Sierra Leone has declared a state of emergency after confirming a second case of mpox within four days, health officials announced on Monday, reports AP. According to the health ministry, neither of the cases had any recent contact with infected animals or individuals. The first case was linked to recent travel, confined to Lungi, an airport town in the northern Port Loko District, between December 26 and January 6. Both patients are being treated in a hospital in Freetown, the capital. Morocco develops Africa's first Mpox tests, reducing reliance on imports Mpox, also called monkeypox, was first identified in 1958 during outbreaks of a “pox-like” disease among monkeys. Historically, most human cases occurred in central and West Africa, typically among people in close contact with infected animals. In 2022, mpox was confirmed to spread via sexual transmission for the first time, leading to outbreaks in over 70 countries that had not previously reported the virus. The Congo has been the hardest hit, accounting for most of the estimated 43,000 suspected cases and 1,000 deaths in Africa this year. US health officials report 1st case of new strain of mpox in a traveler Sierra Leone was also at the heart of the 2014 Ebola outbreak, the deadliest in history. The outbreak, which mainly affected West Africa, claimed nearly 4,000 lives in Sierra Leone alone, out of a global total of over 11,000. The country lost 7% of its healthcare workforce during that crisis.

In response to the detection of Human Metapneumovirus (HMPV) cases, India's federal health ministry has urged states to strengthen their monitoring of Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI). During a review of respiratory illnesses in the country on Monday, the federal health secretary evaluated the existing public health measures for managing such infections. The health ministry stated that data from the Integrated Disease Surveillance Program (IDSP) shows no unusual rise in ILI or SARI cases across the country, a finding supported by sentinel surveillance data from the Indian Council of Medical Research (ICMR). Two cases of HMPV detected in India’s Karnataka HMPV is among the respiratory viruses that affect individuals of all ages, particularly during winter and early spring. Although infections are typically mild and self-limiting, most patients recover without complications. States have been advised to educate the public on preventive measures, including frequent handwashing with soap, covering the mouth and nose while coughing or sneezing, avoiding touching the face with unwashed hands, and maintaining distance from individuals displaying symptoms.

The first U.S. bird flu death has been reported — a person in Louisiana who had been hospitalized with severe respiratory symptoms. State health officials announced the death on Monday, and the Centers for Disease Control and Prevention confirmed it was the nation's first due to bird flu. Health officials have said the person was older than 65, had underlying medical problems and had been in contact with sick and dead birds in a backyard flock. They also said a genetic analysis had suggested the bird flu virus had mutated inside the patient, which could have led to the more severe illness. Few other details about the person have been disclosed. Since March, 66 confirmed bird flu infections have been reported in the U.S., but previous illnesses have been mild and most have been detected among farmworkers exposed to sick poultry or dairy cows. A bird flu death was not unexpected, virus experts said. There have been more than 950 confirmed bird flu infections globally since 2003, and more than 460 of those people died, according to the World Health Organization. The bird flu virus "is a serious threat and it has historically been a deadly virus," said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “This is just a tragic reminder of that.” Nuzzo noted a Canadian teen became severely ill after being infected recently. Researchers are still trying to gauge the dangers of the current version of the virus and determine what causes it to hit some people harder than others, she said. “Just because we have seen mild cases does not mean future cases will continue to be mild,” she added. In a statement, CDC officials described the Louisiana death as tragic but also said “there are no concerning virologic changes actively spreading in wild birds, poultry or cows that would raise the risk to human health.” In two of the recent U.S. cases — an adult in Missouri and a child in California — health officials have not determined how they caught the virus. The origin of the Louisiana person's infection was not considered a mystery. But it was the first human case in the U.S. linked to exposure to backyard birds, according to the CDC. Louisiana officials say they are not aware of any other cases in their state, and U.S. officials have said they do not have any evidence that the virus is spreading from person to person. The H5N1 bird flu has been spreading widely among wild birds, poultry, cows and other animals. Its growing presence in the environment increases the chances that people will be exposed, and potentially catch it, officials have said. Officials continue to urge people who have contact with sick or dead birds to take precautions, including wearing respiratory and eye protection and gloves when handling poultry.

Health officials said Saturday they have confirmed the first U.S. case of a new form of mpox that was first seen in eastern Congo. The person had traveled to eastern Africa and was treated in Northern California upon return, according to the California Department of Public Health. Symptoms are improving and the risk to the public is low. The individual was isolating at home and health workers are reaching out to close contacts as a precaution, the state health department said. Mpox is a rare disease caused by infection with a virus that’s in the same family as the one that causes smallpox. It is endemic in parts of Africa, where people have been infected through bites from rodents or small animals. Milder symptoms can include fever, chills and body aches. In more serious cases, people can develop lesions on the face, hands, chest and genitals. Earlier this year, scientists reported the emergence of a new form of mpox in Africa that was spread through close contact including through sex. It was widely transmitted in eastern and central Africa. But in cases that were identified in travelers outside of the continent, spread has been very limited, according to the U.S. Centers for Disease Control and Prevention. More than 3,100 confirmed cases have been reported just since late September, according to the World Health Organization. The vast majority of them have been in three African countries — Burundi, Uganda, and the Democratic Republic of the Congo. Since then, cases of travelers with the new mpox form have been reported in Germany, India, Kenya, Sweden, Thailand, Zimbabwe, and the United Kingdom. Health officials earlier this month said the situation in Congo appears to be stabilizing. The Africa CDC has estimated Congo needs at least 3 million mpox vaccines to stop the spread, and another 7 million vaccines for the rest of Africa. The spread is mostly through sexual transmission as well as through close contact among children, pregnant women and other vulnerable groups. The current outbreak is different from the 2022 global outbreak of mpox where gay and bisexual men made up the vast majority of cases.

The World Health Organization (WHO) has certified Egypt as malaria-free, marking a significant public health milestone for a country with more than 100 million inhabitants. The achievement follows a nearly 100-year effort by the Egyptian government and people to end a disease that has been present in the country since ancient times. “Malaria is as old as Egyptian civilization itself, but the disease that plagued pharaohs now belongs to its history and not its future,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General on Sunday. "This certification of Egypt as malaria-free is truly historic, and a testament to the commitment of the people and government of Egypt to rid themselves of this ancient scourge. I congratulate Egypt on this achievement, which is an inspiration to other countries in the region, and shows what’s possible with the right resources and the right tools.” Egypt is the third country to be awarded a malaria-free certification in the WHO Eastern Mediterranean Region following the United Arab Emirates and Morocco, and the first since 2010. Globally, a total of 44 countries and 1 territory have reached this milestone. “Receiving the malaria elimination certificate today is not the end of the journey but the beginning of a new phase. We must now work tirelessly and vigilantly to sustain our achievement through maintaining the highest standards for surveillance, diagnosis and treatment, integrated vector management and sustaining our effective and rapid response to imported cases. Our continued multisectoral efforts will be critical to preserving Egypt's malaria-free status,” said Dr Khaled Abdel Ghaffar, Deputy Prime Minister of Egypt. "I reaffirm that we will continue with determination and strong will to safeguard the health of all people in Egypt under the wise leadership's guidance and proceed with enhancing our healthcare system, this will remain a cornerstone in protecting the lives of all people living in and visiting Egypt.” Certification of malaria elimination is granted by WHO when a country has proven, beyond reasonable doubt, that the chain of indigenous malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least the previous three consecutive years. A country must also demonstrate the capacity to prevent the re-establishment of transmission. Egypt’s journey to eliminationMalaria has been traced as far back as 4000 B.C.E. in Egypt, with genetic evidence of the disease found in Tutankhamun and other ancient Egyptian mummies. Early efforts to reduce human-mosquito contact in Egypt began in the 1920s when the country prohibited the cultivation of rice and agricultural crops near homes. With most of Egypt’s population living along the banks of the Nile River and malaria prevalence as high as 40%, the country designated malaria a notifiable disease in 1930 and later opened its first malaria control station focused on diagnosis, treatment and surveillance. “Today, Egypt has proven that with vision, dedication, and unity we can overcome the greatest challenges. This success in eliminating malaria is not just a victory for public health but a sign of hope for the entire world, especially for other endemic countries in our region. This achievement is the result of sustained, robust surveillance investments in a strong, integrated health system, where community engagement and partnerships have enabled progress. Furthermore, collaboration and support to endemic countries, such as Sudan, remain a priority,” said Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean. By 1942, malaria cases in Egypt had spiked to more than 3 million as a result of the Second World War population displacement, the disruption of medical supplies and services, and the invasion of Anopheles arabiensis, a highly efficient mosquito vector, among other factors. Egypt succeeded in controlling the malaria outbreak through the establishment of 16 treatment divisions and the recruitment of more than 4000 health workers. The construction of the Aswan Dam, completed in 1969, created a new malaria risk for the country, as standing water produced breeding grounds for mosquitoes. Egypt, in collaboration with Sudan, launched a rigorous vector control and public health surveillance project to rapidly detect and respond to malaria outbreaks. By 2001, malaria was firmly under control and the Ministry of Health and Population set its sights on preventing the re-establishment of local malaria transmission. Egypt rapidly contained a small outbreak of malaria cases in the Aswan Governorate in 2014 through early case identification, prompt treatment, vector control and public education. Malaria diagnosis and treatment are provided free-of-charge to the entire population in Egypt regardless of legal status, and health professionals are trained nationwide to detect and screen for malaria cases including at borders. Egypt’s strong cross-border partnership with neighbouring countries, including Sudan, has been instrumental for preventing the re-establishment of local malaria transmission, paving the way for the country to be officially certified as malaria-free.

The global vaccine alliance Gavi will buy 500,000 doses of mpox vaccine to battle outbreaks of the disease in African countries, the organization said on Wednesday. The vaccine doses — manufactured by the Danish company Bavarian Nordic — will be available this year, Gavi said, without giving any specific dates. Gavi said the full costs, including the transportation, delivery and administration of the doses, amounting to $50 million, would be covered by the group's First Response Fund, a new financial mechanism created in June 2024. Since the beginning of the year, there have been over 25,000 confirmed mpox cases and 723 related deaths, the vast majority in Congo, and the World Health Organization declared it a global health emergency. So far Congo, the epicenter of the global health emergency, has received only 250,000 vaccine doses, donated by the European Union and the United States. The 250,000 doses are just a fraction of the 3 million doses authorities have said are needed to end the mpox outbreak in the country. EU countries pledged to donate more than 500,000 others, but the timeline for their delivery remained unclear. Congo issued an emergency approval of the vaccine, which has already been used in Europe and the United States in adults. Adults in Equateur, South Kivu and Sankuru, the three most affected provinces, will be vaccinated first, starting on Oct. 2, Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee, told The Associated Press. For the moment, the rollout will be reserved for adults, with priority targeted groups being those who have been in close contact with infected people and sex workers. Gavi's announcement comes days after the World Health Organization said it has granted its first authorization for the use of a vaccine against mpox in adults, calling it an important step toward fighting the disease in Africa. It made it possible for donors like Gavi and UNICEF to buy it. But supplies are limited because there’s only a single manufacturer. “This first (authorization) of a vaccine against mpox is an important step in our fight against the disease, both in the context of the current outbreaks in Africa and in future,” said WHO Director-General Tedros Adhanom Ghebreyesus. Last week, the Africa Center for Disease Control and Prevention and the World Health Organization launched a continent-wide response plan to the outbreak of mpox, three weeks after WHO declared outbreaks in 12 African countries a global emergency.  

The World Health Organization said Friday it has granted its first authorization for use of a vaccine against mpox in adults, calling it an important step toward fighting the disease in Africa and beyond. The pre-qualification of the vaccine by Bavarian Nordic A/S means that donors like GAVI the Vaccine Alliance and UNICEF can buy it. But supplies are limited because there's only a single manufacturer. “This first pre-qualification of a vaccine against mpox is an important step in our fight against the disease, both in the context of the current outbreaks in Africa, and in future,” said WHO Director-General Tedros Adhanom Ghebreyesus. The U.N. health agency chief called for “urgent” scale-up of procurement, donations and rollout to get the vaccine where it is needed most, along with other response measures. Under the WHO authorization, the vaccine can be administered in people aged 18 or above in a two-dose regimen. The approval says that while the vaccine is not currently licensed for those under 18 years old, it may be used in infants, children and adolescents “in outbreak settings where the benefits of vaccination outweigh the potential risks.” Officials at the Africa Center for Disease Control and Prevention said last month that nearly 70% of cases in Congo — the country hardest hit by mpox — are in children younger than 15, who also accounted for 85% of deaths. On Thursday, the Africa CDC said 107 new deaths and 3,160 new cases had been recorded in the past week, just a week after it and WHO launched a continental response plan. Mpox belongs to the same family of viruses as smallpox but causes milder symptoms like fever, chills and body aches. People with more serious cases can develop lesions on the face, hands, chest and genitals.  

Pakistan’s health ministry said Friday it has identified a case of mpox, but sequencing is being done to determine whether it is a new variant, days after the World Health Organization declared the spread of mpox a global health emergency. The case, in a man who had recently returned from a Middle Eastern country, is the first in Pakistan this year but the nature of the variant was yet to be determined. The first case was reported on Thursday by authorities in Sweden. The ministry in a statement said the man was from Mardan, a district in the Khyber Pakhtunkhwa province bordering Afghanistan. It said the ministry has directed officials at border crossing points and airports to ensure strict surveillance and collect samples for medical tests if they see symptoms of the disease in any passenger returning from abroad. It was unclear which Middle Eastern country the man had visited, and no cases of the new variant have yet been reported in that region. The United Arab Emirates, however, has had 16 confirmed cases of mpox since 2022, according to the WHO. The UAE is particularly affected by transnational outbreaks given its role as a hub connecting East and West with its long-haul carriers Emirates and Etihad. On Wednesday, the WHO said there have been more than 14,000 cases and 524 deaths in Africa this year, which already exceed last year’s figures. More than 96% of all cases and deaths have been in Congo. The director of public health for Khyber Pakhtunkhwa, Dr. Irshad Roghani, said the person infected with mpox in Pakistan has mild symptoms. “Contact tracing of the affected person has been started and samples of more people are being obtained,” he told The Associated Press. Roghani said that since 2022, 300 people have been tested in Khyber Pakhtunkhwa, of whom two tested positive last year. This is the first case detected this year.

Nabila Hamada gave birth to twin boys in Gaza early in the war, in a hospital reeking of decaying bodies and full of displaced people. When Israeli forces threatened the hospital, she and her husband fled with only one of the babies, as medical staff said the other was too weak to leave. Soon after, Israeli forces raided the hospital, Gaza’s largest, and she never saw the boy again. The trauma of losing one twin left the 40-year-old Hamada so scared of losing the other that she became frozen and ill-equipped to deal with the daily burden of survival. “I’m unable to take care of my other, older children or give them the love they need,” she said. She is among hundreds of thousands of Palestinians struggling with mental health after nine months of war. The trauma has been relentless. They have endured the killing of family and friends in Israeli bombardments. They have been wounded or disfigured. They have huddled in homes or tents as fighting raged and fled again and again, with no safe place to recover. Anxiety, fear, depression, sleep deprivation, anger and aggression are prevalent, experts and practitioners told The Associated Press. Children are most vulnerable, especially because many parents can barely hold themselves together. There are few resources to help Palestinians process what they are going through. Mental health practitioners say the turmoil and overwhelming number of traumatized people limit their ability to deliver true support. So they’re offering a form of “psychological first aid” to mitigate the worst symptoms. “There are about 1.2 million children who are in need of mental health and psychosocial support. This basically means nearly all Gaza’s children,” said Ulrike Julia Wendt, emergency child protection coordinator with the International Rescue Committee. Wendt has been visiting Gaza since the war began. She said simple programming, such as playtime and art classes, can make a difference: “The goal is to show them that not only bad things are happening.” Repeated displacement compounds trauma: an estimated 1.9 million of Gaza’s 2.3 million people have been driven from their homes. Most live in squalid tent camps and struggle to find food and water. Many survivors of the Oct. 7 attack by Hamas in southern Israel that precipitated the war in Gaza also bear the scars of trauma, and are seeking ways to heal. The militants killed more than 1,200 Israelis and took around 250 hostage. Sheltering near the southern city of Khan Younis, Jehad El Hams said he lost his right eye and fingers on his right hand when he picked up what he thought was a can of food. It was an unexploded ordnance that detonated. His children were almost hit. Since then, he experiences sleeplessness and disorientation. “I cry every time I take a look at myself and see what I’ve become,” he said. He reached out to one of the few mental health initiatives in Gaza, run by the United Nations agency for Palestinian refugees, known as UNRWA. Fouad Hammad, an UNRWA mental health supervisor, said they typically encounter 10 to 15 adults a day at shelters in Khan Younis with eating and sleeping disorders, extreme rage and other issues. Mahmoud Rayhan saw his family shattered. An Israeli strike killed his young son and daughter. His wife's leg was amputated. Now he isolates himself inside his tent and sleeps most of the day. He talks to almost no one. He said he doesn’t know how to express what’s happening to him. He trembles. He sweats. “I’ve been crying and feel nothing but heaviness in my heart.” A relative, Abdul-Rahman Rayhan, lost his father, two siblings and four cousins in a strike. Now when he hears a bombardment, he shakes and gets dizzy, his heart racing. “I feel like I’m in a nightmare, waiting for God to wake me up,” the 20-year-old said. For children, the mental toll of war can have long-term effect on development, Wendt said. Children in Gaza are having nightmares and wetting their beds because of stress, noise, crowding and constant change, she said. Nashwa Nabil in Deir al-Balah said her three children have lost all sense of security. Her eldest is 13 and her youngest is 10. “They could no longer control their pee, they chew on their clothes, they scream and have become verbally and physically aggressive,” she said. “When my son Moataz hears a plane or tank, he hides in the tent.” In the central town of Deir al-Balah, a psychosocial team with the Al Majed Association works with dozens of children, teaching them how to respond to the realities of war and giving them space to play. “In the case of a strike, they place themselves in the fetal position and seek safety away from buildings or windows. We introduce scenarios, but anything in Gaza is possible,” said project manager Georgette Al Khateeb. Even for those who escape Gaza, the mental toll remains high. Mohamed Khalil, his wife and their three children were displaced seven times before they reached Egypt. His wife and children arrived in January and he joined them in March. Their 8-year-old daughter would hide in the bathroom during shelling and shooting, saying, “We are going to die.” Their 6-year-old son could sleep only after his mother told him that dying as a martyr is an opportunity to meet God and ask for the fruits and vegetables they didn’t have in hunger-ravaged Gaza. Khalil recalled their terror as they escaped on foot down a designated “safe corridor” with Israeli guns firing nearby. Even after arriving in Egypt, the children are introverted and fearful, Khalil said. They have enrolled in a new initiative in Cairo, Psychological and Academic Services for Palestinians, which offers art and play therapy sessions and math, language and physical education classes. “We saw a need for these children who have seen more horror than any of us will ever see,” said its founder, psychologist Rima Balshe. On a recent field trip, she recalled, 5-year-old twins from Gaza who were playing and suddenly froze when they heard helicopters. “Is this an Israeli warplane?” they asked. She explained it was an Egyptian aircraft. “So Egyptians like us?” they asked. “Yes,” she reassured them. They had left Gaza, but Gaza had not left them. There is hope that children traumatized by the war can heal, but they have a long way to go, Balshe said. “I wouldn’t say ‘recovering’ but I certainly see evidence of beginning to heal. They may not ever fully recover from the trauma they endured, but we are now working on dealing with loss and grief,” she said. “It’s a long process.”

Dozens of salmonella illnesses have been linked to raw milk from a California farm, a far wider outbreak than previously known, according to newly released state records. As of February, at least 165 people were sickened with salmonella infections tied to products from Raw Farm, of Fresno, California, according to the records. It is the largest reported salmonella outbreak linked to raw milk in the U.S. in the past decade, according to health officials. The disclosure of the outbreak's size comes as health officials warn the public to avoid unpasteurized milk due to a bird flu virus circulating in U.S. dairy cows. The bird flu, known as Type A H5N1, has been detected in more than 140 U.S. dairy herds, and federal health officials say the virus has been detected in high levels in raw milk. State and local health officials hadn't updated the public about the full scope of the salmonella outbreak since October, when officials in San Diego reported about a dozen cases. At the time, Raw Farm issued a voluntary recall of milk and heavy cream sold between Oct. 11 and Nov. 6. Cases continued to mount, however, according to documents obtained by Bill Marler, a Seattle food safety lawyer who shared the records with The Associated Press. Marler said he represents 16 clients allegedly sickened in the outbreak. Investigators matched samples from sick people to samples from the farm and a retail store, the documents said. More than 60% of the people with confirmed infections who were interviewed reported consuming Raw Farm products. People from four states were infected, though the vast majority — 162 — were from California. Four of the people with salmonella were also infected with campylobacter and/or dangerous E. coli bacteria, the documents said. Nearly 40% of illnesses were reported in children younger than 5, officials said. Twenty people were hospitalized. No deaths were reported. California health officials said Wednesday that they had conducted a “robust” investigation in partnership with local teams and state agriculture officials and notified the public about the outbreak through the October recall notice and social media posts in October, November and December. The outbreak ended May 4, officials said. It's not clear whether more cases were reported after February. Mark McAfee, owner of Raw Farm, acknowledged that his products were part of the outbreak. He said that a single cow was infected with salmonella last fall and later removed from the herd. He said he put additional testing protocols in place in response to the outbreak. Jessie McGee, 35, of San Pedro, California, said she plans to sue Raw Farm because her 6-year-old daughter was hospitalized in October with a confirmed infection tied to the outbreak. McGee said she had read about supposed health benefits of raw milk online and started drinking Raw Farm products and feeding them to her daughter and her 2-year-old twins. All three children and McGee fell ill, she said, but her older daughter's symptoms of high fever and stomach cramps were most severe. After the ordeal, McGee said she'll no longer drink unpasteurized milk. “None of the possible benefits you could maybe get from the milk is worth any of that,” she said.