GOMA, Congo — Congolese authorities on Saturday began vaccinations against mpox, nearly two months after the disease outbreak that spread from Congo to several African countries and beyond was declared a global emergency by the World Health Organization.

The 265,000 doses donated to Congo by the European Union and the United States were rolled out in the eastern city of Goma in North Kivu province, where hospitals and health workers have been overstretched, struggling to contain the new and possibly more infectious strain of mpox.

Congo, with about 30,000 suspected mpox cases and 859 deaths, accounts for more than 80% of all the cases and 99% of all the deaths reported in Africa this year. All the Central African nation’s 26 provinces have recorded mpox cases.

Although most mpox infections and deaths recorded in Congo are in children under age 15, the doses being administered are only meant for adults and will be given to at-risk populations and frontline workers, Health Minister Roger Kamba said this week.

“Strategies have been put in place by the services in order to vaccinate all targeted personnel,” Muboyayi ChikayaI, the minister’s chief of staff, said as he kicked off the vaccination.

At least 3 million doses of the vaccine approved for use in children are expected from Japan in the coming days, Kamba said.

Mostly undetected for years

Mpox, also known as monkeypox, had been spreading mostly undetected for years in Africa before the disease prompted the 2022 global outbreak that saw wealthy countries quickly respond with vaccines from their stockpiles while Africa received only a few doses despite pleas from its governments.

However, unlike the global outbreak in 2022 that was overwhelmingly focused in gay and bisexual men, mpox in Africa is now being spread via sexual transmission as well as through close contact among children, pregnant women and other vulnerable groups, Dr. Dimie Ogoina, the chair of WHO’s mpox emergency committee, recently told reporters.

More than 34,000 suspected cases and 866 deaths from the virus have been recorded across 16 countries in Africa this year. That is a 200% increase compared to the same period last year, the Africa Centers for Disease Control and Prevention said.

But access to vaccines remains a challenge.

The continent of 1.4 billion people has only secured commitment for 5.9 million doses of mpox vaccines, expected to be available from October through December, Dr. Jean Kaseya, head of the Africa CDC, told reporters last week. Congo remains a priority, he said.

Province at risk of outbreak

At the vaccination drive in Goma, Dr. Jean Bruno Kibunda, the WHO representative, warned that North Kivu province is at a risk of a major outbreak due to the “promiscuity observed in the camps” for displaced people, as one of the world’s biggest humanitarian crises caused by armed violence unfolds there.

The news of the vaccination program brought relief among many in Congo, especially in hospitals that had been struggling to manage the outbreak.

“If everyone could be vaccinated, it would be even better to stop the spread of the disease,” said Dr. Musole Mulambamunva Robert, the medical director of Kavumu Hospital, one of the mpox treatment centers in eastern Congo.

Eastern Congo has been beset by conflict for years, with more than 100 armed groups vying for a foothold in the mineral-rich area near the border with Rwanda. Some have been accused of carrying out mass killings. 
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wellington, new zealand — A magnitude 5.7 earthquake struck near New Zealand’s capital city of Wellington, government seismic monitor GeoNet said on Sunday, but initial reports indicated there were no injuries or significant damage. 

The quake hit at 5:08 a.m. on Sunday (1608 GMT on Saturday) striking 25 kilometers (15.5 miles) west of Wellington at a focal depth of 30 km (19 miles). 

GeoNet said more than 37,000 people had reported feeling the shake, some as far north as Auckland in the North Island. 

GeoNet said there was no tsunami warning as a result of the quake. 

A spokesperson for Fire and Emergency New Zealand said the service had not received any calls for assistance. 

Government-owned Radio New Zealand said there were no reports of significant damage or reports of injury. 
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KAMITUGA, Congo — It’s been four months since Sifa Kunguja recovered from mpox, but as a sex worker, she said, she’s still struggling to regain clients, with fear and stigma driving away people who’ve heard she had the virus. 

“It’s risky work,” Kunguja, 40, said from her small home in eastern Congo. “But if I don’t work, I won’t have money for my children.”

Sex workers are among those hardest-hit by the mpox outbreak in Kamituga, where some 40,000 of them are estimated to reside — many single mothers driven by poverty to this mineral-rich commercial hub where gold miners comprise the majority of the clientele. Doctors estimate 80% of cases here have been contracted sexually, though the virus also spreads through other kinds of skin-to-skin contact.

Sex workers say the situation threatens their health and livelihoods. Health officials warn that more must be done to stem the spread — with a focus on sex workers — or mpox will creep deeper through eastern Congo and the region.

Mpox causes mostly mild symptoms such as fever and body aches, but serious cases can mean prominent, painful blisters on the face, hands, chest and genitals.

Kunguja and other sex workers insist that despite risks of reinfection or spreading the virus, they have no choice but to keep working. Sex work isn’t illegal in Congo, though related activities such as solicitation are. Rights groups say possible legal consequences and fear of retribution — sex workers are subject to high rates of violence including rape and abuse — prevent women from seeking medical care. That can be especially detrimental during a public health emergency, according to experts.

Health officials in Kamituga are advocating for the government to shutter nightclubs and mines and compensate sex workers for lost business.

Not everyone agrees. Local officials say they don’t have resources to do more than care for those who are sick, and insist it’s sex workers’ responsibility to protect themselves.

Kamituga Mayor Alexandre Bundya M’pila told The Associated Press that the government is creating awareness campaigns but lacks money to reach everyone. He also said sex workers should look for other jobs, without providing examples of what might be available.

Sex work a big part of economy

Miners stream into Kamituga by the tens of thousands. The economy is centered on the mines: Buyers line streets, traders travel to sell gold, small businesses and individuals provide food and lodging, and the sex industry flourishes.

Nearly a dozen sex workers spoke to AP. They said well over half their clients are miners.

The industry is well organized, according to the Kenyan-based African Sex Workers Alliance, composed of sex worker-led groups. The alliance estimates that 13% of Kamituga’s 300,000 residents are sex workers.

The town has 18 sex-worker committees, the alliance said, with a leadership that tries to work with government officials, protect and support colleagues, and advocate for their rights.

But sex work in Congo is dangerous. Women face systematic violence that’s tolerated by society, according to a report by UMANDE, a local sex-worker rights group.

Many women are forced into the industry because of poverty or because, like Kunguja, they’re single parents and must support their families.

Getting mpox can put sex workers out of business

The sex workers who spoke to AP described mpox as an added burden. Many are terrified of getting the virus — it means time away from work, lost income and perhaps losing business altogether.

Those who recover are stigmatized, they said. Kamituga is a small place, where most everyone knows one another. Neighbors whisper and tell clients when someone is sick — people talk and point.

Since contracting mpox in May, Kunguja said she’s gone from about 20 clients daily to five. She’s been supporting her 11 children through sex work for nearly a decade but said she now can’t afford to send them to school. To compensate, she’s selling alcohol by day, but it’s not enough.

Experts say information and awareness are key

Disease experts say a lack of vaccines and information makes stemming the spread difficult.

Some 250,000 vaccines have arrived in Congo, but it’s unclear when any will get to Kamituga. Sex workers and miners are among those slated to receive them first.

Community leaders and aid groups are trying to teach sex workers about protecting themselves and their clients via awareness sessions where they discuss signs and symptoms. They also press condom use, which they say isn’t widespread enough in the industry.

Sex workers told AP that they insist on using condoms when they have them, but that they simply don’t have enough.

Kamituga’s general hospital gives them boxes of about 140 condoms every few months. Some sex workers see up to 60 clients a day — for less than $1 a person. Condoms run out, and workers say they can’t afford more.

Dr. Guy Mukari, an epidemiologist working with the National Institute of Biomedical Research in Congo, noted that the variant running rampant in Kamituga seems more susceptible to transmission via sex, making for a double whammy with the sex industry.
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ASHEVILLE, North Carolina — Nearly a week after Hurricane Helene brought devastation to western North Carolina, a shiny stainless steel tanker truck in downtown Asheville attracted residents carrying 19-liter containers, milk jugs and buckets to fill with what has become a desperately scare resource — drinking water.

Flooding tore through the city’s water system, destroying so much infrastructure that officials said repairs could take weeks. To make do, Anna Ramsey arrived Wednesday with her two children, who each left carrying plastic bags filled with 7.6 liters of water.

“We have no water. We have no power. But I think it’s also been humbling,” Ramsey said.

Helene’s path through the Southeast left a trail of power outages so large the darkness was visible from space. Tens of trillions of liters of rain fell and more than 200 people were killed, making Helene the deadliest hurricane to hit the mainland U.S. since Katrina in 2005. Hundreds of people are still unaccounted for, and search crews must trudge through knee-deep debris to learn whether residents are safe.

It also damaged water utilities so severely and over such a wide inland area that one federal official said the toll “could be considered unprecedented.” As of Thursday, about 136,000 people in the Southeast were served by a nonoperational water provider and more than 1.8 million were living under a boil water advisory, according to the Environmental Protection Agency.

Western North Carolina was especially hard hit. Officials are facing a difficult rebuilding task made harder by the steep, narrow valleys of the Blue Ridge Mountains that during a more typical October would attract throngs of fall tourists.

“The challenges of the geography are just fewer roads, fewer access points, fewer areas of flat ground to stage resources” said Brian Smith, acting deputy division director for the EPA’s water division in the Southeast.

After days without water, people long for more than just a sponge bath.

“I would love a shower,” said Sue Riles in Asheville. “Running water would be incredible.”

The raging floodwaters of Helene destroyed crucial parts of Asheville’s water system, scouring out the pipes that convey water from a reservoir in the mountains above town that is the largest of three water supplies for the system. To reach a second reservoir that was knocked offline, a road had to be rebuilt.

Boosted output from the third source restored water flow in some southern Asheville neighborhoods Friday, but without full repairs schools may not be able to resume in-person classes, hospitals may not restore normal operations, and the city’s hotels and restaurants may not fully reopen.

Even water that’s unfit to drink is scarce. Drew Reisinger, the elected Buncombe County register of deeds, worries about people in apartments who can’t easily haul a bucket of water from a creek to flush their toilet. Officials are advising people to collect nondrinkable water for household needs from a local swimming pool.

“One thing no one is talking about is the amount of poop that exists in every toilet in Asheville,” he said. “We’re dealing with a public health emergency.”

It’s a situation that becomes more dangerous the longer it lasts. Even in communities fortunate enough to have running water, hundreds of providers have issued boil water notices indicating the water could be contaminated. But boiling water for cooking and drinking is time consuming and small mistakes can cause stomach illness, according to Natalie Exum, an assistant professor at Johns Hopkins Bloomberg School of Public Health.

“Every day that goes by, you could be exposed to a pathogen,” Exum said. “These basic services that we take for granted in our everyday lives actually do do a lot to prevent illness.”

Travis Edwards’ faucet worked immediately after the storm. He filled as many containers as he could for himself and his child, but it didn’t take long for the flow to weaken, then stop. They rationed water, switching to hand sanitizer and barely putting any on toothbrushes.

“(We) didn’t realize how dehydrated we were getting,” he said.

Federal officials have shipped millions of liters of water to areas where people also might not be able to make phone calls or switch on the lights.

Power has been restored to about 62% of homes and businesses and 8,000 crews are out working to restore power in the hardest hit parts of North Carolina, federal officials said Thursday. In 10 counties, about half of the cell sites are still down.

The first step for some utilities is simply figuring out how bad the damage is, a job that might require EPA expertise in extreme cases. Ruptured water pipes are a huge problem. They often run beneath roads, many of which were crumpled and twisted by floodwaters.

“Pretty much anytime you see a major road damaged, there’s a very good chance that there’s a pipe in there that’s also gotten damaged,” said Mark White, drinking water global practice leader at the engineering firm CDM Smith.

Generally, repairs start at the treatment plant and move outward, with fixes in nearby big pipes done first, according to the EPA.

“Over time, you’ll gradually get water to more and more people,” White said.

Many people are still missing, and water repair employees don’t typically work around search and rescue operations. It takes a toll, according to Kevin Morley, manager of federal relations with the American Water Works Association.

“There’s emotional support that is really important for all the people involved. You’re seeing people’s lives just wiped out,” he said.

Even private well owners aren’t immune. Pumps on private wells may have lost power and overtopping floodwaters can contaminate them.

There’s often a “blind faith” assumption that drinking water won’t fail. In this case, the technology was insufficient, according to Craig Colten. Before retiring to Asheville, he was a professor in Louisiana focused on resilience to extreme weather. He hopes Helene will prompt politicians to spend more to ensure infrastructure withstands destructive storms.

And climate change will only make the problem more severe, said Erik Olson, a health and food expert at the nonprofit Natural Resources Defense Council.

“I think states and the federal government really need to step back and start looking at how we’re going to prepare for these extreme weather events that are going to be occurring and recurring every single year,” he said.

Edwards has developed a system to save water. He’ll soap dirty dishes and rinse them with a trickle of water with bleach, which is caught and transferred to a bucket — useable for the toilet.

Power and some cell service have returned for him. And water distribution sites have guaranteed some measure of normalcy: Edwards feels like he can start going out to see friends again.

“To not feel guilty about using more than a cup of water to, like, wash yourself … I’m really, really grateful,” he said. 
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HANOI, Vietnam — More than a dozen tigers were incinerated after the animals died after contracted bird flu at a zoo in southern Vietnam, officials said.

State media VNExpress cited a caretaker at Vuon Xoai zoo in Bien Hoa city saying the animals were fed raw chicken bought from nearby farms. The panther and 20 tigers, including several cubs, weighed between 10 and 120 kilograms when they died. The bodies were incinerated and buried on the premises.

“The tigers died so fast. They looked weak, refused to eat and died after two days of falling sick,” said zoo manager Nguyen Ba Phuc.

Samples taken from the tigers tested positive for H5N1, the virus that causes bird flu.

The virus was first identified in 1959 and grew into a widespread and highly lethal menace to migratory birds and domesticated poultry. It has since evolved, and in recent years H5N1 was detected in a growing number of animals ranging from dogs and cats to sea lions and polar bears.

In cats, scientists have found the virus attacking the brain, damaging and clotting blood vessels and causing seizures and death.

More than 20 other tigers were isolated for monitoring. The zoo houses some 3,000 other animals including lions, bears, rhinos, hippos and giraffes.

The 30 staff members who were taking care of the tigers tested negative for bird flu and were in normal health condition, VNExpress reported. Another outbreak also occurred at a zoo in nearby Long An province, where 27 tigers and three lions died within a week in September, the newspaper said.

Unusual flu strains that come from animals are occasionally found in people. Health officials in the United States said Thursday that two dairy workers in California were infected — making 16 total cases detected in the country in 2024.

“The deaths of 47 tigers, three lions, and a panther at My Quynh Safari and Vuon Xoai Zoo amid Vietnam’s bird flu outbreak are tragic and highlight the risks of keeping wild animals in captivity,” PETA Senior Vice President Jason Baker said in a statement sent to The Associated Press.

“The exploitation of wild animals also puts global human health at risk by increasing the likelihood of another pandemic,” Baker said.

Bird flu has caused hundreds of deaths around the world, the vast majority of them involving direct contact between people and infected birds.
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chicago — California is investigating a possible case of bird flu in a dairy worker who had contact with infected cattle, the state’s public health department said Thursday. 

The virus’ jump to cattle in 14 states and infections of 13 dairy and poultry farmworkers this year have concerned scientists and federal officials about the risks to humans from further spread. 

The worker had a “presumptive positive” result to a test for bird flu, and the U.S. Centers for Disease Control and Prevention will do further testing to confirm the finding, the California Department of Public Health said in a statement. 

The person, who was not identified, suffered only conjunctivitis, or pink eye, the department said in a statement. The person is being treated with antiviral medication and staying home, it added. 

The person works at a Central Valley dairy facility suffering an outbreak in cattle, according to the statement. 

Cows at dairy farms in California, the top U.S. milk-producing state, began testing positive for bird flu in late August. 

“The risk to the general public remains low, although people who interact with infected animals are at higher risk of getting bird flu,” the department said. 

Missouri last month confirmed bird flu in a person with underlying medical conditions who had no immediate known animal exposure. Six health care workers who cared for the Missouri patient developed respiratory symptoms, but the virus was not confirmed in any of them. 

Scientists are watching closely for signs that the virus has begun to spread more easily in people. 

The U.S. Food and Drug Administration on Thursday said it would begin testing raw cow’s milk intended for pasteurization at dairy plants to better understand the prevalence of the bird flu virus in milk. 

Participation in the study, set to begin October 28, is voluntary, and pasteurized dairy products remain safe to consume, the agency said. 

Prior FDA testing of retail dairy samples came back negative, and more such testing is underway.
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GENEVA  — The World Health Organization launched a global plan Thursday to address the growing threat of dengue and other deadly arboviruses, which have affected millions of people around the world and put billions more at risk.  

“The rapid spread of dengue and other arboviral diseases in recent years is an alarming trend that demands a coordinated response across sectors and across borders,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. 

An arbovirus is a virus that is transmitted to humans by mosquitoes, ticks, or other arthropods, such as crustaceans, insects and arachnids.   

Dengue has emerged as the most problematic arbovirus disease. The WHO notes the number of cases has nearly doubled each year since 2021, with over 12.3 million cases at the end of August of this year, including more than 6,000 deaths. 

The WHO aims to “turn the tide” against dengue and arboviral diseases, Tedros said, noting that the measures in the proposal could “protect vulnerable populations and pave the way for a healthier future.” 

The WHO chief said everyone has a role to play in the fight against dengue, “from maintaining clean environments to supporting vector control and seeking and providing timely medical care.” 

“Factors such as unplanned urbanization and poor water, sanitation and hygiene practices, climate change and international travel, are facilitating the rapid geographical spread of dengue,” Dr. Raman Velayudhan, WHO unit head, global program on control of neglected tropical diseases, told journalists in Geneva Tuesday, in advance of the plan’s launch. 

“The disease is now endemic in more than 130 countries,” he said. “Similar trends are also observed for other arboviral diseases, such as Zika, chikungunya, and more recently, the Oropouche virus disease, especially in the Americas.” 

Dengue is endemic in tropical and subtropical climates, particularly in Southeast Asia, the Western Pacific and the Americas. The WHO says the majority of dengue cases, as well as several other arboviruses, have been reported from the American region this year.  

WHO officials say the situation is also of concern in Africa, “where countries are battling multiple diseases amid conflict and natural disasters,” placing additional strain on already fragile health systems. 

The Africa CDC reports more than 15,000 cases of dengue have been recorded in 13 African countries this year. 

“This global escalation underscores the urgent need for a robust strategy to mitigate risks and safeguard populations taking into account that urban centers are at greater risk,” Velayudhan said. 

Dengue is a viral infection that spreads from mosquitoes to people. Most people who get dengue get better in one to two weeks. However, some people who develop severe cases can die. 

According to the WHO, prevention is the best protection from dengue. It recommends people avoid mosquito bites, especially during the day, “by covering up.” 

Chikungunya, a virus spread by Aedes mosquitoes, has been reported in 118 countries, with the highest circulation found in Brazil.   

Dr. Diana Rojas Alvarez, team lead on arboviruses, epidemic and pandemic preparedness and prevention at the WHO, notes newborns, elderly and people with pre-existing conditions “have been identified as a risk factor for poor disease outcome.” 

Besides chikungunya, she said Zika and Oropouche, which are spreading widely in the Americas, have symptoms similar to dengue and “can be easily misdiagnosed in areas with co-circulation of multiple arboviruses.”   

To avoid misidentifying those diseases, she said it is critical for countries to strengthen their detection, surveillance, and testing activities and “to make sure populations know which measures to take to protect themselves and their communities.” 

The World Health Organization says the global escalation of arboviral diseases underscores the urgent need for “a robust strategy to mitigate risks and safeguard populations.” 

It urges governments to implement five components of its strategic global plan:  Emergency coordination activities, collaborative detection and surveillance, community protection and prevention measures, safe and scalable care to prevent illness and death, and access to countermeasures, such as the promotion of research for improved treatments and vaccines. 

The WHO estimates $55 million will be required to put the plan into action over the next year.  
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A new exhibit in Washington sheds some light on a little-known layer of the sea and the strange creatures that live there. Artechouse art center and Woods Hole Oceanographic Institution collaborated on the spectacle, called Twilight Zone: Hidden Wonders of the Ocean. Maxim Adams has the story.
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