As Americans head into the holiday season, a rapidly intensifying flu season is straining hospitals already overburdened with patients sick from other respiratory infections. 

More than half the states have high or very high levels of flu, unusually high for this early in the season, the government reported Friday. Those 27 states are mostly in the South and Southwest but include a growing number in the Northeast, Midwest and West. 

This is happening when children’s hospitals already are dealing with a surge of illnesses from RSV, or respiratory syncytial virus, a common cause of cold-like symptoms that can be serious for infants and the elderly. And COVID-19 is still contributing to more than 3,000 hospital admissions each day, according to the Centers for Disease Control and Prevention. 

In Atlanta, Dr. Mark Griffiths describes the mix as a “viral jambalaya.” He said the children’s hospitals in his area have at least 30% more patients than usual for this time of year, with many patients forced to wait in emergency rooms for beds to open up. 

“I tell parents that COVID was the ultimate bully. It bullied every other virus for two years,” said Griffiths, ER medical director of a Children’s Health Care of Atlanta downtown hospital. 

With COVID-19 rates going down, “they’re coming back full force,” he said. 

The winter flu season usually doesn’t get going until December or January. Hospitalization rates from flu haven’t been this high this early since the 2009 swine flu pandemic, CDC officials say. The highest rates are among those 65 and older and children under 5, the agency said. 

“It’s so important for people at higher risk to get vaccinated,” the CDC’s Lynnette Brammer said in a statement Friday. 

But flu vaccinations are down from other years, particularly among adults, possibly because the past two seasons have been mild. Flu shots are recommended for nearly all Americans who are at least 6 months old or older. 

Adults can get RSV too and that infection can be especially dangerous for older adults who are frail or have chronic illnesses, doctors say. There is not yet a vaccine against RSV although some are in development. 

One infectious-disease specialist urged Americans to take precautions before gathering for Thanksgiving, including avoiding public crowds, getting COVID-19 tests before they meet and wearing masks indoors — particularly if you are old or frail, or will be around someone who is. 

“Nobody wants to bring a virus to the table,” said Dr. William Schaffner of Vanderbilt University. 

The American Academy of Pediatrics and Children’s Hospital Association this week urged the Biden administration to declare an emergency and mount a national response to “the alarming surge of pediatric respiratory illnesses.” An emergency declaration would allow waivers of Medicaid, Medicare or Children’s Health Insurance Program requirements so that doctors and hospitals could share resources and access emergency funding, the groups said in a letter. 
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NASA’s Webb Space Telescope is finding bright, early galaxies that until now were hidden from view, including one that may have formed a mere 350 million years after the cosmic-creating Big Bang.

Astronomers said Thursday that if the results are verified, this newly discovered throng of stars would beat the most distant galaxy identified by the Hubble Space Telescope, a record-holder that formed 400 million years after the universe began.

Launched last December as a successor to Hubble, the Webb telescope is indicating stars may have formed sooner than previously thought — perhaps within a couple million years of creation.

Webb’s latest discoveries were detailed in the Astrophysical Journal Letters by an international team led by Rohan Naidu of the Harvard-Smithsonian Center for Astrophysics. The article elaborates on two exceptionally bright galaxies, the first thought to have formed 350 million years after the Big Bang and the other 450 million years after.

Naidu said more observations are needed in the infrared by Webb before claiming a new distance record-holder.

Although some researchers report having uncovered galaxies even closer to the creation of the universe 13.8 billion years ago, those candidates have yet to be verified, scientists stressed at a NASA news conference. Some of those could be later galaxies mimicking earlier ones, they noted.

“This is a very dynamic time,” said Garth Illingworth of the University of California, Santa Cruz, a co-author of the article published Thursday. “There have been lots of preliminary announcements of even earlier galaxies, and we’re still trying to sort out as a community which ones of those are likely to be real.”

Tommaso Treu of the University of California, Los Angeles, a chief scientist for Webb’s early release science program, said the evidence presented so far “is as solid as it gets” for the galaxy believed to have formed 350 million years after the Big Bang.

If the findings are verified and more early galaxies are out there, Naidu and his team wrote that Webb “will prove highly successful in pushing the cosmic frontier all the way to the brink of the Big Bang.”

“When and how the first galaxies formed remains one of the most intriguing questions,” they said in their paper.

NASA’s Jane Rigby, a project scientist with Webb, noted that these galaxies “were hiding just under the limits of what Hubble could do.”

“They were right there waiting for us,” she told reporters. “So, that’s a happy surprise that there are lots of these galaxies to study.”

The $10 billion observatory — the world’s largest and most powerful telescope ever sent into space — is in a solar orbit that’s 1.6 million kilometers from Earth. Full science operations began over the summer, and NASA has since released a series of dazzling snapshots of the universe.
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A global wildlife summit in Panama took an important step Thursday toward upgrading protection for sharks, the ancient ocean vertebrates targeted for their fins used in a status-symbol soup. 

A committee voted to approve a proposal to include requiem and hammerhead sharks on Appendix II of the Convention on International Trade in Endangered Species (CITES).   

The appendix lists species that may not yet be threatened with extinction but may become so unless their trade is closely controlled.   

The Wildlife Conservation Society, advocating for the sharks’ inclusion on the appendix, said the requiem shark family makes up at least 70% of the fin trade. 

According to Luke Warwick of the Wildlife Conservation Society, “we are in the middle of a very large shark extinction crisis.”  

He said sharks, which are vital to the ocean’s ecosystem, are “the second-most-threatened vertebrate group on the planet.”  

Shark fins — which represent a market of some $500 million per year — can sell for about $1,000 a kilogram in East Asia for use in shark fin soup, a delicacy.   

The requiem shark family includes species such as the tiger shark, silky shark and grey reef shark.   

Also before the CITES gathering underway in Panama City is the inclusion on Appendix II of freshwater stingrays and guitarfish, among other species.  

The conference is considering 52 proposals to amend protection levels for species that also include crocodiles, lizards, snakes, freshwater turtles and several species of plants and trees. 

A final decision will be taken at the closing meeting of the CITES conference of parties on November 25.   

CITES, in force since 1975, regulates trade in 36,000 species of plants and animals and provides mechanisms to help crack down on illegal commerce. It sanctions countries that break the rules. Its members include 183 countries and the European Union. 
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Malawi is struggling to contain one of the worst cholera outbreaks in years. It has spread nationwide, killing more than 250 people and infecting more than 8,000.  Authorities and aid groups have stepped up cholera vaccination and hygiene campaigns, as Lameck Masina reports from Blantyre, Malawi.
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Uganda’s tourism sector is once again being hit by effects from a deadly disease.  

In 2021, it was the COVID-19 pandemic. This time, it’s the Ebola outbreak, with 141 confirmed cases and 55 deaths.

President Yoweri Museveni said Tuesday in his address to Ugandans that he had been informed that tourists are canceling trips to the country and some had postponed hotel bookings. 

This comes as the outbreak has spread to a sixth district of Jinja in Eastern Uganda, a favorite destination for tourists. 

“This is most unfortunate and not necessary. As you have seen, Ebola, if you follow the guidelines, it will not get you. Uganda remains safe and we welcome international guests,” Museveni said. 

He also said lists of Ebola contacts are being provided to immigration officials to prevent the virus from spreading outside the country.  

December is usually one of the peak months for Uganda’s tourism industry. 

Scovia Kyarisima, executive director of Legends Gorilla Tours, a company that provides wildlife experiences for visitors, told VOA that several tourists have postponed their visits.  

“I’ve had so far five cancellations from online tourists,” she said. “And they have pushed it to June next year. They don’t say we are not going to come anymore. But they say, considering the situation that is on today, let’s push this to next year.” 

Before the pandemic, Uganda was getting a little over 600,000 tourists each year. That number nosedived to about 200,000 when COVID-19 hit in 2020, costing many Ugandans their jobs. 

Gessa Simplicious, public relations officer for the Uganda Tourism Board, said that in between the pandemic and the Ebola outbreak, the tourism industry was slowly climbing out of its downturn.  

He said industry operators, some of whom borrowed heavily to revamp their facilities, are now facing a crunch as tourism dries up again, while other wildlife destinations like Kenya and Tanzania remain unaffected by the Ebola outbreak.  

“And you see this Ebola is only isolating us as a country. So, it means, tourists can go elsewhere for the same thing and omit Uganda,” Simplicious said. 

The government has tightened measures in two of the most Ebola-hit districts of Mubende and Kasanda by extending a lockdown for another 21 days. It is also banning citizens from seeking treatment from traditional healers and trying to limit individuals’ movement in and out of the districts. 

 
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Heavy rains behind floods that killed more than 600 people in Nigeria this year were about 80 times likelier because of human-induced climate change, scientists reported Wednesday.

The floods mainly struck Nigeria but also Niger, Chad and neighboring countries, displacing more than 1.4 million people and devastating homes and farmland in a region already vulnerable to food insecurity.

Researchers from the World Weather Attribution (WWA) consortium said in a study that the floods, among the deadliest on record in the region, were directly linked to human activity that is exacerbating climate change.

They matched long-term data on climate, which shows the planet has warmed by about 1.2 degrees Celsius since 1800 as carbon emissions have risen, against weather events.

The heavy rainfall that sparked the floods was 80 times more likely because of “human-caused climate change,” according to their findings.

In addition, “this year’s rainy season was 20% wetter than it would have been without the influence of climate change,” they said.

“The influence of climate change means the prolonged rain that led to the floods is no longer a rare event,” the study found.

“The above-average rain over the wet season now has approximately a 1 in 10 chance of happening each year; without human activities it would have been an extremely rare event.”

More than 600 people were killed in Nigeria alone because of the floods from June to October this year, and nearly 200 in Niger and 22 in Chad.

The report comes as COP27 climate talks are under way in Egypt’s Sharm el-Sheikh, where developing nations are demanding rich polluters pay for climate-change linked calamities.

Africa is home to some of the countries least responsible for carbon emissions but hardest hit by an onslaught of weather extremes, with the Horn of Africa currently in the grips of a severe drought.

“This is a real and present problem, and it’s particularly the poorest countries that are getting hit very hard. So it’s clear that solutions are needed,” Maarten van Aalst, director of the Red Cross Red Crescent Climate Centre, said at a WWA press conference.

The WWA publishes rapid-response reports following extreme climate events.

Their studies are not peer-reviewed, a process that can take months, but are widely backed by scientists.
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After mechanical issues and inclement weather forced a series of delays, NASA’s Artemis 1 mission to the moon finally took off from Kennedy Space Center early Wednesday morning. VOA’s Kane Farabaugh has more from Florida. Camera: Adam Greenbaum
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NASA’s new Artemis moon rocket blasted off from the Kennedy Space Center in Florida on its debut flight with three test dummies aboard early Wednesday.

The launch brings the United States a big step closer to putting astronauts back on the lunar surface for the first time since the end of the Apollo program 50 years ago.

The moonshot follows nearly three months of vexing fuel leaks that kept the rocket bouncing between its hangar and the launch pad.

If all goes well with the three-week flight, the rocket will propel an empty crew capsule into a wide orbit around the moon.

The capsule will return to Earth with a splashdown in the Pacific in December.  

NASA hopes to send four astronauts around the moon on the next flight, in 2024, and land humans there as early as 2025.

Some information for this report was provided by the Associated Press.
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Chinese authorities locked down a major university in Beijing on Wednesday after finding one COVID-19 case as they stick to a “zero-COVID” approach despite growing public discontent.

Peking University students and faculty were not allowed to leave the grounds unless necessary and classes on the main campus — where the case was found — were moved online through Friday, a university notice said. Still, some people could be seen entering and leaving the main campus Wednesday in the Chinese capital’s Haidian district.

Beijing reported more than 350 new cases in the latest 24-hour period, a small fraction of its 21-million population but enough to trigger localized lockdowns and quarantines under China’s “zero-COVID” strategy. Nationwide, China reported about 20,000 cases, up from about 8,000 a week ago.

Authorities are steering away from citywide lockdowns to try to minimize the impact on freedom of movement and a sagging economy. They want to avoid a repeat of the Shanghai lockdown earlier this year that paralyzed shipping and prompted neighborhood protests. Revised national guidelines issued last week called on local governments to follow a targeted and scientific approach that avoids unnecessary measures.

Peking University has more than 40,000 students on multiple campuses, most in Beijing. It was unclear how many were affected by the lockdown. The 124-year-old institution is one of China’s top universities and was a center of student protest in earlier decades. Its graduates include leading intellectuals, writers, politicians and businesspeople.

Lockdowns elsewhere have sparked scattered protests. Earlier this week, videos posted online showed crowds pulling down barriers in the southern city of Guangzhou in a densely built area that is home to migrant workers in the clothing industry.

Guangzhou, an industrial export hub near Hong Kong, reported more than 6,000 new cases in what is the nation’s largest ongoing outbreak. The pandemic led the Badminton World Federation to move next month’s HSBC World Tour Finals from Guangzhou to Bangkok, the federation announced this week.

Other cities with major outbreaks include Chongqing in the southwest, Zhengzhou in Henan province and Hohhot, the capital of the Inner Mongolia region in the north.

In Zhengzhou late last month, workers fled their dormitories at a sprawling iPhone factory, some climbing over fences to get out. Apple subsequently warned that customers would face delays in deliveries of iPhone14 Pro models.

Chinese officials and state media have stressed that the government is fine-tuning but not abandoning what it calls a “dynamic” zero-COVID policy, after rumors of an easing sparked a stock market rally earlier this month.
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Cholera cases are overwhelming Haiti, and experts warn the situation could worsen now that the country is bustling following the end of a paralyzing fuel blockade that lasted two months.

Dr. Jeanty Fils, a spokesman for Haiti’s Ministry of Health, told The Associated Press that people are back on the streets and likely spreading cholera as the government struggles to find life-saving equipment, including IV supplies, amid an ongoing discussion on whether to request cholera vaccines.

“We need more resources,” he said. “Cholera cases continue to climb in Haiti.”

At least 161 people have died and more than 7,600 are hospitalized, according to the Pan American Health Organization (PAHO) and Haiti’s government, although officials believe the numbers are much higher as a result of underreporting. Cholera is caused by a bacteria found in contaminated food or water that leads to vomiting and diarrhea. If not treated in time, it can cause fatal dehydration.

The worsening situation led the United Nations to announce Tuesday that it, along with Haiti’s government and other partners, was seeking $146 million to help fight cholera. At least half a million people in Haiti are at risk of contracting the disease, according to PAHO and the World Health Organization.

“The surge in cases in recent weeks and the rapid spread of cholera in the country is worrying,” said Ulrika Richardson, U.N. resident and humanitarian coordinator.

Fils noted that cholera cases were likely contained during the fuel blockade as gas stations were closed and many in the country of more than 11 million people remained at home.

“Now people are going to move around more,” he said. “It could start spreading.”

Stephanie Mayronne, medical operations manager for Doctors Without Borders, agreed.

She said if people sickened with cholera start traveling to areas with poor sanitation and a lack of drinking water, the number of cases will likely rise.

“It’s a match that can light a fire,” she said.

The number of patients seeking help at Doctors Without Borders hospitals in the capital of Port-au-Prince has spiked in recent weeks, with more than 6,500 admitted so far. Beds filled up so quickly that the aid group was forced to open a fifth center two weeks ago, said Alexandre Marcou, Haiti’s field communication manager.

Inside that new center, mothers hovered over their children on a recent morning. One rearranged the tangle of intravenous cables surrounding her baby while another pumped the little cheeks of her young daughter to force her mouth open and give her an oral supplement. Nearby, adult patients sat in silence in plastic chairs with large white buckets between their legs, holding their head to one side with their arm. Some ate rice and red beans out of small containers that nurses later collected.

Marcou noted that people can survive cholera if treated in time, but the recent lack of fuel and ongoing violence between gangs that has worsened since the July 2021 assassination of President Jovenel Moïse has prevented Haitians from reaching hospitals and medical clinics.

“There’s a huge security crisis. And we are tremendously lacking resources,” said Ralph Ternier, chief medical officer in Haiti for the nonprofit Partners in Health. “The epidemic is spreading so quickly that vaccines are really the tool that we need.”

PAHO told the AP that it is supporting Haiti’s government in preparing a request for vaccines as well as to plan and implement vaccination campaigns. But it wasn’t clear if and when that might happen.

In October, the World Health Organization announced a worldwide cholera vaccine shortage that has forced it to suspend the usual double-dose strategy “at a time of unprecedented rise in cholera outbreaks worldwide.” At least 29 countries have reported cholera cases this year, compared with fewer than 20 on average for the past five years, the agency said.

Mayronne said cholera vaccines can be a useful tool but noted that a single dose can lower one’s risk by only 40%.

“In and of itself, a vaccine is not a be-all and end-all,” she said.

Amid the lack of vaccines in Haiti, crushing poverty made worse by a spiraling economic crisis and double-digit inflation is contributing to the spread of cholera because many are unable to access or afford potable water or food that isn’t contaminated.

Lovena Shelove, 30, lost her 2-year-old son to cholera despite a kind neighbor who brought drinking water to try to revive the toddler after severe bouts of vomiting and diarrhea.

“I don’t have anything in the house,” she said in a soft voice. “I could not afford anything to provide for the kids.”

Her other child, a 7-month-old daughter, is still hospitalized.

Cholera is easily transmitted, especially in crowded and unhygienic conditions. Sanitation further worsened during the fuel blockade because companies that supplied drinking water were forced to suspend operations.

Haiti’s first outbreak occurred in 2010 after U.N. peacekeepers introduced the bacteria into the country’s largest river by sewage runoff from their base. Nearly 10,000 people died, and thousands of others were sickened.

The number of cases eventually dwindled, and the World Health Organization was preparing to declare Haiti cholera-free until the government announced in early October that at least three people had died — the first deaths reported in three years.

Patrick Joseph, 40, was among the thousands recently hospitalized after he became severely dehydrated.

“I don’t know where I got cholera from,” he said, although he suspects it’s from the water he buys from a seller who claims it’s treated. “I feared that I would die if I did not go to the doctor.”

It’s a feeling familiar to street vendor Lucna Francois, who had been relying on well water because the fuel blockade prevented her from accessing potable water. The 24-year-old got so sick on a recent evening that she called a relative to take her to the hospital.

“I am dying,” she recalled telling them. “I was very, very weak.”

Fils, with Haiti’s health ministry, said another big challenge the government faces is that many people don’t believe cholera exists and are not taking measures to avoid becoming sick.

“Prevention, it’s a must,” he said. “It’s not just a matter of drinking (clean) water.”
…

The world’s population is projected to hit an estimated 8 billion people on Tuesday, according to a United Nations projection, with much of the growth coming from developing nations in Africa.

Among them is Nigeria, where resources are already stretched to the limit. More than 15 million people in Lagos compete for everything from electricity to light their homes to spots on crowded buses, often for two-hour commutes each way in this sprawling megacity. Some Nigerian children set off for school as early as 5 a.m.

And over the next three decades, the West African nation’s population is expected to soar even more: from 216 million this year to 375 million, the U.N. says. That will make Nigeria the fourth-most populous country in the world after India, China and the United States.

“We are already overstretching what we have — the housing, roads, the hospitals, schools. Everything is overstretched,” said Gyang Dalyop, an urban planning and development consultant in Nigeria.

The U.N.’s Day of 8 Billion milestone Tuesday is more symbolic than precise, officials are careful to note in a wide-ranging report released over the summer that makes some staggering projections.

The upward trend threatens to leave even more people in developing countries further behind, as governments struggle to provide enough classrooms and jobs for a rapidly growing number of youth, and food insecurity becomes an even more urgent problem.

Nigeria is among eight countries the U.N says will account for more than half the world’s population growth between now and 2050 — along with fellow African nations Congo, Ethiopia and Tanzania.

“The population in many countries in sub-Saharan Africa is projected to double between 2022 and 2050, putting additional pressure on already strained resources and challenging policies aimed to reduce poverty and inequalities,” the U.N. report said.

It projected the world’s population will reach around 8.5 billion in 2030, 9.7 billion in 2050 and 10.4 billion in 2100.

Other countries rounding out the list with the fastest growing populations are Egypt, Pakistan, the Philippines and India, which is set to overtake China as the world’s most populous nation next year.

In Congo’s capital, Kinshasa, where more than 12 million people live, many families struggle to find affordable housing and pay school fees. While elementary pupils attend for free, older children’s chances depend on their parents’ incomes.

“My children took turns” going to school, said Luc Kyungu, a Kinshasa truck driver who has six children. “Two studied while others waited because of money. If I didn’t have so many children, they would have finished their studies on time.”

Rapid population growth also means more people vying for scarce water resources and leaves more families facing hunger as climate change increasingly impacts crop production in many parts of the world.

“There is also a greater pressure on the environment, increasing the challenges to food security that is also compounded by climate change,” said Dr. Srinath Reddy, president of the Public Health Foundation of India. “Reducing inequality while focusing on adapting and mitigating climate change should be where our policy makers’ focus should be.”

Still, experts say the bigger threat to the environment is consumption, which is highest in developed countries not undergoing big population increases.

“Global evidence shows that a small portion of the world’s people use most of the Earth’s resources and produce most of its greenhouse gas emissions,” said Poonam Muttreja, executive director of the Population Foundation of India. “Over the past 25 years, the richest 10% of the global population has been responsible for more than half of all carbon emissions.”

According to the U.N., the population in sub-Saharan Africa is growing at 2.5% per year — more than three times the global average. Some of that can be attributed to people living longer, but family size remains the driving factor. Women in sub-Saharan Africa on average have 4.6 births, twice the current global average of 2.3.

Families become larger when women start having children early, and 4 out of 10 girls in Africa marry before they turn 18, according to U.N. figures. The rate of teen pregnancy on the continent is the highest in the world — about half of the children born last year to mothers under 20 worldwide were in sub-Saharan Africa.

Still, any effort to reduce family size now would come too late to significantly slow the 2050 growth projections, the U.N. said. About two-thirds of it “will be driven by the momentum of past growth.”

“Such growth would occur even if childbearing in today’s high-fertility countries were to fall immediately to around two births per woman,” the report found.

There are also important cultural reasons for large families. In sub-Saharan Africa, children are seen as a blessing and as a source of support for their elders — the more sons and daughters, the greater comfort in retirement.

Still, some large families “may not have what it takes to actually feed them,” says Eunice Azimi, an insurance broker in Lagos and mother of three.

“In Nigeria, we believe that it is God that gives children,” she said. “They see it as the more children you have, the more benefits. And you are actually overtaking your peers who cannot have as many children. It looks like a competition in villages.”

Politics also have played a role in Tanzania, where former President John Magufuli, who ruled the East African country from 2015 until his death in 2021, discouraged birth control, saying that a large population was good for the economy.

He opposed family planning programs promoted by outside groups, and in a 2019 speech urged women not to “block ovaries.” He even described users of contraceptives as “lazy” in a country he said was awash with cheap food. Under Magufuli, pregnant schoolgirls were even banned from returning to classrooms.

But his successor, Samia Suluhu Hassan, appeared to reverse government policy in comments last month when she said birth control was necessary in order not to overwhelm the country’s public infrastructure.

Even as populations soar in some countries, the U.N. says rates are expected to drop by 1% or more in 61 nations.

The U.S. population is now around 333 million, according to U.S. Census Bureau data. The population growth rate in 2021 was just 0.1%, the lowest since the country was founded.

“Going forward, we’re going to have slower growth — the question is, how slow?” said William Frey, a demographer at the Brookings Institution. “The real wild card for the U.S. and many other developed countries is immigration.”

Charles Kenny, a senior fellow at the Center for Global Development in Washington, says environmental concerns surrounding the 8 billion mark should focus on consumption, particularly in developed countries.

“Population is not the problem, the way we consume is the problem — let’s change our consumption patterns,” he said.
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Malaria exploded this year in the Ethiopian city of Dire Dawa, which saw more than 10 times as many cases between January and May as it did in all of 2019.

What made this spike in cases unusual is that it happened outside the rainy season, when malaria typically surges across Africa, and in an urban area — malaria is more of a rural problem on the continent. Cities are not immune, but they typically don’t see these kinds of outbreaks.

Something new and insidious has arrived in the Horn of Africa. An invasive species of mosquito called Anopheles stephensi threatens to unravel two decades of gains in malaria control. And it may bring the deadly disease to more of the continent’s rapidly growing cities.

“There is real fear that it could start more transmission in these areas that traditionally don’t have as much malaria,” said Arran Hamlet, a disease modeling expert with the U.S. Centers for Disease Control and Prevention. “And they don’t have infection control strategies implemented to the same levels.”

The new mosquito arrives at a bad time in the fight against malaria.

Africa’s native mosquitoes have become increasingly resistant to insecticides. (Anopheles stephensi is already resistant.) In addition, the malaria parasite is getting not only tougher to kill, but tougher to spot. Malaria strains that don’t show up on rapid diagnostic tests are becoming more common.

“We don’t want the three to meet — the drug resistance, the diagnostic resistance and the highly efficient vector [Anopheles stephensi],” said Fitsum Girma Tadesse, a molecular biologist at Ethiopia’s Armauer Hansen Research Institute.

“What happens if they coexist? We don’t know,” he said. “It’s really dangerous. You can’t detect the parasite. You can’t kill it with a drug. And the mosquito is wise enough to evade your [control] mechanisms.”

Fitsum and his colleagues linked Anopheles stephensi to the Dire Dawa outbreak in a study presented at the American Society of Tropical Medicine and Hygiene in Seattle this month. It is the strongest evidence yet that the mosquito is increasing malaria rates in Ethiopia.

A different mosquito

Malaria fighters started the millennium strong.

With insecticide-treated bed nets, indoor insecticide spraying campaigns and new artemisinin-based drugs, deaths from malaria plunged from nearly 900,000 in 2000 to around 560,000 in 2015. But since then, progress has stalled.

And the tools that have worked up until recently won’t help much against Anopheles stephensi.

“This [mosquito] is different and more insidious than some of the other mosquitoes that transmit malaria that we’re used to seeing in sub-Saharan Africa,” said Johns Hopkins Center for Communication Programs epidemiologist April Monroe.

Africa’s native malaria mosquitoes prefer to bite people inside their homes late at night. That’s why bed nets and indoor spraying have been so effective.

But Anopheles stephensi bites earlier in the evening. When it goes searching for a meal, “people aren’t actually in bed yet, and so they don’t get the same protection” from bed nets, Hamlet said.

It also prefers to take its blood meal outdoors. Or if it does bite indoors, it doesn’t rest there, thereby avoiding indoor insecticides.

The new mosquito’s habitat is different, too. Most malaria mosquitoes live in rural Africa. But Anopheles stephensi is “really highly adapted to urban areas, which isn’t what we typically see,” Monroe said.

It likes to lay its eggs in water storage containers, which are especially common in Africa’s fast-growing unplanned urban areas that lack piped water, Fitsum noted.

Newcomer

Originally from South Asia, Anopheles stephensi was first spotted on the African continent in Djibouti in 2012.

The small nation was on the verge of eliminating malaria at the time. It recorded just 27 cases that year. In 2020, there were more than 73,000.

Besides Djibouti and Ethiopia, the mosquito has turned up in Sudan, Somalia and Nigeria.

One study estimates the mosquito may put an additional 126 million people at risk of malaria in cities across Africa.

In Ethiopia alone, Hamlet and colleagues estimate that Anopheles stephensi could increase malaria cases by 50% and cost hundreds of millions of dollars to control.

“This is very much possibly a cheap option compared to letting Anopheles stephensi spread around the country,” Hamlet said. “There is a lot of economic burden on both individuals and the wider economy in this level of malaria increase.”

The last thing African countries need, however, is new disease vector that is expensive to control.

“Most of the countries affected by malaria have limited resources to deal with already existing prevalent diseases,” Fitsum said.

One bit of relatively good news is that since Anopheles stephensi breeds in the same places as the mosquitoes that carry yellow fever, chikungunya and dengue, efforts that target one would also control the others.

Fitsum says covering water containers with polystyrene beads can help prevent the mosquitoes from laying eggs. He advises people to cover water containers tightly and get rid of any they don’t need.

And keep using bed nets and indoor sprays, he added. Native mosquitoes are still out there.
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