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Major infectious diseases

This entry lists major infectious diseases likely to be encountered in countries where the risk of such diseases is assessed to be very high as compared to the United States. These infectious diseases represent risks to US government personnel traveling to the specified country for a period of less than three years. The degree of risk is assessed by considering the foreign nature of these infectious diseases, their severity, and the probability of being affected by the diseases present. The diseases listed do not necessarily represent the total disease burden experienced by the local population. The risk to an individual traveler varies considerably by the specific location, visit duration, type of activities, type of accommodations, time of year, and other factors. Consultation with a travel medicine physician is needed to evaluate individual risk and recommend appropriate preventive measures such as vaccines. Diseases are organized into the following six exposure categories shown in italics and listed in typical descending order of risk. Note: The sequence of exposure categories listed in individual country entries may vary according to local conditions. food or waterborne diseases acquired through eating or drinking on the local economy: Hepatitis A - viral disease that interferes with the functioning of the liver; spread through consumption of food or water contaminated with fecal matter, principally in areas of poor sanitation; victims exhibit fever, jaundice, and diarrhea; 15% of victims will experience prolonged symptoms over 6–9 months; vaccine available. Hepatitis E - water-borne viral disease that interferes with the functioning of the liver; most commonly spread through fecal contamination of drinking water; victims exhibit jaundice, fatigue, abdominal pain, and dark colored urine. Typhoid fever - bacterial disease spread through contact with food or water contaminated by fecal matter or sewage; victims exhibit sustained high fevers; left untreated, mortality rates can reach 20%. vectorborne diseases acquired through the bite of an infected arthropod: Malaria - caused by single-cell parasitic protozoa Plasmodium; transmitted to humans via the bite of the female Anopheles mosquito; parasites multiply in the liver attacking red blood cells resulting in cycles of fever, chills, and sweats accompanied by anemia; death due to damage to vital organs and interruption of blood supply to the brain; endemic in 100, mostly tropical, countries with 90% of cases and the majority of 1.5–2.5 million estimated annual deaths occurring in sub-Saharan Africa. Dengue fever - mosquito-borne (Aedes aegypti) viral disease associated with urban environments; manifests as sudden onset of fever and severe headache; occasionally produces shock and hemorrhage leading to death in 5% of cases. Yellow fever - mosquito-borne viral disease; severity ranges from influenza-like symptoms to severe hepatitis and hemorrhagic fever; occurs only in tropical South America and sub-Saharan Africa, where most cases are reported; fatality rate is less than 20%. Japanese Encephalitis - mosquito-borne (Culex tritaeniorhynchus) viral disease associated with rural areas in Asia; acute encephalitis can progress to paralysis, coma, and death; fatality rates 30%. African Trypanosomiasis - caused by the parasitic protozoa Trypanosoma; transmitted to humans via the bite of bloodsucking Tsetse flies; infection leads to malaise and irregular fevers and, in advanced cases when the parasites invade the central nervous system, coma and death; endemic in 36 countries of sub-Saharan Africa; cattle and wild animals act as reservoir hosts for the parasites. Cutaneous Leishmaniasis - caused by the parasitic protozoa leishmania; transmitted to humans via the bite of sandflies; results in skin lesions that may become chronic; endemic in 88 countries; 90% of cases occur in Iran, Afghanistan, Syria, Saudi Arabia, Brazil, and Peru; wild and domesticated animals as well as humans can act as reservoirs of infection. Plague - bacterial disease transmitted by fleas normally associated with rats; person-to-person airborne transmission also possible; recent plague epidemics occurred in areas of Asia, Africa, and South America associated with rural areas or small towns and villages; manifests as fever, headache, and painfully swollen lymph nodes; disease progresses rapidly and without antibiotic treatment leads to pneumonic form with a death rate in excess of 50%. Crimean-Congo hemorrhagic fever - tick-borne viral disease; infection may also result from exposure to infected animal blood or tissue; geographic distribution includes Africa, Asia, the Middle East, and Eastern Europe; sudden onset of fever, headache, and muscle aches followed by hemorrhaging in the bowels, urine, nose, and gums; mortality rate is approximately 30%. Rift Valley fever - viral disease affecting domesticated animals and humans; transmission is by mosquito and other biting insects; infection may also occur through handling of infected meat or contact with blood; geographic distribution includes eastern and southern Africa where cattle and sheep are raised; symptoms are generally mild with fever and some liver abnormalities, but the disease may progress to hemorrhagic fever, encephalitis, or ocular disease; fatality rates are low at about 1% of cases. Chikungunya - mosquito-borne (Aedes aegypti) viral disease associated with urban environments, similar to Dengue Fever; characterized by sudden onset of fever, rash, and severe joint pain usually lasting 3–7 days, some cases result in persistent arthritis. water contact diseases acquired through swimming or wading in freshwater lakes, streams, and rivers: Leptospirosis - bacterial disease that affects animals and humans; infection occurs through contact with water, food, or soil contaminated by animal urine; symptoms include high fever, severe headache, vomiting, jaundice, and diarrhea; untreated, the disease can result in kidney damage, liver failure, meningitis, or respiratory distress; fatality rates are low but left untreated recovery can take months. Schistosomiasis - caused by parasitic trematode flatworm Schistosoma; fresh water snails act as intermediate host and release larval form of parasite that penetrates the skin of people exposed to contaminated water; worms mature and reproduce in the blood vessels, liver, kidneys, and intestines releasing eggs, which become trapped in tissues triggering an immune response; may manifest as either urinary or intestinal disease resulting in decreased work or learning capacity; mortality, while generally low, may occur in advanced cases usually due to bladder cancer; endemic in 74 developing countries with 80% of infected people living in sub-Saharan Africa; humans act as the reservoir for this parasite. aerosolized dust or soil contact disease acquired through inhalation of aerosols contaminated with rodent urine: Lassa fever - viral disease carried by rats of the genus Mastomys; endemic in portions of West Africa; infection occurs through direct contact with or consumption of food contaminated by rodent urine or fecal matter containing virus particles; fatality rate can reach 50% in epidemic outbreaks. respiratory disease acquired through close contact with an infectious person: Meningococcal meningitis - bacterial disease causing an inflammation of the lining of the brain and spinal cord; one of the most important bacterial pathogens is Neisseria meningitidis because of its potential to cause epidemics; symptoms include stiff neck, high fever, headaches, and vomiting; bacteria are transmitted from person to person by respiratory droplets and facilitated by close and prolonged contact resulting from crowded living conditions, often with a seasonal distribution; death occurs in 5–15% of cases, typically within 24–48 hours of onset of symptoms; highest burden of meningococcal disease occurs in the hyperendemic region of sub-Saharan Africa known as the "Meningitis Belt" which stretches from Senegal east to Ethiopia. animal contact disease acquired through direct contact with local animals: Rabies - viral disease of mammals usually transmitted through the bite of an infected animal, most commonly dogs; virus affects the central nervous system causing brain alteration and death; symptoms initially are non-specific fever and headache progressing to neurological symptoms; death occurs within days of the onset of symptoms.

Manpower available for military service

This entry gives the number of males and females falling in the military age range for a country (defined as being ages 16–49) and assumes that every individual is fit to serve.

Manpower fit for military service

This entry gives the number of males and females falling in the military age range for a country (defined as being ages 16–49) and who are not otherwise disqualified for health reasons; accounts for the health situation in the country and provides a more realistic estimate of the actual number fit to serve.

Manpower reaching militarily significant age annually

This entry gives the number of males and females entering the military manpower pool (i.e., reaching age 16) in any given year and is a measure of the availability of military-age young adults.

Map references

This entry includes the name of the Factbook reference map on which a country may be found. Note that boundary representations on these maps are not necessarily authoritative. The entry on Geographic coordinates may be helpful in finding some smaller countries.

Maritime claims

This entry includes the following claims, the definitions of which are excerpted from the United Nations Convention on the Law of the Sea (UNCLOS), which alone contains the full and definitive descriptions: territorial sea - the sovereignty of a coastal state extends beyond its land territory and internal waters to an adjacent belt of sea, described as the territorial sea in the UNCLOS (Part II); this sovereignty extends to the air space over the territorial sea as well as its underlying seabed and subsoil; every state has the right to establish the breadth of its territorial sea up to a limit not exceeding 12 nautical miles; the normal baseline for measuring the breadth of the territorial sea is the mean low-water line along the coast as marked on large-scale charts officially recognized by the coastal state; the UNCLOS describes specific rules for archipelagic states. contiguous zone - according to the UNCLOS (Article 33), this is a zone contiguous to a coastal state's territorial sea, over which it may exercise the control necessary to: prevent infringement of its customs, fiscal, immigration, or sanitary laws and regulations within its territory or territorial sea; punish infringement of the above laws and regulations committed within its territory or territorial sea; the contiguous zone may not extend beyond 24 nautical miles from the baselines from which the breadth of the territorial sea is measured (e.g. the US has claimed a 12-nautical mile contiguous zone in addition to its 12-nautical mile territorial sea). exclusive economic zone (EEZ) - the UNCLOS (Part V) defines the EEZ as a zone beyond and adjacent to the territorial sea in which a coastal state has: sovereign rights for the purpose of exploring and exploiting, conserving and managing the natural resources, whether living or non-living, of the waters superjacent to the seabed and of the seabed and its subsoil, and with regard to other activities for the economic exploitation and exploration of the zone, such as the production of energy from the water, currents, and winds; jurisdiction with regard to the establishment and use of artificial islands, installations, and structures; marine scientific research; the protection and preservation of the marine environment; the outer limit of the exclusive economic zone shall not exceed 200 nautical miles from the baselines from which the breadth of the territorial sea is measured. continental shelf - the UNCLOS (Article 76) defines the continental shelf of a coastal state as comprising the seabed and subsoil of the submarine areas that extend beyond its territorial sea throughout the natural prolongation of its land territory to the outer edge of the continental margin, or to a distance of 200 nautical miles from the baselines from which the breadth of the territorial sea is measured where the outer edge of the continental margin does not extend up to that distance; the continental margin comprises the submerged prolongation of the landmass of the coastal state, and consists of the seabed and subsoil of the shelf, the slope and the rise; wherever the continental margin extends beyond 200 nautical miles from the baseline, coastal states may extend their claim to a distance not to exceed 350 nautical miles from the baseline or 100 nautical miles from the 2500 meter isobath; it does not include the deep ocean floor with its oceanic ridges or the subsoil thereof. exclusive fishing zone - while this term is not used in the UNCLOS, some states (e.g., the United Kingdom) have chosen not to claim an EEZ, but rather to claim jurisdiction over the living resources off their coast; in such cases, the term exclusive fishing zone is often used; the breadth of this zone is normally the same as the EEZ or 200 nautical miles.

Market value of publicly traded shares

This entry gives the value of shares issued by publicly traded companies at a price determined in the national stock markets on the final day of the period indicated. It is simply the latest price per share multiplied by the total number of outstanding shares, cumulated over all companies listed on the particular exchange.

Median age

This entry is the age that divides a population into two numerically equal groups; that is, half the people are younger than this age and half are older. It is a single index that summarizes the age distribution of a population. Currently, the median age ranges from a low of about 15 in Uganda and Gaza Strip to 40 or more in several European countries and Japan. See the entry for "Age structure" for the importance of a young versus an older age structure and, by implication, a low versus a higher median age.

Merchant marine

Merchant marine may be defined as all ships engaged in the carriage of goods; or all commercial vessels (as opposed to all nonmilitary ships), which excludes tugs, fishing vessels, offshore oil rigs, etc. This entry contains information in four fields - total, ships by type, foreign-owned, and registered in other countries. Total includes the number of ships (1,000 GRT or over), total DWT for those ships, and total GRT for those ships. DWT or dead weight tonnage is the total weight of cargo, plus bunkers, stores, etc., that a ship can carry when immersed to the appropriate load line. GRT or gross register tonnage is a figure obtained by measuring the entire sheltered volume of a ship available for cargo and passengers and converting it to tons on the basis of 100 cubic feet per ton; there is no stable relationship between GRT and DWT. Ships by type includes a listing of barge carriers, bulk cargo ships, cargo ships, chemical tankers, combination bulk carriers, combination ore/oil carriers, container ships, liquefied gas tankers, livestock carriers, multifunctional large-load carriers, petroleum tankers, passenger ships, passenger/cargo ships, railcar carriers, refrigerated cargo ships, roll-on/roll-off cargo ships, short-sea passenger ships, specialized tankers, and vehicle carriers. Foreign-owned are ships that fly the flag of one country but belong to owners in another. Registered in other countries are ships that belong to owners in one country but fly the flag of another.

Military

This category includes the entries dealing with a country's military structure, manpower, and expenditures.

Military - note

This entry includes miscellaneous military information of significance not included elsewhere.

Military branches

This entry lists the service branches subordinate to defense ministries or the equivalent (typically ground, naval, air, and marine forces).

Military expenditures

This entry gives spending on defense programs for the most recent year available as a percent of gross domestic product (GDP); the GDP is calculated on an exchange rate basis, i.e., not in terms of purchasing power parity (PPP).

Military service age and obligation

This entry gives the required ages for voluntary or conscript military service and the length of service obligation.

Money figures

All money figures are expressed in contemporaneous US dollars unless otherwise indicated.