Fatal attacks on Congo clinics risk resurgence of Ebola epidemic

By Fiston Mahamba

GOMA, Democratic Republic of Congo (Reuters) – International organizations warned on Friday of a potential resurgence of Ebola in Congo after deadly militia attacks on health centers forced aid groups to suspend operations and withdraw staff from the epidemic’s last strongholds.

Mai Mai militia fighters killed four people and injured several others at two Ebola centers on Thursday in the worst yet of violence hampering efforts to tame the outbreak in eastern Democratic Republic of Congo (DRC).

The world’s second biggest Ebola epidemic on record has killed over 2,200 people since mid-2018, but new infections slowed in recent months.

“Ebola was retreating and now it is likely to resurge,” World Health Organization (WHO) spokesman Christian Lindmeier told a news briefing in Geneva. WHO has relocated 173 staff while the U.N. children’s agency UNICEF has evacuated 20 staff.

After Thursday’s fatal raids on health centers in Mangina and Byakoto, a screening center was also attacked overnight in the town of Oicha, Congolese health authorities said.

Mai Mai fighters and local residents have attacked health facilities sometimes because they believe Ebola does not exist and in other cases because of resentment that they have not benefited from the influx of donor funding.

The International Federation of the Red Cross (IFRC) halted operations in the towns of Mangina, Beni and Butembo.

“We’ve had to put all Ebola activities on hold in high-risk areas,” said Corrie Butler, spokeswoman for the IFRC in Congo, saying the attacks had been in areas with most Ebola cases.

At least 1,500 Red Cross staff and volunteers are involved in Ebola work in east Congo, she said, most in areas where activities are now suspended due to violence.

The World Food Programme (WFP), another U.N. agency which provides food to those around infected people and at risk of Ebola, said its activities had also been interrupted due to insecurity.

Congolese health authorities said they had evacuated 13 staff and other transfers were underway.

The Alliance for International Medical Action (ALIMA) charity said activities at its treatment centers in Mambasa and Katwa towns were not suspended but it was monitoring the security situation closely.

Thursday’s attacks followed raids on communities by suspected Islamist rebels believed to have killed at least 100 people in the past month, according to U.N. figures.

At least four people also died this week during protests at the perceived failure of the army and U.N. peacekeepers to protect civilians from the Islamist Allied Democratic Forces (ADF)

(Reporting from Fiston Mahamba in Goma, Stephanie Nebehay in Geneva, Anna Pujol-Mazzini in Dakar; Writing by Anna Pujol-Mazzini; Editing by Alessandra Prentice and Andrew Cawthorne)

IOM suspends some Ebola screening after three aid workers killed in South Sudan

IOM suspends some Ebola screening after three aid workers killed in South Sudan
By Denis Dumo

JUBA (Reuters) – The U.N. migration agency has suspended some screening services for Ebola after three of its aid workers were killed in South Sudan, the latest deadly incident involving relief staff in the violence-ridden country.

In a statement, the International Organization for Migration said the workers – two men and one woman – were hit by crossfire during clashes between rival armed groups in the country’s central Equatoria region.

It said the IOM had stopped screening for Ebola at five border points between South Sudan, Uganda and Democratic Republic of Congo, where an ongoing outbreak of the haemorraghic fever has killed thousands of people.

The dead woman’s four-year-old son was abducted along with another local female IOM volunteer during the armed clash, the IOM said. Two other male volunteers were injured, including one who is recovering from a gunshot wound.

Humanitarian workers are often targeted by rebels operating in South Sudan, which has been in the grip of war that first broke out in late 2013 between soldiers allied to President Salva Kiir and those of his former deputy Riek Machar. Last year, 10 aid workers went missing in Yei, in the same region.

“We …reiterate that humanitarians and civilians are not and should never be subjected to such heinous acts of violence – we are not a target,” IOM Director General António Vitorino said.

It was not clear who was behind the latest fighting.

In the past, government forces have clashed in the region with fighters from the rebel National Salvation Front, led by renegade former General Thomas Cirillo Swaka, who is not a party to a peace deal signed last year by Kiir and Machar.

Lul Ruai Koang, the government’s military spokesman, said that on the day of the attack Cirillo’s fighters had targeted a government position, and that one soldier was killed along with nine from Cirillo’s side.

“If they (National Salvation Front) went and killed the aid workers, this is what I do not know. But the attack on our defense positions didn’t involve any humanitarian workers,” Koang said.

The National Salvation Front was not immediately reachable to comment on the killings.

(Reporting by Denis Dumo with additional reporting and writing by George Obulutsa in Nairobi; Editing by Mark Heinrich)

Fourth Ebola case found in Congo city, raising fears of faster spread

FILE PHOTO: Congolese health workers prepare to administer ebola vaccination to residents at a centre in Goma, Democratic Republic of Congo, August 1, 2019. REUTERS/Djaffer Sabiti

GOMA, Democratic Republic of Congo (Reuters) – A fourth case of Ebola has been confirmed in the eastern Congo city of Goma, the government said late on Thursday, raising fears of an acceleration in infections close to the border with Rwanda.

The new case is the wife of a miner who died of the virus earlier this week and who only sought treatment more than a week after starting to show symptoms, authorities said.

“This time … the individual concerned spent time with his family and spent time [being] very symptomatic within the community. So we did expect further cases and we are seeing further cases,” said Margaret Harris, a spokeswoman for the World Health Organization (WHO).

One of the couple’s daughters has also tested positive for Ebola though the government said on Friday two others were negative in preliminary checks. More than 200 people who came into contact with the man have been tracked and 160 of them vaccinated.

An outbreak on Ebola has killed more than 1,800 people in other parts of Democratic Republic of Congo since it was declared one year ago, making it the second-worst on record. Two people have died in Uganda, which also borders Congo, but no registered cases have occurred in Rwanda.

Fears the disease was gaining a foothold in Goma, a city of 1 million people, had subsided after its first case emerged in July but was not immediately followed by more. The new cases confirmed this week were not linked to that first case, authorities said.

BORDER TOWN

Nestled in hilly country at the foot of an active volcano, Goma lies just 7 km (4.5 miles) from Rwanda’s main border town of Gisenyi.

On Thursday, Rwanda briefly shut its border crossings with Congo around the city, after the new cases emerged.

Increased health screenings caused traffic slowdowns at the border, Rwandan Health Minister Diane Gashumba said, hours after Congolese traders had reported it shut. About 45,000 people a day go through the main border post, an immigration official said.

In July, the outbreak was declared an international health emergency by the WHO, but the body said there should be no trade or travel restrictions.

“When you close borders… two things happen: first you get panic, people see this as a signal to start panicking,” Harris told reporters in Geneva.

“Secondly, people who do have symptoms go underground. Because they don’t want to be seen and they do want to continue their daily lives, and so we are even less likely to detect where this virus is moving,” she added.

(Reporting by Fiston Mahamba in Goma, Anna Pujol-Mazzini in Dakar and Stephanie Nebehay in Geneva; editing by Alison Williams, Larry King and Andrew Heavens)

Rwanda seals Congo border after third Ebola case in Goma

Congolese customs agents gather at the gate barriers at the border crossing point with Rwanda following its closure over ebola threat in Goma, eastern Democratic Republic of Congo, August 1, 2019. REUTERS/Djaffer Sabiti

By Djaffar Al Katanty and Fiston Mahamba

GOMA, Democratic Republic of Congo (Reuters) – Rwandan authorities closed the border with the Ebola-hit Congolese city of Goma on Thursday for everyone other than Congolese citizens leaving Rwanda, as a third case was confirmed in Goma.

The daughter of an Ebola patient in the east Congo city has contracted the virus, Congolese officials confirmed, the third case in a metropolis of at least 1 million people that neighbors Rwanda.

Rwandan state minister for the Foreign Affairs Ministry, Olivier Nduhungirehe, told Reuters by phone that the border had been shut but declined to give further details. Congo deplored the decision.

Confirmation of the third case in Goma increased fears the virus could take root in the densely populated city, which lies more than 350 km (220 miles) south of where the outbreak was first detected.

The second patient died after he sought treatment too late and was already bleeding, authorities said on Wednesday.

The outbreak in Congo has killed more than 1,800 people over the past year and become the second-worst on record.

“The tests on a suspected case at the Goma Ebola treatment center came out positive for the Ebola virus. Investigations are still under way around this … case,” Dr Aaron Aruna Abedi, who coordinates the Ebola response for Congo’s health ministry, told Reuters on the phone.

MSF spokeswoman Jinane Saad said contacts of a patient in Goma were currently being tested.

“DEPLORE THIS DECISION”

Nestled in hilly country at the foot of an active volcano, Goma lies just 7 km (4.5 miles) from Rwanda’s main border town of Gisenyi.

Some 45,000 people go through the main border post between Goma and Gisenyi, according to an immigration official, and many worried of the closure’s impact on their businesses.

After the first Ebola case in Goma was confirmed in mid-July, the World Health Organization (WHO) declared the outbreak an international health emergency. It was earlier reluctant to do so, partly out of fear countries bordering Congo might shut their frontiers.

“By closing the border like this, they deprive a lot of people of their earnings today. Most of the women here cross into Rwanda to find food for us in Goma,” Lucien Kalusha, a Congolese hairdresser who crosses every day to work in Rwanda, told Reuters.

Another, smaller border post near Goma was unusually quiet, as traders and vehicles had left after the closure was announced.

When declaring the emergency, WHO director-general Tedros Adhanom Ghebreyesus said explicitly that no country should close borders or impose any travel or trade restrictions.

“On a unilateral decision by the Rwandan authorities, Rwandan citizens cannot leave for Goma,” the Congolese presidency statement said.

“The Congolese authorities deplore this decision, which runs counter to the advice of the WHO (World Health Organization).”

WHO spokeswoman Nyka Alexander said the agency was “following up with Rwandan officials for clarification”.

The first Ebola case to hit Goma is not linked to the second or third, authorities say.

(Additional reporting by Stanys Bujakera in Kinshasa, Clement Uwiringiyimana in Kigali and Anna Pujol Mazzini in Dakar; Writing by Tim Cocks; Editing by Hugh Lawson and Alison Williams)

Family sent back to DR Congo after two die of Ebola in Uganda

A health worker checks the temperature of a woman as she crosses the Mpondwe border point separating Uganda and the Democratic Republic of Congo as part of the ebola screening at the computerised Mpondwe Health Screening Facility in Mpondwe, Uganda June 13, 2019. REUTERS/Newton Nabwaya

By Elias Biryabarema

KAMPALA (Reuters) – Authorities repatriated the relatives of two people who died of Ebola in Uganda back to the Democratic Republic of Congo on Thursday, including a 3-year-old boy confirmed to be suffering from the disease, the Ugandan health minister said.

The cases marked the first time the virus has crossed an international border since the current outbreak began in Congo last August. The epidemic has already killed 1,390 people in eastern Congo.

The family sent home on Thursday had crossed from Congo to Uganda earlier this week and sought treatment when a 5-year-old boy became unwell. He died of Ebola on Tuesday. His 50-year-old grandmother, who was accompanying them, died of the disease on Wednesday, the ministry said.

They were the first confirmed deaths in Uganda in the current Ebola outbreak.

The dead boy’s father, mother, 3-year-old brother and their 6-month-old baby, along with the family’s maid, were all repatriated, the minister’s statement said.

The 3-year-old has been confirmed to be infected with Ebola. His 23-year-old Ugandan father has displayed symptoms but tested negative, Ugandan authorities said.

“Uganda remains in Ebola response mode to follow up the 27 contacts (of the family),” the statement said.

Three other suspected Ebola cases not related to the family remain in isolation, the ministry said.

The viral disease spreads through contact with bodily fluids, causing hemorrhagic fever with severe vomiting, diarrhea and bleeding.

UGANDA PRECAUTIONS

Authorities in neighboring Uganda and South Sudan have been on high alert in case the disease spreads.

On Thursday, Uganda banned public gatherings in the Kasese district where the family crossed the border. Residents are also taking precautions, local journalist Ronald Kule told Reuters.

“They are a little alarmed now and they realize that the risk of catching Ebola is now real,” he said.

“Hand washing facilities have been put in place, with washing materials like JIK (bleach) and soap. There’s no shaking of hands, people just wave at each other.”

At the border, health workers checked lines of people and isolate one child with a raised temperature, a Reuters journalist said.

Uganda has already vaccinated many frontline health workers and is relatively well prepared to contain the virus.

The World Health Organization (WHO) sent 3,500 doses of a Merck experimental vaccine to Uganda this week, following 4,700 initial doses.

Dr. Mike Ryan, head of WHO’s emergencies program, said that he expected Uganda to approve the use of experimental therapeutic drug treatments, to be shipped “in coming days”.

Monitoring and vaccination had been stepped up, but there had been “no panic reaction” so far to the cases there.

The WHO has said it will reconvene an emergency committee on Friday to decide whether the outbreak is an international public health emergency and how to manage it.

Authorities have struggled to contain the disease partly because health workers have been attacked nearly 200 times this year in conflict-hit eastern Congo, the epicenter of the outbreak.

(Reporting by Elias Biryabarema; Writing by Omar Mohammed and Katharine Houreld; Editing by Angus MacSwan)

East Congo villagers kill Ebola health worker, loot clinic

FILE PHOTO: An Ebola survivor a two-year-old confirmed Ebola patient inside a treatment centre in Beni, Democratic Republic of Congo, March 31, 2019. REUTERS/Baz Ratner/File Photo

GOMA, Democratic Republic of Congo (Reuters) – A mob in eastern Congo killed an Ebola health worker and looted a clinic, the Health Ministry said on Tuesday, underscoring a breakdown in public trust that is hampering efforts to contain the deadly virus.

Attacks on treatment centers by armed groups and mistrust among residents who view the disease as a conspiracy have become major impediments to containing Democratic Republic of Congo’s worst-ever Ebola outbreak.

The hemorrhagic fever has so far killed 1,281 people, according to the latest ministry figures, and shows no signs of slowing its spread, with dozens of new cases a week.

The ministry said that on Saturday residents of the village of Vusahiro, in the Mabalako district, “rose up and attacked the local Ebola response team, made up of village residents who were trained to carry out certain response activities”.

A hygienist from the infection prevention and control team died of his injuries when he was transferred to hospital, it said.

Responders, healthcare workers, and community members are increasingly subjected to threats from armed groups in hotspots such as Katwa and Butembo, the World Health Organization says, complicating efforts to contain Ebola.

U.N. officials say that stopping targeted attacks on health workers requires untangling deep-rooted political problems in eastern Congo. Dialogue has led to a recent reduction in large-scale attacks on health workers, WHO emergencies chief Mike Ryan told reporters in Geneva on Tuesday.

Still, an uphill battle remains. Between January and early May, there were 42 attacks on health facilities, with 85 workers either injured or killed, according to WHO figures from May 3.

Health workers have been attacked six times in the last eight days, WHO Director-General Tedros Adhanom Ghebreyesus told the closing session of the annual World Health Assembly in Geneva on Tuesday.

“These attacks demonstrate that the ongoing Ebola outbreak is more than a health crisis,” he said. “Ending it takes a coordinated and strengthened effort across the U.N. system…with strong leadership from the government.”

(Reporting by Fiston Mahamba in Goma, additional reporting by Stephanie Nebehay and Tom Miles in Geneva; Writing by Tim Cocks and Edward McAllister; Editing by Mark Heinrich)

Congo Ebola death toll nears 1,000, new vaccine planned -WHO

Mike Ryan, Executive Director of the World Health Organisation (WHO) attends a news conference on the Ebola outbreak in the Democratic Republic of Congo at the United Nations in Geneva, Switzerland May 3, 2019. REUTERS/Denis Balibouse

By Stephanie Nebehay

GENEVA (Reuters) – The World Health Organization said on Friday it feared continued “intense transmission” of Ebola virus in the Democratic Republic of Congo, where deaths from a nine-month-old epidemic stood at 994 and were expected to exceed 1,000 within hours.

The WHO plans to expand vaccination with an unlicensed new Ebola vaccine made by Johnson & Johnson, in addition to a Merck vaccine already being used, said Dr. Michael Ryan, executive director of WHO’s Health Emergencies Programme.

“We are anticipating a scenario of continued intense transmission,” Ryan told a news briefing.

“We haven’t exceeded the 1,000 (deaths) as of this morning but we will likely exceed that today when we see the numbers later this evening. We want to use every tool in the tool box.”

Security incidents continue to plague the response to the outbreak, with 119 since January alone, Ryan said. This curtails access and thereby slows efforts to vaccinate more than 900 people a day as well as daily checks on some 12,000 people potentially exposed to the virus, he said.

“We still face major issues of community acceptance and trust,” Ryan added.

There was a would-be assault on an Ebola treatment facility in Butembe on Thursday, he said, adding that nobody was injured and the assailants were captured.

(Reporting by Stephanie Nebehay; Editing by Mark Heinrich)

WHO says Ebola team arrives in Congo

FILE PHOTO: Medecins Sans Frontieres (MSF) workers talk to a worker at an isolation facility, prepared to receive suspected Ebola cases, at the Mbandaka General Hospital, in Mbandaka, Democratic Republic of Congo May 20, 2018. REUTERS/Kenny Katombe

By Tom Miles and Fiston Mahamba

GENEVA/GOMA (Reuters) – An international delegation has arrived in the town of Beni in Democratic Republic of Congo, 30 km (18 miles) from where an Ebola outbreak was declared, the World Health Organization and Congolese officials said on Thursday.

Officials from the United Nations, the World Bank, the WHO and Democratic Republic of Congo’s Ministry of Health, including Health Minister Oly Ilunga, will support a team already on the ground.

Congo declared the new outbreak on Wednesday, just days after another outbreak that had killed 33 people in the northwest was declared over.

Twenty people have died from haemorrhagic fevers in and around Mangina, a densely populated town in North Kivu province about 30 km (18 miles) southwest of the city of Beni and 100 km from the Ugandan border.

The ministry has not made public when the deaths occurred. Another six who are still living are showing signs of fever, of which four tested positive.

“The Government-Partner delegation is holding its first meeting to organize the response,” North Kivu governor Julien Paluku tweeted. “Already a … team from Kinshasa is installing a laboratory and a single coordination center.”

But eastern Congo is a tinderbox of conflicts over land and ethnicity stoked by decades of on-off war and this could hamper efforts to contain the virus.

About 1,000 civilians have been killed by armed groups and government soldiers around Beni since 2014, and the wider region of North Kivu holds over 1 million displaced people.

(Writing by Tim Cocks; editing by Matthew Mpoke Bigg)

First Ebola vaccines given as WHO seeks to beat Congo outbreak

FILE PHOTO: A Congolese child washes her hands as a preventive measure against Ebola at the Church of Christ in Mbandaka, Democratic Republic of Congo May 20, 2018. REUTERS/Kenny Katombe/File Photo

By Kate Kelland

LONDON, (Reuters) – A vaccination campaign aimed at beating an outbreak of Ebola in Congo began on Monday in the port city of Mbandaka, where four cases of the deadly disease have been confirmed.

Use of the VSV-EBOV shot – an experimental vaccine developed by Merck – marks a “paradigm shift” in how to fight Ebola, said the World Health Organization’s head of emergency response, and means regions with Ebola outbreaks can in future expect more than just containment of an outbreak with basic public health measures such as isolation and hygiene.

The shot is designed for use in so-called ring vaccination plans. When a new Ebola case is diagnosed, all people who might have been in recent contact with the patient are traced and vaccinated to keep the disease from spreading.

“It’s the first time in the midst of an outbreak … that we’re using this as a way to stem transmission,” WHO’s Peter Salama said in a telephone interview. “It’s an important moment that changes the way we’ve seen Ebola for 40 years.”

The same strategy was used to test Merck’s vaccine in Guinea in late 2015, towards the end of an Ebola outbreak in West Africa from 2013 to 2016. The trial results showed it was safe and gave very high levels of protection against Ebola.

Around 30 Guinean health workers who were directly involved in that 2015 vaccine trial have travelled to Congo and will help with the immunizations there, Salama said.

Ebola causes hemorrhagic fever, vomiting and diarrhea and spreads through contact with the bodily fluids of an infected person. More than 11,300 people died in the West Africa epidemic.

This latest outbreak has killed 25 people since early April, according to the WHO. It is Congo’s ninth since the disease made its first known appearance near the country’s Ebola river in the 1970s.

Cases in Mbandaka, a port city on the Congo river, have raised concern that the virus could spread downstream to the capital, Kinshasa, which has a population of 10 million.

Salama, who visited Congo after the Ebola outbreak was first reported on May 8, said up to 1,000 people – first in Mbandaka and then in Bikoro and other affected areas -could be vaccinated within the next week.

Some 7,300 doses are already in Congo, and hundreds of thousands more are available in a stockpile built up by Merck.

“If we need any more we can ship it within days,” he said. “We’re fine for vaccine supply; that’s not an issue. The issue is going to be making sure we find every contact, track them down and get them vaccinated if they agree.”

Congolese health ministry data show four cases of Ebola confirmed in Mbandaka’s Wangata neighborhood and two suspected cases. One patient has died. For every case, up to 150 contacts will be offered the vaccine.

Salama said he was particularly concerned about the “unknowns” of the outbreak – namely the potential numbers of cases in the village of Ikobo, where no roads go and even helicopters have trouble landing.

“I’m actually very worried about Ikobo because we have four new suspected cases there and it’s very, very remote. We’ve tried to land helicopters there several times, but we need the community to clear the airstrip, and they haven’t fully cleared it yet,” Salama said.

“And when you haven’t got people on the ground, it’s very hard to assess the extent of the outbreak. I’m worried there are many more cases than we’ve been able to identify so far.”

(Reporting by Kate Kelland; Editing by Larry King)

Exclusive: U.S. needs to improve oversight of labs handling dangerous pathogens – report

Exclusive: U.S. needs to improve oversight of labs handling dangerous pathogens - report

By Julie Steenhuysen

CHICAGO (Reuters) – A year-long audit of the program overseeing U.S. labs that handle lethal pathogens such as Ebola and anthrax found overworked safety inspectors, an absence of independent review and weak biosafety protections that could expose lab workers and the public to harm, a government report will say on Tuesday.

The report by the Government Accountability Office to Congress followed a series of mishaps in which dangerous pathogens were inadvertently released. The report, seen by Reuters, concluded that the Federal Select Agent Program needs an overhaul.

The GAO audited laboratory safety oversight following errors that could have exposed dozens of people to live anthrax bacteria and the deadly toxin ricin. Its report will guide questioning of officials before the House Energy and Commerce Committee’s oversight subcommittee on Thursday.

The Federal Select Agent Program is jointly run by the U.S. Centers for Disease Control and Prevention (CDC) and the Animal and Plant Health Inspection Service (APHIS) of the U.S. Department of Agriculture.

According to the report, a chief concern is that the program is too focused on physical security measures, such as preventing theft from labs, and needs to focus more on biosafety issues that could protect researchers and the wider public from errors.

The GAO report also noted that many of the labs using high-risk pathogens for research belong to either CDC or the USDA, and recommended that Congress consider setting up a fully independent oversight body to remove potential conflicts of interest.

“The Select Agent Program does not fully meet our key elements of effective oversight,” the report stated.

Safety lapses in CDC labs captured headlines in 2014 when scientists at a high-level biosecurity lab did not properly inactivate anthrax bacteria before sending the material to labs with fewer safeguards. More than 80 scientists were exposed to potentially live anthrax, though no one fell ill.

In the months that followed, the Food and Drug Administration disclosed the discovery of decades-old vials of smallpox in a storage closet, while a U.S. Army lab erroneously shipped live anthrax to nearly 200 labs worldwide.

To address concerns of conflict of interest, CDC and APHIS have made structural changes to increase the program’s independence, but according to the GAO report, the program has not undergone a comprehensive risk management review, even as problems with lab safety continue to come to light.

As recently as last November, the Department of Homeland Security found a private lab inadvertently shipped ricin – a lethal poison – to one of its training centers on multiple occasions in 2011.

“Considering the type of research we’re talking about, we should have a much more robust, systematic oversight approach. That seems to be lacking,” said an aide to the House committee who declined to be identified.

To avoid conflicts of interest, inspections of APHIS laboratories are supposed to be carried out by the CDC, and inspections of CDC labs are to be carried out by APHIS. But the report revealed that at least three times in 2015, APHIS inspected its own laboratories, partly because there is no process in place to ensure compliance.

The report also cited excessive workloads for inspectors, which delay inspection reports and make it harder to retain personnel. In some cases, inspectors have been assigned to tasks outside of their expertise. For example, the GAO found that an APHIS physical security expert was asked to inspect ventilation systems – a critical protection against the accidental release of dangerous pathogens.

Short of a move by Congress to create an independent oversight agency, GAO recommended that CDC and APHIS officials conduct a risk assessment of the Select Agent Program and how it handles conflicts of interest. It also recommended that program officials shift inspection priorities to focus on high-risk activities in labs and develop a joint plan to train and hire inspectors.

The Health and Human Services Department, which oversees CDC, and the USDA, which runs APHIS, agreed with many of these recommendations, according to the report. Officials from the CDC and APHIS will testify at the Thursday hearing.

(Reporting by Julie Steenhuysen; Editing by Michele Gershberg)