A green revolution is sweeping Pakistan as consumers switch to generating their own solar electricity. But as VOA Pakistan bureau chief Sarah Zaman reports, the move to the increasingly affordable, green option may also cause a crisis for the national grid. Videographer: Wajid Asad
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BANGKOK — Thailand has detected an mpox case in a European man who arrived from Africa last week and is awaiting test results to determine the strain, a disease control official said on Wednesday.  

Thai authorities were treating the case as if it were the Clade 1 form of mpox, as the person, a 66-year-old European man with residency in Thailand, had arrived on Aug. 14 from an African country where it was spreading, Thongchai Keeratihattayakorn, director-general of the Department of Disease Control, told Reuters.  

“After he arrives from the flight there is very little time frame where he come into contact with others,” Thongchai said. “He arrives around 6 pm and on the next day, Aug 15, he went to see the doctor at the hospital.” 

Thongchai said the man has undergone a test to determine whether the case was a Clade 1 variant, with the result expected by Friday. Authorities are also monitoring 43 people in the country who may come into contact with the patient, he said. 

The director-general did not name the African country the man had been in. He said the man had transited in a Middle Eastern country, which he also did not name, before flying on to Thailand. 

Thailand has detected 800 cases of mpox Clade 2 since 2022, but so far not detected a case of the Clade 1 or Clade 1b variants. 

 
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Palestinian residents of a Jerusalem neighborhood have appealed to the Israeli Supreme Court demanding they be supplied with more water. The 120,000 residents of the area say they receive water only three hours a week. Linda Gradstein reports for VOA from Kufr Aqab. Camera: Ricki Rosen.
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Gaborone, Botswana — Health officials in Botswana have started screening travelers for mpox at the country’s entry points. 

Neighboring South Africa has recorded three deaths as a result of the dangerous strain of mpox, and Botswana is anxious to keep out the rapidly spreading disease.

“Although we have not recorded any case of mpox in Botswana, I want to take this opportunity to assure Botswana that we have significantly enhanced our broader surveillance systems,” the country’s minister of health, Dr Edwin Dikoloti, told the media Tuesday. “We are currently intensifying our surveillance at key entry points, which is borders and airports, focusing on high-risk areas.”

South Africa shares a 1,900-kilometer border with Botswana and as of Aug. 5 had recorded three mpox deaths. In Africa, the disease has claimed the lives of more than 500 people since the beginning of the year.

Botswana Public Health Institute Acting Director Dr. Thebeyame Matsheka says travelers will be required to fill out self-assessment forms at border checkpoints.

“There are sometimes where, through just random checks, we might identify someone who appears not to be well, they will take those travelers aside and investigate further,” Matsheka said.

Meanwhile, Dikoloti said Botswana is engaging with international partners for the supply of vaccines.

According to Africa’s Centers for Disease Control and Prevention, the continent has about 200,000 vaccine doses against a requirement of at least 10 million doses.

Medication to be used for the management of mpox is available at health facilities throughout the country.

“Vaccines exist for mpox but they are not widely available,” Dikoloti added. 

The World Health Organization country representative, Juliet Bataringaya, says the scale of the mpox vaccination will not be broad because the disease affects countries differently.

“We need to have a good understanding of the epidemiology in each and every country, because it is different and to understand the transmission patterns,” Bataringaya said. “These will then guide on the use of vaccines in a more targeted way to have maximum public health impact.”

She said there won’t be the kind of mass vaccination effort implemented during the COVID pandemic because the modes of transmission are different.
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Berlin — A World Health Organization official stressed on Tuesday that mpox, regardless of whether it is the new or old strain, is not the new COVID, as authorities know how to control its spread.

“We can and must tackle mpox together,” said Hans Kluge, WHO regional director for Europe, in a U.N. media briefing.

“So will we choose to put the systems in place to control and eliminate mpox globally? Or we will enter another cycle of panic and neglect? How we respond now and in the years to come will prove a critical test for Europe and the world,” he added.

Mpox, a viral infection that causes pus-filled lesions and flu-like symptoms, is usually mild but can kill.

The clade 1b variety has caused global concern because it seems to spread more easily though routine close contact.

A case of the variant was confirmed last week in Sweden and linked to a growing outbreak in Africa, the first sign of its spread outside the continent. The WHO declared the recent outbreak of the disease a public health emergency of international concern after the new variant was identified.

Kluge said that the focus on the new clade 1 strain will also help in the fight against the less severe clade 2 variety that has spreading globally since 2022, allowing Europe to improve its response through better health advice and surveillance.

About 100 new cases of the clade 2 mpox strain are now being reported in the European region every month, added Kluge.

Mpox transmits through close physical contact, including sexual contact, but unlike previous global pandemics such as COVID-19 there is no evidence it spreads easily through the air.

Health authorities need to be on alert and flexible in case there are new, more transmissible clades or ones that change their transmission route, but there are no recommendations for people to wear masks, said WHO spokesperson Tarik Jasarevic.

 
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Cairo — Sudan has been stricken by a cholera outbreak that has killed nearly two dozen people and sickened hundreds more in recent weeks, health authorities said Sunday. The African nation has been roiled by a 16-month conflict and devastating floods.

Health Minister Haitham Mohamed Ibrahim said in a statement that at least 22 people have died from the disease, and that at least 354 confirmed cases of cholera have been detected across the county in recent weeks.

Ibrahim didn’t give a time frame for the deaths or the tally since the start of the year. The World Health Organization, however, said that 78 deaths were recorded from cholera this year in Sudan as of July 28. The disease also sickened more than 2,400 others between Jan. 1 and July 28, it said.

Cholera is a fast-developing, highly contagious infection that causes diarrhea, leading to severe dehydration and possible death within hours when not treated, according to WHO. It is transmitted through the ingestion of contaminated food or water.

The cholera outbreak is the latest calamity for Sudan, which was plunged into chaos in April last year when simmering tensions between the military and a powerful paramilitary group exploded into open warfare across the country.

The conflict has turned the capital, Khartoum and other urban areas into battlefields, wrecking civilian infrastructure and an already battered health care system. Without the basics, many hospitals and medical facilities have closed their doors.

It has killed thousands of people and pushed many into starvation, with famine already confirmed in a sprawling camp for displaced people in the wrecked northern region of Darfur.

Sudan’s conflict has created the world’s largest displacement crisis. More than 10.7 million people have been forced to flee their homes since fighting began, according to the International Organization for Migration. Over 2 million of those fled to neighboring countries.

The fighting has been marked by atrocities including mass rape and ethnically motivated killings that amount to war crimes and crimes against humanity, according to the U.N. and international rights groups.

Devastating seasonal floods in recent weeks have compounded the misery. Dozens of people have been killed and critical infrastructure has been washed away in 12 of Sudan’s 18 provinces, according to local authorities. About 118,000 people have been displaced due to the floods, according to the U.N. migration agency.

Cholera is not uncommon in Sudan. A previous major outbreak left at least 700 dead and sickened about 22,000 in less than two months in 2017.

Tarik Jasarevic, a spokesperson for WHO, said the outbreak began in the eastern province of Kassala before spreading to nine localities in five provinces.

He said in comments to The Associated Press that data showed that most of the detected cases were not vaccinated. He said the WHO is now working with the Sudanese health authorities and partners to implement a vaccination campaign.

Sudan’s military-controlled sovereign council, meanwhile, said Sunday it will send a government delegation to meet with American officials in Cairo amid mounting U.S. pressure on the military to join ongoing peace talks in Switzerland that aim at finding a way out of the conflict.

The council said in a statement the Cairo meeting will focus on the implementation of a deal between the military and the Rapid Support Forces, which required the paramilitary group to pull out from people’s homes in Khartoum and elsewhere in the country.

The talks began Aug. 14 in Switzerland with diplomats from the U.S., Saudi Arabia, Egypt, the United Arab Emirates, the African Union and the United Nations attending. A delegation from the RSF was in Geneva but didn’t join the meetings.
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moscow — A magnitude 7.0 earthquake struck off the coast of Russia’s far-eastern Kamchatka Peninsula early Sunday morning local time, according to the regional earthquake monitoring service.

The local emergencies ministry said tremors were felt along the coast including in the region’s capital Petropavlovsk-Kamchatsky.

“Operational teams of rescuers and firefighters are inspecting buildings,” the regional branch of Russia’s emergencies ministry in the Kamchatka region said on Telegram.

The earthquake struck at a depth of nearly 50 kilometers just after 7 a.m. local time, some 90 kilometers east of Petropavlovsk-Kamchatsky, the United States Geological Survey reported.

The U.S. National Tsunami Warning Center had initially issued a tsunami threat, but later said the threat had passed. Local authorities never issued a tsunami alert.

Several aftershocks were recorded after the initial quake, but of lower intensity, the Kamchatka branch of Russia’s Unified Geophysical Service reported on its website.

“Most of the aftershocks are imperceptible,” the regional emergency authority said on Telegram.

The peninsula lies on a seismically active belt surrounding most of the Pacific Ocean known as the “Ring of Fire,” and is home to more than two dozen active volcanoes. 
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SAN DIEGO — A rarely seen deep-sea fish resembling a serpent was found floating dead on the ocean surface off the San Diego coast and was brought ashore for study, marine experts said. 

The silvery, 12-foot-long (3.6-meter) oarfish was found last weekend by a group of snorkelers and kayakers in La Jolla Cove, north of downtown San Diego, in the U.S. state of California, the Scripps Institution of Oceanography said in a statement. 

It’s only the 20th time an oarfish is known to have washed up in California since 1901, according to institution fish expert Ben Frable. 

Scripps noted that oarfish have a mythical reputation as predictors of natural disasters or earthquakes, although no correlation has been proven. 

Oarfish can grow longer than 20 feet (6 meters) and normally live in a deep part of the ocean called the mesopelagic zone, where light cannot reach, according to the National Oceanic and Atmospheric Administration. 

Swimmers brought the La Jolla Cove oarfish to shore atop a paddleboard. It was then transferred to the bed of a pickup truck. 

Scientists from NOAA Southwest Fisheries Science Center and Scripps planned a necropsy Friday to try to determine the cause of death. 
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ABUJA, NIGERIA — Barely 48 hours after the World Health Organization declared mpox a global health emergency, Nigeria went on high alert Friday, announcing new mpox cases and raising concerns about the country’s ability to contain the outbreak.

The Nigeria Center for Disease Control and Prevention, or NCDC, said it has recorded 39 cases of mpox so far this year amid a surge in infections across Africa. No deaths have been recorded in Nigeria.

Bayelsa, Cross River, Ogun and Lagos states are the most affected by the outbreak.

Speaking at a news conference, NCDC lead Dr. Olajide Idris said that the nation is ramping up its response to manage the spread of the virus and prevent the disease from being imported.

Mpox is a rare viral zoonotic disease, meaning it is primarily an animal disease that can be transmitted to humans. It is endemic in several African countries, with over 2,800 cases reported across 13 countries this year, claiming more than 500 lives.

Symptoms include fever, body aches, weakness, headaches and rashes.

With a more lethal strain emerging, Idris said that vaccination plans are being considered for high-risk populations.

“The Nigerian government is making effort to make vaccines available to the public, especially for the hotspot areas,” he said. “These vaccines have been shown to have a favorable safety profile. They are not yet in the country, but they are on their way.”

Olayinka Badmus, deputy project director for Global Health Security, Breakthrough Action Nigeria, said the new strain poses a higher risk.

“This particular strain is new, and anything new requires new learning. The things that we have seen related to this particular strain is the fact that it is spreading quite fast, the presenting symptoms — especially the rash — are widespread,” she said, meaning that the rash is all over the body.

“We are also seeing more children affected with mpox compared to the other strains,” Badmus said.

Another cause for concern, she said, is that this strain has “a higher human-to-human transmission at an accelerated rate.”

Idris stressed the need for public awareness in containing the spread and urged people to seek medical attention if they experience symptoms.

“We encourage everybody feeling feverish, muscle pain, sore throat to please visit the nearest health care facility,” he said.

Public health experts are also urging people to adhere to preventive measures such as avoiding contact with potentially infected animals and practicing good hygiene.
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GOMA, Democratic Republic of Congo — Sarah Bagheni had a headache, fever, and itchy and unusual skin lesions for days, but she had no inkling that her symptoms might have been caused by mpox and that she might be another case in a growing global health emergency. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Hundreds killed in DRC

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

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

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

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

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

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

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

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

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

Vaccination drive

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

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

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

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

But it added: “Travel restrictions and border closures don’t work and should be avoided.”
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Abuja, Nigeria — Nigerian authorities on Thursday placed key entry points into the country on high alert following the outbreak of the mpox virus in Africa. Authorities have also put nine Nigerian states, including the commercial hub, Lagos, and the capital, Abuja, under serious surveillance.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The disease, caused by the monkeypox virus, leads to flu-like symptoms and pus-filled lesions. It is usually mild but can kill, with children, pregnant women and people with weakened immune systems, such as those with HIV, all at higher risk of complications.
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