Thanks to a new law, California residents who do not identify as either male or female can choose a third option on their driver’s licenses and birth certificates. VOA’s Genia Dulot spoke with a Berkeley resident who is that third option, known as non-binary.
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Disneyland has shut down and decontaminated two cooling towers following an outbreak of Legionnaires’ disease that sickened 12 people, nine of them guests or employees at the theme park in Anaheim, county health officials said Saturday.

One of the three cases of the respiratory illness not linked to Disneyland was fatal in an individual who had additional health issues, said Jessica Good of the Orange County Health Care Agency.

The chief medical officer for Walt Disney Parks and Resorts, Pamela Hymel, said in a written statement that after learning of the Legionnaires’ cases, park officials ordered the cooling towers treated with chemicals to destroy the bacteria and shut them down.

Cooling towers provide cold water for various uses at Disneyland and give off a vapor or mist that could have carried the Legionnella bacteria.

Disneyland, which opened in 1955 and attracts tens of thousands of visitors a day, is owned by The Walt Disney Co.

Hymel said that local health officials had assured them that there was no longer any risk to guests or employees of the park.

There was no information on the condition of the remaining 11 victims because of patient confidentiality laws.

Good said an investigation of the Legionnaires’ cluster discovered that the 12 people sickened by the serious lung disease had traveled to, lived in, or worked in Anaheim during September.

Ten of the victims, who ranged in age from 52 to 94, were hospitalized.

Legionnaires’ disease can cause potentially fatal respiratory illness and pneumonia. Older people and those with health issues are particularly at risk.

According to the Orange County health agency, Legionella is becoming more common in the United States and in Orange County, where 55 cases have been reported through October 2017, compared with 53 for all of 2016 and 33 in 2015.

Symptoms develop two to 10 days after exposure, the OCHCA said, and include fever, chills, cough, muscle aches and headaches. It is treated with antibiotics, which can improve symptoms and shorten the length of illness.

The disease is not contagious.
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An outbreak of cholera in Tanzania has left 18 dead in two months, the Health Ministry said Saturday, warning that the situation could worsen as the rainy season continues.

The ministry said the outbreak had left “18 dead out of 570 cases recorded” between September 1 and October 30, and it urged local authorities to take measures to keep the disease from spreading.

In 2015, Tanzania was struck by a major outbreak of cholera that infected 10,000 people and left 150 dead.

Cholera is transmitted through contaminated drinking water and causes acute diarrhea.
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Pneumonic plague continues to decline in Madagascar, according to the World Health Organization, whose latest figures put the number of suspected cases at 1,947, including 143 deaths.

The latest reported cases of pneumonic plague, based on the number of people hospitalized and on district reporting in Madagascar, is good news, said Fadela Chaib, WHO spokeswoman.

“As of yesterday, 6 November, there were only 27 people hospitalized with plague compared with 106 on 29 October, for example,” she said. “This decline in new cases is encouraging and shows that the quick steps taken to support the government of Madagascar to contain the outbreak have been effective.”

Vigilance and money

However, Chaib warns that everyone must remain vigilant. She says flare-ups of this deadly disease cannot be ruled out until the plague season ends in April.

WHO, she said, needs $4 million to sustain its effort.

Much vital work remains, she said. For example, samples from sick people and those in contact with them must be laboratory tested, she said. She told VOA that since the start of the outbreak in August, WHO has trained teams of people who have traced 6,000 contacts.

“This is a huge operation,” she sad. “This needs to be done because you will need to maintain a high level of surveillance. You will need to train people. You will need also to provide logistical help to the hospitals and health centers.”

Fighting distrust, too

In Madagascar, Tomislav Jagatic of Doctors Without Borders told Reuters that medical staff fight distrust as well as the disease.

“We are sending teams of outreach, health promoters to discuss with all the people in the community how the plague is transmitted and also more important is we want to gain the trust of the community,” Jagatic said.

So far, there have been no reported cases of plague outside Madagascar.

WHO is working with all countries to strengthen their surveillance systems at the borders, Chaib said. WHO also is urging them to be prepared to quickly contain the disease in case plague is reported.

 
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The U.S. Drug Enforcement Administration plans to ban all illicit versions of fentanyl, the highly addictive opioid painkiller responsible for tens of thousands of deadly drug overdoses in the United States in recent years.

The DEA, an arm of the Justice Department, will classify all “fentanyl-related substances” as a Schedule I drug, effectively making their sale illegal, the Department said on Thursday.

The scheduling is the latest step by the Trump administration to combat an epidemic that has killed more than a half-million Americans since 2000.

U.S. Attorney General Jeff Sessions announced the move, calling it “an important step toward halting the rising death toll caused by illicit fentanyls in the United States.”

“By scheduling all fentanyls, we empower our law enforcement officers and prosecutors to take swift and necessary action against those spreading these deadly poisons,” Sessions said in a statement.

DEA spokesperson Barbara Carreno said no date has been set for publishing the planned classification in the federal register.

The classification will take effect no earlier than 30 days after the DEA publishes its notice of intent and will last up to two years with the option of a one-year extension.

‘Schedules’ of drugs

The DEA divides drugs, substances, and chemicals used to make drugs into five categories or “schedules,” depending on their medical purpose and potential for abuse and dependency.

Schedule I drugs, the agency’s highest classification, have no medial use and have a high potential for abuse. Heroin and marijuana are among substances currently categorized as Schedule I drugs.

Schedule II drugs have an accepted medical use but have a high potential for abuse. Fentanyl, a synthetic opioid pain reliever 100 times more powerful than morphine, is currently listed as a Schedule II drug.

The U.S. opioid epidemic is being fueled in large part by the growing prevalence of illicit fentanyl and fentanyl analogues (variations of fentanyl) imported from China, Mexico and other countries.

Last year, more than 64,000 Americans died of drug overdoses, including more than 20,000 who overdosed on fentanyl-related substances, according to the Centers for Disease Control and Prevention.

To evade U.S. controls, foreign manufacturers of fentanyl create “structural variants” of fentanyl that are not currently listed under the Controlled Substances Act, the Justice Department said.

Carreno said the scheduling of fentanyl analogues “gives us the opportunity to get ahead of the rogue chemists out there to make new drugs by tweaking molecules.”

Once the classification takes effect, “anyone who possesses, imports, distributes, or manufactures any illicit fentanyl analogue will be subject to criminal prosecution in the same manner as for fentanyl and other controlled substances,” the Department of Justice said in a statement.
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The cancer caseload is growing in Africa, but quality treatment options remain limited. By 2030, WHO estimates that for every four deaths from HIV/AIDS on the continent, there will be three deaths from cancer. To address the emerging public health crisis, two major pharmaceutical companies have partnered with the American Cancer Society and the Clinton Health Access Initiative to steeply discount the cost of some cancer drugs to six African countries, including Uganda.
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Rohingya children in Myanmar and Bangladesh face a tenfold increase in malnutrition compared to last year and require immediate attention, the International Rescue Committee said in a statement Friday.

A recent survey conducted by humanitarian agencies led by International Rescue Committee (IRC) partner Action Against Hunger (ACF) in the Cox’s Bazar region of Bangladesh found that 40,000 Rohingya children between the ages of 6 months and 5 years require life-saving assistance and more than $12 million is needed to respond to such humanitarian crisis.

The survey revealed an acute malnutrition rate of 7.5 percent, nearly four times the international emergency level and 10 times higher than last year.

Children younger than 6 months face a tenfold increase in mortality based on the circumference of their arms, the statement said.

​The IRC expects 200,000 new arrivals in coming weeks, bringing the total refugee population in Bangladesh to more than 1 million, exacerbating the crisis further.

“The conditions we are seeing in Cox’s Bazar create a perfect storm for a public health crisis on an unimaginable scale,” said Cat Mahony, the IRC’s emergency response director in Cox’s Bazar.

“Extremely vulnerable families with unmet health needs, high levels of food insecurity, limited access to health services and appalling conditions for hygiene, sanitation and access to clean drinking water — all of which contribute to these awfully high rates of malnutrition,” Mahony said.

The IRC has launched an emergency response on both sides of the Bangladesh-Myanmar border for displaced Rohingya, opening four specialized 24-hour care centers with ACF for the emergency treatment of severe acute malnutrition, as the first step.
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Death definitely becomes this star.

Astronomers reported Wednesday on a massive, distant star that exploded in 2014 — and also, apparently back in 1954. This is one supernova that refuses to bite the cosmic dust, confounding scientists who thought they knew how dying stars ticked.

The oft-erupting star is 500 million light-years away — one light-year is equal to 5.9 trillion miles (9.5 trillion kilometers) — in the direction of the Big Bear constellation. It was discovered in 2014 and, at the time, resembled your basic supernova that was getting fainter.

But a few months later, astronomers at the California-based Las Cumbres Observatory saw it getting brighter. They’ve seen it grow faint, then bright, then faint again five times. They’ve even found past evidence of an explosion 60 years earlier at the same spot.

Supernovas typically fade over 100 days. This one is still going strong after 1,000 days, although it’s gradually fading.

The finding was published Wednesday in the journal Nature.

“It’s very surprising and very exciting,” said astrophysicist Iair Arcavi of the University of California, Santa Barbara who led the study. “We thought we’ve seen everything there is to see in supernovae after seeing so many of them, but you always get surprised by the universe. This one just really blew away everything we thought we understood about them.”

The supernova — officially known as iPTF14hls — is believed to have once been a star up to 100 times more massive than our sun. It could well be the biggest stellar explosion ever observed, which might explain its death-defying peculiarity.

It could be multiple explosions occurring so frequently that they run into one another or perhaps a single explosion that repeatedly gets brighter and fainter, though scientists don’t know exactly how this happens.

One possibility is that this star was so massive, and its core so hot, that an explosion blew away the outer layers and left the center intact enough to repeat the entire process. But this pulsating star theory still doesn’t explain everything about this supernova, Arcavi said.

Harvard University’s astronomy chairman, Avi Loeb, who was not involved in the study, speculates a black hole or magnetar — a neutron star with a strong magnetic field — might be at the center of this never-before-seen behavior. Further monitoring may better explain what’s going on, he said.

Las Cumbres, a global network of robotic telescopes, continues to keep watch.

Scientists do not know whether this particular supernova is unique; it appears rare since no others have been detected.

“We could actually have missed plenty of them because it kind of masquerades as a normal supernova if you only look at it once,” Arcavi said.

Nothing lasts forever — not even this super supernova.

“Eventually, this star will go out at some point,” Arcavi said. “I mean, energy has to run out eventually.”
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Researchers studying a hospital emergency room report a cocktail of simple drug store pain relievers work just as well or sometimes better than prescribed opioids.

The study appears in the latest issue of The Journal of the America Medical Association and could be an effective ground zero in the fight against the current opioid epidemic.

“Preventing new patients from becoming addicted to opioids may have a greater effect on the opioid epidemic than providing sustained treatment to patients already addicted,” emergency medical specialist Demetrios Kyriacou wrote in the Journal.

Studies have shown that many opioid addictions start in the emergency room, where a patient with a broken bone or another injury is sent home with a prescription for a powerful painkiller.

The study shows that patients given a cocktail of the same kind of painkillers found in such well-known, over-the-counter brands as Tylenol and Advil get the same kind of short-term pain relief as they get from the stronger medications.

The study was carried out at the Montefiore Medical Center emergency room in New York City.

Experts say as many as 2 million Americans are addicted to opioids and President Donald Trump has declared it a national health emergency.
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Gov. Jerry Brown announced plans Tuesday to further California’s cooperation with the European Union and China on fighting climate change. 

California and the EU will begin hosting regular meetings, also working with China, on improving carbon markets, which aim to reduce pollution by putting a price on carbon emissions. 

The enhanced collaboration, announced after Brown addressed the European Parliament in Brussels, underscores Brown’s emergence as one of the United States’ leading voices on international climate policy even as the federal government recedes.

His nearly two-week trip to Europe will end at the United Nation’s climate conference in Bonn, Germany, where the international Paris accord to reduce carbon emissions will be a key topic of conversation. President Donald Trump plans to withdraw the United States from the agreement, but Brown and other governors are pledging to meet its targets anyway. 

“If we come together and we see the truth of our situation we can overcome it,” Brown said in his address to the European Parliament. “In America, we don’t all agree among ourselves, but people in cities, in states, corporations, universities and nonprofit organizations are joining together. We’re not waiting.”

The enhanced collaboration with the EU and China will focus on designing and implementing better carbon markets. China is working to create its own, while the EU operates the largest carbon market in the world. California, meanwhile, operates a carbon market in partnership with the Canadian provinces of Quebec and Ontario. 

The market-based system requires polluters to obtain allowances in order to emit carbon. The goal is to reduce emissions over time. Brown has long advocated for linking California’s market with other states and nations, and he said Tuesday he hopes to eventually link California’s program with the EU’s. Next week Brown will address a China-organized forum on cap-and-trade programs.

“Climate change is a threat to all of humanity, to all species and it can only be solved by a global cooperative effort. It must be far greater than it is today,” Brown said.

Brown has started a number of multi-state climate change agreements, including the Under2 Coalition, an agreement by roughly 180 subnational governments to keep global temperature rise below two degrees Celsius. At the U.N. Conference, he’s been named a special adviser for states and regions. 
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The Trump administration is unique in that some officials continue to ask for more evidence that humans are contributing to a warming planet. This, despite a government report issued last week that concludes that human activity is the primary cause of a warming planet. But if that report isn’t proof enough, there are places on the planet, like Mongolia, where climate change is visibly destroying entire landscapes. VOA’s Kevin Enochs reports.
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Scientists are calling for renewed efforts to develop a vaccine for one of the biggest causes of stillbirths and infant deaths worldwide. An estimated one in five pregnant women around the world carry Group B Streptococcus bacteria, and most show no symptoms. However, it can prove deadly for unborn and new-born babies – especially where traditional treatments such as antibiotics are unavailable, as Henry Ridgwell reports.
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When Koutu Saimon’s son, Wheener, was born almost four months premature and “as small as a mouse,” friends and relatives in Chad turned to the new mother and, with sidelong glances and in hushed voices, whispered to her to get rid of the baby.

“They told me: ‘You need to take him to the river, do an exorcism ritual, leave him there. He’s cursed, it’s a snake child’,” Saimon told the Thomson Reuters Foundation.

“They would kill a child like that,” she added incredulously, looking at her son.

Wheener, now a lively eight-year-old, squealed with delight upon seeing his teacher, Adoumkidjim Naiban, who founded Chad’s only school for children with learning disabilities, the CESER Center, almost 20 years ago.

Children with disabilities are often neglected across central Africa, where many believe their condition is caused by curses, supernatural forces or as a punishment.

The CESER Center in the Chadian capital, N’Djamena, only stays open by combining education with social entrepreneurship.

Almost half of Chad’s 14 million population live below the poverty line and more than 10 percent of children die before their fifth birthday, the charity Save the Children says.

Sales from furniture and leather goods produced by the CESER Center’s 80-plus students, as well as vegetables, eggs and cattle from its farm on the city’s outskirts, help keep it running.

“Sometimes the pupils also take food they grow home to feed their families,” said Naiban, who waives school fees of about 70,000 CFA francs ($125) a year for the poorest families.

Chad, the world’s third least-developed country, is also weighed down by drought and floods, conflict with the militant group Boko Haram and some 400,000 refugees fleeing the Lake Chad basin, Sudan and the Central African Republic.

Government resources are hard-stretched and a domestic law which prohibits discrimination against people with disabilities is not effectively enforced, experts say.

Nor has Chad has ratified the 2006 Convention on the Rights of Persons with Disabilities, which requires governments to promote, protect and ensure human rights for disabled people.

It falls mostly to charities to provide for those with special needs, who often lack basic equipment like corrective glasses or wheelchairs.

‘Snake Children’

Negative beliefs about disability are common in rural communities across the world.

This is partly due to the low levels of education – in Chad, over 90 percent of people cannot read – and because information on the medical causes of disability is not widely available, experts say.

In Chad and other countries in the region, children with disabilities are sometimes called ‘snake children’ because they often find movement difficult, meaning they crawl on the ground for longer than other children.

Like snakes, they are regarded as troublesome, and often killed or abandoned in forests or near river-beds where they are believed to turn back into serpents.

“If they don’t throw them out, they hide them,” said Naiban, who was inspired to start the school after seeing his young disabled niece suffering.

“I wanted to do something to help her,” he said, sitting among stacks of papers, books and musical instruments in his cramped office.

When Naiban realized there was no trained teacher for mentally disabled children in the whole of Chad, he decided to train himself.

A Swiss foundation catering to people with special needs, Les Perce-Neige, hosted him for three months and then provided money to buy land for the school.

But running costs, including salaries for six of his 11 staff who are not paid by the government, proved a challenge.

“Many centers of this type all over the world are forced to close because they run out of funding,” said Koundja Mayoubila, Chad’s program manager for Reach for Change, a Swedish charity which provided entrepreneurial funding and training for Naiban.

Pupils learn sewing, masonry, furniture production and farming in workshops inside the school and on its farm.

After they graduate, they use their skills to earn money, often as tailors, carpenters and on construction sites.

“One even plays in a local orchestra,” said Naiban, who has also set up parents’ groups supporting more than 2,000 children with learning difficulties across the vast central African country.

“We explain to the community: ‘No, it’s a congenital malfunction, the cause is biological — it’s malnutrition, maybe malaria, meningitis,'” he said.

“We explain that it’s not evil spirits, they’re not ‘snake children.'”

For Saimon, the center serves as a lifeline, enabling her to hold down a job in a restaurant while Wheener is at school.

“It’s not easy for us, the mothers especially,” she said, adding that her husband left soon after their son was born. “But with this education, he has a chance to make something of his life.”

($1 = 560.0000 CFA francs)
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Two children, backed by the Clean Air Council environmental group, sued U.S. President Donald Trump and two of his Cabinet members on Monday to try to stop them from scrapping a package of pollution-reduction rules known as the Clean Power Plan.

The lawsuit, filed in federal court in the Eastern District of Pennsylvania, says the United States is “relying on junk science” and ignoring “clear and present dangers of climate change, knowingly increasing its resulting damages, death and destruction.”

It was the latest legal action that green advocates have taken to combat Trump administration efforts to roll back environmental regulations through rule changes at agencies like the U.S. Department of Interior and the U.S. Environmental Protection Agency.

The two young plaintiffs, aged 7 and 11, are identified only by their first and last initials in the court papers, which allege that both are suffering from the effects of a rapidly warming climate.

Trump has called climate change a hoax and said in June he would withdraw the United States from a global pact to combat it — calling the deal’s demands for emissions cuts too costly for the U.S. economy.

The lawsuit asks the court to prevent the EPA, Trump and the U.S. Department of Energy, along with Energy Secretary Rick Perry and EPA Administrator Scott Pruitt, from rolling back any rules that “increase the frequency and/or intensity of life-threatening effects of climate change.”

EPA and Energy Department representatives declined to comment. A White House spokeswoman did not immediately respond to a request for comment.

Pruitt said on Oct. 10 he wanted to scrap the Clean Power Plan, put in place under former Democratic President Barack Obama.

On Sept. 29, Perry asked federal regulators to provide price incentives to help keep coal and nuclear power plants open, as a way to address “risks” to the resilience of the electrical grid.

By including the children, the Clean Air Council seemed to model its case after Juliana v. U.S., a pending federal case in which a group of teenagers sued the U.S. government for violating their constitutional rights by causing climate change.

“The Clean Air Council case is taking the legal theories pioneered in Juliana and applying them to a narrow set of facts related to specific rollbacks of the Trump administration,” said Meg Ward, a spokeswoman for Our Children’s Trust, a group leading the Juliana suit.
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From Aztec pigweed to dragon beans – several ancient, often forgotten foods are making their way to the dinner table in an effort to diversify the diet of a growing global population.

In an initiative to cut the world’s dependency on major crops like wheat and rice – Britain’s Prince Charles has launched the Forgotten Foods Network to rediscover long-lost crops, fruit and vegetables.

As rising temperatures wreak havoc on farmers worldwide, scientists are seeking new ways to feed a population that is set to boom to an estimated 9.8 billion by 2050.

Ancient food like pigweed once eaten by the Aztecs can be eaten raw or be ground into flour – one of many crops that could add valuable nutrients to a limited modern diet, say experts.

“We must move beyond the ‘business as usual’ approach of relying on monocultures of major, well-known crops, and invest in agricultural diversity,” Charles said in video message.

The initiative was developed by Crops For the Future, a Malaysian organization doing crop research. Charles launched the campaign at their headquarters last week.
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Artificial respiration can save lives, but it is an imperfect science. It can be difficult for doctors to tell if their patients are getting enough oxygen, or too much. Some new technology called Electrical Impedance Tomography, or EIT, may solve that problem. VOA’s Kevin Enochs reports.
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With hurricanes, floods and other impacts of climate change becoming increasingly destructive, countries urgently need to step up their ambitions to cut emissions if they are to keep global warming within safe limits, experts said ahead of U.N. climate talks starting on Monday.

About 163 countries have submitted plans on how they will contribute to meeting the Paris climate agreement goal to limit global warming to well below 2 degrees Celsius above pre-industrial levels.

But put together, the plans are likely to lead to a 3 degree temperature rise this century, according to the United Nations.

Nicholas Nuttall, spokesman for the U.N. Framework Convention on Climate Change, said the national plans delivered in advance of Paris, “were well known at the time to fall short of the Paris Agreement’s long-term goals.”

But the agreement also calls for countries to take stock of international progress on climate action and ratchet up the ambition of their national plans accordingly.

The first stock taking is set for next year, with the first more ambitious plans due in 2020.

“That will, if followed, eventually get the world on track to the goals and the aim of climate neutrality in the second half of the century,” Nuttall said.

“The U.N. climate conference in Bonn … needs to be a Launch pad to that next ambition moment,” he told the Thomson Reuters Foundation.

This year has seen particularly severe weather of the type climate scientists have long warned about: severe floods in Asia, devastating hurricanes in the Caribbean and United States, and wildfires in California and southern Europe.

In the effort to reduce emissions and stave off worsening impacts, “we’re in a race against time,” Angel Gurria, secretary-general of the OECD, last week.

“We have to make it stick that it’s good business to protect the environment but also that it’s good policy,” he said.

As 195 nations meet starting Monday in Bonn for U.N. climate talks, they will be working to create rules to implement the Paris agreement, including on sometimes contentious issues such as how reductions of climate-changing gases should be reported and checked by other nations.

But time is short, with global emissions of climate changing gases needing to peak by 2020 – just three years away – in order to keep warming to relatively safe levels, according to the World Resources Institute.

Camilla Born, a senior policy adviser for E3G, a London-based climate think tank said: “We are going to have to show increased ambition by 2020 if we’re going to really get on track to delivering those long-term goals.”

“This is a broader and deeper task than we’ve ever seen before. This isn’t just a conversation about raising targets. This is about structuring our economies differently.”

“We are moving in that direction, but we need to move there much faster,” Born told the Thomson Reuters Foundation. “It’s not a done deal but we’ve got lots of ingredients to make that happen,” she said.

Where’s the money?

Many developing country plans to curb emissions and adapt to climate change depend on receiving enough finance to implement them.

Wealthy countries have pledged to raise $100 billion a year in climate finance by 2020, to help developing countries cope with the impacts of climate change and reduce their greenhouse gas emissions.

But more than $4 trillion is needed for developing countries to implement their plans, according to the Least Developed Countries (LDC) Group which represents the world’s poorest 47 countries.

“LDCs and other developing countries cannot take ambitious action to address climate change or protect themselves against its impacts unless all countries fulfill and outdo the pledges they have made,” said Gebru Jember Endalew, the Ethiopian chairof the group.

“(We) face the unique and unprecedented challenge of lifting our people out of poverty and achieving sustainable development without relying on fossil fuels,” he said.

The group is pushing for the Bonn talks to come up with more promises of cash to fund the needed changes. Least-developed countries alone, in their climate action plans, have said they need at least $200 billion just to adapt to worsening climate impacts, including harsher droughts and worsening floods,Endalew said.

Not finding it will be “a serious barrier to ambitious climate action”, he said.

Many of the poorest countries in Africa, Asia, the Caribbean and the Pacific have seen particular devastation from floods, storms, droughts and rising sea levels.

With such impacts following a global temperature rise of just 1.2 degrees Celsius, many poorer nations and organizations representing the world’s vulnerable are pushing hard to keep temperature rises to not just well below 2 degrees but to a more ambitious 1.5 degrees Celsius.

A global temperature rise of 1.5 degrees is “a critical threshold which can still prevent many of the worst impacts on poor populations”, said Sven Harmeling of CARE International.

The Bonn talks “must provide a clear way forward so that countries come back with more ambitious plans to cut emissions,” said Harmeling, who is head of CARE’s delegation to the talks.
…

Smog has enveloped much of Pakistan and neighboring India, causing highway accidents and respiratory problems, and forcing many residents to stay home, officials said Saturday.

Pakistani meteorologist Mohammad Hanif said the pollution, caused by dust, the burning of crops, and emissions from factories and brick kilns in Pakistan and neighboring India, was expected to linger until the middle of the month. He advised people to wear facemasks to protect themselves from respiratory ailments.

Mohammad Arshad, a highway police official, said at least 10 people were killed and 25 injured in road accidents linked to poor visibility in various parts of the Punjab province since Monday. Authorities have advised people to limit road travel.

Average air pollution in Pakistan’s major cities is about four times higher than the World Health Organization limits.

Similar problems have been reported in the Indian capital, New Delhi, where air quality was rated “very poor” Saturday. Some private schools in New Delhi have suspended sports and outdoor activities.

India’s Supreme Court banned the sale of firecrackers in New Delhi ahead of last month’s Hindu Diwali festival to try to curb air pollution in the notoriously smoggy city. Though reports said air quality was better than last year, pollution levels in the capital hit 18 times the healthy limit the night after the festival, as many dodged the ban.
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The World Health Organization says an outbreak of pneumonic plague in Madagascar appears to be slowing.  But, it warns vigilance must be maintained as the spread of the disease is far from over.  

The World Health Organization says plague came early to Madagascar this year and has spread quickly.  Quite unusually, pneumonic plague moved from the remote rural areas to congested urban areas, causing panic since, unlike bubonic plague, this disease is transmitted from human to human.   

The normal plague season of September to April causes about 400 cases of the disease.  But, this year, the WHO says more than 1,800 suspected cases, resulting in 127 deaths were reported in the three-month period from August through late October.  

WHO spokesman Tarik Jasarevic says that is an unusually large number of cases in such a short period of time.  But, he says there has been a decline in the number of new cases since the second week of October.

“There is also a decrease in the number of patients that are hospitalized due to suspicion of a plague,” said Jasarevic. “While this declining trend in new plague cases and reduction in hospitalizations due to plague cases is encouraging, WHO expects more cases of plague to be reported from Madagascar until the typical plague season ends in April 2018.”   

Jasarevic says people must remain vigilant and ongoing operations of surveillance and treatment must be sustained over the coming six months, when the danger will be over.  

He says finding and treating active cases of the plague, identifying people who have come in contact with an infected person, following up and providing antibiotic treatment is important.  In addition, he says rodent and flea control, as well as safe and dignified burials is crucial throughout the plague season.
…

Pakistan is one of three nations in the world that still reports cases of polio. The other two are Afghanistan and Nigeria. But an ongoing effort is slowly making progress toward eradicating the disease. VOA’s Kevin Enochs reports.
…

Nearly half of Hawaii’s coral reefs were bleached during heat waves in 2014 and 2015 and fisheries close to shore are declining, a group of scientists told state lawmakers.

The scientists from the Nature Conservancy briefed the lawmakers Thursday about what they called an unprecedented situation for Hawaii’s sea life.

National Oceanic and Atmospheric Administration officials said 56 percent of the Big Island’s coral were bleached, along with 44 percent along West Maui and 32 percent around Oahu.

Worse to come

The scientists said more severe and frequent bleaching is predicted.

“In the 2030s, 30 to 50 percent of the years will have major bleaching events in Hawaii,” said Kuulei Rogers of the Hawaii Institute of Marine Biology.

When ocean temperatures rise, coral expel the algae they rely on for food. This causes their skeletons to lose their color and appear “bleached.”

Coral can recover if the water cools. But they die if high temperatures persist. Eventually reefs degrade, leaving fish without habitats and coastlines less protected from storm surges.

Fish decline as well

As for Hawaii’s fish, University of Hawaii researchers compiled data for 15 years and found a 90 percent decline in overall catch from the last 100 years, which includes fish such as ulua, moi and oio.

“What we found was pretty overwhelming,” University of Hawaii scientist Alan Friedlander said. “About 40 percent of the species will be classified as overfished. The correlations are more people, less fish.”

Friedlander suggested expanding marine reserves and said gear restrictions and size limits help, but bag limits and quotas don’t work.

Those who fish argued against more regulations.

“If the fishermen don’t stand up and come down here and fight for fisherman’s rights now, we’ll lose more than we can possibly ever imagine,” said Makani Christensen of the Hunting, Farming and Fishing Association.
…

Almost every country in the world now has serious nutrition problems, either because of overeating leading to obesity or a lack of food leading to undernutrition, according to a major study published Saturday.

Researchers behind the Global Nutrition Report, which looked at 140 countries, said the problems were thwarting “human development as a whole” and called for a critical change in the response to this global health threat.

The report found that while malnutrition rates were falling globally, their rate of decrease was not fast enough to meet the internationally agreed Sustainable Development Goal (SDG) to end all forms of malnutrition by 2030.

More than 155 million children under age 5 are stunted because of lack of nutrition, and 52 million are defined as “wasted,” meaning they do not weigh enough for their height, the report said.

At the other end of the spectrum, overeating is taking a heavy toll on people of all ages worldwide: The report found that 2 billion of the world’s 7 billion people are now overweight or obese.

In North America, a third of all men and women are obese.

Worldwide, at least 41 million children under 5 are overweight, and in Africa alone, 10 million children are now classified as overweight.

“Historically, maternal anemia and child undernutrition have been seen as separate problems to obesity and noncommunicable diseases,” said Jessica Fanzo, a professor at Johns Hopkins University in the United States who co-led the Global Nutrition Report.

“The reality is they are intimately connected and driven by inequalities everywhere in the world. That’s why governments … need to tackle them holistically, not as distinct problems.”

Donor funding for nutrition rose by just 2 percent to $867 million in 2015, the report found. It said funding needs to be “turbocharged” and called for a tripling of global investment in nutrition to $70 billion over 10 years.

The Global Nutrition Report is an independently produced annual analysis of the state of the world’s nutrition. It tracks progress on targets for maternal, infant and young child nutrition and on diet-related chronic diseases adopted by World Health Organization member states.
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The U.S. government on Friday released a report on climate change that said there was “no convincing alternative explanation” for global warming besides human causes.

The National Climate Assessment, which the government is mandated by law to publish every four years, said climate change was being driven almost entirely driven by human action. It warned that sea levels could rise by as much as 8 feet by the year 2100. It listed a number of damaging developments across the United States that it attributed to the rise of global temperature by 1.8 degrees Fahrenheit since 1900.

It said the U.S. was already experiencing increasing temperatures, precipitation levels and numbers of wildfires; that more than 25 U.S. coastal cities were already experiencing flooding; and that there was  no precedent in history with which these meteorological changes could be compared.

But, it said, there is “very high confidence” that the rate of climate change will depend on the amount of greenhouse gases released globally over the next few decades.

The report from the U.S. Global Change Research Program, an interagency unit that coordinates and integrates research on environmental changes, runs counter to the position on climate change taken by the current U.S administration, including that of the head of the Environmental Protection Agency.

Trump, Perry, Pruitt have doubts

President Donald Trump, Energy Secretary Rick Perry and EPA head Scott Pruitt have all questioned how much human activity has contributed to climate change. The president has announced the United States will leave the Paris climate agreement that would obligate the U.S. to cut its overall greenhouse gas emissions by at least 26 percent by 2025, compared with 2005 levels.

One of the study authors, climate scientist Robert Kopp of Rutgers University, told The Washington Post he thought the report was “basically the most comprehensive climate science report in the world right now.”

In response to Friday’s release, White House principal deputy press secretary Raj Shah noted a line in the report that said there was “uncertainty in the sensitivity of Earth’s climate to emissions. The climate has changed and is always changing.”
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Life-threatening malnutrition rates are soaring among the children of Rohingya refugees in Bangladesh, who fled Myanmar to escape violence, according to a nutritional assessment by the U.N. children’s fund.

The recently conducted survey in the Kutupalong refugee camp in Cox’s Bazar shows 7.5 percent of Rohingya refugee children suffer from severe acute malnutrition. UNICEF says this is at least two times higher than what was seen among the children in May — about four months before the mass exodus of Rohingya from Myanmar’s northern Rakhine state began. 

UNICEF spokesman Christophe Boulierac says children with severe malnutrition risk dying from the preventable, treatable condition.

“Malnutrition rates among children in northern Rakhine were already above emergency thresholds,” Boulierac said. “The condition of these children has further deteriorated due to the long journey across the border and the conditions in the camps.” 

More than 600,000 Rohingya have fled violence and persecution in Myanmar since August 25. Approximately 25,000 live in the Kutupalong camp, where the nutritional assessment was carried out. UNICEF says the refugees face an acute shortage of food and water. That problem, coupled with the unsanitary conditions, is giving rise to high rates of diarrhea, respiratory infections and other ailments.

Boulierac says more than 2,000 acutely malnourished children are being treated by UNICEF and partners at 15 centers. He tells VOA more treatment centers are being set up, but not fast enough to help some 17,000 other youngsters in need of specialized nutritional feeding.
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