分类： health

Australia is facing a public health emergency as a diphtheria outbreak surges to levels not recorded in 35 years, pushing national case counts above 220. In response to the growing crisis, New South Wales (NSW) has announced a targeted, free vaccination initiative to curb the spread of the potentially fatal bacterial disease and boost lagging immunization rates across the state.

NSW Health Minister Ryan Park unveiled the plan at a Thursday press conference, issuing an urgent public call for residents to verify that their diphtheria vaccinations are up to date. Under the new policy, all doses and boosters will be provided at no cost to patients at Aboriginal Medical Services (AMS) and general practitioner (GP) clinics across NSW. Free access is also extended to all individuals under 19 years of age seeking immunization.

Park emphasized that immunization rates across NSW remain far lower than public health officials recommend, with particularly concerning gaps in coverage among Aboriginal and Torres Strait Islander communities. The state’s intervention comes in response to rising cases nationally, most of which are concentrated in the Northern Territory – the region that recorded Australia’s first diphtheria-related death in nearly a decade in recent weeks. While the outbreak is centered in northern Australia, cases have now spread across state borders: Queensland and South Australia have both reported detections, and NSW confirmed its first cases of the current outbreak earlier this week.

In a direct appeal to First Nations communities, Park specifically urged any Aboriginal or Torres Strait Islander resident who has not received a diphtheria booster in the last 10 years to access free immunization through their local AMS or GP. “Diphtheria has taken hold in some parts of northern Australia, and we need to keep people safe,” Park said. “The best way to do that is vaccination.”

As Australia’s most populous state with the country’s largest public health system and most extensive resources, NSW has committed to ongoing monitoring of the outbreak and stands ready to expand its response if needed. Park noted that the diphtheria outbreak is a shared national challenge, and NSW is willing to contribute additional support to affected regions as the situation evolves.

Diphtheria is a highly contagious bacterial infection that can cause severe respiratory damage, heart and nerve complications, and even death in unvaccinated individuals. Public health officials have long emphasized that widespread immunization is the most effective prevention strategy against the disease, which was largely controlled in high-income countries through routine vaccination programs for decades.

The World Health Organization (WHO) announced Wednesday that the ongoing deadly Ebola outbreak in the eastern Democratic Republic of the Congo (DRC) has likely been spreading undetected for months, updating its official risk assessment as high for the DRC and neighboring regions but low for the entire globe.

Current investigations into the origins of the outbreak — which was formally declared last Friday — are still ongoing, but WHO officials say early evidence points to the virus circulating unreported for a significant period. “Given the scale, we are thinking that it has started probably a couple of months ago,” Anais Legand, a WHO technical officer specializing in viral haemorrhagic fevers, told reporters during a press briefing in Geneva.

Ebola, a severe viral haemorrhagic fever first documented in 1976 and linked to bat reservoirs, has claimed more than 15,000 lives across Africa over the past 50 years. This marks the 17th Ebola outbreak recorded in the DRC, and already, health officials are tracking roughly 600 probable cases with 139 suspected deaths. WHO Director-General Tedros Adhanom Ghebreyesus warned that these numbers are almost certain to rise in the coming weeks, noting that the extended undetected circulation of the virus gives it a head start on containment efforts.

Multiple challenges are complicating the global health body’s response to the crisis. The outbreak is centered in hard-to-access regions of Ituri province, an area long disrupted by armed conflict that limits access for medical teams and contact tracers. Additionally, the outbreak is caused by the rare Bundibugyo Ebola strain, which is not detected by standard diagnostic tests designed for the more common Zaire strain, delaying confirmation of cases.

Over the weekend, Tedros declared the outbreak a Public Health Emergency of International Concern (PHEIC), the second-highest alert level under the binding International Health Regulations (IHR) that triggers coordinated international emergency response. Despite this escalation, Tedros emphasized that the outbreak does not qualify as a pandemic at this stage. “There are several factors that warrant serious concern about the potential for further spread and further deaths,” he noted, but confirmed the WHO’s formal risk assessment: high at national and regional levels, low globally.

The European Commission echoed this assessment, stating that the risk of Ebola transmission within the European Union remains “very low” and that no special protective measures are currently recommended for EU residents. So far, the WHO has not implemented mandatory international travel restrictions, only advising that confirmed cases and known contacts avoid travel. However, a number of countries have moved independently to implement border controls and screening. The United States announced this week that it would begin screening air passengers arriving from affected regions and suspend routine visa services, though it granted an exception for the DRC national football team ahead of their World Cup qualifying match in the U.S. Bahrain has gone further, enacting a 30-day entry ban on visitors arriving from the DRC, South Sudan and Uganda.

As of Wednesday, just 51 cases have been confirmed via laboratory testing, as the remote location of most outbreaks limits access to sample collection and processing. Two confirmed cases have been recorded in the Ugandan capital Kampala, one of which ended in death, and an American citizen working in the DRC tested positive before being transferred to Germany for treatment. Retracing the outbreak’s origins, the first reported symptomatic case was a nurse who presented at a Bunia, Ituri health facility on April 24, but the epicenter of the outbreak is now confirmed to be roughly 90 kilometers away in Mongbwalu, where public health officials believe the virus first began spreading. The WHO first received an alert about an unusual cluster of lethal illness on May 5, and the first positive Ebola test was returned on May 15.

In Wednesday’s briefing, Tedros pushed back against criticism from United States officials over the speed of the WHO’s response. The U.S., which initiated withdrawal from the WHO during the Donald Trump administration, had faced accusations from Secretary of State Marco Rubio that the organization was “a little late to identify this thing.” Tedros countered that the criticism stems from a “lack of understanding of how IHR work, and the responsibilities of WHO and other entities. We don’t replace the countries’ work, we only support them,” he explained.

A deadly Ebola outbreak has spread across hard-to-reach regions of eastern Democratic Republic of the Congo, leaving local communities and healthcare workers severely underprepared and facing a growing crisis as aid efforts move at a glacial pace. Rwampara, one of the outbreak’s current epicenters, illustrates the crippling gaps in the early response: at the area’s main hospital, a flimsy plastic strip is the only marker for a planned isolation ward that has yet to be constructed.

This outbreak marks the 17th recorded flare-up of the highly contagious haemorrhagic fever in the DRC, and it has hit a region already destabilized by decades of armed conflict and widespread displacement. Even though Rwampara sits just 7.5 kilometers from Bunia, the largest city in violence-ravaged Ituri province, critical supplies for isolating and treating Ebola patients only began arriving on Monday, several days after the outbreak was officially declared.

At the hospital entrance, a single masked guard struggles to monitor all visitor traffic. A small number of handwashing basins have been set up outside the blue-painted facility, which a local official confirms is already caring for around 100 suspected Ebola cases. Before Friday, even nursing staff on the front lines lacked full personal protective equipment (PPE) — and local residents performing high-risk tasks are far more exposed. Salama Bamunoba, a local youth organization representative, explained that community members have been digging and filling graves for Ebola victims without gloves or any protective gear at all.

The current outbreak is caused by the Bundibugyo strain of Ebola, for which no targeted vaccine or specific antiviral treatment exists. Congolese authorities have reported that over 130 people are already suspected to have died from the virus, with containment efforts relying almost entirely on basic preventive measures and rapid case identification. Bamunoba called the government and its international partners out for significant delays, noting that establishing a proper triage and isolation zone has been the community’s top priority for days, with little action to show for it.

Despite the escalating crisis, daily life continues on the dusty streets of Rwampara for the moment: markets remain open, motorcycles move through crowds, and schools have not been closed. But anxiety is rapidly spreading across Rwampara and surrounding villages, which are already home to more than a million permanent residents and tens of thousands of people displaced by ongoing conflict. Local resident Gims Maniwa said many residents initially dismissed the outbreak as a minor threat, but the situation has deteriorated quickly. “Here, in Congo, a lot of things are done carelessly and that’s not good,” he told reporters.

Congolese officials have pushed back against criticism, with Health Minister Samuel Roger Kamaba claiming authorities already have all the supplies frontline healthcare workers need. The government’s spokesperson also emphasized this week that the DRC has decades of experience responding to Ebola outbreaks, most of which have been managed without widespread vaccine access. The country’s deadliest recent outbreak, which struck eastern DRC between 2018 and 2020, killed nearly 2,300 people out of more than 3,500 confirmed cases.

In recent days, aid has finally begun moving into the affected region. At Bunia’s airport, dozens of World Health Organization (WHO) staff in high-visibility vests have been unloading 12 tonnes of medical supplies from cargo planes, including protective kits and temporary isolation tents, which the organization confirmed had arrived this Tuesday. Aid group Medecins Sans Frontieres (MSF) has also stockpiled tonnes of supplies, including critical PPE for frontline teams, in its Bunia warehouses.

The response effort is facing headwinds from broader aid cuts, however. International funding for humanitarian work in the region has dropped sharply over the past year, particularly from the United States following Donald Trump’s return to the White House. Even with the new supply delivery, Trish Newport, MSF’s emergency programme manager, said the situation remains extremely strained. “Every facility our team called said: ‘We are full of suspect cases. We don’t have any space’,” Newport explained. “This gives you a vision of how crazy it is right now. What is really important is that we get material on the ground as quickly as possible,” she added, noting that the arrival of PPE will be a huge relief for overstretched staff.

Six years after the World Health Organization officially ended the Covid-19 public health emergency of international concern, a leading global pandemic preparedness expert has issued a stark warning that the world still has not closed critical gaps in early risk detection and pre-outbreak preparedness, as highlighted by two recent high-profile pathogen events.

Helen Clark, former New Zealand Prime Minister and co-chair of the Independent Panel for Pandemic Preparedness and Response, shared her assessment in an exclusive interview with AFP in Geneva on Tuesday. She acknowledged that incremental progress has been made since the devastating Covid-19 pandemic in overhauling global public health response systems. New updated International Health Regulations, the binding global framework for cross-border disease surveillance and response, are already delivering improvements when active outbreaks are declared, she noted.

Clark pointed to two recent cases that demonstrate this partial progress: the Ebola outbreak declared last Friday in the Democratic Republic of the Congo (DRC), and the rare hantavirus outbreak that emerged several weeks ago on the Atlantic cruise ship MV Hondius. In both instances, once official alerts were issued, the coordinated international response unfolded smoothly, she said.

But the core problem, Clark emphasized, lies far upstream of declared outbreaks. Critical gaps remain in the foundational systems of pathogen surveillance and early detection that are designed to stop small outbreaks from becoming large public health crises. “Those basic issues of surveillance, early detection… We’re not there yet,” she stated. Clark argued that the global public health community needs to dramatically expand investment in risk-informed preparedness, with a greater focus on proactively identifying emerging threats before they spiral out of control.

She detailed how the recent hantavirus outbreak on the cruise ship, which killed three people and triggered global concern, exposed these gaps. The specific hantavirus strain involved is known to be endemic in the region of Argentina where the cruise ship departed, but Clark questioned whether shipping operators and global health authorities had sufficient advance awareness of this local risk to put preventive measures in place.

The ongoing Ebola outbreak in the DRC’s remote eastern province reveals even more troubling gaps. The outbreak is caused by the dangerous Bundibugyo Ebola strain, which has already claimed more than 130 lives. Clark revealed that the outbreak spread undetected for four to six weeks, because initial testing targeted a more common Ebola strain and returned false negative results. “How could this have gone for four to six weeks, spreading while not getting the testing results that we needed to show that it was a particular variant?” Clark asked. She called for a full independent investigation into the chain of events to identify critical lessons for strengthening local and global response capacity.

Beyond surveillance gaps, Clark highlighted that sweeping cuts to global health aid have created a “perfect storm” that undermines outbreak prevention in the world’s most vulnerable nations. After major international donors drastically reduced funding, low-income fragile states are suddenly expected to cover the full cost of strengthening their domestic health systems, a burden they simply cannot afford, she explained. “With the best will in the world, the poorest and most fragile countries just haven’t got money sitting in the bank to do that, so things will get neglected across a range of areas,” Clark said.

In closing, Clark reaffirmed that global solidarity remains an irreplaceable pillar of effective pandemic preparedness. Pathogens do not respect national borders, she noted: a confirmed Ebola case in a U.S. citizen linked to the DRC outbreak and cross-border spread of hantavirus from the cruise ship prove that all nations share a common interest in strong prevention systems everywhere. “We’re in this together, and so we have to look to ways of financing preparedness or response which reflect our shared interests,” Clark stressed.

A rapidly worsening outbreak of a little-known Ebola strain in the Democratic Republic of the Congo (DRC) has triggered an urgent global push among scientists to develop and deploy effective countermeasures that can curb the death toll and bring the crisis under control. As of this week, the World Health Organization (WHO) confirmed that more than 130 people have already lost their lives to the outbreak, prompting the United States to issue a level 4 travel advisory warning all American citizens against visiting the affected regions.

This marks the 17th Ebola outbreak recorded in the DRC, but only the third caused by the Bundibugyo strain – a variant for which no vaccines or therapeutic treatments have yet won formal regulatory approval. While no licensed options currently exist, researchers have spent years developing a number of candidate products that have yet to undergo human testing, creating a pipeline of potential solutions that could be accelerated if sufficient support is secured.

The WHO has already begun reviewing all available candidates, including Ervebo, a widely deployed vaccine that targets the more common Zaire Ebola strain, which has been used successfully in multiple previous outbreaks. Thomas Geisbert, a virologist at the University of Texas Medical Branch at Galveston who contributed to the development of Ervebo, has already designed a single-dose vaccine modeled on Ervebo that targets Bundibugyo. Preclinical research in non-human primates has shown the candidate provides robust protection against the strain. However, Geisbert explained that moving from preclinical research to mass manufacturing of doses for human use is a time-consuming and costly process, and major pharmaceutical companies have long had little financial incentive to invest in the product.

“ There hasn’t been an incentive for big pharma to jump in, because it’s not a money-maker, ” Geisbert told Agence France-Presse (AFP). He added that his research on the Bundibugyo candidate was first published back in 2013, and the project has sat dormant ever since – a pattern that mirrors his earlier work on what eventually became Ervebo. First published in 2005, Ervebo only garnered serious attention and investment during the 2014 West Africa Ebola outbreak, which killed more than 11,300 people and became the largest Ebola outbreak in recorded history. After that outbreak began, U.S. pharmaceutical firm MSD (known as Merck in North America) was able to produce the first clinical doses in roughly nine months, and trials later confirmed the vaccine is 84% effective against the Zaire strain. Geisbert said he is optimistic that a similar accelerated timeline could produce usable doses of the Bundibugyo candidate in as little as six to seven months, if a pharmaceutical partner steps forward quickly. A spokesperson for MSD told AFP that independent data on Ervebo’s effectiveness against non-Zaire strains such as Bundibugyo remains limited, with no human data collected to date.

As the DRC outbreak expanded this week, a new potential candidate entered the conversation: a multi-strain mRNA vaccine developed by a team of Chinese researchers, whose findings were published in the *Proceedings of the National Academy of Sciences* (PNAS) on Monday. The candidate leverages the mRNA platform that was widely refined and scaled during the COVID-19 pandemic, and is designed to target the three most common Ebola strains, including Bundibugyo. While Connor Bamford, a virologist at Queen’s University Belfast, praised the research effort, he noted that mRNA vaccines remain costly to produce and require strict cold-chain storage – two factors that could severely limit their deployment in low-resource regions like rural DRC. Geisbert added that the new mRNA candidate has only been tested in mice so far, and positive results in mouse models frequently fail to translate to larger animals, let alone human populations.

Another team of researchers at the University of Oxford is also working to advance a candidate, partnering with the Serum Institute of India, the world’s largest vaccine manufacturer by volume, to ready a viral vector vaccine named ChAdOx1 BDBV for deployment as quickly as possible. “ We are working through the logistics at pace, ” Teresa Lambe, head of vaccine immunology at the Oxford Vaccine Group, told AFP, though she noted that no precise timeline for rollout is available yet.

Beyond vaccines, researchers are also moving quickly to launch clinical trials for two experimental therapeutic treatments for Bundibugyo, under a trial sponsored by the WHO. Amanda Rojek, an Oxford researcher working on the trial, told *Nature* this week that the team is working around the clock to launch the trials as soon as possible, adding that the infrastructure and planning needed are already in place. One of the treatments being considered is remdesivir, a broad-spectrum antiviral developed by U.S. firm Gilead Sciences that has already undergone human testing for the Zaire Ebola strain, though it has never been tested for Bundibugyo. Even so, Geisbert said that in vitro lab testing his team conducted found remdesivir is actually more effective against Bundibugyo than it is against Zaire. The second candidate is MBP134, a monoclonal antibody developed by Mapp Biopharmaceutical that is specifically designed to target multiple Ebola species, including Bundibugyo. Geisbert, who has also tested MBP134 in preclinical research, called the drug “ fantastic, ” noting that it effectively protected non-human primates from death even when administered after infection had already set in. Any clinical trials in affected regions will require formal approval from both the DRC and Ugandan governments before they can begin.