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Tag: World Health Organization

  • WHO renames monkeypox as ‘mpox’ | CNN

    WHO renames monkeypox as ‘mpox’ | CNN



    CNN
     — 

    The World Health Organization announced Monday that “mpox” is now the preferred name for monkeypox.

    “Both names will be used simultaneously for one year while ‘monkeypox’ is phased out,” the organization said.

    Monkeypox was named in 1970, more than a decade after the virus that causes the disease was discovered in captive monkeys, the organization said. But monkeypox probably didn’t start in monkeys – its origin is still unknown – and the virus can be found in several other kinds of animals. The name was created before WHO published best practices for naming diseases in 2015.

    Scientists and experts have pushed since the start of the recent outbreak to change the name to avoid discrimination and stigma that could steer people away from testing and vaccination. Stigma has been an ongoing concern as the outbreak has largely affected men who have sex with men. In the United States, Black and Hispanic people have been disproportionately affected, data from the US Centers for Disease Control and Prevention show.

    This summer, New York City Health Commissioner Dr. Ashwin Vasan sent a letter to WHO to urge it to act quickly on a new name, saying there’s “growing concern for the potentially devastating and stigmatizing effects that the messaging around the ‘monkeypox’ virus can have on these already vulnerable communities.”

    In August, WHO encouraged people to propose new names for monkeypox by submitting suggestions to it website. WHO said Monday that the consultation process included experts from medical, scientific, classification and statistics advisory committees “which constituted of representatives from government authorities of 45 different countries.”

    “The issue of the use of the new name in different languages was extensively discussed. The preferred term mpox can be used in other languages,” WHO said in its statement.

    WHO said Monday that “monkeypox” will remain searchable in the International Classification of Diseases in order to allow access to historic information, and the one-year period when both will be used allows time for publications and communications to be updated.

    So far, more than 81,000 monkeypox cases in 110 cases have been reported to WHO in the recent outbreak. WHO says the global risk remains moderate, and outside of countries in West and Central Africa, the outbreak continues to primarily affect men who have sex with men.

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  • The Future of Monkeypox

    The Future of Monkeypox

    The World Health Organization has recommended a new name for monkeypox, asking countries to forget the original term in favor of a new one, “mpox,” that scientists hope will help destigmatize the disease. But in the United States, the request seems to be arriving late. The outbreak here has already been in slow retreat for months—and has already left many Americans’ minds.

    About 15 cases are now being recorded among Americans each day, less than 4 percent of the tally when the surge was at its worst. After a sluggish and bungled early rollout, tests and treatments for the virus are more available; more than a million doses of the two-shot Jynneos smallpox vaccine have found their way into arms. San Francisco and New York—two of the nation’s first cities to declare mpox a public-health emergency this past summer—have since allowed those orders to expire; so have the states of New York and Illinois. “I think this is the endgame,” says Caitlin Rivers, an infectious-disease epidemiologist at the Johns Hopkins Center for Health Security.

    But “endgame” doesn’t mean “over”—and mpox will be with us for the foreseeable future. The U.S. outbreak is only now showing us its long and ugly tail: 15 daily cases is not zero daily cases; even as the number of new infections declines, inequities are growing. Black and Latino people make up a majority of new mpox cases and are contracting the disease at three to five times the rate of white Americans, but they have received proportionately fewer vaccines. “Now it’s truly the folks who are the most marginalized that we’re seeing,” says Ofole Mgbako, a physician and population-health researcher at New York University. “Which is also why, of course, it’s fallen out of the news.” If the virus sticks around (as it very likely could), and if the disparities persist (as they almost certainly will), then mpox could end up saddling thousands of vulnerable Americans each year with yet another debilitating, stigmatized, and neglected disease.

    Read: America should have been able to handle monkeypox

    At this point, there’s not even any guarantee that this case downturn will persist. “I’m not convinced that we’re out of the woods,” says Sara Bares, an infectious-disease physician at the University of Nebraska Medical Center, in Omaha. Immunity, acquired through infection or vaccines, is now concentrated among those at highest risk, says Jay Varma, a physician and epidemiologist at Weill Cornell Medicine. But researchers still don’t know how well those defenses can stave off another infection, or how long they might last—gaps in knowledge that may be tough to fill, now that incidence is so low. And although months of advocacy and outreach from the LGBTQ community have cut down on risky sexual activities, many cautionary trends will eventually reset to their pre-outbreak norm. “We know extensively from other sexually transmissible infections that behavior change is not usually the most sustained response,” says Boghuma Kabisen Titanji, an infectious-disease physician at Emory University.

    At the same time, this year’s mpox outbreaks are stranger and more unwieldy than those that came before. A ballooning body of evidence suggests that people can become infectious before they develop symptoms, contrary to prior understanding; some physicians are concerned that patients, especially those who are immunocompromised, might remain infectious after the brunt of visible illness resolves, says Philip Ponce, an infectious-disease physician at the University of Texas Health Science Center at San Antonio and the medical director of San Antonio’s Kind Clinic. (Some 40 percent of Americans who have been diagnosed with mpox are living with HIV.) Researchers still don’t have a good grip on which bodily fluids and types of contact may be riskiest over the trajectory of a sickness. Cases are still being missed by primary-care providers who remain unfamiliar with the ins and outs of diagnosis and testing, especially in people with darker skin. And although this epidemic has, for the most part, continued to affect men who have sex with men, women and nonbinary people are getting sick as well, to an underappreciated degree.

    Read: What should worry most Americans about our monkeypox response

    Intel on the only mpox-fighting antiviral on the shelf, a smallpox drug called tecovirimat, also remains concerningly scant, even as experts worry that the virus could develop resistance. The treatment has been given a conditional greenlight for use in people who are currently, or at risk of becoming, severely sick. Anecdotally, it seems to work wonders, shaving days or weeks off the painful, debilitating course of symptoms that can send infected people into long-term isolation. But experts still lack rigorous data in humans to confirm just how well it works, Bares, who’s among the scientists involved in a nationwide study of the antiviral, told me. And although clinical trials for tecovirimat are under way, she added, in the U.S., they’re “struggling to enroll patients” now that infections have plummeted to such a sustained low. It’s a numerical problem as well as a sociocultural one. “The urgency with which people answer questions declines as case counts go down,” Varma told me.

    Recent CDC reports show that a growing proportion of new infections aren’t being reported with a known sexual-contact history, stymieing efforts at contact tracing. That might in part be a product of the outbreak’s gradual migration from liberal, well-off urban centers, hit early on in the epidemic, to more communities in the South and Southwest. “In small towns, the risk of disclosure is high,” Bares told me. In seeking care or vaccination, “you’re outing yourself.” When mpox cases in Nebraska took an unexpected nosedive earlier this fall, “a colleague and I asked one another, ‘Do you think patients are afraid to come in?’” Those concerns can be especially high in certain communities of color, Ponce told me. San Antonio’s Latino population, for instance, “tends to be much more conservative; there’s much more stigma associated with one being LGBT at all, let alone being LGBT and trying to access biomedical interventions.”

    Hidden infections can become fast-spreading ones. Monitoring an infectious disease is far easier when the people most at risk have insurance coverage and access to savvy clinicians, and when they are inclined to trust public-health institutions. “That’s predominantly white people,” says Ace Robinson, the CEO of the Pierce County AIDS Foundation, in Washington. Now that the mpox outbreak is moving out of that population into less privileged ones, Robinson fears “a massive undercount” of cases.

    Americans who are catching the virus during the outbreak’s denouement are paying a price. The means to fight mpox are likely to dwindle, even as the virus entrenches itself in the population most in need of those tools. One concern remains the country’s vaccination strategy, which underwent a mid-outbreak shift: To address limited shot supply, the FDA authorized a new dosing method with limited evidence behind it—a decision that primarily affected people near the back of the inoculation line. The method is safe but tricky to administer, and it can have tough side effects: Some of Titanji’s patients have experienced swelling near their injection site that lasted for weeks after their first dose, and now “they just don’t want to get another shot.”

    The continued shift of mpox into minority populations, Robinson told me, is also further sapping public attention: “As long as this is centered in BIPOC communities, there’s going to be less of a push.” Public interest in this crisis was modest even at its highest point, says Steven Klemow, an infectious-disease physician at Methodist Dallas Medical Center and the medical director of Dallas’s Kind Clinic. Now experts are watching that cycle of neglect reinforce itself as the outbreak continues to affect and compress into marginalized communities, including those that have for decades borne a disproportionate share of the burden of sexually associated infections such as syphilis, gonorrhea, and HIV. “These are not the groups that necessarily get people jumping on their feet,” Titanji told me.

    Some of the people most at risk are moving on as well, Robinson told me. In his community in Washington, he was disappointed to see high rates of vaccine refusal at two recent outreach events serving the region’s Black and American Indian populations. “They had no knowledge of the virus,” he told me. Titanji has seen similar trends in her community in Georgia. “There’s some sense of complacency, like, ‘It’s no longer an issue, so why do I need to get vaccinated?’” she said.

    Read: America is zooming through the pandemic panic-neglect cycle

    The tide seems unlikely to shift. Even tens of thousands of cases deep into the American outbreak, sexual-health clinics—which have been on the front lines of the mpox response—remain short on funds and staff. Although the influx of cases has slowed, Ponce and Klemow are still treating multiple mpox patients a week while trying to keep up the services they typically offer—at a time when STI rates are on a years-long rise. “We’re really assuming that this is going to become another sexually associated disease that is going to be a part of our wheelhouse that we’ll have to manage for the indefinite future,” Klemow told me. “We’ve had to pull resources away from our other services that we provide.” The problem could yet worsen if the national emergency declared in August is allowed to expire, which would likely curb the availability of antivirals and vaccines.

    Rivers still holds out hope for eliminating mpox in the U.S. But getting from low to zero isn’t as easy as it might seem. This current stretch of decline could unspool for years, even decades, especially if the virus finds a new animal host. “We’ve seen this story play out so many times before,” Varma told me. Efforts to eliminate syphilis from the U.S. in the late ’90s and early 2000s, for instance, gained traction for a while—then petered out during what could have been their final stretch. It’s the classic boom-bust cycle to which the country is so prone: As case rates fall, so does interest in pushing them further down.

    Our memories of public-health crises never seem to linger for long. At the start of this mpox outbreak, Titanji told me, there was an opportunity to shore up our systems and buffer ourselves against future epidemics, both imported and homegrown. The country squandered it and failed to send aid abroad. If another surge of mpox cases arrives, as it very likely could, she said, “we will again be going back to the drawing board.”

    Katherine J. Wu

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  • Millions of children left susceptible to measles as vaccination rates drop, new report finds

    Millions of children left susceptible to measles as vaccination rates drop, new report finds

    The threat of a measles outbreak is growing due to a significant decline in vaccination rates among children worldwide, according to joint report released Wednesday by the U.S. Centers for Disease Control and Prevention, and the World Health Organization. 

    For the last few decades, measles has remained relatively contained due to the double-dose vaccination that is 97% effective. The measles vaccination rates have steadily dropped since the start of the COVID-19 pandemic, the report found, with nearly 40 million children missing one or both of the doses in 2021, a record high according to the CDC and WHO. 

    Because of the pandemic, 61 million measles vaccine doses were postponed or missed in 18 countries in 2021, the report found.

    “This decline is a significant setback in global progress towards achieving and maintaining measles elimination and leaves millions of children susceptible to infection,” the two agencies said in a news release.   

    In 2021, there were about 9 million measles cases and 128,000 measles deaths worldwide, according to the CDC and WHO. Twenty-two countries experienced “large and disruptive outbreaks” — a trend that has continued into 2022, according to the report. 

    The report found that, based on the latest data, only 81% of children worldwide are receiving a first dose, and only 71% are receiving a second dose. This marks the “lowest global coverage rates” since 2008, the CDC and WHO found.    

    “The paradox of the pandemic is that while vaccines against COVID-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunization programs were badly disrupted,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said in a statement.

    Now, the two agencies are advising officials across the world to get their immunization systems back on track to prevent more missed vaccinations.

    “Measles outbreaks illustrate weaknesses in immunization programs,” CDC Director Dr. Rochelle P. Walensky said in a statement. “Public health officials can use outbreak response to identify communities at risk, understand causes of under-vaccination, and help deliver locally tailored solutions to ensure vaccinations are available to all.”

    The best way to contain the deadly virus is for all stakeholders to put their resources into immunization surveillance systems, the report stressed.

    Through the Immunization Agenda 2030 global strategy — which aims to give vaccine access to everyone worldwide — the WHO and CDC hope all children can be immunized, and outbreaks can be detected and responded to quickly.

    “We have a short window of opportunity to urgently make up for lost ground in measles vaccination and protect every child,” said Ephrem Tekle Lemango, immunization chief for UNICEF, said in a statement. “The time for decisive action is now.” 

    Last week, health officials in central Ohio reported they were investigating a measles outbreak at several childcare facilities. 18 cases were under investigation, officials said at the time. All of the cases were in unvaccinated children, and 17 of the 18 infected children are under the age of five. 

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  • Armed gangs ‘terrorising’ Haiti as cholera spreads: UN official

    Armed gangs ‘terrorising’ Haiti as cholera spreads: UN official

    UN coordinator in Haiti says nearly 200 murders were recorded last month as cholera cases are now reported in eight of 10 provinces.

    Armed gangs are “terrorising” residents in the Haitian capital of Port-au-Prince, a United Nations official has warned, as deadly violence and instability continue to complicate the country’s response to a worsening outbreak of cholera.

    Ulrika Richardson, the UN’s resident and humanitarian coordinator in Haiti, told reporters on Wednesday, November 16 that 195 murders were recorded in October – about three per day – along with 102 kidnappings.

    Armed gangs that control approximately 60 percent of the territory in Port-au-Prince are using “sexual violence, including rape … to instill fear and to punish and to terrorise the local populations”, Richardson said during a news conference broadcast at UN headquarters.

    “They do this in order to expand their influence throughout the capital,” she added.

    In addition to violence and political instability, Haiti is also grappling with rising numbers of cholera cases. Richardson said on Wednesday that cholera has now been recorded in eight of the country’s 10 provinces.

    People receive treatment for cholera in a tent at a Doctors Without Borders hospital in Cite Soleil, an impoverished neighbourhood of Port-au-Prince, on October 15, 2022 [Ricardo Arduengo/Reuters]

    As of Saturday, more than 7,200 people have been hospitalised with cholera across Haiti and at least 155 have died since the outbreak began in early October, according to the latest figures (PDF) from Haiti’s public health ministry.

    But UN and Haitian officials have said they fear cases will rise, especially after the end of a weeks-long, gang-led blockade on a key petrol terminal that paralysed the capital. The blockade was lifted this month and petrol stations are reopening.

    “The cholera situation in Haiti continues to worsen,” Pan American Health Organization (PAHO) Director Dr Carissa Etienne said during a separate briefing on Wednesday.

    “This is a dangerous situation, and PAHO urges all countries to increase vigilance, while we support Haiti in providing life-saving care to patients, deploying health workers and facilitating access to fuel for health facilities,” Etienne said.

    Haitian hospitals said in late September that they were being forced to cut back on services due to the blockade on the Varreux fuel terminal, which spurred water and electricity shortages and complicated the local response to the cholera outbreak.

    Powerful Haitian gangs have been battling for control in the aftermath of President Jovenel Moise’s assassination in July 2021, which worsened political instability in the country.

    Trucks being loaded with fuel at the Varreux terminal in Port-au-Prince
    A weeks-long blockade on the Varreux fuel terminal was lifted earlier this month [Ralph Tedy Erol/Reuters]

    Last month, the UN’s World Food Programme (WFP) said nearly half of the Haitian population – a record 4.7 million people – were dealing with “acute hunger”. The violence-plagued Port-au-Prince neighbourhood of Cite Soleil faced a particularly alarming situation.

    “Currently, 65 percent of its population, especially the poorest and most vulnerable, are in high levels of food insecurity with 5 percent of them in urgent need of humanitarian assistance,” WFP reported on October 14.

    Cholera is caused by drinking water or eating food contaminated with cholera bacteria, and it can trigger severe diarrhoea as well as vomiting, thirst and other symptoms. It also spreads rapidly in areas without adequate sewage treatment or clean drinking water.

    Haiti had last reported a cholera case more than three years ago, after a 2010 outbreak linked to United Nations peacekeepers caused approximately 10,000 deaths and more than 820,000 infections.

    PAHO has warned that as many as 500,000 Haitians are at risk of contracting cholera in the current outbreak.

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  • Groundbreaking Nutrition-Climate Initiative Launched At COP27

    Groundbreaking Nutrition-Climate Initiative Launched At COP27

    Contributing to the growing momentum around food and agriculture at COP27— and in a groundbreaking moment for the Conference of the Parties— Egypt (in its role as COP27 Presidency) and the World Health Organization have launched the Initiative on Climate Action and Nutrition (I-CAN), an initiative to integrate the global delivery of climate change adaptation and mitigation policy action and nutrition and sustainable food systems to support bi-directional, mutually beneficial outcomes.

    The groundbreaking event took place on November 12th 2022— Adaptation and Agriculture Day at COP 27 in Sharm-El-Sheikh, Egypt following a full day of food systems and climate-related events including the launch of the Food and Agriculture for Sustainable Transformation Initiative (FAST).

    I-CAN is a multi-stakeholder, multi-sectoral initiative that will be implemented with the support of UN agencies and partners including the Food and Agriculture Organization (FAO) and the Global Alliance for Improved Nutrition (GAIN) and emphasizes pillars of action that consist of implementation, action and support, capacity building, data and knowledge transfer, policy and strategy, and investments.

    Dr Maria Helena Semedo, Deputy Director General, of FAO referred to the initiative as a “win-win” for each of the sectors— agriculture, adaptation and nutrition.

    Commitments pertaining to climate and nutrition are scarcely included global climate policies and Nationally determined contributions (NDCs).

    Worldwide, less than 12% of national policies consider climate, biodiversity and nutrition, while only 32% of National Action Plans (NAPs) include adaptation actions related to food safety and nutrition.

    “By working together including through action during the UN Decade of Action on Nutrition, we can deliver healthy diets and a resilient agri-food system,” said Semedo.

    Globally, 30% of all people are facing micro-nutrient deficiency; 828 million people are undernourished, and 676 million are obese. Vulnerable groups are disproportionately impacted. Climate change exacerbates these impacts by threatening global crop productivity from the perspective of both yields and losses (with spillover effects of food prices and calorie intake) and the nutritional quality of crops. Conversely, food systems also contribute to climate changes through the release of greenhouse gases (e.g., CO2, methane and nitrous oxides) and through land degradation.

    “The relationship between nutrition and climate change is a challenge, but it is also an opportunity… We must implement the Initiative on Climate Action and Nutrition for a healthier, safer and greener future for our children and grand children,” said Dr. Tedros Ghebreyesus, Director General of the World Health Organization in remarks delivered via video feed.

    The framers of the initiative indicate that a shift towards sustainable, climate-resilient, healthy diets would help reduce health and climate change costs by up to US$ 1.3 trillion while supporting food security in the face of climate change.”

    Government representatives from Egypt and other nations, including Sweden, Netherlands, Bangladesh and Canada, stressed their commitment to the initiative and its objectives. The representative from Cote d’Ivoire called for the inclusion of the I-CAN launch in the final outcome document from COP27.

    Dr Naeema Al Gasseer, Representative of the World Health Organization in Egypt confirmed that “Nutrition and health are very critical to any environmental policy decision.”

    Dr Khaled Abdel Ghaffar, Egypt Minister of Health and Population confirmed that “The government of Egypt is committed to an integrated approach to nutrition and climate change.”

    Dr Yasmine Fouad, Egyptian Minister of Environment advised that government is looking what it is being produced and how it is being produced and what is being consumed and how it is being consumed. She also stressed that marginalized voices, and particularly women, would be included in the integrated approach towards agriculture, adaptation and nutrition.

    “We will spare no effort to make this happen,” she said.

    Lawrence Haddad, Executive Director for the Global Alliance for Improved Nutrition emphasized the bidirectional relationship between nutrition and climate change, indicating that resilient, sustainable and healthy diets are a critical link between nutrition and climate change.

    Dr Vijay Rangarajan, The Foreign, Commonwealth & Development Office (FCDO) Director General said that “putting nutrition on the agenda is crucial and will remain crucial.”

    According to the I-CAN concept note, “Business as usual will not allow countries to realize their targets of Agenda 2030, including those of SDG 13 (Climate Action), SDG2 (End Hunger) and SDG3 (Health). Transformative policy and action is needed to deliver sustainable, resilient and healthy diets to generate multiple benefits across SDGs.”

    Daphne Ewing-Chow, Senior Contributor

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  • WHO: Ugandan Ebola outbreak ‘rapidly evolving’ after 1 month

    WHO: Ugandan Ebola outbreak ‘rapidly evolving’ after 1 month

    KAMPALA, Uganda — Uganda’s Ebola outbreak is “rapidly evolving” a month after the disease was reported in the East African country, a top World Health Organization official said Thursday, describing a difficult situation for health workers.

    “The Ministry of Health of Uganda has shown remarkable resilience and effectiveness and (is) constantly fine-tuning a response to what is a challenging situation,” Dr. Matshidiso Moeti, the U.N. health agency’s regional director for Africa, told reporters. “A better understanding of the chains of transmission is helping those on the ground respond more effectively.”

    Uganda declared an outbreak of Ebola on Sept. 20, several days after the contagious disease began spreading in a rural farming community. Ebola has since infected 64 people and killed 24, although official figures do not include people who likely died of Ebola before the outbreak was confirmed.

    At least three of the confirmed patients traveled from the virus hot spot in central Uganda to the capital, Kampala, about 150 kilometers (93 miles) away, according to Moeti. Fears that Ebola could spread far from the outbreak’s epicenter caused authorities to impose a lockdown, including nighttime curfews, on two of the five districts reporting Ebola cases.

    Ebola “numbers that we are seeing do pose a risk for spread within the country and its neighbors,” Dr. Ahmed Ogwell, the acting head of the Africa Centers for Disease Control and Prevention, said in a separate briefing Thursday.

    While the risk of cross-border contamination is there, “it’s a manageable risk,” Ogwell said, adding that the outbreak does not yet necessitate going into what he called “full emergency mode.”

    There is no proven vaccine for the Sudan strain of Ebola that’s circulating in Uganda. A WHO official in Uganda told the AP Wednesday that plans are underway to deploy two experimental vaccines in a study targeting health workers and contacts of Ebola patients.

    Ugandan officials have documented more than 1,800 Ebola contacts, 747 of whom have completed 21 days of monitoring for possible signs of the disease that manifests as a viral hemorrhagic fever, Ogwell said.

    Ebola is spread by contact with bodily fluids of an infected person or contaminated materials. Symptoms include fever, vomiting, diarrhea, muscle pain and, at times, internal and external bleeding.

    Scientists don’t know the natural reservoir of Ebola, but they suspect the first person infected in an outbreak acquired the virus through contact with an infected animal or eating its raw meat. Ugandan officials are still investigating the source of the current outbreak.

    Uganda has had multiple Ebola outbreaks, including one in 2000 that killed more than 200 people. The 2014-16 Ebola outbreak in West Africa killed more than 11,000 people, the disease’s largest death toll.

    Ebola was discovered in 1976 in two simultaneous outbreaks in South Sudan and Congo, where it occurred in a village near the Ebola River, after which the disease is named.

    —-

    Larson reported from Dakar, Senegal.

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  • WHO Director-General Says COVID Remains Emergency, Could Still Surprise Us

    WHO Director-General Says COVID Remains Emergency, Could Still Surprise Us

    The director-general of the World Health Organization on Wednesday said the coronavirus pandemic “remains a public health emergency of international concern.”

    Dr. Tedros Adhanom Ghebreyesus said the WHO’s Emergency Committee on COVID-19 came to that conclusion during a meeting last week, and he shares that view. The committee also called on countries to make testing, therapeutics and vaccines more widely available to at-risk communities.

    “While the global situation has obviously improved since the pandemic began, the virus continues to change, and there remain many risks and uncertainties,” the director-general said. “This pandemic has surprised us before and very well could again.”

    The WHO first announced COVID-19 constitutes an emergency in January 2020.

    Last week, the White House announced it was extending its own COVID-19 public health emergency declaration until January as the Biden administration braces for more cases of COVID-19 and flu this winter, defying Republicans who had been calling on the president to end it.

    The emergency declaration has, among other things, allowed the White House to distribute treatments and testing for free, and issue emergency authorization of COVID-19 vaccines, according to The Associated Press.

    U.S. House Minority Leader Kevin McCarthy (R-Calif.) recently told Punchbowl News his party does not plan to approve any additional COVID-19 funding, which President Joe Biden has requested for vaccines and tests.

    Meanwhile, the U.S. is seeing the emergence of new variants.

    For the week ending on Oct. 15, the Centers for Disease Control and Prevention reported BA.5 was still making up the majority of COVID-19 infections, but variants BQ.1.1 and BQ.1 collectively accounted for over 11% of cases.

    Dr. Anthony Fauci, Biden’s chief medical adviser, said the speed with which these two variants are spreading is worrying.

    “When you get variants like that, you look at what their rate of increase is as a relative proportion of the variants, and this has a pretty troublesome doubling time,” Fauci told CBS News.

    Dr. Ashish Jha, the White House COVID-19 response coordinator, has been calling on people to get their updated booster vaccine, which targets the original COVID-19 strain as well as the omicron variant and BA.5 subvariant.

    “Don’t wait. Get your new flu shot and get your new COVID shot today. If Americans did that, we could save hundreds of lives each day this winter,” Jha told White House reporters last week.

    But Americans have reportedly been slow to take it up. As of Oct. 12, only 14.7% of those eligible had been boosted with the new bivalent vaccine, according to the CDC.

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  • “Unprecedented rise in cholera outbreaks” forces “last-resort decision” on vaccine policy

    “Unprecedented rise in cholera outbreaks” forces “last-resort decision” on vaccine policy

    Geneva — A shortage of cholera vaccines has forced a temporary shift to a one-dose strategy, from the usual two, in campaigns to fight a swelling number of outbreaks, the World Health Organization said Wednesday. The United Nations health agency said the “strained global supply of cholera vaccines” had pushed the International Coordinating Group (ICG), which manages emergency supplies of vaccines, to suspend the two-dose regimen.

    “The pivot in strategy will allow for the doses to be used in more countries, at a time of unprecedented rise in cholera outbreaks worldwide,” WHO said in a statement.

    Cholera is an acute diarrheal infection in the small intestine causing sometimes fatal dehydration. It is generally contracted from food or water contaminated with vibrio cholera bacteria.

    Cholera is spreading fast

    WHO chief Tedros Adhanom Ghebreyesus pointed out to reporters that “29 countries have reported outbreaks this year, including 13 countries that did not have outbreaks last year.”

    That compares with the fewer than 20 nations that reported such outbreaks in total over the previous five years.

    “The global trend is moving towards more numerous, more widespread and more severe outbreaks, due to floods, droughts, conflict, population movements and other factors that limit access to clean water and raise the risk of cholera outbreaks,” Wednesday’s statement said.

    Kenya has become the latest nation to declare a cholera outbreak, with officials there saying there were at least 61 confirmed cases as of Thursday.

    Haiti Cholera
    A child suffering cholera symptoms is treated at a clinic run by Doctors Without Borders (MSF) in Port-au-Prince, Haiti, October 7, 2022.

    Odelyn Joseph/AP


    In Haiti, where a political and security crisis has allowed one of the world’s most dangerous cholera outbreaks to flourish, health ministry figures obtained by AFP on Tuesday confirmed there were at least 606 suspected and 66 confirmed cases.

    That constitutes an increase of 222 new suspected cases between October 13 and 17 in an outbreak already blamed for at least 22 deaths. Suspected cases have also been recorded in new regions of the impoverished Caribbean nation.

    A “last-resort decision”

    WHO and other members of the ICG — the Doctors Without Borders (MSF) charity, the U.N. children’s agency UNICEF and the Red Cross — highlighted that a one-dose strategy for cholera vaccines had been proven to be effective in response to outbreaks. But they warned that there was only limited evidence on the exact duration of protection, which appeared to be much lower, especially in children.

    With two doses, when the second dose is given within six months of the first, immunity against infection lasts for three years.

    “The benefit of supplying one dose still outweighs no doses,” the statement said, warning that the current supply of cholera vaccines was “extremely limited.”

    A student receives an oral cholera vaccine from a health
    A student receives an oral cholera vaccine dose from a health worker during a vaccination campaign in Dhaka, Bangladesh, June 6, 2022. 

    Sazzad Hossain/SOPA Images/LightRocket/Getty


    ICG manages a global stockpile of oral cholera vaccines, but of the 36 million doses forecast to be produced this year, 24 million have already been shipped for preventive and reactive campaigns.

    And an additional eight million doses have been approved by ICG for a second round of emergency vaccination in four countries.

    Tedros said the strategy shift was “clearly less than ideal and rationing must only be a temporary solution.”

    Oral cholera vaccine is seen during the vaccination campaign
    Oral cholera vaccine doses are seen during a vaccination campaign in Dhaka, Bangladesh, June 8, 2022.

    Sazzad Hossain/SOPA Images/LightRocket/Getty


    One reason for the growing concern about the situation is that the maker of one of only two cholera vaccines approved for use in humanitarian emergencies, Shanchol, an Indian subsidiary of French pharmaceutical giant Sanofi, has said it will halt production by the end of the year. But a Sanofi spokesman stressed that the vaccine shortage was due to an upsurge in cases, “and not to a halt in vaccine production by Sanofi, because we are continuing to deliver doses of Shanchol.”

    The spokesman pointed out that the company had announced its decision to halt production in 2020, due to the low number of doses it was producing, and because other actors had announced plans to increase capacity.

    MSF said the critical global shortage of cholera vaccines had left it and other ICG members with no choice but to support the “very difficult decision of reducing the doses people will receive from two to one.”

    “It is incredibly frustrating to face this situation as cholera surges in more than 20 countries, including in places already devastated by crisis like Haiti, Nigeria, and Syria,” MSF international medical coordinator Daniela Garone said. “This last-resort decision is the way to avoid making the impossible choice of sending doses to one country over another.”

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  • Lebanon warns deadly cholera outbreak ‘spreading rapidly’

    Lebanon warns deadly cholera outbreak ‘spreading rapidly’

    Lebanon has warned that a deadly cholera outbreak is “spreading rapidly”, with cases rising after the virulent disease spread from neighbouring Syria.

    The outbreak in the economically devastated country, which has left at least five dead, is the first since 1993. Health officials have blamed the country’s financial and political struggles, which have left citizens with poor and crumbling sanitation infrastructure.

    “The epidemic is spreading rapidly in Lebanon,” caretaker Minister of Public Health Firass Abiad told reporters on Wednesday.

    Since October 6, Lebanon has recorded 169 cholera cases, almost half of them in the past two days, according to the health ministry.

    The latest crisis comes after three years of unprecedented economic dire straits in Lebanon and the inability to control porous borders with neighbouring war-torn Syria, where an outbreak is spreading after more than a decade of war.

    Abiad said the first case in Lebanon was recorded on October 5 in the rural northern Lebanese region of Akkar and that the patient, a Syrian national, was receiving treatment and in stable condition.

    He added that, while the “vast majority” of cases were Syrian refugees, health officials “have started to notice an increase in cases among the Lebanese”.

    Lebanon hosts more than one million Syrian refugees, many of them already poverty-stricken and living in crowded camps for the displaced that lack running water or sewage systems – well before Lebanon’s economic collapse began.

    “The lack of sanitation makes crowded camps high-risk areas,” said Al Jazeera’s Zeina Khodr, reporting from Akkar in Lebanon.

    “Cases are no longer confined to camps bordering Syria, but they’ve since spread to poor areas where drinking water is widely polluted and at times, mixed with wastewater.”

    Cholera is generally contracted from contaminated food or water, and causes diarrhoea and vomiting.

    It can also spread in residential areas that lack proper sewage networks or drinking water from mains.

    Abiad said that contaminated water was used for farming, spreading the disease on to fruit and vegetables.

    Lebanon’s water infrastructure is also derelict and the healthcare system has been hit hard by a three-year financial crisis and the August 2020 Beirut port blast that destroyed critical medical infrastructure in the capital.

    Despite humanitarian aid from donor countries, Abiad said the sector would struggle to cope with a large-scale outbreak.

    The Euphrates River is believed to be the source of Syria’s first waterborne disease outbreak since 2009, but cholera has since spread nationwide, with thousands of suspected or confirmed cases reported.

    According to the United Nations, nearly two-thirds of water treatment plants in Syria, half of pumping stations and one-third of water towers have been damaged.

    WHO advises using one cholera vaccine dose due to shortages

    Meanwhile, the World Health Organization and its partners have recommended that countries temporarily switch to using a single dose of the cholera vaccine instead of two due to a supply shortage as outbreaks surge globally.

    In a statement on Wednesday, the UN agency and partners that include UNICEF and the International Federation of Red Cross and Red Crescent Societies said one dose of vaccine has proven effective in stopping outbreaks “even though evidence on the exact duration of protection is limited” and appears to be lower in children.

    WHO Director-General Tedros Adhanom Ghebreyesus has warned that outbreaks in 29 countries this year were putting “unprecedented pressure” on the world’s limited vaccine supply. He said authorities should aim to scale up vaccine production and that “rationing must only be a temporary solution”.

    Cholera can kill within hours if left untreated, according to the WHO, but many of those infected will have no or mild symptoms.

    It can gernally be easily treated with oral rehydration solution, but more severe cases may require intravenous fluids and antibiotics, the WHO has said.

    Worldwide, the disease affects between 1.3 million and four million people each year, killing between 21,000 and 143,000.

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  • Lebanon records first case of cholera since 1993

    Lebanon records first case of cholera since 1993

    The recorded case comes as neighbouring war-torn Syria is struggling to contain an outbreak of the waterborne disease.

    Lebanon has recorded its first case of cholera since 1993, the crisis-hit country’s health ministry announced, as neighbouring war-torn Syria is struggling to contain an outbreak of the waterborne disease that has spread across the country during the past month.

    Lebanon began a downward spiral in late 2019 that has plunged three-quarters of its population into poverty. Rampant power cuts, water shortages, and skyrocketing inflation have deteriorated living conditions for millions.

    Caretaker Health Minister Firas Abiad said on Thursday that the case was recorded on Wednesday in the impoverished, predominantly rural northern Lebanese region of Akkar and that the patient, a Syrian national, was receiving treatment and in stable condition.

    According to the World Health Organization, a cholera infection is caused by consuming food or water infected with the Vibrio cholerae bacteria, and while most cases are mild to moderate, not treating the illness could lead to death.

    Impoverished families in Lebanon often ration water and are unable to afford private water tanks for drinking and domestic use.

    Abiad has met authorities and international organisations following the confirmed case to discuss ways to prevent a possible outbreak.

    He said that the case is likely the result of the outbreak in Syria crossing the porous border between the countries.

    Richard Brennan, regional emergency director of the WHO Eastern Mediterranean Region, confirmed that the organisation has been in talks with authorities in Lebanon and other countries bordering Syria to bring in the necessary supplies to respond to possible cases in the country.

    “Cross-border spread is a concern, we’re taking significant precautions,” Brennan said. “Protecting the most vulnerable will be absolutely vital.”

    Brennan added that vaccines are in short supply relative to global demand.

    In neighbouring Syria, the outbreak has claimed dozens of lives and is posing a danger across the front lines of the country’s 11-year-long war, stirring fears in crowded camps for the displaced who lack running water or sewage systems.

    The UN and Syria’s health ministry have said the source of the outbreak is likely linked to people drinking unsafe water from the Euphrates River and using contaminated water to irrigate crops, resulting in food contamination.

    Syria’s health services have suffered heavily from its years-long war, while much of the country is short on supplies to sanitise water.

    Syrian health officials – as of Wednesday – have documented at least 594 cases of cholera and 39 deaths.

    Meanwhile, in the rebel-held northwest of the country, health authorities documented 605 suspected cases, dozens of confirmed cases, and at least one death.

    Lebanon’s water infrastructure is also decrepit, and the healthcare system has been hit hard by a three-year financial crisis and the August 2020 Beirut port blast that destroyed critical medical infrastructure in the capital.

    Despite humanitarian aid from donor countries, Abiad said the sector would struggle to cope with a large-scale outbreak.

    “We have a very clear signal that the Lebanese healthcare system needs support to strengthen [it],” he said. “Otherwise … it won’t be able to hold.”

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  • Uganda is racing to contain a deadly Ebola outbreak

    Uganda is racing to contain a deadly Ebola outbreak

    UGANDA-HEALTH-VIRUS
    A member of the Ugandan medical staff of the Ebola Treatment Unit stands inside the ward in Personal Protective Equipment (PPE) at Mubende Regional Referral Hospital in Uganda on September 24, 2022.

    BADRU KATUMBA/AFP/Getty


    Johannesburg, South Africa — Two weeks ago, a 24-year-old man in Uganda felt ill. He went to a private clinic several times between September 11 and 13 with a high fever, convulsions, blood in his vomit, pain and swelling everywhere, and bleeding in his eyes. 

    He returned several times with the same symptoms, to report they were not improving. Local health officials finally referred him to the Regional Referral Hospital on September 15 and isolated him as a suspected case of viral hemorrhagic fever. Blood samples were taken that day, and eight days after he first went to the local Madudu clinic, he died. That same day, a lab confirmed he had the Sudan ebolavirus.

    Health authorities sent a team to the village to investigate and found what World Health Organization officials have described as “a number” of community deaths attributed to an unknown illness. 

    Locals described a strange illness, with sudden deaths. According to the Africa Centers for Disease Control and Prevention, officials confirmed that some of those mysterious deaths were in people who had contact with the 24-year-old man. The deaths are now also classified as probable Sudan ebolavirus cases.

    As of Wednesday, authorities still were not sure whether the 24-year-old man was the first person infected, or if the “index case” was one of the other people who died in the area.  

    “I see it getting worse before it gets better,” Dr. Christopher Mabula, who runs operations for the French charity Doctors Without Borders in East Africa, told CBS News on Wednesday.

    UGANDA-HEALTH-VIRUS
    Members of the Doctors Without Borders NGO set up an Ebola treatment isolation unit at the Mubende Regional Referral Hospital in Uganda, September 24, 2022.

    BADRU KATUMBA/AFP/Getty


    He said the 24-year-old man had visited three different health facilities servicing three different bordering districts before he died, vastly increasing his possible human contacts. The man’s village is also located near an active gold mine, and such sites typically draw a large number of workers from other regions, even from outside the country, with high turnover.

    “Symptoms can take between two and 21 days to develop, and with Uganda’s excellent road infrastructure, newly infected people could travel in any direction for some time before becoming symptomatic,” noted the doctor.

    Mabula said that would make tracing all known contacts significantly more difficult than it has been during previous Ebola outbreaks in neighboring Congo, where poor infrastructure makes it easier to contain cases. 

    Ugandan Ministry of Health Officials said Tuesday that a total of 36 cases, including 18 confirmed and 18 more listed as probable, had been reported. There were 23 deaths within that number, five among confirmed cases and 18 among probable ones. Officials have confirmed to CBS News separately that five people are confirmed to have died of Ebola during the current outbreak in Uganda. They say there are 19 other confirmed cases.

    Uganda’s Medical Association said six of the confirmed cases were health care workers who have fallen critically ill after catching the virus while working with the known or probable cases. The head of the association said doctors and nurses were very concerned and at high risk of infection due to a lack of personal protective equipment.   

    Rosemary Byabashaija, the Mubende Resident District Commissioner who doubles as the head of the district’s Ebola taskforce, said authorities had tightened security at the hospital after rumors circulated that some patients suspected of having Ebola wanted to leave the isolation facility. 

    Dr. Jane Ruth Aceng, Uganda’s Minister of Health, said in a tweet on Wednesday morning that there were no confirmed cases of the virus in the capital Kampala, and she appealed for the public “to remain calm and vigilant.” 

    The WHO, Africa CDC and various NGOs have scrambled teams to the area to support Uganda’s Health Service. 

    President Yoweri Museveni addressed the nation Wednesday evening, ruling out lockdowns and other restrictions to movement as the country battles the outbreak. He sought to reassure his nation, stressing that the disease does not spread as easily as COVID-19, and can be controlled by avoiding contact, maintaining personal hygiene and seeking medical treatment as soon as symptoms are detected.  

    Sudan ebolavirus disease was first reported in Southern Sudan in June 1976. Seven outbreaks have been reported since: four in Uganda and three in neighboring Sudan. The deadliest outbreak in Uganda so far was in 2000, when more than 200 people died.   

    The virus is introduced into human populations through direct contact with infected animals. It spreads through bodily fluids including saliva and blood. Fruit bats, primates, forest antelope and porcupines have all been suspected carriers.

    The virus incubates in humans for between two and 21 days and can only be spread once the carrier develops symptoms.

    There are no licensed vaccines or therapies for the treatment or prevention of Sudan ebolavirus disease. According to the WHO, the ERVEBO vaccine, which has been used in recent responses to outbreaks of other Ebola strains, will not provide cross-protection for the Sudan virus.

    There are six candidate vaccines against Sudan ebolavirus in different stages of development, but none are near the final phases of broad clinical trials. The WHO has said its research teams are in contact with all of the vaccine developers, in what the organization calls a “collaborative effort” to see if any are suitable for further evaluation during the current outbreak.   

    Health officials tell CBS News that the WHO, Africa CDC and other agencies are “talking” about the possibility of running some trials on people who have been admitted to hospitals in the country. 

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  • These were the best and worst places for air quality in 2021, new report shows | CNN

    These were the best and worst places for air quality in 2021, new report shows | CNN



    CNN
     — 

    Air pollution spiked to unhealthy levels around the world in 2021, according to a new report.

    The report by IQAir, a company that tracks global air quality, found that average annual air pollution in every country — and 97% of cities — exceeded the World Health Organization’s air quality guidelines, which were designed to help governments craft regulations to protect public health.

    Only 222 cities of the 6,475 analyzed had average air quality that met WHO’s standard. Three territories were found to have met WHO guidelines: the French territory of New Caledonia and the United States territories of Puerto Rico and the US Virgin Islands.

    India, Pakistan and Bangladesh were among the countries with the worst air pollution, exceeding the guidelines by at least 10 times.

    The Scandinavian countries, Australia, Canada, Japan and United Kingdom ranked among the best countries for air quality, with average levels that exceeded the guidelines by 1 to 2 times.

    In the United States, IQAir found air pollution exceeded WHO guidelines by 2 to 3 times in 2021.

    “This report underscores the need for governments around the world to help reduce global air pollution,” Glory Dolphin Hammes, CEO of IQAir North America, told CNN. “(Fine particulate matter) kills far too many people every year and governments need to set more stringent air quality national standards and explore better foreign policies that promote better air quality.”

    Above: IQAir analyzed average annual air quality for more than 6,000 cities and categorized them from best air quality, in blue (Meets WHO PM2.5 guildline) to worst, in purple (Exceeds WHO PM2.5 guideline by over 10 times). An interactive map is available from IQAir.

    It’s the first major global air quality report based on WHO’s new annual air pollution guidelines, which were updated in September 2021. The new guidelines halved the acceptable concentration of fine particulate matter — or PM 2.5 — from 10 down to 5 micrograms per cubic meter.

    PM 2.5 is the tiniest pollutant yet also among the most dangerous. When inhaled, it travels deep into lung tissue where it can enter the bloodstream. It comes from sources like the burning of fossil fuels, dust storms and wildfires, and has been linked to a number of health threats including asthma, heart disease and other respiratory illnesses.

    Millions of people die each year from air quality issues. In 2016, around 4.2 million premature deaths were associated with fine particulate matter, according to WHO. If the 2021 guidelines had been applied that year, WHO found there could have been nearly 3.3 million fewer pollution-related deaths.

    IQAir analyzed pollution-monitoring stations in 6,475 cities across 117 countries, regions and territories.

    In the US, air pollution spiked in 2021 compared to 2020. Out of the more than 2,400 US cities analyzed, Los Angeles air remained the most polluted, despite seeing a 6% decrease compared to 2020. Atlanta and Minneapolis saw significant increases in pollution, the report showed.

    “The (United States’) reliance on fossil fuels, increasing severity of wildfires as well as varying enforcement of the Clean Air Act from administration to administration have all added to U.S. air pollution,” the authors wrote.

    Researchers say the main sources of pollution in the US were fossil fuel-powered transportation, energy production and wildfires, which wreak havoc on the country’s most vulnerable and marginalized communities.

    “We are heavily dependent on fossil fuels, especially in terms of transportation,” said Hammes, who lives a few miles from Los Angeles. “We can act smartly on this with zero emissions, but we’re still not doing it. And this is having a devastating impact on the air pollution that we’re seeing in major cities.”

    Climate change-fueled wildfires played a significant role in reducing air quality in the US in 2021. The authors pointed to a number of fires that led to hazardous air pollution — including the Caldor and Dixie fires in California, as well as the Bootleg Fire in Oregon, which wafted smoke all the way to the East Coast in July.

    China — which is among the countries with the worst air pollution — showed improved air quality in 2021. More than half of the Chinese cities analyzed in the report saw lower levels of air pollution compared to the previous year. The capital city of Beijing continued a five-year trend of improved air quality, according to the report, due to a policy-driven drawdown of polluting industries in the city.

    The report also found that the Amazon Rainforest, which had acted as the world’s major defender against the climate crisis, emitted more carbon dioxide than it absorbed last year. Deforestation and wildfires have threatened the critical ecosystem, polluted the air and contributed to climate change.

    “This is all a part of the formula that will lead to or is leading to global warming.” Hammes said.

    The report also unveiled some inequalities: Monitoring stations remain scant in some developing countries in Africa, South America and the Middle East, resulting in a dearth of air quality data in those regions.

    “When you don’t have that data, you’re really in the dark,” Hammes said.

    Hammes noted the African country of Chad was included in the report for the first time, due to an improvement in its monitoring network. IQAir found the country’s air pollution was the second-highest in the world last year, behind Bangladesh.

    Tarik Benmarhnia, a climate change epidemiologist at Scripps Institution of Oceanography who has studied the health impact of wildfire smoke, also noted that relying only on monitoring stations can lead to blind spots in these reports.

    “I think it is great that they relied on different networks and not only governmental sources,” Benmarhnia, who was not involved in this report, told CNN. “However, many regions do not have enough stations and alternative techniques exist.”

    The UN Intergovernmental Panel on Climate Change concluded in its 2021 report that, in addition to slowing the speed of global warming, curbing the use of fossil fuels would have the added benefit of improving air quality and public health.

    Hammes said the IQAir report is even more reason for the world to wean off fossil fuel.

    “We’ve got the report, we can read it, we can internalize it and really devote ourselves to taking action,” she said. “There needs to be a major move towards renewable energy. We need to take drastic action in order to reverse the tide of global warming; otherwise, the impact and the train that we’re on (would be) irreversible.”

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