GOMA, Democratic Republic of Congo — Sarah Bagheni had a headache, fever, and itchy and unusual skin lesions for days, but she had no inkling that her symptoms might have been caused by mpox and that she might be another case in a growing global health emergency. 

She also has no idea where to go to get medical help. 

She and her husband live in the Bulengo displacement camp in eastern Congo, a region that is effectively ground zero for a series of mpox outbreaks in Africa.

This year’s alarming rise in cases, including a new form of the virus identified by scientists in eastern Congo, led the World Health Organization to declare it a global health emergency on Wednesday. It said the new variant could spread beyond the five African countries where it had already been detected — a timely warning that came a day before Sweden reported its first case of the new strain.

In the vast central African nation of Congo, which has had more than 96% of the world’s roughly 17,000 recorded cases of mpox this year — and some 500 deaths from the disease — many of the most vulnerable seem unaware of its existence or the threat that it poses.

“We know nothing about this,” Bagheni’s husband, Habumuremyiza Hire, said Thursday about mpox. “I watch her condition helplessly because I don’t know what to do. We continue to share the same room.”

Millions are thought to be out of reach of medical help or advice in the conflict-torn east, where dozens of rebel groups have been fighting Congolese army forces for years over mineral-rich areas, causing a huge displacement crisis. Hundreds of thousands of people like Bagheni and her husband have been forced into overcrowded refugee camps around Goma, while more have taken refuge in the city.

Conditions in the camps are dire and medical facilities are almost nonexistent.

Mahoro Faustin, who runs the Bulengo camp, said that about three months ago, administrators first started noticing people in the camp exhibiting fever, body aches and chills — symptoms that could signal malaria, measles or mpox.

There is no way of knowing how many mpox cases there might be in Bulengo because of a lack of testing, he said. There haven’t been any recent health campaigns to educate the tens of thousands of people in the camp about mpox, and Faustin said he’s worried about how many people might be undiagnosed.

“Just look at the overcrowding here,” he said, pointing to a sea of ramshackle tents. “If nothing is done, we will all be infected here, or maybe we are already all infected.”

Around 70% of the new mpox cases in the Goma area in the last two months that were registered at a treatment center run by Medair were from displacement camps, said Dr. Pierre Olivier Ngadjole, the international aid group’s health advisor in Congo. The youngest of those cases was a month-old baby and the oldest a 90-year-old, he said.

In severe cases of mpox, people can develop lesions on the face, hands, arms, chest and genitals. While the disease originated in animals, the virus has in recent years been spreading between people via close physical contact, including sex.

Bagheni’s best hope of getting a diagnosis for her lesions is a government hospital that’s a two-hour drive away. That’s likely out of the question, given that she already struggles with mobility having previously had both her legs amputated.

Seven million people are internally displaced in Congo, with more than 5.5 million of them in the country’s east, according to the U.N. refugee agency. Congo has the largest displacement camp population in Africa, and one of the largest in the world.

The humanitarian crisis in eastern Congo has almost every possible complication when it comes to stopping an mpox outbreak, said Dr. Chris Beyrer, director of Duke University’s Global Health Institute.

That includes war, illicit mining industries that attract sex workers, transient populations near border regions, and entrenched poverty. He also said the global community missed multiple warning signs.

“We’re paying attention to it now, but mpox has been spreading since 2017 in Congo and Nigeria,” Beyrer said, adding that experts have long been calling for vaccines to be shared with Africa, but to little effect. He said the WHO’s emergency declaration was “late in coming,” with more than a dozen countries already affected.

Beyrer said that unlike COVID-19 or HIV, there’s a good vaccine and good treatments and diagnostics for mpox, but “the access issues are worse than ever” in places like eastern Congo.

In 2022, there were outbreaks in more than 70 countries around the world, including the United States, which led the WHO to also declare an emergency that lasted until mid-2023. It was largely shut down in wealthy countries within months through the use of vaccines and treatments, but few doses have been made available in Africa.

The new and possibly more infectious strain of mpox was first detected this year in a mining town in eastern Congo, about 450 kilometers south of Goma. It’s unclear how much the new strain is to blame, but Congo is now enduring its worst outbreak yet and at least 13 African countries have recorded cases, four of them for the first time.

The outbreaks in those four countries — Burundi, Kenya, Rwanda and Uganda — have been linked to Congo’s, and Doctors Without Borders said Friday that Congo’s surge “threatens a major spread of the disease” to other countries.

Salim Abdool Karim, an infectious disease expert who chairs the Africa Centers for Disease Control and Prevention’s emergency committee, said the Congo outbreak has a particularly concerning change, in that it’s disproportionately affecting young people. Children under 15 account for 70% of cases and 85% of all deaths in the country, the Africa CDC reported.

Unlike the 2022 global outbreak, which predominantly affected gay and bisexual men, mpox now appears to be spreading in heterosexual populations.

All of Congo’s 26 provinces have recorded mpox cases, according to the state-run news agency. But Health Minister Samuel-Roger Kamba said Thursday that the country doesn’t have a single vaccine dose yet and he pleaded for “vigilance in all directions from all Congolese.”

Dr. Rachel Maguru, who heads the multi-epidemic center at Goma’s North Kivu provincial hospital, said they also don’t have drugs or any established treatments for mpox and are relying on other experts such as dermatologists to help where they can. A larger outbreak around the city and its numerous displacement camps already overburdened with an influx of people would be “terrible,” she said.

She also noted a pivotal problem: poor and displaced people have other priorities, like earning enough money to eat and survive. Aid agencies and stretched local authorities are already wrestling with providing food, shelter and basic health care to the millions displaced, while also dealing with outbreaks of other diseases like cholera.
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Stockholm — Health authorities warned Friday that Europe must be ready for more cases of a deadly strain of mpox that has killed hundreds of people in the Democratic Republic of Congo.

The World Health Organization urged pharmaceutical firms to ramp up vaccine production and China said it would screen travelers for the disease after the first cases of the more deadly strain to be recorded outside Africa were announced in Sweden and Pakistan.

France’s Prime Minister Gabriel Attal said his country was on the “highest alert” and would implement “new recommendations” for travelers to risk areas.

Mpox is caused by a virus transmitted to humans by animals but can also spread human-to-human through close physical contact.

It causes fever, muscular aches and large boil-like skin lesions.

The WHO on Wednesday declared the rapid spread of the new Clade 1b strain an international public health emergency — the agency’s highest alert.

This follows the spread of the more deadly mpox from Democratic Republic of Congo (DRC) to other African countries.

“We do need the manufacturers to really scale up so that we’ve got access to many, many more vaccines,” WHO spokesperson Margaret Harris told reporters.

The WHO is asking countries with vaccine stockpiles to donate them to countries with outbreaks.

Harris said mpox was “particularly dangerous for those with a weak immune system, so people who maybe have HIV or are malnourished,” and was also dangerous for small children.

The United States has said it will donate 50,000 doses of an mpox vaccine to DRC and Attal said France would also send vaccines to risk countries.

Danish drugmaker Bavarian Nordic said Thursday it would be ready to make up to 10 million doses of its mpox vaccine by 2025 but that it needed contracts to start production.

The Stockholm-based European Center for Disease Prevention and Control (ECDC) said the overall risk in Europe was “low.” But it warned that “effective surveillance, laboratory testing, epidemiological investigation and contact tracing capacities will be vital to detecting cases.”

“Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases,” ECDC director Pamela Rendi-Wagner said in a statement.

Hundreds killed in DRC

The virus has swept across DRC, killing 548 people so far this year, the government said Thursday.

Nigeria has recorded 39 mpox cases this year, but no deaths, according to its health authorities. Previously unaffected countries such as Burundi, Kenya, Rwanda and Uganda have reported outbreaks, according to the Africa Centers for Disease Control and Prevention.

Sweden’s Public Health Agency announced Thursday it had registered a case of Clade 1b.

The patient was infected during a visit to “the part of Africa where there is a major outbreak of mpox Clade 1,” epidemiologist Magnus Gisslen said in a statement.

The mpox strain in the Pakistan case was not immediately known, the country’s health ministry said in a statement.

It said the patient, a 34-year-old man, had “come from a Gulf country.”

China announced it would begin screening people and goods entering the country for mpox over the next six months.

People arriving from countries where outbreaks have occurred, who have been in contact with mpox cases or display symptoms should “declare to customs when entering the country,” China’s customs administration said.

Vehicles, containers and items from areas with mpox cases should be sanitized, it added in a statement.

Vaccination drive

Mpox has two subtypes: the more virulent and deadlier Clade 1, endemic in the Congo Basin in central Africa; and Clade 2, endemic in West Africa.

A worldwide outbreak beginning in 2022 involving the Clade 2b subclade caused some 140 deaths out of about 90,000 cases, mostly affecting gay and bisexual men.

France reported 107 cases of the milder mpox variant between January 1 and June 30 this year.

The WHO’s European regional office in Copenhagen said the Sweden case was “a clear reflection of the interconnectedness of our world.”

But it added: “Travel restrictions and border closures don’t work and should be avoided.”
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BANGKOK — Southeast Asia is among the regions most prone to natural disasters, but a new analysis released Thursday shows its people also feel the best equipped to deal with them.

It seems logical that the countries in and around the Pacific Ring of Fire, vulnerable to earthquakes, typhoons, storm surges and other dangers, are also the best prepared, but the survey by Gallup for the Lloyd’s Register Foundation shows that’s not always the case in other regions.

“Frequent exposure to hazard isn’t the only factor that determines how prepared people feel,” Benedict Vigers, a research consultant with Gallup, told The Associated Press.

The report found the Association of Southeast Asian Nations has played a key role in disaster risk reduction, and Vigers said the region’s wider approach includes widespread and effective early warning systems, scaled-up community approaches and regional cooperation, and good access to disaster finance.

“Southeast Asia’s success in feelings of disaster preparedness can be linked to its high exposure to disasters, its relatively high levels of resilience – from individual people to overall society, and the region’s approach to — and investment into — disaster risk management more broadly,” he said.

Forty percent of people surveyed in Southeast Asia said they had experienced a natural disaster in the past five years, while a similar number — 36% — in Southern Asia said the same. But 67% of Southeast Asians felt among the best prepared to protect their families and 62% had emergency plans, while Southern Asians felt less ready, with 49% and 29% respectively.

Respondents from North America, which is significantly less disaster-prone than Southeast Asia, said they only felt slightly less prepared, while those in Northern and Western Europe were in the middle of the pack.

The results from Southeast Asia, primarily made up of lower-middle-income countries, suggest wealth is not a deciding factor in disaster response and preparation, said Ed Morrow, senior campaigns manager for Lloyd’s Register Foundation, a British-based global safety charity.

Southeast Asia is “a region that clearly has much to teach the world in terms of preparing for disasters,” he said.

Globally, no country ranked higher than the Philippines for having experienced a natural disaster in the past five years, with 87% of respondents saying they had.

It was also among the top four countries where the highest proportion of households have a disaster plan. All were in Southeast Asia: the Philippines (84%), Vietnam (83%), Cambodia (82%) and Thailand (67%), followed by the United States (62%).

Those with the lowest proportion were Egypt, Kosovo and Tunisia, all with 7%.

The data were drawn from the World Risk Poll, conducted every two years, with the main results from the 2023 survey published in June. Questions on disasters focused on natural hazards instead of conflicts or financial disasters, and they excluded the coronavirus pandemic.

Surveys were conducted of people aged 15 and above in 142 countries and based on telephone or face-to-face conversations with approximately 1,000 or more respondents in each country with the exception of China, where some 2,200 people were contacted online.

Margin of error ranged from plus or minus 2.2 to 4.9 percentage points, for an overall 95% confidence level.

“It is our intention that this freely available data should be used by governments, regulators, businesses, NGOs and international bodies to inform and target policies and interventions that make people safer,” Morrow said.
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london — The World Health Organization declared Wednesday that the increasing spread of mpox in Africa is a global health emergency, warning the virus might ultimately spill across international borders. 

The announcement by WHO director-general Tedros Adhanom Ghebreyesus came after a meeting of the United Nation health agency’s emergency committee. The Africa Centers for Disease Control and Prevention declared mpox a public health emergency on the continent on Tuesday. 

The WHO said there have been more than 14,000 cases and 524 deaths in Africa this year, which already exceeds last year’s figures. 

So far, more than 96% of all cases and deaths are in a single country — Congo. Scientists are concerned by the spread of a new version of the disease there that might be more easily transmitted among people. 

Here’s a look at what we know about mpox, and what might be done to contain it: 

What is mpox? 

Mpox, also known as monkeypox, was first identified by scientists in 1958 when there were outbreaks of a “pox-like” disease in monkeys. Until recently, most human cases were seen in people in central and West Africa who had close contact with infected animals. 

In 2022, the virus was confirmed to spread via sex for the first time and triggered outbreaks in more than 70 countries across the world that had not previously reported mpox. 

Mpox belongs to the same family of viruses as smallpox but causes milder symptoms such as fever, chills and body aches. People with more serious cases can develop lesions on the face, hands, chest and genitals. 

What’s happening in Africa that’s causing all this concern? 

The number of cases has jumped dramatically. Last week, the Africa CDC reported that mpox has now been detected in at least 13 African countries. Compared with the same period last year, the agency said cases are up 160% and deaths have increased by 19%. 

Earlier this year, scientists reported the emergence in a Congolese mining town of a new form of mpox that can kill up to 10% of people and may spread more easily. 

Unlike in previous mpox outbreaks, where lesions were mostly seen on the chest, hands and feet, the new form of mpox causes milder symptoms and lesions on the genitals. 

That makes it harder to spot, meaning people might also sicken others without knowing they’re infected, said Dr. Placide Mbala-Kingebeni, a Congolese researcher who led the research into the new form of mpox. 

WHO said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda and Uganda. All of those outbreaks were linked to the epidemic in Congo. Tedros said there was concern for the further spread of the disease within Africa and beyond. 

In the Ivory Coast and South Africa, health authorities have reported outbreaks of a different and less dangerous version of mpox that spread worldwide in 2022 and infected nearly 100,000 people. 

What’s the threat to the rest of the world? 

Like any infectious disease, the new form of mpox seen in Congo could cross borders — cases have already been detected in four other East African countries. 

On Thursday, Sweden’s public health agency said it identified the first case of the new mpox variant in someone who had recently been in Africa, and who sought health care in Stockholm. 

Officials said the risk to the general public was considered “very low” and that they expect sporadic imported cases to continue. 

Kamituga, the region in Congo where the new form of mpox was first spotted, is home to a significant transient population traveling through Africa and beyond. 

Still, given the resources in rich countries to stop mpox, scientists suspect that if new outbreaks linked to Congo were to be identified, transmission could be stopped relatively quickly. 

Unlike COVID-19 or measles, mpox is not airborne and typically requires close, skin-to-skin contact to spread. 

What does an emergency declaration mean? 

WHO’s emergency declaration is meant to spur donor agencies and countries into action. But the global response to previous declarations has been mixed. 

Africa CDC Director General Dr. Jean Kaseya said the agency’s declaration of a public health emergency was meant “to mobilize our institutions, our collective will and our resources to act swiftly and decisively.” He appealed to Africa’s international partners for help, saying that the escalating caseload in Africa had largely been ignored. 

Dr. Boghuma Titanji, an infectious diseases expert at Emory University, said the last WHO emergency declaration for mpox “did very little to move the needle” on getting things like diagnostic tests, medicines and vaccines to Africa. 

How does the current outbreak in Africa compare to the 2022 epidemic? 

During the global outbreak of mpox in 2022, gay and bisexual men made up the vast majority of cases and the virus was mostly spread through close contact, including sex. 

Although some similar patterns have been seen in Africa, children under 15 now account for more than 70% of the mpox cases and 85% of deaths in Congo. 

Greg Ramm, Save the Children’s Congo director, said the organization was particularly worried about the spread of mpox in the crowded camps for refugees in the east, noting there were 345,000 children “crammed into tents in unsanitary conditions.” He said the country’s health system was already “collapsing” under the strain of malnutrition, measles and cholera. 

Emory’s Titanji said it was unclear why children were so disproportionately hit by mpox in Congo. She said it might be because kids are more susceptible to the virus or that social factors, like overcrowding and exposure to parents who caught the disease, might explain it. 

How might mpox be stopped? 

The 2022 outbreak of mpox in dozens of countries was largely shut down with the use of vaccines and treatments in rich countries, in addition to convincing people to avoid risky behavior. But barely any vaccines or treatments have been available in Africa. 

Marks, of the London School of Hygiene and Tropical Medicine, said that immunization would likely help — including inoculating people against smallpox, a related virus. 

“We need a large supply of vaccine so that we can vaccinate populations most at risk,” he said, adding that would mean sex workers, children and adults living in outbreak regions. 

Congolese authorities have asked for 4 million doses mostly for young children, but no doses have yet been received, said Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee. 
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Abuja, Nigeria — Nigerian authorities on Thursday placed key entry points into the country on high alert following the outbreak of the mpox virus in Africa. Authorities have also put nine Nigerian states, including the commercial hub, Lagos, and the capital, Abuja, under serious surveillance.

The Nigerian Center for Disease Control and Prevention told journalists that the action is in response to surging cases of the mpox virus in Africa and to intensify coordination to limit importation and spread of the virus.

This week, the Africa Centers for Disease Control and Prevention said it had recorded 2,863 confirmed cases of mpox, with 517 deaths, across 13 countries this year. It said there are about 17,000 suspected cases of mpox, formerly known as monkeypox, in total.

So far this year, Nigeria has recorded 39 cases of mpox, with no deaths.

Jide Idris, head of the Nigerian CDC, said it’s best to be prepared.

“We’re intensifying surveillance activities by tracking cases across Nigeria to swiftly detect and respond to any new cases,” he said. “Along this line, five designated international airports, some key seaports … land and foot crossing borders have been placed in high alert. Declaration forms have been distributed to airlines where there’s an ongoing outbreak of mpox in the last 90 days.”

The Nigerian CDC said authorities are distributing diagnostic tools to states. They also have issued a public advisory on ways to prevent the spread of the mpox virus, including limiting contact with animals such as rodents and monkeys.

“We’re also considering vaccination efforts for high-risk groups, as Nigeria expects to receive about 10,000 doses of the new vaccines that have just recently been approved for emergency use,” Idris said. “We’re also meeting with collaborative agencies like Ministry of Environment and Agriculture for support and coordination efforts.”

Authorities say a new strain of the virus, which is more deadly and more easily transmitted, is responsible for the recent spread. The strain was first discovered in the Democratic Republic of Congo and later reported in Kenya, Rwanda and Uganda, all previously unaffected nations.

On Tuesday, the Africa CDC declared mpox a public health emergency of international-continental concern.

Jean Kaseya, head of the Africa CDC, said, “This declaration is not merely a formality. It’s a clarion call to action. It’s a recognition that we can no longer afford to be reactive; we must be proactive and aggressive in our effort to contain and eliminate this threat.”

Mpox is a viral disease that causes pus-filled lesions resembling rashes to appear on the skin.

In 2022, the World Health Organization declared it an international health emergency after cases were found in more than 70 countries.

Health analysts say the new strain is worrisome and will need a coordinated international response to control it and save lives.
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PESHAWAR, Pakistan — Pakistan’s health ministry has confirmed at least one case of the mpox virus in a patient who had returned from a Gulf country, it said on Friday, as provincial health authorities reported they had detected three cases.

A health ministry spokesperson said the sequencing of the confirmed case was under way, and that it would not be clear which variant of mpox the patient had until the process was complete.

A new form of the virus has triggered global concern because it seems to spread more easily though routine close contact.

Earlier on Friday, the health department in northern Khyber Pakhtunkhwa province said three cases had been detected in patients on arrival from the United Arab Emirates. It was not clear whether the patient confirmed by the central health ministry was among the three.

The World Health Organization has declared the recent outbreak of the disease as a public health emergency of international concern after the new variant of the virus was identified.

Health ministry spokesperson Sajid Shah said so far they had no confirmation of the new variant, but the sequencing of the sample of the confirmed patient was under way.

“Once that’s done, we will be able to say what strain is this,” said Shah.

Salim Khan, the director general of health services for Khyber Pakhtunkhwa, said three patients were in quarantine.

Global health officials on Thursday confirmed an infection with a new strain of the mpox virus in Sweden and linked it to a growing outbreak in Africa, the first sign of its spread outside the continent.

The WHO on Wednesday sounded its highest level of alert over the outbreak in Africa after cases in the Democratic Republic of Congo spread to nearby countries.

There have been 27,000 cases and more than 1,100 deaths, mainly among children, in Congo since the current outbreak began in January 2023.

The disease, caused by the monkeypox virus, leads to flu-like symptoms and pus-filled lesions. It is usually mild but can kill, with children, pregnant women and people with weakened immune systems, such as those with HIV, all at higher risk of complications.
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cape canaveral, florida — The first of four supermoons this year rises next week, providing tantalizing views of Earth’s constant companion.

Stargazers can catch the first act Monday as the full moon inches a little closer than usual, making it appear slightly bigger and brighter in the night sky.

“I like to think of the supermoon as a good excuse to start looking at the moon more regularly,” said Noah Petro, project scientist for NASA’s Lunar Reconnaissance Orbiter.

August’s supermoon kicks off a string of lunar spectacles. September’s supermoon will coincide with a partial lunar eclipse. October’s will be the year’s closest approach, and November’s will round out the year.

What makes a moon so super?

More a popular term than a scientific one, a supermoon occurs when a full lunar phase syncs up with an especially close swing around Earth. This usually happens only three or four times a year and consecutively, given the moon’s constantly shifting, oval-shaped orbit.

A supermoon obviously isn’t bigger, but it can appear that way, although scientists say the difference can be barely perceptible.

“Unless you have looked at a lot of full moons or compare them in images, it is hard to notice the difference, but people should try,” Petro said in an email.

How do supermoons compare?

There’s a quartet of supermoons this year.

The first will be 361,970 kilometers away. The next will be nearly 4,484 kilometers closer the night of September 17 into the following morning.

A partial lunar eclipse will also unfold that night, visible in much of the Americas, Africa and Europe as the Earth’s shadow falls on the moon, resembling a small bite.

October’s supermoon will be the year’s closest at 357,364 kilometers from Earth, followed by November’s supermoon at 361,867 kilometers.

What’s in it for me?

Scientists point out that only the keenest observers can discern the subtle differences. It’s easier to detect the change in brightness — a supermoon can be 30% brighter than average.

With the U.S. and other countries ramping up lunar exploration with landers and eventually astronauts, the moon beckons brighter than ever. As project scientist for the first team of moonwalkers coming up under Apollo’s follow-on program, Artemis, Petro is thrilled by the renewed lunar interest.

“It certainly makes it more fun to stare at,” Petro said.
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