China orders ‘unprecedented’ lockdown of two cities at virus epicenter

China orders ‘unprecedented’ lockdown of two cities at virus epicenter
By Yawen Chen and Se Young Lee

BEIJING (Reuters) – China on Thursday locked down two cities at the epicenter of a coronavirus outbreak that has killed 17 people and infected nearly 600, as health authorities around the world took action to prevent a global pandemic.

Health officials fear the transmission rate will accelerate as hundreds of millions of Chinese travel at home and abroad during week-long holidays for the Lunar New Year, which begins on Saturday.

The previously unknown virus strain is believed to have emerged late last year from illegally traded wildlife at an animal market in the central Chinese city of Wuhan.

Most transport in Wuhan, a city of 11 million people, was suspended on Thursday morning and people were told not to leave. Hours later, neighboring Huanggang, a city of about 7 million people, announced a similar lockdown.

“The lockdown of 11 million people is unprecedented in public health history, so it is certainly not a recommendation the WHO has made,” Gauden Galea, the World Health Organization’s representative in Beijing, told Reuters.

Other cities were also taking steps to restrict movement and contact. Nearby Ezhou shut its train stations. The capital Beijing canceled major public events, including two well-known Lunar New Year temple fairs, the state-run Beijing News said.

Airports worldwide were screening passengers arriving from China.

There is no vaccine for the virus, which can spread through respiratory transmission. Symptoms include fever, difficulty in breathing and cough, similar to many other respiratory illnesses.

Preliminary research suggested it was passed on to humans from snakes, but government medical adviser Zhong Nanshan has also identified badgers and rats as possible sources.

WHO MEETING

The WHO has said it will decide on Thursday whether to declare the outbreak a global health emergency, which would step up the international response.

If it does so, it will be the sixth international public health emergency to be declared in the last decade. A WHO news conference is expected some time after 1800 GMT.

Chinese authorities gave no new details on the numbers of virus infections but it has been reported in Beijing, Shanghai and Hong Kong. Of eight known cases worldwide, Thailand has confirmed four, while Japan, South Korea, Taiwan and the United States have reported one each.

Authorities had confirmed 571 cases and 17 deaths by the end of Wednesday, China’s National Health Commission said. Earlier, it said another 393 suspected cases had been reported.

In a report on Wednesday, Imperial College London said it estimated a total of 4,000 cases of the coronavirus in Wuhan alone as of Jan. 18, an infection rate based on the number of cases reported in China and elsewhere.

Wuhan shut down all urban transport networks and suspended outgoing flights from 10 a.m. (0200 GMT). Domestic media said some airlines were operating after the deadline, however.

Wuhan’s Hankou rail station was nearly deserted, with gates blocked, state broadcasts showed. The government urged citizens not to leave the city.

State media reported highway toll booths around Wuhan were closing down, which would effectively cut off road exits. Guards were patrolling highways, one resident told Reuters.

As the city slipped into isolation, residents thronged into hospitals for checks and scrambled for supplies, clearing out supermarket shelves and queuing for petrol.

Authorities in Huanggang ordered indoor entertainment venues including cinemas and internet cafes to close.

FACE MASKS

In contrast with its secrecy over the 2002-03 Severe Acute Respiratory Syndrome (SARS) that killed nearly 800 people, China’s Communist Party government has provided regular updates to avoid panic ahead of the holidays.

During a visit to Wuhan, Vice Premier Sun Chunlan said authorities needed to be open about the virus and efforts to contain it, the official Xinhua news agency said.

Some experts believe the new virus is not as dangerous as previous coronaviruses such as SARS and Middle East Respiratory Syndrome (MERS), which has killed more than 700 people since 2012.

“The early evidence at this stage would suggest it’s not as severe,” Australia’s Chief Medical Officer Brendan Murphy told reporters.

Despite China’s response, world shares fell on Thursday, led by the biggest tumble in Chinese stocks in more than eight months, as concern mounted about the outbreak. China’s yuan fell to a two-week low. [MKTS/GLOB]

The economic impact of such outbreaks are hard to quantify but a 2006 estimate by the International Air Transport Association (IATA) calculated that SARS shaved just over 1 percentage point off the GDP of China in 2003.

InterContinental Hotels and Hyatt are allowing guests to change or cancel stays at most Chinese hotels.

A general view shows the monitors of thermal scanners that detect temperatures of passengers at the security check inside the airport in Guatemala City, Guatemala January 22, 2020. REUTERS/Luis Echeverria

Many Chinese were cancelling trips, buying face masks and avoiding shopping centers.

The release of seven movies over the Lunar New Year has been postponed. The holiday is the high season for distributors and cinemas attract huge crowds.

Airports globally, including in Britain, stepped up screening of passengers from China and the European Centre for Disease Control and Prevention said the further global spread of the virus was likely.

“All the fatalities have so far been contained to mainland China, however, this is a rapidly developing situation and the number of deaths and the number of cases is likely to be higher than those that have been confirmed so far and I expect them to rise further,” Health Secretary Matt Hancock told the British parliament.

(Reporting by Yawen Chen, Se Young Lee, Sophie Yu and Gabriel Crossley in Beijing, Sam Shen and Engen Tham in Shanghai, Ben Blanchard in Taiwan, Alison Lui and Donny Kwok in Hong Kong, John Geddie and Aradhana Aravindan in Singapore, Stephanie Nebehay in Geneva, Kate Kelland and Elizabeth Howcroft in London; Writing by Michael Perry; Editing by Stephen Coates and Clarence Fernandez and Alison Williams)

WHO says new China coronavirus could spread, warns hospitals worldwide

By Stephanie Nebehay

GENEVA (Reuters) – There may have been limited human-to-human transmission of a new coronavirus in China within families, and it is possible there could be a wider outbreak, the World Health Organization (WHO) said on Tuesday.

Coronaviruses are a large family of viruses that can cause infections ranging from the common cold to SARS. A Chinese woman has been quarantined in Thailand with a mystery strain of coronavirus, Thai authorities said on Monday, the first time the virus has been detected outside China.

In all, 41 cases of pneumonia have been reported in the central Chinese city of Wuhan, which preliminary lab tests cited by state media showed could be from a new type of coronavirus, and one patient has died. There have since been no new cases or deaths, Wuhan health authorities said on Tuesday.

“From the information that we have it is possible that there is limited human-to-human transmission, potentially among families, but it is very clear right now that we have no sustained human-to-human transmission,” said Maria Van Kerkhove, acting head of WHO’s emerging diseases unit.

The WHO is however preparing for the possibility that there could be a wider outbreak, she told a Geneva news briefing. “It is still early days, we don’t have a clear clinical picture.”

Some types of the virus cause less serious diseases, while others – like the one that causes MERS – are far more severe.

The U.N. agency has given guidance to hospitals worldwide about infection prevention and control in case the new virus spreads. There is no specific treatment for the new virus, but anti-virals are being considered and could be “re-purposed”, Van Kerkhove said.

With Chinese New Year approaching on Jan. 25, when many Chinese tourists visit Thailand, the WHO called on Thai authorities, the public and holidaymakers to be on alert.

Richard Brow, the agency’s representative in Thailand, said anyone with a fever and cough who had spent time in Wuhan should get checked out by a health worker.

(Reporting by Stephanie Nebehay; additional reporting by Chayut Setboonsarng in Bangkok and Vincent Lee; Editing by John Stonestreet and Pravin Char)

WHO decries ‘collective failure’ as measles kills 140,000

By Kate Kelland

LONDON (Reuters) – Measles infected nearly 10 million people in 2018 and killed 140,000, mostly children, as devastating outbreaks of the viral disease hit every region of the world, the World Health Organization said on Thursday.

In figures described by its director general as “an outrage”, the WHO said most of last year’s measles deaths were in children under five years old who had not been vaccinated.

“The fact that any child dies from a vaccine-preventable disease like measles is frankly an outrage and a collective failure to protect the world’s most vulnerable children,” said the WHO’s director general Tedros Adhanom Ghebreysus.

The picture for 2019 is even worse, the WHO said, with provisional data up to November showing a three-fold increase in case numbers compared with the same period in 2018.

The United States has already reported its highest number of measles cases in 25 years in 2019, while four countries in Europe – Albania, the Czech Republic, Greece and Britain – lost their WHO “measles-free” status in 2018 after suffering large outbreaks.

An outbreak in the South Pacific nation of Samoa has infected more than 4,200 people and killed more than 60, mostly babies and children, in a battle complicated by a vocal anti-vaccination movement.

In 2018, measles hit hardest in Liberia, Ukraine, Democratic Republic of Congo, Madagascar and Somalia, the WHO said, with these five nations accounting for nearly half of all cases worldwide.

Globally, measles vaccination rates have stagnated for almost a decade. The WHO and the UNICEF children’s fund say that in 2018, around 86% of children got a first dose of measles vaccine through routine vaccination plans, and fewer than 70% got the second dose recommended to fully protect them.

STAGGERING

Heidi Larson, director of the Vaccine Confidence Project at Britain’s London School of Hygiene & Tropical Medicine, said the numbers were “staggering”.

“Some countries are scrambling to vaccinate in the face of serious outbreaks – far too late for many,” she said.

Measles is one of the most contagious known diseases, more so than Ebola, tuberculosis or flu. It can linger in the air or on surfaces for several hours after an infected person has been and gone, putting anyone not vaccinated at risk.

Among wealthier nations, vaccination rates have been hurt by some parents shunning them for what they say are religious or philosophical reasons. Mistrust of authority and debunked myths about links to autism also weaken vaccine confidence and lead some parents to delay protecting their children.

Research published in October showed that measles infection not only carries a risk of death or severe complications including pneumonia, brain damage, blindness and deafness, but can also damage the victim’s immune memory for months or years – leaving those who survive measles vulnerable to other dangerous diseases such as flu or severe diarrhea.

The WHO data showed there were an estimated 9,769,400 cases of measles and 142,300 related deaths globally in 2018. This compares to 7,585,900 cases and 124,000 deaths in 2017.

Charlie Weller, head of vaccines at the Wellcome Trust global health charity, said the numbers were a tragedy. “If we are to protect lives, we must understand and address the reasons why measles vaccine uptake is lower,” she said.

(Reporting by Kate Kelland, editing by Gareth Jones and Hugh Lawson)

U.S. retains measles-elimination status despite worst outbreak in 25 years: CDC

(Reuters) – The United States has narrowly retained its measles elimination status by World Health Organization standards, despite seeing more than 1,200 measles cases so far this year in the worst outbreak since 1992, federal health officials said on Friday.

The U.S. Centers for Disease Control have attributed the country’s worst outbreak over the past year, which began in New York on Oct. 1, 2018, in large part to parents who declined to vaccinate their children.

The disease was declared eliminated in the United States in 2000, meaning there was no continuous transmission for a year, and the outbreak in New York this year narrowly avoided meeting that threshold. The last rash onset associated with a measles case in New York was recorded on Aug. 19.

“Both jurisdictions have since passed two incubation periods for measles with no additional reported cases associated with these outbreaks as of October 1, 2019; however, continued vigilance is important to ensure that elimination is sustained,” the CDC said in a report released on Friday.

Federal health officials have attributed this year’s outbreak to U.S. parents who refuse to vaccinate their children. These parents believe, contrary to scientific evidence, that ingredients in the vaccine can cause autism.

(Reporting by Gabriella Borter in New York; Editing by Scott Malone and Bernadette Baum)

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)

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)

WHO sounds Ebola alarm as risks intensify

A Congolese health worker administers ebola vaccine to a child at the Himbi Health Centre in Goma, Democratic Republic of Congo, July 17, 2019. REUTERS/Olivia Acland

By Tom Miles

GENEVA (Reuters) – The World Health Organization on Wednesday declared Congo’s Ebola outbreak an international health emergency, sounding a rarely used global alarm after the virus threatened to spread to a major city and into neighboring countries.

Despite a highly effective vaccine and a swift international response after it was declared 11 months ago, the outbreak has proved tenacious in an unstable region beset by violence, becoming Congo’s worst ever, with almost 1,700 dead.

A vast campaign of vigilance and vaccination, with almost 75 million screenings, has kept the highly infectious virus almost entirely confined to two provinces in northeastern Congo. The emergency committee of international health experts that advises WHO had thrice declined to declare an emergency.

But this month a pastor died after traveling to Goma, a city of 2 million and a gateway to other countries in the region. On Wednesday, the WHO reported a fisherwoman had died in Congo after four vomiting incidents at a market in Uganda, where 590 people may be sought for vaccination.

“The committee is concerned that a year into the outbreak, there are worrying signs of possible extension of the epidemic,” the committee’s report said.

The committee had been under pressure from many experts who felt the scale of the outbreak and the risks meant it had to be given the emergency status – only the fifth such disease outbreak since the WHO introduced such designations in 2005.

“It shows no sign of coming under control,” said Peter Piot, a member of the team that discovered Ebola and is now director of the London School of Hygiene & Tropical Medicine.

“I hope that today’s decision serves as a wake-up call to drive high-level political action, improved coordination, and greater funding to support DRC in their efforts to stop this devastating epidemic,” he said.

NO BORDER CLOSURES

The previous international emergencies, under a system introduced after the 2004 Asian SARS epidemic, were the 2013-2016 West African Ebola epidemic that killed over 11,300 people, the 2009 flu pandemic, polio in 2014 and the Zika virus that caused a spate of birth defects across Latin America.

The WHO committee’s chairman, Robert Steffen, tempered the outbreak’s designation as an emergency by saying it remained a regional, rather than a global threat, and stressed that no country should react to Ebola by closing borders or restricting trade.

The WHO has warned that the nearby countries of Rwanda, South Sudan, Burundi and Uganda are the most at risk, while Central African Republic, Angola, Tanzania, Republic of Congo and Zambia are in a second tier.

Earlier this week the WHO said hundreds of millions of dollars were needed immediately to prevent the outbreak billowing out of control and costing far more lives and money.

But WHO chief Tedros Adhanom Ghebreyesus, who convened the emergency committee after viewing the Goma case as a “potential gamechanger”, said the designation as an international emergency was not meant to suggest that some countries had been withholding funds and would now unlock them.

One priority was to accelerate the production of the vaccine, which is in short supply. It is produced by Merck and still unlicensed, which means it can only be used in a clinical trial overseen by Congo’s health ministry.

WHO has already begun using smaller doses to ration supplies and the committee recommended taking “all measures to increase supplies”, including contracting supply to other manufacturers and transferring Merck’s technology.

(Reporting by Tom Miles, Kate Kelland and Nairobi newsroom; Editing by Gareth Jones, John Stonestreet and Dan Grebler)

Eroding trust in vaccines leaves populations vulnerable, global study finds

FILE PHOTO: A vial of measles, mumps and rubella vaccine and an information sheet is seen at Boston Children's Hospital in Boston, Massachusetts February 26, 2015. REUTERS/Brian Snyder/File Photo

By Kate Kelland

LONDON, June 19 (Reuters) – Trust in vaccines – one of the world’s most effective and widely-used medical products – is highest in poorer countries but weaker in wealthier ones where skepticism has allowed outbreaks of diseases such as measles to persist, a global study found on Wednesday.

France has the least confidence of any country in the world in the safety and effectiveness of vaccines, with a third believing that vaccines are unsafe, according to the study.

While most parents do choose to vaccinate their children, varying levels of confidence expose vulnerabilities in some countries to potential disease outbreaks, the study’s authors said, recommending that scientists need to ensure people have access to robust information from those they trust.

Public health experts and the World Health Organization (WHO) say vaccines save up to 3 million lives every year worldwide, and decades of research evidence consistently shows they are safe and effective.

But to achieve “herd immunity” to protect whole populations, immunization coverage rates must generally be above 90% or 95%, and vaccine mistrust can quickly reduce that protection.

“Over the last century, vaccines have made many devastating infectious diseases a distant memory,” said Charlie Weller, head of vaccines at the Wellcome Trust health charity, which co-led the Wellcome Global Monitor study.

“It is reassuring that almost all parents worldwide are vaccinating their children. However, there are pockets of lower confidence in vaccines across the world.”

The spread of measles, including in major outbreaks in the United States, the Philippines and Ukraine, is just one of the health risks linked to lower confidence in vaccines.

In Afghanistan and Pakistan, false rumors about polio vaccines being part of a Western plot have in recent years hampered global efforts to wipe out the crippling disease.

The study, led by Wellcome and polling company Gallup, covered 140,000 people from more than 140 countries.

It found 6% of parents worldwide – equivalent to 188 million – say their children are unvaccinated. “The highest totals were in China at 9%, Austria at 8% and Japan at 7%.”

Seth Berkley, chief executive of the not-for-profit GAVI vaccine alliance, said the report showed a “worrying number of people” questioning vaccine safety. But by focusing on the “vocal minority” who refused to vaccinate, it was easy to forget that the vast majority trusted vaccines and the science that underpinned them.

The study also found that three-quarters of the world’s people trust doctors and nurses more than anyone else for health advice and that in most parts of the world, more education and greater trust in health systems, governments and scientists is a also sign of higher vaccine confidence.

In some high-income regions, however, confidence is weaker. Only 72% of people in North America and 73% in Northern Europe agree that vaccines are safe. In Eastern Europe, it is just 50%.

Heidi Larson, director of the vaccine confidence project at the London School of Hygiene and Tropical Medicine, worked with researchers on this study. She said it “exposes the paradox of Europe” which, despite being a region with among the highest income and education levels, also has the world’s highest levels of vaccine skepticism.

In poorer regions, trust levels tend to be much higher, with 95% in South Asia and 92% in Eastern Africa feeling confident that vaccines are safe and effective.

(Reporting by Kate Kelland; editing by John Stonestreet)

Cholera surge stalks Yemen’s hungry and displaced

A girl, cholera patient, lies on a bed as she receives medical care at a health center in the village of Islim, in the northwestern province of Hajjah, Yemen June 4, 2019. REUTERS/Eissa Alrage

By Eissa al-Rajehy

HAJJAH, Yemen (Reuters) – In the last two weeks Dr Asmahan Ahmed has seen a surge in suspected cholera cases arriving at her health center in Abs, a small, Houthi-held town in northwest Yemen.

“Every day there are 30-50 cases, no fewer. Suddenly it became like this,” she said in the 15-bed diarrhea treatment center.

Yemen is suffering its third major cholera outbreak since 2015 when a Saudi-led military coalition intervened to try to restore Yemen’s internationally recognized government after it was ousted from power in the capital Sanaa by the Iran-aligned Houthi movement.

The conflict has put 10 million people at risk of famine in the world’s most urgent humanitarian crisis.

Cholera causes profuse diarrhea and fluid loss which can kill within hours. Children, the elderly and those weakened by years of poor nutrition are most at risk.

The World Health Organization said last week that Yemen had seen more than 724,000 suspected cholera cases and 1,135 deaths this year, but that case numbers had stabilized in recent weeks.

In the clinic, limp children’s faces are covered with flies and their chests heave as they breathe while receiving intravenous fluid tubes in their feet and wrists.

Children pull water from a water well in the village of Islim in the northern province of Hajjah, Yemen, June 9, 2019. REUTERS/Eissa Alragehi

Children pull water from a water well in the village of Islim in the northern province of Hajjah, Yemen, June 9, 2019. REUTERS/Eissa Alragehi

The recent influx means some patients are forced to lie on the floor and the center has run out of some medicines.

Cholera is spread through dirty water, which more and more Yemenis are forced to drink as water resources are scarce in the poorest Arabian Peninsula nation.

Pumps are needed in many parts of the country of 30 million people to bring water to the surface. Fuel shortages have dramatically increased clean water prices.

“We rely on wells which are uncovered and very dirty … We and livestock drink from these wells, as do children,” said Qassem Massoud, a young man standing at a rural well where people haul water up using plastic containers on string.

Others fill containers from a muddy pool as donkeys drink alongside.

Dr Abdelwahab al-Moayad said Yemen’s internally displaced were particularly at risk.

“The number of cases are increasing by the day and if it continues we would consider it a humanitarian disaster,” he said.

A breakthrough in U.N.-led peace efforts last December, the first in more than two years, had sparked hope for improved humanitarian and aid access.

But implementation of a ceasefire and a troop withdrawal initiative in the main port of Hodeidah, a lifeline for millions, has dragged on for six months. Violence has continued in other parts of Yemen.

Since the deal, more than 255,000 people have been displaced, U.N. migration agency figures show.

The Houthis, who say their revolution is against corruption, control the biggest population centers. The Saudi-backed government is based in the southern port of Aden.

(Reporting by Reuters TV in Yemen; writing by Lisa Barrington; editing by Jason Neely)