Science

Cholera poses new risks for millions of Sudan’s displaced

GENEVA — U.N. agencies are scaling up cholera prevention and treatment programs to get on top of a new, deadly cholera outbreak in Sudan that threatens to further destabilize communities suffering from hunger and the ill effects of more than 16 months of conflict.

The recent cholera outbreak has resurged after several weeks of heavy rainfall and resulting flooding,” Kristine Hambrouck, UNHCR representative in Sudan, told journalists Friday in Geneva.

Speaking on a video-link from Port Sudan, she warned, “Risks are compounded by the continuing conflict and dire humanitarian conditions, including overcrowding in camps and gathering sites for refugees and Sudanese displaced by the war, as well as limited medical supplies and health workers.”

She expressed particular concern about the spread of the deadly disease in areas hosting refugees, mainly in Kassala, Gedaref and al-Jazirah states.

“In addition to hosting refugees from other countries, these states are also sheltering thousands of displaced Sudanese who have sought safety from ongoing hostilities,” she said.

The United Nations describes Sudan as the largest displacement crisis in the world.  Latest figures put the number of people displaced inside Sudan at more than 10.7 million, with an additional 2 million who have fled to neighboring countries as refugees.

Additionally, the UNHCR says Sudan continues to host tens of thousands of refugees from countries such as Ethiopia and Eritrea.

Sudan’s health ministry officially declared a cholera outbreak on August 12. In the one month since the first suspected cases were reported, the World Health Organization says 658 cholera cases and 28 deaths have been reported by five states, “with a high case-fatality ratio of 4.3%.”

Kassala has reported the highest number of cholera cases at 473, followed by Gedaref with 110 cases, and al-Jazairah with 51 cases. Two other states, Khartoum and River Nile, have reported fewer numbers.

“These cases are not linked to the previous cholera outbreak, which had been declared in September 2023,” said Dr. Shible Sahbani, the WHO representative to Sudan, noting that the outbreak “technically ended” in May 2024 after no cases were reported for two consecutive incubation periods.

Speaking from Port Sudan, Sahbani described the situation in Kassala as very worrisome. He said the state’s health system already was under stress because of the large number of displaced people and refugees living there. “So, the health system is not able to cope with the additional influx of refugees and IDPs [internally displaced persons].”

“But in addition to that, it puts a big burden on the WASH system — the water, sanitation, and hygiene system. So, this makes the situation more complicated in favor of the spread of cholera,” he said.

Besides the dangers posed by cholera, UNICEF representative Hambrouck also warns of an increasing number of cases of waterborne diseases, including malaria and diarrhea, which also need to be brought under control.

“Constraints in humanitarian access are also impacting response efforts. Violence, insecurity and persistent rainfall are hampering the transportation of humanitarian aid,” she said.

She noted that more than 7.4 million refugees and internally displaced Sudanese living in White Nile, Darfur and Kordofan states are having to do without “critical medicines and relief supplies” because of delays in delivery.

The WHO and UNHCR are working closely with Sudan’s Ministry of Health to coordinate the cholera outbreak response. Among its many initiatives, UNHCR says it is working with health partners to strengthen surveillance, early warning systems and contact tracing in affected locations.

“Disease surveillance and testing are ongoing, and awareness-raising and training on cholera case management for health staff are also being conducted,” said Hambrouck.

For its part, Sahbani said the WHO has prepositioned cholera kits and other essential medical supplies “in high-risk states in anticipation of the risks associated with the rainy season.”

He said the WHO was spearheading a cholera vaccination campaign, noting that “a three-day oral cholera vaccination campaign in two localities of Kassala state concluded Thursday.”

He said the campaign already has used 51,000 doses and “the good news is that we got the approval of an additional 155,000 doses of cholera vaccine. So, this is the good news in the middle of this horrible crisis.”

One dose of the vaccine, he said, would protect the population against cholera for six months, while two doses would provide protection for up to three years.

“So, this is really good news because this will help us to contain the outbreak,” he said.  Without more funding, however, he warned the good news will quickly evaporate, noting that the WHO has received just one-third of its $85.6 million appeal.

“This will indeed limit our capacity to launch a robust response to reach a larger segment of the people in need,” he said.

His UNHCR colleague, Hambrouck, echoed the sentiments.

“With the humanitarian situation and funding level already precarious prior to this latest cholera outbreak, funds are desperately needed to support the provision of health care and other life-saving aid,” she said.

Cholera spreads as Sudan grapples with rains and displacement

Port Sudan — For the second consecutive year Sudan is in the grip of a cholera outbreak that has left at least 28 people dead in the last month as rains fall in areas crammed with those fleeing the country’s 16-month-old war, officials said.

Since July 22, when the current wave began, 658 cases of cholera have been recorded across five states, World Health Organization (WHO) country director Shible Sahbani told Reuters in Port Sudan.

With much of the country’s health infrastructure collapsed or destroyed and staffing thinned by displacement, 4.3% of cases have resulted in deaths, a high rate compared to other outbreaks, Sahbani said.

Some 200,000 are at high risk of falling ill, he said.

The war between the army and the paramilitary Rapid Support Forces (RSF) has created one of the world’s largest humanitarian crises and displaced more than 10 million people inside Sudan and beyond its borders.

The country is dealing with a total of five concurrent disease outbreaks include dengue fever and measles.

The RSF has advanced across swathes of Sudan, where people have been cut off from aid as the army has withheld access and RSF soldiers loot supplies and hospitals. Efforts to deliver aid to the western region of Darfur have been complicated by rains.

International experts have determined that there is a famine in Darfur’s Zamzam camp, an area flooded in the rains and highly susceptible to cholera.

About 12,000 cases and more than 350 deaths were registered in the previous cholera wave between October 2023 and May 2024, health minister Haitham Mohamed Ibrahim said, adding that there had been no major outbreak in the nine years before the war.

The current outbreak is centered in Kassala and Gedaref states, which host 1.2 million displaced people.

In Gedaref, a Reuters reporter filmed pools of water attracting insects and large ponds of stagnant rain water mixing with refuse. A local official said that the vast majority of diseases were caused by insects, poor water quality, and sewage.

Many people fleeing raids by the RSF shelter in crowded, makeshift displacement centers, where lavatories have overflowed as heavier-than-usual rains continue to fall. Cholera is transmitted from food and water contaminated with infected feces and thrives in such conditions.

Sahbani said that states like Khartoum and Gezira, largely controlled by the RSF, had also seen cholera cases, while states in the Kordofan and Darfur regions could likely see outbreaks.

“The challenge is getting supplies to the areas we need them. Due to the rainy season many roads are not usable now, but also there are security constraints and bureaucratic constraints,” he said.

On Friday, he told reporters in a virtual briefing that the International Coordinated Group for vaccine allocation (ICG) had approved delivery of 455,000 cholera vaccine doses to Sudan, some “good news in the middle of this horrible crisis.”

Ibrahim said the army-aligned government had used “unorthodox measures” including air drops to try to get vaccines and supplies into those RSF-controlled areas as well as isolated army-controlled areas.

Both officials emphasized that the need in Sudan far outweighed the aid effort, particularly as the U.N.’s humanitarian appeal for Sudan is only about one-third funded.

 

Second set of giant panda cubs born in Berlin

BERLIN — The Berlin Zoo announced Friday that longtime resident giant panda Meng Meng has given birth to twins — for a second time.

The cubs were born on Thursday, the zoo said in a statement. They were born only 11 days after ultrasound scans showed that Meng Meng, 11, was pregnant. Their sex has not yet been determined “with certainty.”

“Now it’s time to keep your fingers crossed for the critical first few days,” the zoo said. The cubs are tiny, weighing just 169 grams and 136 grams respectively, and are about 14 centimeters long.

As with other large bears, giant pandas are born deaf, blind and pink. Their black-and-white panda markings only develop later.

“I am relieved that the two were born healthy,” zoo director Andreas Knieriem said. “The little ones make a lively impression and mom Meng Meng takes great care of her offspring.”

The zoo said that giant pandas usually only raise one cub when they give birth to twins, so it will “actively support” Meng Meng’s cub care in cooperation with two experts from China’s Chengdu Research Base of Giant Panda Breeding who are in the German capital.

“With around 20 births a year, they have much more experience and are better able to assess development,” panda curator Florian Sicks said.

The cubs will alternate being with their mother every two to three hours to drink milk and are otherwise being cared for in an incubator donated by a Berlin hospital.

Meng Meng and male panda Jiao Qing arrived in Berlin in 2017. In August 2019, Meng Meng gave birth to male twins Pit and Paule, also known by the Chinese names Meng Xiang and Meng Yuan, the first giant pandas born in Germany.

The twins were a star attraction in Berlin, but they were flown to China in December — a trip that was contractually agreed from the start but delayed by the COVID-19 pandemic. China gifted friendly nations with its unofficial mascot for decades as part of a “panda diplomacy” policy. The country now loans pandas to zoos on commercial terms.

Giant pandas have difficulty breeding and births are particularly welcomed. There are about 1,800 pandas living in the wild in China and a few hundred in captivity worldwide.

Meng Meng was artificially inseminated on March 26. Female pandas are fertile only for a few days per year at the most.

The new arrivals and their mother won’t be on show to the public for the time being — but visitors can still see Jiao Qing, 14, as male pandas don’t get involved in rearing cubs.

Volcano in Iceland erupts for sixth time since December

COPENHAGEN, denmark — A volcano in southwestern Iceland erupted on Thursday, the meteorological office said, spraying red-hot lava and smoke in its sixth outbreak since December.

“An eruption has begun. Work is under way to find out the location of the recordings,” the Icelandic Met Office, which is tasked with monitoring volcanoes, said in a statement.

The total length of the fissure was about 3.9 kilometers (2.42 miles) and had extended by 1.5 kilometers (.93 mile) in about 40 minutes, it said.

Livestreams from the volcano on the Reykjanes peninsula showed glowing hot lava shooting from the ground.

Studies had shown magma accumulating underground, prompting warnings of new volcanic activity in the area just south of Iceland’s capital, Reykjavik.

The most recent eruption on the Reykjanes peninsula, home to 30,000 people or nearly 8% of the country’s total population, ended on June 22 after spewing fountains of molten rock for 24 days.

The eruptions show the challenge faced by the island nation of nearly 400,000 people as scientists warn that the Reykjanes peninsula could face repeated outbreaks for decades or even centuries.

Since 2021, there have been nine eruptions on the peninsula, following the reactivation of geological systems that had been dormant for 800 years.

In response, authorities have constructed barriers to redirect lava flows away from critical infrastructure, including the Svartsengi power plant, the Blue Lagoon outdoor spa and the town of Grindavik.

Flights were unaffected, Reykjavik’s Keflavik Airport said on its web page, but the nearby Blue Lagoon luxury geothermal spa and hotel said it had shut down and evacuated its guests.

Volcanic outbreaks in the Reykjanes peninsula are so-called fissure eruptions, which do not usually disrupt air traffic as they do not cause large explosions or significant dispersal of ash into the stratosphere.

Iceland, which is roughly the size of the U.S. state of Kentucky, boasts more than 30 active volcanoes, making the north European island a prime destination for volcano tourism.

UN agencies help in attempts to contain mpox in south, east Africa

Harare, Zimbabwe — The United Nations said Thursday it is working with governments and health officials in Eastern and Southern Africa to contain the outbreak of mpox there.

UNICEF, the World Health Organization and the Africa Centers for Disease Control and Prevention, along with local partners, are responding to the spread of the new mpox clade 1b variant, said Etleva Kadilli, UNICEF’s regional director for Eastern and Southern Africa.

Kadilli said in a statement that more than 200 confirmed cases have been detected in five countries: Burundi, Kenya, Rwanda, South Africa and Uganda.

Dr. Francis Kasolo, director and head of the WHO at the African Union and U.N. Economic Commission for Africa, told a joint WHO-Africa CDC meeting, “Our collaboration has been instrumental in enhancing surveillance, laboratory capacity and effective deployment of technical capacity to countries. Together we are making progress.”

But, he said, there is still much to be done.

It is imperative that we remain vigilant and proactive in our efforts to combat mpox. This means not only addressing it in the immediate needs, but also investing in long-term strategies that will build resilient health systems capable of withstanding future outbreaks and shocks,” Kasolo said.

Last week, the WHO declared mpox a public health emergency of international concern following a surge of mpox in the Democratic Republic of Congo and a growing number of other African countries.

An earlier emergency was declared in 2022. The U.N. agency said that one was declared over in May 2023.

Botswana and Zimbabwe are now screening for mpox after their neighbor, South Africa, recorded three deaths from the new strain. Zimbabwe is screening for the viral ailment at all ports of entry.

“We have said all those who present [high fever] and rash should be thoroughly investigated — where they are coming from and for how long they have been there and possible contact with people who have monkey pox,” Zimbabwean Health Minister Douglas Mombeshora said, referring to mpox’s previous name.

“We have kits to do tests for monkey pox,” he said. “So yes, we are on a very high alert. … I know there was a scare a few days ago. Some people were reporting on social media that there were people who had presented with some rash. They thought it was monkey pox. We did not take it for granted. The patient was said to have tested negative.”

Dr. Norman Matara of Zimbabwe Doctors for Human Rights said that given the country’s poor health care system, keeping mpox out is better than trying to contain it after cases appear.

“It saves the nation a lot of money because treatment is always expensive,” he said. “It also prevents us from unnecessary lockdown restrictions of movements … like what we saw with COVID-19.”

For now, he said, there is no need to panic.

“At the moment we have not recorded any case of mpox. … We just need to increase our health surveillance so that anyone with symptoms can be isolated and they can be screened and any case can be easily identified and minimize the virus spreading in the country,” Matara said.

Dr. Matshidiso Moeti, the WHO regional director for Africa, told VOA this week that the Democratic Republic of Congo was the “epicenter” of mpox. She said front-line health workers in affected areas should be given priority on vaccinations against the ailment.

“The issue of access to vaccines is something which we are working on collectively at the international level,” she said. “This is really a case of negotiating with pharmaceutical companies that are able to produce the vaccine to ensure they scale up their production and increase availability of vaccines.”

Besides a rash, other symptoms of the viral infection can include lesions, muscle aches and swollen lymph glands. Most people fully recover, but some become very ill and die.

Thailand says mpox case recorded in traveler from Africa 

BANGKOK — Thailand has detected an mpox case in a European man who arrived from Africa last week and is awaiting test results to determine the strain, a disease control official said on Wednesday.  

Thai authorities were treating the case as if it were the Clade 1 form of mpox, as the person, a 66-year-old European man with residency in Thailand, had arrived on Aug. 14 from an African country where it was spreading, Thongchai Keeratihattayakorn, director-general of the Department of Disease Control, told Reuters.  

“After he arrives from the flight there is very little time frame where he come into contact with others,” Thongchai said. “He arrives around 6 pm and on the next day, Aug 15, he went to see the doctor at the hospital.” 

Thongchai said the man has undergone a test to determine whether the case was a Clade 1 variant, with the result expected by Friday. Authorities are also monitoring 43 people in the country who may come into contact with the patient, he said. 

The director-general did not name the African country the man had been in. He said the man had transited in a Middle Eastern country, which he also did not name, before flying on to Thailand. 

Thailand has detected 800 cases of mpox Clade 2 since 2022, but so far not detected a case of the Clade 1 or Clade 1b variants. 

 

Botswana begins mpox screening at entry points

Gaborone, Botswana — Health officials in Botswana have started screening travelers for mpox at the country’s entry points. 

Neighboring South Africa has recorded three deaths as a result of the dangerous strain of mpox, and Botswana is anxious to keep out the rapidly spreading disease.

“Although we have not recorded any case of mpox in Botswana, I want to take this opportunity to assure Botswana that we have significantly enhanced our broader surveillance systems,” the country’s minister of health, Dr Edwin Dikoloti, told the media Tuesday. “We are currently intensifying our surveillance at key entry points, which is borders and airports, focusing on high-risk areas.”

South Africa shares a 1,900-kilometer border with Botswana and as of Aug. 5 had recorded three mpox deaths. In Africa, the disease has claimed the lives of more than 500 people since the beginning of the year.

Botswana Public Health Institute Acting Director Dr. Thebeyame Matsheka says travelers will be required to fill out self-assessment forms at border checkpoints.

“There are sometimes where, through just random checks, we might identify someone who appears not to be well, they will take those travelers aside and investigate further,” Matsheka said.

Meanwhile, Dikoloti said Botswana is engaging with international partners for the supply of vaccines.

According to Africa’s Centers for Disease Control and Prevention, the continent has about 200,000 vaccine doses against a requirement of at least 10 million doses.

Medication to be used for the management of mpox is available at health facilities throughout the country.

“Vaccines exist for mpox but they are not widely available,” Dikoloti added. 

The World Health Organization country representative, Juliet Bataringaya, says the scale of the mpox vaccination will not be broad because the disease affects countries differently.

“We need to have a good understanding of the epidemiology in each and every country, because it is different and to understand the transmission patterns,” Bataringaya said. “These will then guide on the use of vaccines in a more targeted way to have maximum public health impact.”

She said there won’t be the kind of mass vaccination effort implemented during the COVID pandemic because the modes of transmission are different.

WHO official: Mpox is not the new COVID

Berlin — A World Health Organization official stressed on Tuesday that mpox, regardless of whether it is the new or old strain, is not the new COVID, as authorities know how to control its spread.

“We can and must tackle mpox together,” said Hans Kluge, WHO regional director for Europe, in a U.N. media briefing.

“So will we choose to put the systems in place to control and eliminate mpox globally? Or we will enter another cycle of panic and neglect? How we respond now and in the years to come will prove a critical test for Europe and the world,” he added.

Mpox, a viral infection that causes pus-filled lesions and flu-like symptoms, is usually mild but can kill.

The clade 1b variety has caused global concern because it seems to spread more easily though routine close contact.

A case of the variant was confirmed last week in Sweden and linked to a growing outbreak in Africa, the first sign of its spread outside the continent. The WHO declared the recent outbreak of the disease a public health emergency of international concern after the new variant was identified.

Kluge said that the focus on the new clade 1 strain will also help in the fight against the less severe clade 2 variety that has spreading globally since 2022, allowing Europe to improve its response through better health advice and surveillance.

About 100 new cases of the clade 2 mpox strain are now being reported in the European region every month, added Kluge.

Mpox transmits through close physical contact, including sexual contact, but unlike previous global pandemics such as COVID-19 there is no evidence it spreads easily through the air.

Health authorities need to be on alert and flexible in case there are new, more transmissible clades or ones that change their transmission route, but there are no recommendations for people to wear masks, said WHO spokesperson Tarik Jasarevic.

 

Cholera outbreak in Sudan has killed 22 people, health minister says

Cairo — Sudan has been stricken by a cholera outbreak that has killed nearly two dozen people and sickened hundreds more in recent weeks, health authorities said Sunday. The African nation has been roiled by a 16-month conflict and devastating floods.

 

Health Minister Haitham Mohamed Ibrahim said in a statement that at least 22 people have died from the disease, and that at least 354 confirmed cases of cholera have been detected across the county in recent weeks.

 

Ibrahim didn’t give a time frame for the deaths or the tally since the start of the year. The World Health Organization, however, said that 78 deaths were recorded from cholera this year in Sudan as of July 28. The disease also sickened more than 2,400 others between Jan. 1 and July 28, it said.

 

Cholera is a fast-developing, highly contagious infection that causes diarrhea, leading to severe dehydration and possible death within hours when not treated, according to WHO. It is transmitted through the ingestion of contaminated food or water.

 

The cholera outbreak is the latest calamity for Sudan, which was plunged into chaos in April last year when simmering tensions between the military and a powerful paramilitary group exploded into open warfare across the country.

 

The conflict has turned the capital, Khartoum and other urban areas into battlefields, wrecking civilian infrastructure and an already battered health care system. Without the basics, many hospitals and medical facilities have closed their doors.

It has killed thousands of people and pushed many into starvation, with famine already confirmed in a sprawling camp for displaced people in the wrecked northern region of Darfur.

 

Sudan’s conflict has created the world’s largest displacement crisis. More than 10.7 million people have been forced to flee their homes since fighting began, according to the International Organization for Migration. Over 2 million of those fled to neighboring countries.

 

The fighting has been marked by atrocities including mass rape and ethnically motivated killings that amount to war crimes and crimes against humanity, according to the U.N. and international rights groups.

 

Devastating seasonal floods in recent weeks have compounded the misery. Dozens of people have been killed and critical infrastructure has been washed away in 12 of Sudan’s 18 provinces, according to local authorities. About 118,000 people have been displaced due to the floods, according to the U.N. migration agency.

 

Cholera is not uncommon in Sudan. A previous major outbreak left at least 700 dead and sickened about 22,000 in less than two months in 2017.

 

Tarik Jasarevic, a spokesperson for WHO, said the outbreak began in the eastern province of Kassala before spreading to nine localities in five provinces.

 

He said in comments to The Associated Press that data showed that most of the detected cases were not vaccinated. He said the WHO is now working with the Sudanese health authorities and partners to implement a vaccination campaign.

 

Sudan’s military-controlled sovereign council, meanwhile, said Sunday it will send a government delegation to meet with American officials in Cairo amid mounting U.S. pressure on the military to join ongoing peace talks in Switzerland that aim at finding a way out of the conflict.

 

The council said in a statement the Cairo meeting will focus on the implementation of a deal between the military and the Rapid Support Forces, which required the paramilitary group to pull out from people’s homes in Khartoum and elsewhere in the country.

 

The talks began Aug. 14 in Switzerland with diplomats from the U.S., Saudi Arabia, Egypt, the United Arab Emirates, the African Union and the United Nations attending. A delegation from the RSF was in Geneva but didn’t join the meetings.

Magnitude 7 earthquake strikes off coast of Russia’s Kamchatka region

moscow — A magnitude 7.0 earthquake struck off the coast of Russia’s far-eastern Kamchatka Peninsula early Sunday morning local time, according to the regional earthquake monitoring service.

The local emergencies ministry said tremors were felt along the coast including in the region’s capital Petropavlovsk-Kamchatsky.

“Operational teams of rescuers and firefighters are inspecting buildings,” the regional branch of Russia’s emergencies ministry in the Kamchatka region said on Telegram.

The earthquake struck at a depth of nearly 50 kilometers just after 7 a.m. local time, some 90 kilometers east of Petropavlovsk-Kamchatsky, the United States Geological Survey reported.

The U.S. National Tsunami Warning Center had initially issued a tsunami threat, but later said the threat had passed. Local authorities never issued a tsunami alert.

Several aftershocks were recorded after the initial quake, but of lower intensity, the Kamchatka branch of Russia’s Unified Geophysical Service reported on its website.

“Most of the aftershocks are imperceptible,” the regional emergency authority said on Telegram.

The peninsula lies on a seismically active belt surrounding most of the Pacific Ocean known as the “Ring of Fire,” and is home to more than two dozen active volcanoes. 

Rare deep-sea oarfish found in California, scientists want to know why

SAN DIEGO — A rarely seen deep-sea fish resembling a serpent was found floating dead on the ocean surface off the San Diego coast and was brought ashore for study, marine experts said. 

The silvery, 12-foot-long (3.6-meter) oarfish was found last weekend by a group of snorkelers and kayakers in La Jolla Cove, north of downtown San Diego, in the U.S. state of California, the Scripps Institution of Oceanography said in a statement. 

It’s only the 20th time an oarfish is known to have washed up in California since 1901, according to institution fish expert Ben Frable. 

Scripps noted that oarfish have a mythical reputation as predictors of natural disasters or earthquakes, although no correlation has been proven. 

Oarfish can grow longer than 20 feet (6 meters) and normally live in a deep part of the ocean called the mesopelagic zone, where light cannot reach, according to the National Oceanic and Atmospheric Administration. 

Swimmers brought the La Jolla Cove oarfish to shore atop a paddleboard. It was then transferred to the bed of a pickup truck. 

Scientists from NOAA Southwest Fisheries Science Center and Scripps planned a necropsy Friday to try to determine the cause of death. 

India’s doctors strike in protest of rape, murder of colleague

KOLKATA/BHUBANESWAR, India — Hospitals and clinics across India turned away patients except for emergency cases on Saturday as medical professionals staged a 24-hour shutdown in protest over the rape and murder of a doctor this month in the eastern city of Kolkata.

More than 1 million doctors were expected to join the strike, paralyzing medical services across the world’s most-populous nation. Hospitals said faculty from medical colleges had been pressed into service for emergency cases.

The government, in a statement issued on Saturday after a meeting with representatives of medical associations, urged doctors to return to duties in the public interest. The government would set up a committee to suggest measures to improve protection for health care professionals, it said.

In response, the Indian Medical Association said it was studying the government offer, but it did not call off the strike, which was due to end at 6 a.m. Sunday.

The walk-out was the latest action in response to the killing of a 31-year-old trainee doctor last week inside the medical college in Kolkata where she worked.

The crime has triggered nationwide protests among medical workers and a public outpouring of anger over violence against women reminiscent of what followed the notorious gang rape and murder of a 23-year-old student on a bus in New Delhi in 2012.

No elective procedures

The strike halted access to elective medical procedures and out-patient consultations, according to the Indian Medical Association, or IMA.

There was a heavy police presence outside Kolkata’s RG Kar Medical College, where the woman was killed, while the hospital premises were deserted, according to the ANI news agency.

Mamata Banerjee, the chief minister of West Bengal, which includes Kolkata, has backed the protests across the state. Her government announced on Saturday evening measures to improve security for women working night shifts, including designated rest rooms and safe zones monitored by cameras.

It also asked private institutions to consider measures such as night patrols to make the working environment more secure for women.

India’s Central Bureau of Investigation has so far detained one suspect in the case.

The CBI summoned some medical students from the college as part of its investigation, according to a police source in Kolkata, who said the agency also questioned the principal of the hospital on Friday.

There were protests throughout the day in Kolkata, led by doctors, civil society members and political leaders. Many private clinics and diagnostic centers were closed.

Dr. Sandip Saha, a private pediatrician in the city, told Reuters he would not attend to patients except in emergencies.

Hospitals and clinics in Lucknow in Uttar Pradesh, Ahmedabad in Gujarat, Guwahati in Assam and Chennai in Tamil Nadu and other cities joined the strike, set to be one of the largest shutdowns of hospital services in recent memory.

Patients queue at hospitals

Patients queued at hospitals, some unaware that they would not get medical attention.

“I have spent 500 rupees [$6] on travel to come here. I have paralysis and a burning sensation in my feet, head and other parts of my body,” an unidentified patient at SCB Medical College Hospital in the city of Cuttack in Odisha told local television.

“We were not aware of the strike. What can we do? We have to return home.”

Raghunath Sahu, 45, who had lined up at SCB Medical College and Hospital in Cuttack, told Reuters a daily quota set by the doctors to see patients had ended before noon.

“I have brought my ailing grandmother. They did not see her today. I will have to wait for another day and try again,” Sahu said.

India’s government introduced sweeping changes to the criminal justice system, including tougher sentences, after the 2012 Delhi gang-rape, but campaigners say little has changed and not enough has been done to deter violence against women.

“Women form the majority of our profession in this country.

Time and again, we have asked for safety for them,” IMA President R.V. Asokan told Reuters on Friday.

The IMA has called for further legal measures to better protect health care workers from violence.

Nigeria records mpox cases amid global health emergency

ABUJA, NIGERIA — Barely 48 hours after the World Health Organization declared mpox a global health emergency, Nigeria went on high alert Friday, announcing new mpox cases and raising concerns about the country’s ability to contain the outbreak.

The Nigeria Center for Disease Control and Prevention, or NCDC, said it has recorded 39 cases of mpox so far this year amid a surge in infections across Africa. No deaths have been recorded in Nigeria.

Bayelsa, Cross River, Ogun and Lagos states are the most affected by the outbreak.

Speaking at a news conference, NCDC lead Dr. Olajide Idris said that the nation is ramping up its response to manage the spread of the virus and prevent the disease from being imported.

Mpox is a rare viral zoonotic disease, meaning it is primarily an animal disease that can be transmitted to humans. It is endemic in several African countries, with over 2,800 cases reported across 13 countries this year, claiming more than 500 lives.

Symptoms include fever, body aches, weakness, headaches and rashes.

With a more lethal strain emerging, Idris said that vaccination plans are being considered for high-risk populations.

“The Nigerian government is making effort to make vaccines available to the public, especially for the hotspot areas,” he said. “These vaccines have been shown to have a favorable safety profile. They are not yet in the country, but they are on their way.”

Olayinka Badmus, deputy project director for Global Health Security, Breakthrough Action Nigeria, said the new strain poses a higher risk.

“This particular strain is new, and anything new requires new learning. The things that we have seen related to this particular strain is the fact that it is spreading quite fast, the presenting symptoms — especially the rash — are widespread,” she said, meaning that the rash is all over the body.

“We are also seeing more children affected with mpox compared to the other strains,” Badmus said.

Another cause for concern, she said, is that this strain has “a higher human-to-human transmission at an accelerated rate.”

Idris stressed the need for public awareness in containing the spread and urged people to seek medical attention if they experience symptoms.

“We encourage everybody feeling feverish, muscle pain, sore throat to please visit the nearest health care facility,” he said.

Public health experts are also urging people to adhere to preventive measures such as avoiding contact with potentially infected animals and practicing good hygiene.

DR Congo’s humanitarian crisis helped mpox spiral into a global health emergency

GOMA, Democratic Republic of Congo — Sarah Bagheni had a headache, fever, and itchy and unusual skin lesions for days, but she had no inkling that her symptoms might have been caused by mpox and that she might be another case in a growing global health emergency. 

She also has no idea where to go to get medical help. 

She and her husband live in the Bulengo displacement camp in eastern Congo, a region that is effectively ground zero for a series of mpox outbreaks in Africa.

This year’s alarming rise in cases, including a new form of the virus identified by scientists in eastern Congo, led the World Health Organization to declare it a global health emergency on Wednesday. It said the new variant could spread beyond the five African countries where it had already been detected — a timely warning that came a day before Sweden reported its first case of the new strain.

In the vast central African nation of Congo, which has had more than 96% of the world’s roughly 17,000 recorded cases of mpox this year — and some 500 deaths from the disease — many of the most vulnerable seem unaware of its existence or the threat that it poses.

“We know nothing about this,” Bagheni’s husband, Habumuremyiza Hire, said Thursday about mpox. “I watch her condition helplessly because I don’t know what to do. We continue to share the same room.”

Millions are thought to be out of reach of medical help or advice in the conflict-torn east, where dozens of rebel groups have been fighting Congolese army forces for years over mineral-rich areas, causing a huge displacement crisis. Hundreds of thousands of people like Bagheni and her husband have been forced into overcrowded refugee camps around Goma, while more have taken refuge in the city.

Conditions in the camps are dire and medical facilities are almost nonexistent.

Mahoro Faustin, who runs the Bulengo camp, said that about three months ago, administrators first started noticing people in the camp exhibiting fever, body aches and chills — symptoms that could signal malaria, measles or mpox.

There is no way of knowing how many mpox cases there might be in Bulengo because of a lack of testing, he said. There haven’t been any recent health campaigns to educate the tens of thousands of people in the camp about mpox, and Faustin said he’s worried about how many people might be undiagnosed.

“Just look at the overcrowding here,” he said, pointing to a sea of ramshackle tents. “If nothing is done, we will all be infected here, or maybe we are already all infected.”

Around 70% of the new mpox cases in the Goma area in the last two months that were registered at a treatment center run by Medair were from displacement camps, said Dr. Pierre Olivier Ngadjole, the international aid group’s health advisor in Congo. The youngest of those cases was a month-old baby and the oldest a 90-year-old, he said.

In severe cases of mpox, people can develop lesions on the face, hands, arms, chest and genitals. While the disease originated in animals, the virus has in recent years been spreading between people via close physical contact, including sex.

Bagheni’s best hope of getting a diagnosis for her lesions is a government hospital that’s a two-hour drive away. That’s likely out of the question, given that she already struggles with mobility having previously had both her legs amputated.

Seven million people are internally displaced in Congo, with more than 5.5 million of them in the country’s east, according to the U.N. refugee agency. Congo has the largest displacement camp population in Africa, and one of the largest in the world.

The humanitarian crisis in eastern Congo has almost every possible complication when it comes to stopping an mpox outbreak, said Dr. Chris Beyrer, director of Duke University’s Global Health Institute.

That includes war, illicit mining industries that attract sex workers, transient populations near border regions, and entrenched poverty. He also said the global community missed multiple warning signs.

“We’re paying attention to it now, but mpox has been spreading since 2017 in Congo and Nigeria,” Beyrer said, adding that experts have long been calling for vaccines to be shared with Africa, but to little effect. He said the WHO’s emergency declaration was “late in coming,” with more than a dozen countries already affected.

Beyrer said that unlike COVID-19 or HIV, there’s a good vaccine and good treatments and diagnostics for mpox, but “the access issues are worse than ever” in places like eastern Congo.

In 2022, there were outbreaks in more than 70 countries around the world, including the United States, which led the WHO to also declare an emergency that lasted until mid-2023. It was largely shut down in wealthy countries within months through the use of vaccines and treatments, but few doses have been made available in Africa.

The new and possibly more infectious strain of mpox was first detected this year in a mining town in eastern Congo, about 450 kilometers south of Goma. It’s unclear how much the new strain is to blame, but Congo is now enduring its worst outbreak yet and at least 13 African countries have recorded cases, four of them for the first time.

The outbreaks in those four countries — Burundi, Kenya, Rwanda and Uganda — have been linked to Congo’s, and Doctors Without Borders said Friday that Congo’s surge “threatens a major spread of the disease” to other countries.

Salim Abdool Karim, an infectious disease expert who chairs the Africa Centers for Disease Control and Prevention’s emergency committee, said the Congo outbreak has a particularly concerning change, in that it’s disproportionately affecting young people. Children under 15 account for 70% of cases and 85% of all deaths in the country, the Africa CDC reported.

Unlike the 2022 global outbreak, which predominantly affected gay and bisexual men, mpox now appears to be spreading in heterosexual populations.

All of Congo’s 26 provinces have recorded mpox cases, according to the state-run news agency. But Health Minister Samuel-Roger Kamba said Thursday that the country doesn’t have a single vaccine dose yet and he pleaded for “vigilance in all directions from all Congolese.”

Dr. Rachel Maguru, who heads the multi-epidemic center at Goma’s North Kivu provincial hospital, said they also don’t have drugs or any established treatments for mpox and are relying on other experts such as dermatologists to help where they can. A larger outbreak around the city and its numerous displacement camps already overburdened with an influx of people would be “terrible,” she said.

She also noted a pivotal problem: poor and displaced people have other priorities, like earning enough money to eat and survive. Aid agencies and stretched local authorities are already wrestling with providing food, shelter and basic health care to the millions displaced, while also dealing with outbreaks of other diseases like cholera.

Europe warned to prepare for mpox as Pakistan reports first case

Stockholm — Health authorities warned Friday that Europe must be ready for more cases of a deadly strain of mpox that has killed hundreds of people in the Democratic Republic of Congo.

The World Health Organization urged pharmaceutical firms to ramp up vaccine production and China said it would screen travelers for the disease after the first cases of the more deadly strain to be recorded outside Africa were announced in Sweden and Pakistan.

France’s Prime Minister Gabriel Attal said his country was on the “highest alert” and would implement “new recommendations” for travelers to risk areas.

Mpox is caused by a virus transmitted to humans by animals but can also spread human-to-human through close physical contact.

It causes fever, muscular aches and large boil-like skin lesions.

The WHO on Wednesday declared the rapid spread of the new Clade 1b strain an international public health emergency — the agency’s highest alert.

This follows the spread of the more deadly mpox from Democratic Republic of Congo (DRC) to other African countries.

“We do need the manufacturers to really scale up so that we’ve got access to many, many more vaccines,” WHO spokesperson Margaret Harris told reporters.

The WHO is asking countries with vaccine stockpiles to donate them to countries with outbreaks.

Harris said mpox was “particularly dangerous for those with a weak immune system, so people who maybe have HIV or are malnourished,” and was also dangerous for small children.

The United States has said it will donate 50,000 doses of an mpox vaccine to DRC and Attal said France would also send vaccines to risk countries.

Danish drugmaker Bavarian Nordic said Thursday it would be ready to make up to 10 million doses of its mpox vaccine by 2025 but that it needed contracts to start production.

The Stockholm-based European Center for Disease Prevention and Control (ECDC) said the overall risk in Europe was “low.” But it warned that “effective surveillance, laboratory testing, epidemiological investigation and contact tracing capacities will be vital to detecting cases.”

“Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases,” ECDC director Pamela Rendi-Wagner said in a statement.

Hundreds killed in DRC

The virus has swept across DRC, killing 548 people so far this year, the government said Thursday.

Nigeria has recorded 39 mpox cases this year, but no deaths, according to its health authorities. Previously unaffected countries such as Burundi, Kenya, Rwanda and Uganda have reported outbreaks, according to the Africa Centers for Disease Control and Prevention.

Sweden’s Public Health Agency announced Thursday it had registered a case of Clade 1b.

The patient was infected during a visit to “the part of Africa where there is a major outbreak of mpox Clade 1,” epidemiologist Magnus Gisslen said in a statement.

The mpox strain in the Pakistan case was not immediately known, the country’s health ministry said in a statement.

It said the patient, a 34-year-old man, had “come from a Gulf country.”

China announced it would begin screening people and goods entering the country for mpox over the next six months.

People arriving from countries where outbreaks have occurred, who have been in contact with mpox cases or display symptoms should “declare to customs when entering the country,” China’s customs administration said.

Vehicles, containers and items from areas with mpox cases should be sanitized, it added in a statement.

Vaccination drive

Mpox has two subtypes: the more virulent and deadlier Clade 1, endemic in the Congo Basin in central Africa; and Clade 2, endemic in West Africa.

A worldwide outbreak beginning in 2022 involving the Clade 2b subclade caused some 140 deaths out of about 90,000 cases, mostly affecting gay and bisexual men.

France reported 107 cases of the milder mpox variant between January 1 and June 30 this year.

The WHO’s European regional office in Copenhagen said the Sweden case was “a clear reflection of the interconnectedness of our world.”

But it added: “Travel restrictions and border closures don’t work and should be avoided.”