u/Anti-Owl

A Detroit-bound flight from Paris was diverted to Canada on Wednesday night after U.S. Customs discovered a passenger from a country currently affected by the outbreak was allowed on the plane.

There have been 131 deaths associated with the outbreak and 543 suspected cases, with 33 confirmed cases in the Democratic Republic of Congo, as well as two confirmed cases in Uganda.

The U.S. has issued travel restrictions for Congo, Uganda and South Sudan.

Air France said the passenger was taken off the flight in Montreal, and then the rest of the passengers returned to Detroit Metro Airport on Thursday night.

There was no medical emergency on board and it's not believed the passenger was showing active symptoms.

One woman on board said about halfway through the flight, the captain told them they were being diverted and then flight attendants started putting on (sic) mass.

They didn't really tell us why," Deborah Mistor said. "The captain said that it was the U.S. government not allowing us to land in Detroit."

Mistor was on Air France flight 375 when it was diverted to Montreal with no explanation.

"By that point, the flight attendants all had masks on, which no one had prior to the announcement. So it was really concerning, like, what is going on here? Why are we not being allowed to land?" she said.

Mistor said the only information given came from a flight attendant, saying that a passenger from the Democratic Republic of Congo was on board, an area hit by the Ebola outbreak. U.S. CBS confirmed in a statement that the passenger shouldn't have been on the flight.

"This particular passenger did not have any active symptoms or showing any signs of any Ebola activity," Mistor said.

Dr. Matthew Sims, the medical director of infectious disease research for Corewell Health East, said people shouldn't panic.

"It doesn’t spread super easily. It tends to spread more in areas of the world where you just don't have that tracking in place," he said.

On Sunday, the World Health Organization declared the oubreak in Africa a public health emergency of international concern. Then Monday, the CDC ordrered a 30-day entry restirction on non-US Passport holders who've been in the DRC, Uganda or South Sudan in the past 21 days.

Neither airline has offered us any information whatsoever. No health officials offered us any info," Mistor said. "Should we be concerned? Was that person exposed? Was this just an overabundance of caution? What steps should we be taking to protect ourselves or anyone around us

Officials are looking into how the passenger was allowed to board the flight.

One person who recently returned to Ontario from East Africa is being tested for the Ebola virus, the province says.

In a statement to CTV News, a spokesperson for the Ontario Ministry of Health said the person is currently in the hospital.

“Out of an abundance of caution, clinicians are testing the patient for a range of possible infectious diseases, including Ebola virus, given their recent travel history, in accordance with established clinical protocols. All appropriate infection prevention and control measures are in place,” the statement notes.

The spokesperson added that there are no current confirmed cases of Ebola in the province.

It is unclear when the person came back to Canada and what symptoms they are experiencing.

The latest Ebola outbreak in the Democratic Republic of Congo and Uganda has resulted in at least 134 deaths and more than 500 suspected cases.

The outbreak is caused by the Bundibugyo virus, an Ebola strain that has no approved vaccine.

The World Health Organization declared the outbreak a public health emergency of international concern over the weekend. Officials are worried about the scale and speed of the outbreak.

The disease is spread through direct contact with bodily fluids or tissues of an infected person or animal experiencing symptoms. Officials noted that it is not spread through air or casual contact.

Global Affairs Canada said it was not aware of any Canadians in Congo and Uganda who are affected by the Ebola outbreak. About 3,600 Canadians are registered as being in the two African countries.

The federal government has advised Canadians not to travel to the eastern Ituri and North Kivu provinces of Congo.

There are now 600 suspected Ebola cases after the outbreak in Congo and Uganda, the World Health Organisation has said.

WHO Director-General Tedros Adhanom Ghebreyesus said the risk of the disease spreading nationally and regionally was now high - but low at a global level.

He said 51 cases had so far been confirmed in the northern provinces of Ituri and North Kivu in Congo, "although we know the scale of the epidemic is much larger".

Uganda had also told the UN health agency of two confirmed cases in Uganda's capital, Kampala, he added.

"There are several factors that warrant serious concern about the potential for further spread and further deaths," he said.

"First, beyond the confirmed Ebola cases, there are almost 600 suspected cases and 139 suspected deaths. We expect those numbers to keep increasing, given the amount of time the virus was circulating before the outbreak was detected.

"Second, the epidemic has expanded, with cases reported in several urban areas. Third, deaths have been reported among health workers, indicating healthcare-associated transmission. Fourth, there is significant population movement in the area."

Dr Tedros said the outbreak of the rare Ebola strain, known as Bundibugyo, is likely to have started a couple of months ago.

He said there was a suspected death on 20 April but that investigations were continuing.

"WHO has a team on the ground supporting national authorities to respond. We have deployed people, supplies, equipment and funds," he said, adding that $3.9m in emergency funding from the agency had now been approved to support the response.

Congo was expecting shipments from the US and UK of an experimental vaccine for different types of Ebola, developed by researchers at Oxford, Jean-Jacques Muyembe, a virus expert at the National Institute of Biomedical Research, said on Tuesday.

"We will administer the vaccine and see who develops the disease," he said.

Health experts said the delayed detection of the virus, large movements of population in the affected areas, along with the preexisting humanitarian crisis, complicated the response. Parts of eastern Congo are in the hands of armed rebels, hampering the delivery of aid.

Congo had said the first person died from the virus on 24 April in Bunia, but the confirmation did not come for weeks. The body was repatriated to the Mongbwalu health zone, a mining area with a large population.

"That caused the Ebola outbreak to escalate," said Congo's health minister Samuel Roger Kamba.

Dr Anne Ancia, the head of the WHO team in Congo, said authorities still had not identified "patient zero".

There was a long road ahead, she said, adding that cuts in funding had "a marked detrimental effect on humanitarian actors".

Bird flu has been detected in a dead polar bear in the Arctic Svalbard archipelago, marking the first time that the virus has been found in the species in Europe.

The Norwegian Veterinary Institute confirmed the finding on Tuesday, alongside avian influenza in a deceased walrus from the same region, which is roughly halfway between the North Pole and mainland Europe.

The findings are part of a trend where highly pathogenic avian influenza virus is increasingly being detected in mammals in Europe,” the institute said in a statement.

“At the same time, the virus has spread to new areas in recent years, including the Arctic, where it may have consequences for vulnerable populations and ecosystems."

[...]

The Norwegian institute said mammals can be infected with avian influenza through direct contact with birds or other mammals, and that it is investigating whether the virus detected in the polar bear and walrus was specifically adapted to mammals.

The detected virus is of the subtype H5N5 which has in recent years been found in Svalbard in birds, Arctic foxes and a walrus.

The first case of a polar bear being infected with bird flu was confirmed in December 2023.

The bear, which was infected with the H5N1 subtype, was found dead near Utqiagvik, one of the northernmost communities in Alaska.

At the time, the Alaska Department of Environmental Conservation told local media that it was likely the bear had been scavenging on the carcasses of infected birds.

[...]

An American exposed to the deadly hantavirus while on a cruise from Argentina said on Monday that she is not being allowed to leave a federal quarantine unit in Nebraska.

Angela Perryman, 47, received a federal quarantine order, a copy of which she provided to The New York Times, on Monday, after making plans to self-isolate in Florida. It requires her to stay at the National Quarantine Unit in Omaha until the end of May.

Ms. Perryman said she has been tested once for the hantavirus, and the results were negative. She is not experiencing symptoms, she said, although she did have brief conversations on the ship with a passenger who later died from the illness.

It was not immediately clear why Ms. Perryman was being required to stay, though federal law authorizes health officials to impose quarantines to prevent the spread of disease. Representatives from the Department of Health and Human Services and the Nebraska Quarantine Unit did not immediately respond to requests for comment.

Federal health officials have previously said that the 18 American passengers from the cruise ship would need to be screened and monitored at the quarantine unit for several days. Officials had suggested that passengers might not be required to stay for the virus’s full 42-day incubation period.

“At some point, they may be able leave their medical centers to continue quarantines at home, depending on how they are doing,” Captain Brendan Jackson, a U.S. Centers for Disease Control and Prevention official, said in a news conference last week after the passengers arrived in Omaha and Atlanta.

He said that each would have an “individualized decision plan.”

Ms. Perryman said she and the 17 other passengers were told during a video conference call with federal officials on Sunday that if they did not remain at the unit voluntarily, they would receive a mandatory quarantine order keeping them there.

Her order came on Monday, authorized by Jay Bhattacharya, acting director of the Centers for Disease Control and Prevention. Citing federal public health law, it requires her to remain in the Nebraska facility for 21 days after her arrival, a period that expires on May 31.

That three-week period is when the risk of becoming symptomatic from the hantavirus is the highest.

The National Quarantine Unit at the University of Nebraska Medical Center in Omaha is the only federally funded facility of its kind. Two passengers from the ship were originally sent to a facility in Atlanta, but have since been moved to Omaha.

Asymptomatic mpox infections among men who have sex with men (MSM) may be far more common than previously recognized and could be playing a role in ongoing transmission, according to a study published last week in Nature Communications. Researchers estimate that actual infections may outnumber diagnosed cases by 33 to one.

The findings challenge the assumption that most mpox cases are spread by people with symptoms.

1% had asymptomatic mpox

For the study, researchers led by teams at the University of California (UC) at Berkeley and Kaiser Permanente Southern California tested for mpox in MSM in Los Angeles during routine sexually transmitted infection (STI) screening from May to November 2024. Then they monitored the same group of MSM for clinically diagnosed mpox.

Among nearly 8,000 eligible participants, only 15 laboratory-confirmed mpox cases were identified through standard clinical testing. But when the team tested for mpox DNA in 1,190 specimens collected from the routine STI tests, they found infections in six men who never presented with mpox symptoms or received an mpox diagnosis.

“We used the specimens from routine testing for other sexually transmitted diseases to test for mpox and found roughly 1% of men had asymptomatic infections without knowing it,” lead study author Joseph A. Lewnard, PhD, associate professor of epidemiology at the UC Berkeley School of Public Health, said in a news release. “From the testing, we estimated that only about one in every 33 infections gets diagnosed,” meaning infections exceeded reported cases by a 33-fold margin.

Undiagnosed cases may drive 31% to 44% of spread

These cryptic infections likely contribute to under-the-radar mpox spread. The authors estimate that undiagnosed infections may account for at least 31% to 44% of all transmission events and, under “realistic modelling assumptions,” potentially much more.

The findings run counter to current guidance from the Centers for Disease Control and Prevention, which has advised that people with symptoms primarily drive mpox spread, despite a lack of connection to a symptomatic partner.

“We have not known how mpox is transmitted, and why the cases seem to have very few connections to other cases,” senior study author and Kaiser Permanente scientist Sara Y. Tartof, PhD, MPH, said in the news release. “These findings help resolve a fundamental question in the epidemiology of mpox by suggesting that infected people pose a risk of transmitting the disease to others even in the absence of clinical symptoms."

Vaccination may reduce disease severity

The researchers also found that pre-exposure immunization with the Jynneos vaccine was associated with 72% effectiveness against diagnosed mpox. The finding that previously vaccinated men accounted for five of the six subclinical infections identified through routine STI testing suggests that vaccination may help protect against mpox by reducing disease severity, which aligns with previous research.

“Unvaccinated people face risk of severe disease if they are exposed to mpox,” Lewnard said. “And our findings suggest this risk is greater than we previously understood.”

WASHINGTON, May 18 (Reuters) - The U.S. Centers for Disease Control and Prevention said on Monday ‌that one American tested positive for Ebola as part of its work in the Democratic Republic of Congo, where there is an outbreak of a rare strain of the virus, but advised that the immediate risk in the U.S. was low.

The CDC did not name the individual, but the Serge Christian mission organization said one of its medical missionaries, Dr. Peter Stafford, was exposed while treating ​patients at Nyankunde Hospital in the DRC.

A number of Americans who are in the Democratic Republic of the Congo are believed to have had exposure to suspected cases in the country's latest Ebola outbreak, with several deemed to have had high-risk exposures, sources have told STAT. At least one of these individuals may have developed symptoms.

One source said that there are not yet test results for any of the individuals, but the U.S. government is reportedly trying to arrange to transport them out of the DRC to somewhere they can be safely quarantined, and cared for, if they prove to have been infected. It’s not clear if that would be in the United States; there is some discussion of perhaps taking the individuals to an American military base in Germany, a source said.

The sources spoke on condition of anonymity, because they had not been authorized to discuss the situation publicly.

Already, the outbreak’s suspected case count is at least 246 cases, with 80 deaths, including at least four health workers.

The Centers for Disease Control and Prevention held a hastily called news conference on Sunday to discuss the outbreak, which the World Health Organization has declared a public health emergency of international concern (PHEIC). But when specifically asked whether any Americans have been exposed to Ebola, and whether the government is planning on extricating them from the DRC, the CDC’s incident manager, Satish Pillai, did not answer the questions.

Neither the State Department nor the Department of Health and Human Services have responded to repeated requests from STAT for information about the situation.

“We don’t discuss or comment on individual dispositions,” Pillai said. “It is a highly dynamic situation, and at this point, what I would say is, we continue to assess [and] we will continue to keep you posted as we learn more.”

Pillai said the CDC is assessing the needs on the ground and is working to deploy experts to help with the response.

Despite the lack of official answers, STAT has been told that the U.S. government has been reaching out to the health care institutions that have high-containment treatment facilities able to quarantine people who have had high-risk exposures to Ebola, and isolation beds where they can be cared for, if they become ill.

One of the sources who spoke to STAT said the situation is fluid, with numbers changing daily. But what is clear, the individual said, is that there is an effort afoot to get some Americans out of the DRC quickly.

These efforts are likely made more difficult by the fact that one of the facilities that can quarantine people suspected of being infected with a high-consequence pathogen like Ebola and care for them if they are infected is currently housing Americans who were passengers on the MV Hondius, the cruise ship on which there was a recent hantavirus outbreak.

The Ebola outbreak was declared a PHEIC overnight Sunday Geneva time, by WHO Director-General Tedros Adhanom Ghebreyesus. Tedros declared the PHEIC without yet having convened an expert panel to advise him on the situation — an unprecedented move that speaks to the gravity of the unfolding situation.

Confirmation that an Ebola outbreak is underway in northeastern DRC only came Friday from DRC’s National Public Health Institute.

Daniel Jernigan, who led the CDC’s National Center for Emerging and Zoonotic Infectious Diseases until he quit last summer in protest over the firing of former CDC Director Susan Monarez, said the current signs point to an outbreak that may take quite some time to bring under control. It is unusual for Ebola outbreaks to be this large when they are first declared, a fact that suggests tracing all the chains of transmission will be a daunting task.

“There is a lot that we don’t know here, and it has happened very quickly, and the numbers suggest that it’s not going away anytime soon,” Jernigan said.

The WHO said Sunday that the first known suspected case, a health worker, developed symptoms on April 24. A health care worker is unlikely to be the first case in an outbreak; the more probable scenario is that someone infected — either by a bat or by another infected person — brought the virus into a health care setting while seeking care. Either way, the outbreak had been smoldering for some time before the cause of the rising tide of illness was deemed to be caused by Ebola.

Two infected people from DRC traveled — independently of one another — to Kampala, the capital of neighboring Uganda, where one died. At present, there is no indication of ongoing transmission in Uganda, the WHO said.

An Ebola species called Bundibugyo is responsible for the outbreak. This marks only the third detected Bundibugyo outbreak on record; the previous two were in 2007 and 2012.

[...]

https://archive.is/JqHUd

The grim-faced captain had bad news for the people gathered in the lounge of the MV Hondius. One of their fellow passengers had died.

“Tragic as it is, it was due to natural causes, we believe,” the captain, Jan Dobrogowski, told them on April 12. He added that the ship’s doctor had said the man was “not infectious, so the ship is safe.”

Less than two weeks earlier, the captain had convened the same group for a celebratory toast, as the Hondius left Argentina to sail the south Atlantic for bird watching and wildlife spotting on some of the world’s most remote islands.

Now, passengers consoled the dead man’s widow, Mirjam Schilperoord‑Huisman, 69, of the Netherlands. She and her husband, Leo Schilperoord, also 69, had crossed South America in pursuit of rare birds. Some asked if she would prefer that the trip be cut short.

“Everyone is here for a purpose,” she responded, according to ​​Ruhi Cenet, a Turkish documentary filmmaker who was on the ship. She urged her fellow bird watchers to push on because her husband “would have wanted me to do the same.”

Within weeks, two more passengers, including Ms. Schilperoord‑Huisman, would be dead. The cause, health officials say, was almost certainly the Andes species of the hantavirus, a family of viruses carried by rodents that can spread between humans.

Over the following weeks, a world still traumatized by the coronavirus pandemic watched anxiously as the passengers and crew of the Hondius, hailing from at least 23 countries, lived the nautical nightmare of a potential outbreak in close quarters, far out at sea. [...]

It was a trip, priced roughly between $8,000 and $27,000, that began with the promise of seeing life in the wild and ended in protective gear and quarantine. [...]

77 Species in 13 Hours

The Hondius, sailing under a Dutch flag and named after a Flemish cartographer, was built to navigate icy waters and go to some of the world’s most far-flung places. It attracted wildlife lovers eager to glimpse hourglass dolphins, fur seals, assorted whales and penguins and rare migratory birds. Lecturers and guides also joined.

The ship began the journey on April 1, in Ushuaia, Argentina, with passengers disembarking at various islands. Some joined the trip for just parts of the route.

Passengers included a Turkish bird watcher who posted under the name “bird detective”; an American travel influencer; and the ill-fated couple from the Netherlands.

Back home in their Dutch village, Haulerwijk, the couple’s backyard bordered the woods. They walked the quiet, orderly streets on the lookout for birds, binoculars usually hanging from Mr. Schilperoord’s neck, said Jan van Schepen, a neighbor. “They traveled a lot,” he said.

In the months before the couple joined the cruise, they had traipsed around South America in a camper seeking glimpses of wild birds. On Feb. 6, in Algarrobo del Águila, Argentina, they spotted 36 species, including the spectacled tyrant and the Chaco earthcreeper.

They went to Finca Cielo Verde in the northwest Salta Province, where Argentine epidemiologists say there is a history of hantavirus infections. There, they spotted a glittering-bellied emerald and a white-throated cacholote.

In March, they moved to the northeast. On a single day, in the province of Corrientes, they spotted 77 species in 13 hours.

Mr. Schilperoord logged it all on a site for bird watchers, eBird.

Before the ship’s departure, some people, several of whom would join the cruise, went to a bird-watching spot in Ushuaia near a landfill known for attracting birds.

Later, there would be speculation — echoed in internet memes and on late night talk shows — that the landfill was the source of the outbreak. The government of Argentina at first said Mr. Schilperoord had visited the site, but declined to say how it knew that. Several guides who brought different groups there said the Dutch couple were not among them.

A spokesman for the local health ministry in Ushuaia dismissed the landfill theory as a disinformation campaign, meant to damage the area’s reputation as a tourist destination. What is clear is that Mr. Schilperoord, who fastidiously logged so many of his bird-watching visits, did not record one at the landfill site.

On March 30, he logged the buff-winged cinclodes and the dark-faced ground tyrant at a glacier outside Ushuaia. Then he and his wife joined the ship, along with passengers on a trip organized by Oceanwide Expeditions, for the final journey of the season before winter came to the Southern Hemisphere.

At that point, the ship carried 175 people, according to Oceanwide and the W.H.O.

Keep reading: https://archive.is/nMIzv (No-Paywall)

A Canadian isolating in B.C. has presumptively tested positive for hantavirus after leaving the cruise ship affected by an outbreak of the Andes strain in recent weeks, B.C.'s top doctor said Saturday.

Dr. Bonnie Henry, provincial health officer, said Saturday the patient started to develop mild symptoms, including fever and headache, two days ago. The individual was taken to hospital in Victoria, and assessed and tested there.

The BC Centre for Disease Control confirmed a presumptive positive test result on Friday. It will need to be confirmed by a microbiology lab in Winnipeg. The person is still in hospital in isolation and considered stable. [...]

KAMPALA, May 15 (Reuters) - Uganda on ​Friday confirmed an ‌outbreak of the highly ​infectious Ebola ​virus disease, the ⁠health ministry ​said, adding ​that the outbreak involves the Bundibugyo ​strain.

The ministry ​said the case ‌was ⁠an imported infection from the Democratic Republic of ​Congo. ​The ⁠patient died in ​intensive care ​on ⁠May 14 after ⁠developing ​hemorrhagic symptoms.

A COVID-19 outbreak in a residential building in Spain during the early months of the pandemic likely spread through shared bathroom ventilation ducts, according to a study published this week in PLOS One.

The outbreak occurred in June 2020 in a seven-story apartment building in the city of Santander in northern Spain, during a period when transmission in the city (population 172,000) had dropped to zero. Fifteen COVID cases were identified in four vertically stacked apartments connected by the same bathroom ventilation shaft. No cases were detected in surrounding apartments or elsewhere in the building.

Bathroom vents the likely culprit

A team led by researchers at the University of Colorado Boulder sequenced virus samples from infected residents to confirm that the cases were connected, then measured air flow and air pressure in the building. They also tested carbon dioxide (CO2) levels in a vacant apartment. Because CO2 is released into the air when people exhale, high levels of it wouldn’t be expected in a vacant apartment. But the empty apartment was full of it.

“It was like there was a ghost in the room,” David Higuera, an engineer who lived in the building and who first suspected the bathroom ventilation system as the culprit, said in a news release.

The building was constructed in the late 1960s, before new building code standards were introduced in 1970. Units had shared bathroom ducts that used natural convection to vent air out through the roof, a phenomenon known as the chimney or stack effect. That process is driven by temperature-induced differences in air density.

But factors like operating a kitchen fan, opening windows, or pressure changes in the building can reverse the flow of air in the ducts, causing it to go back into the apartments rather than out through the roof. The researchers concluded that infectious aerosols likely traveled through the building’s shared vertical bathroom duct system, allowing virus-laden air from one apartment to enter bathrooms in units above and below.

“The most plausible transmission route was the bathroom vertical ventilation duct system, which facilitated movement of infectious aerosol between vertically connected homes,” write the authors. Residents in units who had modified or blocked their bathroom ventilation systems before the outbreak did not experience infections.

This style of ventilation system is uncommon in the United States, but the outbreak shines a light on a broader concern. “Even if you are far from the source, if your air is connected, you can still get sick,” senior author Shelly Miller, PhD, professor emerita in the Department of Mechanical Engineering at the University of Colorado Boulder, said in the release. “This can happen in a multifamily apartment building through the ducts, in a hotel between the hallway and rooms off the hallway, in office buildings between offices or on a cruise ship.”

Similar outbreak in multi-unit building in 2003

The findings mirror reports from a 2003 severe acute respiratory syndrome (SARS) outbreak at Hong Kong’s Amoy Gardens housing complex, in which virus-laden aerosols traveled through bathroom floor drains, infecting more than 300 people and killing more than 40. In 2022, a study in Hong Kong found that nearly 9% of those who lived in high-rise buildings contracted the Omicron COVID variant because of vertical building transmission.

The researchers say the findings highlight the importance of taking proactive measures to limit the transmission of virus-laden aerosols in multi-unit residential buildings. “By recognizing the role of shared infrastructure in disease propagation, authorities and building managers can implement timely measures to protect occupant health and prevent the spread of airborne pathogens,” they write.

​

It all started with rumors. On May 5, 2026, messages circulated on social media from Mongbwalu, a mining town 90 kilometers from Bunia, in Ituri province. They spoke of unusual deaths, many deaths. More than fifty, it was said.

That's not wrong. Medical teams scrutinizing the records of the General Referral Hospital confirm it: between April 1st and May 13th, 2026, 55 patients died at this facility. What's striking is the acceleration. In April, the case fatality rate in the internal medicine department was 9%. In May, it jumped to 31%.

Four healthcare professionals are among the dead. Four caregivers, in four days.

One family, fifteen dead

The community already has its own explanation. They speak of a pastor who allegedly burned fetishes, called “Tumu,” and who died shortly afterward, along with his wife. Since then, fear has taken hold. A “widespread psychosis,” the authors of the official report published on May 13th soberly note.

But behind the rumors, the figures are real. Field teams, after meetings with five health facilities in the area, have recorded 45 additional deaths occurring in the community, outside of hospitals. Twenty-six in the CECA 20 zone, nineteen in Mongbwalu.

The most disturbing case involves a single family in the Mongbwalu health zone: fifteen deaths. Five of them died in Bunia, after gathering as a family. All presented with the same symptoms: headaches, fever, and vomiting. The period lasted two weeks.

Patient profile

What doctors are observing in the wards looks like this: fever, headache, vomiting, intense fatigue. In some patients, other signs are added: difficulty breathing, nosebleeds, blackish vomit.

Three specific cases are documented in the May 13 report.

A 45-year-old nurse was hospitalized on May 6 at the Abelkozo health center with a persistent fever between 38 and 39 degrees Celsius, headaches, and fatigue. On the fourth day, she experienced nosebleeds and dizziness. She was transferred to the Mongbwalu General Referral Hospital on May 12. She died on May 13.

A 55-year-old man, admitted to several facilities since May 1st, presented with a fever of 39 degrees Celsius, nausea, diarrhea, muscle and joint pain, and red eyes. On the morning of May 13th, hemorrhagic symptoms appeared: nosebleeds and vomiting of blood. He died that evening.

A 17-year-old girl, six months pregnant. Symptoms began on May 10. She was hospitalized on the 13th for seizures, fever, agitation, and bleeding.

Ebola ruled out, then confirmed

The initial tests were reassuring, provisionally. Ebola Zaire, dengue, rotavirus, cholera, malaria, Yersinia pestis, moxibustion, Covid-19: all negative on the samples analyzed in Mongbwalu itself.

Two days later, on May 15, the results from the National Institute of Biomedical Research changed everything. Of the 20 samples tested, 13 were positive for the Ebola virus. Not the Zaire strain, the one known in the DRC and against which vaccines exist. The analyses suggested an Ebola virus of a different species. Sequencing is underway. The results are expected within 24 hours.

The situation has also changed: 246 suspected cases and 65 deaths have now been recorded, mainly in the Mongbwalu and Rwampara health zones. Four deaths have been confirmed by laboratory testing. Suspected cases have been reported as far away as Bunia.

Kinshasa, Kampala, Juba

Africa CDC, the African Union's public health agency, convened an emergency meeting on the afternoon of May 15. Around the table were health authorities from the DRC, Uganda, and South Sudan, the WHO, UNICEF, the WFP, as well as representatives from about ten pharmaceutical laboratories and manufacturers, including Gilead, Merck, Johnson & Johnson, Moderna, BioNTech, and Roche.

Africa CDC is less concerned about Mongbwalu itself than about the area surrounding it. The mining town attracts workers who are constantly on the move. Bunia is a city, with all the density and movement that implies. The Ugandan and South Sudanese borders are close. Population movements in this part of Ituri are intense and difficult to monitor. And the insecurity in the area complicates access for the teams.

“Given the significant population movements between the affected areas and neighbouring countries, rapid regional coordination is essential,” said Dr. Jean Kaseya, Executive Director of Africa CDC.

The shortcomings of the terrain

The field report of May 13th did not mask the difficulties. The Abelkozo health area scored 7% on infection prevention and control assessments. The Mongbwalu General Referral Hospital (HGR) scored 34%. There was no compliant isolation space, not enough testing kits, and no organized triage at the hospital. Staff had not been trained to manage diseases with epidemic potential.

By May 13, twelve contacts had been pre-listed. The list was not yet complete. It is these shortcomings, known from the beginning, that the epidemic is currently experiencing

Translation via [Flutrackers](https://flutrackers.com/forum/forum/africa/ebola-tracking-dem-republic-of-congo/1034822-africa-cdc-convenes-emergency-meeting-after-reports-of-a-large-outbreak-of-non-zaire-ebola-in-the-drc)

Africa's top public health agency said on Friday that there was a confirmed Ebola outbreak in ‌Democratic Republic of Congo's Ituri province, with 65 deaths out of 246 suspected cases so far.

The Africa Centres for Disease Control and Prevention said in a statement that it was convening an urgent meeting with Congo, Uganda, South Sudan and global partners to reinforce ​cross-border surveillance, preparedness and response efforts.

The agency said initial findings suggested the presence of ​a non-Zaire strain of the virus, with sequencing ongoing to further characterise it. Reuters

Analysis below by Michael Coston, Avian Flu Diary:

The preliminary finding of a `non-Zaire' Ebola strain is noteworthy. While a more complete genomic analysis expected within the next 24 hours, the two biggest contenders are the Sudan Ebolavirus (SEBOV) and Bundibugyo Ebolavirus (BEBOV).

Previously, 15 of the 16 confirmed Ebola outbreaks in the DRC since 1976 have been Ebola Zaire, with one outlier, an outbreak of the Bundibugyo Ebolavirus in 2012.

A non-Zaire ebolavirus could complicate matters, since the current Ebola vaccine is designed specifically for ZEBOV, and it is not expected to provide significant cross protection against other strains. [...]

There are 6 known types of Ebolaviruses, with the most recent (Bombali) discovered in 2018.

Ebola virus (species Zaire ebolavirus)

Sudan virus (species Sudan ebolavirus)

Taï Forest virus (species Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus)

Bundibugyo virus (species Bundibugyo ebolavirus)

Reston virus (species Reston ebolavirus)

Bombali virus (species Bombali ebolavirus)

Of these, only 4 are known to infect and sicken humans (Bombali and Reston have yet to do so). These viruses are endemic in bats, can infect non-human primates and other mammalian hosts, and occasionally spill over into humans.

While most Ebola outbreaks are contained after a few dozen - or a few hundred - cases, the 2014-2016 West African outbreak spanned 3 countries, and claimed over 11,000 lives.

Exported cases outside of Africa are rare, but have been reported (see here, here, and here).

All of which means we'll be keeping a close eye on this emerging regional public health emergency.

Michael Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP), which publishes CIDRAP News, said the media and even some public health officials are missing key elements of the hantavirus outbreak on a Dutch cruise ship.

During a Q&A with CIDRAP News, he explained how and why superspreaders are key to understanding the Andes strain of hantavirus, why close proximity is only part of the consideration, and why he doesn’t think this outbreak is the next “big one.”

Per the World Health Organization, the outbreak that began on the MV Hondius cruise ship traveling from Argentina to Europe has resulted in 11 cases. Three patients have died since April 11.

Today, the US Centers for Disease Control and Prevention confirmed that no Americans have been sickened so far in this outbreak. The agency said it is monitoring 41 people for the virus, at least 18 of whom are being quarantined in biocontainment units.

Person-to-person transmission and superspreaders

CIDRAP News: What are the biggest misunderstandings you see in coverage of this outbreak?

Michael Osterholm: Unfortunately, the media and some of my colleagues have missed the main point of this outbreak.

First of all, respiratory person-to-person transmission is not new with the Andes hantavirus. We have an example from Chubut Province, Argentina, which was well-documented in a study in the New England Journal of Medicine. Thirty-four cases and 11 deaths in that outbreak.

We have at least three other outbreaks in Argentina since 1996 that show person-to-person transmission. In 1996 there was an outbreak involving 16 people, in 2002 we saw an outbreak with 13 linked cases, and there were three linked cases in 2014.

CIDRAP News: So, is person-to-person transmission likely?

Michael Osterholm: There have been over 100 cases of hantavirus in Argentina this past year and no reports of person-to-person transmission. It’s a rare phenomenon, but it happens. Transmission likely involves superspreaders, individuals—for reasons not clear—who transmit at high rates via the respiratory route to other humans.

We have a model for that with SARS [severe acute respiratory syndrome] and MERS [Middle East respiratory syndrome], a handful of cases who really drove the activity in a given outbreak.

Another study in Morbidity and Mortality Weekly Report describes a woman who contracted hantavirus in Argentina, flew back to Delaware, and exposed 51 or 52 people. No one became infected.

These experiences give us more reason to believe what is happening on the ship will be self-limited. Many cases do not transmit the virus. From a standpoint of transmission, every person does not pose the same risk, and that point has been missed.

Right now, every person in quarantine from this outbreak is being treated like they are a superspreader who brought it on the ship. Our challenge is we won’t know who a superspreader is until after it happens. And we won’t know if there will be a superspreader for another two to three weeks.

Swapping air and asymptomatic spread

CIDRAP News: The cruise ship element is really driving this story and begging comparisons to COVID. What’s your take on the ship’s role in the outbreak?

Michael Osterholm: From an HVAC [heating, ventilation, and air condition] standpoint, a cold-water cruise ship is all about keeping the ship warm. It’s not a cruise ship in the Caribbean, where people are drinking martinis on the deck; this ship poses different issues.

Many of these ships have lots of air that gets moved around inside the actual ship. This is why we can have cases who were not exposed in close proximity, or close physical contact. It’s all about who is swapping air, and we are not talking about that. Investigators need to think about who swapped air with whom.

CIDRAP News: There’s been some talk about possible asymptomatic transmission in this outbreak; what’s your take?

Michael Osterholm: We don’t know; maybe it could happen in the first 24 hours before symptom onset. There have been 10 cases among more than 160 contacts, not counting Patient Zero. That attack rate is relatively low, around 6%. If I were going to try to devise a transmission event on a cruise ship for cold-weather sailing, I would expect 50% to 60%.

I express my condolences to everyone who died or was on the ship, but I believe the current outbreak is not a major transmission crisis at all. To my knowledge, no one has been infected from someone who got off the ship early.

Prediction: It will likely be over in 2 weeks

CIDRAP News: About those who left the ship early, why aren’t they quarantining for 42 days in biocontainment units like 16 Americans in Nebraska and two in Atlanta?

The lack of consistent response is a huge challenge, because it lends itself to a credibility gap. One of the challenges here is no one has the exact science.

One signal that’s been missed… everybody is focused on 42 days, but the median incubation is 18 days. That means half the cases would be anticipated to occur in the first 18 days after exposure.

We know the original infected patient got on the ship around 30 days ago, and, based on when he got on the ship and when he died, he would likely have been transmitting the virus in his first week on the ship. To me, it points out that there’s not going to be a lot of additional cases from ship exposure.

Now, consistent with the concept of a superspreader, you may see enhanced transmission with one person, but that’s not what every person infected will do. People jump to this conclusion because a cruise ship is involved, and the [COVID-19] pandemic had cruise ships involved, but there’s no evidence this will be a pandemic. I think we will see this fade away over 10 to 14 days.

A young person has died and two others are being treated after an outbreak of meningitis in Berkshire, health officials have said.

It follows a major outbreak in Kent, linked to a Canterbury nightclub, that killed two people and left more than a dozen needing hospital treatment in March. On Thursday, the UK Health Security Agency (UKHSA) confirmed new cases had been found in Reading and that a student had died.

“We understand that many people will be affected by this sad news and would like to offer our condolences to the friends and family of this student,” said Dr Rachel Mearkle, a consultant in health protection.

“Students and staff will naturally be feeling worried about the likelihood of further cases. However, meningococcal meningitis requires very close contact to spread and large outbreaks, as we saw in Kent recently, are thankfully rare.

“We are working closely with partners and have provided public health advice and precautionary antibiotic treatment to close contacts of the cases. Meningococcal disease does not spread easily and the risk to the wider public remains low.”

Health officials said close contacts of the cases were being offered antibiotics as a precaution. “One case been confirmed as meningitis B (MenB) and we are awaiting further testing results.”

While they said information was being sent to “students and parents at all affected schools”, officials did not specify how the cases were linked.

Mearkle said: “Anyone can get meningitis, and around 300 to 400 cases of meningococcal disease are diagnosed in England every year. It’s most common in babies, young children, teenagers and young adults. It needs to be treated quickly so it is important to know the signs and symptoms.

They can appear in any order and may not all be present, so seek rapid medical attention if there is ever any concern.

“Signs and symptoms of meningococcal meningitis and sepsis can include a fever, headache, rapid breathing, drowsiness, shivering, vomiting and cold hands and feet. Sepsis can also cause a characteristic rash that does not fade when pressed against a glass.”

[...]

More than 1,000 passengers are being held on a UK-operated cruise ship in France after 49 people fell ill from gastrointestinal sickness.

Local health authorities in Bordeaux said three passengers had been isolated in their cabins on the Ambition, while other passengers will not be able to disembark in the port.

They added that there was "no reason" to link the outbreak to the hantavirus outbreak on a separate cruise ship.

Ambassador Cruise Line told the BBC a 92-year-old man had passed away onboard on Sunday, but he did not report any related symptoms and his cause of death is yet to be established by a coroner.

The cruise operator added: "We are providing every support to the deceased's friends and family and extend our most sincere condolences to them at this difficult time."

Ambassador Cruise Line said in a separate statement that as of 11:00 BST on Wednesday, 48 passengers were displaying symptoms consistent with gastrointestinal illness, as well as one crew member.

There are currently 1,187 guests and 514 crew members onboard the ship, according to its operator.

The cruise ship set sail from Belfast on 8 May, before heading to Liverpool the next day.

In its statement, Ambassador said there was a reported increase in cases after guests boarded in Liverpool.

It said "a number of guests and crew onboard Ambition have displayed or are displaying symptoms consistent with gastrointestinal illness".

Gastrointestinal illness is a common condition that causes diarrhoea and vomiting. Cases in adults are usually caused by norovirus or food poisoning.

[...]