Day: October 20, 2024

Geneva — The WHO chief on Sunday urged Rwanda to keep up its fightback against Marburg, as the country battles an outbreak of one of the world’s deadliest viruses.  

There have been 62 confirmed cases and 15 deaths in the outbreak, which was first announced in late September.  

No new cases have been detected in the last six days and 44 people have recovered from infection.  

Tedros Adhanom Ghebreyesus, the head of the World Health Organization, visited Rwanda to see the outbreak response for himself and hailed the country’s handling of the situation.  

“We’re pleased to see that there have been no new cases in the past six days, and we hope that remains the case,” he told a press conference in the capital Kigali.  

“But we are dealing with one of the world’s most dangerous viruses, and continued vigilance is essential.  

“Enhanced surveillance, contact tracing and infection prevention and control measures must continue at scale until the outbreak is declared over.”  

Such a declaration can only be made after 42 days — two consecutive incubation periods — without a new confirmed case.  

Marburg is transmitted to humans from fruit bats, and is part of the filovirus family that includes Ebola.  

With a fatality rate of up to 88 percent, Marburg’s highly infectious hemorrhagic fever is often accompanied by bleeding and organ failure.   

However, the case fatality rate in this outbreak has been held down at 24 percent.   

On Saturday, Tedros visited the treatment center where the remaining patients are being looked after.  

“Two of the patients we met had experienced all of the symptoms of Marburg, including multiple organ failure, but they were put on life support, they were successfully intubated and extubated, and are now recovering,” he said.  

“We believe this is the first time patients with Marburg virus have been extubated in Africa. These patients would have died in previous outbreaks.”  

There are currently no officially approved vaccines nor approved antiviral treatments, but potential treatments, including blood products, immune and drug therapies are being evaluated.  

A vaccination program using a trial vaccine was launched in Rwanda earlier this month. 
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The artificial intelligence boom has benefited chatbot makers, computer scientists and Nvidia investors. It’s also providing an unusual windfall for Anguilla, a tiny island in the Caribbean.

ChatGPT’s debut nearly two years ago heralded the dawn of the AI age and kicked off a digital gold rush as companies scrambled to stake their own claims by acquiring websites that end in .ai.

That’s where Anguilla comes in. The British territory was allotted control of the .ai internet address in the 1990s. It was one of hundreds of obscure top-level domains assigned to individual countries and territories based on their names. While the domains are supposed to indicate a website has a link to a particular region or language, it’s not always a requirement.

Google uses google.ai to showcase its artificial intelligence services while Elon Musk uses x.ai as the homepage for his Grok AI chatbot. Startups like AI search engine Perplexity have also snapped up .ai web addresses, redirecting users from the .com version.

Anguilla’s earnings from web domain registration fees quadrupled last year to $32 million, fueled by the surging interest in AI. The income now accounts for about 20% of Anguilla’s total government revenue. Before the AI boom, it hovered at around 5%.

Anguilla’s government, which uses the gov.ai home page, collects a fee every time an .ai web address is renewed. The territory signed a deal Tuesday with a U.S. company to manage the domains amid explosive demand but the fees aren’t expected to change. It also gets paid when new addresses are registered and expired ones are sold off. Some sites have fetched tens of thousands of dollars.

The money directly boosts the economy of Anguilla, which is just 91 square kilometers and has a population of about 16,000. Blessed with coral reefs, clear waters and palm-fringed white sand beaches, the island is a haven for uber-wealthy tourists. Still, many residents are underprivileged, and tourism has been battered by the pandemic and, before that, a powerful hurricane.

Anguilla doesn’t have its own AI industry though Premier Ellis Webster hopes that one day it will become a hub for the technology. He said it was just luck that it was Anguilla, and not nearby Antigua, that was assigned the .ai domain in 1995 because both places had those letters in their names.

Webster said the money takes the pressure off government finances and helps fund key projects but cautioned that “we can’t rely on it solely.”

“You can’t predict how long this is going to last,” Webster said in an interview with the AP. “And so I don’t want to have our economy and our country and all our programs just based on this. And then all of a sudden there’s a new fad comes up in the next year or two, and then we are left now having to make significant expenditure cuts, removing programs.”

To help keep up with the explosive growth in domain registrations, Anguilla said Tuesday it’s signing a deal with a U.S.-based domain management company, Identity Digital, to help manage the effort. They said the agreement will mean more revenue for the government while improving the resilience and security of the web addresses.

Identity Digital, which also manages Australia’s .au domain, expects to migrate all .ai domain services to its systems by the start of next year, Identity Digital Chief Strategy Officer Ram Mohan said in an interview.

A local software entrepreneur had previously helped Anguilla set up its registry system decades earlier.

There are now more than 533,000 .ai web domains, an increase of more than 10-fold since 2018. The International Monetary Fund said in a May report that the earnings will help diversify the economy, “thus making it more resilient to external shocks.

Webster expects domain-related revenues to rise further and could even double this year from last year’s $32 million.

He said the money will finance the airport’s expansion, free medical care for senior citizens and completion of a vocational technology training center at Anguilla’s high school.

The income also provides “budget support” for other projects the government is eyeing, such as a national development fund it could quickly tap for hurricane recovery efforts. The island normally relies on assistance from its administrative power, Britain, which comes with conditions, Webster said.

Mohan said working with Identity Digital will also defend against cyber crooks trying to take advantage of the hype around artificial intelligence.

He cited the example of Tokelau, an island in the Pacific Ocean, whose .tk addresses became notoriously associated with spam and phishing after outsourcing its registry services.

“We worry about bad actors taking something, sticking a .ai to it, and then making it sound like they are much bigger or much better than what they really are,” Mohan said, adding that the company’s technology will quickly take down shady sites.

Another benefit is .AI websites will no longer need to connect to the government’s digital infrastructure through a single internet cable to the island, which leaves them vulnerable to digital bottlenecks or physical disruptions.

Now they’ll use the company’s servers distributed globally, which means it will be faster to access them because they’ll be closer to users.

“It goes from milliseconds to microseconds,” Mohan said.
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MILWAUKEE — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”
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People with HIV can safely receive donated kidneys from deceased donors with the virus, according to a large study that comes as the U.S. government moves to expand the practice. That could shorten the wait for organs for all, regardless of HIV status.

The new study, published Wednesday in the New England Journal of Medicine, looked at 198 kidney transplants performed across the U.S. Researchers found similar results whether the donated organ came from a person with or without the AIDS virus.

Last month, the Department of Health and Human Services proposed a rule change that would allow these types of kidney and liver transplants outside research studies. A final rule would apply to both living and deceased donors. If approved, it could take effect in the coming year.

Participants in the study were HIV positive, had kidney failure and agreed to receive an organ from either an HIV-positive deceased donor or an HIV-negative deceased donor, whichever kidney became available first.

Similar survival rates

Researchers followed the organ recipients for up to four years. They compared the half who received kidneys from HIV-positive donors to those whose kidneys came from donors without HIV.

Both groups had similarly high rates of overall survival and low rates of organ rejection. Virus levels rose for 13 patients in the HIV donor group and for four in the other group, mostly tied to patients failing to take HIV medications consistently, and in all cases returned to very low or undetectable levels.

“This demonstrates the safety and the fantastic outcomes that we’re seeing from these transplants,” said study co-author Dr. Dorry Segev of NYU Langone Health.

In 2010, surgeons in South Africa provided the first evidence that using HIV-positive donor organs was safe in people with HIV. But the practice wasn’t allowed in the United States until 2013 when the government lifted a ban and allowed research studies, at the urging of Segev. At first, the studies were with deceased donors. Then in 2019, Segev and others at Johns Hopkins University in Baltimore performed the world’s first kidney transplant from a living donor with HIV to an HIV-positive recipient.

All told, 500 transplants of kidneys and livers from HIV-positive donors have been done in the U.S.

‘A win-win’

People with HIV have been actively discouraged from signing up to be organ donors by stigma and outdated state laws and policies criminalizing organ donation for people with HIV, said Carrie Foote, a sociology professor at Indiana University in Indianapolis.

“Not only can we help those of us living with this disease, but we free up more organs in the entire organ pool so that those who don’t have HIV can get an organ faster,” said Foote, who is HIV positive and a registered organ donor. “It’s a win-win for everyone.”

More than 90,000 people are on the waiting list for kidney transplants, according to the U.S. Organ Procurement and Transplantation Network. In 2022, more than 4,000 people died waiting for kidneys.

In an editorial in the journal, Dr. Elmi Muller of Stellenbosch University in South Africa predicted the new study will have “far-reaching effects in many countries that do not perform transplantations with these organs.”

“Above all, we have taken yet another step toward fairness and equality for persons living with HIV,” wrote Muller, who pioneered the practice.
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ISLAMABAD — Pakistan said Saturday that two children in its southern Sindh province had been paralyzed by poliovirus, bringing the total number of cases nationwide to 39 for the year since March, when officials confirmed the first case.

The South Asian nation of around 240 million people reported six cases of paralytic poliovirus infections in 2023, following a period of more than a year without any documented cases, only to see the numbers rise again.

“Genetic sequencing of the cases is under way,” said a Pakistan polio eradication program statement Saturday while reporting the two new infections in Sindh. “The intense virus transmission and increase in polio cases are indicative of the harm that children suffer when they miss opportunities for vaccination.”

Pakistan and neighboring Afghanistan, with at least 20 cases this year, are the only two countries where the crippling disease is still endemic.

Pakistani officials are preparing to launch a nationwide vaccination campaign on October 28 to immunize more than 45 million children under 5 against the paralytic disease.

“It is critical for parents to open their doors to vaccinators during this drive and ensure that all children in their care receive two drops of the crucial oral polio vaccine to keep them protected from the devastating effects of polio,” the program emphasized in its Saturday statement.

Pakistan’s southwestern Balochistan province, which sits on the Afghan border, has reported 20 polio cases in 2024, while Sindh has detected 12 cases.

The Khyber Pakhtunkhwa province bordering Afghanistan has documented five paralytic poliovirus cases. Pakistan’s most populous Punjab province and the national capital, Islamabad, reported one case each.

The resurgence of poliovirus in Pakistan is blamed on boycotts of vaccination drives by parents in rural areas who allege the initiatives are a Western plot to sterilize Muslim children.

Anti-state militants in violence-hit districts bordering Afghanistan occasionally attack vaccinators and their police escorts, suspecting them of spying for the government. The violence has claimed the lives of dozens of security forces and vaccinators.

An independent monitoring board of the Global Polio Eradication Initiative noted in a report last month that more than 420,000 Pakistani children could not be inoculated in anti-polio campaigns in 2024.

The board reported more than 200 boycotts of the polio vaccination campaign in Khyber Pakhtunkhwa last year. “It is disturbing to realize that violence, insecurity, and boycotts are still as prevalent in Khyber Pakhtunkhwa as they were in 2023,” the report said.

It highlighted that residents in several impoverished districts of Pakistan also demanded electricity, gas supply, and road construction in return for getting their children vaccinated.

A representative for Pakistan’s Ministry of Health told a World Health Organization meeting in Doha, Qatar, earlier this week that polio eradication is the country’s “top priority,” and efforts have been intensified to halt virus transmission.

“Despite recent resurgence, a unified plan with provinces aims to stop polio transmission by 2025,” Safi Malik stated. “We’re focusing on quality campaigns, digital tracking of missed areas, and a strong Pakistan-Afghanistan collaboration for cross-border vaccinations,” he said. 
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