Day: November 23, 2023

Chinese officials say they did not detect any “unusual or novel diseases” in the country, the World Health Organization said Thursday, following an official request by the U.N. health agency for information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children. 

WHO cited unspecified media reports and a global infectious-disease monitoring service as reporting clusters of undiagnosed pneumonia in children in northern China and formally requested more details from China earlier this week. 

Outside scientists said the situation warranted close monitoring, but they were not convinced that the recent spike in respiratory illnesses in China signaled the start of a new global outbreak. 

The emergence of new flu strains or other viruses capable of triggering pandemics typically starts with undiagnosed clusters of respiratory illness. Both SARS and COVID-19 were first reported as unusual types of pneumonia. 

WHO noted that authorities at China’s National Health Commission on November 13 reported an increase in respiratory diseases, which they said was the result of the lifting of COVID-19 lockdown restrictions. Other countries also saw a jump in respiratory diseases such as respiratory syncytial virus, or RSV, when pandemic restrictions ended. 

WHO said that about a week later, media reported clusters of undiagnosed pneumonia in children in northern China. 

The U.N. agency said it held a teleconference with Chinese health officials on Thursday, during which the data it requested were provided. Those showed an increase in hospital admissions of children due to diseases including bacterial infection, RSV, influenza and common cold viruses since October. 

“No changes in the disease presentation were reported by the Chinese health authorities,” WHO said. It added that Chinese officials said the spike in patients had not overloaded the country’s hospitals. 

New disease doubted

Dr. Paul Hunter, a professor of medicine at Britain’s University of East Anglia, doubted the wave of infections was sparked by a new disease. 

“If it was [a new disease], I would expect to see many more infections in adults,” he said in a statement. “The few infections reported in adults suggest existing immunity from a prior exposure.” 

Francois Balloux of University College London said China was probably experiencing a significant wave of childhood infections since this was the first winter since lockdown restrictions were lifted, which likely reduced children’s immunity to common bugs. 

WHO said that northern China has reported a jump in influenzalike illnesses since mid-October compared with the previous three years. It is rare for the U.N. health agency to publicly ask for more detailed information from countries, as such requests are typically made internally. WHO said it requested further data from China via an international legal mechanism. 

According to internal accounts in China, the outbreaks have swamped some hospitals in northern China, including in Beijing, and health authorities have asked the public to take children with less severe symptoms to clinics and other facilities. 

The average number of patients in the internal medicine department at Beijing Children’s Hospital topped 7,000 per day, exceeding the hospital’s capacity, state-owned China National Radio said in an online article earlier this week. 

China’s National Health Commission, in a written Q&A posted online by the official Xinhua News Agency, suggested Thursday that children with mild symptoms “first visit primary health care institutions or pediatrics departments of general hospitals” because large hospitals are crowded and have long waiting times. 

WHO said that there was too little information at the moment to properly assess the risk of these reported cases of respiratory illness in children. The agency has previously been stymied by a lack of cooperation from countries when new viruses have emerged, particularly in China. 

After SARS broke out in southern China in 2002, Beijing officials told doctors to hide patients, with some being driven around in ambulances while WHO scientists were visiting the country. That prompted WHO to threaten to close its office in China. 

Nearly two decades later, China stalled on sharing critical details about the coronavirus with the U.N. health agency after the new virus emerged in late 2019. WHO publicly applauded China’s commitment to stopping the virus — weeks before it started causing explosive epidemics worldwide. 

“While WHO seeks this additional information, we recommend that people in China follow measures to reduce the risk of respiratory illness,” the agency said, advising people to get vaccinated, isolate if they are feeling ill, wear masks if necessary and get medical care as needed. 
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Authorities in several West African countries are trying to manage their huge diphtheria outbreaks, including in Nigeria where a top health official said Thursday that millions are being vaccinated to cover wide gaps in immunity against the disease.

At least 573 people out of the 11,640 diagnosed with the disease in Nigeria have died since the current outbreak started in December 2022, though officials estimate the toll — now on the decline because of treatment efforts — could be much higher across states unable to detect many cases.

In Niger, 37 people had died out of the 865 cases as of October, while Guinea has reported 58 deaths out of 497 since its outbreak started in June.

“As far as the history that I am aware of, this is the largest outbreak that we have had,” Ifedayo Adetifa, head of the Nigeria Centre for Disease Control, told The Associated Press.

The highly contagious bacterial infection has been reported in 20 of Nigeria’s 36 states so far.

A major driver of the high rate of infection in the region has been a historically wide vaccination gap, the French medical organization Doctors Without Borders, or MSF, said in a statement on Tuesday.

In Nigeria, only 42% of children under 15 years old are fully protected from diphtheria, according to a government survey, while Guinea has a 47% immunization rate — both far below the 80-85% rate recommended by the World Health Organization to maintain community protection.

The fate of the affected countries is worsened by the global shortages of the diphtheria vaccine as demand has increased to respond to outbreaks, MSF said.

“We’re not seeing vaccination happen, not at the scale that is needed,” said Dr. Dagemlidet Tesfaye Worku, emergency medical program manager for MSF in Abidjan, Ivory Coast. “What is needed is a truly massive scale-up of vaccination, as soon as possible.”

The Nigerian government is ramping up vaccination for targeted populations while assisting states to boost their capacity to detect and manage cases, said Adetifa, the Nigeria CDC head.

But several states continue to struggle, including Kano, which accounts for more than 75% of cases in Nigeria but has only two diphtheria treatment centers, according to Abubakar Labaran Yusuf, the state’s top health official.

“Once people have to travel or move significant distances to access treatment, that becomes a challenge,” Adetifa said.
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A 14-year-old Ethiopian-born American in the U.S. state of Virginia has won the 3M Young Scientist Challenge, an annual science competition for U.S. students in grades five through eight. VOA’s Eden Geremew recently spoke with the winner in Fairfax County, Virginia, in this report narrated by Salem Solomon. Camera: Karina Choudhury
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For most of her life, Claudia Stearns dreaded Thanksgiving. As a person who struggled with obesity since childhood, Stearns hated the annual turmoil of obsessing about what she ate — and the guilt of overindulging on a holiday built around food. 

Now, after losing nearly 100 pounds using medications including Wegovy, a powerful new anti-obesity drug, Stearns says the “food noise” in her head has gone very, very quiet. 

“Last year, it felt so lovely to just be able to enjoy my meal, to focus on being with friends and family, to focus on the joy of the day,” says Stearns, 65, of Somerville, Massachusetts. “That was a whole new experience.” 

As millions of Americans struggling with obesity gain access to a new generation of weight-loss drugs, Stearns’ experience is becoming more common — and more noticeable at the times of year when cooking, eating and a sense of abundance can define and heighten gatherings of loved ones and friends. Medical experts and consumers say the drugs are shifting not only what users eat, but also the way they view food.

For some, it means greater mental control over their meals. Others say it saps the enjoyment from social situations, including traditionally food-centric holidays like Thanksgiving, Passover and Christmas.

“It’s something that really changes a lot of things in their life,” says Dr. Daniel Bessesen, chief of endocrinology at Denver Health, who treats patients with obesity. “They go from food being a central focus to it’s just not.”

Undermining the festivities?

The new obesity drugs, originally designed to treat diabetes, include semaglutide, used in Ozempic and Wegovy, and tirzepatide, used in Mounjaro and recently approved as Zepbound. Now aimed at weight loss, too, the drugs delivered as weekly injections work far differently than any diet. They mimic powerful hormones that kick in after people eat to regulate appetite and the feeling of fullness communicated between the gut and the brain. Users can lose as much as 15% to 25% of their body weight, studies show. 

“That’s how it works — it reduces the rewarding aspects of food,” explains Dr. Michael Schwartz, an expert in metabolism, diabetes and obesity at the University of Washington in Seattle. 

For Stearns, who started treatment in 2020, using the weight-loss medications means she can take a few bites of her favorite Thanksgiving pies — and then stop. “I would not feel full,” she says, “but I would feel satisfied.” 

Yet such a shift can have broader implications, both religious and cultural, because it alters the experience of festive and religious holidays that are often built around interactions with food — and lots of it.

“I’m Italian. For us, it’s like going to church, going to a table,” says Joe Sapone, 64, a retiree from Atlantic Highlands, New Jersey, who lost about 100 pounds with dieting and Mounjaro. He no longer needs what he called “the food orgy” of a holiday, but he acknowledges it was an adjustment.

“Part of succeeding at this is disconnecting a good time with what you eat,” he says.

Changes in enjoyment

Many users welcome what they say is greater control over what they eat, even during the emotionally charged holiday season. 

“I may be more selective of the items I put on my plate,” says Tara Rothenhoefer, 48, of Trinity, Florida. She lost more than 200 pounds after joining a clinical trial testing Mounjaro for weight loss in 2020. “I don’t care about the bread as much. I still eat what I enjoy.” 

But others on the drugs lose their appetites entirely or suffer side effects — nausea, vomiting, diarrhea — that undermine the pleasure of any food. 

“I’ve had a handful of patients over the years who were really miserable because they didn’t enjoy food in the same way,” says Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and co-founder of Intellihealth, a clinical and software company that focuses on obesity treatment. 

But, she added, most people who have turned to weight-loss medications have spent years struggling with the physical and mental burdens of chronic obesity and are relieved to discover a decreased desire for food — and grateful to shed pounds. 

When people stop taking the drugs, their appetites return and they regain weight, often faster than they lost it, studies show. One early analysis found that two-thirds of patients who started taking weight-loss drugs were no longer using them a year later. 

Part of that may be due to the high cost and ongoing supply shortages. But the larger question of what it means to alter a basic human drive like appetite needs to be considered as well, says Dr. Jens Juul Holst of the University of Copenhagen. He is one of the researchers who first identified the gut hormone GLP-1, or glucagon-like peptide 1, which eventually led to the new class of obesity drugs. 

Speaking at an international diabetes conference this fall, Holst offered a philosophical critique of the new medications’ real-world impact. 

“Why is it that you’ve lost weight? That’s because you’ve lost your appetite. That’s because you’ve lost the pleasure of eating and the reward of having a beautiful meal,” Holst told his colleagues. “And how long can you stand that? That is the real, real question.” 
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Cindy Dyer, the U.S. ambassador-at-large for monitoring and combating trafficking, is planning to push Cambodia’s new government to ramp up its efforts to crack down on cyberscam operations that trap many trafficking victims in slavelike conditions.

A recently completed visit to Phnom Penh by Dyer “will serve as an opportunity for information sharing and coordination on anti-trafficking efforts,” the State Department said last week in a release.

Dyer met with a range of officials “with the objective of building a relationship with the new government for future coordination and advocating for progress in the most critical areas, including increased investigations and prosecutions of cyberscam operations,” said the November 15 release.

Cambodia’s role as host of cybercriminals has been in an international spotlight. The U.N. High Commissioner for Human Rights (UNHCHR) released a report this summer estimating that the industry has victimized 100,000 people in Cambodia.

Lured by promise of jobs

Operators of these scamming networks recruit unwitting workers from across Asia, often with the promise of well-paying tech jobs, and then force them to attempt to scam victims online while living in slavelike conditions, according to the report.

Countries including Indonesia, Taiwan and China have urged countries like Cambodia and Laos to crack down on the industry, while warning their own citizens of the dangers in traveling to these countries, according to the UNHCHR report.

The U.S. State Department’s annual report on global human trafficking, released in June, placed Cambodia in Tier 3, meaning the government has made insufficient efforts to address human trafficking and does not meet the minimum standards.

During her two-day visit to Cambodia that began November 15, Dyer met with officials from the ministries of justice, labor and social affairs, as well as representatives of the National Police and the National Committee for Counter Trafficking (NCCT) within the Ministry of Interior, according to an email from the U.S. Embassy in Phnom Penh. Dyer also held discussions with civil society groups working on combating human trafficking.

The discussions focused “on Cambodia’s efforts to protect trafficking victims, including providing protection assistance services for victims of trafficking and vulnerable migrants, capacity building for service providers and government officials to improve victim identification and referral, and addressing emerging trends in forced criminality,” the State Department release said.

More training urged

Am Sam Ath, operations director at the Cambodian rights group Licadho, told VOA Khmer that Dyer’s visit highlighted the need for Cambodia to tackle human trafficking and online scams.

“We see that the United States … ranks Cambodia third in the blacklist of human trafficking. It also has a lot of impact on our country, and if Cambodia does not make an effort further in the prevention of human trafficking or online scams, the ranking cannot be improved,” he said by telephone from the group’s Phnom Penh office.

He called on the Cambodian government to strengthen the capacity of officials and authorities to crack down on online crime.

“This crime problem is technologically modern, so the authorities involved in it have to get more training to keep up with the situation, as well as the timing of the crime,” Am Sam Ath added.

National Police spokesperson Chhay Kim Khoeun and Justice Ministry spokesperson Chin Malin declined to comment on Dyer’s visit, referring questions to Chou Bun Eng, permanent deputy chairman of the National Committee for Counter Trafficking. VOA Khmer called Chou Bun Eng, but she did not respond to a request for comment.

U.S. Embassy spokesperson Katherine Diop told VOA Khmer that Dyer’s visit to Cambodia was part of a U.S. effort across the world to encourage governments to take responsibility for preventing human trafficking and protecting victims.

“The United States stands with the Cambodian people to identify, support and seek justice for human trafficking victims,” she wrote in an email.

The UNHCHR report released in late August said the online scams were occurring in five countries in Southeast Asia: Cambodia, Thailand, Laos, Myanmar and the Philippines.

“People who have been trafficked into online forced criminality face threats to their right to life, liberty and security of the person,” said the U.N. report. “They are subject to torture and cruel, inhuman and degrading treatment or punishment, arbitrary detention, sexual violence, forced labor and other forms of labor exploitation as well as a range of other human rights violations and abuses.”

Cambodia first acknowledged the issue last year when Interior Minister Sar Kheng said in August that officials were being deployed across the country to check hotels, casinos and other establishments for potential trafficking victims.

The government has since announced sporadic operations to free victims and arrest traffickers. However, experts recently told VOA Khmer that these efforts have not noticeably curbed the illegal operations or caught ringleaders of the trafficking networks.
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