Virus spreads to more Chinese cities, President Xi says containment is priority

By Se Young Lee and Colin Qian

BEIJING (Reuters) – An outbreak of a new coronavirus has spread to more Chinese cities, including the capital Beijing and Shanghai, authorities said on Monday, and a fourth case has been reported beyond China’s borders.

China’s National Health Commission confirmed that the virus, which causes a type of pneumonia, can pass from person-to-person, the official Xinhua News Agency said.

President Xi Jinping said curbing the outbreak and saving lives was a top priority as the number of patients more than tripled and a third person died.

Adding to the difficulties of containing it, hundreds of millions of Chinese will be traveling domestically and abroad during the Lunar New Year holiday that starts this week.

Authorities around the globe, including in the United States and many Asian countries, have stepped up screening of travelers from Wuhan, the central city where the virus was first discovered.

“Wuhan is a major hub and with travel being a huge part of the fast approaching Chinese New Year, the concern level must remain high. There is more to come from this outbreak,” said Jeremy Farrar, a specialist in infectious disease epidemics and director of the Wellcome Trust global health charity.

Authorities confirmed a total of 217 new cases of the virus in China as of 6 p.m. local time (1000 GMT) on Monday, state television reported, 198 of which were in Wuhan.

Five new cases were confirmed in Beijing and 14 more in Guangdong province, the report said. Another statement confirmed a new case in Shanghai, bringing the number of known cases worldwide to 222.

“People’s lives and health should be given top priority and the spread of the outbreak should be resolutely curbed,” President Xi was quoted as saying by state television.

The virus belongs to the same family of coronaviruses as Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people globally during a 2002/03 outbreak that also started in China.

Its symptoms include fever and difficulty in breathing, which are similar to many other respiratory diseases and pose complications for screening efforts.

Zhong Nanshan, a respiratory expert and head of the health commission team investigating the outbreak, confirmed that two cases of infection in Guangdong province were due to human-to-human transmission, Xinhua said. Some medical staff have been infected, it added, but gave no number.

BEYOND BORDERS

South Korea on Monday confirmed its first case, a 35-year-old Chinese national who had traveled from Wuhan, the fourth patient reported outside China.

Last week, two cases were reported in Thailand and one in Japan. All three involved people from Wuhan or who recently visited the city.

A report by London Imperial College’s MRC Centre for Global Infectious Disease Analysis estimated that by Jan. 12 there were 1,723 cases in Wuhan City with onset of related symptoms. Chinese health authorities have not commented directly on the report.

“This outbreak is extremely concerning. Uncertainty and gaps remain, but it is now clear that there is person to person transmission,” Farrar said.

The World Health Organization said on Monday “an animal source” appeared most likely to be the primary source of the outbreak and that some “limited human-to-human transmission” occurred between close contacts.

China’s state council reiterated the government will step up prevention efforts and find the source of infection and transmission channels as soon as possible, state television said on Monday.

Shares in pharmaceutical firms and mask makers in China surged Monday because of the outbreak.

“Who knows how many people who have been to Wuhan may be unaware that they have already been infected?,” said one commentator on Chinese social media platform Weibo

The state-run Global Times newspaper said in an editorial the government needs to disclose all information and not repeat the mistakes made with SARS. Chinese officials covered up the SARS outbreak for weeks before a growing death toll and rumors forced it to reveal the epidemic.

“Concealment would be a serious blow to the government’s credibility and might trigger greater social panic,” the editorial said.

(Reporting by Winni Zhou and Josh Horwitz in Shanghai, Roxanne Liu, Sophie Yu, Judy Hua and Colin Qian and Se Young Lee in Beijing, Joyce Lee in Seoul and Kate Kelland in London; Writing by Se Young Lee; Editing by Angus MacSwan)

As U.S. vaping injuries taper off, new evidence points to vitamin E

As U.S. vaping injuries taper off, new evidence points to vitamin E
By Julie Steenhuysen

CHICAGO (Reuters) – The U.S. Centers for Disease Control and Prevention released a series of reports on Friday indicating that the outbreak of vaping-related lung injuries appears to be waning, as evidence mounts that vitamin E acetate, a cutting agent used in marijuana vape cartridges, is playing a role in the illnesses.

So far, 54 people have died and more than 2,500 have been hospitalized in the outbreak, which started in the summer and spread to all 50 states, the District of Columbia, and two U.S. territories.

In a telephone briefing with reporters, Dr. Anne Schuchat, principal deputy director of the CDC, said evidence now suggests that vitamin E acetate was increasingly being added to cartridges containing THC – the high-producing compound in marijuana – beginning in June, when the outbreak began to ramp up.

Schuchat said THC vaping “largely explains” the big increase in acute cases that spiked over the summer, but the findings do not imply that nicotine vaping is entirely safe.

In one report, published in the New England Journal of Medicine, public health officials found that emergency room visits for the vaping lung injuries rose sharply beginning in June and peaked in September. Since then, emergency room visits have tapered off but still remain higher than when the outbreak started in June.

In a second report in the New England Journal, researchers report that additional testing of lung samples from people who had vaping injuries strengthens earlier studies pointing to vitamin E acetate as a likely culprit in the outbreak.

The study, which looked at lung samples from patients in 16 states, found vitamin E acetate in 94 percent of lung samples taken from patients who vaped THC.

In a separate study in the CDC’s Mortality and Morbidity Weekly Report, of the 2,409 people whose cases were reported to the CDC as of Dec. 10, thirty-one patients who had been discharged got sick again and had to be readmitted to the hospital, and seven people died shortly after discharge.

Patients who got sick after discharge tended to have a history of heart disease, respiratory conditions and diabetes. Those who died after discharge were more likely to be 50 or older.

With these cases, the CDC is now recommending that patients be clinically stable at the time of discharge, and that they follow up with a doctor within two days of discharge. CDC’s earlier guidance called for a two-week follow-up.

(Reporting by Vishwadha Chander; Editing by Shounak Dasgupta and Steve Orlofsksy)

High-tech mapping, apps fight deadly dengue outbreak in Honduras – medical charity

High-tech mapping, apps fight deadly dengue outbreak in Honduras – medical charity
By Anastasia Moloney

BOGOTA (Thomson Reuters Foundation) – High-tech mapping and mobile phone apps are being used to combat dengue fever in Honduras as the Central American nation struggles to fight the worst outbreak of the mosquito-borne disease on record, medical charity MSF said on Thursday.

Honduras has one of the Americas’ highest incidence rates of dengue, with some 92,000 suspected cases of the infectious disease and 250 deaths recorded this year, according to the Pan-American Health Organization (PAHO).

Across the Americas, more than 2.7 million people have caught the virus and 1,206 have died so far in 2019, making this year’s dengue fever outbreak the highest on record in the region, according to latest PAHO figures.

Medical charity Medicins Sans Frontiers (MSF) said it is using GIS mapping technology and a mobile phone app as key tools to combat the virus and plan their work.

The technology allows health workers to identify dengue hotspots and direct prevention and awareness-raising campaigns to the most-affected areas.

“It allows you to see the evolution of the epidemic in each neighborhood and city and all over the country per day, per week,” said Pascal Olivo, MSF logistics coordinator for Mexico, Honduras and Guatemala.

“We have adapted our strategy accordingly because we can see the evolution of the epidemic on the maps,” he told the Thomson Reuters Foundation.

Using a mobile app to record data, about 20 MSF health workers have been asking residents up to 10 questions about the dengue virus and what is being done to prevent its spread in their neighborhoods.

Questions include whether residents have cleaned water tanks and buckets in their homes – ideal breeding grounds for mosquitoes – if and when local authorities have carried out fumigation, or whether any relative has caught dengue.

The data, along with the GIS maps produced based on data collected by MSF, health authorities and public hospitals, allows health workers to build a timely geographic overview of areas where the virus is most acute and in need of targeting.

As the region faces new mosquito-borne outbreaks, there is a growing need to find new ways to monitor and reduce the spread of infectious diseases like dengue and Zika, which includes using tech and giving affected communities tech-based solutions.

Aid groups are accordingly embracing technology from geographic information system (GIS) mapping tools, drones and satellite imagery to map areas affected by conflict, disease outbreaks and natural disasters, along with mass vaccination programs.

“In the past two to three years we have seen an evolution in GIS, and it’s used by MSF for almost all emergencies,” Olivo said.

(Reporting by Anastasia Moloney @anastasiabogota, Editing by Chris Michaud. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s and LGBT+ rights, human trafficking, property rights, and climate change. Visit http://news.trust.org)

U.S. cases of vaping-related illness rise to 530 as outbreak widens

By Julie Steenhuysen

CHICAGO (Reuters) – U.S. health officials said on Thursday there are now 530 confirmed and probable cases and seven deaths from severe lung-related illnesses tied to vaping, and there are no signs that the outbreak is easing.

That’s up from 380 cases reported a week ago.

The U.S. Food and Drug Administration is now investigating 150 products and substances and said it has activated its criminal investigations arm to explore the supply chain of vaping products and identify the cause of the outbreak. No individual vapers will be targeted, Mitch Zeller, director of the FDA’s Center for Tobacco Products.

Zeller said no single substance or compound, including THC or Vitamin E acetate, has been linked to all of the cases so far.

Seven people have died from vaping-related illness, the Centers for Disease Control and Prevention (CDC) said. The deaths were reported in California (2), Illinois, Indiana, Kansas, Minnesota, and Oregon.

Illinois has reported an 8th death related to the outbreak, state epidemiologist Dr. Jennifer Layden said on a conference call with reporters. The CDC has not yet confirmed that death.

Layden said Illinois has now reported 69 cases, up from 52 a week ago, and the state continues to get reports of new cases daily.

(Reporting by Julie Steenhuysen; Editing by Sonya Hepinstall)

Ebola death toll in east Congo outbreak climbs above 2,000

FILE PHOTO: A health worker fills a syringe with Ebola vaccine before injecting it to a patient, in Goma, Democratic Republic of Congo, August 5, 2019. REUTERS/Baz Ratner/File Photo

By Djaffar Al Katanty and Aaron Ross

GOMA, Democratic Republic of Congo (Reuters) – The death toll from Democratic Republic of Congo’s year-long Ebola outbreak has climbed above 2,000, government data showed on Friday, as responders battle to overcome community mistrust and widespread security problems.

The death in neighboring Uganda of a 9-year-old girl who had tested positive for the virus after entering the country from Congo underscored the challenge medical teams face containing the disease in border territory with a highly mobile population.

The government team overseeing the response said the number of confirmed and probable cases had also hit a milestone of more than 3,000 in what has become the second-worst epidemic of the virus on record.

Despite the development of an effective vaccine and treatments, health workers have struggled to stop the virus spreading in remote and conflict-hit areas of eastern Congo, where many locals are wary of the response effort.

Nevertheless, the World Health Organization said the latest Uganda case highlighted the border authorities’ skill at detecting and isolating potential sources of transmission.

“This case was picked up at the border,” WHO spokeswoman Fadela Chaib said at a briefing in Geneva. “The people who are at the borders have the expertise.”

This is Congo’s 10th Ebola outbreak, but it is the first in the densely forested hillside provinces of North Kivu and Ituri, where militia-led violence and ethnic killing have undermined security in certain areas for decades.

The WHO declared the epidemic an international health emergency in July – only the fifth outbreak to warrant this status since the system was introduced in 2005.

The authorities have since come up against new fronts in their fight to contain the virus, testing the reach and flexibility of responders.

Health workers confirmed the first cases in South Kivu province on Aug. 16. Soon after, a woman contracted the virus in a remote, militia-controlled territory in North Kivu, hundreds of kilometers away from other known cases.

“The response is being spread too thin chasing new cases at the expense of the longer-term community engagement that is crucial if we’re ever to hope of being Ebola free,” Oxfam’s Congo Director Corinne N’Daw said in a statement.

Despite the virus spreading to new areas, the past week’s transmission rate was little changed from that of the past month and a half, which has seen an average of 77 new cases per week, according to the WHO.

Last week the WHO voiced concern about the widening geographic reach of the disease, but confirmed the virus had not gained a foothold in the major city of Goma, even after four cases were recorded there in July and early August.

Goma, a lakeside city of nearly 2 million people on the Rwandan border, had been on high alert for weeks after a gold miner with a large family infected several people with Ebola before dying himself.

The latest government data showed Ebola deaths reaching 2,006 and cases at 3,004.

“Two thousand deaths means that there is a problem,” said Timothée Buliga, a priest, returning home from his church in Goma. “We need to reach the point where we reject Ebola, say no and eradicate it definitively.”

Only the 2013-2016 Ebola outbreak in West Africa has been deadlier than the current outbreak. More than 11,300 people died then out of the 28,000 who were infected.

(Additional reporting by Tom Miles and Stephanie Nebehey in Geneva; Elias Biryabarema in Kampala; Writing by Alessandra Prentice; Editing by Kirsten Donovan and Hugh Lawson)

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)

U.S. records 16 new measles cases as outbreak shows signs of slowing

FILE PHOTO: Materials are seen left at demonstration by people opposed to childhood vaccination after officials in Rockland County, a New York City suburb, banned children not vaccinated against measles from public spaces, in West Nyack, New York, U.S. March 28, 2019. REUTERS/Mike Segar/File Photo

(Reuters) – The United States recorded 16 new measles cases between July 18 and July 25, federal health officials said on Monday, as the spread of the disease, which has infected 1,164 people this year in the worst U.S. outbreak since 1992, shows signs of slowing.

The U.S. Centers for Disease Control and Prevention said the new cases represented a 1.4% increase in the number of cases of the highly contagious and sometimes deadly disease since the previous week.

In recent weeks, the CDC has reported smaller increases in the number of measles cases, compared with a surge of more than a hundred cases reported in a single week earlier this year.

The running tally of cases this year, which have popped up in 30 states, includes active cases and those that have since resolved. No fatalities have been reported.

Health experts say the virus has spread mostly among school-age children whose parents declined to give them the measles-mumps-rubella, or MMR, vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents cites concerns that the vaccine may cause autism despite scientific studies that have debunked such claims.

Measles was declared eliminated in the United States in 2000, meaning there was no continuous transmission of the disease for a year. Still, cases of the virus occur and spread via travelers coming from countries where measles is common.

CDC officials have warned that the country risks losing its measles elimination status if the ongoing outbreak, which began in October 2018 in New York, continues until October 2019.

(Reporting by Gabriella Borter in New York and Ankur Banerjee in Bengaluru; editing by Maju Samuel and Jonathan Oatis)

Congolese cross-border trader’s Ebola death fuels Uganda outbreak fears

FILE PHOTO: A Congolese health worker prepares to administer Ebola vaccine, outside the house of a victim who died from Ebola in the village of Mangina in North Kivu province of the Democratic Republic of Congo, August 18, 2018. REUTERS/Olivia Acland/File Photo

By Tom Miles

GENEVA (Reuters) – A Congolese woman who died of Ebola this month vomited four times in a Ugandan market after crossing the border days earlier to sell fish, the WHO said, fuelling fears that the virus may be spreading beyond the Democratic Republic of Congo.

The current outbreak of the highly infectious disease has been all but confined to Congo, killing 1,673 people there – more than two-thirds of those who contracted it – over the past year, and three in Uganda last month.

A World Health Organization panel is debating whether to declare the outbreak “of international concern”, a designation that the agency’s head suggested a case this month in the large Congolese city of Goma had made more likely.

The fisherwoman traveled across the border to Mpondwe market on July 11, according to a Ugandan Health Ministry report published on Wednesday by the WHO.

It said 19 fishmongers were listed as having had possible contact with her while another 590 could be targeted for vaccination.

The health response to the virus relies on tracking down and testing people who may have been exposed to it and vaccinating them and anybody they have had contact with.

Ugandan and Congolese officials were working to find people who might have been put at risk by the dead woman, who appeared to have used an illegal border crossing, health ministry spokesman Emmanuel Ainebyona said.

So far “no one has been found to be positive of the Ebola virus. The team is still monitoring the tested traders,” he said.

The report said health workers had not established where the fishmonger spent nights, who transported her merchandise and who cleaned up her vomit.

The Ministry and the WHO said there were currently no confirmed Ebola cases in Uganda.

The WHO’s emergency committee of international experts were meeting on Wednesday for a fourth time to consider if the 11-month outbreak constituted a “public health emergency of international concern” (PHEIC), and will announce their decision at 1700 GMT.

A PHEIC declaration would be just the fifth in WHO history and include recommendations for international action. It could also help unlock sorely needed funds.

Last month the committee decided the potential disruption of declaring one risked causing economic harm while achieving nothing.

But WHO chief Tedros Adhanom Ghebreyesus said this week that the case in Goma was a potential game-changer since it meant Ebola might now spread among the urban population and into neighboring Rwanda.

A separate WHO report cited a very high risk for Uganda’s Arua district, which borders a Congolese area where an Ebola patient died after having had contact with over 200 people. Two deaths in Arua were under investigation.

(Reporting by Tom Miles and Nairobi newsroom; Editing by Gareth Jones and John Stonestreet)

First Ebola patient in eastern Congo’s main city dies, fears of epidemic spreading

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

GOMA, Democratic Republic of Congo (Reuters) – The first Ebola patient in eastern Democratic Republic of Congo’s largest city, Goma, has died, the government said on Tuesday.

The spread of the virus to Goma, a city of roughly 1 million people on the border with Rwanda, has raised fears the outbreak, which is already the second deadliest Ebola epidemic ever, could spread more widely.

The patient was a priest who became infected during a visit to the town of Butembo, one of the epicenters of the outbreak, before taking a bus to Goma, according to Congo’s health ministry.

He was being driven from Goma to a clinic in Butembo on Monday to receive treatment when he died, North Kivu province’s Governor Carly Nzanzu told an Ebola response meeting.

The World Health Organization (WHO) said on Monday that health officials had identified 60 people who had come into contact with the pastor since he was taken ill and that half of them had been vaccinated.

Goma, a lakeside city more than 350 kilometers (220 miles) south of where Ebola was first detected a year ago, is the largest city to be affected by the outbreak, which has infected more than 2,500 people and killed nearly 1,700.

Three Ebola cases which originated in Congo were confirmed in neighboring Uganda a month ago, but no new cases have since been registered in that country.

(Reporting by Stanis Bujakera and Djaffar Al Katanty, Writing by Anna Pujol-Mazzini, Editing by Ed Osmond)

U.S. recorded 18 new cases of measles last week

FILE PHOTO: Materials are seen left at demonstration by people opposed to childhood vaccination after officials in Rockland County, a New York City suburb, banned children not vaccinated against measles from public spaces, in West Nyack, New York, U.S. March 28, 2019. REUTERS/Mike Segar/File Photo

(Reuters) – The United States recorded 18 new measles cases last week, taking the total for the year to 1,095 in the worst outbreak since 1992, federal health officials said on Monday.

The U.S. Centers for Disease Control and Prevention said it has recorded cases of the highly contagious and sometimes deadly disease in 28 states as of June 27, the majority of them in New York City and nearby Rockland County.

The running tally includes both active cases and those that have since resolved. No fatalities have been reported.

Health experts say the virus has spread among school-age children whose parents declined to give them the measles-mumps-rubella vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents cite concerns that the vaccine may cause autism, despite scientific studies that have debunked such claims.

Measles was declared eliminated in the United States in 2000, meaning there was no continuous transmission of the disease for a year. Still, cases of the virus occur and spread via travelers coming from countries where measles is common.

CDC officials have warned that the country risks losing its measles elimination status if the ongoing outbreak, which began in October 2018 in New York, continues until October 2019.

(Reporting by Manas Mishra in Bengaluru; Editing by Arun Koyyur and Bill Berkrot)