles or well-concealed nests are only sporadically observed. Unseasonable flooding (during nesting which corresponds with the regional dry season) is not uncommon and has probably destroyed several nests, although statistical likelihood of such an event is not known. The only aspect of mortality in this age range that is well studied is predation and this is most likely the primary cause of death while the saurians are still diminutive. The single most virulent predator of nests is almost certainly the Nile monitor . This predator can destroy about 50% of studied Nile crocodile eggs on its own, often being successful (as are other nest predators) in light of the trance-like state that the mother crocodile enters while brooding or taking advantage of moments where she is distracted or needs to leave the nest. In comparison, perenties ( Varanus giganteus ) (the Australian ecological equivalent of the Nile monitor) succeeds in depredating about 90% of freshwater crocodile ( Crocodylus johnsoni ) eggs and about 25% of saltwater crocodile nests. Mammalian predators can take nearly as heavy of a toll, especially large mongooses such the Egyptian mongoose ( Herpestes ichneumon ) in the north and the water mongoose in the south of crocodile's range. Opportunistic mammals who attack Nile crocodile nests have included wild pigs, medium-sized wild cats and baboon troops. Like Nile monitors, mammalian predators probably locate crocodile nests by scent as the padded-down mound is easy to miss visually. Marabou storks sometimes follow monitors to pirate crocodile eggs for themselves to consume, although can also dig out nests on their own with their massive, awl-like bills if they can visually discern the nest mound. Predators of Nile crocodiles eggs have ranged from insects such as the red flour beetle ( Tribolium castaneum ) to predators as large and formidable as spotted hyenas ( Crocuta crocuta ). Unsurprisingly, once exposed to the elements as hatchlings, the young, small Nile crocodiles are even more vulnerable. Most of the predators of eggs also opportunistically eat young crocodiles, including monitors and marabous, plus almost all co-existing raptorial birds, including vultures, eagles , and large owls and buzzards . Many "large waders" are virulent predators of crocodile hatchlings, from dainty little egrets ( Egretta garzetta ) and compact hamerkops ( Scopus umbretta ) to towering saddle-billed storks ( Ephippiorhynchus senegalensis ), goliath herons and shoebills ( Balaeniceps rex ). Larger corvids and some non-wading water birds (i.e. pelicans ) can also take some young Nile crocodiles. Mammalian carnivores take many hatchlings as well as large turtles and snakes, large predatory freshwater fish, such as the African tigerfish , the introduced largemouth bass , and possibly bull sharks , when they enter river systems. When crocodile nests are dug out and the young placed in water by the mother, in areas such as Royal Natal National Park predators can essentially enter a feeding frenzy. It may take a few years before predation is no longer a major cause of mortality for young crocodiles. African fish eagles can take crocodile hatchlings up to a few months of age and honey badgers can prey on yearlings. Once they reach their juvenile stage, large African rock pythons and big cats remain as the only predatory threat to young crocodiles. Perhaps no predator is more deadly to young Nile crocodiles than larger crocodiles of their own species, as, like most crocodilians, they are cannibalistic. This species may be particularly dangerous to their own kind considering their aggressive dispositions. While the mother crocodile will react aggressively toward potential predators and has been recorded chasing and occasionally catching and killing such interlopers into her range, due to the sheer number of animals who feed on baby crocodiles and the large number of hatchlings, she is more often unsuccessful at deflecting such predators. Conservation organizations have determined that the main threats to Nile crocodiles, in turn, are loss of habitat, pollution, hunting, and human activities such as accidental entanglement in fishing nets. Though the Nile crocodile has been hunted since ancient times, the advent of the readily available firearm made it much easier to kill these potentially dangerous reptiles. The species began to be hunted on a much larger scale from the 1940s to the 1960s, primarily for high-quality leather, although also for meat with its purported curative properties. The population was severely depleted, and the species faced extinction . National laws, and international trade regulations have resulted in a resurgence in many areas, and the species as a whole is no longer wholly threatened with extinction. The status of Nile crocodiles was variable based on the regional prosperity and extent of conserved wetlands by the 1970s. However, as is the case for many large animal species whether they are protected or not, persecution and poaching have continued apace and between the 1950s and 1980s, an estimated 3 million Nile crocodiles were slaughtered by humans for the leather trade. In Lake Sibaya , South Africa, it was determined that in the 21st century, persecution continues as the direct cause for the inability of Nile crocodiles to recover after the leather trade last century. Recovery for the species appears quite gradual and few areas have recovered to bear crocodile populations, i.e. largely insufficient to produce sustainable populations of young crocodiles, on par with times prior to the peak of leather trading. Crocodile 'protection programs' are artificial environments where crocodiles exist safely and without the threat of extermination from hunters. An estimated 250,000 to 500,000 individuals occur in the wild today. The IUCN Red List assesses the Nile crocodile as "Least Concern (LR/lc)". The Convention on International Trade in Endangered Species (CITES) lists the Nile crocodile under Appendix I (threatened with extinction) in most of its range; and under Appendix II (not threatened, but trade must be controlled) in the remainder, which either allows ranching or sets an annual quota of skins taken from the wild. The Nile crocodile is widely distributed, with strong, documented populations in many countries in eastern and southern Africa, including Somalia , Ethiopia , Kenya , Zambia and Zimbabwe . This species is farmed for its meat and leather in some parts of Africa. Successful sustainable-yield programs focused on ranching crocodiles for their skins have been successfully implemented in this area, and even countries with quotas are moving toward ranching. In 1993, 80,000 Nile crocodile skins were produced, the majority from ranches in Zimbabwe and South Africa. Crocodile farming is one of the few burgeoning industries in Zimbabwe. Unlike American alligator flesh, Nile crocodile meat is generally considered unappetizing although edible as tribes such as the Turkana may opportunistically feed on them. According to Graham and Beard (1968), Nile crocodile meat has an "indescribable" and unpleasant taste, greasy texture and a "repellent" smell. The conservation situation is more grim in Central and West Africa presumably for both the Nile and West African crocodiles. The crocodile population in this area is much more sparse, and has not been adequately surveyed. While the natural population in these areas may be lower due to a less-than-ideal environment and competition with sympatric slender-snouted and dwarf crocodiles , extirpation may be a serious threat in some of these areas. At some point in the 20th century, the Nile crocodile appeared to have been extirpated as a breeding species from Egypt , but has locally re-established in some areas such as the Aswan Dam . Additional factors are a loss of wetland habitats, which is addition to direct dredging, damming and irrigation by humans, has retracted in the east, south and north of the crocodile's range, possibly in correlation with global warming . Retraction of wetlands due both to direct habitat destruction by humans and environmental factor possibly related to global warming is perhaps linked to the extinction of Nile crocodiles in the last few centuries in Syria , Israel and Tunisia . In Lake St. Lucia , highly saline water has been pumped into the already brackish waters due to irrigation practices. Some deaths of crocodiles appeared to have been caused by this dangerous salinity, and this one-time stronghold for breeding crocodiles has experienced a major population decline. In yet another historic crocodile stronghold, the Olifants River, which flows through Kruger National Park , numerous crocodile deaths have been reported. These are officially due to unknown causes but analysis has indicated that environmental pollutants caused by humans, particularly the burgeoning coal industry , are the primary cause. Much of the contamination of crocodiles occurs when they consume fish themselves killed by pollutants. Additional ecological surveys and establishing management programs are necessary to resolve these questions. The Nile crocodile is the top predator in its environment, and is responsible for checking the population of mesopredator species, such as the barbel catfish and lungfish , that could overeat fish populations on which other species, including birds, rely. One of the fish predators seriously affected by the unchecked mesopredator fish populations (due again to crocodile declines) is humans, particularly with respect to tilapia , an important commercial fish that has declined due to excessive predation. The Nile crocodile also consumes dead animals that would otherwise pollute the waters. Much of the hunting of and general animosity toward Nile crocodiles stems from their reputation as a man-eater, which is not entirely unjustified. Despite most attacks going unreported, the Nile crocodile along with the saltwater crocodile is estimated to kill hundreds (possibly thousands) of people each year, which is more than all other crocodilian species combined. While these species are much more aggressive toward people than other living crocodilians (as is statistically supported by estimated numbers of crocodile attacks), Nile crocodiles are not particularly more likely to behave aggressively to humans or regard humans as potential prey than saltwater crocodiles. However, unlike other "man-eating" crocodile species, including the saltwater crocodile, the Nile crocodile lives in close proximity to human populations through most of its range, so contact is more frequent. This combined with the species' large size creates a higher risk of attack. Crocodiles as small as 2.1 m (6 ft 11 in) are capable of overpowering and successfully preying on small apes and hominids, presumably including children and smaller adult humans, but a majority of fatal attacks on humans are by crocodiles reportedly exceeding 3 m (9 ft 10 in) in length. In studies preceding the slaughter of crocodiles for the leather trade, when there were believed to be many more Nile crocodiles, a roughly estimated 1,000 human fatalities per annum by Nile crocodiles were posited, with a roughly equal number of aborted attacks. A more contemporary study claimed the number of attacks by Nile crocodiles per year as 275 to 745, of which 63% are fatal, as opposed to an estimated 30 attacks per year by saltwater crocodiles, of which 50% are fatal. With the Nile crocodile and the saltwater crocodile, the mean size of crocodiles involved in non-fatal attacks was about 3 m (9 ft 10 in) as opposed to a reported range of 2.5–5 m (8 ft 2 in – 16 ft 5 in) or larger for crocodiles responsible for fatal attacks. The average estimated size of Nile crocodiles involved in fatal attacks is 3.5 m (11 ft 6 in) . Since a majority of fatal attacks are believed to be predatory in nature, the Nile crocodile can be considered the most prolific predator of humans among wild animals. In comparison, lions, in the years from 1990 to 2006, were responsible for an estimated one-eighth as many fatal attacks on humans in Africa as were Nile crocodiles. Although Nile crocodiles are more than a dozen times more numerous than lions in the wild, probably fewer than a quarter of living Nile crocodiles are old and large enough to pose a danger to humans. Other wild animals responsible for more annual human mortalities either attack humans in self-defense, as do venomous snakes , or are deadly only as vectors of disease or infection, such as snails , rats and mosquitos . Regional reportage from numerous areas with large crocodile populations nearby indicate, per district or large village, that crocodiles often annually claim about a dozen or more lives per year. Miscellaneous examples of areas in the last few decades with a dozen or more fatal crocodile attacks annually include Korogwe District , Tanzania , Niassa Reserve , Mozambique and the area around Lower Zambezi National Park , Zambia. Despite historic claims that the victims of Nile crocodile attacks are usually women and children, there is no detectable trends in this regard and any human, regardless of age, gender, or size is potentially vulnerable. Incautious human behavior is the primary drive behind crocodile attacks. Most fatal attacks occur when a person is standing a few feet away from water on a non-steep bank, is wading in shallow waters, is swimming or has limbs dangling over a boat or pier. Many victims are caught while crouching, and people in jobs that might require heavy usage of water, including laundry workers, fisherman, game wardens and regional guides , are more likely to be attacked. Many fisherman and other workers who are not poverty-stricken will go out of their way to avoid waterways known to harbor large crocodile populations. Most biologists who have engaged in months or even years of field work with Nile crocodiles, including Cott (1961), Graham and Beard (1968) and Guggisberg (1972), have found that with sufficient precautions, their own lives and the lives of their local guides were rarely, if ever, at risk in areas with many crocodiles. However, Guggisberg accumulated several earlier writings that noted the lack of fear of crocodiles among Africans, driven in part perhaps by poverty and superstition, that caused many observed cases of an "appalling" lack of caution within view of large crocodiles, as opposed to the presence of bold lions, which engendered an appropriate panic. Per Guggisberg, this disregard (essentially regarding the crocodile as a lowly creature and thus non-threatening to humans) may account for the higher frequency of deadly attacks by crocodiles than by large mammalian carnivores. Most locals are well aware of how to behave in crocodile-occupied areas, and some of the writings quoted by Guggisberg from the 19th and 20th century may need to be taken with a "grain of salt". Much of the hunting of and general animosity toward Nile crocodiles stems from their reputation as a man-eater, which is not entirely unjustified. Despite most attacks going unreported, the Nile crocodile along with the saltwater crocodile is estimated to kill hundreds (possibly thousands) of people each year, which is more than all other crocodilian species combined. While these species are much more aggressive toward people than other living crocodilians (as is statistically supported by estimated numbers of crocodile attacks), Nile crocodiles are not particularly more likely to behave aggressively to humans or regard humans as potential prey than saltwater crocodiles. However, unlike other "man-eating" crocodile species, including the saltwater crocodile, the Nile crocodile lives in close proximity to human populations through most of its range, so contact is more frequent. This combined with the species' large size creates a higher risk of attack. Crocodiles as small as 2.1 m (6 ft 11 in) are capable of overpowering and successfully preying on small apes and hominids, presumably including children and smaller adult humans, but a majority of fatal attacks on humans are by crocodiles reportedly exceeding 3 m (9 ft 10 in) in length. In studies preceding the slaughter of crocodiles for the leather trade, when there were believed to be many more Nile crocodiles, a roughly estimated 1,000 human fatalities per annum by Nile crocodiles were posited, with a roughly equal number of aborted attacks. A more contemporary study claimed the number of attacks by Nile crocodiles per year as 275 to 745, of which 63% are fatal, as opposed to an estimated 30 attacks per year by saltwater crocodiles, of which 50% are fatal. With the Nile crocodile and the saltwater crocodile, the mean size of crocodiles involved in non-fatal attacks was about 3 m (9 ft 10 in) as opposed to a reported range of 2.5–5 m (8 ft 2 in – 16 ft 5 in) or larger for crocodiles responsible for fatal attacks. The average estimated size of Nile crocodiles involved in fatal attacks is 3.5 m (11 ft 6 in) . Since a majority of fatal attacks are believed to be predatory in nature, the Nile crocodile can be considered the most prolific predator of humans among wild animals. In comparison, lions, in the years from 1990 to 2006, were responsible for an estimated one-eighth as many fatal attacks on humans in Africa as were Nile crocodiles. Although Nile crocodiles are more than a dozen times more numerous than lions in the wild, probably fewer than a quarter of living Nile crocodiles are old and large enough to pose a danger to humans. Other wild animals responsible for more annual human mortalities either attack humans in self-defense, as do venomous snakes , or are deadly only as vectors of disease or infection, such as snails , rats and mosquitos . Regional reportage from numerous areas with large crocodile populations nearby indicate, per district or large village, that crocodiles often annually claim about a dozen or more lives per year. Miscellaneous examples of areas in the last few decades with a dozen or more fatal crocodile attacks annually include Korogwe District , Tanzania , Niassa Reserve , Mozambique and the area around Lower Zambezi National Park , Zambia. Despite historic claims that the victims of Nile crocodile attacks are usually women and children, there is no detectable trends in this regard and any human, regardless of age, gender, or size is potentially vulnerable. Incautious human behavior is the primary drive behind crocodile attacks. Most fatal attacks occur when a person is standing a few feet away from water on a non-steep bank, is wading in shallow waters, is swimming or has limbs dangling over a boat or pier. Many victims are caught while crouching, and people in jobs that might require heavy usage of water, including laundry workers, fisherman, game wardens and regional guides , are more likely to be attacked. Many fisherman and other workers who are not poverty-stricken will go out of their way to avoid waterways known to harbor large crocodile populations. Most biologists who have engaged in months or even years of field work with Nile crocodiles, including Cott (1961), Graham and Beard (1968) and Guggisberg (1972), have found that with sufficient precautions, their own lives and the lives of their local guides were rarely, if ever, at risk in areas with many crocodiles. However, Guggisberg accumulated several earlier writings that noted the lack of fear of crocodiles among Africans, driven in part perhaps by poverty and superstition, that caused many observed cases of an "appalling" lack of caution within view of large crocodiles, as opposed to the presence of bold lions, which engendered an appropriate panic. Per Guggisberg, this disregard (essentially regarding the crocodile as a lowly creature and thus non-threatening to humans) may account for the higher frequency of deadly attacks by crocodiles than by large mammalian carnivores. Most locals are well aware of how to behave in crocodile-occupied areas, and some of the writings quoted by Guggisberg from the 19th and 20th century may need to be taken with a "grain of salt".

Wiki

West Nile

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Cairo Monorail

The Cairo Monorail ( Arabic : ٠ونوريل القاهرة ) is a two-line monorail rapid transit system currently under construction in Cairo and is projected to become the longest driverless monorail system in the world. The two lines will create the first public transport from the New Administrative Capital and 6th of October City to the Cairo metropolitan area when completed. The expected travel time for the 53km Line between the New Administrative City and East Cairo is about 60 minutes and the 42km line connecting 6th of October City with Giza is about 42 minutes. The system was expected to first open to the public in 2023. Construction on this line started in 2019, and was due to be completed in May 2022. However, completion has been delayed until October 2023, and operation by April 2024, before being delayed a further time to October 2024. It will be 56.5 kilometres (35.1 mi) long, with 22 stations starting with Stadium and stops named Hisham Barakat, Nouri Khattab, the 7th District, Free Zone, Marshal Tantawy, Cairo Festival, Air Hospital, Narjis District, Mohammed Naguib, American University, Emaar, Nafoura Square, Al Barwa, Middle Ring Road, Mohammed Bin Zayed, Regional Ring Road, Almasa Hotel, Ministries (Al Wezarat) District, Administrative Capital, and terminating at an unknown station 22 (referred to as Station 22). The line will provide a transfer to the Cairo Metro Line 3 at its terminus in Stadium station. It will also be connected to the Cairo LRT at Almasa Hotel station (transfer to the Arts and Culture City station of the LRT). Work on the October Line started in January 2020, and was projected to begin operating in mid 2023. However work on it has been delayed due to difficulties in expropriating land for the project, pushing the operational date to October 2024. The line will be 45 kilometres (28 mi) long, with 13 stations starting with New October Station, Industrial Zone Station, Sadat Station, Sixth of October City Authority Station, Engineers Association Station, Nile University Station, Hyper One station, Cairo-Alexandria Desert Road, Mansouriya Station, Mariouteya Station, Ring Road Station, Bashteel Station, and termi ating at Nile Valley Station. The line will provide a transfer to the Cairo Metro Line 3 at Nile Valley Station, part of the line's eastern expansion plans.Construction on this line started in 2019, and was due to be completed in May 2022. However, completion has been delayed until October 2023, and operation by April 2024, before being delayed a further time to October 2024. It will be 56.5 kilometres (35.1 mi) long, with 22 stations starting with Stadium and stops named Hisham Barakat, Nouri Khattab, the 7th District, Free Zone, Marshal Tantawy, Cairo Festival, Air Hospital, Narjis District, Mohammed Naguib, American University, Emaar, Nafoura Square, Al Barwa, Middle Ring Road, Mohammed Bin Zayed, Regional Ring Road, Almasa Hotel, Ministries (Al Wezarat) District, Administrative Capital, and terminating at an unknown station 22 (referred to as Station 22). The line will provide a transfer to the Cairo Metro Line 3 at its terminus in Stadium station. It will also be connected to the Cairo LRT at Almasa Hotel station (transfer to the Arts and Culture City station of the LRT).Work on the October Line started in January 2020, and was projected to begin operating in mid 2023. However work on it has been delayed due to difficulties in expropriating land for the project, pushing the operational date to October 2024. The line will be 45 kilometres (28 mi) long, with 13 stations starting with New October Station, Industrial Zone Station, Sadat Station, Sixth of October City Authority Station, Engineers Association Station, Nile University Station, Hyper One station, Cairo-Alexandria Desert Road, Mansouriya Station, Mariouteya Station, Ring Road Station, Bashteel Station, and termi ating at Nile Valley Station. The line will provide a transfer to the Cairo Metro Line 3 at Nile Valley Station, part of the line's eastern expansion plans.Cairo Monorail is to use 70 fully automated, driverless Bombardier Innovia Monorail 300 vehicles for the two lines with four cars each. The rolling stock has been manufactured at Derby Litchurch Lane Works in England.

Wiki

West Nile

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Nile monitor

Lacerta monitor Linnaeus , 1758 — nomen rejectum Lacertus tupinambis Lacépède, 1788 Lacerta capensis Sparrman, 1783 Lacerta nilotica Linnaeus , 1766 Tupinambis elegans Daudin, 1802 Tupinambus ornatus Daudin, 1803 Monitor niloticus Lichtenstein, 1818 Monitor pulcher Leach, 1819 Stellio saurus Laurenti, 1768 Varanus niloticus Mertens, 1942 Varanus (Polydaedalus) niloticus ornatus Mertens, 1942 Varanus (Polydaedalus) ornatus Böhme & Ziegler, 1997 The Nile monitor ( Varanus niloticus ) is a large member of the monitor family ( Varanidae ) found throughout most of Sub-Saharan Africa , particularly in drier regions, and along the Nile River and its tributaries in East Africa . Additionally, there are modern, invasive populations in North America . The population found in West African forests and savannahs is sometimes recognized as a separate species, the West African Nile monitor ( V. stellatus ). While it is dwarfed by its larger relatives, such as the Komodo dragon , the Asian water monitor or the crocodile monitor , it is still one of the largest lizards in the world , reaching (and even surpassing) Australia's perentie in size. Other common names include the African small-grain lizard , as well as iguana and various forms derived from it, such as guana , water leguaan or river leguaan (leguan, leguaan, and likkewaan mean monitor lizard in South African English , and can be used interchangeably). A feral population of Nile monitors (descended from escaped or intentionally-released pets) has become established in several locations in South Florida . In addition to any illegally-released animals, it is speculated that during particularly intense hurricane seasons in Florida, many reptiles potentially escape when their enclosures are damaged or inadvertently unlocked; as Florida has a semi-tropical to tropical climate, many reptiles are housed outdoors, and poorly-secured enclosures may become damaged during bad storms. Along with Nile monitors, Florida is infamous for its feral populations of agamas , Argentine black and white tegus , Burmese pythons , green iguanas , Madagascar giant day geckos , and panther and veiled chameleons , among others. Many of these species are thought to be descendants of hurricane escapees.Members of the Nile monitor species group were already well known to Africans in ancient times. For example, they were commonly caught, likely as food, in the Djenné-Djenno culture at least a millennium ago. The Nile monitor twice was given a scientific name by Carl Linnaeus : First as Lacerta monitor in 1758 in the 10th edition of Systema Naturae , the starting point of zoological nomenclature . He described it again in 1766 as Lacerta nilotica . Despite being older, the name proposed in 1758 is invalid because it was rejected in ICZN opinion 540, making the name of 1766 valid. The genus Varanus was coined in 1820 by Blasius Merrem . Six years later Leopold Fitzinger moved the Nile monitor into this genus as Varanus niloticus , the currently accepted scientific name for the species. As traditionally defined, the Nile monitor is a species complex . The ornate monitor ( V. ornatus ) and West African Nile monitor ( V. stellatus ) were described as species in 1802 and 1803 by François Marie Daudin . In 1942, Robert Mertens moved them both into the Nile monitor ( V. niloticus ); as synonyms or as a valid subspecies . This was the standard treatment until 1997, when a taxonomic review based on color and morphology indicated that the ornate monitor is distinctive and revalidated it as a separate species from rainforests of West and Central Africa . In 2016, a review based primarily on genetics came to another result. They found that monitors from West African forests and adjacent savannah are distinctive and worthy of recognition as a separate species: the West African Nile monitor ( V. stellatus ). It is estimated to have split from the others in the Nile monitor complex about 7.7 million years ago, making it older than the split between humans and chimpanzees . In contrast, those in the Central African rainforests are genetically similar to the Nile monitor. This essentially splits the ornate monitor—as defined in 1997—into two: the western being the West African Nile monitor and the eastern (of Central African rainforests) being moved back into the Nile monitor. As the type locality for the ornate monitor is in the Central African country of Cameroon , the scientific name V. ornatus becomes a synonym of V. niloticus . Individuals with the "ornate color pattern" and individuals with the "Nile color pattern" occur in both the West African Nile monitor and the Nile monitor, with the "ornate" appearing to be more frequent in densely forested habitats. With the West African Nile monitor as a separate species, there are two main clades in the Nile monitor: A widespread clade found throughout much of Southern , Central and East Africa , as well as more locally in coastal West Africa. The other clade includes the monitors of the Sahel ( Mali to Ethiopia ) and Nile regions. Despite the differences, the Reptile Database maintains both the ornate monitor and West African Nile monitor as synonyms of the Nile monitor, but do note that this broad species definition includes distinctive subpopulations. As traditionally defined, the Nile monitor is a species complex . The ornate monitor ( V. ornatus ) and West African Nile monitor ( V. stellatus ) were described as species in 1802 and 1803 by François Marie Daudin . In 1942, Robert Mertens moved them both into the Nile monitor ( V. niloticus ); as synonyms or as a valid subspecies . This was the standard treatment until 1997, when a taxonomic review based on color and morphology indicated that the ornate monitor is distinctive and revalidated it as a separate species from rainforests of West and Central Africa . In 2016, a review based primarily on genetics came to another result. They found that monitors from West African forests and adjacent savannah are distinctive and worthy of recognition as a separate species: the West African Nile monitor ( V. stellatus ). It is estimated to have split from the others in the Nile monitor complex about 7.7 million years ago, making it older than the split between humans and chimpanzees . In contrast, those in the Central African rainforests are genetically similar to the Nile monitor. This essentially splits the ornate monitor—as defined in 1997—into two: the western being the West African Nile monitor and the eastern (of Central African rainforests) being moved back into the Nile monitor. As the type locality for the ornate monitor is in the Central African country of Cameroon , the scientific name V. ornatus becomes a synonym of V. niloticus . Individuals with the "ornate color pattern" and individuals with the "Nile color pattern" occur in both the West African Nile monitor and the Nile monitor, with the "ornate" appearing to be more frequent in densely forested habitats. With the West African Nile monitor as a separate species, there are two main clades in the Nile monitor: A widespread clade found throughout much of Southern , Central and East Africa , as well as more locally in coastal West Africa. The other clade includes the monitors of the Sahel ( Mali to Ethiopia ) and Nile regions. Despite the differences, the Reptile Database maintains both the ornate monitor and West African Nile monitor as synonyms of the Nile monitor, but do note that this broad species definition includes distinctive subpopulations. The Nile monitor is Africa's longest lizard. They grow from about 120 to 220 cm (3 ft 11 in to 7 ft 3 in) in length, with the largest specimens attaining 244 cm (8 ft) . In an average-sized specimen, the snout-to-vent length will be around 50 cm (1 ft 8 in) . In body mass, adults have been reported to vary widely, one study claiming only 0.8 to 1.7 kg (1.8 to 3.7 lb) , others state weights ranging from 5.9 to 15 kg (13 to 33 lb) in big monitors. Variations may be due to age or environmental conditions. Exceptionally large specimens may scale as much as 20 kg (44 lb) , but this species weighs somewhat less on average than the bulkier rock monitor . They have muscular bodies, strong legs, and powerful jaws. Their teeth are sharp and pointed in juvenile animals and become blunt and peg-like in adults. They also possess sharp claws used for climbing, digging, defense, or tearing at their prey. Like all monitors, they have forked tongues, with highly developed olfactory properties. The Nile monitor has quite striking, but variable, skin patterns, as they are greyish-brown above with greenish-yellow barring on the tail and large, greenish-yellow rosette -like spots on their backs with a blackish tiny spot in the middle. Their throats and undersides are an ochre-yellow to a creamy-yellow, often with faint barring. Their nostrils are placed high on their snouts, indicating these animals are very well adapted for an aquatic lifestyle. They are also excellent climbers and quick runners on land. Nile monitors feed on a wide variety of prey items, including fish, frogs, toads (even poisonous ones of the genera Breviceps and Sclerophrys ), small reptiles (such as turtles , snakes , lizards , and young crocodiles ), birds, rodents, other small mammals (up to domestic cats and young antelopes [ Raphicerus ]), eggs (including those of crocodiles, agamids, other monitor lizards, and birds), invertebrates (such as beetles , termites , orthopterans , crabs , caterpillars , spiders , millipedes , earthworms , snails , and slugs ), carrion , human wastes, and feces. Nile monitors are native to Sub-Saharan Africa and along the Nile . They are not found in any of the desert regions of Africa (notably Sahara , Kalahari and much of the Horn of Africa ), however, they thrive around rivers. Nile monitors were reported to live in and around the Jordan River , Dead Sea , and wadis of the Judaean Desert in Israel until the late 19th century, though they are now extinct in the region. In Florida in the United States, established breeding populations of Nile monitors have been known to exist in different parts of the state since at least 1990. Genetic studies have shown that these introduced animals are part of the subpopulation that originates from West Africa, and now often is recognized as its own species, the West African Nile monitor . The vast majority of the established breeding population is in Lee County , particularly in the Cape Coral and surrounding regions, including the nearby barrier islands ( Sanibel , Captiva , and North Captiva ), Pine Island , Fort Myers , and Punta Rassa . Established populations also exist in adjacent Charlotte County , especially on Gasparilla Island . Other areas in Florida with a sizeable number of Nile monitor sightings include Palm Beach County just southwest of West Palm Beach along State Road 80 . In July 2008, a Nile monitor was spotted in Homestead , a small city southwest of Miami . Other sightings have been reported near Hollywood , Naranja , and as far south as Key Largo in the Florida Keys. The potential for the established population of Nile monitors in Lee, Charlotte, and other counties in Florida, to negatively impact indigenous crocodilians, such as American alligators ( Alligator mississippiensis ), and American crocodiles ( Crocodylus acutus ), is enormous, given that they normally raid crocodile nests, eat eggs, and prey on small crocodiles in Africa. Anecdotal evidence indicates a high rate of disappearance of domestic pets and feral cats in Cape Coral.In Florida in the United States, established breeding populations of Nile monitors have been known to exist in different parts of the state since at least 1990. Genetic studies have shown that these introduced animals are part of the subpopulation that originates from West Africa, and now often is recognized as its own species, the West African Nile monitor . The vast majority of the established breeding population is in Lee County , particularly in the Cape Coral and surrounding regions, including the nearby barrier islands ( Sanibel , Captiva , and North Captiva ), Pine Island , Fort Myers , and Punta Rassa . Established populations also exist in adjacent Charlotte County , especially on Gasparilla Island . Other areas in Florida with a sizeable number of Nile monitor sightings include Palm Beach County just southwest of West Palm Beach along State Road 80 . In July 2008, a Nile monitor was spotted in Homestead , a small city southwest of Miami . Other sightings have been reported near Hollywood , Naranja , and as far south as Key Largo in the Florida Keys. The potential for the established population of Nile monitors in Lee, Charlotte, and other counties in Florida, to negatively impact indigenous crocodilians, such as American alligators ( Alligator mississippiensis ), and American crocodiles ( Crocodylus acutus ), is enormous, given that they normally raid crocodile nests, eat eggs, and prey on small crocodiles in Africa. Anecdotal evidence indicates a high rate of disappearance of domestic pets and feral cats in Cape Coral.Nile monitors are often found in the pet trade despite their highly aggressive demeanor and resistance to taming. Juvenile monitors will tail whip as a defensive measure, and as adults, they are capable of inflicting moderate to serious wounds from biting and scratching. Nile monitors require a large cage as juveniles quickly grow when fed a varied diet, and large adults often require custom-built quarters. "There are few lizards less suited to life in captivity than the Nile monitor. Buffrenil (1992) considered that, when fighting for its life, a Nile monitor was a more dangerous adversary than a crocodile of a similar size. Their care presents particular problems on account of the lizards' enormous size and lively dispositions. Very few of the people who buy brightly-coloured baby Nile monitors can be aware that, within a couple of years, their purchase will have turned into an enormous, ferocious carnivore, quite capable of breaking the family cat's neck with a single snap and swallowing it whole."

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West Nile

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Chester M. Southam

Chester Milton Southam (October 4, 1919 – April 15, 2002) was an immunologist and oncologist at Memorial Sloan Kettering Cancer Center and Cornell University Medical College ; he went to Thomas Jefferson University in 1971 and worked there until the end of his career. He ran many experiments involving the injection of live cancer cells into human subjects, without disclosing that they were cancer cells, and using subjects with questionable ability to consent, such as incarcerated people and senile patients in long-term care at a hospital. The New York State Attorney General encouraged the Board of Regents of the University of the State of New York to take away Southam's medical license. Regardless, he went on to be president of the American Association for Cancer Research . His work was labeled by both modern scientists and his contemporaries as highly dangerous and unethical. Southam earned a Bachelor of Science degree and a master's degree from the University of Idaho and his medical degree from Columbia University , graduating in 1947. He became an intern at Presbyterian Hospital in New York City in 1947. In the following year he was promoted from clinical fellow to attending physician at the Memorial Hospital for Cancer and also received a promotion from research fellow to full member at the Chief Division Virology/Immunology. He joined the faculty of Cornell's medical college in 1951 and was eventually promoted to full professor. From the mid-1950s to the mid-1960s, Southam conducted clinical research on people without their informed consent , in which he injected cancer cells ( HeLa cells) into their skin, to see if their immune system would reject the cancer cells or if the cells would grow. He did this to patients under his care or others' care, and to prisoners. In 1963, doctors Avir Kagan, David Leichter and Perry Fersko of Jewish Chronic Disease Hospital objected to the lack of consent in his experiments and reported him to the Regents of the University of the State of New York which found him guilty of fraud, deceit, and unprofessional conduct, and in the end he was placed on probation for a year. Southam's research was conducted in an era when cancer research was closely followed in the mainstream media; his experiments and the case at the Regents were reported in The New York Times and declared highly unethical. In the 1950s, Southam also tested the West Nile Virus as a potential virotherapy ; he injected it into over 100 cancer patients who had terminal cancer and few treatment options. This work had some good results and was also reported in The New York Times , but some people he injected got severe cases of West Nile fever ; he went on to do further research to see if he could "train" the virus to kill cancer without the common side effects of chemotherapy. Southam was later elected president of the American Association for Cancer Research . In 1971, Southam left his positions at Memorial Sloan Kettering and Cornell to become the head of The Division of Medical Oncology at Thomas Jefferson University Hospital and a professor of medicine at Thomas Jefferson University Medical College; he held these positions until the end of his career in 1979. From the mid-1950s to the mid-1960s, Southam conducted clinical research on people without their informed consent , in which he injected cancer cells ( HeLa cells) into their skin, to see if their immune system would reject the cancer cells or if the cells would grow. He did this to patients under his care or others' care, and to prisoners. In 1963, doctors Avir Kagan, David Leichter and Perry Fersko of Jewish Chronic Disease Hospital objected to the lack of consent in his experiments and reported him to the Regents of the University of the State of New York which found him guilty of fraud, deceit, and unprofessional conduct, and in the end he was placed on probation for a year. Southam's research was conducted in an era when cancer research was closely followed in the mainstream media; his experiments and the case at the Regents were reported in The New York Times and declared highly unethical. In the 1950s, Southam also tested the West Nile Virus as a potential virotherapy ; he injected it into over 100 cancer patients who had terminal cancer and few treatment options. This work had some good results and was also reported in The New York Times , but some people he injected got severe cases of West Nile fever ; he went on to do further research to see if he could "train" the virus to kill cancer without the common side effects of chemotherapy. Southam was later elected president of the American Association for Cancer Research . In 1971, Southam left his positions at Memorial Sloan Kettering and Cornell to become the head of The Division of Medical Oncology at Thomas Jefferson University Hospital and a professor of medicine at Thomas Jefferson University Medical College; he held these positions until the end of his career in 1979.

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West Nile

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Nile Delta

The Nile Delta ( Arabic : دلتا النيل , Delta an-Nīl or simply الدلتا , ad-Delta ) is the delta formed in Lower Egypt where the Nile River spreads out and drains into the Mediterranean Sea . It is one of the world's larger deltas—from Alexandria in the west to Port Said in the east, it covers 240 km (150 mi) of Mediterranean coastline and is a rich agricultural region. From north to south the delta is approximately 160 km (100 mi) in length. The Delta begins slightly down-river from Cairo . From north to south, the delta is approximately 160 km (100 mi) in length. From west to east, it covers some 240 km (150 mi) of coastline. The delta is sometimes divided into sections, with the Nile dividing into two main distributaries , the Damietta and the Rosetta , flowing into the Mediterranean at port cities with the same name. In the past, the delta had several distributaries, but these have been lost due to flood control, silting and changing relief. One such defunct distributary is Wadi Tumilat . The Suez Canal is east of the delta and enters the coastal Lake Manzala in the north-east of the delta. To the north-west are three other coastal lakes or lagoons: Lake Burullus , Lake Idku and Lake Mariout . The Nile is considered to be an "arcuate" delta (arc-shaped), as it resembles a triangle or flower when seen from above. Some scholars such as Aristotle have written that the delta was constructed for agricultural purposes due to the drying of the region of Egypt. In modern day, the outer edges of the delta are eroding, and some coastal lagoons have seen increasing salinity levels as their connection to the Mediterranean Sea increases. Since the delta no longer receives an annual supply of nutrients and sediments from upstream due to the construction of the Aswan Dam , the soils of the floodplains have become poorer, and large amounts of fertilizers are now used. Topsoil in the delta can be as much as 21 m (70 ft) in depth.People have lived in the Nile Delta region for thousands of years, and it has been intensively farmed for at least the last five thousand years. The delta was a major constituent of Lower Egypt, and there are many archaeological sites in and around the delta. Artifacts belonging to ancient sites have been found on the delta's coast. The Rosetta Stone was found in the delta in 1799 in the port city of Rosetta (an anglicized version of the name Rashid ). In July 2019 a small Greek temple, ancient granite columns, treasure-carrying ships, and bronze coins from the reign of Ptolemy II , dating back to the third and fourth centuries BC, were found at the sunken city of Heracleion , colloquially known as Egypt's Atlantis. The investigations were conducted by Egyptian and European divers led by the underwater archaeologist Franck Goddio . They also uncovered a devastated historic temple (the city's main temple) underwater off Egypt's north coast. In January 2019 archaeologists led by Mostafa Waziri working in the Kom Al-Khelgan area of the Nile Delta discovered tombs from the Second Intermediate Period and burials from the Naqada II era. The burial site contained the remains of animals, amulets and scarabs carved from faience , round and oval pots with handles, flint knives, broken and burned pottery. All burials included skulls and skeletons in the bending position and were not very well-preserved. Records from ancient times (such as by Ptolemy ) reported that the delta had seven distributaries or branches, (from east to west): Modern Egyptologists suggest that in the Pharaonic era there were at a time five main branches: the Pelusiac the Sebennytic the Canopic the Damietta the Rosetta The first three have dried up over the centuries due to flood control , silting and changing relief, while the last two still exist today. The Delta used to flood annually , but this ended with the construction of the Aswan Dam .Records from ancient times (such as by Ptolemy ) reported that the delta had seven distributaries or branches, (from east to west): Modern Egyptologists suggest that in the Pharaonic era there were at a time five main branches: the Pelusiac the Sebennytic the Canopic the Damietta the Rosetta The first three have dried up over the centuries due to flood control , silting and changing relief, while the last two still exist today. The Delta used to flood annually , but this ended with the construction of the Aswan Dam .Modern Egyptologists suggest that in the Pharaonic era there were at a time five main branches: the Pelusiac the Sebennytic the Canopic the Damietta the Rosetta The first three have dried up over the centuries due to flood control , silting and changing relief, while the last two still exist today. The Delta used to flood annually , but this ended with the construction of the Aswan Dam .About 39 million people live in the Delta region. Outside of major cities, population density in the delta averages 1,000/km 2 (2,600/sq mi) or more. Alexandria is the largest city in the delta with an estimated population of more than 4.5 million. Other large cities in the delta include Shubra El Kheima , Port Said , El Mahalla El Kubra , Mansura , Tanta , and Zagazig . During autumn , parts of the Nile River are red with lotus flowers . The Lower Nile (North) and the Upper Nile (South) have plants that grow in abundance. The Upper Nile plant is the Egyptian lotus, and the Lower Nile plant is the Papyrus Sedge ( Cyperus papyrus ), although it is not nearly as plentiful as it once was, and is becoming quite rare. Several hundred thousand water birds winter in the delta, including the world's largest concentrations of little gulls and whiskered terns . Other birds making their homes in the delta include grey herons , Kentish plovers , shovelers , cormorants , egrets and ibises . Other animals found in the delta include frogs , turtles , tortoises , mongooses , and the Nile monitor . Nile crocodiles and hippopotamus , two animals which were widespread in the delta during antiquity, are no longer found there. Fish found in the delta include the flathead grey mullet and soles.The Delta has a hot desert climate ( Köppen : BWh ) as the rest of Egypt, but its northernmost part, as is the case with the rest of the northern coast of Egypt which is the wettest region in the country, has relatively moderate temperatures, with highs usually not surpassing 31 °C (88 °F) in the summer. Only 100–200 mm (4–8 in) of rain falls on the delta area during an average year, and most of this falls in the winter months. The delta experiences its hottest temperatures in July and August, with a maximum average of 34 °C (93 °F) . Winter temperatures normally range from 9 °C (48 °F) at nights to 19 °C (66 °F) in the daytime. With cooler temperatures and some rain, the Nile Delta region becomes quite humid during the winter months. Egypt's Mediterranean coastline experiences significant loss of land to the sea, in some places amounting to 90 m (100 yd) a year. The low-lying Nile Delta area in particular is vulnerable to sea level rise associated with global warming . This effect is exacerbated by the lack of sediments being deposited since the construction of the Aswan Dam . If the polar ice caps were to melt, much of the northern delta, including the ancient port city of Alexandria , could disappear under the Mediterranean. A 30 cm (12 in) rise in sea level could affect about 6.6% of the total land cover area in the Nile Delta region. At 1 m (3 ft 3 in) sea level rise, an estimated 887 thousand people could be at risk of flooding and displacement and about 100 km 2 (40 sq mi) of vegetation, 16 km 2 (10 sq mi) wetland, 402 km 2 (160 sq mi) cropland, and 47 km 2 (20 sq mi) of urban area land could be destroyed, flooding approximately 450 km 2 (170 sq mi) . Some areas of the Nile Delta's agricultural land have been rendered saline as a result of sea level rise; farming has been abandoned in some places, while in others sand has been brought in from elsewhere to reduce the effect. In addition to agriculture , the delta's ecosystems and tourist industry could be negatively affected by global warming. Food shortages resulting from climate change could lead to seven million "climate refugees" by the end of the 21st century. Nevertheless, environmental damage to the delta is not currently one of Egypt's priorities. The delta's coastline has also undergone significant changes in geomorphology as a result of the reclamation of coastal dunes and lagoons to form new agricultural land and fish farms as well as the expansion of coastal urban areas. The Nile Delta forms part of these 10 governorates : Large cities located in the Nile Delta:

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West Nile

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Idi Amin

King's African Rifles (1946–1962) Uganda Army (1962–1979) Lieutenant (British Empire) Field marshal (Uganda) Idi Amin Dada Oumee ( / ˈ iː d i ɑː ˈ m iː n , ˈ ɪ d i -/ ⓘ , UK also /- æ ˈ m iː n / ; 30 August 1928 – 16 August 2003) was a Ugandan military officer and politician who served as the third president of Uganda from 1971 to 1979. He ruled as a military dictator and is considered one of the most brutal despots in modern world history. Amin was born to a Kakwa father and Lugbara mother. In 1946, he joined the King's African Rifles (KAR) of the British Colonial Army as a cook. He rose to the rank of lieutenant, taking part in British actions against Somali rebels and then the Mau Mau Uprising in Kenya . Uganda gained independence from the United Kingdom in 1962, and Amin remained in the army , rising to the position of major and being appointed commander of the Uganda Army in 1965. He became aware that Ugandan President Milton Obote was planning to arrest him for misappropriating army funds, so he launched the 1971 Ugandan coup d'état and declared himself president. During his years in power, Amin shifted from being a pro-Western ruler enjoying considerable support from Israel to being backed by Libya 's Muammar Gaddafi , Zaire 's Mobutu Sese Seko , the Soviet Union , and East Germany . In 1972, Amin expelled Asians , a majority of whom were Indian-Ugandans , leading India to sever diplomatic relations with his regime. In 1975, Amin became the chairman of the Organisation of African Unity (OAU), a Pan-Africanist group designed to promote solidarity among African states. Uganda was a member of the United Nations Commission on Human Rights from 1977 to 1979. The United Kingdom broke diplomatic relations with Uganda in 1977, and Amin declared that he had defeated the British and added " CBE " to his title for "Conqueror of the British Empire". As Amin's rule progressed into the late 1970s, there was increased unrest against his persecution of certain ethnic groups and political dissidents, along with Uganda's very poor international standing due to Amin's support for PFLP-EO and RZ hijackers in 1976, leading to Israel's Operation Entebbe . He then attempted to annex Tanzania 's Kagera Region in 1978. The Tanzanian president Julius Nyerere ordered his troops to invade Uganda in response. Tanzanian Army and rebel forces successfully captured Kampala in 1979 and ousted Amin from power. Amin went into exile, first in Libya, then Iraq , and finally in Saudi Arabia , where he lived until his death in 2003. Amin's rule was characterised by rampant human rights abuses , including political repression , ethnic persecution , extrajudicial killings , as well as nepotism , corruption, and gross economic mismanagement. International observers and human rights groups estimate that between 100,000 and 500,000 people were killed under his regime. Virtually all retellings of Amin's early life are contradictory, as he did not write an autobiography and never authorized a written account of his life. British governmental records put Amin's birth year in 1925, however, no records were kept for native Africans at the time. In a 1972 interview with Judith Hare , Amin gives his birth place in the village of Koboko and age as forty-six, which would put his birth year in 1926. In a book published in 1977 by Little, Brown and written by a British advisor in Uganda using the pseudonym David Gwyn, Amin was born in Buganda with his age is given as forty-eight, placing his birth year in 1928. The most comprehensive biography of Amin comes from his family based on oral tradition, which has some authority but its details ultimately cannot be confirmed, family tradition and Saudi authorities in Jeddah puts his birth date as 10 Dhu al-Hijja 1346 in the Islamic calendar . According to Amin's family, Ugandan oral tradition, and his Saudi death certificate, Idi Amin Dada Oumee was born on 30 May 1928 at ≈ 4:00 AM in his father's workplace, the Shimoni Police Barracks in Nakasero Hill , Kampala . He was given the name Idi after his birth on the Muslim holiday of Eid al-Adha . According to Fred Guweddeko, a researcher at Makerere University , Amin's birth name was Idi Awo-Ango Angoo. There is disagreement on the meaning of the name "Dada", with some arguing that it meant "sister" or "effeminate" in KiSwahili , but most sources agree that "Dada" was a clan within the Kakwa tribe which was observed over thirteen generations. He was the third son of Amin Dada Nyabira Tomuresu (1889–1976), a Kakwa , and his second wife, Aisha Chumaru Aate (1904–1970), a Lugbara . His father was christened as a Roman Catholic and born with the name Andreas Nyabira Tomuresu. According to British journalist David Martin , Nyabira spent most of his life in South Sudan . He converted to Islam in 1910 after being conscripted as a bugler by the colonial British army under his uncle, the Kakwa tribal leader Sultan Ali Kenyi Dada as a six-year-old child soldier and was given the name Amin Dada. He joined the Protectorate Police Force in Kampala's Nsambia Police Barracks in 1913, at age nine. Nyabira was forcibly conscripted into the British King's African Rifles (KAR) in 1914 where he fought in World War I during East African campaign in Tanganyika before being honorably discharged in 1921 and given a plot of land in Arua . The same year, he joined the Protectorate Police Force in the Nsambia Police Barracks prior to being transferred to the Shimoni Police Barracks in 1928, where Amin was born according to his family. He was transferred to the Kololo Police Barracks and retired from the police force in 1931 and worked at the Office of the Resident District Commissioner in Arua. His mother, Aisha Aate, was born to a Kakwa mother and Lugbara father. By all accounts, Aate was a traditional healer, herbalist, and a midwife. Ten years before Amin's birth, Aate joined the Allah Water (also known as Yakani) movement, which was an anti-colonial alternative medicine congregation centered around a "water of Yakan" that was infused with a psychedelic daffodil plant locally known as Kamiojo, described as the "LSD of Central Africa". The movement was repressed by British colonial authorities who had judged it as rebellion. Despite being largely described as a cult, Amin's family claims that Aate was a priestess in the "Yakanye Order" which they explained as a "secret African society", of which Idi Amin was also a member of, that used "sacred water and other mystical powers" for warfare. According to Amin's family, Aate had cured Irene Drusilla Namaganda, then Queen of Buganda and wife of Daudi Cwa II of Buganda , of her infertility. Aate's high-ranking role in the Allah Water movement allegedly gained the interest of the Bugandan royal family and her alleged connection to the family led to rumors of Amin's biological father being Daudi Chwa II. These rumors were reportedly spread by Nyabira's childless senior wife, who was spiteful of Aate bearing two children. According to Amin's family, Idi Amin was given the name Awon'go ( lit. ' noise ' ) referring to rumors about his alleged paternity. Idi was reportedly chosen to take a 'paternity test' as an infant by tribal elders which involved abandoning him for four days in a forest near Mount Liru in Koboko where they returned to find Amin still alive. The elders attributed this apparent miracle to Nakan, a sacred seven-headed snake in Kakwa folk religion. His parents divorced when he was four, and most accounts suggest that he moved with his mother's family in a rural farming town in north-western Uganda. The divorce of his parents was reportedly due to the lasting rumors regarding Idi's paternity, which angered his mother. Despite this, his family insists that he moved with his father per Muslim tradition in Tanganyika Parish, Arua, while his mother continued to practice healing in Buganda. Amin joined an Islamic school in Bombo in 1941. After a few years, he left school with only a fourth-grade English-language education and did odd jobs before being recruited to the army by a British colonial army officer. According to Amin's family, Ugandan oral tradition, and his Saudi death certificate, Idi Amin Dada Oumee was born on 30 May 1928 at ≈ 4:00 AM in his father's workplace, the Shimoni Police Barracks in Nakasero Hill , Kampala . He was given the name Idi after his birth on the Muslim holiday of Eid al-Adha . According to Fred Guweddeko, a researcher at Makerere University , Amin's birth name was Idi Awo-Ango Angoo. There is disagreement on the meaning of the name "Dada", with some arguing that it meant "sister" or "effeminate" in KiSwahili , but most sources agree that "Dada" was a clan within the Kakwa tribe which was observed over thirteen generations. He was the third son of Amin Dada Nyabira Tomuresu (1889–1976), a Kakwa , and his second wife, Aisha Chumaru Aate (1904–1970), a Lugbara . His father was christened as a Roman Catholic and born with the name Andreas Nyabira Tomuresu. According to British journalist David Martin , Nyabira spent most of his life in South Sudan . He converted to Islam in 1910 after being conscripted as a bugler by the colonial British army under his uncle, the Kakwa tribal leader Sultan Ali Kenyi Dada as a six-year-old child soldier and was given the name Amin Dada. He joined the Protectorate Police Force in Kampala's Nsambia Police Barracks in 1913, at age nine. Nyabira was forcibly conscripted into the British King's African Rifles (KAR) in 1914 where he fought in World War I during East African campaign in Tanganyika before being honorably discharged in 1921 and given a plot of land in Arua . The same year, he joined the Protectorate Police Force in the Nsambia Police Barracks prior to being transferred to the Shimoni Police Barracks in 1928, where Amin was born according to his family. He was transferred to the Kololo Police Barracks and retired from the police force in 1931 and worked at the Office of the Resident District Commissioner in Arua. His mother, Aisha Aate, was born to a Kakwa mother and Lugbara father. By all accounts, Aate was a traditional healer, herbalist, and a midwife. Ten years before Amin's birth, Aate joined the Allah Water (also known as Yakani) movement, which was an anti-colonial alternative medicine congregation centered around a "water of Yakan" that was infused with a psychedelic daffodil plant locally known as Kamiojo, described as the "LSD of Central Africa". The movement was repressed by British colonial authorities who had judged it as rebellion. Despite being largely described as a cult, Amin's family claims that Aate was a priestess in the "Yakanye Order" which they explained as a "secret African society", of which Idi Amin was also a member of, that used "sacred water and other mystical powers" for warfare. According to Amin's family, Aate had cured Irene Drusilla Namaganda, then Queen of Buganda and wife of Daudi Cwa II of Buganda , of her infertility. Aate's high-ranking role in the Allah Water movement allegedly gained the interest of the Bugandan royal family and her alleged connection to the family led to rumors of Amin's biological father being Daudi Chwa II. These rumors were reportedly spread by Nyabira's childless senior wife, who was spiteful of Aate bearing two children. According to Amin's family, Idi Amin was given the name Awon'go ( lit. ' noise ' ) referring to rumors about his alleged paternity. Idi was reportedly chosen to take a 'paternity test' as an infant by tribal elders which involved abandoning him for four days in a forest near Mount Liru in Koboko where they returned to find Amin still alive. The elders attributed this apparent miracle to Nakan, a sacred seven-headed snake in Kakwa folk religion. His parents divorced when he was four, and most accounts suggest that he moved with his mother's family in a rural farming town in north-western Uganda. The divorce of his parents was reportedly due to the lasting rumors regarding Idi's paternity, which angered his mother. Despite this, his family insists that he moved with his father per Muslim tradition in Tanganyika Parish, Arua, while his mother continued to practice healing in Buganda. Amin joined an Islamic school in Bombo in 1941. After a few years, he left school with only a fourth-grade English-language education and did odd jobs before being recruited to the army by a British colonial army officer. Amin joined the King's African Rifles (KAR) in 1946 as an assistant cook, while at the same time receiving military training until 1947. In later life he falsely claimed to have served in the Burma Campaign of World War II . He was transferred to Kenya for infantry service as a private in 1947, and served in the 21st KAR infantry battalion in Gilgil , Kenya Colony until 1949. That year, his unit was deployed to northern Kenya to fight against Somali rebels. In 1952, his brigade was deployed against the Mau Mau rebels in Kenya. He was promoted to corporal the same year, then to sergeant in 1953. In 1959, Amin was made Effendi class 2 (Warrant Officer), the highest rank possible for a black African in the colonial British military of that time. Amin returned to Uganda the same year and received a short-service commission as a lieutenant on 15 July 1961, becoming one of the first two Ugandans to become commissioned officers. He was assigned to quell the cattle rustling between Uganda's Karamojong and Kenya's Turkana nomads. According to researcher Holger Bernt Hansen, Amin's outlook, behaviour and strategies of communication were strongly influenced by his experiences in the colonial military. This included his direct and hands-on leadership style which would eventually contribute to his popularity among certain parts of Ugandan society. In 1962, following Uganda's independence from the United Kingdom, Amin was promoted to captain and then, in 1963, to major. He was appointed Deputy Commander of the Army in 1964 and, the following year, to Commander of the Army. In 1970, he was promoted to commander of all the armed forces. Amin was an athlete during his time in both the British and Uganda Army. At 1.93 m (6 ft 4 in) tall and powerfully built, he was the Ugandan light heavyweight boxing champion from 1951 to 1960, as well as a swimmer. Amin was also a formidable rugby forward, although one officer said of him: "Idi Amin is a splendid type and a good (rugby) player, but virtually bone from the neck up, and needs things explained in words of one letter". In the 1950s, he played for Nile RFC. There is a frequently repeated urban myth that he was selected as a replacement by the East Africa rugby union team for their 1955 tour match against the British Lions . Amin, however, does not appear in the team photograph or on the official team list. Following conversations with a colleague in the military, Amin became a fan of Hayes F.C. , an affection that remained for the rest of his life. In 1965, Prime Minister Milton Obote and Amin were implicated in a deal to smuggle ivory and gold into Uganda from the Democratic Republic of the Congo . The deal, as later alleged by General Nicholas Olenga, an associate of the former Congolese leader Patrice Lumumba , was part of an arrangement to help troops opposed to the Congolese government trade ivory and gold for arms supplies secretly smuggled to them by Amin. In 1966, the Ugandan Parliament demanded an investigation. Obote imposed a new constitution abolishing the ceremonial presidency held by Kabaka (King) Mutesa II of Buganda and declared himself executive president. He promoted Amin to colonel and army commander. Amin led an attack on the Kabaka's palace and forced Mutesa into exile to the United Kingdom, where he remained until his death in 1969. Amin began recruiting members of Kakwa, Lugbara, South Sudanese , and other ethnic groups from the West Nile area bordering South Sudan . The South Sudanese had been residents in Uganda since the early 20th century, having come from South Sudan to serve the colonial army. Many African ethnic groups in northern Uganda inhabit both Uganda and South Sudan; allegations persist that Amin's army consisted mainly of South Sudanese soldiers. Eventually a rift developed between Amin and Obote, exacerbated by the support Amin had built within the Uganda Army by recruiting from the West Nile region , his involvement in operations to support the rebellion in southern Sudan and an attempt on Obote's life in 1969. In October 1970, Obote took control of the armed forces, reducing Amin from his months-old post of commander of all the armed forces to that of the commander of the Uganda Army. Having learned that Obote was planning to arrest him for misappropriating army funds, Amin seized power in a military coup with the assistance of Israeli government agents on 25 January 1971, while Obote was attending that year's Commonwealth summit meeting in Singapore. Troops loyal to Amin sealed off Entebbe International Airport and took Kampala. Soldiers surrounded Obote's residence and blocked major roads. A broadcast on Radio Uganda accused Obote's government of corruption and preferential treatment of the Lango region . Cheering crowds were reported in the streets of Kampala after the radio broadcast. Amin, who presented himself a soldier, not a politician, declared that the military government would remain only as a caretaker regime until new elections, which would be held when the situation was normalised. He promised to release all political prisoners . Amin held a state funeral in April 1971 for Edward Mutesa, former king ( kabaka ) of Buganda and president who had died in exile. On 2 February 1971, one week after the coup, Amin declared himself President of Uganda, Commander-in-Chief of the Armed Forces, Uganda Army Chief of Staff , and Chief of Air Staff. He suspended certain provisions of the Ugandan constitution , and soon instituted an Advisory Defence Council composed of military officers with himself as the chairman. Amin placed military tribunals above the system of civil law , appointed soldiers to top government posts and government-owned corporations , and informed the newly inducted civilian cabinet ministers that they would be subject to military courtesy . Amin ruled by decree ; over the course of his rule he issued approximately 30 decrees. Amin renamed the presidential lodge in Kampala from Government House to "The Command Post". He disbanded the General Service Unit (GSU), an intelligence agency created by the previous government, and replaced it with the State Research Bureau (SRB). SRB headquarters at the Kampala suburb of Nakasero became the scene of torture and capital punishment over the next few years. Other agencies used to persecute dissenters included the military police and the Public Safety Unit (PSU). Obote took refuge in Tanzania, having been offered sanctuary there by the Tanzanian President Julius Nyerere . Obote was soon joined by 20,000 Ugandan refugees fleeing Amin. The exiles attempted but failed to regain Uganda in 1972, through a poorly organised coup attempt. Amin retaliated against the attempted invasion by Ugandan exiles in 1972 , by purging the Uganda Army of Obote supporters, predominantly those from the Acholi and Lango ethnic groups. In July 1971, Lango and Acholi soldiers had been massacred in the Jinja and Mbarara barracks . By early 1972, some 5,000 Acholi and Lango soldiers, and at least twice as many civilians, had disappeared. The victims soon came to include members of other ethnic groups , religious leaders, journalists, artists, senior bureaucrats, judges, lawyers, students and intellectuals, criminal suspects, and foreign nationals. In this atmosphere of violence, many other people were killed for criminal motives or simply at will. Bodies were often dumped into the River Nile. The killings, motivated by ethnic, political, and financial factors, continued throughout Amin's eight years in control. The exact number of people killed is unknown. The International Commission of Jurists estimated the death toll at no fewer than 80,000 and more likely around 300,000. An estimate compiled by exile organisations with the help of Amnesty International puts the number killed at 500,000. In his book State of Blood: The Inside Story of Idi Amin , Henry Kyemba (who was a Ugandan minister for 3 years in Idi Amin's cabinet) states that "Amin's bizarre behaviour derives partly from his tribal background. Like many other warrior societies, the Kakwa, Amin's tribe, are known to have practised blood rituals on slain enemies. These involve cutting a piece of flesh from the body to subdue the dead man's spirit or tasting the victim's blood to render the spirit harmless. Such rituals still exist among the Kakwa. Amin's practices do not stop at tasting blood: on several occasions he has boasted to me and others that he has eaten human flesh". (Kyemba 109–10) Among the most prominent people killed were Benedicto Kiwanuka , a former prime minister and chief justice ; Janani Luwum , the Anglican archbishop ; Joseph Mubiru, the former governor of the central bank of Uganda ; Frank Kalimuzo, the vice-chancellor of Makerere University ; Byron Kawadwa, a prominent playwright; and two of Amin's own cabinet ministers, Erinayo Wilson Oryema and Charles Oboth Ofumbi . Amin recruited his followers from his own ethnic group, the Kakwas, along with South Sudanese, and Nubians. By 1977, these three groups formed 60 per cent of the 22 top generals and 75 per cent of the cabinet. Similarly, Muslims formed 80 per cent and 87.5 per cent of these groups even though they were only 5 per cent of the population. This helps explain why Amin survived eight attempted coups. The Uganda Army grew from 10,000 to 25,000 by 1978. Amin's military was largely a mercenary force. Half the soldiers were South Sudanese and 26 per cent Congolese, with only 24 per cent being Ugandan, mostly Muslim and Kakwa. We are determined to make the ordinary Ugandan master of his own destiny and, above all, to see that he enjoys the wealth of his country. Our deliberate policy is to transfer the economic control of Uganda into the hands of Ugandans, for the first time in our country's history. In August 1972, Amin declared what he called an "economic war", a set of policies that included the expropriation of properties owned by Asians and Europeans. Uganda's 80,000 Asians were mostly from the Indian subcontinent and born in the country, their ancestors having come to Uganda in search of prosperity when India was still a British colony. Many owned businesses, including large-scale enterprises, which formed the backbone of the Ugandan economy. On 4 August 1972, Amin issued a decree ordering the expulsion of the 50,000 Asians who were British passport holders. This was later amended to include all 60,000 Asians who were not Ugandan citizens. Around 30,000 Ugandan Asians emigrated to the UK. Others went to Commonwealth countries such as Australia , South Africa , Canada , and Fiji , or to India , Kenya , Pakistan , Sweden , Tanzania , and the United States . Amin expropriated businesses and properties belonging to the Asians and the Europeans and handed them over to his supporters. Without the experienced owners and proprietors, businesses were mismanaged and many industries collapsed from lack of operational expertise and maintenance. This proved disastrous for the already declining Ugandan economy. At the time, Asians accounted for 90% of the country's tax revenue; with their removal, Amin's administration lost a large chunk of government revenue. The economy all but collapsed. Idi Amin murdered an estimated 500 Yemeni Hadrami Arab merchants. In 1975, Emmanuel Blayo Wakhweya , Idi Amin's finance minister and longest-serving cabinet member at the time, defected to London . This prominent defection helped Henry Kyemba , Amin's health minister and a former official of the first Obote regime, to defect in 1977 and resettle in the UK. Kyemba wrote and published A State of Blood , the first insider exposé of Amin's rule. On 25 June 1976, the Defence Council declared Amin president for life . Initially, Amin was supported by Western powers such as Israel , West Germany , and, in particular, the United Kingdom. During the late 1960s, Obote's move to the left , which included his Common Man's Charter and the nationalisation of 80 British companies, had made the West worried that he would pose a threat to Western capitalist interests in Africa and make Uganda an ally of the Soviet Union . Amin, who had served with the King's African Rifles and taken part in Britain's suppression of the Mau Mau uprising prior to Ugandan independence, was known by the British as "intensely loyal to Britain". This made him an obvious choice as Obote's successor. Although some have claimed that Amin was being groomed for power as early as 1966, the plotting by the British and other Western powers began in earnest in 1969, after Obote had begun his nationalisation programme. Throughout the first year of his presidency, Amin received key military and financial support from the United Kingdom and Israel. In July 1971 he visited both countries and asked for advanced military equipment, but the states refused to provide hardware unless the Ugandan government paid for it. Amin decided to seek foreign support elsewhere and in February 1972 he visited Libya . Amin denounced Zionism , and in return Libyan leader Muammar Gaddafi pledged Uganda an immediate $25 million loan to be followed by more lending from the Libyan–Ugandan Development Bank. Over the following months Amin successively removed Israeli military advisers from his government, expelled all other Israeli technicians, and finally broke diplomatic relations. Gaddafi also mediated a resolution to long-standing Ugandan–Sudanese tensions, with Amin agreeing to stop backing Anyanya rebels in southern Sudan and instead recruit the former guerilla fighters into his army. Following the expulsion of Ugandan Asians in 1972, most of whom were of Indian descent, India severed diplomatic relations with Uganda. The same year, as part of his "economic war", Amin broke diplomatic ties with the United Kingdom and nationalised all British-owned businesses. The United Kingdom and Israel ceased all trade with Uganda, but this commercial gap was quickly filled by Libya, the United States, and the Soviet Union. The Soviet Union under Leonid Brezhnev grew increasingly interested in Uganda as a strategic counterbalance to perceived Chinese influence in Tanzania and Western influence in Kenya. It dispatched a military mission to Uganda in November 1973. While it could not supply the financial level available from the Western powers, the Soviet Union opted to provide Amin with military hardware in exchange for his support. The Soviet Union quickly became Amin's largest arms supplier, sending Uganda tanks, jets, artillery, missiles, and small arms. By 1975, it was estimated that the Soviets had provided Amin's government with $12 million in economic assistance and $48 million in arms. Amin also sent several thousand Ugandans to Eastern Bloc countries for military, intelligence, and technical training, especially Czechoslovakia . East Germany was involved in the General Service Unit and the State Research Bureau, the two agencies that were most notorious for terror. Later during the Ugandan invasion of Tanzania in 1979, East Germany attempted to remove evidence of its involvement with these agencies. In December 1973 Amin launched a sarcastic 'Save Britain Fund' during the 1973–1975 recession to "save and assist our former colonial masters from economic catastrophe", while offering emergency food supplies and urging Ugandans to donate. In June 1976, Amin allowed an Air France airliner from Tel Aviv to Paris hijacked by two members of the Popular Front for the Liberation of Palestine – External Operations (PFLP-EO) and two members of the German Revolutionäre Zellen to land at Entebbe Airport. The hijackers were joined there by three more. Soon after, 156 non-Jewish hostages who did not hold Israeli passports were released and flown to safety, while 83 Jews and Israeli citizens, as well as 20 others who refused to abandon them (among whom were the captain and crew of the hijacked Air France jet), continued to be held hostage. In the subsequent Israeli rescue operation, codenamed Operation Thunderbolt (popularly known as Operation Entebbe ), on the night of 3–4 July 1976, a group of Israeli commandos flew in from Israel and seized control of Entebbe Airport, freeing nearly all the hostages. Three hostages died during the operation and 10 were wounded; 7 hijackers, about 45 Ugandan soldiers, and 1 Israeli soldier, Yoni Netanyahu (the commander of the unit), were killed. A fourth hostage, 75-year-old Dora Bloch , an elderly Jewish Englishwoman who had been taken to Mulago Hospital in Kampala before the rescue operation, was subsequently murdered in reprisal. The incident further soured Uganda's international relations, leading the United Kingdom to close its High Commission in Uganda. In retaliation for Kenya's assistance in the raid, Amin also ordered the killing of hundreds of Kenyans living in Uganda. Uganda under Amin embarked on a large military build-up, which raised concerns in Kenya. Early in June 1975, Kenyan officials impounded a large convoy of Soviet-made arms en route to Uganda at the port of Mombasa . Tension between Uganda and Kenya reached its climax in February 1976, when Amin announced that he would investigate the possibility that parts of southern Sudan and western and central Kenya, up to within 32 kilometres (20 mi) of Nairobi , were historically a part of colonial Uganda. The Kenyan Government responded with a stern statement that Kenya would not part with "a single inch of territory". Amin backed down after the Kenyan army deployed troops and armoured personnel carriers along the Kenya–Uganda border. Amin's relations with Rwanda were tense, and during his tenure he repeatedly jeopardized its economy by denying its commercial vehicles transit to Mombasa and made multiple threats to bomb Kigali . In January 1977 Amin appointed General Mustafa Adrisi Vice President of Uganda. That year, a split in the Uganda Army developed between supporters of Amin and soldiers loyal to Adrisi, who held significant power in the government and wanted to purge foreigners, particularly Sudanese, from the military. The growing dissatisfaction in the Uganda Army was reflected by frequent coup attempts; Amin was even wounded during one of them, namely Operation Mafuta Mingi in June 1977. By 1978, the number of Amin's supporters and close associates had shrunk significantly, and he faced increasing dissent from the populace within Uganda as the economy and infrastructure collapsed as a result of the years of neglect and abuse. After the killings of Bishop Luwum and ministers Oryema and Oboth Ofumbi in 1977, several of Amin's ministers defected or fled into exile. In early 1978, Adrisi was severely injured in a car accident and flown to Cairo for treatment. While he was there, Amin stripped him of his positions as Minister of Defence and Minister of Home Affairs and denounced him for retiring senior prison officials without his knowledge. Amin then proceeded to purge several high-ranking officials from his government and took personal control of several ministerial portfolios. The shakeup caused political unrest and especially angered Adrisi's followers, who believed that the car accident was a failed assassination attempt. In November 1978, troops loyal to Adrisi mutinied. Amin sent troops against the mutineers, some of whom had fled across the Tanzanian border. Fighting consequently broke out along that border, and the Uganda Army invaded Tanzanian territory under unclear circumstances. According to several experts and politicians, Amin directly ordered the invasion in an attempt to distract the Ugandan military and public from the crisis at home. Other accounts suggest, however, that Amin had lost control of parts of the Uganda Army, so Amin's sanction for the invasion was a post-facto action to save face regarding troops who had acted without his orders. In any case, Amin accused Tanzanian President Julius Nyerere of initiating the war against Uganda after the hostilities had erupted, and proclaimed the annexation of a section of Kagera when the Ugandan invasion initially proved to be successful. However, as Tanzania began to prepare a counter-offensive, Amin reportedly realised his precarious situation, and attempted to defuse the conflict without losing face. The Ugandan President publicly suggested that he and Nyerere participate in a boxing match which, in lieu of military action, would determine the outcome of the conflict. [lower-alpha 1] Nyerere ignored the message. In January 1979, Nyerere mobilised the Tanzania People's Defence Force and counterattacked, joined by several groups of Ugandan exiles who had united as the Uganda National Liberation Army (UNLA). Amin's army retreated steadily, despite military help from Libya's Muammar Gaddafi and the Palestine Liberation Organisation (PLO). The President reportedly made several trips abroad to other countries such as Saudi Arabia and Iraq during the war, attempting to enlist more foreign support . He made few public appearances in the final months of his rule, but spoke frequently on radio and television. Following a major defeat in the Battle of Lukaya , parts of the Uganda Army command reportedly urged Amin to step down. He angrily refused and declared: "If you don't want to fight, I'll do it myself." He consequently fired chief of staff Yusuf Gowon . However, Amin was forced to flee the Ugandan capital by helicopter on 11 April 1979, when Kampala was captured . After a short-lived attempt to rally some remnants of the Uganda Army in eastern Uganda which reportedly included Amin proclaiming the city of Jinja his country's new capital, he fled into exile. By the time of his removal from power, Amin had become deeply unpopular in Uganda. The symbols of his rule, his pictures, and buildings associated with him were subject to vandalism during and after the war. On 2 February 1971, one week after the coup, Amin declared himself President of Uganda, Commander-in-Chief of the Armed Forces, Uganda Army Chief of Staff , and Chief of Air Staff. He suspended certain provisions of the Ugandan constitution , and soon instituted an Advisory Defence Council composed of military officers with himself as the chairman. Amin placed military tribunals above the system of civil law , appointed soldiers to top government posts and government-owned corporations , and informed the newly inducted civilian cabinet ministers that they would be subject to military courtesy . Amin ruled by decree ; over the course of his rule he issued approximately 30 decrees. Amin renamed the presidential lodge in Kampala from Government House to "The Command Post". He disbanded the General Service Unit (GSU), an intelligence agency created by the previous government, and replaced it with the State Research Bureau (SRB). SRB headquarters at the Kampala suburb of Nakasero became the scene of torture and capital punishment over the next few years. Other agencies used to persecute dissenters included the military police and the Public Safety Unit (PSU). Obote took refuge in Tanzania, having been offered sanctuary there by the Tanzanian President Julius Nyerere . Obote was soon joined by 20,000 Ugandan refugees fleeing Amin. The exiles attempted but failed to regain Uganda in 1972, through a poorly organised coup attempt. Amin retaliated against the attempted invasion by Ugandan exiles in 1972 , by purging the Uganda Army of Obote supporters, predominantly those from the Acholi and Lango ethnic groups. In July 1971, Lango and Acholi soldiers had been massacred in the Jinja and Mbarara barracks . By early 1972, some 5,000 Acholi and Lango soldiers, and at least twice as many civilians, had disappeared. The victims soon came to include members of other ethnic groups , religious leaders, journalists, artists, senior bureaucrats, judges, lawyers, students and intellectuals, criminal suspects, and foreign nationals. In this atmosphere of violence, many other people were killed for criminal motives or simply at will. Bodies were often dumped into the River Nile. The killings, motivated by ethnic, political, and financial factors, continued throughout Amin's eight years in control. The exact number of people killed is unknown. The International Commission of Jurists estimated the death toll at no fewer than 80,000 and more likely around 300,000. An estimate compiled by exile organisations with the help of Amnesty International puts the number killed at 500,000. In his book State of Blood: The Inside Story of Idi Amin , Henry Kyemba (who was a Ugandan minister for 3 years in Idi Amin's cabinet) states that "Amin's bizarre behaviour derives partly from his tribal background. Like many other warrior societies, the Kakwa, Amin's tribe, are known to have practised blood rituals on slain enemies. These involve cutting a piece of flesh from the body to subdue the dead man's spirit or tasting the victim's blood to render the spirit harmless. Such rituals still exist among the Kakwa. Amin's practices do not stop at tasting blood: on several occasions he has boasted to me and others that he has eaten human flesh". (Kyemba 109–10) Among the most prominent people killed were Benedicto Kiwanuka , a former prime minister and chief justice ; Janani Luwum , the Anglican archbishop ; Joseph Mubiru, the former governor of the central bank of Uganda ; Frank Kalimuzo, the vice-chancellor of Makerere University ; Byron Kawadwa, a prominent playwright; and two of Amin's own cabinet ministers, Erinayo Wilson Oryema and Charles Oboth Ofumbi . Amin recruited his followers from his own ethnic group, the Kakwas, along with South Sudanese, and Nubians. By 1977, these three groups formed 60 per cent of the 22 top generals and 75 per cent of the cabinet. Similarly, Muslims formed 80 per cent and 87.5 per cent of these groups even though they were only 5 per cent of the population. This helps explain why Amin survived eight attempted coups. The Uganda Army grew from 10,000 to 25,000 by 1978. Amin's military was largely a mercenary force. Half the soldiers were South Sudanese and 26 per cent Congolese, with only 24 per cent being Ugandan, mostly Muslim and Kakwa. We are determined to make the ordinary Ugandan master of his own destiny and, above all, to see that he enjoys the wealth of his country. Our deliberate policy is to transfer the economic control of Uganda into the hands of Ugandans, for the first time in our country's history. In August 1972, Amin declared what he called an "economic war", a set of policies that included the expropriation of properties owned by Asians and Europeans. Uganda's 80,000 Asians were mostly from the Indian subcontinent and born in the country, their ancestors having come to Uganda in search of prosperity when India was still a British colony. Many owned businesses, including large-scale enterprises, which formed the backbone of the Ugandan economy. On 4 August 1972, Amin issued a decree ordering the expulsion of the 50,000 Asians who were British passport holders. This was later amended to include all 60,000 Asians who were not Ugandan citizens. Around 30,000 Ugandan Asians emigrated to the UK. Others went to Commonwealth countries such as Australia , South Africa , Canada , and Fiji , or to India , Kenya , Pakistan , Sweden , Tanzania , and the United States . Amin expropriated businesses and properties belonging to the Asians and the Europeans and handed them over to his supporters. Without the experienced owners and proprietors, businesses were mismanaged and many industries collapsed from lack of operational expertise and maintenance. This proved disastrous for the already declining Ugandan economy. At the time, Asians accounted for 90% of the country's tax revenue; with their removal, Amin's administration lost a large chunk of government revenue. The economy all but collapsed. Idi Amin murdered an estimated 500 Yemeni Hadrami Arab merchants. In 1975, Emmanuel Blayo Wakhweya , Idi Amin's finance minister and longest-serving cabinet member at the time, defected to London . This prominent defection helped Henry Kyemba , Amin's health minister and a former official of the first Obote regime, to defect in 1977 and resettle in the UK. Kyemba wrote and published A State of Blood , the first insider exposé of Amin's rule. On 25 June 1976, the Defence Council declared Amin president for life . Initially, Amin was supported by Western powers such as Israel , West Germany , and, in particular, the United Kingdom. During the late 1960s, Obote's move to the left , which included his Common Man's Charter and the nationalisation of 80 British companies, had made the West worried that he would pose a threat to Western capitalist interests in Africa and make Uganda an ally of the Soviet Union . Amin, who had served with the King's African Rifles and taken part in Britain's suppression of the Mau Mau uprising prior to Ugandan independence, was known by the British as "intensely loyal to Britain". This made him an obvious choice as Obote's successor. Although some have claimed that Amin was being groomed for power as early as 1966, the plotting by the British and other Western powers began in earnest in 1969, after Obote had begun his nationalisation programme. Throughout the first year of his presidency, Amin received key military and financial support from the United Kingdom and Israel. In July 1971 he visited both countries and asked for advanced military equipment, but the states refused to provide hardware unless the Ugandan government paid for it. Amin decided to seek foreign support elsewhere and in February 1972 he visited Libya . Amin denounced Zionism , and in return Libyan leader Muammar Gaddafi pledged Uganda an immediate $25 million loan to be followed by more lending from the Libyan–Ugandan Development Bank. Over the following months Amin successively removed Israeli military advisers from his government, expelled all other Israeli technicians, and finally broke diplomatic relations. Gaddafi also mediated a resolution to long-standing Ugandan–Sudanese tensions, with Amin agreeing to stop backing Anyanya rebels in southern Sudan and instead recruit the former guerilla fighters into his army. Following the expulsion of Ugandan Asians in 1972, most of whom were of Indian descent, India severed diplomatic relations with Uganda. The same year, as part of his "economic war", Amin broke diplomatic ties with the United Kingdom and nationalised all British-owned businesses. The United Kingdom and Israel ceased all trade with Uganda, but this commercial gap was quickly filled by Libya, the United States, and the Soviet Union. The Soviet Union under Leonid Brezhnev grew increasingly interested in Uganda as a strategic counterbalance to perceived Chinese influence in Tanzania and Western influence in Kenya. It dispatched a military mission to Uganda in November 1973. While it could not supply the financial level available from the Western powers, the Soviet Union opted to provide Amin with military hardware in exchange for his support. The Soviet Union quickly became Amin's largest arms supplier, sending Uganda tanks, jets, artillery, missiles, and small arms. By 1975, it was estimated that the Soviets had provided Amin's government with $12 million in economic assistance and $48 million in arms. Amin also sent several thousand Ugandans to Eastern Bloc countries for military, intelligence, and technical training, especially Czechoslovakia . East Germany was involved in the General Service Unit and the State Research Bureau, the two agencies that were most notorious for terror. Later during the Ugandan invasion of Tanzania in 1979, East Germany attempted to remove evidence of its involvement with these agencies. In December 1973 Amin launched a sarcastic 'Save Britain Fund' during the 1973–1975 recession to "save and assist our former colonial masters from economic catastrophe", while offering emergency food supplies and urging Ugandans to donate. In June 1976, Amin allowed an Air France airliner from Tel Aviv to Paris hijacked by two members of the Popular Front for the Liberation of Palestine – External Operations (PFLP-EO) and two members of the German Revolutionäre Zellen to land at Entebbe Airport. The hijackers were joined there by three more. Soon after, 156 non-Jewish hostages who did not hold Israeli passports were released and flown to safety, while 83 Jews and Israeli citizens, as well as 20 others who refused to abandon them (among whom were the captain and crew of the hijacked Air France jet), continued to be held hostage. In the subsequent Israeli rescue operation, codenamed Operation Thunderbolt (popularly known as Operation Entebbe ), on the night of 3–4 July 1976, a group of Israeli commandos flew in from Israel and seized control of Entebbe Airport, freeing nearly all the hostages. Three hostages died during the operation and 10 were wounded; 7 hijackers, about 45 Ugandan soldiers, and 1 Israeli soldier, Yoni Netanyahu (the commander of the unit), were killed. A fourth hostage, 75-year-old Dora Bloch , an elderly Jewish Englishwoman who had been taken to Mulago Hospital in Kampala before the rescue operation, was subsequently murdered in reprisal. The incident further soured Uganda's international relations, leading the United Kingdom to close its High Commission in Uganda. In retaliation for Kenya's assistance in the raid, Amin also ordered the killing of hundreds of Kenyans living in Uganda. Uganda under Amin embarked on a large military build-up, which raised concerns in Kenya. Early in June 1975, Kenyan officials impounded a large convoy of Soviet-made arms en route to Uganda at the port of Mombasa . Tension between Uganda and Kenya reached its climax in February 1976, when Amin announced that he would investigate the possibility that parts of southern Sudan and western and central Kenya, up to within 32 kilometres (20 mi) of Nairobi , were historically a part of colonial Uganda. The Kenyan Government responded with a stern statement that Kenya would not part with "a single inch of territory". Amin backed down after the Kenyan army deployed troops and armoured personnel carriers along the Kenya–Uganda border. Amin's relations with Rwanda were tense, and during his tenure he repeatedly jeopardized its economy by denying its commercial vehicles transit to Mombasa and made multiple threats to bomb Kigali . In January 1977 Amin appointed General Mustafa Adrisi Vice President of Uganda. That year, a split in the Uganda Army developed between supporters of Amin and soldiers loyal to Adrisi, who held significant power in the government and wanted to purge foreigners, particularly Sudanese, from the military. The growing dissatisfaction in the Uganda Army was reflected by frequent coup attempts; Amin was even wounded during one of them, namely Operation Mafuta Mingi in June 1977. By 1978, the number of Amin's supporters and close associates had shrunk significantly, and he faced increasing dissent from the populace within Uganda as the economy and infrastructure collapsed as a result of the years of neglect and abuse. After the killings of Bishop Luwum and ministers Oryema and Oboth Ofumbi in 1977, several of Amin's ministers defected or fled into exile. In early 1978, Adrisi was severely injured in a car accident and flown to Cairo for treatment. While he was there, Amin stripped him of his positions as Minister of Defence and Minister of Home Affairs and denounced him for retiring senior prison officials without his knowledge. Amin then proceeded to purge several high-ranking officials from his government and took personal control of several ministerial portfolios. The shakeup caused political unrest and especially angered Adrisi's followers, who believed that the car accident was a failed assassination attempt. In November 1978, troops loyal to Adrisi mutinied. Amin sent troops against the mutineers, some of whom had fled across the Tanzanian border. Fighting consequently broke out along that border, and the Uganda Army invaded Tanzanian territory under unclear circumstances. According to several experts and politicians, Amin directly ordered the invasion in an attempt to distract the Ugandan military and public from the crisis at home. Other accounts suggest, however, that Amin had lost control of parts of the Uganda Army, so Amin's sanction for the invasion was a post-facto action to save face regarding troops who had acted without his orders. In any case, Amin accused Tanzanian President Julius Nyerere of initiating the war against Uganda after the hostilities had erupted, and proclaimed the annexation of a section of Kagera when the Ugandan invasion initially proved to be successful. However, as Tanzania began to prepare a counter-offensive, Amin reportedly realised his precarious situation, and attempted to defuse the conflict without losing face. The Ugandan President publicly suggested that he and Nyerere participate in a boxing match which, in lieu of military action, would determine the outcome of the conflict. [lower-alpha 1] Nyerere ignored the message. In January 1979, Nyerere mobilised the Tanzania People's Defence Force and counterattacked, joined by several groups of Ugandan exiles who had united as the Uganda National Liberation Army (UNLA). Amin's army retreated steadily, despite military help from Libya's Muammar Gaddafi and the Palestine Liberation Organisation (PLO). The President reportedly made several trips abroad to other countries such as Saudi Arabia and Iraq during the war, attempting to enlist more foreign support . He made few public appearances in the final months of his rule, but spoke frequently on radio and television. Following a major defeat in the Battle of Lukaya , parts of the Uganda Army command reportedly urged Amin to step down. He angrily refused and declared: "If you don't want to fight, I'll do it myself." He consequently fired chief of staff Yusuf Gowon . However, Amin was forced to flee the Ugandan capital by helicopter on 11 April 1979, when Kampala was captured . After a short-lived attempt to rally some remnants of the Uganda Army in eastern Uganda which reportedly included Amin proclaiming the city of Jinja his country's new capital, he fled into exile. By the time of his removal from power, Amin had become deeply unpopular in Uganda. The symbols of his rule, his pictures, and buildings associated with him were subject to vandalism during and after the war. Amin first escaped to Libya, where he stayed until 1980, and ultimately settled in Saudi Arabia , where the Saudi royal family allowed him sanctuary and paid him a generous subsidy in return for staying out of politics. Amin lived for a number of years on the top two floors of the Novotel Hotel on Palestine Road in Jeddah. Brian Barron , who covered the Uganda–Tanzania War for the BBC as chief Africa correspondent, together with cameraman Mohamed Amin (no relation) of Visnews in Nairobi , located Amin on June 4th, 1980, and secured the first interview with him since his deposition. While in exile, Amin funded remnants of his army that fought in the Ugandan Bush War . Though he continued to be a controversial figure, some of Amin's former followers as well as several rebel groups continued to fight in his name for decades and occasionally advocated for his amnesty and even his restoration to Ugandan Presidency. During interviews he gave during his exile in Saudi Arabia, Amin held that Uganda needed him and never expressed remorse for the brutal nature of his regime. In January 1989, Amin left his exile without authorization by the Saudi Arabian government and flew alongside one of his sons to Zaire . There, he intended to mobilize a rebel force to reconquer Uganda which was engulfed in another civil war at the time. The rest of his family stayed in Jeddah. Despite using a false Zairean passport, Amin was easily recognized upon arriving with Air Zaïre at N'djili Airport and promptly arrested by Zairean security forces. The Zairean government reacted unfavourably to Amin's arrival and attempted to expel him from the country. At first, Saudi Arabia refused to allow him to return, as its government was deeply offended that he had "abused their hospitality" by leaving without permission, and doing so for political reasons. The Zairean government wanted neither to extradite Amin to Uganda where the ex-president faced murder charges nor keep him in Zaire, thereby straining international relations. As a result, Amin was initially expelled to Senegal from where he was supposed to be sent to Saudi Arabia, but the Senegalese government sent him back to Zaire when Saudi Arabia continued to refuse Amin a visa. Following appeals by Moroccan King Hassan II , the Saudi Arabian government finally relented and allowed Amin to return. In return, Amin had to promise to never again participate in any political or military activities, nor give interviews. He consequently spent the remainder of his life in Saudi Arabia. In the final years of his life, Amin reportedly ate a fruitarian diet. His daily consumption of oranges earned him the nickname "Dr Jaffa" among Saudi Arabians. On 19 July 2003, Amin's fourth wife, Nalongo Madina, reported that he was in a coma and near death at the King Faisal Specialist Hospital and Research Centre in Jeddah , Saudi Arabia, from kidney failure . She pleaded with the Ugandan president, Yoweri Museveni , to allow him to return to Uganda for the remainder of his life. Museveni replied that Amin would have to "answer for his sins the moment he was brought back". Amin's family eventually decided to disconnect life support and Amin consequently died at the hospital in Jeddah on 16 August 2003. He was buried in Ruwais Cemetery in Jeddah in a simple grave, without any fanfare. After Amin's death, David Owen revealed that during his term as the British Foreign Secretary (1977 to 1979), he had proposed having Amin assassinated . He has defended this, arguing: "I'm not ashamed of considering it, because his regime goes down in the scale of Pol Pot as one of the worst of all African regimes". Idi Amin married at least six women, three of whom he divorced . He married his first and second wives, Malyamu and Kay, in 1966. In 1967, he married Nora, and then married Nalongo Madina in 1972. On 26 March 1974, he announced on Radio Uganda that he had divorced Malyamu, Nora, and Kay. Malyamu was arrested in Tororo on the Kenyan border in April 1974 and accused of attempting to smuggle a bolt of fabric into Kenya. In 1974, Kay Amin died under mysterious circumstances, with her body found dismembered. Nora fled to Zaire in 1979; her current whereabouts are unknown. In July 1975, Amin staged a £2 million wedding to 19-year-old Sarah Kyolaba , a go-go dancer with the Revolutionary Suicide Mechanised Regiment Band , nicknamed "Suicide Sarah". The wedding was held during the Organisation of African Unity (OAU) summit meeting in Kampala, and the chairman of the Palestine Liberation Organisation , Yasser Arafat , served as Amin's best man . Before she met Amin, Sarah was living with a boyfriend, Jesse Gitta; he vanished and it is not clear if he was beheaded , or detained after fleeing to Kenya . The couple had four children and enjoyed rally race driving Amin's Citroën SM , with Sarah as navigator. Sarah was a hairdresser in Tottenham when she died in 2015. By 1993, Amin was living with the last nine of his children and one wife, Mama a Chumaru, the mother of the youngest four of his children. His last known child, daughter Iman, was born in 1992. According to The Monitor , Amin married again a few months before his death in 2003, and converted to Islam during his exile. Amin fathered as many as 60 children. [lower-alpha 2] Until 2003, Taban Amin (born 1955), Idi Amin's eldest son, was the leader of West Nile Bank Front (WNBF), a rebel group opposed to the government of Yoweri Museveni. In 2005, he was offered amnesty by Museveni, and in 2006, he was appointed Deputy Director General of the Internal Security Organisation . Another of Amin's sons, Haji Ali Amin, ran for election as Chairman (i.e. mayor) of Njeru Town Council in 2002 but was not elected. Sarah Kyolaba's third child, Faisal Wangita (born in 1983 in Uganda; according to himself born in 1981 in Saudi Arabia) was involved in a brutal gang murder in Camden , North London, in 2006. In connection with this, he was sentenced to 5 years detention in 2007, for conspiracy to wound, conspiracy to possess offensive weapons and violent disorder. He had been convicted for possession of offensive weapons, theft and fraud in the years before. In early 2007, the award-winning film The Last King of Scotland prompted one of his sons, Jaffar Amin (born in 1967), to speak out in his father's defence. Jaffar Amin said he was writing a book to rehabilitate his father's reputation. Jaffar is the tenth of Amin's 40 official children by seven official wives. Among Amin's closest associates was the Briton Bob Astles . Isaac Maliyamungu was an instrumental affiliate and one of the more feared officers in Amin's army. Over the course of his career, Amin gained numerous nicknames, many of them derogatory: As the years progressed, Amin's behaviour became more erratic, unpredictable, and strident. After the United Kingdom broke off all diplomatic relations with his regime in 1977, Amin declared that he had defeated the British, and he conferred on himself the decoration of CBE (Conqueror of the British Empire). His full self-bestowed title ultimately became: "His Excellency, President for Life, Field Marshal Al Hadji Doctor Idi Amin Dada, VC, DSO , MC , CBE, Lord of All the Beasts of the Earth and Fishes of the Seas and Conqueror of the British Empire in Africa in General and Uganda in Particular", in addition to his officially stated claim of being the uncrowned king of Scotland . He never received the Distinguished Service Order (DSO) or the Military Cross (MC). He conferred a doctorate of law on himself from Makerere University as well as the Victorious Cross (VC), a medal made to emulate the British Victoria Cross . Amin became the subject of rumours, including a widespread belief that he was a cannibal . Amin reportedly also boasted that he kept the decapitated heads of political enemies in his freezer, although he said that human flesh was generally "too salty" for his taste. During Amin's time in power, popular media outside of Uganda often portrayed him as an essentially comic and eccentric figure. Julius Harris emphasized Amin's allegedly clownish side in Victory at Entebbe , while Yaphet Kotto drew more praise for projecting Amin's sinister nature in Raid on Entebbe . In a 1977 assessment typical of the time, a Time magazine article described him as a "killer and clown, big-hearted buffoon and strutting martinet ". The comedy-variety series Saturday Night Live aired four Amin sketches between 1976 and 1979, including one in which he was an ill-behaved houseguest in exile, and another in which he was a spokesman against venereal disease . In 1979, radio host Don Imus made multiple on-air telephone calls in an attempt to talk to Amin, and later hosted a phony interview with him that was deemed "very dirty." In a Benny Hill Show episode transmitted in January 1977, Hill portrayed Amin sitting behind a desk that featured a placard reading "ME TARZAN, U GANDA". The foreign media were often criticised by Ugandan exiles and defectors for emphasising Amin's self-aggrandizing eccentricities and taste for excess while downplaying or excusing his murderous behaviour. Other commentators even suggested that Amin had deliberately cultivated his eccentric reputation in the foreign media as an easily parodied buffoon in order to defuse international concern over his administration of Uganda. Ugandan soldier and rebel Patrick Kimumwe argued that Amin's "clowning conceal[ed] a ruthless extinction of human rights" in Uganda. Journalists Tony Avirgan and Martha Honey wrote, "facile explanations of Amin's regime, as either a one-man show or a lawless and ruthless band of killers, do not get at the heart of the power structure." Over the course of his career, Amin gained numerous nicknames, many of them derogatory:As the years progressed, Amin's behaviour became more erratic, unpredictable, and strident. After the United Kingdom broke off all diplomatic relations with his regime in 1977, Amin declared that he had defeated the British, and he conferred on himself the decoration of CBE (Conqueror of the British Empire). His full self-bestowed title ultimately became: "His Excellency, President for Life, Field Marshal Al Hadji Doctor Idi Amin Dada, VC, DSO , MC , CBE, Lord of All the Beasts of the Earth and Fishes of the Seas and Conqueror of the British Empire in Africa in General and Uganda in Particular", in addition to his officially stated claim of being the uncrowned king of Scotland . He never received the Distinguished Service Order (DSO) or the Military Cross (MC). He conferred a doctorate of law on himself from Makerere University as well as the Victorious Cross (VC), a medal made to emulate the British Victoria Cross . Amin became the subject of rumours, including a widespread belief that he was a cannibal . Amin reportedly also boasted that he kept the decapitated heads of political enemies in his freezer, although he said that human flesh was generally "too salty" for his taste. During Amin's time in power, popular media outside of Uganda often portrayed him as an essentially comic and eccentric figure. Julius Harris emphasized Amin's allegedly clownish side in Victory at Entebbe , while Yaphet Kotto drew more praise for projecting Amin's sinister nature in Raid on Entebbe . In a 1977 assessment typical of the time, a Time magazine article described him as a "killer and clown, big-hearted buffoon and strutting martinet ". The comedy-variety series Saturday Night Live aired four Amin sketches between 1976 and 1979, including one in which he was an ill-behaved houseguest in exile, and another in which he was a spokesman against venereal disease . In 1979, radio host Don Imus made multiple on-air telephone calls in an attempt to talk to Amin, and later hosted a phony interview with him that was deemed "very dirty." In a Benny Hill Show episode transmitted in January 1977, Hill portrayed Amin sitting behind a desk that featured a placard reading "ME TARZAN, U GANDA". The foreign media were often criticised by Ugandan exiles and defectors for emphasising Amin's self-aggrandizing eccentricities and taste for excess while downplaying or excusing his murderous behaviour. Other commentators even suggested that Amin had deliberately cultivated his eccentric reputation in the foreign media as an easily parodied buffoon in order to defuse international concern over his administration of Uganda. Ugandan soldier and rebel Patrick Kimumwe argued that Amin's "clowning conceal[ed] a ruthless extinction of human rights" in Uganda. Journalists Tony Avirgan and Martha Honey wrote, "facile explanations of Amin's regime, as either a one-man show or a lawless and ruthless band of killers, do not get at the heart of the power structure." Gender historian Alicia Decker wrote that the "deeply embedded culture of militarism in Uganda is undoubtedly Amin's most enduring legacy." In the immediate aftermath of his deposition, war correspondent Al J Venter stated that Ugandans still spoke about Amin "with a certain amount of awe, now laced with venom". His reputation in Uganda has been viewed over the decades following his rule in more complex ways than in the international community. Some Ugandans have praised him as a "patriot" and supported his decision to expel Asians from the country. At the time of his death, he was particularly well-regarded in north-western Uganda. One of Amin's sons, Jaffar Remo, criticised the negative public perception of his father and called for a commission to investigate the veracity of the abuses committed under his rule. During the 1970s, while Amin was at the height of his infamy, British comic actor John Bird starred on the album The Collected Broadcasts of Idi Amin , with lyrics based on Alan Coren 's anti-Amin Punch columns. In 1975 the satirical single "Amazin' Man", from the album, was released on the Transatlantic label. The record stayed for 12 weeks in the Australian Singles Chart , peaking at number 26. A 1974 documentary film General Idi Amin Dada: A Self Portrait by director Barbet Schroeder was made with the support and participation of Idi Amin. Rise and Fall of Idi Amin (1981) is a Kenyan film that details the history of Idi Amin's reign. This film popularized many rumors about Amin's brutality, such as his alleged mutilation of one of his wives. Amin is played by Joseph Olita , who reprised this role in Mississippi Masala (1991), a film about romance between African and Asian-Americans following Amin's 1972 expulsion of Asians from Uganda . Amin is the subject of English journalist Giles Foden's book The Last King of Scotland (1998), which focuses on Idi Amin's Uganda through the eyes of a young Scottish physician. In 2006, it was adapted into a movie , where Amin is portrayed by Forest Whitaker . Whitaker won the best leading actor award for this role at the Academy Awards , the Golden Globes , the Screen Actor's Guild Award , and the BAFTAs .

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West Nile

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Arbovirus

Arbovirus is an informal name for any virus that is transmitted by arthropod vectors . The term arbovirus is a portmanteau word ( ar thropod- bo rne virus ). Tibovirus ( ti ck- bo rne virus ) is sometimes used to more specifically describe viruses transmitted by ticks , a superorder within the arthropods. Arboviruses can affect both animals (including humans) and plants. In humans, symptoms of arbovirus infection generally occur 3–15 days after exposure to the virus and last three or four days. The most common clinical features of infection are fever , headache , and malaise , but encephalitis and viral hemorrhagic fever may also occur. The incubation period – the time between when infection occurs and when symptoms appear – varies from virus to virus, but is usually limited between 2 and 15 days for arboviruses. The majority of infections, however, are asymptomatic. Among cases in which symptoms do appear, symptoms tend to be non-specific, resembling a flu-like illness , and are not indicative of a specific causative agent. These symptoms include fever, headache, malaise, rash and fatigue. Rarely, vomiting and hemorrhagic fever may occur. The central nervous system can also be affected by infection, as encephalitis and meningitis are sometimes observed. Prognosis is good for most people, but is poor in those who develop severe symptoms, with up to a 20% mortality rate in this population depending on the virus. The very young, elderly, pregnant women, and people with immune deficiencies are more likely to develop severe symptoms. [ citation needed ]Arboviruses maintain themselves in nature by going through a cycle between a host , an organism that carries the virus, and a vector , an organism that carries and transmits the virus to other organisms. For arboviruses, vectors are commonly mosquitoes, ticks, sandflies and other arthropods that consume the blood of vertebrates for nutritious or developmental purposes. Vertebrates which have their blood consumed act as the hosts, with each vector generally having an affinity for the blood of specific species, making those species the hosts. Transmission between the vector and the host occurs when the vector feeds on the blood of the vertebrate, wherein the virus that has established an infection in the salivary glands of the vector comes into contact with the host's blood. While the virus is inside the host, it undergoes a process called amplification, where the virus replicates at sufficient levels to induce viremia , a condition in which there are large numbers of virions present in the blood. The abundance of virions in the host's blood allows the host to transmit the virus to other organisms if its blood is consumed by them. When uninfected vectors become infected from feeding, they are then capable of transmitting the virus to uninfected hosts, resuming amplification of virus populations. If viremia is not achieved in a vertebrate, the species can be called a "dead-end host", as the virus cannot be transmitted back to the vector. An example of this vector-host relationship can be observed in the transmission of the West Nile virus. Female mosquitoes of the genus Culex prefer to consume the blood of passerine birds, making them the hosts of the virus. When these birds are infected, the virus amplifies, potentially infecting multiple mosquitoes that feed on its blood. These infected mosquitoes may go on to further transmit the virus to more birds. If the mosquito is unable to find its preferred food source, it will choose another. Human blood is sometimes consumed, but since the West Nile virus does not replicate that well in mammals , humans are considered a dead-end host. Person-to-person transmission of arboviruses is not common, but can occur. Blood transfusions , organ transplantation , and the use of blood products can transmit arboviruses if the virus is present in the donor's blood or organs. Because of this, blood and organs are often screened for viruses before being administered. Rarely, vertical transmission , or mother-to-child transmission, has been observed in infected pregnant and breastfeeding women. Exposure to used needles may also transmit arboviruses if they have been used by an infected person or animal. This puts intravenous drug users and healthcare workers at risk for infection in regions where the arbovirus may be spreading in human populations. Arboviruses are a polyphyletic group , belonging to various viral genera and therefore exhibiting different virologic characteristics.Arboviruses maintain themselves in nature by going through a cycle between a host , an organism that carries the virus, and a vector , an organism that carries and transmits the virus to other organisms. For arboviruses, vectors are commonly mosquitoes, ticks, sandflies and other arthropods that consume the blood of vertebrates for nutritious or developmental purposes. Vertebrates which have their blood consumed act as the hosts, with each vector generally having an affinity for the blood of specific species, making those species the hosts. Transmission between the vector and the host occurs when the vector feeds on the blood of the vertebrate, wherein the virus that has established an infection in the salivary glands of the vector comes into contact with the host's blood. While the virus is inside the host, it undergoes a process called amplification, where the virus replicates at sufficient levels to induce viremia , a condition in which there are large numbers of virions present in the blood. The abundance of virions in the host's blood allows the host to transmit the virus to other organisms if its blood is consumed by them. When uninfected vectors become infected from feeding, they are then capable of transmitting the virus to uninfected hosts, resuming amplification of virus populations. If viremia is not achieved in a vertebrate, the species can be called a "dead-end host", as the virus cannot be transmitted back to the vector. An example of this vector-host relationship can be observed in the transmission of the West Nile virus. Female mosquitoes of the genus Culex prefer to consume the blood of passerine birds, making them the hosts of the virus. When these birds are infected, the virus amplifies, potentially infecting multiple mosquitoes that feed on its blood. These infected mosquitoes may go on to further transmit the virus to more birds. If the mosquito is unable to find its preferred food source, it will choose another. Human blood is sometimes consumed, but since the West Nile virus does not replicate that well in mammals , humans are considered a dead-end host. Person-to-person transmission of arboviruses is not common, but can occur. Blood transfusions , organ transplantation , and the use of blood products can transmit arboviruses if the virus is present in the donor's blood or organs. Because of this, blood and organs are often screened for viruses before being administered. Rarely, vertical transmission , or mother-to-child transmission, has been observed in infected pregnant and breastfeeding women. Exposure to used needles may also transmit arboviruses if they have been used by an infected person or animal. This puts intravenous drug users and healthcare workers at risk for infection in regions where the arbovirus may be spreading in human populations. Arboviruses are a polyphyletic group , belonging to various viral genera and therefore exhibiting different virologic characteristics.Preliminary diagnosis of arbovirus infection is usually based on clinical presentations of symptoms, places and dates of travel, activities, and epidemiological history of the location where infection occurred. Definitive diagnosis is typically made in a laboratory by employing some combination of blood tests , particularly immunologic , serologic and/or virologic techniques such as ELISA , complement fixation , polymerase chain reaction , neutralization test , and hemagglutination-inhibition test . In the past, arboviruses were organized into one of four groups: A, B, C, and D. Group A denoted members of the genus Alphavirus , Group B were members of the genus Flavivirus , and Group C remains as the Group C serogroup of the genus Orthobunyavirus . Group D was renamed in the mid-1950s to the Guama group and is currently the Guama serogroup in the genus Orthobunyavirus . Currently, viruses are jointly classified according to Baltimore classification and a virus-specific system based on standard biological classification . With the exception of the African swine fever virus , which belongs to the Asfarviridae family of viruses, all major clinically important arboviruses belong to one of the following four groups: [ citation needed ]In the past, arboviruses were organized into one of four groups: A, B, C, and D. Group A denoted members of the genus Alphavirus , Group B were members of the genus Flavivirus , and Group C remains as the Group C serogroup of the genus Orthobunyavirus . Group D was renamed in the mid-1950s to the Guama group and is currently the Guama serogroup in the genus Orthobunyavirus . Currently, viruses are jointly classified according to Baltimore classification and a virus-specific system based on standard biological classification . With the exception of the African swine fever virus , which belongs to the Asfarviridae family of viruses, all major clinically important arboviruses belong to one of the following four groups: [ citation needed ]Vector control measures, especially mosquito control , are essential to reducing the transmission of disease by arboviruses. Habitat control involves draining swamps and removal of other pools of stagnant water (such as old tires, large outdoor potted plants, empty cans, etc.) that often serve as breeding grounds for mosquitoes. Insecticides can be applied in rural and urban areas, inside houses and other buildings, or in outdoor environments. They are often quite effective for controlling arthropod populations, though use of some of these chemicals is controversial, and some organophosphates and organochlorides (such as DDT ) have been banned in many countries. Infertile male mosquitoes have been introduced in some areas in order to reduce the breeding rate of relevant mosquito species. Larvicides are also used worldwide in mosquito abatement programs. Temefos is a common mosquito larvicide. People can also reduce the risk of getting bitten by arthropods by employing personal protective measures such as sleeping under mosquito nets , wearing protective clothing , applying insect repellents such as permethrin and DEET to clothing and exposed skin, and (where possible) avoiding areas known to harbor high arthropod populations. Arboviral encephalitis can be prevented in two major ways: personal protective measures and public health measures to reduce the population of infected mosquitoes. Personal measures include reducing time outdoors particularly in early evening hours, wearing long pants and long sleeved shirts and applying mosquito repellent to exposed skin areas. Public health measures often require spraying of insecticides to kill juvenile (larvae) and adult mosquitoes. Vaccines are available for the following arboviral diseases: Vaccines are in development for the following arboviral diseases:Vaccines are available for the following arboviral diseases: Vaccines are in development for the following arboviral diseases:Because the arboviral encephalitides are viral diseases, antibiotics are not an effective form of treatment and no effective antiviral drugs have yet been discovered. Treatment is supportive, attempting to deal with problems such as swelling of the brain, loss of the automatic breathing activity of the brain and other treatable complications like bacterial pneumonia . The WHO caution against the use of aspirin and ibuprofen as they can increase the risk of bleeding. Most arboviruses are located in tropical areas, however as a group they have a global distribution. The warm climate conditions found in tropical areas allows for year-round transmission by the arthropod vectors. Other important factors determining geographic distribution of arthropod vectors include rainfall, humidity, and vegetation. Mapping methods such as GIS and GPS have allowed for spatial and temporal analyses of arboviruses. Tagging cases or breeding sites geographically has allowed for deeper examination of vector transmission. To see the epidemiology of specific arboviruses, the following resources hold maps, fact sheets, and reports on arboviruses and arboviral epidemics. The WHO also hosts DengueNet, a database which can be queried about Dengue cases. Arboviruses were not known to exist until the rise of modern medicine , with the germ theory and an understanding that viruses were distinct from other microorganisms . The connection between arthropods and disease was not postulated until 1881 when Cuban doctor and scientist Carlos Finlay proposed that yellow fever may be transmitted by mosquitoes instead of human contact, a reality that was verified by Major Walter Reed in 1901. The primary vector, Aedes aegypti , had spread globally from the 15th to the 19th centuries as a result of globalization and the slave trade . This geographic spreading caused dengue fever epidemics throughout the 18th and 19th centuries, and later, in 1906, transmission by the Aedes mosquitoes was confirmed, making yellow fever and dengue fever the first two diseases known to be caused by viruses. Thomas Milton Rivers published the first clear description of a virus as distinct from a bacterium in 1927. The discovery of the West Nile virus came in 1937, and has since been found in Culex populations causing epidemics throughout Africa , the Middle East , and Europe . The virus was introduced into the Western Hemisphere in 1999, sparking a series of epidemics. During the latter half of the 20th century, Dengue fever reemerged as a global disease, with the virus spreading geographically due to urbanization , population growth , increased international travel, and global warming , and continues to cause at least 50 million infections per year, making Dengue fever the most common and clinically important arboviral disease. Yellow fever , alongside malaria , was a major obstacle in the construction of the Panama Canal . French supervision of the project in the 1880s was unsuccessful because of these diseases, forcing the abandonment of the project in 1889. During the American effort to construct the canal in the early 1900s, William C. Gorgas , the Chief Sanitary Officer of Havana , was tasked with overseeing the health of the workers. He had past success in eradicating the disease in Florida and Havana by reducing mosquito populations through draining nearby pools of water, cutting grass, applying oil to the edges of ponds and swamps to kill larvae , and capturing adult mosquitoes that remained indoors during the daytime. Joseph Augustin LePrince , the Chief Sanitary Inspector of the Canal Zone , invented the first commercial larvicide , a mixture of carbolic acid , resin , and caustic soda , to be used throughout the Canal Zone . The combined implementation of these sanitation measures led to a dramatic decline in the number of workers dying and the eventual eradication of yellow fever in the Canal Zone as well as the containment of malaria during the 10-year construction period. Because of the success of these methods at preventing disease, they were adopted and improved upon in other regions of the world.

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West Nile

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American robin

Merula migratoria Planesticus migratorius The American robin ( Turdus migratorius ) is a migratory bird of the true thrush genus and Turdidae, the wider thrush family. It is named after the European robin because of its reddish-orange breast, though the two species are not closely related, with the European robin belonging to the Old World flycatcher family. The American robin is widely distributed throughout North America, wintering from southern Canada to central Mexico and along the Pacific coast. According to the Partners in Flight database (2019), the American robin is the most abundant landbird in North America (with 370 million individuals), ahead of red-winged blackbirds , introduced European starlings , mourning doves and house finches . It has seven subspecies, but only one of them, the San Lucas robin ( T. m. confinis ) of Baja California Sur , is particularly distinctive, with pale gray-brown underparts. The American robin is active mostly during the day and assembles in large flocks at night. Its diet consists of invertebrates (such as beetle grubs , earthworms, and caterpillars), fruits, and berries . It is one of the earliest bird species to lay its eggs, beginning to breed shortly after returning to its summer range from its winter range. The robin's nest consists of long coarse grass, twigs, paper, and feathers, and is smeared with mud and often cushioned with grass or other soft materials. It is among the earliest birds to sing at dawn, and its song consists of several discrete units that are repeated. The adult robin's main predator is the domestic cat; other predators include hawks and snakes. When feeding in flocks, it can be vigilant, watching other birds for reactions to predators. Brown-headed cowbirds ( Molothrus ater ) lay their eggs in robin nests (see brood parasite ), but the robins usually reject the egg. This species was first described in 1766 by Carl Linnaeus in the twelfth edition of his Systema Naturae as Turdus migratorius . The binomial name derives from two Latin words: turdus , "thrush", and migratorius from migrare "to migrate". The term robin for this species has been recorded since at least 1703. There are about 65 species of medium to large thrushes in the genus Turdus , characterized by rounded heads, longish pointed wings, and usually melodious songs. A study of the mitochondrial cytochrome b gene indicates that the American robin is not part of the Central/South American clade of Turdus thrushes; instead it shows genetic similarities to the Kurrichane thrush ( T. libonyanus ) and the olive thrush ( T. olivaceus ), both African species. This conflicts with a 2007 DNA study of 60 of 65 Turdus species, which places the American robin's closest relative as the rufous-collared thrush ( T. rufitorques ) of Central America. Though having distinct plumage , the two species are similar in vocalization and behavior. Beyond this, it lies in a small group of four species of otherwise Central American distribution, suggesting it recently spread northwards into North America. Seven subspecies of American robin are recognized. These subspecies intergrade with each other and are only weakly defined. The eastern subspecies of the American robin ( T. m. migratorius ) is 23 to 28 cm (9.1 to 11.0 in) long with a wingspan ranging from 31 to 41 cm (12 to 16 in) , with similar size ranges across all subspecies. The species averages about 77 g (2.7 oz) in weight, with males ranging from 72 to 94 g (2.5 to 3.3 oz) and females ranging from 59 to 91 g (2.1 to 3.2 oz) . Among standard measurements, the wing chord is 11.5 to 14.5 cm (4.5 to 5.7 in) , the culmen is 1.8 to 2.2 cm (0.71 to 0.87 in) and the tarsus is 2.9 to 3.3 cm (1.1 to 1.3 in) . The head varies from jet black to gray, with white eye arcs and white supercilia . The throat is white with black streaks, and the belly and undertail coverts are white. The American robin has a brown back and a reddish-orange breast, varying from a rich red maroon to peachy orange. The bill is mainly yellow with a variably dark tip, the dusky area becoming more extensive in winter, and the legs and feet are brown. The sexes are similar, but females tend to be duller in color than males, with a brown tint to the head, brown upperparts, and less-bright underparts. However, some birds cannot be accurately sexed on the sole basis of plumage . Juveniles are paler in color than adult males and have dark spots on their breasts and whitish wing coverts. First-year birds are not easily distinguishable from adults, but they tend to be duller, and a small percentage retain a few juvenile wing coverts or other feathers. The American robin breeds throughout most of North America, from Alaska and Canada southward to northern Florida and Mexico. While robins occasionally overwinter in the northern part of the United States and southern Canada, most migrate to winter south of Canada from Florida and the Gulf Coast to central Mexico, as well as along the Pacific Coast. Most depart south by the end of August and begin to return north in February and March (exact dates vary with latitude and climate). The distance by which robins migrate varies significantly depending on their initial habitat; a study found that individual robins tagged in Alaska are known to travel as much as 3.5x further across seasons than robins tagged in Massachusetts. This species is actually a rare vagrant to western Europe, where the majority of records, more than 20, have been in Great Britain. In the autumn of 2003, migration was displaced eastwards leading to massive movements through the eastern U.S., and presumably this is what led to no fewer than three American robins being found in Great Britain, with two attempting to overwinter in 2003–2004, although one was taken by a Eurasian sparrowhawk . A sighting occurred in Great Britain in January 2007. This species has also occurred as a vagrant to Greenland , Jamaica, Hispaniola , Puerto Rico and Belize . Vagrants to Europe, where identified to subspecies, are the eastern subspecies ( T. m. migratorius ), but the Greenland birds also included the Newfoundland subspecies ( T. m. nigrideus ), and some of the southern overshots may have been the southern subspecies ( T. m. achrusterus ). The American robin's breeding habitat is woodland and more open farmland and urban areas. It becomes less common as a breeder in the southernmost part of the Deep South of the United States and there prefers large shade trees on lawns. Its winter habitat is similar but includes more open areas. The American robin is a known reservoir (carrier) for West Nile virus spread by Culex mosquitoes. While crows and jays are often the first noticed deaths in an area with West Nile virus, the American robin is suspected to be a key host and holds a larger responsibility for the transmission of the virus to humans. This is because, while crows and jays die quickly from the virus, the American robin survives the virus longer, hence spreading it to more mosquitoes, which then transmit the virus to humans and other species. A successful West Nile virus vaccine has been administered to six 3-5 week old American robins. A DNA vaccine injected intramuscularly resulted in a 400-fold decrease in average viral load that would likely make robins noninfectious and unable to spread disease. An oral bait is the preferred method of distribution of the vaccine as it would be easier and cheaper than intramuscular injection, but more research would be needed as the existing formulation did not work orally. The American robin is a known reservoir (carrier) for West Nile virus spread by Culex mosquitoes. While crows and jays are often the first noticed deaths in an area with West Nile virus, the American robin is suspected to be a key host and holds a larger responsibility for the transmission of the virus to humans. This is because, while crows and jays die quickly from the virus, the American robin survives the virus longer, hence spreading it to more mosquitoes, which then transmit the virus to humans and other species. A successful West Nile virus vaccine has been administered to six 3-5 week old American robins. A DNA vaccine injected intramuscularly resulted in a 400-fold decrease in average viral load that would likely make robins noninfectious and unable to spread disease. An oral bait is the preferred method of distribution of the vaccine as it would be easier and cheaper than intramuscular injection, but more research would be needed as the existing formulation did not work orally. The American robin is active mostly during the day, and on its winter grounds, it assembles in large flocks at night to roost in trees in secluded swamps or dense vegetation. The flocks break up during the day when the birds feed on fruits and berries in smaller groups. During the summer, the American robin defends a breeding territory and is less social. The American robin's diet generally consists of around 40 percent small invertebrates (mainly insects), such as earthworms, beetle grubs , caterpillars, and grasshoppers, and 60 percent wild and cultivated fruits and berries. Their ability to switch to berries allows them to winter much farther north than most other North American thrushes. They will flock to fermented Pyracantha berries, and after eating sufficient quantities will exhibit intoxicated behavior, such as falling over while walking. Robins forage primarily on the ground for soft-bodied invertebrates, and find worms by sight (and sometimes by hearing), : 149 pouncing on them and then pulling them up. Nestlings are fed mainly on earthworms and other soft-bodied animal prey. In some areas, robins, particularly of the northwestern subspecies ( T. m. caurinus ), will feed on beaches, taking insects and small mollusks. American robins are common pests of fruit orchards in North America. Due to their insectivorous and frugivorous diet they have evolved to lose sucrase . Sucrose is unpalatable to them and can be used by humans as a deterrent. The American robin uses auditory, visual, olfactory and possibly vibrotactile cues to find prey, but vision is the predominant mode of prey detection. It is frequently seen running across lawns picking up earthworms, and its running and stopping behavior is a distinguishing characteristic. In addition to hunting visually, it also has the ability to hunt by hearing. Experiments have shown that it can find earthworms underground by simply using its listening skills. : 149 It typically will take several short hops and then cock its head left, right or forward to detect movement of its prey. In urban areas, robins will gather in numbers soon after lawns are mowed or where sprinklers are in use. Juvenile robins and eggs are preyed upon by squirrels, snakes, and some birds, such as blue jays , California scrub jays , Steller's jays , common grackles , American crows , and common ravens . Adults are primarily taken by Accipiter hawks, cats, and larger snakes (especially rat snakes and gopher snakes ). Mammals, such as foxes and dogs, are mainly likely to grab fledgling young robins from the ground, while raccoons often prey upon nests, and small carnivores such as American martens , ring-tailed cats and long-tailed weasels are agile enough to hunt adults. However, the greatest predatory impact (perhaps alongside domestic cats) is probably from raptorial birds. They may be taken by nearly every variety of North American accipitrid , from the smallest, the sharp-shinned hawk , to one of the two largest, the golden eagle , most every North American falcon from the smallest, the American kestrel , to the largest, the gyrfalcon , and almost all owl species from the northern pygmy owl to the snowy owl . Overall, 28 raptorial bird species are known to hunt American robins. Adult robins are most vulnerable when distracted by breeding activities, though they may also be attacked on the ground or even in flight. However, when feeding in flocks, the American robin is able to remain vigilant and watch other flock members for reactions to predators. The American robin is known to be a rejecter of cowbird eggs, so brood parasitism by the brown-headed cowbird is rare. Even when it occurs, the parasite's chick does not normally survive to fledge . In a study of 105 juvenile robins, 77.1% were infected with one or more species of endoparasite , with Syngamus species the most commonly encountered, found in 57.1% of the birds. The American robin begins to breed shortly after returning to its summer range. It is one of the first North American bird species to lay eggs, and normally has two to three broods per breeding season, which lasts from April to July. The nest is most commonly located 1.5–4.5 m (4.9–14.8 ft) above the ground in a dense bush or in a fork between two tree branches, and is built by the female alone. The outer foundation consists of long coarse grass, twigs, paper, and feathers. This is lined with smeared mud and cushioned with fine grass or other soft materials. The American robin builds a new nest for each brood; in northern areas the nest for the first clutch will usually be located in an evergreen tree or shrub, while later broods are raised in deciduous trees. The species is not shy about nesting close to human habitations. A clutch consists of three to five cyan-colored eggs , and is incubated by the female alone. The eggs hatch after 14 days, and the chicks leave the nest a further two weeks later. The altricial chicks are naked and have their eyes closed for the first few days after hatching. The chicks are fed earthworms, insects, and berries. Waste accumulation does not occur in the nest because the adults collect and take it away. Chicks are fed, and then raise tails for elimination of waste, a solid white clump that is collected by a parent prior to flying off. All chicks in the brood leave the nest within two days of each other. Juveniles become capable of sustained flight two weeks after fledging. Chicks become sexually mature at one year of age. Bird banders have found that only 25% of young robins survive their first year. The longest known lifespan of an American robin in the wild is 14 years; the average lifespan is about two years. The male American robin, as with many thrushes, has a complex and almost continuous song. It is commonly described as a cheery carol, made up of discrete units, often repeated, and spliced together into a string with brief pauses in between. The song varies regionally, and its style varies by the time of day. The song period is from late February or early March to late July or early August; some birds, particularly in the east, sing occasionally into September or later. They are often among the first songbirds to sing as dawn rises or hours before, and last as evening sets in. It usually sings from a high perch in a tree. The song of the San Lucas subspecies ( T. m. confinis ) is weaker than that of the eastern subspecies ( T. m. migratorius ), and lacks any clear notes. The American robin also sings when storms approach and again when storms have passed. In addition to its song, the species has a number of calls used for communicating specific information, such as when a ground predator approaches and when a nest or another American robin is being directly threatened. Even during nesting season, when they exhibit mostly competitive and territorial behavior, they may still band together to drive away a predator. The American robin's diet generally consists of around 40 percent small invertebrates (mainly insects), such as earthworms, beetle grubs , caterpillars, and grasshoppers, and 60 percent wild and cultivated fruits and berries. Their ability to switch to berries allows them to winter much farther north than most other North American thrushes. They will flock to fermented Pyracantha berries, and after eating sufficient quantities will exhibit intoxicated behavior, such as falling over while walking. Robins forage primarily on the ground for soft-bodied invertebrates, and find worms by sight (and sometimes by hearing), : 149 pouncing on them and then pulling them up. Nestlings are fed mainly on earthworms and other soft-bodied animal prey. In some areas, robins, particularly of the northwestern subspecies ( T. m. caurinus ), will feed on beaches, taking insects and small mollusks. American robins are common pests of fruit orchards in North America. Due to their insectivorous and frugivorous diet they have evolved to lose sucrase . Sucrose is unpalatable to them and can be used by humans as a deterrent. The American robin uses auditory, visual, olfactory and possibly vibrotactile cues to find prey, but vision is the predominant mode of prey detection. It is frequently seen running across lawns picking up earthworms, and its running and stopping behavior is a distinguishing characteristic. In addition to hunting visually, it also has the ability to hunt by hearing. Experiments have shown that it can find earthworms underground by simply using its listening skills. : 149 It typically will take several short hops and then cock its head left, right or forward to detect movement of its prey. In urban areas, robins will gather in numbers soon after lawns are mowed or where sprinklers are in use. Juvenile robins and eggs are preyed upon by squirrels, snakes, and some birds, such as blue jays , California scrub jays , Steller's jays , common grackles , American crows , and common ravens . Adults are primarily taken by Accipiter hawks, cats, and larger snakes (especially rat snakes and gopher snakes ). Mammals, such as foxes and dogs, are mainly likely to grab fledgling young robins from the ground, while raccoons often prey upon nests, and small carnivores such as American martens , ring-tailed cats and long-tailed weasels are agile enough to hunt adults. However, the greatest predatory impact (perhaps alongside domestic cats) is probably from raptorial birds. They may be taken by nearly every variety of North American accipitrid , from the smallest, the sharp-shinned hawk , to one of the two largest, the golden eagle , most every North American falcon from the smallest, the American kestrel , to the largest, the gyrfalcon , and almost all owl species from the northern pygmy owl to the snowy owl . Overall, 28 raptorial bird species are known to hunt American robins. Adult robins are most vulnerable when distracted by breeding activities, though they may also be attacked on the ground or even in flight. However, when feeding in flocks, the American robin is able to remain vigilant and watch other flock members for reactions to predators. The American robin is known to be a rejecter of cowbird eggs, so brood parasitism by the brown-headed cowbird is rare. Even when it occurs, the parasite's chick does not normally survive to fledge . In a study of 105 juvenile robins, 77.1% were infected with one or more species of endoparasite , with Syngamus species the most commonly encountered, found in 57.1% of the birds. The American robin begins to breed shortly after returning to its summer range. It is one of the first North American bird species to lay eggs, and normally has two to three broods per breeding season, which lasts from April to July. The nest is most commonly located 1.5–4.5 m (4.9–14.8 ft) above the ground in a dense bush or in a fork between two tree branches, and is built by the female alone. The outer foundation consists of long coarse grass, twigs, paper, and feathers. This is lined with smeared mud and cushioned with fine grass or other soft materials. The American robin builds a new nest for each brood; in northern areas the nest for the first clutch will usually be located in an evergreen tree or shrub, while later broods are raised in deciduous trees. The species is not shy about nesting close to human habitations. A clutch consists of three to five cyan-colored eggs , and is incubated by the female alone. The eggs hatch after 14 days, and the chicks leave the nest a further two weeks later. The altricial chicks are naked and have their eyes closed for the first few days after hatching. The chicks are fed earthworms, insects, and berries. Waste accumulation does not occur in the nest because the adults collect and take it away. Chicks are fed, and then raise tails for elimination of waste, a solid white clump that is collected by a parent prior to flying off. All chicks in the brood leave the nest within two days of each other. Juveniles become capable of sustained flight two weeks after fledging. Chicks become sexually mature at one year of age. Bird banders have found that only 25% of young robins survive their first year. The longest known lifespan of an American robin in the wild is 14 years; the average lifespan is about two years. The male American robin, as with many thrushes, has a complex and almost continuous song. It is commonly described as a cheery carol, made up of discrete units, often repeated, and spliced together into a string with brief pauses in between. The song varies regionally, and its style varies by the time of day. The song period is from late February or early March to late July or early August; some birds, particularly in the east, sing occasionally into September or later. They are often among the first songbirds to sing as dawn rises or hours before, and last as evening sets in. It usually sings from a high perch in a tree. The song of the San Lucas subspecies ( T. m. confinis ) is weaker than that of the eastern subspecies ( T. m. migratorius ), and lacks any clear notes. The American robin also sings when storms approach and again when storms have passed. In addition to its song, the species has a number of calls used for communicating specific information, such as when a ground predator approaches and when a nest or another American robin is being directly threatened. Even during nesting season, when they exhibit mostly competitive and territorial behavior, they may still band together to drive away a predator. The American robin has an extensive range, estimated at 16,000,000 km 2 (6,200,000 sq mi) , and a large population of about 370 million individuals. The western subspecies ( T. m. propinquus ) in central California is considered to be expanding its range, as is likely the case elsewhere in the United States. It is threatened by climate change and severe weather, but the population trend appears to be stable, and the species does not approach the vulnerable species thresholds under the population trend criterion (>30% decline over ten years or three generations), and therefore International Union for Conservation of Nature evaluated it as least concern . At one point, the bird was killed for its meat, but it is now protected throughout its range in the United States by the Migratory Bird Treaty Act . Robin egg blue is a color named after the color of the bird's eggs. The American robin is the state bird of Connecticut , Michigan , and Wisconsin . It was also depicted on the 1986 Birds of Canada series Canadian $2 note (this note was subsequently withdrawn.) It has a place in Native American mythology . The story of how the robin got its red breast by fanning the dying flames of a campfire to save a Native American man and a boy is similar to those that surround the European robin. The Tlingit people of northwestern North America held it to be a culture hero created by Raven to please the people with its song. The Peace Bridge robins were a family of American robins that attracted minor publicity in the mid-1930s for their prominent nest on the Canadian side of the Peace Bridge connecting Buffalo, New York , to Fort Erie, Ontario . The American robin is considered a symbol of spring. A well-known example is a poem by Emily Dickinson titled "I Dreaded That First Robin So". Among other 19th-century poems about the first robin of spring is "The First Robin" by William Henry Drummond , which, according to the author's wife, is based on a Quebec superstition that whoever sees the first robin of spring will have good luck. The association has continued down to the present day, as, for example, in one Calvin and Hobbes cartoon from 1990 that had Calvin celebrating his inevitable wealth and fame after seeing the first robin of spring. The harbinger of spring sobriquet is borne out by the fact that American robins tend to follow the 37 °F (3 °C) isotherm north in spring, but also south in fall. American popular songs featuring this bird include " When the Red, Red Robin (Comes Bob, Bob, Bobbin' Along) ", written by Harry M. Woods . Although the comic book superhero Robin was inspired by an N. C. Wyeth illustration of Robin Hood , a later version had his mother nicknaming him Robin because he was born on the first day of spring.

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West Nile

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West Nile Cup

West Nile Cup is the annual football tournament contested by the political districts in the West Nile sub-region of Uganda . The tournament was started in 2012 by Lawrence Mulindwa, a year before he ceased to be the president of the Federation of Uganda Football Associations , Uganda's football-governing body. The first edition was hosted by Arua and it was organised to bring West Nile together. The other mission is to identify talent for inter-region tournaments like Airtel Under 17 , which can also be a backup wellspring for the Uganda Cranes, the nickname for the national team.It is the brainchild and legacy of Lawrence Mulindwa and is open to any West Niler from the eight political districts in West Nile. The champion district emerges after a number of selective games leading to a two-team final.The 2014 invitations were given to each district and announcements delivered via Nile FM. Meanwhile, Radio Pacis Saturday Sports Show presenter Sam Anecho provided analytical reviews and hosted participants. The next tournament was scheduled to take place in Koboko . Moyo hosted the third edition of the cup in February, and it was won by Koboko who beat Yumbe , their neighbours on the eastern side, through a penalty shootout in the finals. Koboko received UGX:1.5 million as prize money. The runners-up who won UGX:1 million had knocked out Arua in the semis. Other teams that participated included Adjumani in fourth place, who earned UGX:300,000 and the hosts Moyo. Three other teams were expected to take part but Maracha District was still under the Arua District Football Association, Nebbi District turned down the invitation again due to costs plus distance (apparently), and Zombo District was also still under Nebbi's Football Association.Hosted by Koboko in the first week of February, it was won by Adjumani who edged tournament favourites Arua 4-1 on penalties after a 1-1 draw in the final on Wednesday 4 February 2015 at St. Charles Lwanga SS. The 2nd Runners-up Zombo District , who bagged 750,000 UgX, beat Yumbe 2-0 in the third place playoff. Edama Sabir with 6 goals was the Top Scorer, the Best Player was De Guzman Durman (Koboko), Best Goal Keeper was Henry Madrama (Adjumani), Fair Play went to Koboko, while the Best Referee was Atiku Rahman from Koboko. This was the first time all the eight existing political districts in West Nile took part - Koboko, Yumbe, Moyo, Adjumani, Arua, Zombo, Nebbi and newcomers Maracha . Lawrence Mulindwa, as well as Brigadier Dick Olum offered 5 Million each to sponsor the fourth edition of the tournament. The winner won 1.5 Million, Runner-up got 1 Million while fourth-placed team received 500,000 UgX.After a goalless draw in the February 2016 final, Arua edged Nebbi 4-2 in the post-match penalty shootout. In the semis, Arua beat Yumbe 3-0 while Nebbi overcame Koboko by just one goal.

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West Nile

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Domestic rabbit

The domestic or domesticated rabbit , commonly known as a pet rabbit , is the domesticated form of the European rabbit , a member of the lagomorph order. A male rabbit is known as a buck, a female is a doe, and a young rabbit is a kit . Rabbits were first domesticated and used for their food and fur by the Romans , and have been kept as pets in Western nations since the early 1900s. Rabbits can be housed inside but the idea of the domestic rabbit as a house companion, a so-called house rabbit similar to a house cat , was only strongly promoted starting with publications in the 1980s. Rabbits can be litter box -trained and taught to come when called , but they require exercise and can damage a house that has not been "rabbit proofed" based on their innate need to chew. Accidental interactions between pet rabbits and wild rabbits, while seemingly harmless, are usually strongly discouraged due to the species' different temperaments as well as wild rabbits potentially carrying diseases. Unwanted pet rabbits end up in animal shelters , especially after the Easter season (see Easter Bunny ). In 2017, they were the United States' third most abandoned pet. Some of them go on to be adopted and become family pets in various forms. Because their wild counterparts have become invasive in Australia , pet rabbits are banned in the state of Queensland . Pet rabbits, being a domesticated breed that lack survival instincts, do not fare well in the wild if they are abandoned or escape from captivity. Besides being used as pets, domesticated rabbits are used as laboratory animals and are farmed as livestock for their meat, wool and fur. Specific breeds are used in different industries; Rex rabbits , for example, are commonly raised for their fur, and the New Zealand rabbit is commonly used in animal testing for its docility and good health.Phoenician sailors visiting the coast of Spain c. 12th century BC, mistaking the European rabbit for a species from their homeland (the rock hyrax Procavia capensis ), gave it the name i-shepan-ham (land or island of hyraxes). The captivity of rabbits as a food source is recorded as early as the 1st century BC, when the Roman writer Pliny the Elder described the use of rabbit hutches , along with enclosures called leporaria [ fr ] . A controversial theory is that a corruption of the rabbit's name used by the Romans became the Latin name for the peninsula, Hispania . In Rome, rabbits were raised in large walled colonies with walls extended underground. According to Pliny, the consumption of unborn and newborn rabbits, called laurices , was considered a delicacy . Evidence for the domestic rabbit is rather late. In the Middle Ages , wild rabbits were often kept for the hunt. Monks in southern France were crossbreeding rabbits at least by the 12th century AD. Domestication was probably a slow process that took place from the Roman period (or earlier) until the 1500s. In the 19th century, as animal fancy in general began to emerge, rabbit fanciers began to sponsor rabbit exhibitions and fairs in Western Europe and the United States. Breeds of various domesticated animals were created and modified for the added purpose of exhibition , a departure from the breeds that had been created solely for food, fur, or wool . The rabbit's emergence as a household pet began during the Victorian era . The keeping of the rabbit as a pet commencing from the 1800s coincides with the first observable skeletal differences between the wild and domestic populations, even though captive rabbits had been exploited for over 2,000 years. Domestic rabbits have been popular in the United States since the late 19th century. What became known as the "Belgian Hare Boom" began with the importation of the first Belgian Hares from England in 1888 and, soon after, the founding of the American Belgian Hare Association, the first rabbit club in America. From 1898 to 1901, many thousands of Belgian Hares were imported to America. Today, the Belgian Hare is one of the rarest breeds, with only 132 specimens found in the United States in a 2015 census. The American Rabbit Breeders Association (ARBA) was founded in 1910 and is the national authority on rabbit raising and rabbit breeds having a uniform Standard of Perfection, registration and judging system. The domestic rabbit continues to be popular as a show animal and pet. Many thousand rabbit shows occur each year and are sanctioned in Canada and the United States by the ARBA. Today, the domesticated rabbit is the third most popular mammalian pet in Britain after dogs and cats . Rabbits have been and continue to be used in laboratory work such as production of antibodies for vaccines and research of human male reproductive system toxicology . In 1972, around 450,000 rabbits were used for experiments in the United States, decreasing to around 240,000 in 2006. The Environmental Health Perspective, published by the National Institute of Health , states, "The rabbit [is] an extremely valuable model for studying the effects of chemicals or other stimuli on the male reproductive system." According to the Humane Society of the United States, rabbits are also used extensively in the study of bronchial asthma , stroke prevention treatments , cystic fibrosis , diabetes , and cancer . Animal rights activists have opposed animal experimentation for non-medical purposes, such as the testing of cosmetic and cleaning products, which has resulted in decreased use of rabbits in these areas. The New Zealand White is one of the most commonly used breeds for research and testing. The use of rabbits for the Draize test , a method of testing cosmetics on animals , has been cited as an example of cruelty in animal research by animal rights activists. Albino rabbits are typically used in the Draize tests because they have less tear flow than other animals, and the lack of eye pigment makes the effects easier to visualize. Rabbits have been and continue to be used in laboratory work such as production of antibodies for vaccines and research of human male reproductive system toxicology . In 1972, around 450,000 rabbits were used for experiments in the United States, decreasing to around 240,000 in 2006. The Environmental Health Perspective, published by the National Institute of Health , states, "The rabbit [is] an extremely valuable model for studying the effects of chemicals or other stimuli on the male reproductive system." According to the Humane Society of the United States, rabbits are also used extensively in the study of bronchial asthma , stroke prevention treatments , cystic fibrosis , diabetes , and cancer . Animal rights activists have opposed animal experimentation for non-medical purposes, such as the testing of cosmetic and cleaning products, which has resulted in decreased use of rabbits in these areas. The New Zealand White is one of the most commonly used breeds for research and testing. The use of rabbits for the Draize test , a method of testing cosmetics on animals , has been cited as an example of cruelty in animal research by animal rights activists. Albino rabbits are typically used in the Draize tests because they have less tear flow than other animals, and the lack of eye pigment makes the effects easier to visualize. Male rabbits are called bucks ; females are called does . An older term for an adult rabbit is coney , while rabbit once referred only to the young animals. Another term for a young rabbit is bunny , though this term is often applied informally (especially by children and rabbit enthusiasts) to rabbits generally, especially domestic ones. More recently, the term kit or kitten has been used to refer to a young rabbit. A young hare is called a leveret ; this term is sometimes informally applied to a young rabbit as well. A group of rabbits is known as a "colony" or a "nest". The study of rabbit genetics is of interest to fanciers, the fiber and fur industry, medical researchers, and the meat industry . Among rabbit fanciers, the genetics of rabbit health and diversity are paramount. The fiber & fur industry focuses on the genetics of coat color and hair properties. In the biomedical research community and the pharmaceutical industry, rabbit genetics are important in model organism research, antibody production, and toxicity testing. The meat industry relies on genetics for disease resistance, feed conversion ratios , and reproduction potential in rabbits. The rabbit genome has been sequenced and is publicly available. The mitochondrial DNA has also been sequenced. In 2011, parts of the rabbit genome were re-sequenced in greater depth in order to expose variation within the genome. There are 11 color gene groups (or loci) in rabbits. A rabbit's coat has either two pigments (pheomelanin for yellow, and eumelanin for dark brown) or no pigment (for an albino rabbit) . Clusters of color genes plus their modifiers control such aspects as coat patterns (e.g. Dutch or English markings), color hues and their intensity or dilution, and the location of color bands on the hair shaft (e.g., silvering). As a refinement of the diet of the wild rabbit, the diet of the domestic rabbit is often a function of its purpose. Show rabbits are fed for vibrant health, strong musculoskeletal systems, and — like rabbits intended for the fur trade — optimal coat production and condition. Rabbits intended for the meat trade are fed for swift and efficient production of flesh, while rabbits in research settings have closely controlled diets for specific goals. Nutritional needs of the domestic rabbit may also be focused on developing a physique that allows for the safe delivery of larger litters of healthy kits. Optimizing costs and producing feces that meet local waste regulations may also be factors. The diet of a pet rabbit, too, is geared toward its purpose — as a healthy and long-lived companion. Hay is an essential part of the diet of all rabbits and it is a major component of the commercial food pellets that are formulated for domestic rabbits and available in many areas. Pellets are typically fed to adult rabbits in limited quantities once or twice a day, to mimic their natural behavior and to prevent obesity. It is recommended only a teaspoon to an egg cup full of pellets is fed to adult rabbits each day. Most rabbit pellets are alfalfa-based for protein and fiber, with other grains completing the carbohydrate requirements. "Muesli" style rabbit foods are also available; these contain separate components—e.g., dried carrot, pea flakes and hay pellets as opposed to a uniform pellet. These are not recommended as rabbits will choose favored parts and leave the rest. Muesli style feeds are often lower in fiber than pelleted versions of rabbit food. Additionally, numerous studies have found they increase the risk of obesity and dental disease. Minerals and vitamins are added during production of rabbit pellets to meet the nutritional requirements of the domestic rabbit. Along with pellets, many commercial rabbit raisers also feed one or more types of loose hay , for its freshness and important cellulose components. Alfalfa in particular is recommended for the growth needs of young rabbits. Alfalfa hay is not recommended for adult rabbits, as it is too rich in protein and too high in calcium. Grass hays are best because they are lower in protein and calcium. Common sources of hay for rabbits include bluegrass, brome, fescue, marsh, orchard, timothy, oat and ryegrass. Offering a diversity of hay is important nutritionally. A diversity of hay also desensitizes rabbits to small changes in smell and texture, resulting in good, consistent eaters. Easily digestible food is processed in the gastrointestinal tract & expelled as regular feces. But in order to get nutrients out of hard to digest fiber, rabbits ferment fiber in the cecum (in the GI tract) and then expel the contents as cecotropes , which are reingested ( cecotrophy ). The cecotropes are then absorbed in the small intestine to utilize the nutrients. Rabbits are prolific breeders, in part because rabbits reach breeding age quickly. To prevent unwanted offspring, rabbits may be spayed or neutered at sexual maturity. Sexual maturity is determined as the point at which the production rate of spermatozoa stops increasing, which ranges based on the size of the breed: 4–5 months for small breeds (e.g., Mini Rex, Netherland Dwarf), 4–6 months for medium-sized breeds (e.g., Rex, New Zealand), and 5–8 months for large breeds (e.g., Flemish Giant). Bucks usually require more time to sexually mature than does. Like all mammals, rabbits produce milk for their young. Female rabbits have six to eight nipples and can produce milk for more than six weeks after birthing. Rabbit milk is relatively high in fat, as a percentage by mass. While most herbivores produce approximately 5% milk fat, rabbits produce 12%. The excerpted table below compares milk characteristics among mammals. The study of rabbit genetics is of interest to fanciers, the fiber and fur industry, medical researchers, and the meat industry . Among rabbit fanciers, the genetics of rabbit health and diversity are paramount. The fiber & fur industry focuses on the genetics of coat color and hair properties. In the biomedical research community and the pharmaceutical industry, rabbit genetics are important in model organism research, antibody production, and toxicity testing. The meat industry relies on genetics for disease resistance, feed conversion ratios , and reproduction potential in rabbits. The rabbit genome has been sequenced and is publicly available. The mitochondrial DNA has also been sequenced. In 2011, parts of the rabbit genome were re-sequenced in greater depth in order to expose variation within the genome. There are 11 color gene groups (or loci) in rabbits. A rabbit's coat has either two pigments (pheomelanin for yellow, and eumelanin for dark brown) or no pigment (for an albino rabbit) . Clusters of color genes plus their modifiers control such aspects as coat patterns (e.g. Dutch or English markings), color hues and their intensity or dilution, and the location of color bands on the hair shaft (e.g., silvering).As a refinement of the diet of the wild rabbit, the diet of the domestic rabbit is often a function of its purpose. Show rabbits are fed for vibrant health, strong musculoskeletal systems, and — like rabbits intended for the fur trade — optimal coat production and condition. Rabbits intended for the meat trade are fed for swift and efficient production of flesh, while rabbits in research settings have closely controlled diets for specific goals. Nutritional needs of the domestic rabbit may also be focused on developing a physique that allows for the safe delivery of larger litters of healthy kits. Optimizing costs and producing feces that meet local waste regulations may also be factors. The diet of a pet rabbit, too, is geared toward its purpose — as a healthy and long-lived companion. Hay is an essential part of the diet of all rabbits and it is a major component of the commercial food pellets that are formulated for domestic rabbits and available in many areas. Pellets are typically fed to adult rabbits in limited quantities once or twice a day, to mimic their natural behavior and to prevent obesity. It is recommended only a teaspoon to an egg cup full of pellets is fed to adult rabbits each day. Most rabbit pellets are alfalfa-based for protein and fiber, with other grains completing the carbohydrate requirements. "Muesli" style rabbit foods are also available; these contain separate components—e.g., dried carrot, pea flakes and hay pellets as opposed to a uniform pellet. These are not recommended as rabbits will choose favored parts and leave the rest. Muesli style feeds are often lower in fiber than pelleted versions of rabbit food. Additionally, numerous studies have found they increase the risk of obesity and dental disease. Minerals and vitamins are added during production of rabbit pellets to meet the nutritional requirements of the domestic rabbit. Along with pellets, many commercial rabbit raisers also feed one or more types of loose hay , for its freshness and important cellulose components. Alfalfa in particular is recommended for the growth needs of young rabbits. Alfalfa hay is not recommended for adult rabbits, as it is too rich in protein and too high in calcium. Grass hays are best because they are lower in protein and calcium. Common sources of hay for rabbits include bluegrass, brome, fescue, marsh, orchard, timothy, oat and ryegrass. Offering a diversity of hay is important nutritionally. A diversity of hay also desensitizes rabbits to small changes in smell and texture, resulting in good, consistent eaters. Easily digestible food is processed in the gastrointestinal tract & expelled as regular feces. But in order to get nutrients out of hard to digest fiber, rabbits ferment fiber in the cecum (in the GI tract) and then expel the contents as cecotropes , which are reingested ( cecotrophy ). The cecotropes are then absorbed in the small intestine to utilize the nutrients. Rabbits are prolific breeders, in part because rabbits reach breeding age quickly. To prevent unwanted offspring, rabbits may be spayed or neutered at sexual maturity. Sexual maturity is determined as the point at which the production rate of spermatozoa stops increasing, which ranges based on the size of the breed: 4–5 months for small breeds (e.g., Mini Rex, Netherland Dwarf), 4–6 months for medium-sized breeds (e.g., Rex, New Zealand), and 5–8 months for large breeds (e.g., Flemish Giant). Bucks usually require more time to sexually mature than does. Like all mammals, rabbits produce milk for their young. Female rabbits have six to eight nipples and can produce milk for more than six weeks after birthing. Rabbit milk is relatively high in fat, as a percentage by mass. While most herbivores produce approximately 5% milk fat, rabbits produce 12%. The excerpted table below compares milk characteristics among mammals. Disease is rare when rabbits are raised in sanitary conditions and provided with adequate care. Rabbits have fragile bones, especially in their spines , and need support on the bottom when they are picked up. Rabbits will gnaw on almost anything, including electrical cords (possibly leading to electrocution ), potentially poisonous plants, and material like carpet and fabric that may cause life-threatening intestinal blockages , so areas to which they have access need to be pet-proofed. Neutering is possible for both female and male rabbits; however, spaying females can pose significant risks. This is because spaying female rabbits requires a far bigger surgery with a higher mortality rate (during or in relation to the procedure) compared to males, as their lower abdomen needs to be opened up in order to remove ovaries and uterus . In addition, spaying is known to have severe negative effects on a female rabbit's health. One particularly dangerous consequence is the development of osteoporosis due to the lack of estrogen caused by the removal of the ovaries, which, among other things, greatly increases the risk of dental problems and bone fractures . Other negative health outcomes that have been reported include colonic obstruction , urinary incontinence , ureteral stenosis , increased ageing of ligaments , and alterations of the rabbit's cornea . In general, due to the wide range and severity of possible negative health effects and the high risk for complications from anesthesia and the surgery itself, spaying female rabbits should only be considered in case of acute medical reasons (e.g., ovarian or uterine cancer ), if they show signs of hormonal problems, like overly frequent phases of heat or pseudopregnancies , or unusually aggressive behavior, which cannot be attributed to environmental factors, e.g., a lack of exercise. As of today, assertions of female rabbits near inevitably developing cancer if left unneutered, as well as neutered females living longer, have no scientific foundation. However, castration of male pet rabbits is necessary, if they are to be kept species-appropriate (together with at least one other rabbit), which wouldn't otherwise be possible. Uncastrated male rabbits will engage in severe and often bloody fights with each other upon reaching adulthood, which can even end fatally. To prevent uncontrolled reproduction, it is advised to castrate males instead of females, as the necessary procedure, which requires only a small incision, has proven to be relatively safe and to have far less adverse effects on the rabbit's overall health. In most jurisdictions, including the United States (except where required by local animal control ordinances), rabbits do not require vaccination . Vaccinations exist for both rabbit hemorrhagic disease and myxomatosis . These vaccinations are usually given annually, two weeks apart. If there is an outbreak of myxomatosis locally, this vaccine can be administered every six months for extra protection. Myxomatosis immunizations are not available in all countries, including Australia, due to fears that immunity will pass on to feral rabbits. However, they are recommended by some veterinarians as prophylactics , where they are legally available. : 182 A rabbit cannot be declawed . Lacking pads on the bottoms of its feet, a rabbit requires its claws for traction. Removing its claws would render it unable to stand. Coping with stress is a key aspect of rabbit behavior, and this can be traced to part of the brain known as ventral tegmental area (VTA). Dopaminergic neurons in this part of the brain release the hormone dopamine . In rabbits, it is released as part of a coping mechanism while in a heightened state of fear or stress, and has a calming effect. Dopamine has also been found in the rabbit's medial prefrontal cortex , the nucleus accumbens , and the amygdala . Tonic immobility (TI) is sometimes called "trancing" or "playing dead". Physiological and behavioral responses to human-induced TI have been found to indicate a fear-motivated stress state in rabbits. Accordingly, even though people think the rabbits enjoy it, the promotion of TI to try to increase a bond between rabbits and their owners is misplaced. However, some researchers conclude that inducing TI in rabbits is appropriate for certain medical procedures, as it holds less risk than anesthesia. The formation of open sores on the rabbit's hocks , commonly called sore hocks , is a problem that commonly afflicts mostly heavy-weight rabbits kept in cages with wire flooring or soiled solid flooring. The problem is most prevalent in rex-furred rabbits and heavy-weight rabbits (over 4 kg (9 lb) ), as well as those with thin foot bristles. The condition results when, over the course of time, the protective bristle-like fur on the rabbit's hocks thins down. Standing urine or other unsanitary cage conditions can exacerbate the problem by irritating the sensitive skin. The exposed skin in turn can result in tender areas or, in severe cases, open sores, which may then become infected and abscessed if not properly cared for. Gastrointestinal stasis (GI stasis) is a serious and potentially fatal condition that occurs in some rabbits in which gut motility is severely reduced and possibly completely stopped. When untreated or improperly treated, GI stasis can be fatal in as little as 24 hours. GI stasis is the condition of food not moving through the gut as quickly as normal. The gut contents may dehydrate and compact into a hard, immobile mass (impacted gut), blocking the digestive tract of the rabbit. Food in an immobile gut may also ferment , causing significant gas buildup and resultant gas pain for the rabbit. The first noticeable symptom of GI stasis may be that the rabbit suddenly stops eating. Treatment frequently includes intravenous or subcutaneous fluid therapy ( rehydration through injection of a balanced electrolyte solution), pain control, possible careful massage to promote gas expulsion and comfort, drugs to promote gut motility, and careful monitoring of all inputs and outputs. The rabbit's diet may also be changed as part of treatment, to include force-feeding to ensure adequate nutrition. Surgery to remove the blockage is not generally recommended and comes with a poor prognosis. Some rabbits are more prone to GI stasis than others. The causes of GI stasis are not completely understood, but common contributing factors are thought to include stress, reduced food intake, low fiber in the diet, dehydration, reduction in exercise or blockage caused by excess fur or carpet ingestion. Stress factors can include changes in housing, transportation, or medical procedures under anesthesia. As many of these factors may occur together (poor dental structure leading to decreased food intake, followed by a stressful veterinary dental procedure to correct the dental problem), establishing a root cause may be difficult. GI stasis is sometimes misdiagnosed as "hair balls" by veterinarians or rabbit keepers not familiar with the condition. While fur is commonly found in the stomach following a fatal case of GI stasis, it is also found in healthy rabbits. Molting and chewing fur can be a predisposing factor in the occurrence of GI stasis; however, the primary cause is the change in motility of the gut. Dental disease has several causes, namely genetics , inappropriate diet , injury to the jaw , infection , or cancer . Signs of dental difficulty include difficulty eating, weight loss and small stools and visibly overgrown teeth. However, there are many other causes of ptyalism , including pain due to other causes. An over- diagnosed ailment amongst rabbits is respiratory infection , known as rhinitis or colloquially as "snuffles". Pasteurella , a bacterium , was historically misdiagnosed as the main cause of respiratory disease in rabbits, as the bacterium is present in the respiratory tract of most adult rabbits. The bacterium may, under poor conditions, reproduce rapidly and produce symptoms of pasteurellosis , though this is known to be a factor in the overuse of antibiotics among rabbits and is not always the cause of respiratory disease. A runny nose, for instance, can have several causes, among those being high temperature or humidity , extreme stress , environmental pollution (like perfume or incense), a sinus infection or dental disorders. Options for treating this is removing the pollutant, lowering or raising the temperature accordingly, and medical treatment for sinus infections. Sneezing can be a sign of environmental pollution, such as too much dust or high ammonia levels. Runny eyes and other conjunctival problems can be caused by dental disease or a blockage of the tear duct . Environmental pollution, corneal disease, entropion , distichiasis , or inflammation of the eyes are also causes. Some conjunctival problems are effectively treated with topical or systemic gentamicin . Rabbits are subject to infection by a variety of viruses . Some have had deadly and widespread impact. Myxomatosis is a virulent threat to all rabbits but not to humans. The intentional introduction of myxomatosis in rabbit-ravaged Australia killed an estimated 500 million feral rabbits between 1950 and 1952. The Australian government will not allow veterinarians to purchase and use the myxomatosis vaccine that would protect domestic rabbits, for fear that this immunity would be spread into the wild via escaped livestock and pets. This potential consequence is also one motivation for the pet-rabbit ban in Queensland. In Australia, rabbits caged outdoors in areas with high numbers of mosquitoes are vulnerable to myxomatosis. In Europe, fleas are the carriers of myxomatosis. In some countries, annual vaccinations against myxomatosis are available. Rabbit hemorrhagic disease (RHD), also known as viral hemorrhagic disease (VHD) or rabbit calicivirus disease (RCD), is caused by a rabbit-specific calicivirus known as rabbit hemorrhagic disease virus (RHDV) or rabbit calicivirus (RCV). Discovered in 1983, RHD is highly infectious and usually fatal. Initial signs of the disease may be limited to fever and lethargy, until significant internal organ damage results in labored breathing, squealing, bloody mucus, and eventual coma and death. Internally, the infection causes necrosis of the liver and damages other organs, especially the spleen, kidneys, and small intestine. RHD, like myxomatosis, has been intentionally introduced to control feral rabbit populations in Australia and (illegally) in New Zealand, and RHD has, in some areas, escaped quarantine . The disease has killed tens of millions of rabbits in China (unintentionally) as well as Australia, with other epidemics reported in Bolivia, Mexico, South Korea, and continental Europe. Rabbit populations in New Zealand have bounced back after developing a genetic immunity to RHD, and the disease has, so far, had no effect on the genetically divergent native wild rabbits and hares in the Americas. In the United States, an October 2013 USDA document stated: RHD has been found in the United States as recently as 2010, and was detected in Canada in 2011. Thus far, outbreaks have been controlled quickly through quarantine, depopulation, disease tracing, and cleaning and disinfection; however, rabbit losses have been in the thousands. An RHD vaccine exists, but it is not recommended for use where the disease is not widespread in wildlife, as it may hide signs of disease and is not considered a practical response for such a rapidly spreading disease. In the UK, reports of RHD (as recently as February 2018) have been submitted to the British Rabbit Council 's online "Notice Board". Vaccines for RHD are available — and mandatory — in the UK. A new strain of the virus has been discovered, called rabbit hemorrhagic disease virus 2 ( RHDV2 ). West Nile virus is another threat to domestic as well as wild rabbits. It is a fatal disease, and while vaccines are available for other species, there are none yet specifically indicated for rabbits. Wry neck (or head tilt or torticollis) is a condition in rabbits that can be fatal, due to the resulting disorientation that causes the animal to stop eating, drinking or performing other tasks, or through other afflictions causing the condition, such as pasteurellosis. The causes of wry neck can be middle- or inner-ear infections, ear mites ( Psoroptes cuniculi ), nematodes (roundworms, Baylisascaris procyonis ), cancer (in brain, neck, ear), cervical muscle contractions, ingestion of lead or toxic plants, or diseases or injuries affecting the brain (stroke, abscess, tumor, trauma). However, the most common cause is a parasitic microscopic fungus called Encephalitozoon cuniculi ( E. cuniculi ). Note that: "despite approximately half of all pet rabbits carrying the infection, only a small proportion of these cases ever show any illness". Symptoms may include drinking more water than usual, frequent peeing, seizures and even complete paralysis. Stressful situations may worsen the symptoms. There is a precedent for antibiotic treatment against E. cuniculi in rabbits exhibiting symptoms of torticollis. The usual drugs for treatment and prevention are the benzimidazole anthelmintics , particularly fenbendazole (also used as a deworming agent in other animal species). In the UK, fenbendazole (under the brand name Panacur Rabbit ) is sold over-the-counter in oral paste form as a nine-day treatment. Fenbendazole is particularly recommended for rabbits kept in colonies and as a preventive before mixing new rabbits with each other, and there have been anecdotal reports of successful treatments with ponazuril . Ear Canker is caused by nonburrowing ear mites Psoroptes cuniculi . It causes severe scabbing and inflammation on the ears and is very painful. Infected rabbits scratch a lot, which causes secondary bacterial infections. Rabbits should be treated as soon as possible, as the mites & infections can cause severe complications. It can also cause Wry neck (as described above). Fur mites can be any of a variety of species including Leporacarus gibbus , but most commonly Cheyletiella parasitivorax . C. parasitivorax do not burrow into the skin but rather live in the keratin layer. They can cause dandruff, itching and fur loss. Diagnosis is not easy & it might take several tries to determine if mites are present. Sarcoptic mange (also known as scabies ) is usually caused by the burrowing mite Sarcoptes scabiei (also known as S. scabei ). Symptoms are beige crusts around the borders of the ears, edges of the eyelids, the nose, mouth and toes. Also loss of fur. Scratching can lead to secondary bacterial infection. If untreated, the crusts can cover extensive areas of the body. Even mild cases should be treated as soon a possible. Tropical rat mites ( Ornithonyssus bacoti ) (and pigeon mites) cause severe itching. While rabbits can be easily treated (described below), to prevent reinfection, the host species (e.g., rat, pigeon) must also be treated or removed. Burrowing mange mites ( Trixacarus caviae ) are rare in rabbits but can cause such painful itching that the rabbit can become aggressive. All mites that infect rabbits can be treated by drugs given orally, by injection or applied on the skin (most common treatment), at intervals, as dictated by a veterinarian. The environment must also be treated. Fly strike , or blowfly ( Lucilia sericata ) strike, is a condition that occurs when flies lay their eggs in a rabbit's damp or soiled fur, or in an open wound. Within 12 hours, the eggs hatch into the larval stage of the fly, known as maggots . Initially small but quickly growing to 15 mm (0.59 in) long, maggots can burrow into skin and feed on an animal's tissue, leading to shock and death. The most susceptible rabbits are those in unsanitary conditions, sedentary ones, and those unable to clean their excretory areas. Rabbits with diarrhea should be inspected often for fly strike, especially during the summer months. The topical treatment Rearguard (from Novartis) is approved in the United Kingdom for 10-week-per-application prevention of fly strike. Bot flies that infect rabbits (generally Cuterebra buccata ) lay their eggs where rabbits live. The eggs hatch into larvae which enter the rabbit through the nose, mouth or open wound. The larvae migrate within the rabbit to just under the skin, where it forms a visible bump with breathing hole. It feeds off of the rabbit's flesh and bodily fluids for up to 30 days, reaching up to 3 cm (1.2 in) long. It then exits through the hole, pupates in the ground & emerges as an adult. These bot flies live in the eastern US and Canada and as far west as Arizona. Whereas flystrike occurs in rabbits with soiled fur, bot flies can infect even very clean rabbits. Even before the bump and hole are visible, the larvae are very painful and the rabbit may become depressed, weak, lose weight or even go into shock. The hole may become moist and cause secondary bacterial or fungal infections. The larvae can also migrate to the nasal cavity, eyes, trachea and brain. Larvae are typically treated through careful removal by a veterinarian when they are identified. If the larvae are damaged, the rabbit can die from an anaphylactic reaction. The most common tumor type of rabbits is uterine adenomcarcinoma, followed by neoplasia in hematopoietic organs, skin, mammary gland, testes, and the digestive system. Subsequently, female intact rabbits have highest prevalence of neoplasia (19.7%) as compared to all sex combined (prevalence: 14.4%). Overall prevalence of neoplasia continuously increases with age and may affect up to 45% of rabbits older than 6 years. Histologic criteria of malignancy is present in most tumor specimens and distant spread to other organs is common for lymphoma and uterine adenocarcinoma. Lymphoma commonly occur in younger rabbits and frequently affect lymph nodes, gastrointestinal tract, kidneys, spleen, and liver.Neutering is possible for both female and male rabbits; however, spaying females can pose significant risks. This is because spaying female rabbits requires a far bigger surgery with a higher mortality rate (during or in relation to the procedure) compared to males, as their lower abdomen needs to be opened up in order to remove ovaries and uterus . In addition, spaying is known to have severe negative effects on a female rabbit's health. One particularly dangerous consequence is the development of osteoporosis due to the lack of estrogen caused by the removal of the ovaries, which, among other things, greatly increases the risk of dental problems and bone fractures . Other negative health outcomes that have been reported include colonic obstruction , urinary incontinence , ureteral stenosis , increased ageing of ligaments , and alterations of the rabbit's cornea . In general, due to the wide range and severity of possible negative health effects and the high risk for complications from anesthesia and the surgery itself, spaying female rabbits should only be considered in case of acute medical reasons (e.g., ovarian or uterine cancer ), if they show signs of hormonal problems, like overly frequent phases of heat or pseudopregnancies , or unusually aggressive behavior, which cannot be attributed to environmental factors, e.g., a lack of exercise. As of today, assertions of female rabbits near inevitably developing cancer if left unneutered, as well as neutered females living longer, have no scientific foundation. However, castration of male pet rabbits is necessary, if they are to be kept species-appropriate (together with at least one other rabbit), which wouldn't otherwise be possible. Uncastrated male rabbits will engage in severe and often bloody fights with each other upon reaching adulthood, which can even end fatally. To prevent uncontrolled reproduction, it is advised to castrate males instead of females, as the necessary procedure, which requires only a small incision, has proven to be relatively safe and to have far less adverse effects on the rabbit's overall health. In most jurisdictions, including the United States (except where required by local animal control ordinances), rabbits do not require vaccination . Vaccinations exist for both rabbit hemorrhagic disease and myxomatosis . These vaccinations are usually given annually, two weeks apart. If there is an outbreak of myxomatosis locally, this vaccine can be administered every six months for extra protection. Myxomatosis immunizations are not available in all countries, including Australia, due to fears that immunity will pass on to feral rabbits. However, they are recommended by some veterinarians as prophylactics , where they are legally available. : 182A rabbit cannot be declawed . Lacking pads on the bottoms of its feet, a rabbit requires its claws for traction. Removing its claws would render it unable to stand. Coping with stress is a key aspect of rabbit behavior, and this can be traced to part of the brain known as ventral tegmental area (VTA). Dopaminergic neurons in this part of the brain release the hormone dopamine . In rabbits, it is released as part of a coping mechanism while in a heightened state of fear or stress, and has a calming effect. Dopamine has also been found in the rabbit's medial prefrontal cortex , the nucleus accumbens , and the amygdala . Tonic immobility (TI) is sometimes called "trancing" or "playing dead". Physiological and behavioral responses to human-induced TI have been found to indicate a fear-motivated stress state in rabbits. Accordingly, even though people think the rabbits enjoy it, the promotion of TI to try to increase a bond between rabbits and their owners is misplaced. However, some researchers conclude that inducing TI in rabbits is appropriate for certain medical procedures, as it holds less risk than anesthesia. The formation of open sores on the rabbit's hocks , commonly called sore hocks , is a problem that commonly afflicts mostly heavy-weight rabbits kept in cages with wire flooring or soiled solid flooring. The problem is most prevalent in rex-furred rabbits and heavy-weight rabbits (over 4 kg (9 lb) ), as well as those with thin foot bristles. The condition results when, over the course of time, the protective bristle-like fur on the rabbit's hocks thins down. Standing urine or other unsanitary cage conditions can exacerbate the problem by irritating the sensitive skin. The exposed skin in turn can result in tender areas or, in severe cases, open sores, which may then become infected and abscessed if not properly cared for.Gastrointestinal stasis (GI stasis) is a serious and potentially fatal condition that occurs in some rabbits in which gut motility is severely reduced and possibly completely stopped. When untreated or improperly treated, GI stasis can be fatal in as little as 24 hours. GI stasis is the condition of food not moving through the gut as quickly as normal. The gut contents may dehydrate and compact into a hard, immobile mass (impacted gut), blocking the digestive tract of the rabbit. Food in an immobile gut may also ferment , causing significant gas buildup and resultant gas pain for the rabbit. The first noticeable symptom of GI stasis may be that the rabbit suddenly stops eating. Treatment frequently includes intravenous or subcutaneous fluid therapy ( rehydration through injection of a balanced electrolyte solution), pain control, possible careful massage to promote gas expulsion and comfort, drugs to promote gut motility, and careful monitoring of all inputs and outputs. The rabbit's diet may also be changed as part of treatment, to include force-feeding to ensure adequate nutrition. Surgery to remove the blockage is not generally recommended and comes with a poor prognosis. Some rabbits are more prone to GI stasis than others. The causes of GI stasis are not completely understood, but common contributing factors are thought to include stress, reduced food intake, low fiber in the diet, dehydration, reduction in exercise or blockage caused by excess fur or carpet ingestion. Stress factors can include changes in housing, transportation, or medical procedures under anesthesia. As many of these factors may occur together (poor dental structure leading to decreased food intake, followed by a stressful veterinary dental procedure to correct the dental problem), establishing a root cause may be difficult. GI stasis is sometimes misdiagnosed as "hair balls" by veterinarians or rabbit keepers not familiar with the condition. While fur is commonly found in the stomach following a fatal case of GI stasis, it is also found in healthy rabbits. Molting and chewing fur can be a predisposing factor in the occurrence of GI stasis; however, the primary cause is the change in motility of the gut.Dental disease has several causes, namely genetics , inappropriate diet , injury to the jaw , infection , or cancer . Signs of dental difficulty include difficulty eating, weight loss and small stools and visibly overgrown teeth. However, there are many other causes of ptyalism , including pain due to other causes. An over- diagnosed ailment amongst rabbits is respiratory infection , known as rhinitis or colloquially as "snuffles". Pasteurella , a bacterium , was historically misdiagnosed as the main cause of respiratory disease in rabbits, as the bacterium is present in the respiratory tract of most adult rabbits. The bacterium may, under poor conditions, reproduce rapidly and produce symptoms of pasteurellosis , though this is known to be a factor in the overuse of antibiotics among rabbits and is not always the cause of respiratory disease. A runny nose, for instance, can have several causes, among those being high temperature or humidity , extreme stress , environmental pollution (like perfume or incense), a sinus infection or dental disorders. Options for treating this is removing the pollutant, lowering or raising the temperature accordingly, and medical treatment for sinus infections. Sneezing can be a sign of environmental pollution, such as too much dust or high ammonia levels. Runny eyes and other conjunctival problems can be caused by dental disease or a blockage of the tear duct . Environmental pollution, corneal disease, entropion , distichiasis , or inflammation of the eyes are also causes. Some conjunctival problems are effectively treated with topical or systemic gentamicin . Rabbits are subject to infection by a variety of viruses . Some have had deadly and widespread impact. Myxomatosis is a virulent threat to all rabbits but not to humans. The intentional introduction of myxomatosis in rabbit-ravaged Australia killed an estimated 500 million feral rabbits between 1950 and 1952. The Australian government will not allow veterinarians to purchase and use the myxomatosis vaccine that would protect domestic rabbits, for fear that this immunity would be spread into the wild via escaped livestock and pets. This potential consequence is also one motivation for the pet-rabbit ban in Queensland. In Australia, rabbits caged outdoors in areas with high numbers of mosquitoes are vulnerable to myxomatosis. In Europe, fleas are the carriers of myxomatosis. In some countries, annual vaccinations against myxomatosis are available. Rabbit hemorrhagic disease (RHD), also known as viral hemorrhagic disease (VHD) or rabbit calicivirus disease (RCD), is caused by a rabbit-specific calicivirus known as rabbit hemorrhagic disease virus (RHDV) or rabbit calicivirus (RCV). Discovered in 1983, RHD is highly infectious and usually fatal. Initial signs of the disease may be limited to fever and lethargy, until significant internal organ damage results in labored breathing, squealing, bloody mucus, and eventual coma and death. Internally, the infection causes necrosis of the liver and damages other organs, especially the spleen, kidneys, and small intestine. RHD, like myxomatosis, has been intentionally introduced to control feral rabbit populations in Australia and (illegally) in New Zealand, and RHD has, in some areas, escaped quarantine . The disease has killed tens of millions of rabbits in China (unintentionally) as well as Australia, with other epidemics reported in Bolivia, Mexico, South Korea, and continental Europe. Rabbit populations in New Zealand have bounced back after developing a genetic immunity to RHD, and the disease has, so far, had no effect on the genetically divergent native wild rabbits and hares in the Americas. In the United States, an October 2013 USDA document stated: RHD has been found in the United States as recently as 2010, and was detected in Canada in 2011. Thus far, outbreaks have been controlled quickly through quarantine, depopulation, disease tracing, and cleaning and disinfection; however, rabbit losses have been in the thousands. An RHD vaccine exists, but it is not recommended for use where the disease is not widespread in wildlife, as it may hide signs of disease and is not considered a practical response for such a rapidly spreading disease. In the UK, reports of RHD (as recently as February 2018) have been submitted to the British Rabbit Council 's online "Notice Board". Vaccines for RHD are available — and mandatory — in the UK. A new strain of the virus has been discovered, called rabbit hemorrhagic disease virus 2 ( RHDV2 ). West Nile virus is another threat to domestic as well as wild rabbits. It is a fatal disease, and while vaccines are available for other species, there are none yet specifically indicated for rabbits. Myxomatosis is a virulent threat to all rabbits but not to humans. The intentional introduction of myxomatosis in rabbit-ravaged Australia killed an estimated 500 million feral rabbits between 1950 and 1952. The Australian government will not allow veterinarians to purchase and use the myxomatosis vaccine that would protect domestic rabbits, for fear that this immunity would be spread into the wild via escaped livestock and pets. This potential consequence is also one motivation for the pet-rabbit ban in Queensland. In Australia, rabbits caged outdoors in areas with high numbers of mosquitoes are vulnerable to myxomatosis. In Europe, fleas are the carriers of myxomatosis. In some countries, annual vaccinations against myxomatosis are available.Rabbit hemorrhagic disease (RHD), also known as viral hemorrhagic disease (VHD) or rabbit calicivirus disease (RCD), is caused by a rabbit-specific calicivirus known as rabbit hemorrhagic disease virus (RHDV) or rabbit calicivirus (RCV). Discovered in 1983, RHD is highly infectious and usually fatal. Initial signs of the disease may be limited to fever and lethargy, until significant internal organ damage results in labored breathing, squealing, bloody mucus, and eventual coma and death. Internally, the infection causes necrosis of the liver and damages other organs, especially the spleen, kidneys, and small intestine. RHD, like myxomatosis, has been intentionally introduced to control feral rabbit populations in Australia and (illegally) in New Zealand, and RHD has, in some areas, escaped quarantine . The disease has killed tens of millions of rabbits in China (unintentionally) as well as Australia, with other epidemics reported in Bolivia, Mexico, South Korea, and continental Europe. Rabbit populations in New Zealand have bounced back after developing a genetic immunity to RHD, and the disease has, so far, had no effect on the genetically divergent native wild rabbits and hares in the Americas. In the United States, an October 2013 USDA document stated: RHD has been found in the United States as recently as 2010, and was detected in Canada in 2011. Thus far, outbreaks have been controlled quickly through quarantine, depopulation, disease tracing, and cleaning and disinfection; however, rabbit losses have been in the thousands. An RHD vaccine exists, but it is not recommended for use where the disease is not widespread in wildlife, as it may hide signs of disease and is not considered a practical response for such a rapidly spreading disease. In the UK, reports of RHD (as recently as February 2018) have been submitted to the British Rabbit Council 's online "Notice Board". Vaccines for RHD are available — and mandatory — in the UK. A new strain of the virus has been discovered, called rabbit hemorrhagic disease virus 2 ( RHDV2 ).West Nile virus is another threat to domestic as well as wild rabbits. It is a fatal disease, and while vaccines are available for other species, there are none yet specifically indicated for rabbits. Wry neck (or head tilt or torticollis) is a condition in rabbits that can be fatal, due to the resulting disorientation that causes the animal to stop eating, drinking or performing other tasks, or through other afflictions causing the condition, such as pasteurellosis. The causes of wry neck can be middle- or inner-ear infections, ear mites ( Psoroptes cuniculi ), nematodes (roundworms, Baylisascaris procyonis ), cancer (in brain, neck, ear), cervical muscle contractions, ingestion of lead or toxic plants, or diseases or injuries affecting the brain (stroke, abscess, tumor, trauma). However, the most common cause is a parasitic microscopic fungus called Encephalitozoon cuniculi ( E. cuniculi ). Note that: "despite approximately half of all pet rabbits carrying the infection, only a small proportion of these cases ever show any illness". Symptoms may include drinking more water than usual, frequent peeing, seizures and even complete paralysis. Stressful situations may worsen the symptoms. There is a precedent for antibiotic treatment against E. cuniculi in rabbits exhibiting symptoms of torticollis. The usual drugs for treatment and prevention are the benzimidazole anthelmintics , particularly fenbendazole (also used as a deworming agent in other animal species). In the UK, fenbendazole (under the brand name Panacur Rabbit ) is sold over-the-counter in oral paste form as a nine-day treatment. Fenbendazole is particularly recommended for rabbits kept in colonies and as a preventive before mixing new rabbits with each other, and there have been anecdotal reports of successful treatments with ponazuril . Ear Canker is caused by nonburrowing ear mites Psoroptes cuniculi . It causes severe scabbing and inflammation on the ears and is very painful. Infected rabbits scratch a lot, which causes secondary bacterial infections. Rabbits should be treated as soon as possible, as the mites & infections can cause severe complications. It can also cause Wry neck (as described above). Fur mites can be any of a variety of species including Leporacarus gibbus , but most commonly Cheyletiella parasitivorax . C. parasitivorax do not burrow into the skin but rather live in the keratin layer. They can cause dandruff, itching and fur loss. Diagnosis is not easy & it might take several tries to determine if mites are present. Sarcoptic mange (also known as scabies ) is usually caused by the burrowing mite Sarcoptes scabiei (also known as S. scabei ). Symptoms are beige crusts around the borders of the ears, edges of the eyelids, the nose, mouth and toes. Also loss of fur. Scratching can lead to secondary bacterial infection. If untreated, the crusts can cover extensive areas of the body. Even mild cases should be treated as soon a possible. Tropical rat mites ( Ornithonyssus bacoti ) (and pigeon mites) cause severe itching. While rabbits can be easily treated (described below), to prevent reinfection, the host species (e.g., rat, pigeon) must also be treated or removed. Burrowing mange mites ( Trixacarus caviae ) are rare in rabbits but can cause such painful itching that the rabbit can become aggressive. All mites that infect rabbits can be treated by drugs given orally, by injection or applied on the skin (most common treatment), at intervals, as dictated by a veterinarian. The environment must also be treated. Fly strike , or blowfly ( Lucilia sericata ) strike, is a condition that occurs when flies lay their eggs in a rabbit's damp or soiled fur, or in an open wound. Within 12 hours, the eggs hatch into the larval stage of the fly, known as maggots . Initially small but quickly growing to 15 mm (0.59 in) long, maggots can burrow into skin and feed on an animal's tissue, leading to shock and death. The most susceptible rabbits are those in unsanitary conditions, sedentary ones, and those unable to clean their excretory areas. Rabbits with diarrhea should be inspected often for fly strike, especially during the summer months. The topical treatment Rearguard (from Novartis) is approved in the United Kingdom for 10-week-per-application prevention of fly strike. Bot flies that infect rabbits (generally Cuterebra buccata ) lay their eggs where rabbits live. The eggs hatch into larvae which enter the rabbit through the nose, mouth or open wound. The larvae migrate within the rabbit to just under the skin, where it forms a visible bump with breathing hole. It feeds off of the rabbit's flesh and bodily fluids for up to 30 days, reaching up to 3 cm (1.2 in) long. It then exits through the hole, pupates in the ground & emerges as an adult. These bot flies live in the eastern US and Canada and as far west as Arizona. Whereas flystrike occurs in rabbits with soiled fur, bot flies can infect even very clean rabbits. Even before the bump and hole are visible, the larvae are very painful and the rabbit may become depressed, weak, lose weight or even go into shock. The hole may become moist and cause secondary bacterial or fungal infections. The larvae can also migrate to the nasal cavity, eyes, trachea and brain. Larvae are typically treated through careful removal by a veterinarian when they are identified. If the larvae are damaged, the rabbit can die from an anaphylactic reaction. Bot flies that infect rabbits (generally Cuterebra buccata ) lay their eggs where rabbits live. The eggs hatch into larvae which enter the rabbit through the nose, mouth or open wound. The larvae migrate within the rabbit to just under the skin, where it forms a visible bump with breathing hole. It feeds off of the rabbit's flesh and bodily fluids for up to 30 days, reaching up to 3 cm (1.2 in) long. It then exits through the hole, pupates in the ground & emerges as an adult. These bot flies live in the eastern US and Canada and as far west as Arizona. Whereas flystrike occurs in rabbits with soiled fur, bot flies can infect even very clean rabbits. Even before the bump and hole are visible, the larvae are very painful and the rabbit may become depressed, weak, lose weight or even go into shock. The hole may become moist and cause secondary bacterial or fungal infections. The larvae can also migrate to the nasal cavity, eyes, trachea and brain. Larvae are typically treated through careful removal by a veterinarian when they are identified. If the larvae are damaged, the rabbit can die from an anaphylactic reaction. The most common tumor type of rabbits is uterine adenomcarcinoma, followed by neoplasia in hematopoietic organs, skin, mammary gland, testes, and the digestive system. Subsequently, female intact rabbits have highest prevalence of neoplasia (19.7%) as compared to all sex combined (prevalence: 14.4%). Overall prevalence of neoplasia continuously increases with age and may affect up to 45% of rabbits older than 6 years. Histologic criteria of malignancy is present in most tumor specimens and distant spread to other organs is common for lymphoma and uterine adenocarcinoma. Lymphoma commonly occur in younger rabbits and frequently affect lymph nodes, gastrointestinal tract, kidneys, spleen, and liver.As of 2017, there were at least 305 breeds of domestic rabbit in 70 countries around the world. The American Rabbit Breeders Association currently recognizes 52 rabbit breeds and the British Rabbit Council recognizes 106. Selective breeding has produced rabbits ranging in size from dwarf to giant. Across the world, rabbits are raised as livestock (in cuniculture ) for their meat, pelts, and wool, and also by fanciers and hobbyists as pets. Rabbits have been selectively bred since ancient times to achieve certain desired characteristics. Variations include size and body shape, coat type (including hair length and texture), coat color, ear carriage (erect or lop ), and ear length. As with any animal, domesticated rabbits' temperaments vary in such factors as energy level and novelty seeking. Many genetic defects in the domestic rabbit (such as dental problems in the Holland Lop breed) are due to recessive genes. Genetics are carefully tracked by fanciers who show rabbits, to breed out defects. Rabbits have been kept as pets in Western nations since the 19th century, but because of the destructive history of feral rabbits in Australia, domestic rabbits are illegal as pets in Queensland . Rabbits can bond with humans, can learn to follow simple voice commands and to come when called, : 166 and are curious and playful. Rabbits, like many other pets, do not make good pets for small children because rabbits are fragile and easily injured by rough handling, can bite when hurt or frightened, and are easily frightened by loud noises and sudden motions. With the right guidance, rabbits can be trained to live indoors perfectly. Rabbits are especially popular as pets in the United States during the Easter season, due to their association with the holiday. However, animal shelters that accept rabbits often complain that during the weeks and months following Easter, there is a rise in unwanted and neglected rabbits that were bought as Easter gifts, especially for children. Similar problems arise in rural areas after county fairs and the like, in jurisdictions where rabbits are legal prizes in fairground games . Thus, there are many humane societies , animal shelters , and rescue groups that have rabbits available for pet adoption . Fancy rabbit breeds are often purchased from pet stores, private breeders, and fanciers. Rabbits may be kept inside as small house pets . Rabbits that live indoors are less exposed to the dangers of predators , parasites , diseases, adverse weather, and pesticides , which in turn increases their lifespan. Cages are generally too small so it is recommended that instead of a cage, domestic rabbits free-roam. If they must be kept in a cage, they should be let out regularly for needed exercise. All areas should be "rabbit-proofed" to reduce the risks associated with their intrinsic need to chew. Rabbits are easily litter box trained . Rabbits are often compatible with others of their kind, or with birds or guinea pigs , but opinion differs regarding the dangers of housing different species together. For example, while rabbits can synthesize their own vitamin C , guinea pigs cannot, so the two species should not be fed the same diet. Also, most rabbits tend to be stronger than guinea pigs, so this may cause deliberate or inadvertent injury. Some people consider rabbits a pocket pet even though they are rather large. Rabbits as house companions began appearing with frequency in the late 19th century. The most notable documentation is from Beatrix Potter's published diaries and letters. Potter allowed both rabbits to live at least part time in the house with her. "Both were fond of the fire, and one used to lie inside the fender", and one rabbit slept, "under the grate on the hot ashes when the fire had gone out." The strongest push to keep rabbits as litter-trained spayed and neutered indoor pets came with the publication of Marinell Harriman's House Rabbit Handbook: How to Live with an Urban Rabbit in 1985. As the domestic descendants of wild prey animals , rabbits are alert, timid creatures that startle fairly easily, and many of their behaviors are triggered by the fight-or-flight response to perceived threats. According to the House Rabbit Society, the owner of a pet rabbit can use various behavioral approaches to gain the animal's trust and reduce aggression, though this can be a long and difficult process. In addition, there is evidence to suggest that young rabbits that occupy the periphery of the " litter huddle" obtain less milk from the mother and, as a result, have a lower weight. It has been suggested that this factor may contribute to behavioural differences in litter mates during adolescence . When bonding two rabbits, the journey usually commences with carefully supervised meetings on neutral territory. This helps minimize territorial aggression and allows the rabbits to establish a hierarchy. Over time, through these encounters, the rabbits will learn to tolerate with each other's presence, form a social bond, and engage in vital social behaviors such as grooming, playing, and snuggling. Once a successful bond is established, the rabbits can progress to sharing the same habitat, enabling them to coexist as companions in a safe and contented environment. However, not all bonding attempts result in success, and sometimes bonds may break due to various factors, including personality clashes or stress. In such cases, it is essential to carefully assess the situation and, if necessary, seek guidance from experienced rabbit caregivers or veterinarians to provide the best possible care for the rabbits involved. During bonding, as rabbits become more comfortable with each other's presence, they often engage in mutual grooming sessions. On the flip side, when rabbit bonds break, it can have detrimental effects on their physical and emotional well-being. Rabbits are highly social animals, and sudden separation from a bonded partner can cause stress and anxiety. This stress can lead to health issues, such as gastrointestinal problems, reduced appetite, and even a weakened immune system. Additionally, the sudden absence of a grooming partner can result in neglected fur, making the rabbit more susceptible to matting and skin issues. Not all veterinarians will treat rabbits, and pet owners may have to seek out an exotic animal veterinarian for their rabbit's care. Rabbits need annual checkups at the veterinarian because they may hide signs of illness or disease. They should be given things to chew on, the owner should check their teeth every month and they should have their nails trimmed every 6–8 weeks. They should be groomed every week; however, during their molts they should be groomed every day. Baby rabbits under eight weeks old should be watched for enteritis along with gut stasis and bloat . Pet rabbits can often exhibit behaviour problems, including aggression towards humans and conspecifics, particularly with poor husbandry. Rabbit owners can seek behaviour help through their vets and rabbit behaviourists. Some advantages of keeping rabbits as pets is that they can be friendly, sociable and playful. They may or may not react favorably to handling and petting, depending on their personality and how they were raised. There are many different sizes and characteristics available, owing to a long history of breeding. Rabbits can be friendly to each other, especially when introduced while young, and are often compatible with other pets given time and space. Rabbits are herbivores and their diet is relatively simple. Compared to other small animals kept as pets, rabbits are physically robust creatures with strong hind legs that enable them to run fast, and they have powerful teeth. Rabbits breed rapidly and so it is often easy, and affordable, to find one to buy or adopt; however, since they are a social species, it is better to keep at least 2 rabbits. A disadvantage of keeping rabbits as pets is that they may chew things in the house. Rabbits chew as a natural behavior to maintain their dental health and must be provided with a healthy way to do so. Rabbits can potentially be aggressive and territorial, and unneutered male rabbits may spray their territory with a strong-smelling urine. Unspayed female urine is also pungent, and a litter box may smell and requires training to use. Additionally, fearful rabbits can bite and scratch, and may do so to communicate displeasure. Rabbits should never be picked up by the ears or the "scruff" on the back of their neck, as their skeletons are light and fragile in comparison to their bodies, and are susceptible to trauma from falling, twisting and kicking. They have to be picked up and handled properly to avoid injury to the rabbit or the owner. Rabbits have needs that differ from other common household pets, which can lead to poor quality of life for the animal if their owners are unaware of these needs and often results in rabbits being returned to animal shelters. Inappropriate treatment of a rabbit can include inadequate diet, housing, or socialisation. A lack of knowledge may also lead to improper treatment and health care for rabbits. Rabbits also have a body language that is more subtle than that of common domestic pets, such as cats and dogs , and compared to these species are prey animals rather than predators, which poses different challenges to a potential owner. Rabbits may be kept inside as small house pets . Rabbits that live indoors are less exposed to the dangers of predators , parasites , diseases, adverse weather, and pesticides , which in turn increases their lifespan. Cages are generally too small so it is recommended that instead of a cage, domestic rabbits free-roam. If they must be kept in a cage, they should be let out regularly for needed exercise. All areas should be "rabbit-proofed" to reduce the risks associated with their intrinsic need to chew. Rabbits are easily litter box trained . Rabbits are often compatible with others of their kind, or with birds or guinea pigs , but opinion differs regarding the dangers of housing different species together. For example, while rabbits can synthesize their own vitamin C , guinea pigs cannot, so the two species should not be fed the same diet. Also, most rabbits tend to be stronger than guinea pigs, so this may cause deliberate or inadvertent injury. Some people consider rabbits a pocket pet even though they are rather large. Rabbits as house companions began appearing with frequency in the late 19th century. The most notable documentation is from Beatrix Potter's published diaries and letters. Potter allowed both rabbits to live at least part time in the house with her. "Both were fond of the fire, and one used to lie inside the fender", and one rabbit slept, "under the grate on the hot ashes when the fire had gone out." The strongest push to keep rabbits as litter-trained spayed and neutered indoor pets came with the publication of Marinell Harriman's House Rabbit Handbook: How to Live with an Urban Rabbit in 1985. As the domestic descendants of wild prey animals , rabbits are alert, timid creatures that startle fairly easily, and many of their behaviors are triggered by the fight-or-flight response to perceived threats. According to the House Rabbit Society, the owner of a pet rabbit can use various behavioral approaches to gain the animal's trust and reduce aggression, though this can be a long and difficult process. In addition, there is evidence to suggest that young rabbits that occupy the periphery of the " litter huddle" obtain less milk from the mother and, as a result, have a lower weight. It has been suggested that this factor may contribute to behavioural differences in litter mates during adolescence . When bonding two rabbits, the journey usually commences with carefully supervised meetings on neutral territory. This helps minimize territorial aggression and allows the rabbits to establish a hierarchy. Over time, through these encounters, the rabbits will learn to tolerate with each other's presence, form a social bond, and engage in vital social behaviors such as grooming, playing, and snuggling. Once a successful bond is established, the rabbits can progress to sharing the same habitat, enabling them to coexist as companions in a safe and contented environment. However, not all bonding attempts result in success, and sometimes bonds may break due to various factors, including personality clashes or stress. In such cases, it is essential to carefully assess the situation and, if necessary, seek guidance from experienced rabbit caregivers or veterinarians to provide the best possible care for the rabbits involved. During bonding, as rabbits become more comfortable with each other's presence, they often engage in mutual grooming sessions. On the flip side, when rabbit bonds break, it can have detrimental effects on their physical and emotional well-being. Rabbits are highly social animals, and sudden separation from a bonded partner can cause stress and anxiety. This stress can lead to health issues, such as gastrointestinal problems, reduced appetite, and even a weakened immune system. Additionally, the sudden absence of a grooming partner can result in neglected fur, making the rabbit more susceptible to matting and skin issues. Not all veterinarians will treat rabbits, and pet owners may have to seek out an exotic animal veterinarian for their rabbit's care. Rabbits need annual checkups at the veterinarian because they may hide signs of illness or disease. They should be given things to chew on, the owner should check their teeth every month and they should have their nails trimmed every 6–8 weeks. They should be groomed every week; however, during their molts they should be groomed every day. Baby rabbits under eight weeks old should be watched for enteritis along with gut stasis and bloat . Pet rabbits can often exhibit behaviour problems, including aggression towards humans and conspecifics, particularly with poor husbandry. Rabbit owners can seek behaviour help through their vets and rabbit behaviourists.Some advantages of keeping rabbits as pets is that they can be friendly, sociable and playful. They may or may not react favorably to handling and petting, depending on their personality and how they were raised. There are many different sizes and characteristics available, owing to a long history of breeding. Rabbits can be friendly to each other, especially when introduced while young, and are often compatible with other pets given time and space. Rabbits are herbivores and their diet is relatively simple. Compared to other small animals kept as pets, rabbits are physically robust creatures with strong hind legs that enable them to run fast, and they have powerful teeth. Rabbits breed rapidly and so it is often easy, and affordable, to find one to buy or adopt; however, since they are a social species, it is better to keep at least 2 rabbits. A disadvantage of keeping rabbits as pets is that they may chew things in the house. Rabbits chew as a natural behavior to maintain their dental health and must be provided with a healthy way to do so. Rabbits can potentially be aggressive and territorial, and unneutered male rabbits may spray their territory with a strong-smelling urine. Unspayed female urine is also pungent, and a litter box may smell and requires training to use. Additionally, fearful rabbits can bite and scratch, and may do so to communicate displeasure. Rabbits should never be picked up by the ears or the "scruff" on the back of their neck, as their skeletons are light and fragile in comparison to their bodies, and are susceptible to trauma from falling, twisting and kicking. They have to be picked up and handled properly to avoid injury to the rabbit or the owner. Rabbits have needs that differ from other common household pets, which can lead to poor quality of life for the animal if their owners are unaware of these needs and often results in rabbits being returned to animal shelters. Inappropriate treatment of a rabbit can include inadequate diet, housing, or socialisation. A lack of knowledge may also lead to improper treatment and health care for rabbits. Rabbits also have a body language that is more subtle than that of common domestic pets, such as cats and dogs , and compared to these species are prey animals rather than predators, which poses different challenges to a potential owner. Rabbits have been kept as livestock since ancient times for their meat, wool, and fur. In modern times, rabbits are also utilized in scientific research as laboratory animals . Breeds such as the New Zealand and Californian are frequently utilized for meat in commercial rabbitries. These breeds have efficient metabolisms and grow quickly; they are ready for slaughter by approximately 14 to 16 weeks of age. The main consumer of rabbit meat in the world was China, as of 2017. Rabbit fryers are rabbits that are between 70 and 90 days of age, and weighing between 3–5 lb (1.4–2.3 kg) live weight. Rabbit roasters are rabbits from 90 days to 6 months of age weighing between 5–8 lb (2.3–3.6 kg) live weight. Rabbit stewers are rabbits from 6 months on weighing over 8 lb (3.6 kg) . Any type of rabbit can be slaughtered for meat, but those exhibiting the "commercial" body type are most commonly raised for meat purposes. Dark fryers (any other color but albino whites) are sometimes lower in price than albino fryers because of the slightly darker tinge of the fryer (purely pink carcasses are preferred by consumers) and because the dark hairs are easier to see than if there are residual white hairs on the carcass. There is no difference in skinability. Rabbits such as the Angora , American Fuzzy Lop , and Jersey Wooly produce wool . However, since the American Fuzzy Lop and Jersey Wooly are both dwarf breeds, only the much larger Angora breeds such as the English Angora, Satin Angora, Giant Angora, and French Angoras are used for commercial wool production. Their long fur is sheared, combed , or plucked (gently pulling loose hairs from the body during molting ) and then spun into yarn used to make a variety of products. Angora sweaters can be purchased in many clothing stores and is generally mixed with other types of wool due to the poor durability of angora fibers on their own. Rabbit breeds that were developed for their fur qualities include the Rex with its plush texture, the Satin with its lustrous color, and the Chinchilla for its exotic pattern. White rabbit fur may be dyed in an array of colors that are not produced naturally. Rabbits in the fur industry are fed a diet focused for robust coat production and pelts are harvested after the rabbit reaches prime condition, which takes longer than in the meat industry. Rabbit fur is used in local and commercial textile industries throughout the world. Rabbits can live outdoors in properly constructed, sheltered hutches , which provide protection from the elements in winter and keep rabbits cool in summer heat. To protect from predators, rabbit hutches are usually situated in a fenced yard, shed , barn , or other enclosed structure , which may also contain a larger pen for exercise. Rabbits in such an environment can alternatively be allowed to roam the secured area freely, and simply be provided with an adapted doghouse for shelter. A more elaborate setup is an artificial warren . Inside housing is discussed in House rabbits . Rabbit show jumping, a form of animal sport between rabbits, began in the 1970s and has since become popular in Europe , particularly Sweden and the United Kingdom . When rabbit jumping was first starting out, the rules of competition were the same as horse jumping rules. However, rules were later changed to reflect a rabbit's abilities. The first national championship for rabbit show jumping was held in Stockholm, Sweden in 1987. Any rabbit, regardless of breed, may participate in this kind of competition, as it is based on athletic skill.Breeds such as the New Zealand and Californian are frequently utilized for meat in commercial rabbitries. These breeds have efficient metabolisms and grow quickly; they are ready for slaughter by approximately 14 to 16 weeks of age. The main consumer of rabbit meat in the world was China, as of 2017. Rabbit fryers are rabbits that are between 70 and 90 days of age, and weighing between 3–5 lb (1.4–2.3 kg) live weight. Rabbit roasters are rabbits from 90 days to 6 months of age weighing between 5–8 lb (2.3–3.6 kg) live weight. Rabbit stewers are rabbits from 6 months on weighing over 8 lb (3.6 kg) . Any type of rabbit can be slaughtered for meat, but those exhibiting the "commercial" body type are most commonly raised for meat purposes. Dark fryers (any other color but albino whites) are sometimes lower in price than albino fryers because of the slightly darker tinge of the fryer (purely pink carcasses are preferred by consumers) and because the dark hairs are easier to see than if there are residual white hairs on the carcass. There is no difference in skinability.Rabbits such as the Angora , American Fuzzy Lop , and Jersey Wooly produce wool . However, since the American Fuzzy Lop and Jersey Wooly are both dwarf breeds, only the much larger Angora breeds such as the English Angora, Satin Angora, Giant Angora, and French Angoras are used for commercial wool production. Their long fur is sheared, combed , or plucked (gently pulling loose hairs from the body during molting ) and then spun into yarn used to make a variety of products. Angora sweaters can be purchased in many clothing stores and is generally mixed with other types of wool due to the poor durability of angora fibers on their own. Rabbit breeds that were developed for their fur qualities include the Rex with its plush texture, the Satin with its lustrous color, and the Chinchilla for its exotic pattern. White rabbit fur may be dyed in an array of colors that are not produced naturally. Rabbits in the fur industry are fed a diet focused for robust coat production and pelts are harvested after the rabbit reaches prime condition, which takes longer than in the meat industry. Rabbit fur is used in local and commercial textile industries throughout the world. Rabbits can live outdoors in properly constructed, sheltered hutches , which provide protection from the elements in winter and keep rabbits cool in summer heat. To protect from predators, rabbit hutches are usually situated in a fenced yard, shed , barn , or other enclosed structure , which may also contain a larger pen for exercise. Rabbits in such an environment can alternatively be allowed to roam the secured area freely, and simply be provided with an adapted doghouse for shelter. A more elaborate setup is an artificial warren . Inside housing is discussed in House rabbits .Rabbit show jumping, a form of animal sport between rabbits, began in the 1970s and has since become popular in Europe , particularly Sweden and the United Kingdom . When rabbit jumping was first starting out, the rules of competition were the same as horse jumping rules. However, rules were later changed to reflect a rabbit's abilities. The first national championship for rabbit show jumping was held in Stockholm, Sweden in 1987. Any rabbit, regardless of breed, may participate in this kind of competition, as it is based on athletic skill.

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West Nile

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Phiona Nyamutoro

Phiona Nyamutoro is a Ugandan politician and legislator representing the Youth in the parliament of Uganda, she is the National female youth Member of parliament in the parliament of Uganda . She is a member of the National Resistance Movement (NRM) on whose ticket she got to parliament. She is also the current Minister of state for Minerals in the Ministry of Energy and Minerals Development, to which she was appointed on 22 March 2024.Nyamutoro holds a first class degree in Arts (Luganda, Sociology) and a master's degree in public administration from Makerere university . She went to Najjera progressives for her primary school education, Misanvu SS in Kibinge Bukomansimbi for O'level and Maleku Secondary school for A'level. Nyamutoro was a vice guild president while Makerere University 2015 -2016. She was also a member of the National Youth council representing Nebbi district . Nyamutoro is the first National youth Member of Parliament hailing from Nebbi district. Nyamutoro is also a champion of anti pregnancy and Gender issues. In the 11th parliament, she is a member of the committee on education and sports. She was appointed Minister of State for Minerals in the Ministry of Energy and Minerals Development as part of the cabinet reshuffle by President Museveni

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Corvidae

See text Corvidae is a cosmopolitan family of oscine passerine birds that contains the crows , ravens , rooks , magpies , jackdaws , jays , treepies , choughs , and nutcrackers . In colloquial English, they are known as the crow family or corvids . Currently, 135 species are included in this family. The genus Corvus containing 47 species makes up over a third of the entire family. Corvids ( ravens ) are the largest passerines. Corvids display remarkable intelligence for animals of their size, and are among the most intelligent birds thus far studied. Specifically, members of the family have demonstrated self-awareness in mirror tests ( Eurasian magpies ) and tool-making ability (e.g. crows and rooks ), skills which until recently were thought to be possessed only by humans and a few other higher mammals . Their total brain-to-body mass ratio is equal to that of non-human great apes and cetaceans , and only slightly lower than that of humans. They are medium to large in size, with strong feet and bills, rictal bristles , and a single moult each year (most passerines moult twice). Corvids are found worldwide, except for the southern tip of South America and the polar ice caps . The majority of the species are found in tropical South and Central America and in southern Asia, with fewer than 10 species each in Africa and Australasia . The genus Corvus has re-entered Australia in relatively recent geological prehistory, with five species and one subspecies there. Several species of raven have reached oceanic islands, and some of these species are now highly threatened with extinction , or have already become extinct.The name Corvidae for the family was introduced by the English zoologist William Elford Leach in a guide to the contents of the British Museum published in 1820. Over the years, much disagreement has arisen on the exact evolutionary relationships of the corvid family and their relatives. What eventually seemed clear was that corvids are derived from Australasian ancestors, and spread throughout the world from there. Other lineages derived from these ancestors evolved into ecologically diverse, but often Australasian, groups. In the late 1970s and throughout the 1980s, Sibley and Ahlquist united the corvids with other taxa in the Corvida , based on DNA–DNA hybridization . The presumed corvid relatives included: currawongs , birds of paradise , whipbirds , quail-thrushes , whistlers , monarch flycatchers and drongos , shrikes , vireos , and vangas , but current research favors the theory that this grouping is partly artificial. The corvids constitute the core group of the Corvoidea , together with their closest relatives (the birds of paradise, Australian mud-nesters , and shrikes). They are also the core group of the Corvida, which includes the related groups, such as Old World orioles and vireos. Clarification of the interrelationships of the corvids has been achieved based on cladistic analysis of several DNA sequences . The jays and magpies do not constitute monophyletic lineages, but rather seem to split up into an American and Old World lineage, and an Holarctic and Oriental lineage, respectively. These are not closely related among each other. The position of the azure-winged magpie , which has always been of undistinguished lineage, is less clear than previously thought. The crested jayshrike ( Platylophus galericulatus ) is traditionally included in the Corvidae, but is not a true member of this family, being closer to the helmetshrikes ( Malaconotidae ) or shrikes ( Laniidae ). Likewise, the Hume's ground "jay" ( Pseudopodoces humilis ) is, in fact, a member of the tit family, Paridae . The following tree showing the phylogeny of the crow family is based on a molecular study by Jenna Mcullough and collaborators published in 2023. Pyrrhocorax – choughs (2 species) Crypsirina – treepies (2 species) Dendrocitta – treepies (7 species) Temnurus – ratchet-tailed treepie Platysmurus – black magpies (2 species) Cissa – green magpies (4 species) Urocissa – blue magpies (5 species) Cyanopica – magpies (2 species) Perisoreus – jays (3 species) Cyanolyca – jays (9 species) Cyanocorax – New World jays (17 species) Psilorhinus – brown jay Calocitta – magpie-jays (2 species) Aphelocoma – jays and scrub jays (7 species) Gymnorhinus – pinyon jay Cyanocitta – jays (2 species) Garrulus – Old World jays (3 species) Ptilostomus – piapiac Zavattariornis – Stresemann's bushcrow Podoces – ground jays (4 species) Pica – magpies (7 species) Nucifraga – nutcrackers (3 species) Coloeus – jackdaws (2 species) Corvus – crows, ravens, rook (47 species) The earliest corvid fossils date to mid- Miocene Europe, about 17 million years ago; Miocorvus and Miopica may be ancestral to crows and some of the magpie lineage, respectively, or similar to the living forms, due to convergent evolution . The known prehistoric corvid genera appear to be mainly of the New World and Old World jay and Holarctic magpie lineages: In addition, there are numerous fossil species of extant genera since the Mio – Pliocene , mainly European Corvus . [lower-alpha 1]The earliest corvid fossils date to mid- Miocene Europe, about 17 million years ago; Miocorvus and Miopica may be ancestral to crows and some of the magpie lineage, respectively, or similar to the living forms, due to convergent evolution . The known prehistoric corvid genera appear to be mainly of the New World and Old World jay and Holarctic magpie lineages: In addition, there are numerous fossil species of extant genera since the Mio – Pliocene , mainly European Corvus . [lower-alpha 1]Corvids are large to very large passerines with a robust build and strong legs; all species, except the pinyon jay , have nostrils covered by bristle-like feathers. Many corvids of temperate zones have mainly black or blue coloured plumage ; however, some are pied black and white, some have a blue-purple iridescence, and many tropical species are brightly coloured. The sexes are very similar in color and size. Corvids have strong, stout bills and large wingspans. The family includes the largest members of the passerine order. The smallest corvid is the dwarf jay ( Aphelocoma nana ), at 41 g (1.4 oz) and 21.5 cm (8.5 in) . The largest corvids are the common raven ( Corvus corax ) and the thick-billed raven ( Corvus crassirostris ), both of which regularly exceed 1,400 grams (3.1 pounds) and 65 cm (26 in) . Species can be identified based on size, shape, and geography; however, some, especially the Australian crows , are best identified by their raucous calls. Corvids occur in most climatic zones. Most are sedentary, and do not migrate significantly. However, during a shortage of food, irruptive migration can occur. When species are migratory, they will form large flocks in the fall (around August in the Northern Hemisphere) and travel south. One reason for the success of crows, compared to ravens, is their ability to overlap breeding territory. During breeding season, crows were shown to overlap breeding territory six times as much as ravens. This invasion of breeding ranges allowed a related increase in local population density. Since crows and magpies have benefited and even increased in numbers due to human development, it was suggested that this might cause increased rates of nest predation of smaller bird species, leading to declines. Several studies have shown this concern to be unfounded. One study examined American crows , which had increased in numbers, were a suspect in nest predation of threatened marbled murrelets . However, Steller's jays , which are successful independently of human development, are more efficient in plundering small birds' nests than American crows and common ravens . Therefore, the human relationship with crows and ravens did not significantly increase nest predation when compared to other factors, such as habitat destruction . Similarly, a study examining the decline of British songbirds found no link between Eurasian magpie numbers and population changes of 23 songbird species. Some corvids have strong organization and community groups. Jackdaws, for example, have a strong social hierarchy, and are facultatively colonial during breeding. Providing mutual aid has also been recorded within many of the corvid species. Young corvids have been known to play and take part in elaborate social games . Documented group games follow "king of the mountain" or "follow the leader" patterns. Other play involves the manipulation, passing, and balancing of sticks. Corvids also take part in other activities, such as sliding down smooth surfaces. These games are understood to play a large role in the adaptive and survival ability of the birds. Mate selection is quite complex, and accompanied with much social play in the Corvidae. Youngsters of social corvid species undergo a series of tests, including aerobatic feats, before being accepted as a mate by the opposite sex. Some corvids can be aggressive. Blue jays , for example, are well known to attack anything that threatens their nest. Crows have been known to attack dogs, cats, ravens, and birds of prey. Most of the time, these assaults take place as a distraction long enough to allow an opportunity for stealing food. The natural diet of many corvid species is omnivorous, consisting of invertebrates , nestlings, small mammals, berries, fruits, seeds, and carrion . However, some corvids, especially the crows, have adapted well to human conditions, and have come to rely on human food sources. In a US study of American crows , common ravens , and Steller's jays around campgrounds and human settlements, the crows appeared to have the most diverse diet of all, taking anthropogenic foods, such as: bread, spaghetti, fried potatoes, dog food, sandwiches, and livestock feed. The increase in available human food sources is contributing to population rises in some corvid species. Some corvids are predators of other birds. During the wintering months, corvids typically form foraging flocks. However, some crows also eat many agricultural pests, including cutworms , wireworms , grasshoppers , and harmful weeds. Some corvids will eat carrion , and since they lack a specialized beak for tearing into flesh, they must wait until animals are opened, whether by other predators or as roadkill. Many species of corvid are territorial , protecting territories throughout the year, or simply during the breeding season. In some cases, territories may only be guarded during the day, with the pair joining off-territory roosts at night. Some corvids are well-known communal roosters. Some groups of roosting corvids can be very large, with a roost of 65,000 rooks counted in Scotland . Some, including the rook and the jackdaw , are also communal nesters. The partner bond in corvids is extremely strong, and even lifelong in some species. This monogamous lifestyle, however, can still contain extra-pair copulations. Males and females build large nests together in trees or on ledges; jackdaws are known to breed in buildings and in rabbit warrens . The male will also feed the female during incubation. The nests are constructed of a mass of bulky twigs lined with grass and bark. Corvids can lay between 3 and 10 eggs, typically ranging between 4 and 7. The eggs are usually greenish in colour with brown blotches. Once hatched, the young remain in the nests for up to 6–10 weeks depending on the species. Corvids use several different forms of parental care, including bi-parental care and cooperative breeding . Cooperative breeding takes place when parents are helped in raising their offspring, usually by relatives, but also sometimes by non-related adults. Such helpers at the nest in most cooperatively-breeding birds are males, while females join other groups. White-throated magpie-jays are cooperatively-breeding corvids where the helpers are mostly female. Jerison (1973) has suggested that the degree of brain encephalization (the ratio of brain size to body size, EQ) may correlate with an animal's intelligence and cognitive skills . Corvids and psittacids have higher EQ than other bird families, similar to that of the apes. Among the Corvidae, ravens possess the largest brain to body size ratio. In addition to the high EQ, the Corvid's intelligence is boosted by their living environment. Firstly, Corvids are found in some of the harshest environments on Earth, where surviving requires higher intelligence and better adaptations. Secondly, most of the Corvids are omnivorous, suggesting that they are exposed to more different stimuli and environments. Furthermore, many corvid species live in a large family group, and demonstrate high social complexities. Their intelligence is boosted by the long growing period of the young. By remaining with the parents, the young have more opportunities to learn necessary skills. When compared to dogs and cats in an experiment testing the ability to seek out food according to three-dimensional clues, corvids out-performed the mammals. A meta-analysis testing how often birds invented new ways to acquire food in the wild found corvids to be the most innovative birds. A 2004 review suggested that their cognitive abilities are on par with those of non-human great apes . Despite structural differences, the brains of corvids and great apes both evolved the ability to make geometrical measurements. Ravens are found to show bystander affiliation, and solicited bystander affiliation after aggressive conflicts. Most of the time, bystanders already sharing a valuable relationship with the victim are more likely to affiliate with the victim to alleviate the victim's distress ("consolation") as a representation of empathy . Ravens are believed to be able to be sensitive to other's emotions. Emotion contagion refers to the emotional state matching between individuals. Adriaense et al. (2018) used a bias paradigm to quantify emotional valence , which along with emotional arousal , define emotions. They manipulated the positive and negative affective states in the demonstrator ravens, which showed significantly different responses to the two states: behaving pessimism to the negative states, and optimism to the positive states. Then, the researchers trained another observer raven to first observe the demonstrator's responses. The observer raven was then presented with ambiguous stimuli. The experiment results confirmed the existence of negative emotional contagions in ravens, while the positive emotional contagion remained unclear. Therefore, ravens are capable of both discerning the negative emotions in their conspecifics and showing signs of empathy. Interspecific communications are evolutionarily beneficial for species living in the same environment. Facial expressions are the most widely used method to express emotions by humans. Tate et al. (2006) explored the issue of non-human mammals processing the visual cues from faces to achieve interspecific communication with humans. Researchers also examined the avian species' capabilities to interpret this non-verbal communication, and their extent of sensitivity to human emotions. Based on the experimental subject of American Crows' behavioral changes to varying human gazes and facial expressions, Clucas et al. (2013) identified that crows are able to change their behaviors to the presence of direct human gaze, but did not respond differentially to human emotional facial expressions. They further suggested that the high intelligence of the crows enables them to adapt well to human-dominated environments. It is considered difficult to study emotions in animals when humans could not communicate with them. One way to identify animal personality traits is to observe the consistency of the individual's behavior over time and circumstances. For group-living species, there are two opposing hypotheses regarding the assortment of personalities within a group: the social niche specialization hypothesis, and the conformity hypothesis. To test these two hypotheses, McCune et al. (2018) performed an experiment on the boldness of two species in Corvidae: the Mexican Jay and California Scrub-Jay . Their results confirmed the conformity hypothesis, supported by the significant differences in the group effects. The individual personality is both determined by genetics and shaped by social contexts . Miller et al. (2016) examined the role of the developmental and social environment in personality formation in common ravens and carrion crows, which are highly social corvids. The researchers highlighted the correlation between social contexts and an individual's consistent behavior over time (personality), by showing that conspecific presence promoted the behavioral similarities between individuals. Therefore, the researchers demonstrated that social contexts had a significant impact on the development of the raven's and crow's personalities. The social complexity hypothesis suggests that living in a social group enhances the cognitive abilities of animals. Corvid ingenuity is represented through their feeding skills, memorization abilities, use of tools, and group behaviour. Living in large social groups has long been connected with high cognitive ability. To live in a large group, a member must be able to recognize individuals, and track the social position and foraging of other members over time. Members must also be able to distinguish between sex, age, reproductive status, and dominance, and to update this information constantly. It might be that social complexity corresponds to their high cognition, as well as contributing to the spread of information between members of the group. The Eurasian magpie is the only non-mammal species known to be able to recognize itself in a mirror test , although later research could not replicate this finding. Studies using very similar setups could not find such behaviour in other corvids (e.g., Carrion crows ). Magpies have been observed taking part in elaborate grieving rituals, which have been likened to human funerals , including laying grass wreaths. Marc Bekoff, at the University of Colorado , argues that it shows that they are capable of feeling complex emotions, including grief . Furthermore, carrion crows show a neuronal response that correlates with their perception of a stimulus, which some scientists have argued to be an empirical marker of ( avian/corvid ) sensory consciousness —the conscious perception of sensory input—in the crows which do not have a cerebral cortex . A related study shows that the birds' pallium's neuroarchitecture is reminiscent of the mammalian cortex. There are also specific examples of corvid cleverness. One carrion crow was documented cracking nuts by placing them on a crosswalk, letting the passing cars crack the shell, waiting for the light to turn red, and then safely retrieving the contents. A group of crows in England took turns lifting garbage bin lids while their companions collected food. Members of the corvid family have been known to watch other birds, remember where they hide their food, then return once the owner leaves. Corvids also move their food around between hiding places to avoid thievery—but only if they have previously been thieves themselves (that is, they remember previous relevant social contexts, use their own experience of having been a thief to predict the behavior of a pilferer, and can determine the safest course to protect their caches from being pilfered). Studies to assess similar cognitive abilities in apes have been inconclusive. The ability to hide food requires highly accurate spatial memories . Corvids have been recorded to recall their food's hiding places up to nine months later. It is suggested that vertical landmarks (like trees) are used to remember locations. There has also been evidence that California scrub jays , which store perishable foods, not only remember where they stored their food, but for how long. This has been compared to episodic memory , previously thought unique to humans. New Caledonian crows ( Corvus moneduloides ) are notable for their highly developed tool fabrication. They make angling tools of twigs and leaves trimmed into hooks, and then subsequently use the hooks to pull insect larvae from tree holes. Tools are engineered according to task, and apparently, also to learned preferences. Recent studies revealed abilities to solve complicated problems, which suggested high levels of innovation of a complex nature. Other corvids that have been observed using tools include: the American crow , blue jay , and green jay . Researchers have discovered that New Caledonian crows do not just use single objects as tools—they can also construct novel compound tools through assemblage of otherwise non-functional elements. Diversity in tool design among corvids suggests cultural variation. Again, great apes are the only other animals known to use tools in such a fashion. Clark's nutcrackers and jackdaws were compared in a 2002 study based on geometric rule learning. The corvids, along with a domestic pigeon , had to locate a target between two landmarks, while distances and landmarks were altered. The nutcrackers were more accurate in their searches than the jackdaws and pigeons. The scarecrow is an archetypal scare tactic in the agricultural business. However, due to corvids' quick wit, scarecrows are soon ignored, and used as perches. Despite farmers' efforts to rid themselves of corvid pests, their attempts have only expanded corvid territories, and strengthened their numbers. Contrary to earlier teleological classifications, in which they were seen as "highest" songbirds due to their intelligence, current systematics might place corvids—based on their total number of physical characteristics, instead of just their brains (which are the most developed of birds)—in the lower middle of the passerine evolutionary tree, dependent on which subgroup is chosen as the most derived. As per one observer: During the 19th century, there arose the belief that these were the "most advanced" birds, based upon the belief that Darwinian evolution brings "progress." In such a classification, the "most intelligent" of birds were listed last, reflecting their position "atop the pyramid." Modern biologists reject the concept of hierarchical "progress" in evolution [...]. The other major group of highly intelligent birds of the order Psittaciformes (which includes 'true' parrots , cockatoos , and New Zealand parrots ) is not closely related to corvids. A study found that four-months-old ravens can have physical and social cognitive skills similar to that of adult great apes, and concluded that the "dynamic of the different influences that, during ontogeny , contributes to adult cognition" is required for the study of cognition. The natural diet of many corvid species is omnivorous, consisting of invertebrates , nestlings, small mammals, berries, fruits, seeds, and carrion . However, some corvids, especially the crows, have adapted well to human conditions, and have come to rely on human food sources. In a US study of American crows , common ravens , and Steller's jays around campgrounds and human settlements, the crows appeared to have the most diverse diet of all, taking anthropogenic foods, such as: bread, spaghetti, fried potatoes, dog food, sandwiches, and livestock feed. The increase in available human food sources is contributing to population rises in some corvid species. Some corvids are predators of other birds. During the wintering months, corvids typically form foraging flocks. However, some crows also eat many agricultural pests, including cutworms , wireworms , grasshoppers , and harmful weeds. Some corvids will eat carrion , and since they lack a specialized beak for tearing into flesh, they must wait until animals are opened, whether by other predators or as roadkill.Many species of corvid are territorial , protecting territories throughout the year, or simply during the breeding season. In some cases, territories may only be guarded during the day, with the pair joining off-territory roosts at night. Some corvids are well-known communal roosters. Some groups of roosting corvids can be very large, with a roost of 65,000 rooks counted in Scotland . Some, including the rook and the jackdaw , are also communal nesters. The partner bond in corvids is extremely strong, and even lifelong in some species. This monogamous lifestyle, however, can still contain extra-pair copulations. Males and females build large nests together in trees or on ledges; jackdaws are known to breed in buildings and in rabbit warrens . The male will also feed the female during incubation. The nests are constructed of a mass of bulky twigs lined with grass and bark. Corvids can lay between 3 and 10 eggs, typically ranging between 4 and 7. The eggs are usually greenish in colour with brown blotches. Once hatched, the young remain in the nests for up to 6–10 weeks depending on the species. Corvids use several different forms of parental care, including bi-parental care and cooperative breeding . Cooperative breeding takes place when parents are helped in raising their offspring, usually by relatives, but also sometimes by non-related adults. Such helpers at the nest in most cooperatively-breeding birds are males, while females join other groups. White-throated magpie-jays are cooperatively-breeding corvids where the helpers are mostly female.Jerison (1973) has suggested that the degree of brain encephalization (the ratio of brain size to body size, EQ) may correlate with an animal's intelligence and cognitive skills . Corvids and psittacids have higher EQ than other bird families, similar to that of the apes. Among the Corvidae, ravens possess the largest brain to body size ratio. In addition to the high EQ, the Corvid's intelligence is boosted by their living environment. Firstly, Corvids are found in some of the harshest environments on Earth, where surviving requires higher intelligence and better adaptations. Secondly, most of the Corvids are omnivorous, suggesting that they are exposed to more different stimuli and environments. Furthermore, many corvid species live in a large family group, and demonstrate high social complexities. Their intelligence is boosted by the long growing period of the young. By remaining with the parents, the young have more opportunities to learn necessary skills. When compared to dogs and cats in an experiment testing the ability to seek out food according to three-dimensional clues, corvids out-performed the mammals. A meta-analysis testing how often birds invented new ways to acquire food in the wild found corvids to be the most innovative birds. A 2004 review suggested that their cognitive abilities are on par with those of non-human great apes . Despite structural differences, the brains of corvids and great apes both evolved the ability to make geometrical measurements. Ravens are found to show bystander affiliation, and solicited bystander affiliation after aggressive conflicts. Most of the time, bystanders already sharing a valuable relationship with the victim are more likely to affiliate with the victim to alleviate the victim's distress ("consolation") as a representation of empathy . Ravens are believed to be able to be sensitive to other's emotions. Emotion contagion refers to the emotional state matching between individuals. Adriaense et al. (2018) used a bias paradigm to quantify emotional valence , which along with emotional arousal , define emotions. They manipulated the positive and negative affective states in the demonstrator ravens, which showed significantly different responses to the two states: behaving pessimism to the negative states, and optimism to the positive states. Then, the researchers trained another observer raven to first observe the demonstrator's responses. The observer raven was then presented with ambiguous stimuli. The experiment results confirmed the existence of negative emotional contagions in ravens, while the positive emotional contagion remained unclear. Therefore, ravens are capable of both discerning the negative emotions in their conspecifics and showing signs of empathy. Interspecific communications are evolutionarily beneficial for species living in the same environment. Facial expressions are the most widely used method to express emotions by humans. Tate et al. (2006) explored the issue of non-human mammals processing the visual cues from faces to achieve interspecific communication with humans. Researchers also examined the avian species' capabilities to interpret this non-verbal communication, and their extent of sensitivity to human emotions. Based on the experimental subject of American Crows' behavioral changes to varying human gazes and facial expressions, Clucas et al. (2013) identified that crows are able to change their behaviors to the presence of direct human gaze, but did not respond differentially to human emotional facial expressions. They further suggested that the high intelligence of the crows enables them to adapt well to human-dominated environments. It is considered difficult to study emotions in animals when humans could not communicate with them. One way to identify animal personality traits is to observe the consistency of the individual's behavior over time and circumstances. For group-living species, there are two opposing hypotheses regarding the assortment of personalities within a group: the social niche specialization hypothesis, and the conformity hypothesis. To test these two hypotheses, McCune et al. (2018) performed an experiment on the boldness of two species in Corvidae: the Mexican Jay and California Scrub-Jay . Their results confirmed the conformity hypothesis, supported by the significant differences in the group effects. The individual personality is both determined by genetics and shaped by social contexts . Miller et al. (2016) examined the role of the developmental and social environment in personality formation in common ravens and carrion crows, which are highly social corvids. The researchers highlighted the correlation between social contexts and an individual's consistent behavior over time (personality), by showing that conspecific presence promoted the behavioral similarities between individuals. Therefore, the researchers demonstrated that social contexts had a significant impact on the development of the raven's and crow's personalities. The social complexity hypothesis suggests that living in a social group enhances the cognitive abilities of animals. Corvid ingenuity is represented through their feeding skills, memorization abilities, use of tools, and group behaviour. Living in large social groups has long been connected with high cognitive ability. To live in a large group, a member must be able to recognize individuals, and track the social position and foraging of other members over time. Members must also be able to distinguish between sex, age, reproductive status, and dominance, and to update this information constantly. It might be that social complexity corresponds to their high cognition, as well as contributing to the spread of information between members of the group. The Eurasian magpie is the only non-mammal species known to be able to recognize itself in a mirror test , although later research could not replicate this finding. Studies using very similar setups could not find such behaviour in other corvids (e.g., Carrion crows ). Magpies have been observed taking part in elaborate grieving rituals, which have been likened to human funerals , including laying grass wreaths. Marc Bekoff, at the University of Colorado , argues that it shows that they are capable of feeling complex emotions, including grief . Furthermore, carrion crows show a neuronal response that correlates with their perception of a stimulus, which some scientists have argued to be an empirical marker of ( avian/corvid ) sensory consciousness —the conscious perception of sensory input—in the crows which do not have a cerebral cortex . A related study shows that the birds' pallium's neuroarchitecture is reminiscent of the mammalian cortex. There are also specific examples of corvid cleverness. One carrion crow was documented cracking nuts by placing them on a crosswalk, letting the passing cars crack the shell, waiting for the light to turn red, and then safely retrieving the contents. A group of crows in England took turns lifting garbage bin lids while their companions collected food. Members of the corvid family have been known to watch other birds, remember where they hide their food, then return once the owner leaves. Corvids also move their food around between hiding places to avoid thievery—but only if they have previously been thieves themselves (that is, they remember previous relevant social contexts, use their own experience of having been a thief to predict the behavior of a pilferer, and can determine the safest course to protect their caches from being pilfered). Studies to assess similar cognitive abilities in apes have been inconclusive. The ability to hide food requires highly accurate spatial memories . Corvids have been recorded to recall their food's hiding places up to nine months later. It is suggested that vertical landmarks (like trees) are used to remember locations. There has also been evidence that California scrub jays , which store perishable foods, not only remember where they stored their food, but for how long. This has been compared to episodic memory , previously thought unique to humans. New Caledonian crows ( Corvus moneduloides ) are notable for their highly developed tool fabrication. They make angling tools of twigs and leaves trimmed into hooks, and then subsequently use the hooks to pull insect larvae from tree holes. Tools are engineered according to task, and apparently, also to learned preferences. Recent studies revealed abilities to solve complicated problems, which suggested high levels of innovation of a complex nature. Other corvids that have been observed using tools include: the American crow , blue jay , and green jay . Researchers have discovered that New Caledonian crows do not just use single objects as tools—they can also construct novel compound tools through assemblage of otherwise non-functional elements. Diversity in tool design among corvids suggests cultural variation. Again, great apes are the only other animals known to use tools in such a fashion. Clark's nutcrackers and jackdaws were compared in a 2002 study based on geometric rule learning. The corvids, along with a domestic pigeon , had to locate a target between two landmarks, while distances and landmarks were altered. The nutcrackers were more accurate in their searches than the jackdaws and pigeons. The scarecrow is an archetypal scare tactic in the agricultural business. However, due to corvids' quick wit, scarecrows are soon ignored, and used as perches. Despite farmers' efforts to rid themselves of corvid pests, their attempts have only expanded corvid territories, and strengthened their numbers. Contrary to earlier teleological classifications, in which they were seen as "highest" songbirds due to their intelligence, current systematics might place corvids—based on their total number of physical characteristics, instead of just their brains (which are the most developed of birds)—in the lower middle of the passerine evolutionary tree, dependent on which subgroup is chosen as the most derived. As per one observer: During the 19th century, there arose the belief that these were the "most advanced" birds, based upon the belief that Darwinian evolution brings "progress." In such a classification, the "most intelligent" of birds were listed last, reflecting their position "atop the pyramid." Modern biologists reject the concept of hierarchical "progress" in evolution [...]. The other major group of highly intelligent birds of the order Psittaciformes (which includes 'true' parrots , cockatoos , and New Zealand parrots ) is not closely related to corvids. A study found that four-months-old ravens can have physical and social cognitive skills similar to that of adult great apes, and concluded that the "dynamic of the different influences that, during ontogeny , contributes to adult cognition" is required for the study of cognition. Ravens are found to show bystander affiliation, and solicited bystander affiliation after aggressive conflicts. Most of the time, bystanders already sharing a valuable relationship with the victim are more likely to affiliate with the victim to alleviate the victim's distress ("consolation") as a representation of empathy . Ravens are believed to be able to be sensitive to other's emotions.Emotion contagion refers to the emotional state matching between individuals. Adriaense et al. (2018) used a bias paradigm to quantify emotional valence , which along with emotional arousal , define emotions. They manipulated the positive and negative affective states in the demonstrator ravens, which showed significantly different responses to the two states: behaving pessimism to the negative states, and optimism to the positive states. Then, the researchers trained another observer raven to first observe the demonstrator's responses. The observer raven was then presented with ambiguous stimuli. The experiment results confirmed the existence of negative emotional contagions in ravens, while the positive emotional contagion remained unclear. Therefore, ravens are capable of both discerning the negative emotions in their conspecifics and showing signs of empathy. Interspecific communications are evolutionarily beneficial for species living in the same environment. Facial expressions are the most widely used method to express emotions by humans. Tate et al. (2006) explored the issue of non-human mammals processing the visual cues from faces to achieve interspecific communication with humans. Researchers also examined the avian species' capabilities to interpret this non-verbal communication, and their extent of sensitivity to human emotions. Based on the experimental subject of American Crows' behavioral changes to varying human gazes and facial expressions, Clucas et al. (2013) identified that crows are able to change their behaviors to the presence of direct human gaze, but did not respond differentially to human emotional facial expressions. They further suggested that the high intelligence of the crows enables them to adapt well to human-dominated environments. It is considered difficult to study emotions in animals when humans could not communicate with them. One way to identify animal personality traits is to observe the consistency of the individual's behavior over time and circumstances. For group-living species, there are two opposing hypotheses regarding the assortment of personalities within a group: the social niche specialization hypothesis, and the conformity hypothesis. To test these two hypotheses, McCune et al. (2018) performed an experiment on the boldness of two species in Corvidae: the Mexican Jay and California Scrub-Jay . Their results confirmed the conformity hypothesis, supported by the significant differences in the group effects. The individual personality is both determined by genetics and shaped by social contexts . Miller et al. (2016) examined the role of the developmental and social environment in personality formation in common ravens and carrion crows, which are highly social corvids. The researchers highlighted the correlation between social contexts and an individual's consistent behavior over time (personality), by showing that conspecific presence promoted the behavioral similarities between individuals. Therefore, the researchers demonstrated that social contexts had a significant impact on the development of the raven's and crow's personalities. The social complexity hypothesis suggests that living in a social group enhances the cognitive abilities of animals. Corvid ingenuity is represented through their feeding skills, memorization abilities, use of tools, and group behaviour. Living in large social groups has long been connected with high cognitive ability. To live in a large group, a member must be able to recognize individuals, and track the social position and foraging of other members over time. Members must also be able to distinguish between sex, age, reproductive status, and dominance, and to update this information constantly. It might be that social complexity corresponds to their high cognition, as well as contributing to the spread of information between members of the group. The Eurasian magpie is the only non-mammal species known to be able to recognize itself in a mirror test , although later research could not replicate this finding. Studies using very similar setups could not find such behaviour in other corvids (e.g., Carrion crows ). Magpies have been observed taking part in elaborate grieving rituals, which have been likened to human funerals , including laying grass wreaths. Marc Bekoff, at the University of Colorado , argues that it shows that they are capable of feeling complex emotions, including grief . Furthermore, carrion crows show a neuronal response that correlates with their perception of a stimulus, which some scientists have argued to be an empirical marker of ( avian/corvid ) sensory consciousness —the conscious perception of sensory input—in the crows which do not have a cerebral cortex . A related study shows that the birds' pallium's neuroarchitecture is reminiscent of the mammalian cortex. There are also specific examples of corvid cleverness. One carrion crow was documented cracking nuts by placing them on a crosswalk, letting the passing cars crack the shell, waiting for the light to turn red, and then safely retrieving the contents. A group of crows in England took turns lifting garbage bin lids while their companions collected food. Members of the corvid family have been known to watch other birds, remember where they hide their food, then return once the owner leaves. Corvids also move their food around between hiding places to avoid thievery—but only if they have previously been thieves themselves (that is, they remember previous relevant social contexts, use their own experience of having been a thief to predict the behavior of a pilferer, and can determine the safest course to protect their caches from being pilfered). Studies to assess similar cognitive abilities in apes have been inconclusive. The ability to hide food requires highly accurate spatial memories . Corvids have been recorded to recall their food's hiding places up to nine months later. It is suggested that vertical landmarks (like trees) are used to remember locations. There has also been evidence that California scrub jays , which store perishable foods, not only remember where they stored their food, but for how long. This has been compared to episodic memory , previously thought unique to humans. New Caledonian crows ( Corvus moneduloides ) are notable for their highly developed tool fabrication. They make angling tools of twigs and leaves trimmed into hooks, and then subsequently use the hooks to pull insect larvae from tree holes. Tools are engineered according to task, and apparently, also to learned preferences. Recent studies revealed abilities to solve complicated problems, which suggested high levels of innovation of a complex nature. Other corvids that have been observed using tools include: the American crow , blue jay , and green jay . Researchers have discovered that New Caledonian crows do not just use single objects as tools—they can also construct novel compound tools through assemblage of otherwise non-functional elements. Diversity in tool design among corvids suggests cultural variation. Again, great apes are the only other animals known to use tools in such a fashion. Clark's nutcrackers and jackdaws were compared in a 2002 study based on geometric rule learning. The corvids, along with a domestic pigeon , had to locate a target between two landmarks, while distances and landmarks were altered. The nutcrackers were more accurate in their searches than the jackdaws and pigeons. The scarecrow is an archetypal scare tactic in the agricultural business. However, due to corvids' quick wit, scarecrows are soon ignored, and used as perches. Despite farmers' efforts to rid themselves of corvid pests, their attempts have only expanded corvid territories, and strengthened their numbers. Contrary to earlier teleological classifications, in which they were seen as "highest" songbirds due to their intelligence, current systematics might place corvids—based on their total number of physical characteristics, instead of just their brains (which are the most developed of birds)—in the lower middle of the passerine evolutionary tree, dependent on which subgroup is chosen as the most derived. As per one observer: During the 19th century, there arose the belief that these were the "most advanced" birds, based upon the belief that Darwinian evolution brings "progress." In such a classification, the "most intelligent" of birds were listed last, reflecting their position "atop the pyramid." Modern biologists reject the concept of hierarchical "progress" in evolution [...]. The other major group of highly intelligent birds of the order Psittaciformes (which includes 'true' parrots , cockatoos , and New Zealand parrots ) is not closely related to corvids. A study found that four-months-old ravens can have physical and social cognitive skills similar to that of adult great apes, and concluded that the "dynamic of the different influences that, during ontogeny , contributes to adult cognition" is required for the study of cognition. Corvids are reservoirs (carriers) for the West Nile virus in the United States. They are infected by mosquitoes (the vectors ), primarily of the Culex species. Crows and ravens are quickly killed by this disease, so their deaths are an early-warning system when West Nile virus arrives in an area (as are horses and other bird-species deaths). One of the first signs that West Nile virus first arrived in the US in 1999 was the death of crows in New York . Several different corvids, particularly ravens , have occasionally served as pets , although they are not able to speak as readily as parrots , and are not suited to a caged environment. It is illegal to own corvids, or any other migratory bird , without a permit in North America, due to the Migratory Bird Act . Humans have been able to coexist with many members of the Corvidae family throughout history, most notably crows and ravens (see: "Role in myth and culture" section below). These positive interactions have extended into modern times. Folklore often represents corvids as clever, and even mystical, animals. Some Native Americans , such as the Haida , believed that a raven created the earth, and despite being a trickster spirit, ravens were popular on totems , credited with creating man, and considered responsible for placing the Sun in the sky. Due to their carrion diet, the Celtic peoples strongly associated corvids with war, death, and the battlefield; their great intelligence meant that they were often considered messengers, or manifestations of the gods, such as Bendigeidfran (Welsh for "Blessed Crow") or the Irish Morrigan (Middle Irish for "Great Queen"), both who were underworld deities that may be related to the later Arthurian Fisher King . The Welsh Dream of Rhonabwy illustrates well the association of ravens with war. In many parts of Britain, gatherings of crows, or more often magpies, are counted using the divination rhyme : " one for sorrow, two for joy, three for a girl, four for a boy, five for silver, six for gold, seven for a secret never to be told." Another rhyme is: " one for sorrow, two for mirth, three for a funeral, four for a birth, five for heaven, six for hell, and seven for the Devil, his own sel." Cornish superstition holds that when a lone magpie is encountered, it must be loudly greeted with respect. Various Germanic peoples highly revered the raven, and the raven was often depicted as a motif on shields or other war gear in Anglo-Saxon art , such as the Sutton Hoo burial, and Vendel period art. The major deity, Odin , was so commonly associated with ravens throughout history that he gained the kenning "Raven God," [lower-alpha 2] and the raven banner was the flag of various Viking Age Scandinavian chieftains. Odin was also attended by Hugin and Munin , two ravens who flew all over the world, and whispered information they acquired into his ears. The Valravn sometimes appeared in modern Scandinavian folklore. On a shield and purse lid excavated among the Sutton Hoo treasures, imagery of stylised corvids with scrolled beaks are meticulously detailed in the decorative enamel work. The corvid symbolism reflected their common totemic status to the Anglo-Saxons, whose pre-Christian indigenous beliefs were of the same origin as that of the aforementioned Vikings. The sixth century BCE Greek scribe Aesop featured corvids as intelligent antagonists in many fables. Later, in western literature, popularized by American poet Edgar Allan Poe 's work " The Raven ", the common raven becomes a symbol of the main character's descent into madness. The children's book Mrs. Frisby and the Rats of NIMH and its animated film adaptation features a protagonist crow named Jeremy. Unlike many other bird families , corvid fitness and reproduction, especially with many crows, has increased due to human development. The survival and reproductive success of certain crows and ravens is assisted by their close relationship with humans. Human development provides additional resources by clearing land, creating shrublands rich in berries and insects. When the cleared land naturally replenishes, jays and crows use the young dense trees for nesting sites. Ravens typically use larger trees in denser forest. Despite the fact that most corvids are not threatened (many even increasing due to human activity) a few species are in danger. For example, the destruction of the Southeast Asian rainforest is endangering mixed-species feeding flocks with members from the family Corvidae. Also, since its semiarid scrubland habitat is an endangered ecosystem , the Florida scrub jay has a small and declining population. A number of island species, which are more vulnerable to introduced species and habitat loss, have been driven to extinction, such as the New Zealand raven , or are threatened, like the Mariana crow . The American crow population of the United States has grown over the years. It is possible that the American crow, due to humans increasing suitable habitat, will cause Northwestern crows and fish crows to decline. Folklore often represents corvids as clever, and even mystical, animals. Some Native Americans , such as the Haida , believed that a raven created the earth, and despite being a trickster spirit, ravens were popular on totems , credited with creating man, and considered responsible for placing the Sun in the sky. Due to their carrion diet, the Celtic peoples strongly associated corvids with war, death, and the battlefield; their great intelligence meant that they were often considered messengers, or manifestations of the gods, such as Bendigeidfran (Welsh for "Blessed Crow") or the Irish Morrigan (Middle Irish for "Great Queen"), both who were underworld deities that may be related to the later Arthurian Fisher King . The Welsh Dream of Rhonabwy illustrates well the association of ravens with war. In many parts of Britain, gatherings of crows, or more often magpies, are counted using the divination rhyme : " one for sorrow, two for joy, three for a girl, four for a boy, five for silver, six for gold, seven for a secret never to be told." Another rhyme is: " one for sorrow, two for mirth, three for a funeral, four for a birth, five for heaven, six for hell, and seven for the Devil, his own sel." Cornish superstition holds that when a lone magpie is encountered, it must be loudly greeted with respect. Various Germanic peoples highly revered the raven, and the raven was often depicted as a motif on shields or other war gear in Anglo-Saxon art , such as the Sutton Hoo burial, and Vendel period art. The major deity, Odin , was so commonly associated with ravens throughout history that he gained the kenning "Raven God," [lower-alpha 2] and the raven banner was the flag of various Viking Age Scandinavian chieftains. Odin was also attended by Hugin and Munin , two ravens who flew all over the world, and whispered information they acquired into his ears. The Valravn sometimes appeared in modern Scandinavian folklore. On a shield and purse lid excavated among the Sutton Hoo treasures, imagery of stylised corvids with scrolled beaks are meticulously detailed in the decorative enamel work. The corvid symbolism reflected their common totemic status to the Anglo-Saxons, whose pre-Christian indigenous beliefs were of the same origin as that of the aforementioned Vikings. The sixth century BCE Greek scribe Aesop featured corvids as intelligent antagonists in many fables. Later, in western literature, popularized by American poet Edgar Allan Poe 's work " The Raven ", the common raven becomes a symbol of the main character's descent into madness. The children's book Mrs. Frisby and the Rats of NIMH and its animated film adaptation features a protagonist crow named Jeremy.Unlike many other bird families , corvid fitness and reproduction, especially with many crows, has increased due to human development. The survival and reproductive success of certain crows and ravens is assisted by their close relationship with humans. Human development provides additional resources by clearing land, creating shrublands rich in berries and insects. When the cleared land naturally replenishes, jays and crows use the young dense trees for nesting sites. Ravens typically use larger trees in denser forest. Despite the fact that most corvids are not threatened (many even increasing due to human activity) a few species are in danger. For example, the destruction of the Southeast Asian rainforest is endangering mixed-species feeding flocks with members from the family Corvidae. Also, since its semiarid scrubland habitat is an endangered ecosystem , the Florida scrub jay has a small and declining population. A number of island species, which are more vulnerable to introduced species and habitat loss, have been driven to extinction, such as the New Zealand raven , or are threatened, like the Mariana crow . The American crow population of the United States has grown over the years. It is possible that the American crow, due to humans increasing suitable habitat, will cause Northwestern crows and fish crows to decline. FAMILY CORVIDAE

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West Nile

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Clark Middleton

Clark Tinsley Middleton (April 13, 1957 – October 4, 2020) was an American actor. He is best known for his supporting roles in Kill Bill: Vol. 2 , Sin City , Fringe , Snowpiercer , and The Blacklist .Middleton's first step toward acting was signing up for a $15 acting class with friends at a California junior college. After participating in a little bit of theater in L.A., he moved to New York City to study acting. He took classes at the Herbert Berghof Studio, and Geraldine Page became his teacher. He made his film debut in the 1983 TV movie, Miss Lonelyhearts . In 1997, Middleton wrote the one-person play, Miracle Mile, about his lifelong struggle with juvenile rheumatoid arthritis . He performed it in New York City and other parts of the US. In the 1990s, Middleton had a recurring role on Law & Order as forensics technician, Ellis. He also played a recurring character known as Edward Markham, a rare book dealer , in the science-fiction series, Fringe . Middleton appeared as a recurring cast member on The Blacklist in which he played Glen Carter, a DMV worker who moonlights as a tracker. This is arguably his most well-known role. In 2017, he was cast as Charlie, Audrey Horne 's husband, in the Showtime Network series, Twin Peaks: The Return , the sequel to the 1990s TV series, Twin Peaks . His final performance, via Zoom , was in July 2020. He played a weary Times Square hotel night clerk in Eugene O'Neill's one-act play, Hughie . He performed it from his bedroom. Following Middleton's death, his character Glen also died of West Nile virus in The Blacklist (season 8) episode 6, "The Wellstone Agency." The episode was dedicated to Middleton, and featured Huey Lewis playing himself as part of the character's memorial.Born Clark Tinsley Middleton on April 13, 1957, in Bristol, Tennessee, he grew up in Tucson, Arizona. Middleton learned that he had juvenile rheumatoid arthritis when he was four and a half years old. The doctors said he would probably not live through another winter in the cold, damp climate. He summarized its effects in an interview: "At first it distorted my hands. Then the cortisone I had to take made my cheeks fat. At 8, I lost movement in my neck. When I was 15, my hip snapped. After an operation, I had to be on crutches and later, after I broke my leg falling over my dog, on canes." He remained at a height of 5 ft 4 in (163 cm) . He married Elissa Meyers in 2006. Middleton died of complications from West Nile virus on October 4, 2020, at Cedars-Sinai Medical Center . He was 63 years old. He is survived by his wife Elissa.

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West Nile

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West Nile campaign (October 1980)

Ugandan government victory Massacres and mass displacement in West Nile Region Uganda Army Alleged support by: Zaire Sudan Saudi Arabia Uganda National Liberation Army (UNLA) Tanzania People's Defence Force (TPDF) Acholi and Langi militants c. 7,100 (total Uganda Army) c. 500 (initial attack) In October 1980, Uganda's West Nile Region was the site of a major military campaign, as Uganda Army (UA) remnants invaded from Zaire as well as Sudan and seized several major settlements, followed by a counteroffensive by the Uganda National Liberation Army (UNLA) supported by militias and Tanzanian forces. The campaign resulted in large-scale destruction and massacres of civilians, mostly perpetrated by the UNLA and allied militants, with 1,000 to 30,000 civilians killed and 250,000 displaced. The clashes mark the beginning of the Ugandan Bush War .In 1971, Ugandan President Milton Obote was overthrown in a military coup . He was succeeded by Idi Amin who established a repressive military dictatorship . Ethnic groups perceived as supportive of Obote, most importantly the Acholi and Langi , were subjected to suppression and violence by the new regime; Acholi and Langi soldiers in the Uganda Army (UA) were purged and massacred. In turn, Amin empowered natives of the West Nile Region , furthering existing ethnic tensions. Obote and other opposition members went into exile, from where they attempted to organize rebel groups. Amin was ultimately overthrown by Tanzania and the Uganda National Liberation Army (UNLA), a rebel coalition, during the Uganda–Tanzania War of 1978–79. After the Fall of Kampala , Uganda's capital, a new government led by President Yusuf Lule was formed by the Uganda National Liberation Front (UNLF) and the Tanzanians. Many Amin loyalists and Uganda Army soldiers fled to the West Nile Region which became the last part of Uganda to remain outside Tanzanian-UNLA control. When the Tanzania People's Defence Force (TPDF) moved to occupy West Nile Region, it recognized the enmity between the West Nile natives and the UNLA, as the latter largely consisted of Acholi and Langi troops. The TPDF restricted the involvement of UNLA troops during the operation. With the exception of a clash at Bondo , the TPDF encountered no resistance while securing the West Nile Region. The Tanzanians were informed by locals that instead of making a last stand in the area, thousands of Ugandan soldiers had fled to Sudan and Zaire (present-day Democratic Republic of the Congo ). Even though its troops were accused of looting, the TPDF behaved mostly disciplined in the West Nile Region, and made an effort to improve the security. Many civilian refugees consequently returned, hoping that they would be left alone. However, tribal militias and UNLA troops soon moved into the area, and started to attack local communities, seeking revenge for the abuses committed by Amin's regime. The unrest and dissatisfaction was furthered by the UNLF government's refusal to employ Amin-era soldiers in its armed forces, forcing most ex-UA members to seek new jobs or join the Amin loyalists in exile. UNLA and TPDF soldiers also intimidated, arrested, harassed, and killed former UA soldiers, in addition to confiscating and destroying property belonging to ex-soldiers including houses, schools, and hospitals. Many West Nile natives consequently resented the new authorities, feeling marginalized, unsafe, and wishing for revenge. At the same time, Uganda became embroiled in a political crisis, as President Lule struggled with other political figures and the UNLA for control. As he tried to exert his powers and circumvent the UNLF's powerful National Consultative Committee, the latter removed him from office on 20 June 1979. Lule was replaced by Godfrey Binaisa who lacked his own power base. In May 1980, Binaisa was also deposed and Uganda fell under the control of the UNLF's Military Commission that was supposed to rule until the scheduled December 1980 general election . Both Lule as well as Binaisa had tried to limit the violent abuses in the West Nile Region, with the former ordering the Tanzanians to only station "moderate and unprejudiced soldiers" there. With these two removed from power, extremist Acholi and Langi factions grew in influence. The situation was further complicated by the upcoming elections, as political parties and various factions struggled to rally supporters, intimidate opponents, and gain possible legal as well illegal advantages. Ex-President Obote returned to Uganda and began reorganising the Uganda People's Congress (UPC) in preparation for general elections. The Uganda Army remnants in Sudan and Zaire intended to launch an insurgency and retake Uganda. Many ex-soldiers started to operate as bandits, crossing the borders into Uganda to plunder. Groups of UA raiders were active in Karamoja as well as the West Nile Region. In the latter region, the situation initially remained under control, as the TPDF garrisons were capable of easily eliminating UA groups. However, the TPDF was trying to reduce its presence, and gradually handed over responsibility for the West Nile Region to the UNLF government's security forces in April 1980. Even though the UNLF's Military Commission supported the move and wanted the TPDF troops transferred to other areas, the handover was hampered by the UNLA soldiers' reluctance to engage the UA raiders in combat. UNLA patrols repeatedly fled without firing their weapons upon encountering smaller UA groups. To the frustration of Tanzanian officers, UNLA soldiers reasoned that the TPDF had been "hired" to take care of the Uganda Army, making them unwilling to risk their lives in battle. The new UNLA garrisons also behaved much more brutally toward the West Nile Region's population. According to researcher A. Kasozi, an assassination attempt on Obote during an election campaign rally at the town of Koboko in August 1980 provoked harsh repression by the UNLA and Acholi/Langi militias, furthering the local discontent. By August and September 1980, the UA remnants were banding together in Sudan and Zaire and preparing a full invasion of the West Nile Region. [lower-alpha 1] Their 7,100-strong force never adopted an official name, but is generally called "Uganda Army" as it consisted for the most part of old troops of Amin's Uganda Army (it was also known as "West Front" or "Western Nile Front"). Even though ex-UA chief of staff Isaac Lumago later claimed that the UA had remained structurally "intact" in exile, the rebels factually operated as independent bands that were loyal to numerous officers who had previously served under Amin such as Emilio Mondo , Isaac Lumago, Isaac Maliyamungu , Elly Hassan , Christopher Mawadri , and Moses Ali . These bands had no political program, and were primarily motivated by the "feeling of insecurity and revenge" among West Nile natives. Journalists Tony Avirgan and Martha Honey disparagingly described the rebels as "nothing more than a large pack of looters and bandits". Having announced his intention to eventually resume power in Uganda, Amin arranged for the Uganda Army remnants to receive money from Saudi Arabia in preparation for the planned cross-border attack. The Ugandan government would later claim that the pro-Amin forces were supported by Zaire, Sudan, and Saudi Arabia. Juma Oris , an Amin loyalist who played a major role in setting up the rebel coalition, was known to have good contacts to the Sudanese security services. On 6 October, one week before the offensive was to commence, about 500 UA rebels crossed the border and attacked Koboko. The 200-strong UNLA garrison was on parade at the time and was unarmed; the rebels massacred the soldiers. One local civilian and the Makerere University 's Refugee Law Project later reported that the insurgents also assaulted other towns such as Aringa, Yumbe , and Bondo around the same time. Word of the attacks quickly spread to other UNLA garrisons in West Nile, who then fled to the Nile River, leaving the Uganda Army's advance mostly unopposed. Many UNLA troops initially sought refuge at Bondo where one of the region's main barracks was located. Eventually, five UA detachments attacked Bondo in force; according to researchers Tom Cooper and Adrien Fontanellaz, this operation took place on 8 October. The local UNLA troops were again caught by surprise during a morning parade; most were killed, and the rest fled in disarray. The rebels were welcomed by much of the local population, although many civilians fled across the borders to Sudan and Zaire, considering the UA militants little better than the pro-government forces. On 8 or 9 October, Arua as well as its airport were reportedly attacked and conquered by a combined force coming from Sudan and Zaire; after it fell, the civilians initially hailed the UA troops "liberators". To the frustration of the locals, however, the invaders immediately started to loot coffee and transport it abroad. This incident greatly damaged the insurgents' reputation among the civilians, and different rebel groups would later blame each other for the looting. The insurgents also assaulted and burned down Moyo . Kasozi stated that the local UNLA battalion had already fled at this point, whereas the Makerere University's Refugee Law Project claimed that the town's UNLA garrison was overrun by UA forces. Terego , Maracha , and Oraba were also captured by the insurgents. By mid-October, Ugandan government officials believed Koboko, Arua, Bondo, Moyo, and Lodonga to be controlled by the rebel troops. The Minority Rights Group International and Kasozi argued that there was a "popular uprising" in support of the invasion, and many settlements actually fell to revolting locals instead of the rebels. As the insurgents knew that they could not hold the captured territory against a full UNLA counter-offensive, they mostly retreated back into Sudan after a few days with a large amount of loot. East of the Nile, the invasion caused fighting between armed Madi and Acholi civilians. In response to the invasion, the UNLA commandeered vehicles in the capital Kampala , while Minister of Foreign Affairs Otema Allimadi handed a diplomatic note of protest to the ambassadors of Zaire and Sudan. Military police personnel set up posts at all roads leading out of the West Nile Region to stop the fleeing UNLA soldiers. You, who have made us suffer, now it is your turn to die. — Acholi UNLA soldier to a Lugbara during the campaign The UNLA began its counteroffensive on 12 October accompanied by TPDF troops, advancing from Pakwach northward. This force was backed by thousands of Acholi and Langi militants and "volunteers", including the Kitgum militia. The latter group was an exclusively Acholi private army , regarded as sympathetic toward the UPC. The counteroffensive only encountered significant resistance at Bondo, where six Tanzanians were killed during an eight-hour battle. Lieutenant Colonel Elly Aseni was among the Uganda Army fighters who died in combat near Bondo. Even though the rebels had mostly fled, the UNLA began brutal reprisals. Considering the local population hostile, UNLA troops engaged in a campaign of destruction and looting across the West Nile, while Tanzanian officers tried in vain to restrain them. Many settlements in the region were torched, women raped, grain storages destroyed, and civilians driven into huts which were set on fire. Everything portable was carried away by the troops and militiamen. UNLA soldiers leveled the town of Arua, reportedly leaving only its Catholic Cathedral standing. A TPDF soldier stated that when he and his comrades arrived at the town, it had been "wiped out" by UNLA soldiers and entirely depopulated, with women, children, and even dogs shot dead and left rotting in the streets. The destruction was only halted when Tanzanian troops intervened. The punitive expedition also targeted the territories inhabited by the Madi, namely Moyo and the areas east of the Nile. In Moyo, UNLA soldiers were reportedly seen walking around with the cut-off genitals of their victims at their belts, while east of the river militiamen and their families plundered and stole cattle. The UNLA soldiers even crossed the border to Zaire in pursuit of the insurgents, clashing with UA guerrillas "near" Isiro . Instead of evicting the Ugandan intruders or stopping the clashes, the local Zairian Armed Forces ( Forces Armées Zaïroises , FAZ) garrison fled westward. However, UNLA's attempt to dislodge the UA remnants from the Sudanese border town of Kaya failed, allowing it to remain a "rebel stronghold" from where the insurgents could strike into Uganda and set up ambushes at the Kaya-Oraba road. The exact civilian death toll of the UNLA counter-attack remains unknown. Estimates ranged from 1,000 to 30,000. Among the victims were Martin Okwera, Uganda Airlines branch manager for Arua, and his entire family of ten as well as relatives of cabinet members Anthony Ochaya and Moses Apiliga. The brutality of the UNLA provoked the flight of over 250,000 refugees to Sudan and Zaire, and inspired further unrest, as peasants and ex-soldiers took up arms to defend their lands from the government forces. Amid the unrest, communication between the West Nile Region and the outside world largely collapsed. On 6 October, one week before the offensive was to commence, about 500 UA rebels crossed the border and attacked Koboko. The 200-strong UNLA garrison was on parade at the time and was unarmed; the rebels massacred the soldiers. One local civilian and the Makerere University 's Refugee Law Project later reported that the insurgents also assaulted other towns such as Aringa, Yumbe , and Bondo around the same time. Word of the attacks quickly spread to other UNLA garrisons in West Nile, who then fled to the Nile River, leaving the Uganda Army's advance mostly unopposed. Many UNLA troops initially sought refuge at Bondo where one of the region's main barracks was located. Eventually, five UA detachments attacked Bondo in force; according to researchers Tom Cooper and Adrien Fontanellaz, this operation took place on 8 October. The local UNLA troops were again caught by surprise during a morning parade; most were killed, and the rest fled in disarray. The rebels were welcomed by much of the local population, although many civilians fled across the borders to Sudan and Zaire, considering the UA militants little better than the pro-government forces. On 8 or 9 October, Arua as well as its airport were reportedly attacked and conquered by a combined force coming from Sudan and Zaire; after it fell, the civilians initially hailed the UA troops "liberators". To the frustration of the locals, however, the invaders immediately started to loot coffee and transport it abroad. This incident greatly damaged the insurgents' reputation among the civilians, and different rebel groups would later blame each other for the looting. The insurgents also assaulted and burned down Moyo . Kasozi stated that the local UNLA battalion had already fled at this point, whereas the Makerere University's Refugee Law Project claimed that the town's UNLA garrison was overrun by UA forces. Terego , Maracha , and Oraba were also captured by the insurgents. By mid-October, Ugandan government officials believed Koboko, Arua, Bondo, Moyo, and Lodonga to be controlled by the rebel troops. The Minority Rights Group International and Kasozi argued that there was a "popular uprising" in support of the invasion, and many settlements actually fell to revolting locals instead of the rebels. As the insurgents knew that they could not hold the captured territory against a full UNLA counter-offensive, they mostly retreated back into Sudan after a few days with a large amount of loot. East of the Nile, the invasion caused fighting between armed Madi and Acholi civilians. In response to the invasion, the UNLA commandeered vehicles in the capital Kampala , while Minister of Foreign Affairs Otema Allimadi handed a diplomatic note of protest to the ambassadors of Zaire and Sudan. Military police personnel set up posts at all roads leading out of the West Nile Region to stop the fleeing UNLA soldiers. You, who have made us suffer, now it is your turn to die. — Acholi UNLA soldier to a Lugbara during the campaign The UNLA began its counteroffensive on 12 October accompanied by TPDF troops, advancing from Pakwach northward. This force was backed by thousands of Acholi and Langi militants and "volunteers", including the Kitgum militia. The latter group was an exclusively Acholi private army , regarded as sympathetic toward the UPC. The counteroffensive only encountered significant resistance at Bondo, where six Tanzanians were killed during an eight-hour battle. Lieutenant Colonel Elly Aseni was among the Uganda Army fighters who died in combat near Bondo. Even though the rebels had mostly fled, the UNLA began brutal reprisals. Considering the local population hostile, UNLA troops engaged in a campaign of destruction and looting across the West Nile, while Tanzanian officers tried in vain to restrain them. Many settlements in the region were torched, women raped, grain storages destroyed, and civilians driven into huts which were set on fire. Everything portable was carried away by the troops and militiamen. UNLA soldiers leveled the town of Arua, reportedly leaving only its Catholic Cathedral standing. A TPDF soldier stated that when he and his comrades arrived at the town, it had been "wiped out" by UNLA soldiers and entirely depopulated, with women, children, and even dogs shot dead and left rotting in the streets. The destruction was only halted when Tanzanian troops intervened. The punitive expedition also targeted the territories inhabited by the Madi, namely Moyo and the areas east of the Nile. In Moyo, UNLA soldiers were reportedly seen walking around with the cut-off genitals of their victims at their belts, while east of the river militiamen and their families plundered and stole cattle. The UNLA soldiers even crossed the border to Zaire in pursuit of the insurgents, clashing with UA guerrillas "near" Isiro . Instead of evicting the Ugandan intruders or stopping the clashes, the local Zairian Armed Forces ( Forces Armées Zaïroises , FAZ) garrison fled westward. However, UNLA's attempt to dislodge the UA remnants from the Sudanese border town of Kaya failed, allowing it to remain a "rebel stronghold" from where the insurgents could strike into Uganda and set up ambushes at the Kaya-Oraba road. The exact civilian death toll of the UNLA counter-attack remains unknown. Estimates ranged from 1,000 to 30,000. Among the victims were Martin Okwera, Uganda Airlines branch manager for Arua, and his entire family of ten as well as relatives of cabinet members Anthony Ochaya and Moses Apiliga. The brutality of the UNLA provoked the flight of over 250,000 refugees to Sudan and Zaire, and inspired further unrest, as peasants and ex-soldiers took up arms to defend their lands from the government forces. Amid the unrest, communication between the West Nile Region and the outside world largely collapsed. Following the October invasion, Tanzanian Foreign Minister Benjamin Mkapa flew to Kampala and met with the Military Commission, informing them of the Tanzanian government's "dismay" at the widespread destruction committed by UNLA in the West Nile Region. The Ugandan government sent Ministers Apiliga and Anthony Butele to investigate the situation in West Nile. They toured the region from October to November 1980, and wrote a report that detailed the massive damage as well as the brutality of the UNLA, commenting that "most civilians are shot on sight". Even though this report was seconded by other government officials who visited the region in the next months, the Ugandan government arrested Uganda Times journalist Ben Bella Elakut for writing about the massacres. One UNLA officer, Lieutenant Colonel Ojul, was arrested due to his involvement in the massacres around Moyo, but quickly released. Researcher Gardener Thompson concluded that the UNLF government, "if not directly sponsored [the massacre], evidently condoned" it. The chaos in the West Nile Region severely disrupted the local preparations for the upcoming elections. Voter registration in the area had been scheduled for 6 October, but consequently became impossible, as did any meaningful elections. The UPC took advantage of the chaos: First, election officials accepted the UPC candidates and disqualified all candidates of other parties, most importantly the Democratic Party . When they tried to register, DP candidates were denied the usual security measures by the authorities, and instead arrested and harassed by UNLA soldiers and militiamen based on suspicions that they were rebel supporters. Their registrations were also shut down based on a lack of tax documents, despite these having been destroyed during the fighting. Secondly, the lack of voter registration meant that there were no actual elections in West Nile, yet the UPC parliamentary candidates were declared the unopposed winners of the local constituencies. Aided by these and other irregularities, the UPC won the December 1980 elections, and formed a government with Milton Obote as president. The international Commonwealth Observer Groups sent to observe the election criticized the exclusion of DP candidates for the West Nile election, but did not mention the fighting and massacre at all, and overall praised the election's conduct. The results were strongly disputed by other candidates, leading to increasing strife. Several political factions claimed electoral fraud , and believed themselves to be proven correct when Obote immediately launched a campaign of political repression. In 1981, President Obote expressed "pride" at the massacre in the West Nile Region, and warned the Baganda people that the same could happen to them. The October campaign in West Nile marked the de facto beginning of the Ugandan Bush War, a civil war which would last until 1985. Following the disputed elections, the northern rebellion would be joined by insurgencies in southern Uganda, organized by anti-Obote opposition groups. The Uganda Army launched its next offensive just before the December 1980 elections. In one of their most daring actions, the rebels ambushed Obote as he was touring the West Nile region. They almost killed him and Tito Okello , a high-ranking UNLA commander. This time, the Uganda Army also held the areas it captured in West Nile, and set up a parallel government after retaking Koboko. After about one month of combat, the insurgents had captured most of West Nile, leaving only some towns under UNLA control. However, many rebels focused more on looting the area and taking the plunder back to Zaire and Sudan than on fighting the UNLA. In addition, political differences began to emerge among the rebels, and the Uganda Army fully fractured into two rival movements, known as the Former Uganda National Army (FUNA) and Uganda National Rescue Front (UNRF). By February 1981, the two groups were fighting each other. Meanwhile, Acholi militiamen committed further massacres in the Madi-inhabited areas in February and March 1981, even as UNLA control eroded in the area. When the last Tanzanian troops left Uganda in October 1981, the rebels made larger incursions into the West Nile District. Heavy fighting continued and caused further damage to the area. By September 1981, at least 140,000 Ugandan refugees had relocated to the Zairian border town of Aru , while 250,000 had fled to Sudan. Large sections of the West Nile Region were depopulated, and Arua remained in ruins. The Ugandan government was not able to contain the West Nile insurgency until 1982. Following the October invasion, Tanzanian Foreign Minister Benjamin Mkapa flew to Kampala and met with the Military Commission, informing them of the Tanzanian government's "dismay" at the widespread destruction committed by UNLA in the West Nile Region. The Ugandan government sent Ministers Apiliga and Anthony Butele to investigate the situation in West Nile. They toured the region from October to November 1980, and wrote a report that detailed the massive damage as well as the brutality of the UNLA, commenting that "most civilians are shot on sight". Even though this report was seconded by other government officials who visited the region in the next months, the Ugandan government arrested Uganda Times journalist Ben Bella Elakut for writing about the massacres. One UNLA officer, Lieutenant Colonel Ojul, was arrested due to his involvement in the massacres around Moyo, but quickly released. Researcher Gardener Thompson concluded that the UNLF government, "if not directly sponsored [the massacre], evidently condoned" it. The chaos in the West Nile Region severely disrupted the local preparations for the upcoming elections. Voter registration in the area had been scheduled for 6 October, but consequently became impossible, as did any meaningful elections. The UPC took advantage of the chaos: First, election officials accepted the UPC candidates and disqualified all candidates of other parties, most importantly the Democratic Party . When they tried to register, DP candidates were denied the usual security measures by the authorities, and instead arrested and harassed by UNLA soldiers and militiamen based on suspicions that they were rebel supporters. Their registrations were also shut down based on a lack of tax documents, despite these having been destroyed during the fighting. Secondly, the lack of voter registration meant that there were no actual elections in West Nile, yet the UPC parliamentary candidates were declared the unopposed winners of the local constituencies. Aided by these and other irregularities, the UPC won the December 1980 elections, and formed a government with Milton Obote as president. The international Commonwealth Observer Groups sent to observe the election criticized the exclusion of DP candidates for the West Nile election, but did not mention the fighting and massacre at all, and overall praised the election's conduct. The results were strongly disputed by other candidates, leading to increasing strife. Several political factions claimed electoral fraud , and believed themselves to be proven correct when Obote immediately launched a campaign of political repression. In 1981, President Obote expressed "pride" at the massacre in the West Nile Region, and warned the Baganda people that the same could happen to them. The October campaign in West Nile marked the de facto beginning of the Ugandan Bush War, a civil war which would last until 1985. Following the disputed elections, the northern rebellion would be joined by insurgencies in southern Uganda, organized by anti-Obote opposition groups. The Uganda Army launched its next offensive just before the December 1980 elections. In one of their most daring actions, the rebels ambushed Obote as he was touring the West Nile region. They almost killed him and Tito Okello , a high-ranking UNLA commander. This time, the Uganda Army also held the areas it captured in West Nile, and set up a parallel government after retaking Koboko. After about one month of combat, the insurgents had captured most of West Nile, leaving only some towns under UNLA control. However, many rebels focused more on looting the area and taking the plunder back to Zaire and Sudan than on fighting the UNLA. In addition, political differences began to emerge among the rebels, and the Uganda Army fully fractured into two rival movements, known as the Former Uganda National Army (FUNA) and Uganda National Rescue Front (UNRF). By February 1981, the two groups were fighting each other. Meanwhile, Acholi militiamen committed further massacres in the Madi-inhabited areas in February and March 1981, even as UNLA control eroded in the area. When the last Tanzanian troops left Uganda in October 1981, the rebels made larger incursions into the West Nile District. Heavy fighting continued and caused further damage to the area. By September 1981, at least 140,000 Ugandan refugees had relocated to the Zairian border town of Aru , while 250,000 had fled to Sudan. Large sections of the West Nile Region were depopulated, and Arua remained in ruins. The Ugandan government was not able to contain the West Nile insurgency until 1982.

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West Nile

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Anglican dioceses of Northern Uganda

The Anglican dioceses of Northern Uganda are the Anglican presence in (roughly) the Northern Region, Uganda ; they are part of the Church of Uganda . The remaining dioceses of the Church are in the areas of Buganda , of Eastern Uganda , of Ankole and Kigezi , and of Rwenzori .The first diocese to be erected in this area was that called simply the Diocese of Northern Uganda , which was split from the Diocese on the Upper Nile in 1961. Today the mother church is St Philip's Cathedral, Gulu . 1964–1966: Silvanus Wani, assistant bishop Allan Oboma, assistant bishop 1964–1966: Silvanus Wani, assistant bishop Allan Oboma, assistant bishop Erected from Northern Uganda diocese in 1969; See at Emmanuel Cathedral, Mvara (near Arua ). Split in 1976 from the Diocese of Soroti ; St Philip's Cathedral, Moroto .Erected from Northern Uganda, 1976; Lira Cathedral.Created in 1993 from the Diocese of Madi—West Nile; St Stephen's Cathedral, Goli .Created in 1995 from Northern Uganda diocese; the See is Kitgum , where stands All Saints' Cathedral.Christ Church Cathedral, Kotido is the mother church of this diocese, erected from Karamoja in 2007.Split from Lango diocese, 2014; St Peter's Cathedral, Aduku .

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West Nile

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Nile Rodgers

Record producer composer musician songwriter philanthropist Guitar vocals Nile Gregory Rodgers Jr. (born September 19, 1952) is an American record producer, guitarist, composer, and philanthropist. The co-founder of Chic , he has written, produced, and performed on records that have sold more than 500 million albums and 75 million singles worldwide. Rodgers is a Rock and Roll Hall of Fame and Songwriters Hall of Fame inductee. He has received six Grammy Awards , including the Grammy Lifetime Achievement/Special Merit Award . Known for his chucking guitar style, in 2014 Rolling Stone wrote that "the full scope of Nile Rodgers' career is still hard to fathom". In 2023, Rolling Stone placed Rodgers 7th on a list of the 250 greatest guitarists of all time, writing: "There's 'influential,' then there's 'massively influential', then there's Nile Rodgers... a true innovator who never slows down, still making history with his guitar." Formed as the Big Apple Band in 1972 with bassist Bernard Edwards , Chic released their self-titled debut album in 1977; it featured the hit singles " Dance, Dance, Dance (Yowsah, Yowsah, Yowsah) " and " Everybody Dance ". The 1978 album C'est Chic included " I Want Your Love " and " Le Freak ", with the latter selling more than seven million singles worldwide. The song " Good Times " from the 1979 album Risqué was a number one single on the pop and soul charts, and became one of the most-sampled songs of all time, predominantly in hip-hop, starting with the Sugarhill Gang 's " Rapper's Delight ". With Edwards, Rodgers wrote and produced music for other artists, including the songs " He's the Greatest Dancer " and " We Are Family " (for Sister Sledge ) and " I'm Coming Out " and " Upside Down " (for Diana Ross ). After Chic's breakup in 1983, Rodgers produced albums and singles for other artists, including David Bowie 's Let's Dance ; " Original Sin " by INXS ; Duran Duran 's " The Reflex " and " Notorious "; and Madonna 's Like a Virgin . He worked with artists including The B-52s , Jeff Beck , Daft Punk , Mick Jagger , Grace Jones , The Vaughan Brothers , Bryan Ferry , Christina Aguilera and Lady Gaga . He won three Grammy Awards in 2014 for his work on Daft Punk 's Random Access Memories , and two in 2023 for his work with Beyoncé on her album Renaissance . In 2018, Rodgers co-founded Hipgnosis Songs Fund , a publicly traded music intellectual property investment company.Rodgers was born on September 19, 1952, in the Lower East Side , New York City , to Beverly Goodman. She gave birth to Rodgers when she was 14. His biological father, Nile Rodgers Sr., was a travelling percussionist who specialized in Afro-Cuban beats and was rarely present as Rodgers grew up; although influential in his life, Rodgers saw his father only a "handful" of times prior to his death in 1970. In 1959, Goodman married Bobby Glanzrock. Rodgers described Glanzrock in his 2011 autobiography as a " beatnik PhD, whose observations had angles that would make Miles Davis contemplate his cool." Richard Pryor , Thelonious Monk , and Lenny Bruce often visited their home in Greenwich Village . Glanzrock and Goodman were addicted to heroin , and Rodgers began using drugs at 13. Before learning to play the guitar at 16, Rodgers played the flute and the clarinet . As a teenager, he played guitar with African, Persian, Latin, jazz and Boogaloo bands. He became a subsection leader of the Lower Manhattan branch of the New York Black Panther Party . He was raised as a Catholic . Rodgers' cousin, trumpeter Robert "Spike" Mickens, was a member of Kool and the Gang from 1964 to 1986. Rodgers met bassist Bernard Edwards in 1970 while working as a touring musician for the Sesame Street stage show. Together they formed The Big Apple Band and initially worked as back-up musicians for the vocal group New York City (" I'm Doin' Fine Now "). New York City's one hit allowed them to tour extensively, opening for The Jackson 5 on the American leg of their first world tour in 1973. The band dissolved after their second album failed to yield a hit. Rodgers and Edwards subsequently joined forces with drummer Tony Thompson to form The Boys, playing gigs up and down the East Coast. Although there was label interest, record companies passed on the band after discovering its members were black, believing that black rock artists would be too hard to promote. As the Big Apple Band, Rodgers and Edwards worked with Ashford & Simpson and Luther Vandross , among others. Since another New York artist, Walter Murphy , had a band called The Big Apple Band, in 1977 Rodgers and Edwards changed the band's name to Chic. [ citation needed ] Inspired by Roxy Music , Chic developed a sound that was a fusion of jazz, soul, and funk grooves with melodies and lyrics with a European influence. Between gigs, they recorded the song "Dance, Dance, Dance", with then-boss Luther Vandross on vocals. Originally released by Buddah Records , it was a hit when it was re-released by Atlantic in the summer of 1977. Atlantic picked up an album option with Rodgers and Edwards, who quickly wrote more songs, and Chic's self-titled debut was released in November. The band scored numerous top ten hits, including " Le Freak ", " I Want Your Love ", " Everybody Dance ", " Dance, Dance, Dance (Yowsah, Yowsah, Yowsah) ", " My Forbidden Lover ", and " Good Times " becoming club/pop/R&B standards. "Le Freak" was Atlantic Records ' only triple platinum selling single at the time, and "Good Times" shot to No. 1 in August 1979 despite that year's " Disco Sucks " campaign. The success of Chic's first singles led Atlantic to offer Rodgers and Edwards the opportunity to produce any act on its roster. They chose Sister Sledge , whose 1979 album, We Are Family , hit #3 on the Billboard charts, charting well into 1980. The first two singles, " He's the Greatest Dancer " and the title cut " We Are Family " both reached No. 1 on the R&B chart, and No. 6 and No. 2, respectively on the pop chart. In April 2018, "We Are Family" was selected to be preserved in the Library of Congress. The 1979 disco backlash derailed Chic, and Edwards retreated from work, while Rodgers' drug use accelerated. Rodgers and Edwards delivered their final Atlantic album under contract, Believer , in 1982. They completed one of their last projects together in 1980, writing and producing the album Diana for Diana Ross , which yielded the hits " Upside Down " and " I'm Coming Out ". They produced Deborah Harry 's 1981 solo album Koo Koo , and produced the hit "Spacer" for the French disco act Sheila and B. Devotion . During the same time period, Chic's song " Good Times " was sampled on The Sugarhill Gang 's " Rapper's Delight ", the first multiple-platinum hip hop single. The song continued to influence the sounds of others, including Queen , with the 1980 hit "Another One Bites the Dust" and Blondie , who had a #1 hit with "Rapture". Following Chic's breakup, Rodgers released his first solo album, Adventures in the Land of the Good Groove . With Chic no longer occupying most of his time, Rodgers was free to focus on working with other artists. He produced David Bowie's biggest selling album, Let's Dance , which yielded the hit singles "Let's Dance", "China Girl", and "Modern Love". He produced the single "Original Sin" by INXS , and in 1984, he produced Madonna 's album Like a Virgin , which scored four hit singles including its title track, " Material Girl ", and "Dress You Up". He worked extensively with Duran Duran , remixing their biggest-selling single, "The Reflex", producing "Wild Boys" on their 1984 live album, Arena , and co-producing the album Notorious . In 1985, Rodgers produced albums for Sheena Easton , Jeff Beck , Thompson Twins , Mick Jagger , and others, and performed at Live Aid with Madonna and the Thompson Twins. He was named the #1 Singles Producer in the World by Billboard at the end of the year. At the end of the decade, he produced albums for Grace Jones , Al Jarreau ( L is for Lover ), Earth Wind and Fire 's vocalist Philip Bailey , and performed on " Higher Love " with Steve Winwood , as well as on records for Cyndi Lauper , and others. In 1989, he co-produced the B-52's multi-platinum album Cosmic Thing ; it reached No. 4 on the Billboard 200 album chart, and yielded the singles "Love Shack", and "Roam". He produced Workin' Overtime , Diana Ross ' return to Motown , and the soundtracks for Alphabet City , Gremlins , White Nights , [ better source needed ] and The Fly . [ better source needed ] He later composed an orchestral soundtrack, his first, for the film Coming to America . Rodgers formed the short-lived experimental band Outloud in 1987, with David Letterman 's guitarist, composer, and vocalist Felicia Collins and French session musician, producer, composer, and keyboardist Philippe Saisse ; the trio released a single album, Out Loud , on Warner Bros. Records . In September 1990, shortly after the death of Stevie Ray Vaughan , the Rodgers-produced Vaughan Brothers album Family Style was released. He produced records for David Bowie , Eric Clapton , The B-52s , David Lee Roth , Ric Ocasek , The Stray Cats and others early in the decade, and worked on the soundtracks for Thelma and Louise , Cool World , and The Beavis and Butt-head Experience . Rodgers and Edwards reformed Chic in 1992 and recorded new material for the album Chic-Ism . In 1996, they released a Japan-only album consisting of old Chic material rerecorded with guest vocalists, Chic Freak and More Treats . Edwards and Rodgers performed with Sister Sledge , Steve Winwood , and Slash in a series of commemorative concerts in Japan. Edwards died following a concert on April 17, 1996. Rodgers discovered his body. He later said that he "cried like a baby and suffered intensely but eventually realised the best tribute to him would be to carry on and be the best I could be." A year later, Rodgers returned to Japan to pay homage to Edwards, and in 1999, Rodgers released Live at the Budokan , a live recording of Edwards' final performance. The album was not overdubbed or changed in order to keep the recording pure. Rodgers started playing live concerts again while composing and producing music for the film soundtracks Beverly Hills Cop III , Blue Chips , The Flintstones and Feeling Minnesota , working with Bob Dylan , among others. In 1997, The Notorious B.I.G. released " Mo Money Mo Problems " sampling Rodgers and Edwards' song " I'm Coming Out " from Diana Ross's platinum album Diana . "Mo Money, Mo Problems" topped the Billboard Hot 100 for two weeks and was nominated for the 1998 Grammy Award for Best Rap Performance by a Duo or Group . In 1998, Rodgers founded Sumthing Else Music Works record label and Sumthing Distribution , an independent music label distributor. Sumthing focused on distributing video game soundtracks, and released the world's first 5.1 surround DVD game-soundtrack album. Its titles include the Halo , Resident Evil , Gears of War and Borderlands series. In the early 2000s, Rodgers worked extensively on film and video game soundtracks, including Halo 2 , Rush Hour 2 , Snow Dogs , [ better source needed ] and Semi-Pro starring Will Ferrell , who co-wrote the title song " Love Me Sexy " with Rodgers. In 2002, Rodgers returned to work again with the original five members of Duran Duran when he co-produced Astronaut . The album rose to No. 3 in the UK. Following the September 11 attacks , Rodgers brought together more than 200 musicians and celebrities to record "We Are Family". It was recorded in New York at Avatar Studios (previously The Power Station, where the original recording of "We Are Family" took place in 1978), and in Los Angeles at the Record Plant . The accompanying music video was directed by Spike Lee . An 80-minute documentary, The Making and Meaning of We Are Family , directed by Danny Schechter , premiered at the Sundance Film Festival in 2002. In a collaboration between Disney , Nickelodeon and PBS , more than 100 children's television characters participated in a "We Are Family" children's music video, and on March 11, 2002, Disney Channel, Nickelodeon and PBS aired the video to promote tolerance and diversity on the 6-month anniversary of 9/11. In July 2002, Rodgers co-founded the We Are Family Foundation with his life partner, Nancy Hunt. A non-profit organization that promotes "cultural diversity while nurturing and mentoring the vision, talents, and ideas of young people who are positively changing the world", it is dedicated to the vision of a global family. In 2010, Rhino Records released a four-CD box set , Nile Rodgers Presents The Chic Organization, Volume 1: Savoir Faire , which for the first time collected tracks from all of the acts produced by The Chic Organization up to their original break-up in 1983. Rodgers provided liner notes for the set, which was also reissued in 2013. Rodgers' critically acclaimed autobiography, Le Freak: An Upside Down Story of Family, Disco, and Destiny was published by Spiegel & Grau , a Random House imprint, in late 2011. It was named one of the top 10 of the 25 Greatest Rock Memoirs of All Time by Rolling Stone . In February 2012, Rodgers announced that he was collaborating with electronic band Daft Punk for their latest album, "teasing out their R&B influences". The record, Random Access Memories was released in 2013. Rodgers co-wrote and played guitar on three tracks: " Give Life Back to Music ", " Lose Yourself to Dance ", and " Get Lucky ". In April, "Get Lucky" entered the UK Singles Chart at No. 3, only 24 hours after its release, and two weeks later rose to No. 1. In an interview with Official Charts Company , Rodgers said, "I've had big records and Number 1s; I have had records that were Number 1 in the United States but nowhere else ... I've had records which have done well [in the UK], but not in the States. But to have this ubiquitous record, that is a hit everywhere ... It's amazing to me! I'm out on the road and I can hear it wherever I go. I'm flabbergasted!" "Get Lucky" became one of the UK's biggest-selling singles of all time. Rhino Records released Nile Rodgers Presents The Chic Organization Up All Night (The Greatest Hits) , a compilation album featuring songs written, played or produced by Rodgers and Bernard Edwards for Chic and various artists, including Diana Ross, Sister Sledge, Carly Simon, Debbie Harry, Johnny Mathis, Sheila & B. Devotion and Norma Jean Wright. Up All Night reached No. 2 on the UK Compilation Album Chart for the week ending July 13, 2013. In October 2013, Rhino released Nile Rodgers Presents The Chic Organization Up All Night (The Greatest Hits Disco Edition) , which included a medley taken from Chic ft. Nile Rodgers' live performance at the 2013 Glastonbury Festival . Rodgers and Bernard Edwards were nominated to the Songwriters Hall of Fame in October 2013. In January 2014, Rodgers performed "Get Lucky" with Daft Punk on the Grammy Awards, along with Pharrell Williams and Stevie Wonder , with a medley including elements of Chic's " Le Freak " and Wonder's " Another Star ". Rodgers won three Grammy Awards for his work with Daft Punk on Random Access Memories , including Best Pop Duo/Group Performance, Record of the Year and Album of the Year. In March, Rolling Stone named Rodgers one of the 50 Most Important People in EDM, stating, "The full scope of Nile Rodgers' career is still hard to fathom, and it's not just ongoing, it's in overdrive." In December, NARAS announced that "Le Freak" would be inducted into The Grammy Hall of Fame. Rodgers' solo single "Do What You Wanna Do ( IMS Anthem)" was released on August 10, 2014 to benefit the We Are Family Foundation. A year later, in March 2015, Rodgers released Chic 's first single in more than 23 years, " I'll Be There ", with a live streamed concert from The Roundhouse in London. The song was produced using original Chic outtake tapes from the 70s, with Bernard Edwards , Tony Thompson , and vocalists Alfa Anderson and Luci Martin. The song went to #1 on Billboard's Dance Music Chart on June 20, 2015. In August, Rodgers launched FOLD Festival (FreakOut! Let's Dance), a multi-day event with a diverse line-up of artists including Beck , Duran Duran , Chaka Khan , Keith Urban , Janelle Monáe , Ginger Minj , Chic and others. Rodgers collaborated with Lady Gaga to remake Chic's hit, "I Want Your Love" for Tom Ford 's Spring/Summer 2016 collection video in lieu of a fashion show. Rodgers and Bernard Edwards were inducted into the Songwriters Hall of Fame on June 9, 2016. In 2017, after 11 nominations for Chic, Rodgers was inducted into the Rock and Roll Hall of Fame with an award for Musical Excellence. "It's sort of bittersweet," says Rodgers. "I'm quite flattered that they believed that I was worthy, but my band Chic didn't win. They plucked me out of the band and said, 'You're better than Chic.' That's wacky to me ... I am flattered and I think it's cool, but I feel like somebody put me in the lifeboat and told my family they can't get in." On the evening of 25th June 2017, Rodgers and Chic returned to the Glastonbury Festival , as headliners on the Pyramid Stage, for an audience of close to 100,000. In September of the same year, a version of George Michael's song " Fantasy " was released, credited to "George Michael featuring Nile Rodgers." The track, released as a B-side by Michael's label in 1990, was reworked by Rodgers and featured him prominently on guitar. It was Michael's only posthumous release. In June 2018, "Till the World Falls", the first single from Nile Rodgers & Chic's first album since 1992, It's About Time , was released. The song featured Mura Masa , Cosha and Vic Mensa . The album was released in September 2018, and hit the Top 10 in the UK. It was the first Chic record to hit the Top 10 in 25 years. Two singles from the album were subsequently released: "Sober" featuring Craig David and Stefflon Don , and "Do You Wanna Party" featuring LunchMoney Lewis . In December 2018, Nile Rodgers & Chic began their first UK arena tour. They were nominated for a Brit Award in the "Best International Group Category", in January 2019. In July 2018, Rodgers co-founded Hipgnosis Songs Fund with Merck Mercuriadis . An IP investment and song management company, Hipgnosis Songs Fund went public later that year. In November 2018, to mark the 40th anniversary of "Le Freak", Rhino/Atlantic released The Chic Organisation 1977-79 , a 6-CD box set containing Chic's first three albums, Sister Sledge's We Are Family and a collection of rarities, including a facsimile of Chic's first single – a 12″ promo for "Dance, Dance, Dance (Yowsah, Yowsah, Yowsah)" released by Buddah Records in 1977. In January 2019, Rodgers offered 600 free tickets to furloughed US Federal workers during the US Government Shutdown to the Nile Rodgers & Chic concert at the MGM National Harbor in Washington, DC. He played at Cardiff Castle on July 12, 2019, and on February 17, 2020, he participated in Eric Clapton's tribute concert for Ginger Baker. [ citation needed ] Rodgers has hosted a podcast on Apple Music since August 2020. Titled Deep Hidden Meaning , he has interviewed guests including David Foster , Carole Bayer Sager , Bryan Adams , Timbaland , and Paul McCartney . On November 13, 2020, Rodgers was featured on " Stop Crying Your Heart Out " as part of the BBC Radio 2's Allstars' Children in Need charity single. The single debuted at number 7 on the Official UK Singles Chart and number 1 on both the Official UK Singles Sales Chart and the Official UK Singles Download Chart. Among other artists, in 2021, Rodgers worked with Jack Savoretti and Keith Urban. "Who's Hurting Who ft. Nile Rodgers", the first single from Savoretti's Europiana album was released in May. [ citation needed ] In April 2021 he teamed with Urban and Breland on the music video for "The Cage", a track from Urban's 2020 album The Speed of Now Part 1 . In the summer of 2021, Rodgers, with Constellation Immersive, launched DiscOasis, an ongoing 1970s-themed disco and roller skating pop-up party at the South Coast Botanic Garden in Rancho Palos Verdes . Developed in part to provide an outside experience during the COVID-19 pandemic , DJs select music from crates of records that Rodgers hand picked from his personal collection. In July 2022, Hipgnosis Songs Fund was valued at US $2.69 billion. An asteroid approximately 300 million miles away from Earth was named nilerodgers (191911) in honor of Rodgers' 70th birthday in 2022. Rodgers donated $1 million to the We Are Family Foundation, the organization he co-founded, to mark both his birthday and the foundation's 20th anniversary. Rodgers performed " Modern Love " and " Let's Dance " with Josh Homme , Omar Hakim and Gaz Coombes at the Taylor Hawkins Tribute Concert at Wembley Stadium on September 3, 2022. Rodgers won two Grammy Awards, Best Electronic/Dance Album and Best R&B Song ("Cuff It"), for his work with Beyonce on her 2022 album Renaissance in 2023. He also received the Lifetime Achievement/Special Merit Grammy Award. Rodgers worked with South Korean girl group Le Sserafim on their album Unforgiven in February 2023. He was featured on the album's title track. He collaborated with Duran Duran on their September 2023 single "Black Moonlight", one of three original songs on Duran Duran's Halloween-inspired album Danse Macabre . Performing live with Chic, he brought "maximum funkocity" to NPR 's Tiny Desk Concert in October 2023. The half-hour set included "Le Freak". "Let's Dance", "Get Lucky" and "Soul Glo", the fake commercial jingle Rodgers wrote for the 1988 film Coming to America. In January 2024 the World Economic Forum announced that Rodgers would receive its 2024 Crystal Award. Presented during the opening session of the event, the announcement stated that Rodgers would be honored for his "efforts to make the world a more peaceful, equal and inclusive place through his music, his commitment to fighting systemic racism, inequality and injustice, and by championing innovative youth voices." Also in 2024, Rodgers contributed guitar to a re-release of Mark Knopfler 's " Going Home: Theme of the Local Hero " in aid of the Teenage Cancer Trust . Rodgers was named Polar Music Prize Laureate in March 2024. Rodgers met bassist Bernard Edwards in 1970 while working as a touring musician for the Sesame Street stage show. Together they formed The Big Apple Band and initially worked as back-up musicians for the vocal group New York City (" I'm Doin' Fine Now "). New York City's one hit allowed them to tour extensively, opening for The Jackson 5 on the American leg of their first world tour in 1973. The band dissolved after their second album failed to yield a hit. Rodgers and Edwards subsequently joined forces with drummer Tony Thompson to form The Boys, playing gigs up and down the East Coast. Although there was label interest, record companies passed on the band after discovering its members were black, believing that black rock artists would be too hard to promote. As the Big Apple Band, Rodgers and Edwards worked with Ashford & Simpson and Luther Vandross , among others. Since another New York artist, Walter Murphy , had a band called The Big Apple Band, in 1977 Rodgers and Edwards changed the band's name to Chic. [ citation needed ] Inspired by Roxy Music , Chic developed a sound that was a fusion of jazz, soul, and funk grooves with melodies and lyrics with a European influence. Between gigs, they recorded the song "Dance, Dance, Dance", with then-boss Luther Vandross on vocals. Originally released by Buddah Records , it was a hit when it was re-released by Atlantic in the summer of 1977. Atlantic picked up an album option with Rodgers and Edwards, who quickly wrote more songs, and Chic's self-titled debut was released in November. The band scored numerous top ten hits, including " Le Freak ", " I Want Your Love ", " Everybody Dance ", " Dance, Dance, Dance (Yowsah, Yowsah, Yowsah) ", " My Forbidden Lover ", and " Good Times " becoming club/pop/R&B standards. "Le Freak" was Atlantic Records ' only triple platinum selling single at the time, and "Good Times" shot to No. 1 in August 1979 despite that year's " Disco Sucks " campaign. The success of Chic's first singles led Atlantic to offer Rodgers and Edwards the opportunity to produce any act on its roster. They chose Sister Sledge , whose 1979 album, We Are Family , hit #3 on the Billboard charts, charting well into 1980. The first two singles, " He's the Greatest Dancer " and the title cut " We Are Family " both reached No. 1 on the R&B chart, and No. 6 and No. 2, respectively on the pop chart. In April 2018, "We Are Family" was selected to be preserved in the Library of Congress. The 1979 disco backlash derailed Chic, and Edwards retreated from work, while Rodgers' drug use accelerated. Rodgers and Edwards delivered their final Atlantic album under contract, Believer , in 1982. They completed one of their last projects together in 1980, writing and producing the album Diana for Diana Ross , which yielded the hits " Upside Down " and " I'm Coming Out ". They produced Deborah Harry 's 1981 solo album Koo Koo , and produced the hit "Spacer" for the French disco act Sheila and B. Devotion . During the same time period, Chic's song " Good Times " was sampled on The Sugarhill Gang 's " Rapper's Delight ", the first multiple-platinum hip hop single. The song continued to influence the sounds of others, including Queen , with the 1980 hit "Another One Bites the Dust" and Blondie , who had a #1 hit with "Rapture". Following Chic's breakup, Rodgers released his first solo album, Adventures in the Land of the Good Groove . With Chic no longer occupying most of his time, Rodgers was free to focus on working with other artists. He produced David Bowie's biggest selling album, Let's Dance , which yielded the hit singles "Let's Dance", "China Girl", and "Modern Love". He produced the single "Original Sin" by INXS , and in 1984, he produced Madonna 's album Like a Virgin , which scored four hit singles including its title track, " Material Girl ", and "Dress You Up". He worked extensively with Duran Duran , remixing their biggest-selling single, "The Reflex", producing "Wild Boys" on their 1984 live album, Arena , and co-producing the album Notorious . In 1985, Rodgers produced albums for Sheena Easton , Jeff Beck , Thompson Twins , Mick Jagger , and others, and performed at Live Aid with Madonna and the Thompson Twins. He was named the #1 Singles Producer in the World by Billboard at the end of the year. At the end of the decade, he produced albums for Grace Jones , Al Jarreau ( L is for Lover ), Earth Wind and Fire 's vocalist Philip Bailey , and performed on " Higher Love " with Steve Winwood , as well as on records for Cyndi Lauper , and others. In 1989, he co-produced the B-52's multi-platinum album Cosmic Thing ; it reached No. 4 on the Billboard 200 album chart, and yielded the singles "Love Shack", and "Roam". He produced Workin' Overtime , Diana Ross ' return to Motown , and the soundtracks for Alphabet City , Gremlins , White Nights , [ better source needed ] and The Fly . [ better source needed ] He later composed an orchestral soundtrack, his first, for the film Coming to America . Rodgers formed the short-lived experimental band Outloud in 1987, with David Letterman 's guitarist, composer, and vocalist Felicia Collins and French session musician, producer, composer, and keyboardist Philippe Saisse ; the trio released a single album, Out Loud , on Warner Bros. Records . In September 1990, shortly after the death of Stevie Ray Vaughan , the Rodgers-produced Vaughan Brothers album Family Style was released. He produced records for David Bowie , Eric Clapton , The B-52s , David Lee Roth , Ric Ocasek , The Stray Cats and others early in the decade, and worked on the soundtracks for Thelma and Louise , Cool World , and The Beavis and Butt-head Experience . Rodgers and Edwards reformed Chic in 1992 and recorded new material for the album Chic-Ism . In 1996, they released a Japan-only album consisting of old Chic material rerecorded with guest vocalists, Chic Freak and More Treats . Edwards and Rodgers performed with Sister Sledge , Steve Winwood , and Slash in a series of commemorative concerts in Japan. Edwards died following a concert on April 17, 1996. Rodgers discovered his body. He later said that he "cried like a baby and suffered intensely but eventually realised the best tribute to him would be to carry on and be the best I could be." A year later, Rodgers returned to Japan to pay homage to Edwards, and in 1999, Rodgers released Live at the Budokan , a live recording of Edwards' final performance. The album was not overdubbed or changed in order to keep the recording pure. Rodgers started playing live concerts again while composing and producing music for the film soundtracks Beverly Hills Cop III , Blue Chips , The Flintstones and Feeling Minnesota , working with Bob Dylan , among others. In 1997, The Notorious B.I.G. released " Mo Money Mo Problems " sampling Rodgers and Edwards' song " I'm Coming Out " from Diana Ross's platinum album Diana . "Mo Money, Mo Problems" topped the Billboard Hot 100 for two weeks and was nominated for the 1998 Grammy Award for Best Rap Performance by a Duo or Group . In 1998, Rodgers founded Sumthing Else Music Works record label and Sumthing Distribution , an independent music label distributor. Sumthing focused on distributing video game soundtracks, and released the world's first 5.1 surround DVD game-soundtrack album. Its titles include the Halo , Resident Evil , Gears of War and Borderlands series. In the early 2000s, Rodgers worked extensively on film and video game soundtracks, including Halo 2 , Rush Hour 2 , Snow Dogs , [ better source needed ] and Semi-Pro starring Will Ferrell , who co-wrote the title song " Love Me Sexy " with Rodgers. In 2002, Rodgers returned to work again with the original five members of Duran Duran when he co-produced Astronaut . The album rose to No. 3 in the UK. Following the September 11 attacks , Rodgers brought together more than 200 musicians and celebrities to record "We Are Family". It was recorded in New York at Avatar Studios (previously The Power Station, where the original recording of "We Are Family" took place in 1978), and in Los Angeles at the Record Plant . The accompanying music video was directed by Spike Lee . An 80-minute documentary, The Making and Meaning of We Are Family , directed by Danny Schechter , premiered at the Sundance Film Festival in 2002. In a collaboration between Disney , Nickelodeon and PBS , more than 100 children's television characters participated in a "We Are Family" children's music video, and on March 11, 2002, Disney Channel, Nickelodeon and PBS aired the video to promote tolerance and diversity on the 6-month anniversary of 9/11. In July 2002, Rodgers co-founded the We Are Family Foundation with his life partner, Nancy Hunt. A non-profit organization that promotes "cultural diversity while nurturing and mentoring the vision, talents, and ideas of young people who are positively changing the world", it is dedicated to the vision of a global family. In 2010, Rhino Records released a four-CD box set , Nile Rodgers Presents The Chic Organization, Volume 1: Savoir Faire , which for the first time collected tracks from all of the acts produced by The Chic Organization up to their original break-up in 1983. Rodgers provided liner notes for the set, which was also reissued in 2013. Rodgers' critically acclaimed autobiography, Le Freak: An Upside Down Story of Family, Disco, and Destiny was published by Spiegel & Grau , a Random House imprint, in late 2011. It was named one of the top 10 of the 25 Greatest Rock Memoirs of All Time by Rolling Stone . In February 2012, Rodgers announced that he was collaborating with electronic band Daft Punk for their latest album, "teasing out their R&B influences". The record, Random Access Memories was released in 2013. Rodgers co-wrote and played guitar on three tracks: " Give Life Back to Music ", " Lose Yourself to Dance ", and " Get Lucky ". In April, "Get Lucky" entered the UK Singles Chart at No. 3, only 24 hours after its release, and two weeks later rose to No. 1. In an interview with Official Charts Company , Rodgers said, "I've had big records and Number 1s; I have had records that were Number 1 in the United States but nowhere else ... I've had records which have done well [in the UK], but not in the States. But to have this ubiquitous record, that is a hit everywhere ... It's amazing to me! I'm out on the road and I can hear it wherever I go. I'm flabbergasted!" "Get Lucky" became one of the UK's biggest-selling singles of all time. Rhino Records released Nile Rodgers Presents The Chic Organization Up All Night (The Greatest Hits) , a compilation album featuring songs written, played or produced by Rodgers and Bernard Edwards for Chic and various artists, including Diana Ross, Sister Sledge, Carly Simon, Debbie Harry, Johnny Mathis, Sheila & B. Devotion and Norma Jean Wright. Up All Night reached No. 2 on the UK Compilation Album Chart for the week ending July 13, 2013. In October 2013, Rhino released Nile Rodgers Presents The Chic Organization Up All Night (The Greatest Hits Disco Edition) , which included a medley taken from Chic ft. Nile Rodgers' live performance at the 2013 Glastonbury Festival . Rodgers and Bernard Edwards were nominated to the Songwriters Hall of Fame in October 2013. In January 2014, Rodgers performed "Get Lucky" with Daft Punk on the Grammy Awards, along with Pharrell Williams and Stevie Wonder , with a medley including elements of Chic's " Le Freak " and Wonder's " Another Star ". Rodgers won three Grammy Awards for his work with Daft Punk on Random Access Memories , including Best Pop Duo/Group Performance, Record of the Year and Album of the Year. In March, Rolling Stone named Rodgers one of the 50 Most Important People in EDM, stating, "The full scope of Nile Rodgers' career is still hard to fathom, and it's not just ongoing, it's in overdrive." In December, NARAS announced that "Le Freak" would be inducted into The Grammy Hall of Fame. Rodgers' solo single "Do What You Wanna Do ( IMS Anthem)" was released on August 10, 2014 to benefit the We Are Family Foundation. A year later, in March 2015, Rodgers released Chic 's first single in more than 23 years, " I'll Be There ", with a live streamed concert from The Roundhouse in London. The song was produced using original Chic outtake tapes from the 70s, with Bernard Edwards , Tony Thompson , and vocalists Alfa Anderson and Luci Martin. The song went to #1 on Billboard's Dance Music Chart on June 20, 2015. In August, Rodgers launched FOLD Festival (FreakOut! Let's Dance), a multi-day event with a diverse line-up of artists including Beck , Duran Duran , Chaka Khan , Keith Urban , Janelle Monáe , Ginger Minj , Chic and others. Rodgers collaborated with Lady Gaga to remake Chic's hit, "I Want Your Love" for Tom Ford 's Spring/Summer 2016 collection video in lieu of a fashion show. Rodgers and Bernard Edwards were inducted into the Songwriters Hall of Fame on June 9, 2016. In 2017, after 11 nominations for Chic, Rodgers was inducted into the Rock and Roll Hall of Fame with an award for Musical Excellence. "It's sort of bittersweet," says Rodgers. "I'm quite flattered that they believed that I was worthy, but my band Chic didn't win. They plucked me out of the band and said, 'You're better than Chic.' That's wacky to me ... I am flattered and I think it's cool, but I feel like somebody put me in the lifeboat and told my family they can't get in." On the evening of 25th June 2017, Rodgers and Chic returned to the Glastonbury Festival , as headliners on the Pyramid Stage, for an audience of close to 100,000. In September of the same year, a version of George Michael's song " Fantasy " was released, credited to "George Michael featuring Nile Rodgers." The track, released as a B-side by Michael's label in 1990, was reworked by Rodgers and featured him prominently on guitar. It was Michael's only posthumous release. In June 2018, "Till the World Falls", the first single from Nile Rodgers & Chic's first album since 1992, It's About Time , was released. The song featured Mura Masa , Cosha and Vic Mensa . The album was released in September 2018, and hit the Top 10 in the UK. It was the first Chic record to hit the Top 10 in 25 years. Two singles from the album were subsequently released: "Sober" featuring Craig David and Stefflon Don , and "Do You Wanna Party" featuring LunchMoney Lewis . In December 2018, Nile Rodgers & Chic began their first UK arena tour. They were nominated for a Brit Award in the "Best International Group Category", in January 2019. In July 2018, Rodgers co-founded Hipgnosis Songs Fund with Merck Mercuriadis . An IP investment and song management company, Hipgnosis Songs Fund went public later that year. In November 2018, to mark the 40th anniversary of "Le Freak", Rhino/Atlantic released The Chic Organisation 1977-79 , a 6-CD box set containing Chic's first three albums, Sister Sledge's We Are Family and a collection of rarities, including a facsimile of Chic's first single – a 12″ promo for "Dance, Dance, Dance (Yowsah, Yowsah, Yowsah)" released by Buddah Records in 1977. In January 2019, Rodgers offered 600 free tickets to furloughed US Federal workers during the US Government Shutdown to the Nile Rodgers & Chic concert at the MGM National Harbor in Washington, DC. He played at Cardiff Castle on July 12, 2019, and on February 17, 2020, he participated in Eric Clapton's tribute concert for Ginger Baker. [ citation needed ]Rodgers has hosted a podcast on Apple Music since August 2020. Titled Deep Hidden Meaning , he has interviewed guests including David Foster , Carole Bayer Sager , Bryan Adams , Timbaland , and Paul McCartney . On November 13, 2020, Rodgers was featured on " Stop Crying Your Heart Out " as part of the BBC Radio 2's Allstars' Children in Need charity single. The single debuted at number 7 on the Official UK Singles Chart and number 1 on both the Official UK Singles Sales Chart and the Official UK Singles Download Chart. Among other artists, in 2021, Rodgers worked with Jack Savoretti and Keith Urban. "Who's Hurting Who ft. Nile Rodgers", the first single from Savoretti's Europiana album was released in May. [ citation needed ] In April 2021 he teamed with Urban and Breland on the music video for "The Cage", a track from Urban's 2020 album The Speed of Now Part 1 . In the summer of 2021, Rodgers, with Constellation Immersive, launched DiscOasis, an ongoing 1970s-themed disco and roller skating pop-up party at the South Coast Botanic Garden in Rancho Palos Verdes . Developed in part to provide an outside experience during the COVID-19 pandemic , DJs select music from crates of records that Rodgers hand picked from his personal collection. In July 2022, Hipgnosis Songs Fund was valued at US $2.69 billion. An asteroid approximately 300 million miles away from Earth was named nilerodgers (191911) in honor of Rodgers' 70th birthday in 2022. Rodgers donated $1 million to the We Are Family Foundation, the organization he co-founded, to mark both his birthday and the foundation's 20th anniversary. Rodgers performed " Modern Love " and " Let's Dance " with Josh Homme , Omar Hakim and Gaz Coombes at the Taylor Hawkins Tribute Concert at Wembley Stadium on September 3, 2022. Rodgers won two Grammy Awards, Best Electronic/Dance Album and Best R&B Song ("Cuff It"), for his work with Beyonce on her 2022 album Renaissance in 2023. He also received the Lifetime Achievement/Special Merit Grammy Award. Rodgers worked with South Korean girl group Le Sserafim on their album Unforgiven in February 2023. He was featured on the album's title track. He collaborated with Duran Duran on their September 2023 single "Black Moonlight", one of three original songs on Duran Duran's Halloween-inspired album Danse Macabre . Performing live with Chic, he brought "maximum funkocity" to NPR 's Tiny Desk Concert in October 2023. The half-hour set included "Le Freak". "Let's Dance", "Get Lucky" and "Soul Glo", the fake commercial jingle Rodgers wrote for the 1988 film Coming to America. In January 2024 the World Economic Forum announced that Rodgers would receive its 2024 Crystal Award. Presented during the opening session of the event, the announcement stated that Rodgers would be honored for his "efforts to make the world a more peaceful, equal and inclusive place through his music, his commitment to fighting systemic racism, inequality and injustice, and by championing innovative youth voices." Also in 2024, Rodgers contributed guitar to a re-release of Mark Knopfler 's " Going Home: Theme of the Local Hero " in aid of the Teenage Cancer Trust . Rodgers was named Polar Music Prize Laureate in March 2024. In 1982, Rodgers and Edwards produced the soundtrack for the movie Soup for One. As Chic, they wrote and performed three songs, including the film's title track. Edwards and Rodgers also wrote and produced Carly Simon's "Why", a top 10 hit in the UK that helped resurrect Simon's career. The soundtrack, which also featured Sister Sledge, Debbie Harry, and Teddy Pendergrass , was a bigger hit than the film. Rodgers became increasingly in-demand as a producer and composer for film and television following the success of the Soup for One soundtrack. In 1984, he produced Al Jarreau 's theme for the television series Moonlighting ; he wrote, produced and scored the soundtrack for Alphabet City , and in 1986 and worked with Laurie Anderson on her concert film, Home of the Brave . In 1988, in addition to producing the soundtrack for Earth Girls Are Easy , he composed the orchestral score for Eddie Murphy's Coming to America . He also served as film's music supervisor, and wrote and produced its title track, a hit for The System , and wrote the jingle for the Soul Glo commercial, "the most iconic fake ad in cinematic history." In 1999, he executive produced, scored, music-supervised and appeared in Public Enemy , a documentary about the Black Panthers. In a review of the soundtrack, critic Maria Blandford wrote: "The disc realistically supports the conflicting and controversial nature of this historical period, and opens the arena for present-day discussion and evaluation...this recording is an examination of the American conscience." Between the mid-1980s and the late 2000s, songs written, produced or performed by Rodgers (and/or Chic) were included in the films or on the soundtracks for Shrek 2 ("Le Freak"), Thelma and Louise , Rush Hour 2 , Cool World , Beavis and Butthead Do America , The Flintstones (in collaboration with the B-52s ), Summer of Sam , Space Jam (with Seal), Feeling Minnesota (with Bob Dylan), Curdled , Bowie's Cool World , Snow Dogs , White Hot , Gremlins , That's Dancing! and The Fly , among others. He scored the film Blue Chips , and reunited with Murphy to score Beverly Hills Cop III. He also produced a remake of "Axel F", from the first Beverly Hills Cop, which he performed with Richard Hilton. In 2008, he cowrote Semi-Pro's "Love Me Sexy" with Will Ferrell , who starred in the movie. In the 2010s, music by Rodgers was featured in movies including Arctic Tale , Trolls and Bridget Jones's Baby, a s well as on the TV shows Vinyl , The Get Down , and Horrid Henry, among others. In 2019, he collaborated with Andrew Lloyd Webber on the soundtrack for the film Cats. In 2023 it was announced that he and The-Dream were co-writing music for the Mark Anthony Green horror film, Opus. Since his 1978 debut with Chic on American Bandstand , Rodgers has performed on more than 150 television programs. He has been the subject of documentaries including the BBC 's Nile Rodgers: The Hitmaker , Front and Center: Songwriters Hall of Fame: Nile Rodgers on PBS, Arte France's Nile Rodgers: Secrets of a Hitmaker , and the short film Composing America: The Musical Talents of Nile Rodgers . The BBC also broadcast Nile Rodgers: How To Make It in the Music Business , a three-hour, three part special. In 2018, Once in a Lifetime Sessions with Nile Rodgers premiered on Netflix . Rodgers has appeared in documentaries about David Bowie, Diana Ross, Elton John, Michael Jackson, Rick James, George Michael, Duran Duran, Daft Punk, Public Enemy, Madonna, Avicii, Studio 54, the Seventies, the Eighties, the Nineties, recorded music, girl groups, the disco era, disco, house music, funk, and soul music. [ better source needed ] He was featured in the 2023 BBC documentary about Little Richard , Little Richard: King and Queen of Rock'n'Roll. Rodgers most frequently plays Fender Stratocasters, as well as Gibson Les Pauls and archtop guitars such as the Gibson ES-300 and D'Angelico New Yorker. He auctioned more than 100 guitars and bass guitars from his personal collection to benefit We Are Family Foundation in December 2021. Rodgers plays a 1960 Fender Stratocaster with a 1959 neck, nicknamed The Hitmaker , which he acquired as a trade-in at a shop in Miami Beach, Florida . Exceptionally light, it has a maple fingerboard and a worn white finish. Rodgers claims it has a unique sound. After Rodgers purchased the guitar, Edwards taught him how to play it in a chop chord style, which he called "chucking". In his autobiography, Rodgers wrote: "He fingered the chords with his left hand, and his right hand would continuously play sixteen notes to the bar while accenting the main parts of the rhythm ... One lesson was all I needed. For the next few nights straight, while my roommate pursued all manner of trysts, I was having a love affair in the bathroom with my new ax. In just a few days, I'd emerge as a chucking funk guitarist who knew more jazz chord inversions than most of my R&B counterparts." The Fender Custom Shop introduced a limited edition Nile Rodgers Hitmaker Stratocaster, a recreation of Rodgers' guitar, in January 2014. In 1982, Rodgers and Edwards produced the soundtrack for the movie Soup for One. As Chic, they wrote and performed three songs, including the film's title track. Edwards and Rodgers also wrote and produced Carly Simon's "Why", a top 10 hit in the UK that helped resurrect Simon's career. The soundtrack, which also featured Sister Sledge, Debbie Harry, and Teddy Pendergrass , was a bigger hit than the film. Rodgers became increasingly in-demand as a producer and composer for film and television following the success of the Soup for One soundtrack. In 1984, he produced Al Jarreau 's theme for the television series Moonlighting ; he wrote, produced and scored the soundtrack for Alphabet City , and in 1986 and worked with Laurie Anderson on her concert film, Home of the Brave . In 1988, in addition to producing the soundtrack for Earth Girls Are Easy , he composed the orchestral score for Eddie Murphy's Coming to America . He also served as film's music supervisor, and wrote and produced its title track, a hit for The System , and wrote the jingle for the Soul Glo commercial, "the most iconic fake ad in cinematic history." In 1999, he executive produced, scored, music-supervised and appeared in Public Enemy , a documentary about the Black Panthers. In a review of the soundtrack, critic Maria Blandford wrote: "The disc realistically supports the conflicting and controversial nature of this historical period, and opens the arena for present-day discussion and evaluation...this recording is an examination of the American conscience." Between the mid-1980s and the late 2000s, songs written, produced or performed by Rodgers (and/or Chic) were included in the films or on the soundtracks for Shrek 2 ("Le Freak"), Thelma and Louise , Rush Hour 2 , Cool World , Beavis and Butthead Do America , The Flintstones (in collaboration with the B-52s ), Summer of Sam , Space Jam (with Seal), Feeling Minnesota (with Bob Dylan), Curdled , Bowie's Cool World , Snow Dogs , White Hot , Gremlins , That's Dancing! and The Fly , among others. He scored the film Blue Chips , and reunited with Murphy to score Beverly Hills Cop III. He also produced a remake of "Axel F", from the first Beverly Hills Cop, which he performed with Richard Hilton. In 2008, he cowrote Semi-Pro's "Love Me Sexy" with Will Ferrell , who starred in the movie. In the 2010s, music by Rodgers was featured in movies including Arctic Tale , Trolls and Bridget Jones's Baby, a s well as on the TV shows Vinyl , The Get Down , and Horrid Henry, among others. In 2019, he collaborated with Andrew Lloyd Webber on the soundtrack for the film Cats. In 2023 it was announced that he and The-Dream were co-writing music for the Mark Anthony Green horror film, Opus. Since his 1978 debut with Chic on American Bandstand , Rodgers has performed on more than 150 television programs. He has been the subject of documentaries including the BBC 's Nile Rodgers: The Hitmaker , Front and Center: Songwriters Hall of Fame: Nile Rodgers on PBS, Arte France's Nile Rodgers: Secrets of a Hitmaker , and the short film Composing America: The Musical Talents of Nile Rodgers . The BBC also broadcast Nile Rodgers: How To Make It in the Music Business , a three-hour, three part special. In 2018, Once in a Lifetime Sessions with Nile Rodgers premiered on Netflix . Rodgers has appeared in documentaries about David Bowie, Diana Ross, Elton John, Michael Jackson, Rick James, George Michael, Duran Duran, Daft Punk, Public Enemy, Madonna, Avicii, Studio 54, the Seventies, the Eighties, the Nineties, recorded music, girl groups, the disco era, disco, house music, funk, and soul music. [ better source needed ] He was featured in the 2023 BBC documentary about Little Richard , Little Richard: King and Queen of Rock'n'Roll. Rodgers most frequently plays Fender Stratocasters, as well as Gibson Les Pauls and archtop guitars such as the Gibson ES-300 and D'Angelico New Yorker. He auctioned more than 100 guitars and bass guitars from his personal collection to benefit We Are Family Foundation in December 2021. Rodgers plays a 1960 Fender Stratocaster with a 1959 neck, nicknamed The Hitmaker , which he acquired as a trade-in at a shop in Miami Beach, Florida . Exceptionally light, it has a maple fingerboard and a worn white finish. Rodgers claims it has a unique sound. After Rodgers purchased the guitar, Edwards taught him how to play it in a chop chord style, which he called "chucking". In his autobiography, Rodgers wrote: "He fingered the chords with his left hand, and his right hand would continuously play sixteen notes to the bar while accenting the main parts of the rhythm ... One lesson was all I needed. For the next few nights straight, while my roommate pursued all manner of trysts, I was having a love affair in the bathroom with my new ax. In just a few days, I'd emerge as a chucking funk guitarist who knew more jazz chord inversions than most of my R&B counterparts." The Fender Custom Shop introduced a limited edition Nile Rodgers Hitmaker Stratocaster, a recreation of Rodgers' guitar, in January 2014. In the early 1990s, Rodgers woke up in the hospital to learn that his heart had stopped eight times, and he was alive due only to the actions of the doctor who was filling out his death certificate. He stopped using drugs and alcohol in 1994 after a friend showed him a tape of a performance during which he was inebriated. Rodgers was diagnosed with an aggressive form of prostate cancer in October 2010. He documented his illness on a blog called Walking on Planet C . He was given the all-clear in 2013. In 2017, a growth on his right kidney was diagnosed as two different cancers within one mass. The mass was surgically removed in November 2017. He said he expected a 100% recovery. At his performance at the Hollywood Bowl, on July 4, 2019, Rodgers announced that he was "100% cancer-free." Rodgers lived in Westport, Connecticut until July 2021 when he moved to Miami, Florida with his life partner, Nancy Hunt. Chic Solo Outloud Outloud (1987) Soundtracks Live albumsChic Solo Outloud Outloud (1987) Soundtracks Live albums

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Niles West High School

Niles West High School ( NWHS ), officially Niles Township High School West , is a public four-year high school located in Skokie, Illinois , a north suburb of Chicago , in the United States. NWHS is part of the Niles Township Community High School District 219 , which also includes Niles North High School . The name of the school teams originally was the Indians , which later was changed to the Wolves , in 2001. The feeder middle-schools for NWHS are Lincoln Junior High School (Skokie), Fairview South School (Skokie), Lincoln Hall Middle School ( Lincolnwood ), Culver Middle School ( Niles ), and Park View School (Morton Grove). Niles West High School also matriculates many students from MCC Academy, Morton Grove, Illinois .Niles West High School sits on over an acre of land. The school opened in the fall of 1958. In 1996, the Niles Township Federation of Teachers went on a strike for two weeks over negotiations with administrators. During that time numerous students staged a walkout and pledged their allegiance to Niles West. Strikes have also happened in 1979 and 1985 with similar results.In 2007, Niles West had an average composite ACT score of 22.3, and graduated 93.2% of its senior class. The average class size was 19.2. In 2012, Newsweek ranked Niles West on its list of the Top 1000 Public Schools in the nation. As of March 2020, many 8th or 7th graders have been attending Niles West High School as part as an off-level program. The "West Word" student newspaper has been awarded first place for seven years running, with special merit twice, by the American Scholastic Press Association Newspaper contest. Starting in the 2010 – 2011 school year, the print newspaper was retired, renamed "Niles West News", and moved online. In April 2007, both Niles West and Niles North received the Kennedy Center Alliance for Arts Education Network and National School Boards Association Award for excellence in arts education. In summer 2010, the Niles West High School Theatre Department performed at the 2010 American High School Theatre Festival in Scotland. The Illinois Art Education Association awarded the Fine Arts Departments with three awards in 2020: Art Education Program of the Year, Patti-Anne Ford as the Art and Design Administrator of the Year, and Deanna Sortino as the Secondary Art Educator of the Year. Niles West competes in the Central Suburban League and Illinois High School Association (IHSA). Teams are stylized as the Wolves . Until the end of the 1999 – 2000 school year, the sports teams were known as Niles West Indians, a name which was changed to the Wolves so as not to offend Native Americans. Niles West sponsors interscholastic athletic teams for boys and girls in basketball , cheerleading, cross country , golf , gymnastics , soccer , water polo , swimming & diving , tennis , track & field , and volleyball . Boys may also compete in baseball and football . Girls can also compete on the wrestling team and may compete in softball . While not sponsored by the IHSA, the school also sponsors a poms team for girls. The baseball team has won two IHSA state championships (1971–72 and 1974 – 75). The girls basketball team won the IHSA state championship in 1978-79. Niles West also won the IHSA state championship for boys gymnastics in 2016. The "West Word" student newspaper has been awarded first place for seven years running, with special merit twice, by the American Scholastic Press Association Newspaper contest. Starting in the 2010 – 2011 school year, the print newspaper was retired, renamed "Niles West News", and moved online.In April 2007, both Niles West and Niles North received the Kennedy Center Alliance for Arts Education Network and National School Boards Association Award for excellence in arts education. In summer 2010, the Niles West High School Theatre Department performed at the 2010 American High School Theatre Festival in Scotland. The Illinois Art Education Association awarded the Fine Arts Departments with three awards in 2020: Art Education Program of the Year, Patti-Anne Ford as the Art and Design Administrator of the Year, and Deanna Sortino as the Secondary Art Educator of the Year. Niles West competes in the Central Suburban League and Illinois High School Association (IHSA). Teams are stylized as the Wolves . Until the end of the 1999 – 2000 school year, the sports teams were known as Niles West Indians, a name which was changed to the Wolves so as not to offend Native Americans. Niles West sponsors interscholastic athletic teams for boys and girls in basketball , cheerleading, cross country , golf , gymnastics , soccer , water polo , swimming & diving , tennis , track & field , and volleyball . Boys may also compete in baseball and football . Girls can also compete on the wrestling team and may compete in softball . While not sponsored by the IHSA, the school also sponsors a poms team for girls. The baseball team has won two IHSA state championships (1971–72 and 1974 – 75). The girls basketball team won the IHSA state championship in 1978-79. Niles West also won the IHSA state championship for boys gymnastics in 2016.

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Culex pipiens

Culex pipiens is a species of mosquito commonly referred to as the common house mosquito or northern house mosquito , as it is the most common mosquito to the northern regions of the US. They can be found in both urban and suburban temperate and tropical regions across the world. Culex pipiens ' diet typically consists of vertebrate blood, as they consume human blood, but prefer bird blood of species that are nearly linked to human interaction, such as doves and pigeons . Furthermore, at the end of the summer and the start of the fall season before it is time for them to overwinter , C. pipiens subsist on nectar and other sugary food sources in order to store fat. In California populations, it was shown that most females of Culex pipiens do not enter reproductive diapause during the winter, which differs from other mosquito species, such as Culex stigmatosoma or Culex tarsalis . Most of them overwinter in a stage of host-seeking arrest. The practice of overwintering tends to vary based on location, and in effect temperature and the period of time per day an organism receives sunlight, also known as the photoperiod . Parous females may overwinter together with nulliparous . Overwintering mosquitoes are considered as hibernating by mosquito scientists. Typically, mosquitoes copulate when temperatures are the most temperate , and many species begin breeding when temperatures reach 50 °F (10 °C) . Because of this temperature condition, mosquito breeding seasons vary by region and climate characteristics of a given area.In general, Culex pipiens take on a pale-to-light brown color, and are adorned with lighter stripes on the abdomen . In regards to size, these organisms can range between three and seven millimeters long. C. pipiens can be distinguished by the presence of pale colored bands located on the insect's abdomen. Another distinguishing feature of the species' appearance is its brown or grey-brown color. C. pipiens can also be characterized by the presence of their proboscis , or the elongated mouthpart that is used for sucking up fluids. This feature, in addition to their wings, are also brown in color, matching the remainder of their body.C. pipiens can be found in both urban and sub-urban temperate and tropical regions across the world. It is prevalent on most continents, including North and South America , Europe , and some areas of Asia and Northern Africa .The Culex genus, and a large number of other mosquito species, thrive in mostly wet, humid, and temperate climates. In California population, it was shown that most females of Culex pipiens do not enter reproductive diapause during the winter, which differs from other mosquito species, such as Culex stigmatosoma or Culex tarsalis . Most of them overwinters in a stage of host-seeking arrest. During the winter season, they survive by living in areas where they are sheltered from the elements, such as basements or sheds. Some members of this species also spend the winter season living in caves. The practice of overwintering tends to vary based on location, temperature and the period of time per day an organism receives sunlight, also known as the photoperiod . Parous females may overwinter together with nulliparous females. The habitats of C. pipiens larval habitats can be divided into two categories: natural, and artificial. Natural habitats include marshes, pools, manure piles, streams, and shallow ponds. Some artificial larval habitats are barrels, sewage ditches, and intermittent puddles. Many physical and chemical components of the materials that make up these habitats are critical to larval survival. Stable pH values, salt content in water, and the temperature of the habitat's environment, are all factors that can either positively or negatively influence larval survival rates. The presence of organic materials typically results in positive survival outcomes for C. pipiens. Ideal environments for C. pipiens contain significant amounts of organic matter. C. pipiens is a pollinator of Silene otites, Tanacetum vulgare, and Achillea millefolium . It can see in the ultraviolet range and uses UV cues on flowers to locate them. Lab studies have measured values related to the survival rates of C. pipiens in relation to pH levels, levels of organic material present in their habitats, temperature, and salinity levels. These studies showed that C. pipiens are capable of surviving all of these metrics in extreme values, demonstrating their eurytopic nature. Eurytopicity describes an organism's ability to tolerate a large range of habitat or ecological conditions. According to V. V. Tarabrin and M. M. Orlov , the development from larva to imago occurs within 20–25 days.The optimal air temperature for reproduction is 26-29 °C, relative humidity is ≈ 80%, water temperature is not less than 16-17 °C. The habitats of C. pipiens larval habitats can be divided into two categories: natural, and artificial. Natural habitats include marshes, pools, manure piles, streams, and shallow ponds. Some artificial larval habitats are barrels, sewage ditches, and intermittent puddles. Many physical and chemical components of the materials that make up these habitats are critical to larval survival. Stable pH values, salt content in water, and the temperature of the habitat's environment, are all factors that can either positively or negatively influence larval survival rates. The presence of organic materials typically results in positive survival outcomes for C. pipiens. Ideal environments for C. pipiens contain significant amounts of organic matter. C. pipiens is a pollinator of Silene otites, Tanacetum vulgare, and Achillea millefolium . It can see in the ultraviolet range and uses UV cues on flowers to locate them. Lab studies have measured values related to the survival rates of C. pipiens in relation to pH levels, levels of organic material present in their habitats, temperature, and salinity levels. These studies showed that C. pipiens are capable of surviving all of these metrics in extreme values, demonstrating their eurytopic nature. Eurytopicity describes an organism's ability to tolerate a large range of habitat or ecological conditions. According to V. V. Tarabrin and M. M. Orlov , the development from larva to imago occurs within 20–25 days.The optimal air temperature for reproduction is 26-29 °C, relative humidity is ≈ 80%, water temperature is not less than 16-17 °C. As all mosquito larvae live in the water, they are often referred to as "wigglers," since they can be characterized by a wiggling type movement in the water. The development period of larvae can range anywhere between seven and ten days, which is when they reach the pupal stage. In the pupal stage, the organisms spend less time feeding, and invest more time toward the surface of the water, taking in air from the exposed surface. After about one to three days in the pupal stage, the mosquito adult breaks through. The growth rates of larvae are dependent on factors including temperature, food and water provisions, larval density and characteristics of the breeding season they are born into.The C. pipiens species complex consists of: C. p. pallens – human-biting (Northeast Asia) C. p. pipiens (Global, temperate) C. p. p. f. pipiens – "bird-biting" C. p. p. f. molestus – London Underground mosquito The C. pipiens complex is characterized by its ability to thrive in mainly water-based habitats that contain high amounts of organic material. Furthermore, measured rates of success of the complex has been associated with consumption of "food" found in standing water sources that have been developed by humans and livestock . Some interspecific hybrids are widespread. As vector borne pathogen transmission is highly influenced by the ecology of the vector, it is evident that C. pipiens ' ability to adapt to "human-altered environments" led to its global distribution as a vector. With these environmental adaptations, the species' interactions with humans and other organisms (especially birds), has also led to an increase in the number of avian pathogens that humans around the world are exposed to. In C. pipiens , there is a strong correlation between the digestion of blood and ovary development. The cycle of blood digestion leading to ovarian developments is known as the gonotrophic cycle. It occurs in three stages: finding a blood source, digesting blood, and laying eggs. Laying eggs is also referred to as oviposition . The number of cycles a female C.pipiens goes through depends on a variety of environmental factors. Each one of the gonotrophic cycles results in morphological changes in the female's reproductive organs, stomach, and throat. Temperature is one environmental factor in particular that affects the rate of blood consumption and its correlation to ovary development. Culex pipiens prefer the blood of bird species that are closely linked to human interaction such as doves and pigeons; however, they do consume human blood. At the end of the summer and the start of the fall season before it is time for them to overwinter, C. pipiens subsist on nectar and other sugary food sources in order to store fat. Therefore, C. pipiens consume both vertebrate blood (including human blood) as well as sugar-heavy energy sources like nectar. Only females feed on blood, while male C. pipiens consume on these carbohydrate food sources. The time of day is also a factor that influences C. pipiens ' eating behaviors. C. pipiens feed the most frequently during the early hours of sunset. Feeding on carbohydrate sources, rather than blood, helps with fat storage. This is why this specific feeding behavior is seen before the winter season. C. pipiens feed on a variety of different food sources. Sugar is one important source of food that provides C. pipiens with similar amounts of energy as blood does. Both males and females obtain sugar through feeding on plant sugar, floral nectar, and honeydew , which are found via olfactory and visual cues. Female C. pipiens differ from males in the way that they consume both blood and sugar as sources of food, whereas males only rely on these sugar sources for energy. C. pipiens obtain blood hosts such as birds, humans, cattle , etc. for feeding. Searching for sources of blood requires a complex of behavioral responses that influence C. pipiens sensory mechanisms that help them to locate hosts. [ clarification needed ] Females contain 1,300 sensory organs , while males have 1,350. [ citation needed ] Garvin et al 2018 find C. pipiens to be more attracted to adult birds than nestlings, by differentiating between uropygial gland secretions of different ages (tested in Passer domesticus ). There are many stages that make up C. pipiens feeding activity. These stages are known as activation, orientation, landing, and probing. Locating a host requires both visual and chemical cues from the environment to allow C. pipiens to sense where the host is.C. pipiens feed on a variety of different food sources. Sugar is one important source of food that provides C. pipiens with similar amounts of energy as blood does. Both males and females obtain sugar through feeding on plant sugar, floral nectar, and honeydew , which are found via olfactory and visual cues. Female C. pipiens differ from males in the way that they consume both blood and sugar as sources of food, whereas males only rely on these sugar sources for energy. C. pipiens obtain blood hosts such as birds, humans, cattle , etc. for feeding. Searching for sources of blood requires a complex of behavioral responses that influence C. pipiens sensory mechanisms that help them to locate hosts. [ clarification needed ] Females contain 1,300 sensory organs , while males have 1,350. [ citation needed ] Garvin et al 2018 find C. pipiens to be more attracted to adult birds than nestlings, by differentiating between uropygial gland secretions of different ages (tested in Passer domesticus ). There are many stages that make up C. pipiens feeding activity. These stages are known as activation, orientation, landing, and probing. Locating a host requires both visual and chemical cues from the environment to allow C. pipiens to sense where the host is.Typically, mosquitoes copulate when temperatures are the most temperate, and many species begin breeding when temperatures reach 50 °F (10 °C) . Because of this temperature condition, mosquito breeding seasons vary by region and climate characteristics of a given area. Sexual activity in C. pipiens first begins within the first 2–3 days of emergence from the larval development stage. Antennal fibrillae play an important role in C. pipiens mating practices. The erection of these fibrillae is considered to be the first stage in reproduction. These fibrillae serve different functions across the sexes. As antennal fibrillae are used by female C. pipiens to locate hosts to feed on, male C. pipiens utilize them to locate female mates. Temperature has a direct impact on the outcome of fertilization in C. pipiens. Studies have demonstrated that female insemination relies on higher temperatures to produce successful outcomes, as colder temperatures increase the number of underdeveloped C. pipiens eggs. Another factor that affects fertilization outcomes is the age of the C. pipiens females. In 1972, Lea and Evans performed a study that yielded results showing that the number of inseminated females drastically increased with age. Specifically, only females older than 18–24 hours can be successfully inseminated by a male mate. Furthermore, C. pipiens is believed to be a monogamous species , mating only once (and with one partner) throughout the duration of its life. Courting C. pipiens males have the chance to be directly accepted by a mating female. However, there is evidence for a mating behavior performed by female C. pipiens in which females utilize rejection kicks to deter courting males away. Despite this behavior, there is evidence that courting males can still be accepted by females after these rejection kicks. According to a study done to observe this mating behavior found in C. pipiens , pursuing males are accepted by the female upon first genital contact at a rate of 38.95%, and are accepted at a rate of 17.89% after some rejection kicks from the female, demonstrating that there is a chance of successful mating between male and female C.pipiens even if this rejection mechanism is performed by the female. Furthermore, the recorded success of females performing this behavior with their right limbs is higher than those who used their left. This courting behavior illustrates a behavioral mechanism for females to dismiss certain males from mating with them, and demonstrate an overall functional advantage that is associated with the use of right hind limbs over left ones. C. pipiens reproduce in bodies of water—specifically in flood-prone areas and in standing water. Other breeding sites include: natural marshes , cesspits , gutters , and other unkempt artificial water structures. Furthermore, the presence of organic material in C. pipiens breeding grounds are essential for the larval developmental stage. All mosquito species produce larvae that live in the water. According to Daniel Markowski from the Vector Disease Control International, " Culex pipiens larvae specifically thrive in such stagnant water with the most organic material pollution". The number of larvae present in one breeding site also impacts the success rates of offspring survival. A 1973 study done by Skierska analyzed the effects that larval density had on survival rates. The study showed that the highest larval survival occurred when the larvae density ranged between 20-50 organisms. Within this population range, development periods of the larvae were also the fastest compared to larvae densities that existed above this range. Increased larval densities also affected how many eggs were produced among females that survived within the original experimental population. When densities were higher, less eggs were produced by these surviving females. Swarming is not essential to mating for C.pipiens , as lab experiments have demonstrated that successful mating can occur in laboratory settings, where swarming patterns are unattainable. C. pipiens mating can occur as a female is resting. However, there has been evidence found linked to how swarming patterns do operate, when present in certain C. pipiens populations. The position of the sun has an effect on C. pipiens swarming patterns. Light patterns associated with both sunset and sunrise can cause swarming to develop. Swarms develop usually to a distinct marker, in which C. pipiens use as a common metric to denote where swarming should occur. Within these swarm formations, C. pipiens have been observed to move around in elliptical loop patterns. Autogeny describes C.pipiens ' ability to lay eggs without prior consumption of blood. This trait varies across the C. pipiens complex, and could limit transmission of pathogens since females do not risk food contamination in order to lay eggs. Temperature has a direct impact on the outcome of fertilization in C. pipiens. Studies have demonstrated that female insemination relies on higher temperatures to produce successful outcomes, as colder temperatures increase the number of underdeveloped C. pipiens eggs. Another factor that affects fertilization outcomes is the age of the C. pipiens females. In 1972, Lea and Evans performed a study that yielded results showing that the number of inseminated females drastically increased with age. Specifically, only females older than 18–24 hours can be successfully inseminated by a male mate. Furthermore, C. pipiens is believed to be a monogamous species , mating only once (and with one partner) throughout the duration of its life.Courting C. pipiens males have the chance to be directly accepted by a mating female. However, there is evidence for a mating behavior performed by female C. pipiens in which females utilize rejection kicks to deter courting males away. Despite this behavior, there is evidence that courting males can still be accepted by females after these rejection kicks. According to a study done to observe this mating behavior found in C. pipiens , pursuing males are accepted by the female upon first genital contact at a rate of 38.95%, and are accepted at a rate of 17.89% after some rejection kicks from the female, demonstrating that there is a chance of successful mating between male and female C.pipiens even if this rejection mechanism is performed by the female. Furthermore, the recorded success of females performing this behavior with their right limbs is higher than those who used their left. This courting behavior illustrates a behavioral mechanism for females to dismiss certain males from mating with them, and demonstrate an overall functional advantage that is associated with the use of right hind limbs over left ones.C. pipiens reproduce in bodies of water—specifically in flood-prone areas and in standing water. Other breeding sites include: natural marshes , cesspits , gutters , and other unkempt artificial water structures. Furthermore, the presence of organic material in C. pipiens breeding grounds are essential for the larval developmental stage. All mosquito species produce larvae that live in the water. According to Daniel Markowski from the Vector Disease Control International, " Culex pipiens larvae specifically thrive in such stagnant water with the most organic material pollution". The number of larvae present in one breeding site also impacts the success rates of offspring survival. A 1973 study done by Skierska analyzed the effects that larval density had on survival rates. The study showed that the highest larval survival occurred when the larvae density ranged between 20-50 organisms. Within this population range, development periods of the larvae were also the fastest compared to larvae densities that existed above this range. Increased larval densities also affected how many eggs were produced among females that survived within the original experimental population. When densities were higher, less eggs were produced by these surviving females. Swarming is not essential to mating for C.pipiens , as lab experiments have demonstrated that successful mating can occur in laboratory settings, where swarming patterns are unattainable. C. pipiens mating can occur as a female is resting. However, there has been evidence found linked to how swarming patterns do operate, when present in certain C. pipiens populations. The position of the sun has an effect on C. pipiens swarming patterns. Light patterns associated with both sunset and sunrise can cause swarming to develop. Swarms develop usually to a distinct marker, in which C. pipiens use as a common metric to denote where swarming should occur. Within these swarm formations, C. pipiens have been observed to move around in elliptical loop patterns. Swarming is not essential to mating for C.pipiens , as lab experiments have demonstrated that successful mating can occur in laboratory settings, where swarming patterns are unattainable. C. pipiens mating can occur as a female is resting. However, there has been evidence found linked to how swarming patterns do operate, when present in certain C. pipiens populations. The position of the sun has an effect on C. pipiens swarming patterns. Light patterns associated with both sunset and sunrise can cause swarming to develop. Swarms develop usually to a distinct marker, in which C. pipiens use as a common metric to denote where swarming should occur. Within these swarm formations, C. pipiens have been observed to move around in elliptical loop patterns. Autogeny describes C.pipiens ' ability to lay eggs without prior consumption of blood. This trait varies across the C. pipiens complex, and could limit transmission of pathogens since females do not risk food contamination in order to lay eggs. Mosquito-borne diseases are widespread throughout the globe. According to the World Health Organization , these diseases affected nearly 350 million people worldwide in 2017. Culex pipiens is one of the many members of the mosquito family that is a carrier of disease. Specifically, C. pipiens are well known carriers of West Nile virus , Saint Louis encephalitis viruses, avian malaria ( Plasmodium relictum ), and filarial worms . Cu. pipiens is not a vector of P. homocircumflexum , a parasite of unknown vector which is only known to be unable to get beyond the oocyst stage in this and several other mosquitoes. Mosquito bites can affect warm, uncovered areas of the body, and reactions to the bites vary in severity. Once a host is bitten by a mosquito, the mosquito uses its proboscis to take in blood. In the process of digesting blood, mosquitoes inject saliva instantly after the proboscis enters the host. Many humans display an allergic reaction to the saliva. Arboviruses are diseases that are transmitted to vertebrates by arthropods , including insects. C. pipiens carries many arbovirus diseases across many regions of the globe. Cases of Rift Valley fever have been present in Africa, Japan encephalitis has been prevalent in East Asian countries, and West Nile virus has been seen all over the globe. Mosquito bites can affect warm, uncovered areas of the body, and reactions to the bites vary in severity. Once a host is bitten by a mosquito, the mosquito uses its proboscis to take in blood. In the process of digesting blood, mosquitoes inject saliva instantly after the proboscis enters the host. Many humans display an allergic reaction to the saliva.Arboviruses are diseases that are transmitted to vertebrates by arthropods , including insects. C. pipiens carries many arbovirus diseases across many regions of the globe. Cases of Rift Valley fever have been present in Africa, Japan encephalitis has been prevalent in East Asian countries, and West Nile virus has been seen all over the globe. In February 2019, a theoretical modelling study was reported regarding the potential role of Culex pipiens in transmitting West Nile Virus in the UK . Empirical data were taken from a study conducted during 2015 in Southern England in order to obtain a better understanding of the seasonal abundance patterns, thereby helping to identify the season(s) when the species thrives best and is the most populous.

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West Nile

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Nile perch

Labrus niloticus Linnaeus, 1758 Centropomus niloticus (Linnaeus, 1758) Lates niloticus macrolepidota Pellegrin, 1922 Lates albertianus Worthington, 1929 Lates niloticus albertianus Worthington, 1929 Lates nilotus rudolfianus Worthington, 1929 The Nile perch ( Lates niloticus ), also known as the African snook , Goliath perch , African barramundi , Goliath barramundi , Giant lates or the Victoria perch , is a species of freshwater fish in family Latidae of order Perciformes . It is widespread throughout much of the Afrotropical realm , being native to the Congo , Nile , Senegal , Niger and Lake Chad , Volta , Lake Turkana , and other river basins. It also occurs in the brackish waters of Lake Maryut in Egypt . The Nile perch is a fish of substantial economic and food-security importance in East Africa. Originally described as Labrus niloticus, among the marine wrasses , the species has also been referred to as Centropomus niloticus . Common names include African snook, Victoria perch (a misleading trade name, as the species is not native to Lake Victoria , though they have been introduced there), and many local names in various African languages, such as the Luo name mbuta or mputa . In Tanzania , it is called sangara , sankara , or chenku . In Francophone African countries, it is known as capitaine . Its name in the Hausa language is giwan ruwa , meaning "water elephant".L. niloticus is silver in color with a blue tinge. It has distinctive dark-black eyes, with a bright-yellow outer ring. One of the largest freshwater fishes , it reaches a maximum length of nearly 2 m (6 ft 7 in) , weighing up to 200 kg (440 lb) . Mature fish typically range from 1.21–1.37 m (4 ft 0 in – 4 ft 6 in) , although many fish are caught before they can grow this large. Adult Nile perch occupy all habitats of a lake with sufficient oxygen concentrations, while juveniles are restricted to shallow or nearshore environments. A fierce predator that dominates its surroundings, the Nile perch feeds on fish (including its own species), crustaceans , molluscs , and insects ; the juveniles also feed on zooplankton . Nile perch use schooling as a mechanism to protect themselves from other predators. Nile perch have been introduced to many other lakes in Africa, including Lake Victoria and the artificial Lake Nasser . The World Conservation Union 's Invasive Species Specialist Group considers L. niloticus one of the world's 100 worst invasive species. The state of Queensland in Australia levies heavy fines on anyone found in possession of a living Nile perch, since it competes directly with the native barramundi , which is similar and grows to 1.5 m (4 ft 11 in) long, while the Nile perch grows to 2.0 m (6 ft 7 in) long. The species is of great commercial importance as a food fish. The Nile perch is also popular with sport anglers , as it attacks artificial fishing lures , and it is also raised in aquaculture . The introduction of this species to Lake Victoria is one of the most cited examples of the negative effects alien species can have on ecosystems. The Nile perch was introduced to Lake Victoria in East Africa in the 1950s, and has since been fished commercially. In 2003, Nile perch sales to the EU reached 169 million euros. Sport-fishing in the region of Uganda and Tanzania provided additional income from tourism. Its introduction was ecologically disruptive and is attributed with causing the extinction or near- extinction of several hundred native species, with some populations fluctuating with commercial fishing and the actual Nile perch stocks. The Nile perch initially fed on native cichlids, but with decreasing availability of this prey, it now consumes mainly small shrimp and minnows . The alteration of the native ecosystem had disruptive socioeconomic effects on local communities bordering the lake. Many local people have been displaced from their traditional occupations in the fishing trade and brought them into the cash economy, or before the establishment of export-oriented fisheries, turned them into economic refugees . At least initially, nets strong enough to hold adult Nile perch could not be manufactured locally and had to be imported for a high price. The introduction of Nile perch has also had additional ecological effects on shore. Native cichlids were traditionally sun-dried, but because Nile perch have a high fat content (higher than cichlids), they need to be smoked to avoid spoiling. This has led to an increased demand for firewood in a region already hard-hit by deforestation , soil erosion , and desertification . The Academy Award -nominated documentary Darwin's Nightmare by Hubert Sauper (a French-Austrian-Belgian production, 2004) deals with the damage that has been caused by Nile perch introduction, including the import of weapons and ammunition in cargo planes from Europe, which are then used to export Nile perch, further exacerbating conflict and misery in the surrounding regions. Regardless of whether it is considered positive or negative, the trophic web of Lake Victoria appears to have been drastically impoverished by the introduction of this novel near- top-level predator . While the ecosystem seems to be moving towards a new equilibrium, neither its former state nor the state of fisheries on Lake Victoria can ever easily be brought back. The introduction of this species to Lake Victoria is one of the most cited examples of the negative effects alien species can have on ecosystems. The Nile perch was introduced to Lake Victoria in East Africa in the 1950s, and has since been fished commercially. In 2003, Nile perch sales to the EU reached 169 million euros. Sport-fishing in the region of Uganda and Tanzania provided additional income from tourism. Its introduction was ecologically disruptive and is attributed with causing the extinction or near- extinction of several hundred native species, with some populations fluctuating with commercial fishing and the actual Nile perch stocks. The Nile perch initially fed on native cichlids, but with decreasing availability of this prey, it now consumes mainly small shrimp and minnows . The alteration of the native ecosystem had disruptive socioeconomic effects on local communities bordering the lake. Many local people have been displaced from their traditional occupations in the fishing trade and brought them into the cash economy, or before the establishment of export-oriented fisheries, turned them into economic refugees . At least initially, nets strong enough to hold adult Nile perch could not be manufactured locally and had to be imported for a high price. The introduction of Nile perch has also had additional ecological effects on shore. Native cichlids were traditionally sun-dried, but because Nile perch have a high fat content (higher than cichlids), they need to be smoked to avoid spoiling. This has led to an increased demand for firewood in a region already hard-hit by deforestation , soil erosion , and desertification . The Academy Award -nominated documentary Darwin's Nightmare by Hubert Sauper (a French-Austrian-Belgian production, 2004) deals with the damage that has been caused by Nile perch introduction, including the import of weapons and ammunition in cargo planes from Europe, which are then used to export Nile perch, further exacerbating conflict and misery in the surrounding regions. Regardless of whether it is considered positive or negative, the trophic web of Lake Victoria appears to have been drastically impoverished by the introduction of this novel near- top-level predator . While the ecosystem seems to be moving towards a new equilibrium, neither its former state nor the state of fisheries on Lake Victoria can ever easily be brought back. Despite being a successful invasive species, the fish faces threats. Being a species of megafauna , the most obvious threats to the species are overfishing and the use of illegal fishing gear, as well as invasive water hyacinths . Prey depletion is also a factor, as it decreases the size of the fish and makes it vulnerable to larger predators, such as crocodiles. [ citation needed ]In 2021, The Uganda Fish Processors and Exporters Association called on the parliament to ban the local consumption of the species so as to protect its export. Nile perch were involved with the worship of Neith . As a result nile perch were sometimes mummified. A deposit of several thousand mummified perch was excavated in an area to the west of Esna where there was a temple to Neith. Mummified perch have also been found at Gurob near a temple to Neith while perch statuettes have been found at Sais again in the context of a temple to Neith.

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West Nile

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Rabies

Rabies is a viral disease that causes encephalitis in humans and other mammals . It was historically referred to as hydrophobia ("fear of water") due to the symptom of panic when presented with liquids to drink. Early symptoms can include fever and abnormal sensations at the site of exposure. These symptoms are followed by one or more of the following symptoms: nausea, vomiting, violent movements, uncontrolled excitement, fear of water, an inability to move parts of the body, confusion, and loss of consciousness . Once symptoms appear, the result is virtually always death. The time period between contracting the disease and the start of symptoms is usually one to three months but can vary from less than one week to more than one year. The time depends on the distance the virus must travel along peripheral nerves to reach the central nervous system . Rabies is caused by lyssaviruses , including the rabies virus and Australian bat lyssavirus . It is spread when an infected animal bites or scratches a human or other animals. Saliva from an infected animal can also transmit rabies if the saliva comes into contact with the eyes, mouth, or nose. Globally, dogs are the most common animal involved. In countries where dogs commonly have the disease, more than 99% of rabies cases are the direct result of dog bites . In the Americas , bat bites are the most common source of rabies infections in humans, and less than 5% of cases are from dogs. Rodents are very rarely infected with rabies. The disease can be diagnosed only after the start of symptoms. Animal control and vaccination programs have decreased the risk of rabies from dogs in a number of regions of the world. Immunizing people before they are exposed is recommended for those at high risk, including those who work with bats or who spend prolonged periods in areas of the world where rabies is common. In people who have been exposed to rabies, the rabies vaccine and sometimes rabies immunoglobulin are effective in preventing the disease if the person receives the treatment before the start of rabies symptoms. Washing bites and scratches for 15 minutes with soap and water, povidone-iodine , or detergent may reduce the number of viral particles and may be somewhat effective at preventing transmission. As of 2016 [ update ] , only fourteen people were documented to have survived a rabies infection after showing symptoms. However, research conducted in 2010 among a population of people in Peru with a self-reported history of one or more bites from vampire bats (commonly infected with rabies), found that out of 73 individuals reporting previous bat bites, seven people had rabies virus-neutralizing antibodies (rVNA). Since only one member of this group reported prior vaccination for rabies, the findings of the research suggest previously undocumented cases of infection and viral replication followed by an abortive infection. This could indicate that people may have an exposure to the virus without treatment and develop natural antibodies as a result. Rabies causes about 59,000 deaths worldwide per year, about 40% of which are in children under the age of 15. More than 95% of human deaths from rabies occur in Africa and Asia. Rabies is present in more than 150 countries and on all continents but Antarctica. More than 3 billion people live in regions of the world where rabies occurs. A number of countries, including Australia and Japan, as well as much of Western Europe, do not have rabies among dogs. Many Pacific islands do not have rabies at all. It is classified as a neglected tropical disease . The name rabies is derived from the Latin rabies , "madness". The Greeks derived the word lyssa , from lud or "violent"; this root is used in the genus name of the rabies virus, Lyssavirus . The period between infection and the first symptoms (incubation period) is typically one to three months in humans. This period may be as short as four days or longer than six years, depending on the location and severity of the wound and the amount of virus introduced. Initial symptoms of rabies are often nonspecific such as fever and headache. As rabies progresses and causes inflammation of the brain and meninges , symptoms can include slight or partial paralysis , anxiety , insomnia , confusion , agitation , abnormal behavior, paranoia , terror , and hallucinations . The person may also have fear of water. The symptoms eventually progress to delirium , and coma . Death usually occurs two to ten days after first symptoms. Survival is almost unknown once symptoms have presented, even with intensive care. Rabies has also occasionally been referred to as hydrophobia ("fear of water") throughout its history. It refers to a set of symptoms in the later stages of an infection in which the person has difficulty swallowing, shows panic when presented with liquids to drink, and cannot quench their thirst. Saliva production is greatly increased, and attempts to drink, or even the intention or suggestion of drinking, may cause excruciatingly painful spasms of the muscles in the throat and larynx . Since the infected individual cannot swallow saliva and water, the virus has a much higher chance of being transmitted, because it multiplies and accumulates in the salivary glands and is transmitted through biting. Hydrophobia is commonly associated with furious rabies, which affects 80% of rabies-infected people. This form of rabies causes irrational aggression in the host, which aids in the spreading of the virus through animal bites; [ medical citation needed ] a "foaming at the mouth" effect, caused by the accumulation of saliva, is also commonly associated with rabies in the public perception and in popular culture. The remaining 20% may experience a paralytic form of rabies that is marked by muscle weakness , loss of sensation, and paralysis ; this form of rabies does not usually cause fear of water. Rabies is caused by a number of lyssaviruses including the rabies virus and Australian bat lyssavirus . Duvenhage lyssavirus may cause a rabies-like infection. The rabies virus is the type species of the Lyssavirus genus , in the family Rhabdoviridae , order Mononegavirales . Lyssavirions have helical symmetry, with a length of about 180 nm and a cross-section of about 75 nm. These virions are enveloped and have a single-stranded RNA genome with negative sense . The genetic information is packed as a ribonucleoprotein complex in which RNA is tightly bound by the viral nucleoprotein. The RNA genome of the virus encodes five genes whose order is highly conserved: nucleoprotein (N), phosphoprotein (P), matrix protein (M), glycoprotein (G), and the viral RNA polymerase (L). To enter cells, trimeric spikes on the exterior of the membrane of the virus interact with a specific cell receptor, the most likely one being the acetylcholine receptor. The cellular membrane pinches in a procession known as pinocytosis and allows entry of the virus into the cell by way of an endosome . The virus then uses the acidic environment, which is necessary, of that endosome and binds to its membrane simultaneously, releasing its five proteins and single-strand RNA into the cytoplasm. Once within a muscle or nerve cell, the virus undergoes replication. The L protein then transcribes five mRNA strands and a positive strand of RNA all from the original negative strand RNA using free nucleotides in the cytoplasm. These five mRNA strands are then translated into their corresponding proteins (P, L, N, G and M proteins) at free ribosomes in the cytoplasm. Some proteins require post-translational modifications. For example, the G protein travels through the rough endoplasmic reticulum , where it undergoes further folding, and is then transported to the Golgi apparatus , where a sugar group is added to it ( glycosylation ). When there are enough viral proteins, the viral polymerase will begin to synthesize new negative strands of RNA from the template of the positive-strand RNA. These negative strands will then form complexes with the N, P, L and M proteins and then travel to the inner membrane of the cell, where a G protein has embedded itself in the membrane. The G protein then coils around the N-P-L-M complex of proteins taking some of the host cell membrane with it, which will form the new outer envelope of the virus particle. The virus then buds from the cell. From the point of entry, the virus is neurotropic , traveling along the neural pathways into the central nervous system . The virus usually first infects muscle cells close to the site of infection, where they are able to replicate without being 'noticed' by the host's immune system. Once enough virus has been replicated, they begin to bind to acetylcholine receptors at the neuromuscular junction. The virus then travels through the nerve cell axon via retrograde transport , as its P protein interacts with dynein , a protein present in the cytoplasm of nerve cells. Once the virus reaches the cell body it travels rapidly to the central nervous system (CNS), replicating in motor neurons and eventually reaching the brain. After the brain is infected, the virus travels centrifugally to the peripheral and autonomic nervous systems, eventually migrating to the salivary glands, where it is ready to be transmitted to the next host. : 317All warm-blooded species, including humans, may become infected with the rabies virus and develop symptoms. Birds were first artificially infected with rabies in 1884; however, infected birds are largely, if not wholly, asymptomatic, and recover. Other bird species have been known to develop rabies antibodies , a sign of infection, after feeding on rabies-infected mammals. The virus has also adapted to grow in cells of cold-blooded vertebrates. Most animals can be infected by the virus and can transmit the disease to humans. Worldwide, about 99% of human rabies cases come from domestic dogs. Other sources of rabies in humans include bats , monkeys , raccoons , foxes , skunks , cattle , wolves , coyotes , cats , and mongooses (normally either the small Asian mongoose or the yellow mongoose). Rabies may also spread through exposure to infected bears , domestic farm animals , groundhogs , weasels , and other wild carnivorans . However, lagomorphs , such as hares and rabbits , and small rodents , such as chipmunks , gerbils , guinea pigs , hamsters , mice , rats , and squirrels , are almost never found to be infected with rabies and are not known to transmit rabies to humans. Bites from mice, rats, or squirrels rarely require rabies prevention because these rodents are typically killed by any encounter with a larger, rabid animal, and would, therefore, not be carriers. The Virginia opossum (a marsupial, unlike the other mammals named in this paragraph, which are all eutherians / placental ), has a lower internal body temperature than the rabies virus prefers and therefore is resistant but not immune to rabies. Marsupials , along with monotremes ( platypuses and echidnas ), typically have lower body temperatures than similarly sized eutherians . The virus is usually present in the nerves and saliva of a symptomatic rabid animal. The route of infection is usually, but not always, by a bite. In many cases, the infected animal is exceptionally aggressive, may attack without provocation, and exhibits otherwise uncharacteristic behavior. This is an example of a viral pathogen modifying the behavior of its host to facilitate its transmission to other hosts. After a typical human infection by bite, the virus enters the peripheral nervous system . It then travels retrograde along the efferent nerves toward the central nervous system . During this phase, the virus cannot be easily detected within the host, and vaccination may still confer cell-mediated immunity to prevent symptomatic rabies. When the virus reaches the brain , it rapidly causes encephalitis , the prodromal phase, which is the beginning of the symptoms. Once the patient becomes symptomatic, treatment is almost never effective and mortality is over 99%. Rabies may also inflame the spinal cord , producing transverse myelitis . Although it is theoretically possible for rabies-infected humans to transmit it to others by biting or otherwise, no such cases have ever been documented, because infected humans are usually hospitalized and necessary precautions taken. Casual contact, such as touching a person with rabies or contact with non-infectious fluid or tissue (urine, blood, feces), does not constitute an exposure and does not require post-exposure prophylaxis. But as the virus is present in sperm and vaginal secretions, it might be possible for rabies to spread through sex. There are only a small number of recorded cases of human-to-human transmission of rabies, and all occurred through organ transplants , most frequently with corneal transplantation , from infected donors. Rabies can be difficult to diagnose because, in the early stages, it is easily confused with other diseases or even with a simple aggressive temperament. The reference method for diagnosing rabies is the fluorescent antibody test (FAT), an immunohistochemistry procedure, which is recommended by the World Health Organization (WHO). The FAT relies on the ability of a detector molecule (usually fluorescein isothiocyanate) coupled with a rabies-specific antibody, forming a conjugate, to bind to and allow the visualisation of rabies antigen using fluorescent microscopy techniques. Microscopic analysis of samples is the only direct method that allows for the identification of rabies virus-specific antigen in a short time and at a reduced cost, irrespective of geographical origin and status of the host. It has to be regarded as the first step in diagnostic procedures for all laboratories. Autolysed samples can, however, reduce the sensitivity and specificity of the FAT. The RT PCR assays proved to be a sensitive and specific tool for routine diagnostic purposes, particularly in decomposed samples or archival specimens. The diagnosis can be reliably made from brain samples taken after death. The diagnosis can also be made from saliva, urine, and cerebrospinal fluid samples, but this is not as sensitive or reliable as brain samples. Cerebral inclusion bodies called Negri bodies are 100% diagnostic for rabies infection but are found in only about 80% of cases. If possible, the animal from which the bite was received should also be examined for rabies. Some light microscopy techniques may also be used to diagnose rabies at a tenth of the cost of traditional fluorescence microscopy techniques, allowing identification of the disease in less-developed countries. A test for rabies, known as LN34, is easier to run on a dead animal's brain and might help determine who does and does not need post-exposure prevention. The test was developed by the Centers for Disease Control and Prevention (CDC) in 2018. The differential diagnosis in a case of suspected human rabies may initially include any cause of encephalitis , in particular infection with viruses such as herpesviruses , enteroviruses , and arboviruses such as West Nile virus . The most important viruses to rule out are herpes simplex virus type one, varicella zoster virus , and (less commonly) enteroviruses, including coxsackieviruses , echoviruses , polioviruses , and human enteroviruses 68 to 71. New causes of viral encephalitis are also possible, as was evidenced by the 1999 outbreak in Malaysia of 300 cases of encephalitis with a mortality rate of 40% caused by Nipah virus , a newly recognized paramyxovirus . Likewise, well-known viruses may be introduced into new locales, as is illustrated by the outbreak of encephalitis due to West Nile virus in the eastern United States. Almost all human exposure to rabies was fatal until a vaccine was developed in 1885 by Louis Pasteur and Émile Roux . Their original vaccine was harvested from infected rabbits, from which the virus in the nerve tissue was weakened by allowing it to dry for five to ten days. Similar nerve tissue-derived vaccines are still used in some countries, as they are much cheaper than modern cell culture vaccines. The human diploid cell rabies vaccine was started in 1967. Less expensive purified chicken embryo cell vaccine and purified vero cell rabies vaccine are now available. A recombinant vaccine called V-RG has been used in Belgium, France, Germany, and the United States to prevent outbreaks of rabies in undomesticated animals. Immunization before exposure has been used in both human and nonhuman populations, where, as in many jurisdictions, domesticated animals are required to be vaccinated. The Missouri Department of Health and Senior Services Communicable Disease Surveillance 2007 Annual Report states the following can help reduce the risk of contracting rabies: Vaccinating dogs, cats, and ferrets against rabies Keeping pets under supervision Not handling wild animals or strays Contacting an animal control officer upon observing a wild animal or a stray, especially if the animal is acting strangely If bitten by an animal, washing the wound with soap and water for 10 to 15 minutes and contacting a healthcare provider to determine if post-exposure prophylaxis is required 28 September is World Rabies Day , which promotes the information, prevention, and elimination of the disease. In Asia and in parts of the Americas and Africa, dogs remain the principal host. Mandatory vaccination of animals is less effective in rural areas. Especially in developing countries, pets may not be privately kept and their destruction may be unacceptable. Oral vaccines can be safely distributed in baits, a practice that has successfully reduced rabies in rural areas of Canada , France , and the United States . In Montreal , Quebec, Canada, baits are successfully used on raccoons in the Mount-Royal Park area. Vaccination campaigns may be expensive, but cost-benefit analysis suggests baits may be a cost-effective method of control. In Ontario , a dramatic drop in rabies was recorded when an aerial bait-vaccination campaign was launched. The number of recorded human deaths from rabies in the United States has dropped from 100 or more annually in the early 20th century to one or two per year due to widespread vaccination of domestic dogs and cats and the development of human vaccines and immunoglobulin treatments. Most deaths now result from bat bites, which may go unnoticed by the victim and hence untreated. Treatment after exposure can prevent the disease if given within 10 days. The rabies vaccine is 100% effective if given before symptoms of rabies appear. Every year, more than 15 million people get vaccinated after potential exposure. While this works well, the cost is significant. In the US it is recommended people receive one dose of human rabies immunoglobulin (HRIG) and four doses of rabies vaccine over a 14-day period. HRIG is expensive and makes up most of the cost of post-exposure treatment, ranging as high as several thousand dollars. In the UK, one dose of HRIG costs the National Health Service £1,000, although this is not flagged as a "high-cost medication". A full course of vaccine costs £120–180. As much as possible of HRIG should be injected around the bites, with the remainder being given by deep intramuscular injection at a site distant from the vaccination site. People who have previously been vaccinated against rabies do not need to receive the immunoglobulin—only the postexposure vaccinations on days 0 and 3. The side effects of modern cell-based vaccines are similar to the side effects of flu shots. The old nerve-tissue-based vaccination required multiple injections into the abdomen with a large needle but is inexpensive. It is being phased out and replaced by affordable World Health Organization intradermal-vaccination regimens. In children less than a year old, the lateral thigh is recommended. Thoroughly washing the wound as soon as possible with soap and water for approximately five minutes is effective in reducing the number of viral particles. Povidone-iodine or alcohol is then recommended to reduce the virus further. Awakening to find a bat in the room, or finding a bat in the room of a previously unattended child or mentally disabled or intoxicated person, is an indication for post-exposure prophylaxis (PEP). The recommendation for the precautionary use of PEP in bat encounters where no contact is recognized has been questioned in the medical literature, based on a cost–benefit analysis . However, a 2002 study has supported the protocol of precautionary administration of PEP where a child or mentally compromised individual has been alone with a bat, especially in sleep areas, where a bite or exposure may occur with the victim being unaware. Once rabies develops, death almost certainly follows. Palliative care in a hospital setting is recommended with administration of large doses of pain medication, and sedatives in preference to physical restraint. Ice fragments can be given by mouth for thirst, but there is no good evidence intravenous hydration is of benefit. A treatment known as the Milwaukee protocol, which involves putting a person into a chemically induced coma and using antiviral medications , has been proposed. It initially came into use in 2003, following Jeanna Giese, a teenage girl from Wisconsin , becoming the first person known to have survived rabies without preventive treatments before symptom onset. The protocol has been tried multiple times since, but has been assessed as an ineffective treatment, and concerns raised about the costs and ethics of its use. Treatment after exposure can prevent the disease if given within 10 days. The rabies vaccine is 100% effective if given before symptoms of rabies appear. Every year, more than 15 million people get vaccinated after potential exposure. While this works well, the cost is significant. In the US it is recommended people receive one dose of human rabies immunoglobulin (HRIG) and four doses of rabies vaccine over a 14-day period. HRIG is expensive and makes up most of the cost of post-exposure treatment, ranging as high as several thousand dollars. In the UK, one dose of HRIG costs the National Health Service £1,000, although this is not flagged as a "high-cost medication". A full course of vaccine costs £120–180. As much as possible of HRIG should be injected around the bites, with the remainder being given by deep intramuscular injection at a site distant from the vaccination site. People who have previously been vaccinated against rabies do not need to receive the immunoglobulin—only the postexposure vaccinations on days 0 and 3. The side effects of modern cell-based vaccines are similar to the side effects of flu shots. The old nerve-tissue-based vaccination required multiple injections into the abdomen with a large needle but is inexpensive. It is being phased out and replaced by affordable World Health Organization intradermal-vaccination regimens. In children less than a year old, the lateral thigh is recommended. Thoroughly washing the wound as soon as possible with soap and water for approximately five minutes is effective in reducing the number of viral particles. Povidone-iodine or alcohol is then recommended to reduce the virus further. Awakening to find a bat in the room, or finding a bat in the room of a previously unattended child or mentally disabled or intoxicated person, is an indication for post-exposure prophylaxis (PEP). The recommendation for the precautionary use of PEP in bat encounters where no contact is recognized has been questioned in the medical literature, based on a cost–benefit analysis . However, a 2002 study has supported the protocol of precautionary administration of PEP where a child or mentally compromised individual has been alone with a bat, especially in sleep areas, where a bite or exposure may occur with the victim being unaware. Once rabies develops, death almost certainly follows. Palliative care in a hospital setting is recommended with administration of large doses of pain medication, and sedatives in preference to physical restraint. Ice fragments can be given by mouth for thirst, but there is no good evidence intravenous hydration is of benefit. A treatment known as the Milwaukee protocol, which involves putting a person into a chemically induced coma and using antiviral medications , has been proposed. It initially came into use in 2003, following Jeanna Giese, a teenage girl from Wisconsin , becoming the first person known to have survived rabies without preventive treatments before symptom onset. The protocol has been tried multiple times since, but has been assessed as an ineffective treatment, and concerns raised about the costs and ethics of its use. Vaccination after exposure, PEP, is highly successful in preventing rabies. In unvaccinated humans, rabies is almost certainly fatal after neurological symptoms have developed. In 2010, an estimated 26,000 people died from rabies, down from 54,000 in 1990. The majority of the deaths occurred in Asia and Africa. As of 2015 [ update ] , India (approximately 20,847), followed by China (approximately 6,000) and the Democratic Republic of the Congo (5,600), had the most cases. A 2015 collaboration between the World Health Organization, World Organization of Animal Health (OIE), Food and Agriculture Organization of the United Nation (FAO), and Global Alliance for Rabies Control has a goal of eliminating deaths from rabies by 2030. India has the highest rate of human rabies in the world, primarily because of stray dogs, whose number has greatly increased since a 2001 law forbade the killing of dogs. Effective control and treatment of rabies in India is hindered by a form of mass hysteria known as puppy pregnancy syndrome (PPS). Dog bite victims with PPS, male as well as female, become convinced that puppies are growing inside them, and often seek help from faith healers rather than medical services. An estimated 20,000 people die every year from rabies in India, more than a third of the global total. Australia has an official rabies-free status, although Australian bat lyssavirus (ABLV), discovered in 1996, is a rabies-causing virus related to the rabies virus prevalent in Australian native bat populations. Canine-specific rabies has been eradicated in the United States, but rabies is common among wild animals, and an average of 100 dogs become infected from other wildlife each year. Due to high public awareness of the virus, efforts at vaccination of domestic animals and curtailment of feral populations, and availability of postexposure prophylaxis , incidence of rabies in humans is very rare in the United States. From 1960 to 2018, a total of 125 human rabies cases were reported in the United States; 36 (28%) were attributed to dog bites during international travel. Among the 89 infections acquired in the United States, 62 (70%) were attributed to bats. The most recent rabies death in the United States was in November 2021, where a Texas child was bitten by a bat in late August 2021 but his parents failed to get him treatment. He died less than three months later. Either no or very few cases of rabies are reported each year in Europe; cases are contracted both during travel and in Europe. In Switzerland the disease was virtually eliminated after scientists placed chicken heads laced with live attenuated vaccine in the Swiss Alps . Foxes, proven to be the main source of rabies in the country, ate the chicken heads and became immunized. Italy, after being declared rabies-free from 1997 to 2008, has witnessed a reemergence of the disease in wild animals in the Triveneto regions ( Trentino-Alto Adige/Südtirol , Veneto and Friuli Venezia Giulia ), due to the spreading of an epidemic in the Balkans that also affected Austria. An extensive wild animal vaccination campaign eliminated the virus from Italy again, and it regained the rabies-free country status in 2013, the last reported case of rabies being reported in a red fox in early 2011. The United Kingdom has been free of rabies since the early 20th century except for a rabies-like virus (EBLV-2) in a few Daubenton's bats . There has been one fatal case of EBLV-2 transmission to a human. There have been four deaths from rabies, transmitted abroad by dog bites, since 2000. The last infection in the UK occurred in 1922, and the last death from indigenous rabies was in 1902. Sweden and mainland Norway have been free of rabies since 1886. Bat rabies antibodies (but not the virus) have been found in bats. On Svalbard, animals can cross the arctic ice from Greenland or Russia. Mexico was certified by the World Health Organization as being free of dog-transmitted rabies in 2019 because no case of dog-human transmission had been recorded in two years. India has the highest rate of human rabies in the world, primarily because of stray dogs, whose number has greatly increased since a 2001 law forbade the killing of dogs. Effective control and treatment of rabies in India is hindered by a form of mass hysteria known as puppy pregnancy syndrome (PPS). Dog bite victims with PPS, male as well as female, become convinced that puppies are growing inside them, and often seek help from faith healers rather than medical services. An estimated 20,000 people die every year from rabies in India, more than a third of the global total. Australia has an official rabies-free status, although Australian bat lyssavirus (ABLV), discovered in 1996, is a rabies-causing virus related to the rabies virus prevalent in Australian native bat populations.Canine-specific rabies has been eradicated in the United States, but rabies is common among wild animals, and an average of 100 dogs become infected from other wildlife each year. Due to high public awareness of the virus, efforts at vaccination of domestic animals and curtailment of feral populations, and availability of postexposure prophylaxis , incidence of rabies in humans is very rare in the United States. From 1960 to 2018, a total of 125 human rabies cases were reported in the United States; 36 (28%) were attributed to dog bites during international travel. Among the 89 infections acquired in the United States, 62 (70%) were attributed to bats. The most recent rabies death in the United States was in November 2021, where a Texas child was bitten by a bat in late August 2021 but his parents failed to get him treatment. He died less than three months later. Either no or very few cases of rabies are reported each year in Europe; cases are contracted both during travel and in Europe. In Switzerland the disease was virtually eliminated after scientists placed chicken heads laced with live attenuated vaccine in the Swiss Alps . Foxes, proven to be the main source of rabies in the country, ate the chicken heads and became immunized. Italy, after being declared rabies-free from 1997 to 2008, has witnessed a reemergence of the disease in wild animals in the Triveneto regions ( Trentino-Alto Adige/Südtirol , Veneto and Friuli Venezia Giulia ), due to the spreading of an epidemic in the Balkans that also affected Austria. An extensive wild animal vaccination campaign eliminated the virus from Italy again, and it regained the rabies-free country status in 2013, the last reported case of rabies being reported in a red fox in early 2011. The United Kingdom has been free of rabies since the early 20th century except for a rabies-like virus (EBLV-2) in a few Daubenton's bats . There has been one fatal case of EBLV-2 transmission to a human. There have been four deaths from rabies, transmitted abroad by dog bites, since 2000. The last infection in the UK occurred in 1922, and the last death from indigenous rabies was in 1902. Sweden and mainland Norway have been free of rabies since 1886. Bat rabies antibodies (but not the virus) have been found in bats. On Svalbard, animals can cross the arctic ice from Greenland or Russia.Mexico was certified by the World Health Organization as being free of dog-transmitted rabies in 2019 because no case of dog-human transmission had been recorded in two years. Rabies has been known since around 2000 BC. The first written record of rabies is in the Mesopotamian Codex of Eshnunna ( c. 1930 BC ), which dictates that the owner of a dog showing symptoms of rabies should take preventive measures against bites. If another person were bitten by a rabid dog and later died, the owner was heavily fined. In Ancient Greece, rabies was supposed to be caused by Lyssa , the spirit of mad rage. Ineffective folk remedies abounded in the medical literature of the ancient world. The physician Scribonius Largus prescribed a poultice of cloth and hyena skin; Antaeus recommended a preparation made from the skull of a hanged man. Rabies appears to have originated in the Old World, the first epizootic in the New World occurring in Boston in 1768. Rabies was considered a scourge for its prevalence in the 19th century. In France and Belgium, where Saint Hubert was venerated, the " St Hubert's Key " was heated and applied to cauterize the wound. By an application of magical thinking , dogs were branded with the key in hopes of protecting them from rabies. It was not uncommon for a person bitten by a dog merely suspected of being rabid to commit suicide or to be killed by others. In ancient times the attachment of the tongue (the lingual frenulum , a mucous membrane) was cut and removed, as this was where rabies was thought to originate. This practice ceased with the discovery of the actual cause of rabies. Louis Pasteur's 1885 nerve tissue vaccine was successful, and was progressively improved to reduce often severe side-effects. In modern times, the fear of rabies has not diminished, and the disease and its symptoms, particularly agitation, have served as an inspiration for several works of zombie or similarly themed fiction, often portraying rabies as having mutated into a stronger virus which fills humans with murderous rage or incurable illness, bringing about a devastating, widespread pandemic. Rabies is infectious to mammals ; three stages of central nervous system infection are recognized. The clinical course is often shorter in animals than in humans, but result in similar symptoms and almost always death. The first stage is a one- to three-day period characterized by behavioral changes and is known as the prodromal stage . The second is the excitative stage, which lasts three to four days. This stage is often known as "furious rabies" for the tendency of the affected animal to be hyper-reactive to external stimuli and bite or attack anything near. In some cases, animals skip the excitative stage and develop paralysis, as in the third phase; the paralytic phase. This stage develops due to damage to motor neurons . Incoordination is seen, owing to rear limb paralysis , and drooling and difficulty swallowing is caused by paralysis of facial and throat muscles. Death is usually caused by respiratory arrest .

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Culex

Culex or typical mosquitoes are a genus of mosquitoes , several species of which serve as vectors of one or more important diseases of birds, humans, and other animals. The diseases they vector include arbovirus infections such as West Nile virus , Japanese encephalitis , or St. Louis encephalitis , but also filariasis and avian malaria . They occur worldwide except for the extreme northern parts of the temperate zone , and are the most common form of mosquito encountered in some major U.S. cities, such as Los Angeles .In naming this genus , Carl Linnaeus used the nonspecific Latin term for a midge or gnat: culex . Depending on the species, the adult Culex mosquito may measure from 4–10 mm (0.2–0.4 in) . The adult morphology is typical of flies in the suborder Nematocera with the head , thorax , and abdomen clearly defined and the two forewings held horizontally over the abdomen when at rest. As in all Diptera capable of flight, the second pair of wings is reduced and modified into tiny, inconspicuous halteres . [ citation needed ] Formal identification is important in mosquito control, but it is demanding and requires careful measurements of bodily proportions and noting the presence or absence of various bristles or other bodily features. In the field, informal identification is more often important, and the first question as a rule is whether the mosquito is anopheline or culicine . Given a specimen in good condition, one of the first things to notice is the length of the maxillary palps. Especially in the female, palps as long as the proboscis are characteristic of anopheline mosquitoes. Culicine females have short palps. Anopheline mosquitoes tend to have dappled or spotted wings, while culicine wings tend to be clear. Anopheline mosquitoes tend to sit with their heads low and their rear ends raised high, especially when feeding, while culicine females keep their bodies horizontal. Anopheline larvae tend to float horizontal at the surface of the water when not in motion, whereas culicine larvae float with head low and only the siphon at the tail held at the surface. The developmental cycle of most species takes about two weeks in warm weather. The metamorphosis is typical of holometabolism in an insect: the female lays eggs in rafts of as many as 300 on the water's surface. Suitable habitats for egg-laying are small bodies of standing fresh water: puddles, pools, ditches, tin cans, buckets, bottles, and water storage tanks (tree boles are suitable for only a few species). The tiny, cigar-shaped, dark brown eggs adhere to each other through adhesion forces, not any kind of cement, and are easily separated. Eggs hatch only in the presence of water, and the larvae are obligately aquatic, linear in form, and maintain their position and mostly vertical attitude in water by movements of their bristly mouthparts. To swim, they lash their bodies back and forth through the water. During the larval stage, the insect lives submerged in water and feeds on particles of organic matter, microscopic organisms or plant material; after several instars it then develops into a pupa . Unlike the larva, the pupa is comma-shaped. It does not feed, but can swim in rapid jerking motions to avoid potential predators. It must remain in regular contact with the surface to breathe, but it must not become desiccated. After 24–48 hours, the pupa ruptures and the adult emerges from the shed exoskeleton. [ citation needed ]Diseases borne by one or more species of Culex mosquitoes vary in their dependence on the species of vector. Some are rarely and only incidentally transmitted by Culex species, but Culex and closely related genera of culicine mosquitoes readily support perennial epidemics of certain major diseases if they become established in a particular region. [ citation needed ] Nonanal has been identified as a compound that attracts Culex mosquitoes, perhaps pheromonally. Nonanal acts synergistically with carbon dioxide . Culex is a diverse genus. It comprises over 20 subgenera that include a total of well over 1,000 species. Publications of newly described species are frequent. [ citation needed ]

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Disease vector

In epidemiology , a disease vector is any living agent that carries and transmits an infectious pathogen such as a parasite or microbe, to another living organism. Agents regarded as vectors are mostly blood-sucking insects such as mosquitoes. The first major discovery of a disease vector came from Ronald Ross in 1897, who discovered the malaria pathogen when he dissected the stomach tissue of a mosquito . Arthropods form a major group of pathogen vectors with mosquitoes , flies , sand flies , lice , fleas , ticks , and mites transmitting a huge number of pathogens. Many such vectors are haematophagous , which feed on blood at some or all stages of their lives. When the insects feed on blood, the pathogen enters the blood stream of the host. This can happen in different ways. The Anopheles mosquito, a vector for malaria , filariasis , and various arthropod-borne-viruses ( arboviruses ), inserts its delicate mouthpart under the skin and feeds on its host's blood. The parasites the mosquito carries are usually located in its salivary glands (used by mosquitoes to anaesthetise the host). Therefore, the parasites are transmitted directly into the host's blood stream. Pool feeders such as the sand fly and black fly , vectors for pathogens causing leishmaniasis and onchocerciasis respectively, will chew a well in the host's skin, forming a small pool of blood from which they feed. Leishmania parasites then infect the host through the saliva of the sand fly. Onchocerca force their own way out of the insect's head into the pool of blood. Triatomine bugs are responsible for the transmission of a trypanosome , Trypanosoma cruzi , which causes Chagas disease . The Triatomine bugs defecate during feeding and the excrement contains the parasites, which are accidentally smeared into the open wound by the host responding to pain and irritation from the bite. There are several species of Thrips that act as vectors for over 20 viruses, especially Tospoviruses , and cause all sorts of plant diseases . Some plants and fungi act as vectors for various pathogens. For example, the big-vein disease of lettuce was long thought to be caused by a member of the fungal division Chytridiomycota , namely Olpidium brassicae . Eventually, however, the disease was shown to be viral. Later it transpired that the virus was transmitted by the zoospores of the fungus and also survived in the resting spores. Since then, many other fungi in Chytridiomycota have been shown to vector plant viruses. Many plant pests that seriously damage important crops depend on other plants, often weeds, to harbour or vector them; the distinction is not always clear. In the case of Puccinia graminis for example, Berberis and related genera act as alternate hosts in a cycle of infection of grain. More directly, when they twine from one plant to another, parasitic plants such as Cuscuta and Cassytha have been shown to convey phytoplasmal and viral diseases between plants. Rabies is transmitted through exposure to the saliva or brain tissue of an infected animal. Any warm-blooded animal can carry rabies, but the most common vectors are dogs , skunks , raccoons , and bats . Several articles, recent to early 2014, warn that human activities are spreading vector-borne zoonotic diseases. [lower-alpha 1] Several articles were published in the medical journal The Lancet , and discuss how rapid changes in land use , trade globalization , climate change and "social upheaval" are causing a resurgence in zoonotic disease across the world. Examples of vector-borne zoonotic diseases include: Many factors affect the incidence of vector-borne diseases. These factors include animals hosting the disease, vectors, and people. Humans can also be vectors for some diseases, such as Tobacco mosaic virus , physically transmitting the virus with their hands from plant to plant. [ citation needed ]The World Health Organization (WHO) states that control and prevention of vector-borne diseases are emphasizing "Integrated Vector Management (IVM)", which is an approach that looks at the links between health and environment, optimizing benefits to both. [lower-alpha 2] In April 2014, WHO launched a campaign called "Small bite, big threat" to educate people about vector-borne illnesses. WHO issued reports indicating that vector-borne illnesses affect poor people, especially people living in areas that do not have adequate levels of sanitation, drinking water and housing. It is estimated that over 80% of the world's population resides in areas under threat of at least one vector borne disease.

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West Nile

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Nile Wilson

Nile Michael Wilson (born 17 January 1996) is a former British artistic gymnast . He won an Olympic bronze medal in the men's horizontal bar at the 2016 Summer Olympics ; he was a world medallist as a member of the silver-medal winning British team at the 2015 World Artistic Gymnastics Championships , the first world men's team medal in British gymnastics history. A five-time Commonwealth Games champion, he won the all-around title in 2018, and is a former European horizontal bar champion, the first Briton to win the title. In January 2021, Wilson announced his retirement from competitive gymnastics due to injuries and mental health concerns. In March 2023, he won the fifteenth series of Dancing on Ice with dance partner Olivia Smart . Wilson was born 17 January 1996 in Leeds to Sally and Neil Wilson and is the great nephew of Duncan Fearnley . He has a sister, Joanna. He attended ' Farsley Farfield' Primary School and Pudsey Grangefield School . Wilson runs a YouTube channel where he posts vlogs about his workouts, daily life and gymnastics (Nile Wilson) where he has more than 1.51 million subscribers, and another channel with his father (Neil and Nile Vlogs) which has more than 171,000 subscribers.Wilson was crowned British Junior Champion in March 2014 and received the Young Sportsman male award at the Leeds Sports Awards. He competed at the 2014 European Championships in Sofia in May, winning five gold medals to become the first British gymnast ever to win five gold medals at the European Junior Gymnastics Championships . He was then selected to compete for the England Commonwealth Games team, graduating to senior level.At the 2014 Commonwealth Games , Wilson contributed a score of 86.607 for the England team to win the Team Gold and qualify second for the Individual all-around final, behind teammate Max Whitlock . Wilson then won a bronze medal in the all-around final with a score of 87.965. He won silver in the Parallel bars final with a score of 15.433 behind Scottish gymnast Daniel Purvis . Wilson took his first individual Commonwealth gold in the Horizontal Bar final with a score of 14.966. His teammate Kristian Thomas took silver. Wilson competed at the 2015 Gymnastics World Championships in Glasgow. He placed tenth all around in qualification with 88.365, but did not advance due to the two per country rule. Wilson competed on three apparatus in the team final: Still Rings (14.933), Parallel Bars (15.033) and Horizontal bar (14.833), contributing to the team silver medal. Wilson also qualified to the Parallel Bars final, placing 8th with a score of 15.233. Wilson competed at the AT&T American Cup on 5 March 2016. He struggled in the competition, receiving execution scores below eight on three apparatuses. He did, however, receive the third highest score on parallel bars, scoring 15.266. He came fifth overall with a score of 84.131. On 12 July 2016, Wilson was named to the 2016 Olympic team along with Louis Smith , Max Whitlock , Kristian Thomas and Brinn Bevan . At the 2016 Olympics, Wilson became the first British gymnast to win the bronze medal on the horizontal bar , with a score of 15.466. In January 2017, Wilson suffered an injury to his left ankle ligament while training, which required surgery. He recovered in time to compete in the 2017 Artistic Gymnastics World Championships where he finished sixth in the all around final. In 2018, Wilson was selected to represent England and compete at the Commonwealth Games in the Gold Coast , Australia . On 5 April, he won a gold medal in the men's artistic team all-around and qualified in first place for the individual all-around which he went on to win for his second gold medal. He added a third gold on the horizontal bar , and won silver on the rings and on the parallel bars . Wilson underwent surgery on his neck in February 2019 to fix a bulging disc that was causing arm pain, and as a result, he missed a number of competitions that year, including the Birmingham World Cup and European Championships. On 14 January 2021, Wilson uploaded a video entitled "I've Retired from Gymnastics" to his YouTube channel, in which he announced his official retirement from competitive gymnastics. In the video, he cited health problems caused by gymnastics as the main factor in his retirement. Following his retirement from professional gymnastics, Wilson has raised allegations of a culture of abuse within British gymnastics. Whilst speaking with BBC Sport, Wilson stated that he was "without a doubt" abused during his training, was subject to "emotional manipulation", and was forced to "live in fear" of his coaches and the consequences of underperforming. Wilson also informed BBC Sport that he waited until after his retirement to raise these allegations as he feared he would face professional consequences, including deselection from the British Olympic team, if he spoke up whilst continuing to work as a professional gymnast. In March 2023, he won the fifteenth series of Dancing on Ice with dance partner Olivia Smart . At the 2014 Commonwealth Games , Wilson contributed a score of 86.607 for the England team to win the Team Gold and qualify second for the Individual all-around final, behind teammate Max Whitlock . Wilson then won a bronze medal in the all-around final with a score of 87.965. He won silver in the Parallel bars final with a score of 15.433 behind Scottish gymnast Daniel Purvis . Wilson took his first individual Commonwealth gold in the Horizontal Bar final with a score of 14.966. His teammate Kristian Thomas took silver. Wilson competed at the 2015 Gymnastics World Championships in Glasgow. He placed tenth all around in qualification with 88.365, but did not advance due to the two per country rule. Wilson competed on three apparatus in the team final: Still Rings (14.933), Parallel Bars (15.033) and Horizontal bar (14.833), contributing to the team silver medal. Wilson also qualified to the Parallel Bars final, placing 8th with a score of 15.233. Wilson competed at the AT&T American Cup on 5 March 2016. He struggled in the competition, receiving execution scores below eight on three apparatuses. He did, however, receive the third highest score on parallel bars, scoring 15.266. He came fifth overall with a score of 84.131. On 12 July 2016, Wilson was named to the 2016 Olympic team along with Louis Smith , Max Whitlock , Kristian Thomas and Brinn Bevan . At the 2016 Olympics, Wilson became the first British gymnast to win the bronze medal on the horizontal bar , with a score of 15.466. In January 2017, Wilson suffered an injury to his left ankle ligament while training, which required surgery. He recovered in time to compete in the 2017 Artistic Gymnastics World Championships where he finished sixth in the all around final. In 2018, Wilson was selected to represent England and compete at the Commonwealth Games in the Gold Coast , Australia . On 5 April, he won a gold medal in the men's artistic team all-around and qualified in first place for the individual all-around which he went on to win for his second gold medal. He added a third gold on the horizontal bar , and won silver on the rings and on the parallel bars . Wilson underwent surgery on his neck in February 2019 to fix a bulging disc that was causing arm pain, and as a result, he missed a number of competitions that year, including the Birmingham World Cup and European Championships. On 14 January 2021, Wilson uploaded a video entitled "I've Retired from Gymnastics" to his YouTube channel, in which he announced his official retirement from competitive gymnastics. In the video, he cited health problems caused by gymnastics as the main factor in his retirement. Following his retirement from professional gymnastics, Wilson has raised allegations of a culture of abuse within British gymnastics. Whilst speaking with BBC Sport, Wilson stated that he was "without a doubt" abused during his training, was subject to "emotional manipulation", and was forced to "live in fear" of his coaches and the consequences of underperforming. Wilson also informed BBC Sport that he waited until after his retirement to raise these allegations as he feared he would face professional consequences, including deselection from the British Olympic team, if he spoke up whilst continuing to work as a professional gymnast. In March 2023, he won the fifteenth series of Dancing on Ice with dance partner Olivia Smart .

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West Nile

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Funeral of a Mummy on the Nile

Funeral of a Mummy on the Nile (also known as Funeral of a Mummy , French : Les Funérailles d'une momie ) is an oil on canvas painting by American artist Frederick Arthur Bridgman . It was painted between 1876 and 1877 and is considered his most acclaimed painting. Since 1990, it has been exhibited in Louisville, Kentucky , at the Speed Art Museum .Bridgman, who lived in Paris since 1866, made several trips to North Africa between 1872 and 1874. In the winter of 1873–74, he traveled to Egypt for the first time, accompanied by fellow artist Charles Sprague Pearce . After spending some time in Cairo , they traveled upstream along the Nile , reaching as far as Abu Simbel in the south of Egypt. During this trip, Bridgman produced approximately 300 sketches and ink drawings, which became the source material for several later oil paintings. After returning to Paris in the summer of 1874, he commenced numerous large Egypt-themed compositions, among them several ambitious reconstructions of antique Egyptian life. Bridgman started working on Funeral of a Mummy on the Nile in 1876; the painting took him over six months to complete. Funeral of a Mummy on the Nile depicts a historical reconstruction of an ancient Egyptian funerary procession. The ancient Egyptians used funerary boats made of wood to transport mummified corpses across the Nile to the western bank, where most burials took place. The painting portrays three boats moving across the Nile toward its west bank at sunset, with the rear boat, the funerary barge, carrying the royal sarcophagus under a canopy. Near the stern of the barge, a group of female professional mourners are depicted, while two priests are standing on the other side of the sarcophagus, in front of an altar. Behind them, three seated musicians are playing a flute, a lute and a harp. Two other boats precede the funerary barge: a white boat with rowers, carrying the grave goods , is connected to the main barge by a rope and tows it across the Nile. Behind it is the third barge, with a decorated sail, carrying the family of the deceased and the members of the funeral procession. Dotting the water's surface alongside the funeral barge are colorful flowers which have been tossed into the river by the mourners. The background of the painting is formed by a low-ranging view of the river shoreline and the sky, with the yellow and orange colors of a sunset dominating the scene. The painting was signed with "FA Bridgman 1876–7" in the lower left corner. Funeral of a Mummy on the Nile is particularly notable for its historical accuracy. It features many archaeological details and ornaments associated with old Egyptian burial practices, which show Bridgman's passion for the culture of ancient Egypt and his in-depth studies of the ancient traditions. He utilized many available archaeological sources to create an accurate portrayal of life in ancient Egypt. Bridgman also had personal contact with the noted Egyptologist Gaston Maspero , who may have provided him with details about the funeral rites. Funeral of a Mummy on the Nile is particularly notable for its historical accuracy. It features many archaeological details and ornaments associated with old Egyptian burial practices, which show Bridgman's passion for the culture of ancient Egypt and his in-depth studies of the ancient traditions. He utilized many available archaeological sources to create an accurate portrayal of life in ancient Egypt. Bridgman also had personal contact with the noted Egyptologist Gaston Maspero , who may have provided him with details about the funeral rites. Funeral of a Mummy on the Nile was exhibited in 1877 in the Salon de Paris . It garnered a lot of attention, became an exhibition favorite and established Bridgman's success as an artist. The painting was praised for its artistic quality, authenticity and strong academic method and was described by art critic Earl Shinn as a "masterpiece". It was considered to be on par with the Orientalist works of Bridgman's teacher Jean-Léon Gérôme by some critics such as Albert Wolff . In the Paris Salon exhibition, the painting earned a third class medal, which was Bridgman's first Salon prize. It was subsequently purchased by James Gordon Bennett Jr. , publisher of the New York Herald , for $5000. The painting was then exhibited at the 1878 Exposition Universelle , before disappearing from public view for more than 100 years. The painting reappeared in 1990 in an auction at Sotheby's in New York. It was purchased by American art collector Wendell Cherry , who donated it to the Speed Art Museum in Louisville, Kentucky , where it is exhibited today. Bridgman produced two variants of Funeral of a Mummy on the Nile . They were painted on smaller canvases than the original Salon painting, but have a similar composition, as they also feature a funeral barge and two accompanying boats, one of which has a sail, in front of the river shoreline and the sunset sky. The landscape is the most significant difference between the three versions. In the Salon painting, the highest shoreline elevation is on the left side of the canvas, while the highest hills in both variants appear on the right side of the canvas. One of the variants was exhibited in the Royal Academy of Arts in 1881. On the occasion of the exhibition of Funeral of a Mummy on the Nile at the 1878 Exposition Universelle, Goupil & Cie issued a series of photogravure reproductions of the painting. Two of these prints are presently in the collection of the New York Public Library .

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West Nile

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Flavivirus

See text Flavivirus , renamed Orthoflavivirus in 2023, is a genus of positive-strand RNA viruses in the family Flaviviridae . The genus includes the West Nile virus , dengue virus , tick-borne encephalitis virus , yellow fever virus , Zika virus and several other viruses which may cause encephalitis , as well as insect-specific flaviviruses (ISFs) such as cell fusing agent virus (CFAV), Palm Creek virus (PCV), and Parramatta River virus (PaRV). While dual-host flaviviruses can infect vertebrates as well as arthropods, insect-specific flaviviruses are restricted to their competent arthropods. The means by which flaviviruses establish persistent infection in their competent vectors and cause disease in humans depends upon several virus-host interactions, including the intricate interplay between flavivirus-encoded immune antagonists and the host antiviral innate immune effector molecules. Flaviviruses are named for the yellow fever virus; the word flavus means 'yellow' in Latin , and yellow fever in turn is named from its propensity to cause yellow jaundice in victims. Flaviviruses share several common aspects: common size (40–65 nm), symmetry ( enveloped , icosahedral nucleocapsid ), nucleic acid ( positive-sense , single-stranded RNA around 10,000–11,000 bases), and appearance under the electron microscope . [ citation needed ] Most of these viruses are primarily transmitted by the bite from an infected arthropod (mosquito or tick), and hence are classified as arboviruses . Human infections with most of these arboviruses are incidental, as humans are unable to replicate the virus to high enough titers to reinfect the arthropods needed to continue the virus life-cycle – humans are then a dead end host . The exceptions to this are the yellow fever virus , dengue virus and zika virus . These three viruses still require mosquito vectors but are well-enough adapted to humans as to not necessarily depend upon animal hosts (although they continue to have important animal transmission routes, as well). Other virus transmission routes for arboviruses include handling infected animal carcasses, blood transfusion, sex, childbirth and consumption of unpasteurised milk products. Transmission from nonhuman vertebrates to humans without an intermediate vector arthropod however mostly occurs with low probability. For example, early tests with yellow fever showed that the disease is not contagious . The known non-arboviruses of the flavivirus family reproduce in either arthropods or vertebrates, but not both, with one odd member of the genus affecting a nematode . Flaviviruses are enveloped and spherical and have icosahedral geometries with a pseudo T=3 symmetry. The virus particle diameter is around 50 nm. Flaviviruses have positive-sense , single-stranded RNA genomes which are non-segmented and around 10–11 kbp in length. In general, the genome encodes three structural proteins (Capsid, prM, and Envelope) and seven non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B, NS5). The genomic RNA is modified at the 5′ end of positive-strand genomic RNA with a cap-1 structure (me 7 -GpppA-me 2 ). Flaviviruses replicate in the cytoplasm of the host cells. The genome mimics the cellular mRNA molecule in all aspects except for the absence of the poly-adenylated (poly-A) tail . This feature allows the virus to exploit cellular apparatuses to synthesize both structural and non-structural proteins, during replication . The cellular ribosome is crucial to the replication of the flavivirus, as it translates the RNA, in a similar fashion to cellular mRNA, resulting in the synthesis of a single polyprotein . Cellular RNA cap structures are formed via the action of an RNA triphosphatase , with guanylyltransferase , N7- methyltransferase and 2′-O methyltransferase. The virus encodes these activities in its non-structural proteins. The NS3 protein encodes a RNA triphosphatase within its helicase domain. It uses the helicase ATP hydrolysis site to remove the γ-phosphate from the 5′ end of the RNA. The N-terminal domain of the non-structural protein 5 (NS5) has both the N7-methyltransferase and guanylyltransferase activities necessary for forming mature RNA cap structures. RNA binding affinity is reduced by the presence of ATP or GTP and enhanced by S-adenosyl methionine . This protein also encodes a 2′-O methyltransferase. Once translated , the polyprotein is cleaved by a combination of viral and host proteases to release mature polypeptide products. Nevertheless, cellular post-translational modification is dependent on the presence of a poly-A tail; therefore this process is not host-dependent. Instead, the poly-protein contains an autocatalytic feature which automatically releases the first peptide, a virus specific enzyme. This enzyme is then able to cleave the remaining poly-protein into the individual products. One of the products cleaved is a RNA-dependent RNA polymerase , responsible for the synthesis of a negative-sense RNA molecule. Consequently, this molecule acts as the template for the synthesis of the genomic progeny RNA. [ citation needed ] Flavivirus genomic RNA replication occurs on rough endoplasmic reticulum membranes in membranous compartments. New viral particles are subsequently assembled. This occurs during the budding process which is also responsible for the accumulation of the envelope and cell lysis . [ citation needed ] A G protein-coupled receptor kinase 2 (also known as ADRBK1) appears to be important in entry and replication for several viruses in Flaviviridae . Humans, mammals, mosquitoes, and ticks serve as the natural host. Transmission routes are zoonosis and bite. The positive sense RNA genome of Flavivirus contains 5' and 3' untranslated regions (UTRs). The 5'UTRs are 95–101 nucleotides long in Dengue virus . There are two conserved structural elements in the Flavivirus 5'UTR, a large stem loop (SLA) and a short stem loop (SLB). SLA folds into a Y-shaped structure with a side stem loop and a small top loop. SLA is likely to act as a promoter, and is essential for viral RNA synthesis. SLB is involved in interactions between the 5'UTR and 3'UTR which result in the cyclisation of the viral RNA, which is essential for viral replication. The 3'UTRs are typically 0.3–0.5 kb in length and contain a number of highly conserved secondary structures which are conserved and restricted to the flavivirus family. The majority of analysis has been carried out using West Nile virus (WNV) to study the function the 3'UTR. [ citation needed ] Currently 8 secondary structures have been identified within the 3'UTR of WNV and are (in the order in which they are found with the 3'UTR) SL-I, SL-II, SL-III, SL-IV, DB1, DB2 and CRE. Some of these secondary structures have been characterised and are important in facilitating viral replication and protecting the 3'UTR from 5' endonuclease digestion. Nuclease resistance protects the downstream 3' UTR RNA fragment from degradation and is essential for virus-induced cytopathicity and pathogenicity. [ citation needed ] SL-II SL-II has been suggested to contribute to nuclease resistance. It may be related to another hairpin loop identified in the 5'UTR of the Japanese encephalitis virus (JEV) genome. The JEV hairpin is significantly over-represented upon host cell infection and it has been suggested that the hairpin structure may play a role in regulating RNA synthesis. [ citation needed ] SL-IV This secondary structure is located within the 3'UTR of the genome of Flavivirus upstream of the DB elements. The function of this conserved structure is unknown but is thought to contribute to ribonuclease resistance. [ citation needed ] DB1/DB2 These two conserved secondary structures are also known as pseudo-repeat elements. They were originally identified within the genome of Dengue virus and are found adjacent to each other within the 3'UTR. They appear to be widely conserved across the Flaviviradae. These DB elements have a secondary structure consisting of three helices and they play a role in ensuring efficient translation. Deletion of DB1 has a small but significant reduction in translation but deletion of DB2 has little effect. Deleting both DB1 and DB2 reduced translation efficiency of the viral genome to 25%. CRE CRE is the Cis-acting replication element, also known as the 3'SL RNA elements, and is thought to be essential in viral replication by facilitating the formation of a "replication complex". Although evidence has been presented for an existence of a pseudoknot structure in this RNA, it does not appear to be well conserved across flaviviruses. Deletions of the 3' UTR of flaviviruses have been shown to be lethal for infectious clones. A conserved hairpin (cHP) structure was later found in several Flavivirus genomes and is thought to direct translation of capsid proteins. It is located just downstream of the AUG start codon . The 5'UTRs are 95–101 nucleotides long in Dengue virus . There are two conserved structural elements in the Flavivirus 5'UTR, a large stem loop (SLA) and a short stem loop (SLB). SLA folds into a Y-shaped structure with a side stem loop and a small top loop. SLA is likely to act as a promoter, and is essential for viral RNA synthesis. SLB is involved in interactions between the 5'UTR and 3'UTR which result in the cyclisation of the viral RNA, which is essential for viral replication. The 3'UTRs are typically 0.3–0.5 kb in length and contain a number of highly conserved secondary structures which are conserved and restricted to the flavivirus family. The majority of analysis has been carried out using West Nile virus (WNV) to study the function the 3'UTR. [ citation needed ] Currently 8 secondary structures have been identified within the 3'UTR of WNV and are (in the order in which they are found with the 3'UTR) SL-I, SL-II, SL-III, SL-IV, DB1, DB2 and CRE. Some of these secondary structures have been characterised and are important in facilitating viral replication and protecting the 3'UTR from 5' endonuclease digestion. Nuclease resistance protects the downstream 3' UTR RNA fragment from degradation and is essential for virus-induced cytopathicity and pathogenicity. [ citation needed ] SL-II SL-II has been suggested to contribute to nuclease resistance. It may be related to another hairpin loop identified in the 5'UTR of the Japanese encephalitis virus (JEV) genome. The JEV hairpin is significantly over-represented upon host cell infection and it has been suggested that the hairpin structure may play a role in regulating RNA synthesis. [ citation needed ] SL-IV This secondary structure is located within the 3'UTR of the genome of Flavivirus upstream of the DB elements. The function of this conserved structure is unknown but is thought to contribute to ribonuclease resistance. [ citation needed ] DB1/DB2 These two conserved secondary structures are also known as pseudo-repeat elements. They were originally identified within the genome of Dengue virus and are found adjacent to each other within the 3'UTR. They appear to be widely conserved across the Flaviviradae. These DB elements have a secondary structure consisting of three helices and they play a role in ensuring efficient translation. Deletion of DB1 has a small but significant reduction in translation but deletion of DB2 has little effect. Deleting both DB1 and DB2 reduced translation efficiency of the viral genome to 25%. CRE CRE is the Cis-acting replication element, also known as the 3'SL RNA elements, and is thought to be essential in viral replication by facilitating the formation of a "replication complex". Although evidence has been presented for an existence of a pseudoknot structure in this RNA, it does not appear to be well conserved across flaviviruses. Deletions of the 3' UTR of flaviviruses have been shown to be lethal for infectious clones.A conserved hairpin (cHP) structure was later found in several Flavivirus genomes and is thought to direct translation of capsid proteins. It is located just downstream of the AUG start codon . Subgenomic flavivirus RNA (sfRNA) is an extension of the 3' UTR and has been demonstrated to play a role in flavivirus replication and pathogenesis. sfRNA is produced by incomplete degradation of genomic viral RNA by the host cells 5'-3' exoribonuclease 1 (XRN1). As the XRN1 degrades viral RNA, it stalls at stemloops formed by the secondary structure of the 5' and 3' UTR. This pause results in an undigested fragment of genome RNA known as sfRNA. sfRNA influences the life cycle of the flavivirus in a concentration dependent manner. Accumulation of sfRNA causes (1) antagonization of the cell's innate immune response, thus decreasing host defense against the virus (2) inhibition of XRN1 and Dicer activity to modify RNAi pathways that destroy viral RNA (3) modification of the viral replication complex to increase viral reproduction. Overall, sfRNA is implied in multiple pathways that compromise host defenses and promote infection by flaviviruses. [ citation needed ]The flaviviruses can be divided into two clades: one with vector-borne viruses and the other with no known vector. The vector clade, in turn, can be subdivided into a mosquito-borne clade and a tick-borne clade. These groups can be divided again. The mosquito group can be divided into two branches: one branch contains neurotropic viruses, often associated with encephalitic disease in humans or livestock. This branch tends to be spread by Culex species and to have bird reservoirs. The second branch is the non-neurotropic viruses associated with human haemorrhagic disease. These tend to have Aedes species as vectors and primate hosts. [ citation needed ] The tick-borne viruses also form two distinct groups: one is associated with seabirds and the other – the tick-borne encephalitis complex viruses – is associated primarily with rodents . [ citation needed ] The viruses that lack a known vector can be divided into three groups: one closely related to the mosquito-borne viruses, which is associated with bats ; a second, genetically more distant, is also associated with bats; and a third group is associated with rodents. [ citation needed ] Evolutionary relationships between endogenised viral elements of Flaviviruses and contemporary flaviviruses using maximum likelihood approaches have identified that arthropod-vectored flaviviruses likely emerged from an arachnid source. This contradicts earlier work with a smaller number of extant viruses showing that the tick-borne viruses emerged from a mosquito-borne group. Several partial and complete genomes of flaviviruses have been found in aquatic invertebrates such as the sea spider Endeis spinosa and several crustaceans and cephalopods. These sequences appear to be related to those in the insect-specific flaviviruses and also the Tamana bat virus groupings. While it is not presently clear how aquatic flaviviruses fit into the evolution of this group of viruses, there is some evidence that one of these viruses, Wenzhou shark flavivirus, infects both a crustacean ( Portunus trituberculatus ) Pacific spadenose shark ( Scoliodon macrorhynchos ) shark host, indicating an aquatic arbovirus life cycle. Estimates of divergence times have been made for several of these viruses. The origin of these viruses appears to be at least 9400 to 14,000 years ago. The Old World and New World dengue strains diverged between 150 and 450 years ago. The European and Far Eastern tick-borne encephalitis strains diverged about 1087 (1610–649) years ago. European tick-borne encephalitis and louping ill viruses diverged about 572 (844–328) years ago. This latter estimate is consistent with historical records. Kunjin virus diverged from West Nile virus approximately 277 (475–137) years ago. This time corresponds to the settlement of Australia from Europe. The Japanese encephalitis group appears to have evolved in Africa 2000–3000 years ago and then spread initially to South East Asia before migrating to the rest of Asia. Phylogenetic studies of the West Nile virus has shown that it emerged as a distinct virus around 1000 years ago. This initial virus developed into two distinct lineages, lineage 1 and its multiple profiles is the source of the epidemic transmission in Africa and throughout the world. Lineage 2 was considered an Africa zoonosis . However, in 2008, lineage 2, previously only seen in horses in sub-Saharan Africa and Madagascar, began to appear in horses in Europe, where the first known outbreak affected 18 animals in Hungary in 2008. Lineage 1 West Nile virus was detected in South Africa in 2010 in a mare and her aborted fetus ; previously, only lineage 2 West Nile virus had been detected in horses and humans in South Africa. A 2007 fatal case in a killer whale in Texas broadened the known host range of West Nile virus to include cetaceans . Omsk haemorrhagic fever virus appears to have evolved within the last 1000 years. The viral genomes can be divided into 2 clades — A and B. Clade A has five genotypes, and clade B has one. These clades separated about 700 years ago. This separation appears to have occurred in the Kurgan province. Clade A subsequently underwent division into clade C, D and E 230 years ago. Clade C and E appear to have originated in the Novosibirsk and Omsk Provinces, respectively. The muskrat Ondatra zibethicus , which is highly susceptible to this virus, was introduced into this area in the 1930s.In the genus Flavivirus there are 53 defined species: Species and strains sorted by vectors: Mammalian tick-borne virus group Seabird tick-borne virus groupIn the genus Flavivirus there are 53 defined species: Species and strains sorted by vectors: Mammalian tick-borne virus group Seabird tick-borne virus groupMammalian tick-borne virus group Seabird tick-borne virus groupThe very successful yellow fever 17D vaccine , introduced in 1937, produced dramatic reductions in epidemic activity. [ citation needed ] Effective inactivated Japanese encephalitis and Tick-borne encephalitis vaccines were introduced in the middle of the 20th century. Unacceptable adverse events have prompted change from a mouse-brain inactivated Japanese encephalitis vaccine to safer and more effective second generation Japanese encephalitis vaccines. These may come into wide use to effectively prevent this severe disease in the huge populations of Asia—North, South and Southeast. [ citation needed ] The dengue viruses produce many millions of infections annually due to transmission by a successful global mosquito vector. As mosquito control has failed, several dengue vaccines are in varying stages of development. CYD-TDV, sold under the trade name Dengvaxia, is a tetravalent chimeric vaccine that splices structural genes of the four dengue viruses onto a 17D yellow fever backbone. Dengvaxia is approved in five countries. An alternate approach to the development of flavivirus vaccine vectors is based on the use of viruses that infect insects. Insect-specific flaviviruses, such as Binjari virus, are unable to replicate in vertebrate cells. Nevertheless, recombinant viruses in which structural protein genes (prME) of Binjari virus are exchanged with those of dengue virus, Zika virus, West Nile virus, yellow fever virus, or Japanese encephalitis virus replicate efficiently in insect cells where high titers of infectious virus particles are produced. Immunization of mice with a Binjari vaccine bearing the Zika virus structural proteins protected mice from disease after challenge . A similar approach employs the insect-specific alphavirus Eilat virus as a vaccine platform . ... These new vaccine platforms generated from insect-specific flaviviruses and alphaviruses represent affordable, efficient, and safe approaches to rapid development of infectious, attenuated vaccines against pathogens from these two virus families.

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White stork

Breeding range Winter range Ardea ciconia Linnaeus, 1758 The white stork ( Ciconia ciconia ) is a large bird in the stork family, Ciconiidae. Its plumage is mainly white, with black on the bird's wings. Adults have long red legs and long pointed red beaks, and measure on average 100–115 cm (39–45 in) from beak tip to end of tail, with a 155–215 cm (61–85 in) wingspan. The two subspecies , which differ slightly in size, breed in Europe (north to Finland ), northwestern Africa, southwestern Asia (east to southern Kazakhstan ) and southern Africa. The white stork is a long-distance migrant , wintering in Africa from tropical Sub-Saharan Africa to as far south as South Africa , or on the Indian subcontinent . When migrating between Europe and Africa, it avoids crossing the Mediterranean Sea and detours via the Levant in the east or the Strait of Gibraltar in the west, because the air thermals on which it depends for soaring do not form over water. A carnivore , the white stork eats a wide range of animal prey, including insects, fish, amphibians, reptiles, small mammals and small birds. It takes most of its food from the ground, among low vegetation, and from shallow water. It is a monogamous breeder, and both members of the pair build a large stick nest, which may be used for several years. Each year the female can lay one clutch of usually four eggs, which hatch asynchronously 33–34 days after being laid. Both parents take turns incubating the eggs and both feed the young. The young leave the nest 58–64 days after hatching, and continue to be fed by the parents for a further 7–20 days. The white stork has been rated as least concern by the International Union for Conservation of Nature (IUCN). It benefited from human activities during the Middle Ages as woodland was cleared, but changes in farming methods and industrialisation saw it decline and disappear from parts of Europe in the 19th and early 20th centuries. Conservation and reintroduction programs across Europe have resulted in the white stork resuming breeding in the Netherlands, Belgium, Switzerland, Sweden and the United Kingdom. It has few natural predators, but may harbour several types of parasite; the plumage is home to chewing lice and feather mites , while the large nests maintain a diverse range of mesostigmatic mites. This conspicuous species has given rise to many legends across its range, of which the best-known is the story of babies being brought by storks.English naturalist Francis Willughby wrote about the white stork in the 17th century, having seen a drawing sent to him by Sir Thomas Browne of Norwich. He named it Ciconia alba . They noted they were occasional vagrants to England, blown there by storms. [lower-alpha 1] It was one of the many bird species originally described by Carl Linnaeus in the 10th edition of Systema Naturae , where it was given the binomial name of Ardea ciconia . It was reclassified to and designated the type species of the new genus Ciconia by Mathurin Jacques Brisson in 1760. Both the genus and specific epithet , cĭcōnia , are the Latin word for "stork". There are two subspecies : The stork family contains six genera in three broad groups: the open-billed and wood storks ( Mycteria and Anastomus ), the giant storks ( Ephippiorhynchus , Jabiru and Leptoptilos ) and the "typical" storks ( Ciconia ). The typical storks include the white stork and six other extant species, which are characterised by straight pointed beaks and mainly black and white plumage. Its closest relatives are the larger, black-billed Oriental stork ( Ciconia boyciana ) of East Asia , which was formerly classified as a subspecies of the white stork, and the maguari stork ( C. maguari ) of South America. Close evolutionary relationships within Ciconia are suggested by behavioural similarities and, biochemically, through analysis of both mitochondrial cytochrome b gene sequences and DNA-DNA hybridization . A Ciconia fossil representing the distal end of a right humerus has been recovered from Miocene beds of Rusinga Island , Lake Victoria, Kenya. The 24–6 million year old fossil could have originated from either a white stork or a black stork ( C. nigra ), which are species of about the same size with very similar bone structures. The Middle Miocene beds of Maboko Island have yielded further remains. The white stork is a large bird. It has a length of 100–115 cm (39–45 in) , [lower-alpha 2] and a standing height of 100–125 cm (39–49 in) . The wingspan is 155–215 cm (61–85 in) and its weight is 2.3–4.5 kg (5.1–9.9 lb) . Like all storks, it has long legs, a long neck and a long straight pointed beak . The sexes are identical in appearance, except that males are larger than females on average. The plumage is mainly white with black flight feathers and wing coverts ; the black is caused by the pigment melanin . The breast feathers are long and shaggy forming a ruff which is used in some courtship displays. The irises are dull brown or grey, and the peri- orbital skin is black. The adult has a bright red beak and red legs, the colouration of which is derived from carotenoids in the diet. In parts of Spain, studies have shown that the pigment is based on astaxanthin obtained from an introduced species of crayfish ( Procambarus clarkii ) and the bright red beak colours show up even in nestlings, in contrast to the duller beaks of young white storks elsewhere. As with other storks, the wings are long and broad enabling the bird to soar. In flapping flight its wingbeats are slow and regular. It flies with its neck stretched forward and with its long legs extended well beyond the end of its short tail. It walks at a slow and steady pace with its neck upstretched. In contrast, it often hunches its head between its shoulders when resting. Moulting has not been extensively studied, but appears to take place throughout the year, with the primary flight feathers replaced over the breeding season. Upon hatching, the young white stork is partly covered with short, sparse, whitish down feathers . This early down is replaced about a week later with a denser coat of woolly white down. By three weeks, the young bird acquires black scapulars and flight feathers . On hatching the chick has pinkish legs, which turn to greyish-black as it ages. Its beak is black with a brownish tip. By the time it fledges , the juvenile bird's plumage is similar to that of the adult, though its black feathers are often tinged with brown, and its beak and legs are a duller brownish-red or orange. The beak is typically orange or red with a darker tip. The bills gain the adults' red colour the following summer, although the black tips persist in some individuals. Young storks adopt adult plumage by their second summer. Within its range the white stork is distinctive when seen on the ground. The winter range of C. c. asiatica overlaps that of the Asian openbill , which has similar plumage but a different bill shape. When seen at a distance in flight, the white stork can be confused with several other species with similar underwing patterns, such as the yellow-billed stork , great white pelican and Egyptian vulture . The yellow-billed stork is identified by its black tail and a longer, slightly curved, yellow beak. The white stork also tends to be larger than the yellow-billed stork. The great white pelican has short legs which do not extend beyond its tail, and it flies with its neck retracted, keeping its head near to its stocky body, giving it a different flight profile. Pelicans also behave differently, soaring in orderly, synchronised flocks rather than in disorganised groups of individuals as the white stork does. The Egyptian vulture is much smaller, with a long wedge-shaped tail, shorter legs and a small yellow-tinged head on a short neck. The common crane , which can also look black and white in strong light, shows longer legs and a longer neck in flight. Within its range the white stork is distinctive when seen on the ground. The winter range of C. c. asiatica overlaps that of the Asian openbill , which has similar plumage but a different bill shape. When seen at a distance in flight, the white stork can be confused with several other species with similar underwing patterns, such as the yellow-billed stork , great white pelican and Egyptian vulture . The yellow-billed stork is identified by its black tail and a longer, slightly curved, yellow beak. The white stork also tends to be larger than the yellow-billed stork. The great white pelican has short legs which do not extend beyond its tail, and it flies with its neck retracted, keeping its head near to its stocky body, giving it a different flight profile. Pelicans also behave differently, soaring in orderly, synchronised flocks rather than in disorganised groups of individuals as the white stork does. The Egyptian vulture is much smaller, with a long wedge-shaped tail, shorter legs and a small yellow-tinged head on a short neck. The common crane , which can also look black and white in strong light, shows longer legs and a longer neck in flight. The nominate race of the white stork has a wide although disjunct summer range across Europe, clustered in the Iberian Peninsula and North Africa in the west, and much of eastern and central Europe, with 25% of the world's population concentrated in Poland, as well as parts of western Asia . The asiatica population of about 1450 birds is restricted to a region in central Asia between the Aral Sea and Xinjiang in western China. The Xinjiang population is believed to have become extinct around 1980. Migration routes extend the range of this species into many parts of Africa and India. Some populations adhere to the eastern migration route, which passes across Israel into eastern and central Africa. In Africa the white stork may spend the winter in Tunisia, Morocco, Uganda, Angola, Zimbabwe, Djibouti, Botswana, Mozambique, Zambia, Swaziland, Gambia, Guinea, Algeria, and Ghana. A few records of breeding from South Africa have been known since 1933 at Calitzdorp , and about 10 birds have been known to breed since the 1990s around Bredasdorp . A small population of white storks winters in India and is thought to derive principally from the C. c. asiatica population as flocks of up to 200 birds have been observed on spring migration in the early 1900s through the Kurram Valley . However, birds ringed in Germany have been recovered in western ( Bikaner ) and southern ( Tirunelveli ) India. An atypical specimen with red orbital skin, a feature of the Oriental white stork, has been recorded and further study of the Indian population is required. North of the breeding range, it is a passage migrant or vagrant in Finland, Iceland, Ireland, Norway and Sweden, and west to the Azores and Madeira . Despite their geographical proximity, in Finland the species is rare, while in Estonia there are an estimated 5,000 breeding pairs. In recent years, the range has expanded into western Russia. The white stork's preferred feeding grounds are grassy meadows, farmland and shallow wetlands. It avoids areas overgrown with tall grass and shrubs. In the Chernobyl area of northern Ukraine, white stork populations declined after the 1986 nuclear accident there as farmland was succeeded by tall grass and shrubs. In parts of Poland, poor natural foraging grounds have forced birds to seek food at rubbish dumps since 1999. White storks have also been reported foraging in rubbish dumps in the Middle East, North Africa and South Africa. Anthropogenic litter was found in the pellets of one third of breeding pairs in Poland, even though all pairs nested far from major dumps and landfills. The white stork breeds in greater numbers in areas with open grasslands, particularly grassy areas which are wet or periodically flooded, and less in areas with taller vegetation cover such as forest and shrubland. They make use of grasslands, wetlands, and farmland on the wintering grounds in Africa. White storks were probably aided by human activities during the Middle Ages as woodland was cleared and new pastures and farmland were created, and they were found across much of Europe, breeding as far north as Sweden. The population in Sweden is thought to have established in the 16th century after forests were cut down for agriculture. About 5000 pairs were estimated to breed in the 18th century which declined subsequently. The first accurate census in 1917 found 25 pairs and the last pair failed to breed around 1955. A similar pattern was seen in Denmark where the white stork appears to have become established in the 15th century when forests were being replaced by farmland and meadows, followed by a rapid population increase in the next centuries and then a rapid decline due mainly to modern, high-intensity agriculture in the last 200 years. The white stork has been a rare visitor to the British Isles , with about 20 birds seen in Britain every year, and prior to 2020 there were no records of nesting since a pair nested atop St Giles High Kirk in Edinburgh , Scotland in 1416. In 2020, a pair bred in the United Kingdom for the first time in over 600 years, as part of a re-introduction initiative in West Sussex called the White Stork Project. A decline in population began in the 19th century due to industrialisation and changes in agricultural methods. White storks no longer nest in many countries, and the current strongholds of the western population are in Portugal, Spain, Ukraine and Poland. In the Iberian Peninsula, populations are concentrated in the southwest, and have also declined due to agricultural practices. A study published in 2005 found that the Podhale region in the uplands of southern Poland had seen an influx of white storks, which first bred there in 1931 and have nested at progressively higher altitudes since, reaching 890 m (3000 ft) in 1999. The authors proposed that this was related to climate warming and the influx of other animals and plants to higher altitudes. White storks arriving in Poznań province ( Greater Poland Voivodeship ) in western Poland in spring to breed did so some 10 days earlier in the last twenty years of the 20th century than at the end of the 19th century. Systematic research into migration of the white stork began with German ornithologist Johannes Thienemann who commenced bird ringing studies in 1906 at the Rossitten Bird Observatory , on the Curonian Spit in what was then East Prussia . Although not many storks passed through Rossitten itself, the observatory coordinated the large-scale ringing of the species throughout Germany and elsewhere in Europe. Between 1906 and the Second World War about 100,000, mainly juvenile, white storks were ringed, with over 2,000 long-distance recoveries of birds wearing Rossitten rings reported between 1908 and 1954. White storks fly south from their summer breeding grounds in Europe in August and September, heading for Africa. There, they spend the winter in savannah from Kenya and Uganda south to the Cape Province of South Africa. In these areas, they congregate in large flocks which may exceed a thousand individuals. Some diverge westwards into western Sudan and Chad, and may reach Nigeria. In spring, the birds return north; they are recorded from Sudan and Egypt from February to April. They arrive back in Europe around late March and April, after an average journey of 49 days. By comparison, the autumn journey is completed in about 26 days. Tailwinds and scarcity of food and water en route (birds fly faster over regions lacking resources) increase average speed. To avoid a long sea crossing over the Mediterranean, birds from central Europe either follow an eastern migration route by crossing the Bosphorus in Turkey, traversing the Levant , then bypassing the Sahara Desert by following the Nile valley southwards, or follow a western route over the Strait of Gibraltar . These migration corridors maximise help from the thermals and thus save energy. In winter 2013–2014, white storks were observed in southern India's Mudumalai National Park for the first time. The eastern route is by far the more important with 530,000 white storks using it annually, making the species the second commonest migrant there (after the European honey buzzard ). The flocks of migrating raptors , white storks and great white pelicans can stretch for 200 km (125 mi). The eastern route is twice as long as the western, but storks take the same time to reach the wintering grounds by either. Juvenile white storks set off on their first southward migration in an inherited direction but, if displaced from that bearing by weather conditions, they are unable to compensate, and may end up in a new wintering location. Adults can compensate for strong winds and adjust their direction to finish at their normal winter sites, because they are familiar with the location. For the same reason, all spring migrants, even those from displaced wintering locations, can find their way back to the traditional breeding sites. An experiment with young birds raised in captivity in Kaliningrad and released in the absence of wild storks to show them the way revealed that they appeared to have an instinct to fly south, although the scatter in direction was large. White storks rely on the uplift of air thermals to soar and glide the long distances of their annual migrations between Europe and Sub-Saharan Africa . For many, the shortest route would take them over the Mediterranean Sea ; however, since air thermals do not form over water, they generally detour over land to avoid the trans-Mediterranean flights that would require prolonged energetic wing flapping. It has been estimated that flapping flight metabolises 23 times more body fat than soaring flight per distance travelled. Thus, flocks spiral upwards on rising warm air until they emerge at the top, up to 1,200–1,500 m (3,900–4,900 ft) above the ground (though one record from Western Sudan observed an altitude of 3,300 m (10,800 ft) ). Long flights over water may occasionally be undertaken. A young white stork ringed at the nest in Denmark subsequently appeared in England, where it spent some days before moving on. It was later seen flying over St Mary's, Isles of Scilly , and arrived in a poor condition in Madeira three days later. That island is 500 km (320 mi) from Africa, and twice as far from the European mainland. Migration through the Middle East may be hampered by the khamsin , winds bringing gusty overcast days unsuitable for flying. In these situations, flocks of white storks sit out the adverse weather on the ground, standing and facing into the wind. Systematic research into migration of the white stork began with German ornithologist Johannes Thienemann who commenced bird ringing studies in 1906 at the Rossitten Bird Observatory , on the Curonian Spit in what was then East Prussia . Although not many storks passed through Rossitten itself, the observatory coordinated the large-scale ringing of the species throughout Germany and elsewhere in Europe. Between 1906 and the Second World War about 100,000, mainly juvenile, white storks were ringed, with over 2,000 long-distance recoveries of birds wearing Rossitten rings reported between 1908 and 1954. White storks fly south from their summer breeding grounds in Europe in August and September, heading for Africa. There, they spend the winter in savannah from Kenya and Uganda south to the Cape Province of South Africa. In these areas, they congregate in large flocks which may exceed a thousand individuals. Some diverge westwards into western Sudan and Chad, and may reach Nigeria. In spring, the birds return north; they are recorded from Sudan and Egypt from February to April. They arrive back in Europe around late March and April, after an average journey of 49 days. By comparison, the autumn journey is completed in about 26 days. Tailwinds and scarcity of food and water en route (birds fly faster over regions lacking resources) increase average speed. To avoid a long sea crossing over the Mediterranean, birds from central Europe either follow an eastern migration route by crossing the Bosphorus in Turkey, traversing the Levant , then bypassing the Sahara Desert by following the Nile valley southwards, or follow a western route over the Strait of Gibraltar . These migration corridors maximise help from the thermals and thus save energy. In winter 2013–2014, white storks were observed in southern India's Mudumalai National Park for the first time. The eastern route is by far the more important with 530,000 white storks using it annually, making the species the second commonest migrant there (after the European honey buzzard ). The flocks of migrating raptors , white storks and great white pelicans can stretch for 200 km (125 mi). The eastern route is twice as long as the western, but storks take the same time to reach the wintering grounds by either. Juvenile white storks set off on their first southward migration in an inherited direction but, if displaced from that bearing by weather conditions, they are unable to compensate, and may end up in a new wintering location. Adults can compensate for strong winds and adjust their direction to finish at their normal winter sites, because they are familiar with the location. For the same reason, all spring migrants, even those from displaced wintering locations, can find their way back to the traditional breeding sites. An experiment with young birds raised in captivity in Kaliningrad and released in the absence of wild storks to show them the way revealed that they appeared to have an instinct to fly south, although the scatter in direction was large. White storks rely on the uplift of air thermals to soar and glide the long distances of their annual migrations between Europe and Sub-Saharan Africa . For many, the shortest route would take them over the Mediterranean Sea ; however, since air thermals do not form over water, they generally detour over land to avoid the trans-Mediterranean flights that would require prolonged energetic wing flapping. It has been estimated that flapping flight metabolises 23 times more body fat than soaring flight per distance travelled. Thus, flocks spiral upwards on rising warm air until they emerge at the top, up to 1,200–1,500 m (3,900–4,900 ft) above the ground (though one record from Western Sudan observed an altitude of 3,300 m (10,800 ft) ). Long flights over water may occasionally be undertaken. A young white stork ringed at the nest in Denmark subsequently appeared in England, where it spent some days before moving on. It was later seen flying over St Mary's, Isles of Scilly , and arrived in a poor condition in Madeira three days later. That island is 500 km (320 mi) from Africa, and twice as far from the European mainland. Migration through the Middle East may be hampered by the khamsin , winds bringing gusty overcast days unsuitable for flying. In these situations, flocks of white storks sit out the adverse weather on the ground, standing and facing into the wind. White storks fly south from their summer breeding grounds in Europe in August and September, heading for Africa. There, they spend the winter in savannah from Kenya and Uganda south to the Cape Province of South Africa. In these areas, they congregate in large flocks which may exceed a thousand individuals. Some diverge westwards into western Sudan and Chad, and may reach Nigeria. In spring, the birds return north; they are recorded from Sudan and Egypt from February to April. They arrive back in Europe around late March and April, after an average journey of 49 days. By comparison, the autumn journey is completed in about 26 days. Tailwinds and scarcity of food and water en route (birds fly faster over regions lacking resources) increase average speed. To avoid a long sea crossing over the Mediterranean, birds from central Europe either follow an eastern migration route by crossing the Bosphorus in Turkey, traversing the Levant , then bypassing the Sahara Desert by following the Nile valley southwards, or follow a western route over the Strait of Gibraltar . These migration corridors maximise help from the thermals and thus save energy. In winter 2013–2014, white storks were observed in southern India's Mudumalai National Park for the first time. The eastern route is by far the more important with 530,000 white storks using it annually, making the species the second commonest migrant there (after the European honey buzzard ). The flocks of migrating raptors , white storks and great white pelicans can stretch for 200 km (125 mi). The eastern route is twice as long as the western, but storks take the same time to reach the wintering grounds by either. Juvenile white storks set off on their first southward migration in an inherited direction but, if displaced from that bearing by weather conditions, they are unable to compensate, and may end up in a new wintering location. Adults can compensate for strong winds and adjust their direction to finish at their normal winter sites, because they are familiar with the location. For the same reason, all spring migrants, even those from displaced wintering locations, can find their way back to the traditional breeding sites. An experiment with young birds raised in captivity in Kaliningrad and released in the absence of wild storks to show them the way revealed that they appeared to have an instinct to fly south, although the scatter in direction was large. White storks rely on the uplift of air thermals to soar and glide the long distances of their annual migrations between Europe and Sub-Saharan Africa . For many, the shortest route would take them over the Mediterranean Sea ; however, since air thermals do not form over water, they generally detour over land to avoid the trans-Mediterranean flights that would require prolonged energetic wing flapping. It has been estimated that flapping flight metabolises 23 times more body fat than soaring flight per distance travelled. Thus, flocks spiral upwards on rising warm air until they emerge at the top, up to 1,200–1,500 m (3,900–4,900 ft) above the ground (though one record from Western Sudan observed an altitude of 3,300 m (10,800 ft) ). Long flights over water may occasionally be undertaken. A young white stork ringed at the nest in Denmark subsequently appeared in England, where it spent some days before moving on. It was later seen flying over St Mary's, Isles of Scilly , and arrived in a poor condition in Madeira three days later. That island is 500 km (320 mi) from Africa, and twice as far from the European mainland. Migration through the Middle East may be hampered by the khamsin , winds bringing gusty overcast days unsuitable for flying. In these situations, flocks of white storks sit out the adverse weather on the ground, standing and facing into the wind. The white stork is a gregarious bird; flocks of thousands of individuals have been recorded on migration routes and at wintering areas in Africa. Non-breeding birds gather in groups of 40 or 50 during the breeding season. The smaller dark-plumaged Abdim's stork is often encountered with white stork flocks in southern Africa. Breeding pairs of white stork may gather in small groups to hunt, and colony nesting has been recorded in some areas. However, groups among white stork colonies vary widely in size and the social structure is loosely defined; young breeding storks are often restricted to peripheral nests, while older storks attain higher breeding success while occupying the better quality nests toward the centres of breeding colonies. Social structure and group cohesion is maintained by altruistic behaviours such as allopreening . White storks exhibit this behaviour exclusively at the nest site. Standing birds preen the heads of sitting birds, sometimes these are parents grooming juveniles, and sometimes juveniles preen each other. Unlike most storks, it never adopts a spread-winged posture, though it is known to droop its wings (holding them away from its body with the primary feathers pointing downwards) when its plumage is wet. A white stork's droppings, containing faeces and uric acid , are sometimes directed onto its own legs, making them appear white. The resulting evaporation provides cooling and is termed urohidrosis . Birds that have been ringed can sometimes be affected by the accumulation of droppings around the ring leading to constriction and leg trauma. The white stork has also been noted for tool use by squeezing moss in the beak to drip water into the mouths of its chicks. The adult white stork's main sound is noisy bill-clattering, which has been likened to distant machine gun fire. The bird makes these sounds by rapidly opening and closing its beak so that a knocking sound is made each time its beak closes. The clattering is amplified by its throat pouch , which acts as a resonator . Used in a variety of social interactions, bill-clattering generally grows louder the longer it lasts, and takes on distinctive rhythms depending on the situation—for example, slower during copulation and briefer when given as an alarm call . The only vocal sound adult birds generate is a weak barely audible hiss; however, young birds can generate a harsh hiss, various cheeping sounds, and a cat-like mew they use to beg for food. Like the adults, young also clatter their beaks. The up-down display is used for a number of interactions with other members of the species. Here a stork quickly throws its head backwards so that its crown rests on its back before slowly bringing its head and neck forwards again, and this is repeated several times. The display is used as a greeting between birds, post coitus, and also as a threat display . Breeding pairs are territorial over the summer, and use this display, as well as crouching forward with the tails cocked and wings extended. The white stork breeds in open farmland areas with access to marshy wetlands, building a large stick nest in trees, on buildings, or on purpose-built man-made platforms. Each nest is 1–2 m (3.3–6.6 ft) in depth, 0.8–1.5 m (2.6–4.9 ft) in diameter, and 60–250 kg (130–550 lb) in weight. Nests are built in loose colonies. Not persecuted as it is viewed as a good omen, it often nests close to human habitation; in southern Europe, nests can be seen on churches and other buildings. The nest is typically used year after year especially by older males. The males arrive earlier in the season and choose the nests. Larger nests are associated with greater numbers of young successfully fledged, and appear to be sought after. Nest change is often related to a change in the pairing and failure to raise young the previous year, and younger birds are more likely to change nesting sites. Although a pair may be found to occupy a nest, partners may change several times during the early stages and breeding activities begin only after a stable pairing is achieved. Several bird species often nest within the large nests of the white stork. Regular occupants are house sparrows , tree sparrows , and common starlings ; less common residents include Eurasian kestrels , little owls , European rollers , white wagtails , black redstarts , Eurasian jackdaws , and Spanish sparrows . Active nests may attract insectivorous birds such as swallows , martins , and swifts , where they prey on insects flying around. Paired birds greet by engaging in up-down and head-shaking crouch displays, and clattering the beak while throwing back the head. Pairs copulate frequently throughout the month before eggs are laid. High-frequency pair copulation is usually associated with sperm competition and high frequency of extra-pair copulation . It has been considered that extra-pair copulation rates were low but a 2016 DNA sample study suggests that extra-pair copulation occasionally occurs in white storks. Despite the relatively high extra-pair paternity occurrence compared to other long-lived monogamous birds, white storks form strong pair bonds and high nest fidelity maintained across years. A white stork pair raises a single brood a year. The female typically lays four eggs , though clutches of one to seven have been recorded. The eggs are white, but often look dirty or yellowish due to a glutinous covering. They typically measure 73 mm × 52 mm (2.9 in × 2.0 in) , and weigh 96–129 g (3.4–4.6 oz) , of which about 11 g (0.39 oz) is shell. Incubation begins as soon as the first egg is laid, so the brood hatches asynchronously, beginning 33 to 34 days later. The first hatchling typically has a competitive edge over the others. While stronger chicks are not aggressive towards weaker siblings, as is the case in some species, weak or small chicks are sometimes killed by their parents. This behavior occurs in times of food shortage to reduce brood size and hence increase the chance of survival of the remaining nestlings. White stork nestlings do not attack each other, and their parents' feeding method (disgorging large amounts of food at once) means that stronger siblings cannot outcompete weaker ones for food directly, hence parental infanticide is an efficient way of reducing brood size. Despite this, this behavior has not commonly been observed. The temperature and weather around the time of hatching in spring is important; cool temperatures and wet weather increase chick mortality and reduce breeding success rates. Somewhat unexpectedly, studies have found that later-hatching chicks which successfully reach adulthood produce more chicks than do their earlier-hatching nestmates. The body weight of the chicks increases rapidly in the first few weeks and reaches a plateau of about 3.4 kg (7.5 lb) in 45 days. The length of the beak increases linearly for about 50 days. Young birds are fed with earthworms and insects, which are regurgitated by the parents onto the floor of the nest. Older chicks reach into the mouths of parents to obtain food. Chicks fledge 58 to 64 days after hatching. White storks generally begin breeding when about four years old, although the age of first breeding has been recorded as early as two years and as late as seven years. The oldest known wild white stork lived for 39 years after being ringed in Switzerland, while captive birds have lived for more than 35 years. White storks consume a wide variety of animal prey. They prefer to forage in meadows that are within roughly 5 km (3 mi) of their nest and sites where the vegetation is shorter so that their prey is more accessible. Their diet varies according to season, locality and prey availability. Common food items include insects (primarily beetles, grasshoppers, locusts and crickets), earthworms, reptiles, amphibians, particularly frog species such as the edible frog ( Pelophylax kl. esculentus ) and common frog ( Rana temporaria ) and small mammals such as voles, moles and shrews. Less commonly, they also eat bird eggs and young birds, fish, molluscs, crustaceans and scorpions. They hunt mainly during the day, swallowing small prey whole, but killing and breaking apart larger prey before swallowing. Rubber bands are mistaken for earthworms and consumed, occasionally resulting in fatal blockage of the digestive tract. Birds returning to Latvia during spring have been shown to locate their prey, moor frogs ( Rana arvalis ), by homing in on the mating calls produced by aggregations of male frogs. The diet of non-breeding birds is similar to that of breeding birds, but food items are more often taken from dry areas. White storks wintering in western India have been observed to follow blackbuck to capture insects disturbed by them. Wintering white storks in India sometimes forage along with the woolly-necked stork ( Ciconia episcopus ). Food piracy has been recorded in India with a rodent captured by a western marsh harrier appropriated by a white stork, while Montagu's harrier is known to harass white storks foraging for voles in some parts of Poland. White storks can exploit landfill sites for food during the breeding season, migration period and winter. The adult white stork's main sound is noisy bill-clattering, which has been likened to distant machine gun fire. The bird makes these sounds by rapidly opening and closing its beak so that a knocking sound is made each time its beak closes. The clattering is amplified by its throat pouch , which acts as a resonator . Used in a variety of social interactions, bill-clattering generally grows louder the longer it lasts, and takes on distinctive rhythms depending on the situation—for example, slower during copulation and briefer when given as an alarm call . The only vocal sound adult birds generate is a weak barely audible hiss; however, young birds can generate a harsh hiss, various cheeping sounds, and a cat-like mew they use to beg for food. Like the adults, young also clatter their beaks. The up-down display is used for a number of interactions with other members of the species. Here a stork quickly throws its head backwards so that its crown rests on its back before slowly bringing its head and neck forwards again, and this is repeated several times. The display is used as a greeting between birds, post coitus, and also as a threat display . Breeding pairs are territorial over the summer, and use this display, as well as crouching forward with the tails cocked and wings extended. The white stork breeds in open farmland areas with access to marshy wetlands, building a large stick nest in trees, on buildings, or on purpose-built man-made platforms. Each nest is 1–2 m (3.3–6.6 ft) in depth, 0.8–1.5 m (2.6–4.9 ft) in diameter, and 60–250 kg (130–550 lb) in weight. Nests are built in loose colonies. Not persecuted as it is viewed as a good omen, it often nests close to human habitation; in southern Europe, nests can be seen on churches and other buildings. The nest is typically used year after year especially by older males. The males arrive earlier in the season and choose the nests. Larger nests are associated with greater numbers of young successfully fledged, and appear to be sought after. Nest change is often related to a change in the pairing and failure to raise young the previous year, and younger birds are more likely to change nesting sites. Although a pair may be found to occupy a nest, partners may change several times during the early stages and breeding activities begin only after a stable pairing is achieved. Several bird species often nest within the large nests of the white stork. Regular occupants are house sparrows , tree sparrows , and common starlings ; less common residents include Eurasian kestrels , little owls , European rollers , white wagtails , black redstarts , Eurasian jackdaws , and Spanish sparrows . Active nests may attract insectivorous birds such as swallows , martins , and swifts , where they prey on insects flying around. Paired birds greet by engaging in up-down and head-shaking crouch displays, and clattering the beak while throwing back the head. Pairs copulate frequently throughout the month before eggs are laid. High-frequency pair copulation is usually associated with sperm competition and high frequency of extra-pair copulation . It has been considered that extra-pair copulation rates were low but a 2016 DNA sample study suggests that extra-pair copulation occasionally occurs in white storks. Despite the relatively high extra-pair paternity occurrence compared to other long-lived monogamous birds, white storks form strong pair bonds and high nest fidelity maintained across years. A white stork pair raises a single brood a year. The female typically lays four eggs , though clutches of one to seven have been recorded. The eggs are white, but often look dirty or yellowish due to a glutinous covering. They typically measure 73 mm × 52 mm (2.9 in × 2.0 in) , and weigh 96–129 g (3.4–4.6 oz) , of which about 11 g (0.39 oz) is shell. Incubation begins as soon as the first egg is laid, so the brood hatches asynchronously, beginning 33 to 34 days later. The first hatchling typically has a competitive edge over the others. While stronger chicks are not aggressive towards weaker siblings, as is the case in some species, weak or small chicks are sometimes killed by their parents. This behavior occurs in times of food shortage to reduce brood size and hence increase the chance of survival of the remaining nestlings. White stork nestlings do not attack each other, and their parents' feeding method (disgorging large amounts of food at once) means that stronger siblings cannot outcompete weaker ones for food directly, hence parental infanticide is an efficient way of reducing brood size. Despite this, this behavior has not commonly been observed. The temperature and weather around the time of hatching in spring is important; cool temperatures and wet weather increase chick mortality and reduce breeding success rates. Somewhat unexpectedly, studies have found that later-hatching chicks which successfully reach adulthood produce more chicks than do their earlier-hatching nestmates. The body weight of the chicks increases rapidly in the first few weeks and reaches a plateau of about 3.4 kg (7.5 lb) in 45 days. The length of the beak increases linearly for about 50 days. Young birds are fed with earthworms and insects, which are regurgitated by the parents onto the floor of the nest. Older chicks reach into the mouths of parents to obtain food. Chicks fledge 58 to 64 days after hatching. White storks generally begin breeding when about four years old, although the age of first breeding has been recorded as early as two years and as late as seven years. The oldest known wild white stork lived for 39 years after being ringed in Switzerland, while captive birds have lived for more than 35 years. White storks consume a wide variety of animal prey. They prefer to forage in meadows that are within roughly 5 km (3 mi) of their nest and sites where the vegetation is shorter so that their prey is more accessible. Their diet varies according to season, locality and prey availability. Common food items include insects (primarily beetles, grasshoppers, locusts and crickets), earthworms, reptiles, amphibians, particularly frog species such as the edible frog ( Pelophylax kl. esculentus ) and common frog ( Rana temporaria ) and small mammals such as voles, moles and shrews. Less commonly, they also eat bird eggs and young birds, fish, molluscs, crustaceans and scorpions. They hunt mainly during the day, swallowing small prey whole, but killing and breaking apart larger prey before swallowing. Rubber bands are mistaken for earthworms and consumed, occasionally resulting in fatal blockage of the digestive tract. Birds returning to Latvia during spring have been shown to locate their prey, moor frogs ( Rana arvalis ), by homing in on the mating calls produced by aggregations of male frogs. The diet of non-breeding birds is similar to that of breeding birds, but food items are more often taken from dry areas. White storks wintering in western India have been observed to follow blackbuck to capture insects disturbed by them. Wintering white storks in India sometimes forage along with the woolly-necked stork ( Ciconia episcopus ). Food piracy has been recorded in India with a rodent captured by a western marsh harrier appropriated by a white stork, while Montagu's harrier is known to harass white storks foraging for voles in some parts of Poland. White storks can exploit landfill sites for food during the breeding season, migration period and winter. White stork nests are habitats for an array of small arthropods, particularly over the warmer months after the birds arrive to breed. Nesting over successive years, the storks bring more material to line their nests and layers of organic material accumulate within them. Not only do their bodies tend to regulate temperatures within the nest, but excrement, food remains and feather and skin fragments provide nourishment for a large and diverse population of free-living mesostigmatic mites. A survey of twelve nests found 13,352 individuals of 34 species, the most common being Macrocheles merdarius , M. robustulus , Uroobovella pyriformis and Trichouropoda orbicularis , which together represented almost 85% of all the specimens collected. These feed on the eggs and larvae of insects and on nematodes , which are abundant in the nest litter. These mites are dispersed by coprophilous beetles, often of the family Scarabaeidae , or on dung brought by the storks during nest construction. Parasitic mites do not occur, perhaps being controlled by the predatory species. The overall effect of the mite population is unclear, the mites may have a role in suppressing harmful organisms (and hence be beneficial), or they may themselves have an adverse effect on nestlings. The birds themselves host species belonging to more than four genera of feather mites . These mites, including Freyanopterolichus pelargicus , and Pelargolichus didactylus live on fungi growing on the feathers. The fungi found on the plumage may feed on the keratin of the outer feathers or on feather oil. Chewing lice such as Colpocephalum zebra tend to be found on the wings, and Neophilopterus incompletus elsewhere on the body. The white stork also carries several types of internal parasites, including Toxoplasma gondii and intestinal parasites of the genus Giardia . A study of 120 white stork carcasses from Saxony-Anhalt and Brandenburg in Germany yielded eight species of trematode (fluke), four cestode (tapeworm) species, and at least three species of nematode . One species of fluke, Chaunocephalus ferox , caused lesions in the wall of the small intestine in a number of birds admitted to two rehabilitation centres in central Spain, and was associated with reduced weight. It is a recognised pathogen and cause of morbidity in the Asian openbill ( Anastomus oscitans ). More recently, the thorough study performed by J. Sitko and P. Heneberg in the Czech Republic in 1962–2013 suggested that the central European white storks host 11 helminth species. Chaunocephalus ferox , Tylodelphys excavata and Dictymetra discoidea were reported to be the dominant ones. The other species found included Cathaemasia hians , Echinochasmus spinulosus , Echinostoma revolutum , Echinostoma sudanense , Duboisia syriaca , Apharyngostrigea cornu , Capillaria sp. and Dictymetra discoidea . Juvenile white storks were shown to host less species, but the intensity of infection was higher in the juveniles than in the adult storks. West Nile virus (WNV) is mainly a bird infection that is transmitted between birds by mosquitos . Migrating birds appear to be important in spread of the virus, the ecology of which remains poorly known. On 26 August 1998, a flock of about 1,200 migrating white storks that had been blown off course on their southward journey landed in Eilat , in southern Israel. The flock was stressed as it had resorted to flapping flight to return to its migratory route, and a number of birds died. A virulent strain of West Nile virus was isolated from the brains of eleven dead juveniles. Other white storks subsequently tested in Israel have shown anti-WNV antibodies . In 2008 three juvenile white storks from a Polish wildlife refuge yielded seropositive results indicating exposure to the virus, but the context or existence of the virus in Poland is unclear. The white stork's decline due to industrialisation and agricultural changes (principally the draining of wetlands and conversion of meadows to crops such as maize ) began in the 19th century: the last wild individual in Belgium was seen in 1895, in Sweden in 1955, in Switzerland in 1950 and in the Netherlands in 1991. However, the species has since been reintroduced to many regions. It has been rated as least concern by the IUCN since 1994, after being evaluated as near threatened in 1988. The white stork is one of the species to which the Agreement on the Conservation of African-Eurasian Migratory Waterbirds ( AEWA ) applies. Parties to the agreement are required to engage in a wide range of conservation strategies described in a detailed action plan. The plan is intended to address key issues such as species and habitat conservation, management of human activities, research, education, and implementation. Threats include the continued loss of wetlands, collisions with overhead power lines, use of persistent pesticides (such as DDT ) to combat locusts in Africa, and largely illegal hunting on migration routes and wintering grounds. A large population of white storks breeds in central (Poland, Ukraine and Germany) and southern Europe (Spain and Turkey). In a 2004/05 census, there were 52,500 pairs in Poland , 30,000 pairs in Ukraine , 20,000 pairs in Belarus , 13,000 pairs in Lithuania (the highest known density of this species in the world), 10,700 pairs in Latvia , and 10,200 in Russia . There were around 5,500 pairs in Romania , 5,300 in Hungary , and an estimated 4,956 breeding pairs in Bulgaria . In former Yugoslavia there are 1,700 in Croatia , 1,400 in Serbia , 236 in Slovenia and an estimated 40 breeding pairs in Bosnia and Herzegovina . In Germany , the majority of the total 4,482 pairs were in the eastern region, especially in the states of Brandenburg and Mecklenburg-Vorpommern (1296 and 863 pairs in 2008 respectively). Apart from Spain and Portugal (33,217 and 7,684 pairs in 2004/05 respectively), populations are generally much less stable. In the eastern Mediterranean region Turkey has a sizeable population of 6,195 pairs, and Greece 2,139 pairs. In Western Europe the white stork remains a rare bird despite conservation efforts. In 2004 France had only 973 pairs, and the Netherlands 528 pairs. In Denmark, the species had consistently bred since the 15th century, peaking at several thousands pairs around 1800. Afterwards it began declining mainly due to habitat loss (especially conversion of wetlands and meadows into modern farming), with only a few tens of breeding pairs in 1974 and none in 2008. Since then, it has reestablished itself and the population has slowly started to increase, reaching ten pairs in 2023. In Armenia the population of the white stork slightly increased in the period between 2005 and 2015, and by last data reached 652 pairs. In the early 1980s, the population had fallen to fewer than nine pairs in the entire upper Rhine River valley, an area closely identified with the white stork for centuries. Conservation efforts successfully increased the population of birds there to 270 pairs (in 2008), largely due to the actions of the Association for the Protection and Reintroduction of Storks in Alsace and Lorraine . The reintroduction of zoo -reared birds has halted further declines in Italy, the Netherlands, and Switzerland. There were 601 pairs breeding in Armenia and around 700 pairs in the Netherlands in 2008, and few pairs also breed in South Africa, typically recent colonists from within the normal wintering population. In Poland, electric poles have been modified with a platform at the top to prevent the white stork's large nest from disrupting the electricity supply, and sometimes nests are moved from an electric pole to a man-made platform. Introductions of zoo-reared birds in the Netherlands has been followed up by feeding and nest-building programs by volunteers. Similar reintroduction programs are taking place in Sweden, and Switzerland, where 175 pairs were recorded breeding in 2000. Long-term viability of the population in Switzerland is unclear as breeding success rates are low, and supplementary feeding does not appear to be of benefit. However, as of 2017, 470 adults and 757 young ones were recorded in Switzerland. Historically, the species' northern breeding limit was at Estonia , but it has moved slowly northwards (possibly due to warmer temperatures ) into Karelia and in 2015 the first ever known breeding happened in Finland . In August 2019, 24 juveniles were released at the Knepp Estate in West Sussex , and others at a site near Tunbridge Wells and at the Wintershall Estate, near Godalming , as part of a project to reintroduce the white stork as a breeding species in South East England , for the first time since 1416. In 2020, the program was successful with the birth of five baby storks. Due to its large size, predation on vermin, and nesting behaviour close to human settlements and on rooftops, the white stork has an imposing presence that has influenced human culture and folklore. The Hebrew word for the white stork is chasidah (חסידה), meaning "merciful" or "kind". Greek and Roman mythology portray storks as models of parental devotion. The 3rd century Roman writer Aelian citing the authority of Alexander of Myndus noted in his De natura animalium (book 3, chapter 23) that aged storks flew away to oceanic islands where they were transformed into humans as a reward for their piety towards their parents. The bird is featured in at least three of Aesop's Fables : The Fox and the Stork , The Farmer and the Stork , and The Frogs Who Desired a King . Storks were also thought to care for their aged parents, feeding them and even transporting them, and children's books depicted them as a model of filial values. A Greek law called Pelargonia , from the Ancient Greek word pelargos for stork, required citizens to take care of their aged parents. The Greeks also held that killing a stork could be punished with death. Storks were allegedly protected in Ancient Thessaly as they hunted snakes, and widely held to be Virgil 's "white bird". Roman writers noted the white stork's arrival in spring, which alerted farmers to plant their vines. On occasion ancient Egyptians mummified White storks. Followers of Islam revered storks because they made an annual pilgrimage to Mecca on their migration. Some of the earliest understanding on bird migration were initiated by an interest in white storks; Pfeilstörche ("arrow storks") were found in Europe with African arrows embedded in their bodies. A well-known example of such a stork found in the summer of 1822 in the German town of Klütz in Mecklenburg was made into a mounted taxidermy specimen, complete with the ornate African arrow, that is now in the University of Rostock . Storks have little fear of humans if not disturbed, and often nest on buildings in Europe. In Germany, the presence of a nest on a house was believed to protect against fires. They were also protected because of the belief that their souls were human. German, Dutch and Polish households would encourage storks to nest on houses, sometimes by constructing purpose-built high platforms, to bring good luck. Across much of Central and Eastern Europe it is believed that storks bring harmony to a family on whose property they nest. The white stork is a popular motif on postage stamps , and it is featured on more than 120 stamps issued by more than 60 stamp-issuing entities. It is the national bird of Lithuania, Belarus and Poland, and it was a Polish mascot at the Expo 2000 Fair in Hanover. Storks nesting in Polish villages such as Żywkowo have made them tourist attractions, drawing 2000–5000 visitors a year in 2014. In the 19th century, storks were also thought to only live in countries having a republican form of government. Polish poet Cyprian Kamil Norwid mentioned storks in his poem Moja piosnka (II) ("My Song (II)"): For the land where it's a great travesty To harm a stork's nest in a pear tree, For storks serve us all ... I am homesick, Lord! ... In 1942 Heinrich Himmler sought to use storks to carry Nazi propaganda leaflets so as to win support from the Boers in South Africa. The idea for this "Storchbein-Propaganda" plan was a secret that was transmitted by Walter Schellenberg to be examined by the German ornithologist Ernst Schüz at the Rossiten bird observatory , who pointed out that the probability of finding marked storks in Africa was less than one percent, requiring a 1000 birds to transmit 10 leaflets successfully. The plan was then dropped. According to European folklore, the stork is responsible for bringing babies to new parents. The legend is very ancient, but was popularised by a 19th-century Hans Christian Andersen story called "The Storks". German folklore held that storks found babies in caves or marshes and brought them to households in a basket on their backs or held in their beaks. These caves contained adebarsteine or "stork stones". The babies would then be given to the mother or dropped down the chimney. Households would notify when they wanted children by placing sweets for the stork on the window sill. From there the folklore has spread around the world to the Philippines and countries in South America . Birthmarks on the back of the head of newborn baby, nevus flammeus nuchae , are sometimes referred to as stork-bite. In Slavic mythology and pagan religion , storks were thought to carry unborn souls from Vyraj to Earth in spring and summer. This belief still persists in the modern folk culture of many Slavic countries, in the simplified child story that "storks bring children into the world". Storks were seen by Early Slavs as bringing luck, and killing one would bring misfortune. Likewise, in Norse mythology , the god Hœnir , responsible for giving reason to the first humans, Ask and Embla , has been connected with the stork through his epithets long-legs and mud-king , along with Indo-European cognates such as Greek κύκνος 'swan' and Sanskrit शकुन . A long-term study that showed a spurious correlation between the numbers of stork nests and human births is widely used in the teaching of basic statistics as an example to highlight that correlation does not necessarily indicate causation . Psychoanalyst Marvin Margolis suggests the enduring nature of the stork fable of the newborn is linked to its addressing a psychological need, in that it allays the discomfort of discussing sex and procreation with children. Birds have long been associated with the maternal symbols from pagan goddesses such as Juno to the Holy Ghost , and the stork may have been chosen for its white plumage (depicting purity), size, and flight at high altitude (likened to flying between Earth and Heaven). The fable and its relation to the internal world of the child have been discussed by Sigmund Freud and Carl Jung . In fact, Jung recalled being told the story himself upon the birth of his own sister. The traditional link with the newborn continues with their use in advertising for such products as nappies and baby announcements . There were negative aspects to stork folklore as well; a Polish folk tale relates how God made the stork's plumage white, while the Devil gave it black wings, imbuing it with both good and evil impulses. They were also associated with handicapped or stillborn babies in Germany, explained as the stork having dropped the baby en route to the household, or as revenge or punishment for past wrongdoing. A mother who was confined to bed around the time of childbirth was said to have been "bitten" by the stork. In Denmark, storks were said to toss a nestling off the nest and then an egg in successive years. In medieval England, storks were also associated with adultery, possibly inspired by their courtship rituals. Their preening and posture saw them linked with the attribute of self-conceit. Children of African American slaves were sometimes told that white babies were brought by storks, while black babies were born from buzzard eggs. According to European folklore, the stork is responsible for bringing babies to new parents. The legend is very ancient, but was popularised by a 19th-century Hans Christian Andersen story called "The Storks". German folklore held that storks found babies in caves or marshes and brought them to households in a basket on their backs or held in their beaks. These caves contained adebarsteine or "stork stones". The babies would then be given to the mother or dropped down the chimney. Households would notify when they wanted children by placing sweets for the stork on the window sill. From there the folklore has spread around the world to the Philippines and countries in South America . Birthmarks on the back of the head of newborn baby, nevus flammeus nuchae , are sometimes referred to as stork-bite. In Slavic mythology and pagan religion , storks were thought to carry unborn souls from Vyraj to Earth in spring and summer. This belief still persists in the modern folk culture of many Slavic countries, in the simplified child story that "storks bring children into the world". Storks were seen by Early Slavs as bringing luck, and killing one would bring misfortune. Likewise, in Norse mythology , the god Hœnir , responsible for giving reason to the first humans, Ask and Embla , has been connected with the stork through his epithets long-legs and mud-king , along with Indo-European cognates such as Greek κύκνος 'swan' and Sanskrit शकुन . A long-term study that showed a spurious correlation between the numbers of stork nests and human births is widely used in the teaching of basic statistics as an example to highlight that correlation does not necessarily indicate causation . Psychoanalyst Marvin Margolis suggests the enduring nature of the stork fable of the newborn is linked to its addressing a psychological need, in that it allays the discomfort of discussing sex and procreation with children. Birds have long been associated with the maternal symbols from pagan goddesses such as Juno to the Holy Ghost , and the stork may have been chosen for its white plumage (depicting purity), size, and flight at high altitude (likened to flying between Earth and Heaven). The fable and its relation to the internal world of the child have been discussed by Sigmund Freud and Carl Jung . In fact, Jung recalled being told the story himself upon the birth of his own sister. The traditional link with the newborn continues with their use in advertising for such products as nappies and baby announcements . There were negative aspects to stork folklore as well; a Polish folk tale relates how God made the stork's plumage white, while the Devil gave it black wings, imbuing it with both good and evil impulses. They were also associated with handicapped or stillborn babies in Germany, explained as the stork having dropped the baby en route to the household, or as revenge or punishment for past wrongdoing. A mother who was confined to bed around the time of childbirth was said to have been "bitten" by the stork. In Denmark, storks were said to toss a nestling off the nest and then an egg in successive years. In medieval England, storks were also associated with adultery, possibly inspired by their courtship rituals. Their preening and posture saw them linked with the attribute of self-conceit. Children of African American slaves were sometimes told that white babies were brought by storks, while black babies were born from buzzard eggs.

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West Nile

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Deborah Asnis

Deborah Susan Asnis (July 17, 1956 – September 12, 2015) was an American infectious disease specialist and H.I.V. clinical researcher, who is credited with reporting the first human cases of West Nile virus in the United States . In August 1999, Asnis, the chief of infectious diseases at Flushing Hospital Medical Center in Queens, New York , noticed two male patients with similar, mysterious symptoms. Their symptoms included loss of arm and leg control, high fevers, and disorientation. She reported her patients' unusual symptoms to health authorities, who pursued further testing and analysis of the illness. Asnis' patients were diagnosed with West Nile virus in September 1999, the first known human cases of the disease in the United States . Asnis had been praised for reporting her patients' symptoms to authorities. Not only did her actions lead to the discovery of the West Nile virus in the United States, but, by alerting authorities, Asnis likely prevented a more widespread initial outbreak of West Nile in the country. Asnis was born on July 17, 1956, in New Hyde Park, New York , to Ruth (née Kornblum), an accounting teacher, and Myron Asnis, a dentist. She graduated from Roslyn High School in Roslyn, New York . Asnis then earned her bachelor's degree from Northwestern University and her medical degree from Northwestern's Feinberg School of Medicine in 1981. She resided in Hewlett, New York , with her husband, Hal Kazdin; the couple had two sons, Joshua and Matthew Kazdin. In August 1999, Deborah Asnis, an infectious disease specialist at Flushing Hospital Medical Center in Queens , noticed two male patients who were suffering from similar, unusual symptoms. The two patients, aged 60 and 75 respectively, were exhibiting sudden paralysis in their arms and legs, as well as disorientation and high fevers. Lab testing also showed elevated numbers of white blood cells within the spinal fluid of both males. None of the patients were responding to antiviral drugs. Possible early hypothesizes included botulism , viral encephalitis , Guillain–Barré syndrome , or meningitis , but none of these illnesses exactly matched the symptoms. Asnis decided to pursue a more concrete diagnosis by contacting authorities and other colleagues. Asnis contacted Marcelle Layton , the New York City Department of Health 's chief epidemiologist , on Monday, August 23, 1999, to report her patients' symptoms. Layton advised Asnis to send samples of the patients' blood and spinal fluid to the New York State Department of Health in Albany for further analysis. By Friday, August 27, 1999, just four days after Asnis had contacted Layton, two additional patients had been identified in Queens. The number rose to eight by Sunday, August 29, at Flushing Hospital Medical Center and other hospitals in Queens. All of the early patients resided within a few miles of one another. They were also frequent gardeners in the evenings. The Centers for Disease Control and Prevention (C.D.C.) initially identified the mystery illness as St. Louis encephalitis on September 3, 1999. The city of New York began widespread spraying for mosquitos later that same day. However, laboratory testing continued to determine a definitive cause of the symptoms. The U.S. federal government revised its diagnosis from St. Louis encephalitis to West Nile virus on September 27, 1999, citing research by Duane J. Gubler, a C.D.C. expert on arborviruses , as well as several bird deaths in the Bronx , located to the north of Queens. Deborah Asnis was credited by health experts with the early identification of West Nile virus in the United States. Her actions likely prevented a more widespread outbreak. In their 2003 book, "The New Killer Diseases: How the Alarming Evolution of Germs Threatens Us All," authors Elinor Levy and Mark Fischetti praised Dr. Asnis' response to the symptoms, writing that, "Asnis did something other doctors might not have bothered to do." They elaborated that, "One of the worst problems with our disease-detection system is that many doctors never report cases of strange symptoms, either because they are unsure of the disease they are facing, they're ignorant of the reporting requirement, or they simply never get around to it. Deborah Asnis was highly conscientious." Asnis continued to practice as the chief of infectious diseases at Flushing Hospital Medical Center. She died from breast cancer at Memorial Sloan Kettering Cancer Center in Manhattan , New York City , on September 12, 2015, at the age of 59. She was survived by her husband, Hal Kazdin; their sons, Joshua and Matthew Kazdin; and one of her two brothers, Gregory Asnis. Her mother, Ruth Asnis, died 6 days later on September 18, 2015. In August 1999, Deborah Asnis, an infectious disease specialist at Flushing Hospital Medical Center in Queens , noticed two male patients who were suffering from similar, unusual symptoms. The two patients, aged 60 and 75 respectively, were exhibiting sudden paralysis in their arms and legs, as well as disorientation and high fevers. Lab testing also showed elevated numbers of white blood cells within the spinal fluid of both males. None of the patients were responding to antiviral drugs. Possible early hypothesizes included botulism , viral encephalitis , Guillain–Barré syndrome , or meningitis , but none of these illnesses exactly matched the symptoms. Asnis decided to pursue a more concrete diagnosis by contacting authorities and other colleagues. Asnis contacted Marcelle Layton , the New York City Department of Health 's chief epidemiologist , on Monday, August 23, 1999, to report her patients' symptoms. Layton advised Asnis to send samples of the patients' blood and spinal fluid to the New York State Department of Health in Albany for further analysis. By Friday, August 27, 1999, just four days after Asnis had contacted Layton, two additional patients had been identified in Queens. The number rose to eight by Sunday, August 29, at Flushing Hospital Medical Center and other hospitals in Queens. All of the early patients resided within a few miles of one another. They were also frequent gardeners in the evenings. The Centers for Disease Control and Prevention (C.D.C.) initially identified the mystery illness as St. Louis encephalitis on September 3, 1999. The city of New York began widespread spraying for mosquitos later that same day. However, laboratory testing continued to determine a definitive cause of the symptoms. The U.S. federal government revised its diagnosis from St. Louis encephalitis to West Nile virus on September 27, 1999, citing research by Duane J. Gubler, a C.D.C. expert on arborviruses , as well as several bird deaths in the Bronx , located to the north of Queens. Deborah Asnis was credited by health experts with the early identification of West Nile virus in the United States. Her actions likely prevented a more widespread outbreak. In their 2003 book, "The New Killer Diseases: How the Alarming Evolution of Germs Threatens Us All," authors Elinor Levy and Mark Fischetti praised Dr. Asnis' response to the symptoms, writing that, "Asnis did something other doctors might not have bothered to do." They elaborated that, "One of the worst problems with our disease-detection system is that many doctors never report cases of strange symptoms, either because they are unsure of the disease they are facing, they're ignorant of the reporting requirement, or they simply never get around to it. Deborah Asnis was highly conscientious." Asnis continued to practice as the chief of infectious diseases at Flushing Hospital Medical Center. She died from breast cancer at Memorial Sloan Kettering Cancer Center in Manhattan , New York City , on September 12, 2015, at the age of 59. She was survived by her husband, Hal Kazdin; their sons, Joshua and Matthew Kazdin; and one of her two brothers, Gregory Asnis. Her mother, Ruth Asnis, died 6 days later on September 18, 2015.

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Zika virus

Zika virus ( ZIKV ; pronounced / ˈ z iː k ə / or / ˈ z ɪ k ə / ) is a member of the virus family Flaviviridae . It is spread by daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus . Its name comes from the Ziika Forest of Uganda , where the virus was first isolated in 1947. Zika virus shares a genus with the dengue , yellow fever , Japanese encephalitis , and West Nile viruses. Since the 1950s, it has been known to occur within a narrow equatorial belt from Africa to Asia. From 2007 to 2016 [ update ] , the virus spread eastward, across the Pacific Ocean to the Americas, leading to the 2015–2016 Zika virus epidemic . The infection, known as Zika fever or Zika virus disease, often causes no or only mild symptoms, similar to a very mild form of dengue fever . While there is no specific treatment, paracetamol (acetaminophen) and rest may help with the symptoms. As of April 2019, no vaccines have been approved for clinical use, however a number of vaccines are currently in clinical trials. Zika can spread from a pregnant woman to her baby. This can result in microcephaly , severe brain malformations , and other birth defects. Zika infections in adults may result rarely in Guillain–Barré syndrome . In January 2016, the United States Centers for Disease Control and Prevention (CDC) issued travel guidance on affected countries, including the use of enhanced precautions, and guidelines for pregnant women including considering postponing travel. Other governments or health agencies also issued similar travel warnings, while Colombia , the Dominican Republic , Puerto Rico , Ecuador , El Salvador , and Jamaica advised women to postpone getting pregnant until more is known about the risks. Zika virus belongs to the family Flaviviridae and the genus Flavivirus , thus is related to the dengue , yellow fever , Japanese encephalitis , and West Nile viruses. Like other flaviviruses, Zika virus is enveloped and icosahedral and has a nonsegmented, single-stranded, 10 kilobase , positive-sense RNA genome . It is most closely related to the Spondweni virus and is one of the two known viruses in the Spondweni virus clade . A positive-sense RNA genome can be directly translated into viral proteins. As in other flaviviruses, such as the similarly sized West Nile virus, the RNA genome encodes seven nonstructural proteins and three structural proteins in the form of a single polyprotein ( Q32ZE1 ). One of the structural proteins encapsulates the virus. This protein is the flavivirus envelope glycoprotein, that binds to the endosomal membrane of the host cell to initiate endocytosis. The RNA genome forms a nucleocapsid along with copies of the 12-kDa capsid protein. The nucleocapsid, in turn, is enveloped within a host-derived membrane modified with two viral glycoproteins . Viral genome replication depends on the making of double-stranded RNA from the single-stranded, positive-sense RNA (ssRNA(+)) genome followed by transcription and replication to provide viral mRNAs and new ssRNA(+) genomes. A longitudinal study shows that 6 hours after cells are infected with Zika virus , the vacuoles and mitochondria in the cells begin to swell. This swelling becomes so severe, it results in cell death, also known as paraptosis. This form of programmed cell death requires gene expression. IFITM3 is a trans-membrane protein in a cell that is able to protect it from viral infection by blocking virus attachment. Cells are most susceptible to Zika infection when levels of IFITM3 are low. Once the cell has been infected, the virus restructures the endoplasmic reticulum, forming the large vacuoles, resulting in cell death. There are two Zika lineages: the African lineage and the Asian lineage. Phylogenetic studies indicate that the virus spreading in the Americas is 89% identical to African genotypes, but is most closely related to the Asian strain that circulated in French Polynesia during the 2013 – 2014 outbreak . The Asian strain appears to have first evolved around 1928. The vertebrate hosts of the virus were primarily monkeys in a so-called enzootic mosquito-monkey-mosquito cycle, with only occasional transmission to humans. Before 2007, Zika "rarely caused recognized 'spillover' infections in humans, even in highly enzootic areas". Infrequently, however, other arboviruses have become established as a human disease and spread in a mosquito–human–mosquito cycle, like the yellow fever virus and the dengue fever virus (both flaviviruses), and the chikungunya virus (a togavirus ). Though the reason for the pandemic is unknown, dengue, a related arbovirus that infects the same species of mosquito vectors , is known in particular to be intensified by urbanization and globalization . Zika is primarily spread by Aedes aegypti mosquitoes, and can also be transmitted through sexual contact or blood transfusions . The basic reproduction number ( R 0 , a measure of transmissibility) of Zika virus has been estimated to be between 1.4 and 6.6 . In 2015, news reports drew attention to the rapid spread of Zika in Latin America and the Caribbean. At that time, the Pan American Health Organization published a list of countries and territories that experienced "local Zika virus transmission" comprising Barbados, Bolivia, Brazil, Colombia, the Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, and Venezuela. By August 2016, more than 50 countries had experienced active (local) transmission of Zika virus . Zika is primarily spread by the female Aedes aegypti mosquito, which is active mostly in the daytime. The mosquitos must feed on blood to lay eggs. : 2 The virus has also been isolated from a number of arboreal mosquito species in the genus Aedes , such as A. africanus , A. apicoargenteus , A. furcifer , A. hensilli , A. luteocephalus , and A. vittatus , with an extrinsic incubation period in mosquitoes around 10 days. The true extent of the vectors is still unknown. Zika has been detected in many more species of Aedes , along with Anopheles coustani, Mansonia uniformis , and Culex perfuscus , although this alone does not incriminate them as vectors. To detect the presence of the virus usually requires genetic material to be analysed in a lab using the technique RT-PCR . A much cheaper and faster method involves shining a light at the head and thorax of the mosquito, and detecting chemical compounds characteristic of the virus using near-infrared spectroscopy . Transmission by A. albopictus , the tiger mosquito, was reported from a 2007 urban outbreak in Gabon, where it had newly invaded the country and become the primary vector for the concomitant chikungunya and dengue virus outbreaks. New outbreaks can occur if a person carrying the virus travels to another region where A. albopictus is common. The potential societal risk of Zika can be delimited by the distribution of the mosquito species that transmit it. The global distribution of the most cited carrier of Zika, A. aegypti , is expanding due to global trade and travel. A. aegypti distribution is now the most extensive ever recorded – on parts of all continents except Antarctica, including North America and even the European periphery ( Madeira , the Netherlands, and the northeastern Black Sea coast). A mosquito population capable of carrying Zika has been found in a Capitol Hill neighborhood of Washington, DC, and genetic evidence suggests they survived at least four consecutive winters in the region. The study authors conclude that mosquitos are adapting for persistence in a northern climate. Zika virus appears to be contagious via mosquitoes for around a week after infection. The virus is thought to be infectious for a longer period of time after infection (at least 2 weeks) when transmitted via semen . Research into its ecological niche suggests that Zika may be influenced to a greater degree by changes in precipitation and temperature than dengue, making it more likely to be confined to tropical areas. However, rising global temperatures would allow for the disease vector to expand its range further north, allowing Zika to follow. Zika can be transmitted from men and women to their sexual partners; most known cases involve transmission from symptomatic men to women. As of April 2016, sexual transmission of Zika has been documented in six countries – Argentina, Australia, France, Italy, New Zealand, and the United States – during the 2015 outbreak. ZIKV can persist in semen for several months, with viral RNA detected up to one year. The virus replicates in the human testis, where it infects several cell types including testicular macrophages, peritubular cells and germ cells, the spermatozoa precursors. Semen parameters can be altered in patients for several weeks post-symptoms onset, and spermatozoa can be infectious. Since October 2016, the CDC has advised men who have traveled to an area with Zika should use condoms or not have sex for at least six months after their return as the virus is still transmissible even if symptoms never develop. Zika virus can spread by vertical (or "mother-to-child") transmission , during pregnancy or at delivery. An infection during pregnancy has been linked to changes in neuronal development of the unborn child. Severe progressions of infection have been linked to the development of microcephaly in the unborn child, while mild infections potentially can lead to neurocognitive disorders later in life. Congenital brain abnormalities other than microcephaly have also been reported after a Zika outbreak. Studies in mice have suggested that maternal immunity to dengue virus may enhance fetal infection with Zika, worsen the microcephaly phenotype and/or enhance damage during pregnancy, but it is unknown whether this occurs in humans. As of April 2016 [ update ] , two cases of Zika transmission through blood transfusions have been reported globally, both from Brazil, after which the US Food and Drug Administration (FDA) recommended screening blood donors and deferring high-risk donors for 4 weeks. A potential risk had been suspected based on a blood-donor screening study during the French Polynesian Zika outbreak, in which 2.8% (42) of donors from November 2013 and February 2014 tested positive for Zika RNA and were all asymptomatic at the time of blood donation. Eleven of the positive donors reported symptoms of Zika fever after their donation, but only three of 34 samples grew in culture. Zika is primarily spread by the female Aedes aegypti mosquito, which is active mostly in the daytime. The mosquitos must feed on blood to lay eggs. : 2 The virus has also been isolated from a number of arboreal mosquito species in the genus Aedes , such as A. africanus , A. apicoargenteus , A. furcifer , A. hensilli , A. luteocephalus , and A. vittatus , with an extrinsic incubation period in mosquitoes around 10 days. The true extent of the vectors is still unknown. Zika has been detected in many more species of Aedes , along with Anopheles coustani, Mansonia uniformis , and Culex perfuscus , although this alone does not incriminate them as vectors. To detect the presence of the virus usually requires genetic material to be analysed in a lab using the technique RT-PCR . A much cheaper and faster method involves shining a light at the head and thorax of the mosquito, and detecting chemical compounds characteristic of the virus using near-infrared spectroscopy . Transmission by A. albopictus , the tiger mosquito, was reported from a 2007 urban outbreak in Gabon, where it had newly invaded the country and become the primary vector for the concomitant chikungunya and dengue virus outbreaks. New outbreaks can occur if a person carrying the virus travels to another region where A. albopictus is common. The potential societal risk of Zika can be delimited by the distribution of the mosquito species that transmit it. The global distribution of the most cited carrier of Zika, A. aegypti , is expanding due to global trade and travel. A. aegypti distribution is now the most extensive ever recorded – on parts of all continents except Antarctica, including North America and even the European periphery ( Madeira , the Netherlands, and the northeastern Black Sea coast). A mosquito population capable of carrying Zika has been found in a Capitol Hill neighborhood of Washington, DC, and genetic evidence suggests they survived at least four consecutive winters in the region. The study authors conclude that mosquitos are adapting for persistence in a northern climate. Zika virus appears to be contagious via mosquitoes for around a week after infection. The virus is thought to be infectious for a longer period of time after infection (at least 2 weeks) when transmitted via semen . Research into its ecological niche suggests that Zika may be influenced to a greater degree by changes in precipitation and temperature than dengue, making it more likely to be confined to tropical areas. However, rising global temperatures would allow for the disease vector to expand its range further north, allowing Zika to follow. Zika can be transmitted from men and women to their sexual partners; most known cases involve transmission from symptomatic men to women. As of April 2016, sexual transmission of Zika has been documented in six countries – Argentina, Australia, France, Italy, New Zealand, and the United States – during the 2015 outbreak. ZIKV can persist in semen for several months, with viral RNA detected up to one year. The virus replicates in the human testis, where it infects several cell types including testicular macrophages, peritubular cells and germ cells, the spermatozoa precursors. Semen parameters can be altered in patients for several weeks post-symptoms onset, and spermatozoa can be infectious. Since October 2016, the CDC has advised men who have traveled to an area with Zika should use condoms or not have sex for at least six months after their return as the virus is still transmissible even if symptoms never develop. Zika virus can spread by vertical (or "mother-to-child") transmission , during pregnancy or at delivery. An infection during pregnancy has been linked to changes in neuronal development of the unborn child. Severe progressions of infection have been linked to the development of microcephaly in the unborn child, while mild infections potentially can lead to neurocognitive disorders later in life. Congenital brain abnormalities other than microcephaly have also been reported after a Zika outbreak. Studies in mice have suggested that maternal immunity to dengue virus may enhance fetal infection with Zika, worsen the microcephaly phenotype and/or enhance damage during pregnancy, but it is unknown whether this occurs in humans. As of April 2016 [ update ] , two cases of Zika transmission through blood transfusions have been reported globally, both from Brazil, after which the US Food and Drug Administration (FDA) recommended screening blood donors and deferring high-risk donors for 4 weeks. A potential risk had been suspected based on a blood-donor screening study during the French Polynesian Zika outbreak, in which 2.8% (42) of donors from November 2013 and February 2014 tested positive for Zika RNA and were all asymptomatic at the time of blood donation. Eleven of the positive donors reported symptoms of Zika fever after their donation, but only three of 34 samples grew in culture. Zika virus replicates in the mosquito's midgut epithelial cells and then its salivary gland cells. After 5–10 days, the virus can be found in the mosquito's saliva. If the mosquito's saliva is inoculated into human skin, the virus can infect epidermal keratinocytes, skin fibroblasts in the skin and the Langerhans cells . The pathogenesis of the virus is hypothesized to continue with a spread to lymph nodes and the bloodstream. Flaviviruses replicate in the cytoplasm , but Zika antigens have been found in infected cell nuclei. The viral protein numbered NS4A can lead to small head size ( microcephaly ) because it disrupts brain growth by hijacking a pathway which regulates growth of new neurons. In fruit flies, both NS4A and the neighboring NS4B restrict eye growth. Zika fever (also known as Zika virus disease) is an illness caused by Zika virus . Around 80% of cases are estimated to be asymptomatic, though the accuracy of this figure is hindered by the wide variance in data quality, and figures from different outbreaks can vary significantly. Symptomatic cases are usually mild and can resemble dengue fever . Symptoms may include fever , red eyes , joint pain , headache, and a maculopapular rash . Symptoms generally last less than seven days. It has not caused any reported deaths during the initial infection. Infection during pregnancy causes microcephaly and other brain malformations in some babies. Infection in adults has been linked to Guillain–Barré syndrome (GBS) and Zika virus has been shown to infect human Schwann cells . Diagnosis is by testing the blood, urine, or saliva for the presence of Zika virus RNA when the person is sick. In 2019, an improved diagnostic test, based on research from Washington University in St. Louis , that detects Zika infection in serum was granted market authorization by the FDA . Prevention involves decreasing mosquito bites in areas where the disease occurs, and proper use of condoms. Efforts to prevent bites include the use of DEET or picaridin - based insect repellent , covering much of the body with clothing, mosquito nets , and getting rid of standing water where mosquitoes reproduce. There is no vaccine . Health officials recommended that women in areas affected by the 2015–2016 Zika outbreak consider putting off pregnancy and that pregnant women not travel to these areas. While no specific treatment exists, paracetamol (acetaminophen) and rest may help with the symptoms. Admission to a hospital is rarely necessary. It is advised, for an affected person with the zika virus, to drink a lot of water to stay hydrated, to lie down, and to treat the fever and agony with liquid solutions; taking drugs like acetaminophen or paracetamol helps to relieve fever and pain. [ according to whom? ] Referring to the US CDC it is not recommended to take anti-inflammatory and non-steroid drugs like aspirin for example. If the patient affected is already taking treatment for another medical condition it is advisable to inform your attending physician before taking any other drug or additional treatment; The World Health Organization has suggested that priority should be to develop inactivated vaccines and other nonlive vaccines, which are safe to use in pregnant women. As of March 2016 [ update ] , 18 companies and institutions were developing vaccines against Zika, but they state a vaccine is unlikely to be widely available for about 10 years. In June 2016, the FDA granted the first approval for a human clinical trial for a Zika vaccine. In March 2017, a DNA vaccine was approved for phase-2 clinical trials. This vaccine consists of a small, circular piece of DNA, known as a plasmid, that expresses the genes for the Zika virus envelope proteins. As the vaccine does not contain the full sequence of the virus, it cannot cause infection. As of April 2017, both subunit and inactivated vaccines have entered clinical trials. It is advised, for an affected person with the zika virus, to drink a lot of water to stay hydrated, to lie down, and to treat the fever and agony with liquid solutions; taking drugs like acetaminophen or paracetamol helps to relieve fever and pain. [ according to whom? ] Referring to the US CDC it is not recommended to take anti-inflammatory and non-steroid drugs like aspirin for example. If the patient affected is already taking treatment for another medical condition it is advisable to inform your attending physician before taking any other drug or additional treatment; The World Health Organization has suggested that priority should be to develop inactivated vaccines and other nonlive vaccines, which are safe to use in pregnant women. As of March 2016 [ update ] , 18 companies and institutions were developing vaccines against Zika, but they state a vaccine is unlikely to be widely available for about 10 years. In June 2016, the FDA granted the first approval for a human clinical trial for a Zika vaccine. In March 2017, a DNA vaccine was approved for phase-2 clinical trials. This vaccine consists of a small, circular piece of DNA, known as a plasmid, that expresses the genes for the Zika virus envelope proteins. As the vaccine does not contain the full sequence of the virus, it cannot cause infection. As of April 2017, both subunit and inactivated vaccines have entered clinical trials. The virus was first isolated in April 1947 from a rhesus macaque monkey placed in a cage in the Ziika Forest of Uganda , near Lake Victoria , by the scientists of the Yellow Fever Research Institute . A second isolation from the mosquito A. africanus followed at the same site in January 1948. When the monkey developed a fever, researchers isolated from its serum a "filterable transmissible agent" which was named Zika in 1948. Zika was first known to infect humans from the results of a serological survey in Uganda, published in 1952. Of 99 human blood samples tested, 6.1% had neutralizing antibodies. As part of a 1954 outbreak investigation of jaundice suspected to be yellow fever, researchers reported isolation of the virus from a patient, but the pathogen was later shown to be the closely related Spondweni virus . Spondweni was also determined to be the cause of a self-inflicted infection in a researcher reported in 1956. Subsequent serological studies in several African and Asian countries indicated the virus had been widespread within human populations in these regions. The first true case of human infection was identified by Simpson in 1964, who was himself infected while isolating the virus from mosquitoes. From then until 2007, there were only 13 further confirmed human cases of Zika infection from Africa and Southeast Asia. A study published in 2017 showed that the Zika virus, despite only a few cases were reported, has been silently circulated in West Africa for the last two decades when blood samples collected between 1992 and 2016 were tested for the ZIKV IgM antibodies. In 2017, Angola reported two cases of Zika fever. Zika was also occurring in Tanzania as of 2016. In April 2007, the first outbreak outside of Africa and Asia occurred on the island of Yap in the Federated States of Micronesia, characterized by rash, conjunctivitis, and arthralgia, which was initially thought to be dengue, chikungunya , or Ross River disease . Serum samples from patients in the acute phase of illness contained RNA of Zika. There were 49 confirmed cases, 59 unconfirmed cases, no hospitalizations, and no deaths. After October 2013 Oceania's first outbreak showed an estimated 11% population infected for French Polynesia that also presented with Guillain–Barre syndrome (GBS). The spread of ZIKV continued to New Caledonia, Easter Island, and the Cook Islands and where 1385 cases were confirmed by January 2014. During the same year, Easter Island acknowledged 51 cases. Australia began seeing cases in 2012. Research showed it was brought by travelers returning from Indonesia and other infected countries. New Zealand also experienced infections rate increases through returning foreign travelers. Oceania countries experiencing Zika today are New Caledonia, Vanuatu, Solomon Islands, Marshall Islands, American Samoa, Samoa, and Tonga. Between 2013 and 2014, further epidemics occurred in French Polynesia , Easter Island , the Cook Islands , and New Caledonia . There was an epidemic in 2015 and 2016 in the Americas . The outbreak began in April 2015 in Brazil , and spread to other countries in South America , Central America , North America , and the Caribbean . In January 2016, the WHO said the virus was likely to spread throughout most of the Americas by the end of the year; and in February 2016, the WHO declared the cluster of microcephaly and Guillain–Barré syndrome cases reported in Brazil – strongly suspected to be associated with the Zika outbreak – a Public Health Emergency of International Concern . It was estimated that 1.5 million people were infected by Zika in Brazil, with over 3,500 cases of microcephaly reported between October 2015 and January 2016. A number of countries issued travel warnings , and the outbreak was expected to significantly impact the tourism industry. Several countries have taken the unusual step of advising their citizens to delay pregnancy until more is known about the virus and its impact on fetal development. With the 2016 Summer Olympics hosted in Rio de Janeiro , health officials worldwide voiced concerns over a potential crisis, both in Brazil and when international athletes and tourists returned home and possibly would spread the virus. Some researchers speculated that only one or two tourists might be infected during the three-week period, or approximately 3.2 infections per 100,000 tourists. In November 2016, the World Health Organization declared that Zika virus was no longer a global emergency while noting that the virus still represents "a highly significant and a long-term problem". As of August 2017 the number of new Zika virus cases in the Americas had fallen dramatically. On May 15, 2017, three cases of Zika virus infection in India were reported in the state of Gujarat . By late 2018, there had been at least 159 cases in Rajasthan and 127 in Madhya Pradesh . In July 2021, the first case of Zika virus infection in the Indian state of Kerala was reported. After the first confirmed case, 19 other people who had previously presented symptoms were tested, and 13 of those had positive results, showing that Zika had been circulating in Kerala since at least May 2021. By August 6th 2021, there had been 65 reported cases in Kerala. On October 22, 2021, an officer in the Indian Air Force in Kanpur tested positive for Zika virus, making it the first reported case in the Indian state of Uttar Pradesh . On 22 March 2016, Reuters reported that Zika was isolated from a 2014 blood sample of an elderly man in Chittagong in Bangladesh as part of a retrospective study . Between August and November 2016, 455 cases of Zika virus infection were confirmed in Singapore . In 2023, 722 Zika virus cases were reported in Thailand. From 2019-2022 the Robert Koch-Institut reported 29 imported Zikavirus cases imported into Germany. Of the altogether 16 imported Zika virus cases in 2023, 10 were diagnosed after a trip to Thailand with 62% of all Zika virus cases a significant relative and absolute increase. The virus was first isolated in April 1947 from a rhesus macaque monkey placed in a cage in the Ziika Forest of Uganda , near Lake Victoria , by the scientists of the Yellow Fever Research Institute . A second isolation from the mosquito A. africanus followed at the same site in January 1948. When the monkey developed a fever, researchers isolated from its serum a "filterable transmissible agent" which was named Zika in 1948. Zika was first known to infect humans from the results of a serological survey in Uganda, published in 1952. Of 99 human blood samples tested, 6.1% had neutralizing antibodies. As part of a 1954 outbreak investigation of jaundice suspected to be yellow fever, researchers reported isolation of the virus from a patient, but the pathogen was later shown to be the closely related Spondweni virus . Spondweni was also determined to be the cause of a self-inflicted infection in a researcher reported in 1956. Subsequent serological studies in several African and Asian countries indicated the virus had been widespread within human populations in these regions. The first true case of human infection was identified by Simpson in 1964, who was himself infected while isolating the virus from mosquitoes. From then until 2007, there were only 13 further confirmed human cases of Zika infection from Africa and Southeast Asia. A study published in 2017 showed that the Zika virus, despite only a few cases were reported, has been silently circulated in West Africa for the last two decades when blood samples collected between 1992 and 2016 were tested for the ZIKV IgM antibodies. In 2017, Angola reported two cases of Zika fever. Zika was also occurring in Tanzania as of 2016. In April 2007, the first outbreak outside of Africa and Asia occurred on the island of Yap in the Federated States of Micronesia, characterized by rash, conjunctivitis, and arthralgia, which was initially thought to be dengue, chikungunya , or Ross River disease . Serum samples from patients in the acute phase of illness contained RNA of Zika. There were 49 confirmed cases, 59 unconfirmed cases, no hospitalizations, and no deaths. After October 2013 Oceania's first outbreak showed an estimated 11% population infected for French Polynesia that also presented with Guillain–Barre syndrome (GBS). The spread of ZIKV continued to New Caledonia, Easter Island, and the Cook Islands and where 1385 cases were confirmed by January 2014. During the same year, Easter Island acknowledged 51 cases. Australia began seeing cases in 2012. Research showed it was brought by travelers returning from Indonesia and other infected countries. New Zealand also experienced infections rate increases through returning foreign travelers. Oceania countries experiencing Zika today are New Caledonia, Vanuatu, Solomon Islands, Marshall Islands, American Samoa, Samoa, and Tonga. Between 2013 and 2014, further epidemics occurred in French Polynesia , Easter Island , the Cook Islands , and New Caledonia . There was an epidemic in 2015 and 2016 in the Americas . The outbreak began in April 2015 in Brazil , and spread to other countries in South America , Central America , North America , and the Caribbean . In January 2016, the WHO said the virus was likely to spread throughout most of the Americas by the end of the year; and in February 2016, the WHO declared the cluster of microcephaly and Guillain–Barré syndrome cases reported in Brazil – strongly suspected to be associated with the Zika outbreak – a Public Health Emergency of International Concern . It was estimated that 1.5 million people were infected by Zika in Brazil, with over 3,500 cases of microcephaly reported between October 2015 and January 2016. A number of countries issued travel warnings , and the outbreak was expected to significantly impact the tourism industry. Several countries have taken the unusual step of advising their citizens to delay pregnancy until more is known about the virus and its impact on fetal development. With the 2016 Summer Olympics hosted in Rio de Janeiro , health officials worldwide voiced concerns over a potential crisis, both in Brazil and when international athletes and tourists returned home and possibly would spread the virus. Some researchers speculated that only one or two tourists might be infected during the three-week period, or approximately 3.2 infections per 100,000 tourists. In November 2016, the World Health Organization declared that Zika virus was no longer a global emergency while noting that the virus still represents "a highly significant and a long-term problem". As of August 2017 the number of new Zika virus cases in the Americas had fallen dramatically. On May 15, 2017, three cases of Zika virus infection in India were reported in the state of Gujarat . By late 2018, there had been at least 159 cases in Rajasthan and 127 in Madhya Pradesh . In July 2021, the first case of Zika virus infection in the Indian state of Kerala was reported. After the first confirmed case, 19 other people who had previously presented symptoms were tested, and 13 of those had positive results, showing that Zika had been circulating in Kerala since at least May 2021. By August 6th 2021, there had been 65 reported cases in Kerala. On October 22, 2021, an officer in the Indian Air Force in Kanpur tested positive for Zika virus, making it the first reported case in the Indian state of Uttar Pradesh . On 22 March 2016, Reuters reported that Zika was isolated from a 2014 blood sample of an elderly man in Chittagong in Bangladesh as part of a retrospective study . Between August and November 2016, 455 cases of Zika virus infection were confirmed in Singapore . In 2023, 722 Zika virus cases were reported in Thailand. From 2019-2022 the Robert Koch-Institut reported 29 imported Zikavirus cases imported into Germany. Of the altogether 16 imported Zika virus cases in 2023, 10 were diagnosed after a trip to Thailand with 62% of all Zika virus cases a significant relative and absolute increase.

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