The deadly Ebola virus has broken out in the Democratic Republic of Congo, but things are very different this time in the speed of response and tools available for this outbreak versus the one that hit West Africa in 2014-2016. For one, the World Health Organization is already involved.

Dr. Tedros Adhanom Ghebreyesus, director of the WHO, led a delegation to the DRC May 13 that included Dr. Matshidiso Moeti, the WHO regional director for Africa, and Dr. Peter Salama, WHO deputy director-general for emergency preparedness and response. Tedros and the others went to personally evaluate the response to the country’s Ebola outbreak and meet with President Joseph Kabila and the country’s minister of health.

Stephen Morrison, director of the Global Health Policy Center at a Washington research organization, the Center for Strategic and International Studies, conducted research on the West African outbreak that claimed more than 11,000 lives and is carefully watching the current outbreak in a rural area of northeast DRC.

“I thought it was very commendable and a great sign of the change of outlook that Dr. Tedros was personally there on the ground, and that was very important,” Morrison said. “It rallies the troops, it shows determination and commitment and speed.”

​Rapid response

One of the changes from the 2014 outbreak is that the WHO has an emergency fund to get experts in place to start to contain the outbreak. 

A team left Wednesday for the country’s rural northwest. The first batch of experimental Ebola vaccines arrived in the Democratic Republic of Congo May 16 and will be administered to health care workers and those exposed to the virus in days. Merck, the pharmaceutical giant that makes the vaccine, has promised the WHO to supply whatever is needed for this outbreak. Although the vaccine is not licensed, and therefore is called “experimental,” it was proved safe and effective in West Africa.

A multidisciplinary team, including WHO experts and staff from Médecins Sans Frontières (Doctors Without Borders), has been in Bikoro, where the outbreak first occurred May 10. The U.S. Centers for Disease Control and Prevention also has personnel in place. In addition, the World Food Program is providing an air bridge to get the vaccine and supplies to the affected region with several flights a day. Treatment centers that isolate the sick are in place, as are hand-washing stations containing a solution of bleach and water to kill the virus.

‘A lot of learning’

Morrison said what is unfolding in Central Africa “shows a lot of learning and a different pattern of response. The response to this outbreak has been quite different from a very delayed response over a six month period in 2014 in the outbreak in West Africa.” 

That, and that this is the ninth Ebola outbreak in the DRC since 1974, when the country was named Zaire and the virus was named after the Ebola River, near the source of the outbreak. Morrison points out that Congo has a lot of experience in dealing with outbreaks of Ebola, but Sierra Leone, Guinea and Liberia in West Africa hadn’t experienced Ebola until 2014. The international response was slow, and more than 11,000 people died as a result.

Morrison says a lot of lessons were learned from that epidemic. Even though the virus is in a remote, rural area, no one involved is complacent. 

“We are very concerned, and we are planning for all scenarios, including the worst case scenario,” Dr. Salama said.

In that scenario, the virus could travel to heavily populated urban areas and get out of control. Bikoro is on a lake that feeds into rivers that connect to Kinshasa, Brazzaville and other major cities. In Congo the government, WHO and others are working to make sure, if at all possible, this doesn’t happen.
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The deadly Ebola virus has been confirmed in the Democratic Republic of Congo. A team of experts left Wednesday to visit the country’s rural northwest to help prevent its spread. VOA’s Carol Pearson reports on what’s different about the outbreak in Congo and the epidemic that swept through West Africa four years ago.
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U.S. birth rates declined last year for women in their teens, 20s and — surprisingly — their 30s, leading to the fewest babies in 30 years, according to a government report released Thursday.

Experts said several factors may be combining to drive the declines, including shifting attitudes about motherhood and changing immigration patterns. 

The provisional report, based on a review of more than 99 percent of the birth certificates filed nationwide, counted 3.853 million births last year. That’s the lowest tally since 1987.

Births have been declining since 2014, but 2017 saw the greatest year-to-year drop, about 92,000 less than the previous year.

That was surprising, because baby booms often parallel economic booms, and last year was a period of low unemployment and a growing economy. 

What’s causing this?

But other factors are likely at play, experts said.

One may be shifting attitudes about motherhood among millennials, who are in their prime child-bearing years right now. They may be more inclined to put off child-bearing or have fewer children, researchers said.

Another may be changes in the immigrant population, who generate nearly a quarter of the babies born in the U.S. each year. For example, Asians are making up a larger proportion of immigrants, and they have typically had fewer children than other immigrant groups.

Also, use of IUDs and other long-acting forms of contraception has been increasing.

Other findings

The Centers for Disease Control and Prevention report also found: 

The rate of births to women ages 15 to 44, known as the general fertility rate, sank to a record low of about 60 per 1,000.  

 
Women in their early 40s were the only group with higher birth rates in 2017, up 2 percent from the year. The rate has been rising since the early 1980s. 

 
The cesarean section rate rose by a tiny amount after having decreased four years. Studies have shown C-sections are more common in first-time births involving older moms. 

 
Rates of preterm and low birth weight babies rose for the third straight year, possibly for the same reason. 

 
Birth rates for teens continued to nosedive, as they have since the early 1990s. In 2017, they dropped 7 percent from the year before. 

 
Rates for women in their 20s continued to fall and hit record lows. They fell 4 percent. 

 
Perhaps most surprising, birth rates for women in their 30s fell slightly, dipping 2 percent for women ages 30 to 34 and 1 percent for women 35 to 39.

 
Birth rates for women in their 30s had been rising steadily to the highest levels in at least half a century, and women in their early 30s recently became the age group that has the most babies. That decline caused some experts’ eyebrows to shoot up, but they also noted the dip was very small. 

“It’s difficult to say yet whether it marks a fundamental change or it’s just a blip,” said Hans-Peter Kohler, a University of Pennsylvania demographer who studies birth trends.

Generation can’t replace itself 

Another notable finding: The current generation is getting further away from having enough children to replace itself.

The U.S. once was among a handful of developed countries with a fertility rate that ensured each generation had enough children to replace it.

The rate in the U.S. now stands less than the standard benchmark for replacement. It’s still above countries such as Spain, Greece, Japan and Italy, but the gap appears to be closing. 

A decade ago, the estimated rate was 2.1 kids per U.S. woman. In 2017, it fell below 1.8, hitting its lowest level since 1978. 

“That’s a pretty remarkable decline,” said Dr. John Santelli, a Columbia University professor of population and family health and pediatrics.
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Whenever the all-female Nigerian biker group D’Angels hits the streets, people would stare in amazement at the sight of women on motorbikes. So they made up their minds to use the attention for a good cause.

Enter the Female Bikers Initiative (FBI), which has provided free breast and cervical cancer screening to 500 women in Nigeria’s commercial capital Lagos.

This August, D’Angels and another female biker group in Lagos, Amazon Motorcycle Club, plan to provide free screening to 5,000 women, a significant undertaking in a country where many lack access to proper health care.

“What touched us most was the women,” D’Angels co-founder Nnenna Samuila, 39, told the Thomson Reuters Foundation by phone from Lagos.

“Some asked if the bikes really belonged to us. Some asked if they could sit on our bikes. We decided to use the opportunity to do something to touch women’s lives.”

Major killers

Breast and cervical cancer are huge killers in Nigeria, accounting for half the 100,000 cancer deaths each year, according to the World Health Organization. Screening and early detection can dramatically reduce the mortality rate for cervical cancer in particular.

But oncologist Omolola Salako, whose Lagos charity partnered with the FBI last year, says there is not enough awareness of the need for screening.

“Among the 600-plus women we have screened since October, about 60 percent were being screened for the first time,” said Salako, executive director of Sebeccly Cancer Care. “It was the first time they were hearing about it.”

Even if women do know they should be screened, affordability is a barrier, said Salako, whose charity provides the service for free and also raises funds to treat cancer patients.

Raising awareness

This year the bikers will put on a week of awareness-raising and mobile screening, after which free screenings will be available at Sebeccly every Thursday for the rest of the year.

Members of the two clubs and any other female bikers who want to join in will ride through the streets, to schools, malls and other public places, distributing fliers and talking to women about the importance of screening.

“All the bikers turn up,” said Samuila, one of five women on the FBI’s board of trustees. “We just need to tell them, this is the location for the activity, and this is what we need you to do.”

Last year their funds, from private and corporate donors, could only stretch to two mastectomies, and they hope they will be able to sponsor more treatments this year.

“We encourage this person to come, and then she finds out that something is wrong and you abandon her,” said Samuila, a former telecoms executive who now runs her own confectionery and coffee company. “We would love to be able to follow up with whatever comes out of the testing.”

This is just the latest in a number of projects the bikers have organized.

In 2016 they launched Beyond Limits, a scheme to encourage young girls to fulfill their potential beyond societal expectations of marriage and babies. They travel to schools to give talks and invite senior women working in science, technology and innovation to take part.

Turning point

Samuila formed D’Angels with 37-year-old Jeminat Olumegbon in 2009 after they were denied entry to the established, all-male bikers’ groups in Lagos.

“They didn’t want us. They were like, ‘No, women don’t do this. Women are used to being carried around. Why don’t you guys just be on the sidelines?’ That sort of pissed us off and we then went on to form our own club,” Samuila said.

In 2010, the pair rode from Lagos to the southern city of Port Harcourt to attend a bikers’ event, a 617-km (383-mile) trip that the men had told them was impossible for a woman.

“That was the turning point in our relationship with the male bikers,” Samuila said.

The two-day ride earned them a new respect from the male riders, some of whom now take part in the screening awareness programs themselves.

Bigger challenges

In 2015 Olumegbon, also an FBI board member, took on an even bigger challenge riding 20,000 km through eight West African countries in 30 days to raise funds for children in orphanages.

“I’ve been riding since 2007. At first, I was the only female riding, then I found Nnenna and the other girls,” she said. “Because we started riding, more females decided to look inwards, and decided that they could do so as well.”

The bikers plan to extend their initiative to other parts of Nigeria, and have also received invitations from women riders in other West African countries.

For now though, they want to focus on making sure their efforts reach every woman in Lagos.

“When we speak to people on the streets, many don’t even know of cervical cancer,” Samuila said. “It’s so painful to hear that so many people are dying from the disease when it can be prevented.”
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For some lizards it’s easy being green. It’s in their blood. Six species of lizards in New Guinea bleed lime green thanks to evolution gone weird.

It’s unusual, but there are critters that bleed different colors of the rainbow besides red. The New Guinea lizards’ blood — along with their tongues, muscles and bones — appear green because of incredibly large doses of a green bile pigment. The bile levels are higher than other animals, including people, could survive.

Scientists still don’t know why this happened, but evolution is providing some hints into this nearly 50-year mystery.

By mapping the evolutionary family tree of New Guinea lizards, researchers found that green blood developed inside the amphibians at four independent points in history, likely from a red-blooded ancestor, according to a study in Wednesday’s journal Science Advances.

This isn’t a random accident of nature but suggests this trait of green blood gives the lizards an evolutionary advantage of some kind, said Christopher Austin of Louisiana State University.

“Evolution can do amazing things given enough time,” Austin said. “The natural world is a fascinating place.”

Austin first thought that maybe being green and full of bile would make New Guinea lizards taste bad to potential predators.

“I actually ate several lizards myself and they didn’t taste bad,” Austin said. He also fed plenty of them to a paradise kingfisher bird with no ill effects except maybe a fatter bird.

Understanding bile is probably key. Blood cells don’t last forever. After they break down, the iron is recycled for new red blood cells, but toxins are also produced, which is essentially bile.

In the New Guinea lizards, levels of a green bile pigment are 40 times higher than what would be toxic in humans. It’s green enough to overwhelm the color of the red blood cells and turn everything green, Austin said.

In people, elevated green bile pigment levels sometimes kill malaria parasites. Austin thinks that might be why lizards evolved to be green-blooded because malaria is an issue for New Guinea and lizards. It might be the result of evolution trying to kill the malaria parasite in lizards or it might be past lizards were infected so heavily that this was the body’s reaction, he said.

The next step is to search for the specific genes involved.

Michael Oellermann, a researcher at the University of Tasmania in Australia, praised Austin’s work and wondered if there is an evolutionary cost to having green blood.

Otherwise more critters would bleed green or another color, he said.

Many insects, spiders and molluscs have the copper-containing blood pigment that’s clear unless it attaches to oxygen and then it turns blue. Squids and octopuses have intense blue blood. Icefish in Antarctica have clear blood, while little crustaceans from Lake Baikal in Siberia have blood that’s blue or red or green.

Marine worms called lamp shells have violet to pink blood, according to the American Chemical Society.

“Biology is incredibly diverse,” Austin said.
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Many women with a common and aggressive form of breast cancer that is treated with Herceptin can get by with six months of the drug instead of the usual 12, greatly reducing the risk of heart damage it sometimes can cause, a study suggests.

It’s good news, but it comes nearly two decades after the drug first went on the market and many patients have suffered that side effect.    

The study was done in the United Kingdom and funded by UK government grants. Results were released Wednesday by the American Society of Clinical Oncology and will be presented at the group’s meeting next month.

Herceptin transformed care of a dreaded disease when it was approved in 1998 for women with advanced breast cancers whose growth is aided by a faulty HER2 gene, as 15 percent to 20 percent of cases are. It was later approved for treatment of those cancers in earlier stages, too, based on studies that had tested it in patients for 12 months. That guess, that the drug should be taken for a year, became the standard of care.

But the drug can hurt the heart’s ability to pump. That often eases if treatment is stopped but the damage can be permanent and lead to heart failure.

Some studies tested shorter use, but results conflicted. The new study is the largest so far, and involved more than 4,000 women with early-stage cancers who were given usual chemotherapy plus Herceptin for either six or 12 months.   

After four years, about 90 percent of both groups were alive without signs of the disease. Only 4 percent on the shorter treatment dropped out due to heart problems versus 8 percent of those treated for a year.

“It’s great news” for patients, said the study leader, Dr. Helena Earl of the University of Cambridge in England. Earl has consulted for Herceptin’s maker, Roche. The company had no role in the study.

Compelling findings

“There’s no reason to not immediately change practice. The findings are persuasive,” said Dr. Richard Schilsky, chief medical officer for the oncology society. Most of Herceptin’s cancer-fighting benefit seems to come in the early months of use, he said.

Others said that because so few women have died or relapsed after being treated with the drug, longer followup may be needed to make sure the findings hold up before guidelines should be changed.  Doctors also want to see results published, and to study them to see if certain groups of women need longer treatment.

Herceptin is given through an IV every three weeks; a year of it costs $34,000 to $40,000 in England and about $70,000 in the U.S. In December, a copycat competitor known as a biosimilar was approved in the U.S. and already is used in some other countries.

Dr. Harold Burstein, a breast cancer expert at Dana-Farber Cancer Institute in Boston, said shorter treatment may increase access to the drug in countries where many women can’t afford it now, but that in the U.S., “my guess is that people will continue to aim for a year of treatment” because of lingering concerns that longer use is better, as a smaller, previous study suggested.

Dr. Jennifer Litton, a breast specialist at MD Anderson Cancer Center in Houston, said Herceptin was a true breakthrough, but scaling back treatment whenever possible is just as important to patients. She said the results show how important it can be to study drugs already on the market, and that drug companies alone should not be relied on to do studies like this.

 “It’s really important that we continue to have public funding for trials so we can continue to ask all of these questions for our patients,” she said.   

Herceptin’s developer, Genentech, now part of Roche, said in a statement that the new study must be viewed along with several smaller previous ones that found one year to be best. The goal of treatment “is to provide people with the best chance for a cure,” so women need to talk with their doctors about how best to reach that goal, the statement says.

Earlier this year, the American Heart Association issued its first statement on the heart effects of cancer drugs, saying women should consider carefully the risks and benefits of any therapies that may hurt hearts.

 
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Patients suffering from opioid addiction may soon be given the first non-opioid drug to help them handle withdrawal symptoms. 

The Food and Drug Administration on Wednesday approved use of the drug Lucemyra, saying it gives doctors a new option for treating the side effects of withdrawal.

“We know that the physical symptoms of opioid withdrawal can be one of the biggest barriers for patients seeking help and ultimately overcoming addiction,” FDA Commissioner Scott Gottlieb said. “The fear of experiencing withdrawal symptoms often prevents those suffering from opioid addiction from seeking help.”

Those symptoms include anxiety, muscle aches, sweating, vomiting and a craving for drugs.

Opioids are synthetic painkillers generally prescribed by doctors or used in hospital emergency rooms. But they can become highly addictive, even after the original injury has healed.

Doctors usually treat addiction by substituting one opioid for another, then gradually reducing use or transitioning to other drugs.

Part of long-term plan

Lucemyra is an oral treatment and can be used for only 14 days. The FDA said Lucemyra is not a treatment for opioid addiction but can be used as part of a long-term plan to fight the problem.

Last year, President Donald Trump declared the opioid epidemic a national public health emergency. 

Despite public pronouncements on the need to cut back on opioid prescriptions and to punish drug dealers more harshly, administration critics said they have yet to see any concrete plans from the White House to battle the crisis.
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Something strange is happening with a now-banned chemical that eats away at Earth’s protective ozone layer: Scientists say there’s more of it — not less — going into the atmosphere and they don’t know where it is coming from.

When a hole in the ozone formed over Antarctica, countries around the world in 1987 agreed to phase out several types of ozone-depleting chemicals called chlorofluorocarbons (CFCs). Production was banned, emissions fell and the hole slowly shrank.

But starting in 2013, emissions of the second most common kind started rising, according to a study in Wednesday’s journal Nature . The chemical, called CFC11, was used for making foam, degreasing stains and for refrigeration.

“It’s the most surprising and unexpected observation I’ve made in my 27 years” of measurements, said study lead author Stephen Montzka, a research chemist at the National Oceanic and Atmospheric Administration.

“Emissions today are about the same as it was nearly 20 years ago,” he said.

Countries have reported close to zero emissions of the chemical since 2006 but the study found about 14,300 tons (13,000 metric tons) a year has been released since 2013. Some seeps out of foam and buildings and machines, but scientists say what they’re seeing is much more than that.

Measurements from a dozen monitors around the world suggest the emissions are coming from somewhere around China, Mongolia and the Koreas, according to the study. The chemical can be a byproduct in other chemical manufacturing, but it is supposed to be captured and recycled.

Either someone’s making the banned compound or it’s sloppy byproducts that haven’t been reported as required, Montzka said.

An outside expert, Ross Salawitch, an atmospheric scientist at the University of Maryland, is less diplomatic. He calls it “rogue production,” adding that if it continues “the recovery of the ozone layer would be threatened.”

High in the atmosphere, ozone shields Earth from ultraviolet rays that cause skin cancer, crop damage and other problems.

Nature removes 2 percent of the CFC11 out of the air each year, so concentrations of the chemical in the atmosphere are still falling, but at a slower rate because of the new emissions, Montzka said. The chemical stays in the air for about 50 years.
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The first batch of 4,000 experimental Ebola vaccines to combat an outbreak suspected of killing 23 people arrived in Congo’s capital Kinshasa on Wednesday.

The Health Ministry said vaccinations would start at the weekend, the first time the vaccine would come into use since it was developed two years ago.

The vaccine, developed by Merck and sent from Europe by the World Health Organization, is still not licensed but proved effective during limited trials in West Africa in the biggest ever outbreak of Ebola, which killed 11,300 people in Guinea, Liberia and Sierra Leone from 2014-2016.

Health officials hope they can use it to contain the latest outbreak in northwest Democratic Republic of Congo.

8,000 doses needed

Peter Salama, WHO’s deputy director-general for emergency preparedness and response, said the current number of cases stood at 42, with 23 deaths attributed to the outbreak.

“Our current estimate is we need to vaccinate around 8,000 people, so we are sending 8,000 doses in two lots,” he told Reuters in Geneva.

“Over the next few days we will be reassessing the projected numbers of cases that we might have and then if we need to bring in more vaccine we will do so in a very short notice.”

Health workers have recorded confirmed, probable and suspected cases of Ebola in three health zones of Congo’s Equateur province, and have identified 432 people who may have had contact with the disease.

WHO spokesman Tarik Jasarevic said the supplies sent to Congo included more than 300 body bags for safe burials in affected communities. The vaccine will be reserved for people suspected of coming into contact with the disease, as well as health workers.

“In our experience, for each confirmed case of Ebola there are about 100-150 contacts and contacts of contacts eligible for vaccination,” Jasarevic said. “So it means this first shipment would be probably enough for around 25-26 rings — each around one confirmed case.”

Storage temperature 

The vaccine is complicated to use, requiring storage at a temperature between -60 and -80 degrees Celsius.

“It is extremely difficult to do that as you can imagine in a country with very poor infrastructures,” Salama said.

“The other issue is, we are now tracing more than 4,000 contacts of patients and they have spread out all over the region of northwest Congo, so they have to be followed up and the only way to reach them is motorcycles.”

The outbreak was first spotted in the Bikoro zone, which has 31 of the cases and 274 contacts. There have also been eight cases and 115 contacts in Iboko health zone.

The WHO is worried about the disease reaching the city of Mbandaka with a population of about 1 million people, which would make the outbreak far harder to tackle. Two brothers in Mbandaka who recently stayed in Bikoro for funerals are probable cases, with samples awaiting laboratory confirmation.

The WHO report said 1,500 sets of personal protective equipment and an emergency sanitary kit sufficient for 10,000 people for three months were being put in place.
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Most U.S. insurance companies have not adapted their strategies to address the dangers of climate change, making them likely to raise rates or deny coverage in high-risk areas, said a study released Tuesday.

With predictions of an above-average Atlantic hurricane season approaching, thousands of people could be unable to afford insurance protection or lose it altogether, said the Canadian research study published in the British Journal of Management.

Scientific consensus holds that climate change increases the intensity and frequency of extreme weather, from hurricanes to flooding. Last year, three record hurricanes struck the Gulf of Mexico and the Caribbean, causing billions of dollars’ worth of damage.

Yet insurance and reinsurance companies overwhelmingly continue to treat storms as “anomalous rather than correlated to climate change,” the study said.

“Insurers that ignore climate change will not put away enough money to cover their claims. To recoup those losses, they’ll have to raise rates or pull coverage from high-risk areas,” said lead author Jason Thistlethwaite, an assistant professor of environment and business at the University of Waterloo.

They will face whopping payouts associated with disasters, he said.

So long, coverage

“When this shift happens, thousands of people will lose coverage or it will be unaffordable,” he said.

Insured losses hit an all-time high between 2004 and 2014, according to a 2015 analysis by reinsurer Swiss Re.

Insurance companies use reinsurance to minimize their risk. 

But in 2015, only 3 percent out of a sample of 178 U.S. property insurers and reinsurers were taking into account climate change in corporate governance, underwriting and investment, the study found.

However, the number of companies factoring in climate change in at least one area of operation doubled to about three dozen from 2012 to 2015, it said.

With storm-related payouts soaring, insurance companies may go out of business or lose investors, Thistlethwaite said.

A shrinking insurance market will drive up costs to consumers, he said.

The researchers analyzed insurers in California, Connecticut, Minnesota, New York, Washington and New Mexico.

Less than a month away, the Atlantic hurricane season has been predicted to be “above average” by Colorado State University meteorologists. The season runs from June 1 to November 30.
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Poland’s environment minister has decided to stop the extensive logging in one of Europe’s oldest forests that has been declared illegal by a top European Union court, authorities said Tuesday.

Environment Minister Henryk Kowalczyk has ordered the government’s 2017 permission for the increased felling of trees in the Bialowieza Forest to be halted by the top forestry official, a move expected this week.

It was the Polish government’s official reaction to a ruling last month by the European Court of Justice that said the increased logging was against EU environmental laws. Poland has vowed to abide by the ruling.

Environmentalists have welcomed the move, but also urged the waiving of a 2016 decision by then-minister Jan Szyszko that laid the ground for increasing the logging in Bialowieza.

“This is a step in the right direction, but we are waiting also for the other annulment” that should close the matter, said Agata Szafraniuk of ClientEarth.

She said that the logging in one of Europe’s last pristine forests has stopped.

The logging was ordered by Szyszko, who argued it was to stop a bark beetle infestation. Environmentalists questioned that, suspecting profit motives.      

 
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