A giant rhinoceros the size of three African elephants once grazed on treetops in Tibet, but succumbed to climate change more than 20 million years ago.

The high treetops disappeared, along with its food source, says Xiaoming Wang of the Natural History Museum of Los Angeles County. Wang has done field research on the long-legged rhino, more formally called the Indricotherium, one of the stars of a new exhibit that shows how radical adaptations that aid survival in one setting can spell disaster in another.

Through fossils and reconstructions, the exhibit tells the story of Mother Nature’s radical gambits to keep organisms alive in changing conditions. The show was built around an earlier exhibit from the American Museum of Natural History in New York, which also included ice age remains from the La Brea Tar Pits in Los Angeles.

Mammals that have adapted in the extreme include an ancient whale that walked on land and more recent pygmy mammoths on California’s Channel Islands, whose small size is illustrated with side-by-side jaw bones of a Columbian mammoth and its pygmy relative, which shrunk to cope with limited food resources on the islands.

Many species challenged

Climatic variations over the ages and the more recent incursion of humans have challenged many species, said Emily Lindsey of the La Brea Tar Pits, a site rich with fossils from the mammoths and giant cats that once roamed California, but died out more than 10,000 years ago.

Seen in the exhibit are the extinct American lion, “which along with the cave lion in Europe was the biggest cat that ever lived,” Lindsey said.

There are fossils from a scimitar cat, also extinct, and a long-gone subspecies of jaguar.

“And then we have the mountain lion, which is the only one of those five big cats that’s still alive today,” she notes.

Also known as the cougar, panther or puma, the species is represented with a photo of a celebrated cat that continues to roam through the hills above Los Angeles.

“People thought he would just spend a couple of days there, then continue to move on or attempt to move on,” said Miguel Ordenana, who coordinates the amateur citizens scientists who make wildlife observations to help scientists better understand the region. Mountain lions, he said, typically do not survive crossing busy freeways, but this intrepid mountain lion is a survivor, as is his species.

Arctic island was once like Florida

Other mammals in the exhibit include the Batodonoides, a long-extinct shrewlike mammal from 50 million years ago so tiny that it could have perched on a pencil. The South American Macrauchenia, with a camellike body and giraffelike neck, had a flexible trunk, like an elephant. It went extinct a mere 10,000 years ago, but is represented here in a reconstruction.

Earth’s extreme changes can be seen in a diorama of Ellesmere Island in the Arctic.

Just 1,000 kilometers from the North Pole, it was home to warm swamps 50 million years ago and a host of animals adapted to a Floridalike climate.

Those intense changes served many species well, but presented extreme problems. Especially as environmental conditions caused the Arctic freeze over, leaving Ellesmere Island one of the coldest and driest locations on Earth.

An earlier version of this report had Xiaoming Wang’s name misspelled. VOA regrets the error.
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The challenges of adaptation and survival are the themes of a new exhibit at the Natural History Museum of Los Angeles. Mike O’Sullivan reports that the the exhibit, Extreme Mammals, shows the radical changes in animal species over millions of years and the extinctions of species that failed to adapt.
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Recent studies suggest that as many as 400 million people around the world do not have access to basic health care. In some cases it’s because of conflict, but in some cases it’s just geography: humans live in some very far away places, Siberia for instance. That’s where the medical ship comes in handy. VOA’s Kevin Enochs reports.
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Recent studies suggest that as many as 400 million people around the world do not have access to basic health care. In some cases it’s because of conflict, but in some cases it’s just geography: humans live in some very far away places, Siberia for instance. That’s where the medical ship comes in handy. VOA’s Kevin Enochs reports.
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Health ministers of the G20 leading economies, meeting for the first time Saturday, agreed to work together to tackle issues such as a growing resistance to antibiotics and to start implementing national action plans by the end of 2018.

Germany, which holds the G20 presidency this year, said it was an “important breakthrough” that all nations had agreed to address the problem and work toward obligatory prescriptions for antibiotics.

Pandemics

Saying that globalization caused infectious diseases to spread more quickly than previously, the 20 nations also pledged to strengthen health systems and improve their ability to react to pandemics and other health risks.

“By putting global health on the agenda of the G20 we affirm our role in strengthening the political support for existing initiatives and working to address the economic aspects of global health issues,” the communique said.

The results of the meeting will feed into a G20 leaders’ summit in Hamburg in July.

Overprescription

While the discovery of antibiotics has provided cures for many bacterial infections that had previously been lethal, overprescription has led to the evolution of resistance strains of many bacteria.

An EU report last year found that newly resistant strains of bacteria were responsible for more than 25,000 deaths a year in the 28-member bloc alone.

Germany has argued that even having a discussion about it will help raise public awareness about the problem. The G20 also said they agreed to help improve access to affordable medicine in poorer countries.

 
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A warmer, wetter climate is helping push dozens of Eastern U.S. trees to the north and, surprisingly, west, a new study finds.

The eastern white pine is going west, more than 80 miles (130 kilometers) since the early 1980s. The eastern cottonwood has been heading 77 miles north (124 kilometers), according to the research based on about three decades of forest data.

The northward shift to get to cooler weather was expected, but lead author Songlin Fei of Purdue University and several outside experts were surprised by the move to the west, which was larger and in a majority of the species.

New trees tend to sprout farther north and west while the trees that are farther south and east tend to die off, shifting the geographic center of where trees live. 

86 tree species

Detailed observations of 86 tree species showed, in general, the concentrations of eastern U.S. tree species have shifted more than 25 miles west (45 kilometers) and 20 miles (33 kilometers) north, the researchers reported in the journal Science Advances Wednesday.

One of the more striking examples is the scarlet oak, which in nearly three decades has moved more than 127 miles (205 kilometers) to the northwest from the Appalachians, he said. Now it’s reduced in the Southeast and more popular in the Midwest.

“This analysis provides solid evidence that changes are occurring,” former U.S. Forest Chief Michael Dombeck said in an email. “It’s critical that we not ignore what analyses like these and what science is telling us about what is happening in nature.”

Dryer South, wetter West

The westward movement helped point to climate change, especially wetter weather, as the biggest of many culprits behind the shift, Fei said. The researchers did factor in people cutting down trees and changes to what trees are planted and where, he said.

With the Southeast generally drying and the West getting wetter, that explanation makes some sense, but not completely, said Brent Sohngen at Ohio State University, who was not involved in the study.

“There is no doubt some signature of climate change,” he said in an email. But given the rapid rates of change reported, harvesting, forest fires and other disturbances, are probably still playing a more significant role than climate change, he wrote.
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Norway is repairing the entrance of a “doomsday” seed vault on an Arctic island after an unexpected thaw of permafrost let water into a building meant as a deep freeze to safeguard the world’s food supplies.

The water, limited to the 15-meter (50-foot) entrance hall in the melt late last year, had no impact on millions of seeds of crops including rice, maize, potatoes and wheat that are stored more than 110 meters inside the mountainside.

Still, water was an unexpected problem for the vault on the Svalbard archipelago, about 1,000 kilometers (620 miles) from the North Pole. It seeks to safeguard seeds from cataclysms such as nuclear war or disease in natural permafrost.

“Svalbard Global Seed Vault is facing technical improvements in connection with water intrusion,” Norwegian state construction group Statsbygg, which built the vault that opened in 2008, said in a statement on Saturday. “The seeds in the seed vault have never been threatened.”

Spokeswoman Hege Njaa Aschim said Statsbygg had removed electrical equipment from the entrance — a source of heat — and was building waterproof walls inside and ditches outside to channel away any water.

The number of visitors would be reduced to limit human body heat, she said. Some of the water that flowed in re-froze and had to be chipped out by workers from the local fire service.

An underlying problem was that permafrost around the entrance of the vault, which had thawed from the heat of construction a decade ago, has not re-frozen as predicted by scientists, Aschim said.

Temperatures in the Arctic region have been rising at twice the global average in a quickening trend that climate scientists blame on man-made greenhouse gases. Svalbard has sometimes had rain even in the depths of winter when the sun does not rise.

“There’s no doubt that the permafrost will remain in the mountainside where the seeds are,” said Marie Haga, head of the Bonn-based Crop Trust that works with Norway to run the vault. “But we had not expected it to melt around the tunnel.”

Haga said the trust had so far raised just over $200 million toward an $850 million endowment fund to help safeguard seeds in collections around the globe. “That is an extremely cheap insurance policy for the world,” she said.
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One of the coldest areas in the world is getting greener, and researchers say it’s because of global warming.

Researchers from the University of Exeter in England who first studied the increase of moss and microbes in the Antarctic Peninsula in 2013, now say the greening of the region is widespread.

“This gives us a much clearer idea of the scale over which these changes are occurring,” says lead author Matthew Amesbury of the University of Exeter.

“Previously, we had only identified such a response in a single location at the far south of the Antarctic Peninsula, but now we know that moss banks are responding to recent climate change across the whole of the Peninsula.”

The peninsula, researchers say, is one of the more rapidly warming area in the world, adding that temperatures have risen by about a half-degree Celsius each decade since the 1950s.

For their study, researchers looked at five more core samples from three areas of moss banks over 150 years old. The new samples included three Antarctic Islands off the peninsula.

The cores, researchers say, showed “increased biological activity” over the past 50 years as the peninsula warmed. Researchers say their findings show “fundamental and widespread change,” and that the change was “striking.”

The changes are likely to continue.

“Temperature increases over roughly the past half-century on the Antarctic Peninsula have had a dramatic effect on moss banks growing in the region, with rapid increases in growth rates and microbial activity,” says Dan Charman, who led the research. “If this continues, and with increasing amounts of ice-free land from continued glacier retreat, the Antarctic Peninsula will be a much greener place in the future.”

The next step for researchers is to look back even further in history to see how climate change affected the region before humans made an impact.

The findings appeared in Current Biology on May 18.
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Mozambique has declared an end to a cholera epidemic that was triggered by heavy rains and infected more than 2,000 people, a senior government official said Friday.

The outbreak was another setback for Mozambique, which is grappling with a financial crisis as it strives to woo investors to develop huge offshore gas reserves.

“The epidemic is under control: In the last 28 to 29 days, we have not registered new cases of cholera and so we are declaring the epidemic terminated,” Francisco Mbofana, national director of public health, told a news conference.

Five cholera treatment centers installed in the most affected provinces have already been dismantled, Mbofana said.

Four people died between Jan. 5 and April 22 out of the 2,131 cases registered by health authorities. Last year, in the same period, 103 people died of cholera across the country.

Cholera causes severe vomiting and diarrhea and is often lethal if not treated swiftly.
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Yemen could see as many as 250,000 new cases of cholera within six months, in addition to 50,000 already reported, the World Health Organization said Friday.

“The speed of the resurgence of this cholera epidemic is unprecedented,” Nevio Zagaria, WHO country representative for Yemen, told reporters during a conference call on Friday.

He said the death toll from the outbreak has already reached 240 and more than 50,000 cases have been registered in the past three weeks.

Two years into a war between Houthi rebels and government forces allied with a Saudi-led Arab military coalition, which has killed more than 8,000 people, Yemen has declared a state of emergency Sunday in the capital, Sana’a, over the outbreak.

Fighting has taken a toll on medical facilities in the war-torn country, as more than half of Yemen’s facilities, which are now operated by Houthi rebels, no longer function.

The U.N. says some 17 million of Yemen’s 26 million people lack sufficient food and at least three million malnourished children are in “grave peril.”

Yemen, which is the Arab world’s poorest nation, is now classified by the World Health Organization as a level three emergency, alongside Syria, South Sudan, Nigeria and Iraq. This is the country’s second cholera outbreak in less than a year.

Cholera is highly contagious and can be contracted from ingesting contaminated food and water.
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The World Health Organization has delivered dramatic news about the causes of death for young people the world over. Governments and health agencies have made great strides in reducing deaths of young children through immunization and programs that address maternal and infant care. But adolescents have somehow fallen through the cracks.

Dr. Anthony Costello, director of WHO’s Department of Maternal, Newborn, Child and Adolescent Health told VOA, “We’re finding 1.2 million (adolescents) die each year. That’s 3,000 deaths a day. That’s 10 jumbo jets.” What’s more, Costello says these deaths are largely preventable.

The study shows traffic injuries are the top cause of death among adolescents, those between 10 and 19. In most cases, the adolescent is struck by a car while walking or riding a bicycle.

Other leading causes of death include lower respiratory infections and suicide, the report found. The causes differ by gender, age and region. Boys between 15 and 19 years old are more likely to die from traffic injuries than girls or than younger boys. In sub-Saharan Africa, children are more likely to contract HIV.   

Girls between 10 and 14 are at risk for getting respiratory infections from indoor air pollution and from breathing in fumes from cooking fuels. Older girls, between 15 and 19, had a greater risk of death from pregnancy complications, childbirth or unsafe abortions. Teenage girls generally have small pelvises which lead to difficult labor.  

Costello said pregnant adolescent girls are also “more likely to get high blood pressure; they may be more vulnerable to bleeding, they may be more anemic. They may be in situations more vulnerable to malaria, to HIV.”  

The point of the study that was conducted by the WHO and partners at other U.N. agencies and the World Bank.

Looking forward

While the study focuses on the causes of death, Costello said the point was to help develop a framework and a plan to improve the health of adolescents. If adolescents had access to good health services, education and social support, fewer young people would die. In the case of traffic related deaths, he said better traffic laws, speed limits, the use of seatbelts could save lives in countries that don’t have strict driving safety laws. Costello pointed out that “In India, for example, there are 90,000 deaths on the road each year; many of those are adolescents and children.”

Dr. Flavia Bustreo, the assistant director-general at WHO, said, “Adolescents have been entirely absent from national health plans for decades.” The report proposes changing these plans and trying to help adolescents develop healthy lifestyle habits.

Costello said, “The roots of diabetes, of heart attacks, of strokes, of lung cancer, the root of that lies in the adolescent years, how the adolescents approach nutrition, and diet and exercise, whether they start to smoke or not, or abuse other substances.

Concept shift

Costello said countries need to create more adolescent friendly cities so adolescents have places to play, gather together safely and avoid gang violence.  

“Governments have got to invest in young people,” Costello said, because “they’re the future. We mustn’t be afraid to involve children in designing their own environments, in coming up with creative ideas, in working with peer groups, and investing in things that will give them an exciting life without exposing them to long term risks that could be avoidable.”

A study published in The Lancet in April shows that improving the physical, mental and sexual health of adolescents could result in significant economic returns. The study contends that an investment of about $4.60 per person per year would yield more than 10 times as much in benefits to society. This study was conducted by researchers from Victoria University and the University of Melbourne along with the United Nations Populations Fund.
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Commercial development of the globe’s huge reserves of a frozen fossil fuel known as “combustible ice” has moved closer to reality after Japan and China successfully extracted the material from the seafloor off their coastlines.

But experts said Friday that large-scale production remains many years away, and if not done properly could flood the atmosphere with climate-changing greenhouse gases. 

Frozen mix of water, gas

Combustible ice is a frozen mixture of water and concentrated natural gas. Technically known as methane hydrate, it can be lit on fire in its frozen state and is believed to comprise one of the world’s most abundant fossil fuels. 

The official Chinese news agency Xinhua reported that the fuel was successfully mined from beneath the South China Sea on Thursday. Chinese Minister of Land and Resources Jiang Daming declared the event a breakthrough moment heralding a potential “global energy revolution.” 

A drilling crew in Japan reported a similar successful operation two weeks earlier, on May 4 along the Shima Peninsula. 

For Japan, methane hydrate offers the chance to reduce its heavy reliance on imported fuels. In China, it could serve as a cleaner substitute for coal-burning power plants and steel factories that have polluted much of the country with lung-damaging smog.

Estimated reserves are large

Methane hydrate has been found beneath seafloors and buried inside Arctic permafrost and beneath Antarctic ice. 

Estimates of worldwide reserves range from 280 trillion cubic meters (10,000 trillion cubic feet) up to 2,800 trillion cubic meters (100,000 trillion cubic feet), according to the U.S. Energy Information Administration. By comparison, total worldwide production of natural gas was 3.5 billion cubic meters (124 billion cubic feet) in 2015, the most recent year available.

That means methane hydrate reserves could meet global gas demands for 80 to 800 years at current consumption rates.

Yet efforts to successfully extract the fuel at a profit have eluded private and state-owned energy companies for decades. That’s in part because of the cost of extraction techniques, which involve large amounts of water and power to flood methane hydrate reserves so the fuel can be released and brought to the surface.

There are also environmental concerns, said David Sandalow, a former senior official with the U.S. State Department now at Columbia University’s Center on Global Energy Policy.

If methane hydrate leaks during the extraction process, it can increase greenhouse gas emissions. If it can be used without leaking, it has the potential to replace dirtier coal in the power sector.

“The climate implications of producing natural gas hydrates are complicated.There are potential benefits, but substantial risks,” Sandalow said.
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Scientists have discovered a possible cure for all five known Ebola viruses, one of which ravaged West Africa in recent years.

The so-called broadly neutralizing antibodies were discovered in the blood of a survivor of the West African epidemic, which ran from late 2013 to mid-2016. The deadly virus killed more than 11,000 people of the nearly 29,000 who became infected in Liberia, Guinea and Sierra Leone.

Ebola got its name from the first documented outbreak, which occurred along the Ebola River in the Democratic Republic of the Congo, formerly Zaire, in 1976. Since then, there have been two dozen outbreaks of Ebola in Africa, including a current one that has infected nine people in the DRC. Three people have died.

Kartik Chandran, a professor in the Department of Microbiology and Immunology at the Albert Einstein College of Medicine in Bronx, New York, helped identify the antibodies, which were described online in the journal Cell. He is optimistic that the antibodies can be used as a single therapy to treat all Ebola viruses.

“Based on the nonhuman primate studies that are ongoing, and given the fact that they are pretty predictive, I would be optimistic that they could be used to protect people and reverse disease,” Chandran said.

350 antibodies isolated

Researchers isolated about 350 antibodies from the human blood sample, two of which showed promise in neutralizing three viruses in tissue culture. The antibodies work by interfering with a process that the pathogen uses to infect and multiply inside cells.

The drug company Mapp Pharmaceutical Inc. is now testing the antibodies in monkeys to make sure they are safe and effective.

A forerunner of the experimental drug, called Zmapp, was in the experimental stages when it was pressed into service during the last epidemic. Zmapp is a combination of cloned antibodies discovered in mice that enlist the body’s natural immune system to fight infection. If given up to five days after symptoms appear, it can cure the disease.

The problem, Chandran said, is Zmapp is not terribly specific and works to neutralize only Ebola Zaire, one of the five known viruses. He said the broadly neutralizing human antibodies attack and destroy all of the viruses.   

It took scientists just six months to discover the antibodies, according to Chandran, “so this is really incredibly fast and incredibly gratifying.  And we are hoping that things will continue at this pace and that in very short order we will be in a position to be able to test these things in people.”

While the broadly neutralizing antibodies are being developed as a treatment, Chandran envisions using them in a vaccine that can be given ahead of an Ebola outbreak to guard against infection.
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Heavy rain shaped the Martian landscape billions of years ago, according to a new study.

According to researchers at the Smithsonian Institution and the Johns Hopkins University Applied Physics Laboratory, rain on Mars once carved river beds and created valleys much like rain on Earth has, and does. It no longer rains on the Red Planet, and the water that remains is mostly in the form of ice.

The rain appears to have slowly changed over time, researchers said, noting that changes in the Martian atmosphere influenced how heavy the rain was, particularly the size of the raindrops.

When Mars formed 4.5 billion years ago, it had a much thicker atmosphere and higher atmospheric pressure. Pressure, researchers say, influences the size of raindrops.

They say that early in the planet’s history, the rain would have actually been more like fog, so it would unlikely have made much of an impact on the terrain. But as the atmosphere thinned over time, larger raindrops could form and were heavy enough to “cut into the soil” changing the shape of craters and leading to running water that could have carved valleys.

Specifically, researcher say the atmospheric pressure on the Red Planet was about four bars, compared to one bar on Earth today. This means the raindrops could not have been bigger than three millimeters across. Over time the pressure dropped to 1.5 bars allowing for larger drops measuring about 7.3 millimeters across.

“By using basic physical principles to understand the relationship between the atmosphere, raindrop size and rainfall intensity, we have shown that Mars would have seen some pretty big raindrops that would have been able to make more drastic changes to the surface than the earlier fog-like droplets,” said Ralph Lorenz of John Hopkins APL.
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Colon cancer patients who adopt a healthy lifestyle after treatment could potentially reduce their risk of death from a recurrence by more than 40 percent, according to new research.

The findings were released ahead of a conference of the American Society of Clinical Oncology, the world’s largest organization of clinical cancer professionals.

Researchers from the University of California, San Francisco analyzed data gathered in a prospective study of 1,000 advanced, stage III colon cancer patients from across the United States who were enrolled from 1999-2001. The volunteers, from 13 institutions, were evaluated over a period of seven years.

At two points during the trial, participants filled out a questionnaire asking whether their lifestyle following treatment matched prevention guidelines recommended by the American Cancer Society.

Body weight

The guidelines include maintaining a healthy body weight, eating a diet rich in fruits and vegetables, limiting consumption of red and processed meats, and engaging in regular physical activity.

Nine percent of patients in the study adhered to the guidelines. Of those, there was a reduction in death by 42 percent and a 31 percent lower risk of cancer recurrence compared to patients who did not follow the guidelines. In the study, colon cancer returned in 355 patients, 256 of whom died.

The federally-funded study was the first to look at colon cancer survivorship. Other studies have focused on cancer prevention through adoption of a healthy lifestyle.

There are a reported one million colon cancer survivors in the United States; the disease is the second-leading cause of cancer death. 

UCSF lead author Erin Van Blarigan said treated colon cancer patients are living longer than ever before, but there needs to be more emphasis on survivorship care. She called for an increase in resources to help more people adopt a healthy lifestyle in the aftermath of a diagnosis and treatment.

“There is a pressing need for improved survivorship care and resources to help people adopt and maintain a healthy lifestyle after cancer diagnosis,” Blarigan said.

Harvard University in Massachusetts administered the lifestyle questionnaire. The results were analyzed by researchers at the University of California.
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An ongoing measles outbreak in Minnesota has shined a light on the fact that many Somali immigrants choose not to vaccinate their children.   

According to the Minnesota Department of Health, 63 measles cases have been reported statewide as of May 16, and 53 of those cases were Minnesotans of Somali origin. Sixty of the reported cases involve individuals confirmed to not be vaccinated.

Public health officials blame false rumors that vaccines are linked to autism and other health problems for the high rate of unvaccinated children in Minnesota’s Somali-American community.  

The department’s disease director, Kris Ehresmann, said anti-vaccination groups have targeted the community with events and have even translated the anti-vaccine documentary “Vaxxed: From Cover-Up to Catastrophe” into Somali.

“They have been very aggressive and are continuing in their efforts to reach out to the community with misinformation throughout the duration of this outbreak,” Ehresmann said.

Anti-vaccine views

In interviews with Somali mothers, VOA’s Somali Service found that anti-vaccine views are widespread.

“I have a baby boy who was well before the vaccine, but eventually he became autistic because of the vaccine. After him, I have never vaccinated my children,” said Safia Sheikh Mohamed, a mother of four children.

Mohamed listed a number of problems she believes are associated with vaccines, including food allergies, ear infections and eczema, a treatable condition in which the skin becomes inflamed or irritated.

Another mother said she vaccinated her child, but did so later in life. “I never gave vaccines to my last born child before he turned 6, during his first year of school.”  

Community leaders reach out

Multiple large-scale studies have found there is no connection between autism and the measles, mumps and rubella (MMR) vaccine, despite rumors to the contrary.

The Minnesota Department of Health is working hard to dispel such beliefs through outreach campaigns.  The department has a Somali staff member and a group of Somali health advisers who meet one-on-one with people and attend various community meetings.

“Our challenge at this point is really scalability,” Ehresmann said. “If we could multiply our efforts by 10-fold or more, that would be great, but obviously there are resource challenges.”

Ahmed Roble, a Somali-American physician who owns a clinic in Minnesota, said he and his colleagues try to dispel misinformation.

“As health professionals, our aim is not only to cure the patient but also to give them counseling,” he said. “That is what we do for the worrying mothers and fathers who are skeptical about MMR vaccination.”

Perhaps the best argument for vaccinating children is the current outbreak, which may be frightening parents into action. Prior to the outbreak, about 30 Somali children per week received the MMR vaccine in Minnesota, but, since the outbreak, that number has grown to 500 children per week.

“We know that as a result of the outbreak and perhaps as a result of seeing measles in real life there, that combined with other messaging has made an impact on a number of the parents,” Ehresmann said.

Additionally, parents are beginning to see the consequences of not vaccinating children. Children who are not vaccinated are forced to stay out of daycare for 21 days if a measles case is reported and could be forced to stay out indefinitely if multiple cases occur.

State Rep. Ilhan Omar, the first Somali-American elected to serve in a state legislature, invited parents, doctors, owners of clinics and community leaders to share their thoughts at a meeting on Wednesday. She called for parents who do not vaccinate their children to take responsibility.

“It will be the parents’ responsibility if they don’t want to vaccinate. They should go and discuss with doctors, and then, if they insist, it’s their responsibility.  It will be documented,” she said.

The state is bracing for an uptick in cases as the month of Ramadan approaches in late May and June and families gather for the celebration. The final celebration of Eid al-Fitr has the greatest potential for spreading the disease.

“It would represent the biggest risk for potential transmission,” said Ehresmann, because “it’s bringing together kids and adults and everybody, and it’s not just the population of a single mosque, it’s multiple mosques coming together.  That factor means that could have the potential for transmission.”

Reporter Steve Baragona contributed to this report.
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Cuba said on Thursday 1,847 residents had so far contracted the mosquito-borne Zika virus, warning that certain provinces on the Caribbean island still had high rates of infestation despite a series of measures to stave off the epidemic.

At the start of the global Zika outbreak, Cuba managed for months to fend off the virus that can cause microcephaly in babies as well as Guillain-Barre syndrome, even as neighboring territories like Puerto Rico were hard hit.

The Communist-run country called out the military to help fumigate, activated neighborhood watch groups to check for places with standing water where mosquitoes breed, and instituted health checks at airports and other entry points to the island.

“Even though we have managed to reduce the cases of infestation … there are still provinces like Havana, Guantanamo, Cienfuegos and Camaguey, with big risks and rates of infestation,” the head of the Civil Defense’s Department of Disaster Reduction, Gloria Gely, was quoted as saying by state-run media.

Although generally a mild disease, the virus is a particular risk to pregnant women as it can cause microcephaly – a severe birth defect in which babies are born with abnormally small heads and underdeveloped brains.

Gely did not detail how many of the cases were contracted locally nor whether there had been any instances of babies born with microcephaly on the island of 11.2 million inhabitants.

There is no preventive treatment against Zika, but drug companies are rushing to develop a vaccine. The virus has spread to more than 60 countries and territories since the current outbreak was identified in Brazil during 2015.
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We producing nearly 300 million tons of plastic every year, half of which is used once, then thrown away. In the United States, we discard more than 33 million tons of plastics, and only a little more than 14 percent is recycled or used as fuel. The rest ends up in landfills or strewn along roadways or washed into the ocean. Getting rid of it will be an enduring challenge, but one man has a plan to start cleaning up our mess. VOA’s Faith Lapidus reports.
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Despite the health warnings, smoking in many places is still the “thing to do.” For those who have quit but still want to hang out with their smoking friends, a French design group has the Sifflu. It lets people act like they are smoking while teaching them how to breathe, but without the worry of cancer and a shortened life span. VOA’s Kevin Enochs reports.
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Most doctors did not discuss the cost of cancer treatment with patients, spent less than two minutes on it when they did, and usually did so only after patients brought it up, a study that taped hundreds of visits at several large hospitals finds.

Cancer patients are three times more likely to declare bankruptcy than people without cancer are, but many doctors are not having the conversations that might help prevent this and sometimes don’t know the cost themselves, the results suggest.     

“That would not occur in any other industry I can think of” where a service or product is sold, said the study leader, Dr. Rahma Warsame of the Mayo Clinic.

Results were released Wednesday by the American Society of Clinical Oncology and will be discussed next month at its annual meeting in Chicago.

The study has some limitations – it’s not nationwide, and it includes newly diagnosed patients, where cost is most likely to come up, as well as others further along in treatment who may have discussed this earlier.

But the larger point is clear, Warsame said: The “financial toxicity” of treatments that can cost more than $100,000 a year is growing, and talks about that aren’t happening enough.

“I’ve had people say ‘no’ to really life-extending therapies” because of worries about bankrupting their family, she said.

For the study, researchers taped 529 conversations between doctors and patients with various types of cancer at three outpatient clinics – the kind of places chemo often is given – at Mayo, Los Angeles County Hospital and the University of Southern California’s Norris campus in Los Angeles.

Patients and doctors knew they were being taped but didn’t know why. Cost came up in 151 of the visits. Patients brought it up in 106 cases and doctors did in 45.

Appointments lasted about 15 minutes on average at the two California hospitals and half an hour at Mayo, but cost discussions ran only one to two minutes when they occurred at all.

Even when doctors acknowledged a cost concern, they rarely acted on it. Only six patients were referred to social services to seek help with affording care.

“Maybe a lot of patients don’t know to ask questions” about cost, said Karla Mees, 63, a nursing instructor from Rochester, Minnesota, who was treated for breast cancer at Mayo Clinic.

Doctors warned her in advance that she might have to pay $4,500 for gene tests on her tumor to help determine care, but she never knew how much chemo and radiation would cost until the bills came.  

“I just remember thinking, ‘I need the stuff, I’ll worry about payment later,’” she said, thankful that her insurance capped her annual out-of-pocket costs at $2,500.

Doctors also may be reluctant to talk money and have to give medical issues top priority in the short time they have during patient visits, said Dr. Lowell Schnipper, a cancer expert at Boston’s Beth Israel Deaconess Medical Center and head of the cancer group’s panel on value in cancer care.

“Most of us are not very well skilled in bringing it up,” he said. “In school you’re trained to simply take the best care you can of your patient and not worry about anything other than doing exactly that.”

In 2015, the cancer society launched a tool to help doctors and patients decide whether a cancer drug is worth it – the amount of benefit it gives versus its cost. It’s a good starting point for money talks, he said.
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Scientists say they have identified the “sea monster” that washed ashore on an Indonesian beach.

The badly decomposing carcass measures over 15 meters long and baffled scientists since it washed up on Seram Island last week.

Marine biologists now believe the carcass is a dead baleen whale, largely because of a visible skeleton, which would rule out speculation that the creature was a giant squid.

“Giant squid are invertebrates and there are clearly bones visible, so I am very comfortable saying it’s some type of rorqual whale,” said Regina Asmutis-Silvia, executive director of Whale and Dolphin Conservation in an interview with the Huffington Post. “Certain species of baleen whales (rorquals) have ‘ventral grooves’ which run from their chin to their belly button. It is stretchy tissue that expands when they feed.”

Alexander Werth, a whale biologist at Hampden-Sydney College in Virginia agrees with the assessment after seeing photos of the carcass on social media that showed the nearly amorphous carcass surrounded by blood in the water. He added that the carcass probably stinks “to high heaven.”

“That’s yet another reason you don’t want to be close to these things, not because it’s a scary, spooky creature, but [because] it would just be releasing some pretty foul, noxious gases,” Werth told Live Science.

Locals have asked the government for help in removing the whale.
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Pregnant women who come down with the flu are at greater risk of illness requiring hospitalization. A new study found that in resource-poor countries, flu vaccination reduced the risk of illness to mother and baby.  

An estimated 40 percent of the world’s population lives in subtropical and tropical zones, where influenza sometimes circulates year-round. Yet influenza vaccine is rarely used.

Mark Steinhoff is director of the Global Health Center at Cincinnati Children’s Hospital in Ohio. He said the influenza virus, which is often mild in healthy people, can result in hospitalization of pregnant women.  

With a growing fetus pressed up against their lungs, Steinhoff says, women with the flu can have trouble breathing.  He also said a pregnant woman is  more susceptible to illness as the growing baby siphons off her natural defenses.

But in a first-of-its-kind study, Steinhoff and colleagues found vaccinating women year-round in a developing country, Nepal near the Indian border, dramatically reduced the incidence of influenza in mothers and benefited their babies.

The study was published in the journal Lancet Infectious Diseases.

“It reduced disease in the mothers and in the infants by about 60 percent reduction in the second year. It’s really quite remarkable. But it also reduced the rate of low birth weight — that is, kids born less than 2.5 kilos. It reduced that by 16 percent,” said Steinhoff.

Babies benefited from the shots because they received antibodies against the illness from their mothers while in the womb.

The study

The study ran between April 2011 and September 2013 and involved a total of 3,693 mothers between the ages of 15 and 40.   

There were two phases of the trial, with one group of women being vaccinated in the first year and a different group of pregnant women the following year.  Half of the women received a placebo.

Because influenza in some countries can circulate year-round, there’s no particular flu season as in more temperate climates. The women were therefore vaccinated at various times with a shot that contained three inactivated flu strains. Each group was followed for up to 180 days to see whether they developed fevers and body aches.

Steinhoff said the benefits of influenza vaccination have long been known in the United States and other Western countries.

“The vaccine you know was developed many years ago. It was known to be safe. There were no bad reactions to it,” Steinhoff said.

He said it’s up to individual countries to decide whether they want to launch influenza vaccination campaigns for pregnant women. In the meantime, he said, researchers will be obtaining additional data on year-round immunization programs in developing countries.
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A regional drought has displaced more than half a million people in Somalia and left the country at risk of famine. A cholera outbreak is further complicating relief efforts, in particular in the southern part of the country where some villages remain under al-Shabab control.

Bay Regional Hospital, the biggest in the southwest federal state, is filled with patients suffering from stomach pain, vomiting, and diarrhea.

Cholera has sickened more than 40,000 people in Somalia since December. More than half of the cases have been in this state. Most of the victims have been malnourished children.

Five-year-old Fatuma was admitted to the cholera treatment ward last night. Her mother Bisharo Mohammed says she can not lose another child.

She says her eldest daughter was suffering from diarrhea, and she died two months ago in Busley village on the outskirts of Baidoa. She says the girl was seven years old.

Cholera treatment

Cholera is treatable. The World Health Organization recommends “prompt administration of oral rehydration salts.” Mohamed says Fatuma is already feeling better with treatment. They hope to be released soon.

But they will not be going home.

Aid agencies say the areas worst hit by cholera and hunger are villages like Busley which are under al-Shabab control. Accessing them is a challenge. Fatuma and her family are among the tens of thousands of people who have walked to government-controlled areas like Baidoa to seek help and are now living in makeshift camps.

World Health Organization cholera expert Dr. Abdinasir Abubakar says the outbreak is getting worse due to security challenges.

“If you look at Bay, Bakool, Middle Juba, Gedo some of those areas where none of us is able to access, the deaths and cases due to cholera is very high, and we expect the situation will get worse,” says Abubakar.

Rains this month in southern and central Somalia have contributed to a surge in cholera cases, according to Bay Regional Hospital cholera treatment ward deputy supervisor Salima Sheikh Shuaib.

She says “the cholera cases were going down, but the past three days we have seen an increase in cholera cases. This morning, we have received 16 cases and most of them are children under the age of five.”

Life in camps

More than 150,000 displaced people are living in the makeshift camps around Baidoa and more continue to arrive.

At the camps, many families do not have plastic tarps or covered places to sleep. Stagnant puddles and mud dot the walkways. There is no regular food provided. Clean water is available, but it is not enough.

Medics supported by UNICEF and the WHO are going to IDP camps around Baidoa to provide oral cholera vaccination to children.

But Abubakar of the WHO says it is hard to contain the spread of cholera so long as the general humanitarian situation is not improving.

“We cannot only solve cholera. We cannot only deal with cholera unless we deal with food insecurity, unless we deal with water issues, malnutrition and I think collectedly both the wash, the health, the nutrition, and the food security partners we are working closely and we are coordinating but again in Somalia one of the challenges. We are facing a shortage of resources to support all these interventions,” says Abubakar.

Somalia continues to report between 200 and 300 cases of cholera nationwide each day.
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The beaches on a remote, uninhabited island in the middle of the Pacific Ocean have the highest amount of plastic debris in the world.

Researchers from the University of Tasmania say Henderson Island, which is more than 5,000 kilometer from any major population center, is strewn with roughly 37.7 million pieces of plastic waste.

Put another way, the beaches on Henderson Island are covered with about 671 pieces of plastic litter per square meter, which researchers say is the highest density ever recorded.

“What’s happened on Henderson Island shows there’s no escaping plastic pollution even in the most distant parts of our oceans,” said Jennifer Lavers of the Institute for Marine and Antarctic Studies and lead author of a paper about the pollution in the journal Proceedings of the National Academy of Sciences.

Henderson Island, which is part of the UK’s Pitcairn Islands territory, sits right in the middle of the Pacific Gyre current, which makes it a “focal point” for garbage from South America as well as from fishing boats.

Researchers say their sampling of the debris at five sites on the island leads them to believe there is more than 17 tons of plastic on the island and around 3,570 new pieces of litter being deposited every day.

Lavers noted, “It’s likely that our data actually underestimates the true amount of debris on Henderson Island as we were only able to sample pieces bigger than two millimeters down to a depth of 10 centimeters, and we were unable to sample along cliffs and rocky coastline.”

Every year, the world produces some 300 million tons of plastic, much of which is not recycled. Plastic disintegrates very slowly, and when it ends up floating in the ocean, it can lead to “entanglement and ingestion” by animals, birds and fish.

“Research has shown that more than 200 species are known to be at risk from eating plastic, and 55 percent of the world’s seabirds, including two species found on Henderson Island, are at risk from marine debris,” Lavers said.
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