ASHEVILLE, North Carolina — Nearly a week after Hurricane Helene brought devastation to western North Carolina, a shiny stainless steel tanker truck in downtown Asheville attracted residents carrying 19-liter containers, milk jugs and buckets to fill with what has become a desperately scare resource — drinking water.

Flooding tore through the city’s water system, destroying so much infrastructure that officials said repairs could take weeks. To make do, Anna Ramsey arrived Wednesday with her two children, who each left carrying plastic bags filled with 7.6 liters of water.

“We have no water. We have no power. But I think it’s also been humbling,” Ramsey said.

Helene’s path through the Southeast left a trail of power outages so large the darkness was visible from space. Tens of trillions of liters of rain fell and more than 200 people were killed, making Helene the deadliest hurricane to hit the mainland U.S. since Katrina in 2005. Hundreds of people are still unaccounted for, and search crews must trudge through knee-deep debris to learn whether residents are safe.

It also damaged water utilities so severely and over such a wide inland area that one federal official said the toll “could be considered unprecedented.” As of Thursday, about 136,000 people in the Southeast were served by a nonoperational water provider and more than 1.8 million were living under a boil water advisory, according to the Environmental Protection Agency.

Western North Carolina was especially hard hit. Officials are facing a difficult rebuilding task made harder by the steep, narrow valleys of the Blue Ridge Mountains that during a more typical October would attract throngs of fall tourists.

“The challenges of the geography are just fewer roads, fewer access points, fewer areas of flat ground to stage resources” said Brian Smith, acting deputy division director for the EPA’s water division in the Southeast.

After days without water, people long for more than just a sponge bath.

“I would love a shower,” said Sue Riles in Asheville. “Running water would be incredible.”

The raging floodwaters of Helene destroyed crucial parts of Asheville’s water system, scouring out the pipes that convey water from a reservoir in the mountains above town that is the largest of three water supplies for the system. To reach a second reservoir that was knocked offline, a road had to be rebuilt.

Boosted output from the third source restored water flow in some southern Asheville neighborhoods Friday, but without full repairs schools may not be able to resume in-person classes, hospitals may not restore normal operations, and the city’s hotels and restaurants may not fully reopen.

Even water that’s unfit to drink is scarce. Drew Reisinger, the elected Buncombe County register of deeds, worries about people in apartments who can’t easily haul a bucket of water from a creek to flush their toilet. Officials are advising people to collect nondrinkable water for household needs from a local swimming pool.

“One thing no one is talking about is the amount of poop that exists in every toilet in Asheville,” he said. “We’re dealing with a public health emergency.”

It’s a situation that becomes more dangerous the longer it lasts. Even in communities fortunate enough to have running water, hundreds of providers have issued boil water notices indicating the water could be contaminated. But boiling water for cooking and drinking is time consuming and small mistakes can cause stomach illness, according to Natalie Exum, an assistant professor at Johns Hopkins Bloomberg School of Public Health.

“Every day that goes by, you could be exposed to a pathogen,” Exum said. “These basic services that we take for granted in our everyday lives actually do do a lot to prevent illness.”

Travis Edwards’ faucet worked immediately after the storm. He filled as many containers as he could for himself and his child, but it didn’t take long for the flow to weaken, then stop. They rationed water, switching to hand sanitizer and barely putting any on toothbrushes.

“(We) didn’t realize how dehydrated we were getting,” he said.

Federal officials have shipped millions of liters of water to areas where people also might not be able to make phone calls or switch on the lights.

Power has been restored to about 62% of homes and businesses and 8,000 crews are out working to restore power in the hardest hit parts of North Carolina, federal officials said Thursday. In 10 counties, about half of the cell sites are still down.

The first step for some utilities is simply figuring out how bad the damage is, a job that might require EPA expertise in extreme cases. Ruptured water pipes are a huge problem. They often run beneath roads, many of which were crumpled and twisted by floodwaters.

“Pretty much anytime you see a major road damaged, there’s a very good chance that there’s a pipe in there that’s also gotten damaged,” said Mark White, drinking water global practice leader at the engineering firm CDM Smith.

Generally, repairs start at the treatment plant and move outward, with fixes in nearby big pipes done first, according to the EPA.

“Over time, you’ll gradually get water to more and more people,” White said.

Many people are still missing, and water repair employees don’t typically work around search and rescue operations. It takes a toll, according to Kevin Morley, manager of federal relations with the American Water Works Association.

“There’s emotional support that is really important for all the people involved. You’re seeing people’s lives just wiped out,” he said.

Even private well owners aren’t immune. Pumps on private wells may have lost power and overtopping floodwaters can contaminate them.

There’s often a “blind faith” assumption that drinking water won’t fail. In this case, the technology was insufficient, according to Craig Colten. Before retiring to Asheville, he was a professor in Louisiana focused on resilience to extreme weather. He hopes Helene will prompt politicians to spend more to ensure infrastructure withstands destructive storms.

And climate change will only make the problem more severe, said Erik Olson, a health and food expert at the nonprofit Natural Resources Defense Council.

“I think states and the federal government really need to step back and start looking at how we’re going to prepare for these extreme weather events that are going to be occurring and recurring every single year,” he said.

Edwards has developed a system to save water. He’ll soap dirty dishes and rinse them with a trickle of water with bleach, which is caught and transferred to a bucket — useable for the toilet.

Power and some cell service have returned for him. And water distribution sites have guaranteed some measure of normalcy: Edwards feels like he can start going out to see friends again.

“To not feel guilty about using more than a cup of water to, like, wash yourself … I’m really, really grateful,” he said. 
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HANOI, Vietnam — More than a dozen tigers were incinerated after the animals died after contracted bird flu at a zoo in southern Vietnam, officials said.

State media VNExpress cited a caretaker at Vuon Xoai zoo in Bien Hoa city saying the animals were fed raw chicken bought from nearby farms. The panther and 20 tigers, including several cubs, weighed between 10 and 120 kilograms when they died. The bodies were incinerated and buried on the premises.

“The tigers died so fast. They looked weak, refused to eat and died after two days of falling sick,” said zoo manager Nguyen Ba Phuc.

Samples taken from the tigers tested positive for H5N1, the virus that causes bird flu.

The virus was first identified in 1959 and grew into a widespread and highly lethal menace to migratory birds and domesticated poultry. It has since evolved, and in recent years H5N1 was detected in a growing number of animals ranging from dogs and cats to sea lions and polar bears.

In cats, scientists have found the virus attacking the brain, damaging and clotting blood vessels and causing seizures and death.

More than 20 other tigers were isolated for monitoring. The zoo houses some 3,000 other animals including lions, bears, rhinos, hippos and giraffes.

The 30 staff members who were taking care of the tigers tested negative for bird flu and were in normal health condition, VNExpress reported. Another outbreak also occurred at a zoo in nearby Long An province, where 27 tigers and three lions died within a week in September, the newspaper said.

Unusual flu strains that come from animals are occasionally found in people. Health officials in the United States said Thursday that two dairy workers in California were infected — making 16 total cases detected in the country in 2024.

“The deaths of 47 tigers, three lions, and a panther at My Quynh Safari and Vuon Xoai Zoo amid Vietnam’s bird flu outbreak are tragic and highlight the risks of keeping wild animals in captivity,” PETA Senior Vice President Jason Baker said in a statement sent to The Associated Press.

“The exploitation of wild animals also puts global human health at risk by increasing the likelihood of another pandemic,” Baker said.

Bird flu has caused hundreds of deaths around the world, the vast majority of them involving direct contact between people and infected birds.
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chicago — California is investigating a possible case of bird flu in a dairy worker who had contact with infected cattle, the state’s public health department said Thursday. 

The virus’ jump to cattle in 14 states and infections of 13 dairy and poultry farmworkers this year have concerned scientists and federal officials about the risks to humans from further spread. 

The worker had a “presumptive positive” result to a test for bird flu, and the U.S. Centers for Disease Control and Prevention will do further testing to confirm the finding, the California Department of Public Health said in a statement. 

The person, who was not identified, suffered only conjunctivitis, or pink eye, the department said in a statement. The person is being treated with antiviral medication and staying home, it added. 

The person works at a Central Valley dairy facility suffering an outbreak in cattle, according to the statement. 

Cows at dairy farms in California, the top U.S. milk-producing state, began testing positive for bird flu in late August. 

“The risk to the general public remains low, although people who interact with infected animals are at higher risk of getting bird flu,” the department said. 

Missouri last month confirmed bird flu in a person with underlying medical conditions who had no immediate known animal exposure. Six health care workers who cared for the Missouri patient developed respiratory symptoms, but the virus was not confirmed in any of them. 

Scientists are watching closely for signs that the virus has begun to spread more easily in people. 

The U.S. Food and Drug Administration on Thursday said it would begin testing raw cow’s milk intended for pasteurization at dairy plants to better understand the prevalence of the bird flu virus in milk. 

Participation in the study, set to begin October 28, is voluntary, and pasteurized dairy products remain safe to consume, the agency said. 

Prior FDA testing of retail dairy samples came back negative, and more such testing is underway.
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GENEVA  — The World Health Organization launched a global plan Thursday to address the growing threat of dengue and other deadly arboviruses, which have affected millions of people around the world and put billions more at risk.  

“The rapid spread of dengue and other arboviral diseases in recent years is an alarming trend that demands a coordinated response across sectors and across borders,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. 

An arbovirus is a virus that is transmitted to humans by mosquitoes, ticks, or other arthropods, such as crustaceans, insects and arachnids.   

Dengue has emerged as the most problematic arbovirus disease. The WHO notes the number of cases has nearly doubled each year since 2021, with over 12.3 million cases at the end of August of this year, including more than 6,000 deaths. 

The WHO aims to “turn the tide” against dengue and arboviral diseases, Tedros said, noting that the measures in the proposal could “protect vulnerable populations and pave the way for a healthier future.” 

The WHO chief said everyone has a role to play in the fight against dengue, “from maintaining clean environments to supporting vector control and seeking and providing timely medical care.” 

“Factors such as unplanned urbanization and poor water, sanitation and hygiene practices, climate change and international travel, are facilitating the rapid geographical spread of dengue,” Dr. Raman Velayudhan, WHO unit head, global program on control of neglected tropical diseases, told journalists in Geneva Tuesday, in advance of the plan’s launch. 

“The disease is now endemic in more than 130 countries,” he said. “Similar trends are also observed for other arboviral diseases, such as Zika, chikungunya, and more recently, the Oropouche virus disease, especially in the Americas.” 

Dengue is endemic in tropical and subtropical climates, particularly in Southeast Asia, the Western Pacific and the Americas. The WHO says the majority of dengue cases, as well as several other arboviruses, have been reported from the American region this year.  

WHO officials say the situation is also of concern in Africa, “where countries are battling multiple diseases amid conflict and natural disasters,” placing additional strain on already fragile health systems. 

The Africa CDC reports more than 15,000 cases of dengue have been recorded in 13 African countries this year. 

“This global escalation underscores the urgent need for a robust strategy to mitigate risks and safeguard populations taking into account that urban centers are at greater risk,” Velayudhan said. 

Dengue is a viral infection that spreads from mosquitoes to people. Most people who get dengue get better in one to two weeks. However, some people who develop severe cases can die. 

According to the WHO, prevention is the best protection from dengue. It recommends people avoid mosquito bites, especially during the day, “by covering up.” 

Chikungunya, a virus spread by Aedes mosquitoes, has been reported in 118 countries, with the highest circulation found in Brazil.   

Dr. Diana Rojas Alvarez, team lead on arboviruses, epidemic and pandemic preparedness and prevention at the WHO, notes newborns, elderly and people with pre-existing conditions “have been identified as a risk factor for poor disease outcome.” 

Besides chikungunya, she said Zika and Oropouche, which are spreading widely in the Americas, have symptoms similar to dengue and “can be easily misdiagnosed in areas with co-circulation of multiple arboviruses.”   

To avoid misidentifying those diseases, she said it is critical for countries to strengthen their detection, surveillance, and testing activities and “to make sure populations know which measures to take to protect themselves and their communities.” 

The World Health Organization says the global escalation of arboviral diseases underscores the urgent need for “a robust strategy to mitigate risks and safeguard populations.” 

It urges governments to implement five components of its strategic global plan:  Emergency coordination activities, collaborative detection and surveillance, community protection and prevention measures, safe and scalable care to prevent illness and death, and access to countermeasures, such as the promotion of research for improved treatments and vaccines. 

The WHO estimates $55 million will be required to put the plan into action over the next year.  
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A new exhibit in Washington sheds some light on a little-known layer of the sea and the strange creatures that live there. Artechouse art center and Woods Hole Oceanographic Institution collaborated on the spectacle, called Twilight Zone: Hidden Wonders of the Ocean. Maxim Adams has the story.
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Abuja — Hundreds gathered in Abuja, Nigeria for the 2024 Childhood Cancer Awareness Walk, raising awareness and support for pediatric cancer. Despite progress in cancer care, Nigerian children face high costs and delayed diagnoses, which the walk aims to address.

Titilayo Adewumi joined the walk with her 13-year-old son Shittu, diagnosed with leukemia at age 5. With support from the Okapi Children Cancer Foundation, Shittu is now cancer-free.

Adewumi recounts the toll her son’s cancer diagnosis took on her family.

“I had to stop working for like 4 – 5 years so I could concentrate on him,” she said. “We went out of cash, we didn’t have money, that is when the Okapi visited us … I was so excited when the doctor told me that he was free of cancer, I felt like jumping into the roof and back I was so happy because it was not easy.”

Among the walkers was Izuyor Tobi. He brought his daughter Hope, who battled neuroblastoma. Treatment costs nearly drained the family’s finances until Okapi intervened. Today, Hope is healthy.

Tobi believes that spreading awareness about pediatric cancer will save lives.

“If not for Okapi Children Cancer Foundation, I don’t think my daughter will be alive today… What I do is to create more awareness by telling people what Okapi Children Cancer Foundation has done for my daughter,” he said.

The World Health Organization (WHO) estimates that 80% of childhood cancers occur in low-income countries like Nigeria, where many cases go undiagnosed or are detected late.

Pediatric oncologist Ifeoma Ezeukwu from the Federal Medical Center explained barriers to care.

“Ignorance is also another barrier,” she said. “I have come across so many people who will tell you, I never knew children could have cancer. … Early detection is key to survival in childhood cancer unlike the adult cancers; children, the prognosis are better in them when they are seen early, once you capture cancer early, you know that cure is what is expected.”

Kemi Adekanye founded the Okapi Children Cancer Foundation in 2017 and has been mobilizing community awareness and support. Funded by friends and family, the foundation has helped over 200 children access treatment, despite costs starting at $180.

Adekanye says they’re focused on influencing government action for pediatric cancer.

“As of today, there’s currently no supports being provided to children battling cancer, so we expect the government to intervene in terms of subsidizing treatment costs for children battling cancer, as well as equipping our hospitals more so people don’t have to travel far and wide to access oncology centers,” she said.

Health policy analyst Ejike Oji called for systemic reforms across Nigeria to ease the burden on families.

“The government should establish dedicated pediatric oncology wards across the country to provide grounds for training health care professionals to ensure their skills are good in diagnosing and treating childhood cancer,” he said. “If you look at the cancer from diagnosis to treatment, it’s a lot of money. Radiotherapy is one of the most expensive; most families cannot afford.”

The large turnout at the 8th Childhood Cancer Awareness Walk — ‘Bridge The Gap’ —showed the power of community mobilization.

Nigerians are advocating for better health care, early diagnosis and family support, ensuring no child faces cancer alone.
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Cape Canaveral, Florida — The two astronauts stuck at the International Space Station since June welcomed their new ride home with Sunday’s arrival of a SpaceX capsule.

SpaceX launched the rescue mission on Saturday with a downsized crew of two astronauts and two empty seats reserved for Butch Wilmore and Suni Williams, who will return next year. The Dragon capsule docked in darkness high over Botswana as the two craft soared 420 kilometers above Earth.

NASA switched Wilmore and Williams to SpaceX following concerns over the safety of their Boeing Starliner capsule. It was the first Starliner test flight with a crew, and NASA decided the thruster failures and helium leaks that cropped up after liftoff were too serious and poorly understood to risk the test pilots’ return. So Starliner returned to Earth empty earlier this month.

The Dragon carrying NASA’s Nick Hague and the Russian Space Agency’s Alexander Gorbunov will remain at the space station until February, turning what should have been a weeklong trip for Wilmore and Williams into a mission lasting more than eight months.

Two NASA astronauts were pulled from the mission to make room for Wilmore and Williams on the return leg.

NASA likes to replace its station crews every six months or so. SpaceX has provided the taxi service since the company’s first astronaut flight in 2020. NASA also hired Boeing for ferry flights after the space shuttles were retired, but flawed software and other Starliner issues led to years of delays and more than $1 billion in repairs.

Starliner inspections are underway at NASA’s Kennedy Space Center, with post-flight reviews of data set to begin this week.

“We’re a long way from saying, ‘Hey, we’re writing off Boeing,'” NASA’s associate administrator Jim Free said at a pre-launch briefing.

The arrival of two fresh astronauts means the four who have been up there since March can now return to Earth in their own SpaceX capsule in just over a week. Their stay was extended a month because of the Starliner turmoil.

Although Saturday’s liftoff went well, SpaceX said the rocket’s spent upper stage ended up outside its targeted impact zone in the Pacific because of a bad engine firing. The company has halted all Falcon launches until it figures out what went wrong.
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WASHINGTON — The first rocky planet ever spotted orbiting a burned out star called a white dwarf offers a glimpse of what may be in store for Earth billions of years from now — showing it is possible our planet might survive the death of the sun, albeit as a cold and desolate outpost in space.

The planet, with a mass about 1.9 times that of Earth, is orbiting the white dwarf about 4,200 light-years away from our solar system near the bulge at the center of the Milky Way galaxy, according to a study using data from Hawaii-based telescopes. A light year is the distance light travels in a year, about 9.5 trillion kilometers.

The white dwarf began as an ordinary star one or two times the mass of the sun. Its current mass is about half the sun’s. Stars with a mass less than eight times the sun’s end their lives as a white dwarf, the most common type of stellar remnant.

Before its host star’s death, the planet orbited at a distance possibly placing it in the “habitable zone” — not too hot and not too cold, where liquid water could exist on the surface and perhaps support life. It originally orbited at about the same distance as Earth is to the sun. Following its star’s demise, it is at 2.1 times that distance.

“It’s currently a freezing world because the white dwarf, which is in fact smaller than the planet, is extremely faint compared to when it was a normal star,” said University of California, San Diego astronomer Keming Zhang, lead author of the study published on Thursday in the journal Nature Astronomy.

The sun, roughly 4-1/2 billion years old, is destined to become a white dwarf.

“At the end of our sun’s life, it will puff up to enormous size — astronomers call it a red giant — and gently blow off its outer layers in a wind,” University of California, Berkeley astronomer and study co-author Jessica Lu said. “As our sun loses mass, the planets’ orbits will expand to larger sizes. Eventually, the sun loses all of its outer layers and leaves behind a hot compact core. This is called a white dwarf.”

Earth won’t always be habitable

Astronomers have debated whether Earth — the third planet from the sun, with Venus the second and Mars the fourth — would be engulfed and destroyed when the sun expands during its red giant phase, estimated to occur 7 billion years from now. It will become a white dwarf a billion years after that.

“Theoretical models disagree as to whether Earth could survive. Venus will most certainly be engulfed whereas Mars will most certainly survive. Our modeling shows that this planet very likely had a similar orbit to Earth before its host star became a red giant. It implies that Earth’s chances for survival may be higher than currently thought,” Zhang said.

Until now, only gas-giant planets larger than Jupiter, our solar system’s biggest planet, had been spotted orbiting white dwarfs.

The white dwarf is orbited by two bodies — the Earth-like planet and, further out, a brown dwarf, an object bigger than a planet but smaller than a star.

The planet endured tough times during its star’s death throes.

“It may have been a lava planet when the star became a red giant, then eventually cooled down to its current freezing state,” Zhang said.

As the sun ages and heats up, our solar system’s habitable zone would move outward. Earth will remain habitable for less than about a billion more years from now, by which point its oceans likely will have evaporated, Zhang said.

Does this mean certain doom for humankind — or whatever life still resides on Earth?

“We must migrate out of Earth prior to the 1-billion-year time scale,” Zhang said.

By the time the sun becomes a red giant, certain large moons in the outer solar system like Jupiter’s Ganymede and Saturn’s Titan and Enceladus may offer a refuge, Zhang added.

“There’s hope,” Zhang said.
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new york — U.S. suicides last year remained at about the highest level in the nation’s history, preliminary data suggests. 

A little more than 49,300 suicide deaths were reported in 2023, according to provisional data from the Centers for Disease Control and Prevention. That number that could grow a little as some death investigations are wrapped up and reported. 

Just under 49,500 were reported in 2022, according to final data released Thursday. The numbers are close enough that the suicide rate for the two years are the same, CDC officials said. 

U.S. suicide rates have been rising for nearly 20 years, aside from a two-year drop around the beginning of the COVID-19 pandemic. So “a leveling off of any increase in suicide is cautiously promising news,” said Katherine Keyes, a Columbia University public health professor who studies suicide. 

Indeed, there’s reason for optimism. A 2-year-old national crisis line allows anyone in the U.S. to dial 988 to reach mental health specialists. That and other efforts may be starting to pay off, Keyes said, but it “really remains to be seen.” 

Experts caution that suicide — the nation’s 11th-leading cause of death in 2022 — is complicated and that attempts can be driven by a range of factors. Contributors include higher rates of depression, limited availability of mental health services, and the availability of guns. About 55% of all suicide deaths in 2022 involved firearms, according to CDC data. 

The CDC’s Thursday report said: 

—Suicide was the second-leading cause of death for people ages 10–14 and 20–34, and the third-leading cause for people ages 15–19. 

—Deaths continue to be more common among boys and men than girls and women. The highest suicide rate for any group — by far — was in men ages 75 and older, at about 44 suicides per 100,000 men that age. 

—Among women, the highest rate was in those who were middle-aged, about 9 per 100,000. But more dramatic increases have been seen in teens and young women, with the rate for that group doubling in the last two decades. 

—The overall suicide rate in 2022 and 2023 was 14.2 per 100,000. It also was that high in 2018. Before then, it hadn’t been that high since 1941. 
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WASHINGTON — Fall means it’s time for just about everybody to get up to date on their flu and COVID-19 vaccines – and a lot of older adults also need protection against another risky winter virus, RSV.

Yes, you can get your flu and COVID-19 shots at the same time. Don’t call them boosters — they’re not just another dose of last year’s protection. The coronavirus and influenza are escape artists that constantly mutate to evade your body’s immune defenses, so both vaccines are reformulated annually to target newer strains.

“Right now is the best time” to get all the recommended fall vaccinations, said Dr. Mandy Cohen, director of the Centers for Disease Control and Prevention, as she got her flu shot Wednesday. She has an appointment for her COVID-19 shot, too. It’s “the single most effective thing you can do to protect yourself, your family, your community.”

While they’re not perfect, vaccinations offer strong protection against a bad case of flu or COVID-19 — or dying from it.

“It may not prevent every infection but those infections are going to be less severe,” said CDC’s Dr. Demetre Daskalakis. “I would rather have my grandmother or my great-grandmother have a sniffle than have to go to the emergency room on Thanksgiving.”

The challenge: Getting more Americans to roll up their sleeves. Last year, just 45% of adults got a flu vaccination and even fewer, 23%, got a COVID-19 shot. A survey released Wednesday by the National Foundation for Infectious Diseases shows an equally low number intend to this fall.

And the coronavirus still killed more Americans than flu last year.

“Maybe we believe that it’s not going to be me but let’s not take a chance,” said Dr. Michael Knight of George Washington University. “Why not get a vaccine that’s going to help you reduce that risk?”

Who needs a fall COVID-19 or flu vaccination?

The CDC urges both an updated COVID-19 shot and yearly flu vaccine for everyone ages 6 months and older. If you recently had COVID-19, you can wait two or three months but still should get an updated vaccination because of the expected winter surge.

Both viruses can be especially dangerous to certain groups including older people and those with weak immune systems and lung or heart disease. Young children also are more vulnerable. The CDC counted 199 child deaths from flu last year.

Pregnancy also increases the chances of serious COVID-19 or flu – and vaccination guards mom plus ensures the newborn has some protection, too.

What’s new about the COVID-19 shots?

Last fall’s shots targeted a coronavirus strain that’s no longer spreading while this year’s are tailored to a new section of the coronavirus family tree. The Pfizer and Moderna shots are formulated against a virus subtype called KP.2 while the Novavax vaccine targets its parent strain, JN.1. Daskalakis said all should offer good cross protection to other subtypes now spreading.

The Pfizer and Moderna mRNA vaccines can be used by adults and children as young as 6 months. The Novavax shot is a more traditional protein vaccine combined with an immune booster, and open to anyone 12 and older.

Which flu vaccine to choose?

High-dose shots and one with a special immune booster are designed for people 65 and older, but if they can’t find one easily they can choose a regular all-ages flu shot.

For the shot-averse, the nasal spray FluMist is available for ages 2 to 49 at pharmacies and clinics — although next year it’s set to be available for use at home.

All flu vaccinations this year will guard against two Type A flu strains and one Type B strain. Another once-common form of Type B flu quit spreading a few years ago and was removed from the vaccine.

What about that other virus, RSV?

RSV, or respiratory syncytial virus, is a coldlike nuisance for most people but it, too, packs hospitals every winter and can be deadly for children under 5, the elderly and people with certain high-risk health problems.

The CDC recommends an RSV vaccination for everyone 75 and older, and for people 60 to 74 who are at increased risk. This is a one-time shot, not a yearly vaccination – but only 24% of seniors got it last year. It’s also recommended late in pregnancy to protect babies born during the fall and winter.

And while “your arm may hurt and you may feel crummy for a day,” it’s also fine to get the RSV, flu and COVID-19 vaccines at the same time, Daskalakis said.

What will it cost?

The vaccines are supposed to be free under Medicare, Medicaid and most private insurance plans if people use an in-network provider.

About 1.5 million uninsured adults got free COVID-19 vaccinations through a federal program last year but that has ended. Instead, the CDC is providing $62 million to health departments to help improve access — and states and large cities are starting to roll out their plans.

Call your local health department to ask about options because in many areas, “availability of vaccine at lower or no cost is expected to trickle in over the next couple of weeks,” advised Dr. Raynard Washington, who heads the Mecklenburg County, North Carolina, health department.

Check the government website, vaccines.gov, for availability at local pharmacies.
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CAPE CANAVERAL, Florida — SpaceX launched a rescue mission for the two stuck astronauts at the International Space Station on Saturday, sending up a downsized crew to bring them home but not until next year. 

The capsule rocketed into orbit to fetch the test pilots whose Boeing spacecraft returned to Earth empty earlier this month because of safety concerns. The switch in rides left it to NASA’s Nick Hague and Russia’s Alexander Gorbunov to retrieve Butch Wilmore and Suni Williams. 

Because NASA rotates space station crews approximately every six months, this newly launched flight with two empty seats reserved for Wilmore and Williams won’t return until late February. Officials said there wasn’t a way to bring them back earlier on SpaceX without interrupting other scheduled missions. 

By the time they return, the pair will have logged more than eight months in space. They expected to be gone just a week when they signed up for Boeing’s first astronaut flight that launched in June. 

NASA ultimately decided that Boeing’s Starliner was too risky after a cascade of thruster troubles and helium leaks marred its trip to the orbiting complex. The space agency cut two astronauts from this SpaceX launch to make room on the Dragon capsule’s return leg for Wilmore and Williams. 

Wilmore and Williams watched the liftoff via a live link sent to the space station, prompting a cheer of “Go Dragon!” from Williams, NASA deputy program manager Dina Contella said. 

Williams has been promoted to commander of the space station, which will soon be back to its normal population of seven. Once Hague and Gorbunov arrive Sunday, four astronauts living there since March can leave in their own SpaceX capsule. Their homecoming was delayed a month by Starliner’s turmoil. 

Hague noted before the flight that change is the one constant in human spaceflight. 

“There’s always something that is changing. Maybe this time it’s been a little more visible to the public,” he said. 

Hague was thrust into the commander’s job for the rescue mission based on his experience and handling of a launch emergency six years ago. The Russian rocket failed shortly after liftoff, and the capsule carrying him and a cosmonaut catapulted off the top to safety. 

Rookie NASA astronaut Zena Cardman and veteran space flier Stephanie Wilson were pulled from this flight after NASA opted to go with SpaceX to bring the stuck astronauts home. Promised a future space mission, both were at NASA’s Kennedy Space Center, taking part in the launch livestream. Gorbunov remained on the flight under an exchange agreement between NASA and the Russian Space Agency. 

“Every crewed launch that I have ever watched has really brought me a lot of emotion. This one today was especially unique,” a teary-eyed Cardman said following the early afternoon liftoff. “It was hard not to watch that rocket lift off without thinking, ‘That’s my rocket and that’s my crew.'” 

Moments before liftoff, Hague paid tribute to his two colleagues left behind: “Unbreakable. We did it together.” Once in orbit, he called it a “sweet ride” and thanked everyone who made it possible. 

Earlier, Hague acknowledged the challenges of launching with half a crew and returning with two astronauts trained on another spacecraft. 

“We’ve got a dynamic challenge ahead of us,” Hague said after arriving from Houston last weekend. “We know each other and we’re professionals and we step up and do what’s asked of us.” 

SpaceX has long been the leader in NASA’s commercial crew program, established as the space shuttles were retiring more than a decade ago. SpaceX beat Boeing in delivering astronauts to the space station in 2020, and it is now up to 10 crew flights for NASA. 

Boeing has struggled with a variety of issues over the years, repeating a Starliner test flight with no one on board after the first one veered off course. The Starliner that left Wilmore and Williams in space landed without any issues in the New Mexico desert on September 6, and has since returned to Kennedy Space Center. A week ago, Boeing’s defense and space chief was replaced. 

Delayed by Hurricane Helene pounding Florida, the latest SpaceX liftoff marked the first for astronauts from Launch Complex 40 at Cape Canaveral Space Force Station. SpaceX took over the old Titan rocket pad nearly two decades ago and used it for satellite and station cargo launches, while flying crews from Kennedy’s former Apollo and shuttle pad next door. The company wanted more flexibility as more Falcon rockets soared. 
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KIGALI, Rwanda — Rwanda has confirmed six deaths and 20 cases of Marburg disease, the country’s health minister Sabin Nsanzimana said late on Saturday.

The majority of victims are health workers in the intensive care unit, Nsanzimana said in a video statement posted on X.

“We are counting 20 people who are infected, and six who have already passed away due to this virus. The large majority of cases and deaths are among healthcare workers, mainly in the intensive care unit,” the health minister said.

Marburg disease, a viral hemorrhagic fever, can cause death among some patients, with symptoms including severe headache, vomiting, muscle aches and stomach aches, the ministry has said.

Institutions and partners are working to trace those who have been in contact with the virus-affected individuals, the minister added.

With a fatality rate of as high as 88%, Marburg is from the same virus family as the one responsible for Ebola and is transmitted to people from fruit bats. It then spreads through contact with bodily fluids of infected people.

Neighboring Tanzania had cases of Marburg in 2023, while Uganda had similar ones in 2017. 
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PERRY, Florida — Hurricane Helene caused dozens of deaths and billions of dollars of destruction across a wide swath of the southeastern United States, and more than 3 million customers went into the weekend without power and, for some, a continued threat of floods.

Helene blew ashore in Florida’s Big Bend region as a Category 4 hurricane late Thursday packing winds of 225 kilometers per hour and then quickly moved through Georgia, the Carolinas and Tennessee. The storm uprooted trees, splintered homes and sent creeks and rivers over their banks and straining dams.

Western North Carolina was essentially cut off because of landslides and flooding that forced the closure of Interstate 40 and other roads. There were hundreds of water rescues, none more dramatic than in rural Unicoi County in eastern Tennessee, where dozens of patients and staff were plucked by helicopter from the roof of a hospital that was surrounded by water from a flooded river.

The storm, now a post-tropical cyclone, was expected to hover over the Tennessee Valley on Saturday and Sunday, the National Hurricane Center said. Several flood and flash flood warnings remained in effect in parts of the southern and central Appalachian Mountains, while high wind warnings also covered parts of Tennessee and Ohio.

Among the at least 44 people killed in the storm were three firefighters, a woman and her 1-month-old twins, and an 89-year-old woman whose house was struck by a falling tree. According to an Associated Press tally, the deaths occurred in Florida, Georgia, North Carolina, South Carolina and Virginia.

When the water hit knee-level in Kera O’Neil’s home in Hudson, Florida, she knew it was time to escape.

“There’s a moment where you are thinking, ‘If this water rises above the level of the stove, we are not going to have much room to breathe,’” she said, recalling how she and her sister waded through chest-deep water with one cat in a plastic carrier and another in a cardboard box.

Evacuations and record rainfall

In North Carolina, a lake featured in the movie “Dirty Dancing” overtopped a dam and surrounding neighborhoods were evacuated, although there were no immediate concerns it would fail.

People also were evacuated from Newport, Tennessee, a town of about 7,000 people, amid concerns about a dam near there, although officials later said the structure had not failed.

Tornadoes hit some areas, including one in Nash County, North Carolina, that critically injured four people.

Atlanta received a record 28.24 centimeters of rain in 48 hours, the most the city has seen in a two-day period since recordkeeping began in 1878, Georgia’s Office of the State Climatologist said on the social platform X. Some neighborhoods were so badly flooded that only car roofs could be seen poking above the water.

Moody’s Analytics said it expects $15 billion to $26 billion in property damage.

Climate change has exacerbated conditions that allow such storms to thrive, rapidly intensifying in warming waters and turning into powerful cyclones sometimes in a matter of hours.

Big Bend region hit hard

Florida’s Big Bend is a part of the state where salt marshes and pine flatwoods stretch into the horizon, and where the condo developments and strip malls that have carved up so much of the state’s coastlines elsewhere are largely absent.

It’s a place where Susan Sauls Hartway and her 4-year-old Chihuahua mix, Lucy, could afford to live within walking distance of the beach on her salary as a housekeeper.

At least, until her house was carried away by Helene. Friday afternoon, Hartway wandered around her street near Ezell Beach, searching for where the storm may have deposited her home.

“It’s gone. I don’t know where it’s at. I can’t find it,” she said of her house.

Born and raised in rural Taylor County, Hartway said there is nowhere in the world she would rather be, even after Helene. But she’s watched as wealthier residents from out of state have bought up second homes here. She wonders how many of them will sell out — and what will happen to the locals who have nowhere else to go.

“There’s so many people down here … this was all they had,” she said.

The community has taken direct hits from three hurricanes since August 2023.

All five who died in one Florida county were in neighborhoods where residents were told to evacuate, said Bob Gualtieri, the sheriff in Pinellas County in the St. Petersburg area. Some who stayed ended up having to retreat to their attics to escape the rising water. He said the death toll could rise as crews go door-to-door in flooded areas.

More deaths were reported in Georgia and the Carolinas, including two South Carolina firefighters and a Georgia firefighter who died when trees struck their trucks. Virginia Governor Glenn Youngkin reported at least one death in his state.

Power loss and infrastructure damage

President Joe Biden said he was praying for survivors, and the head of the Federal Emergency Management Agency headed to the area. The agency deployed more than 1,500 workers, and they helped with 400 rescues by late Friday morning.

Officials urged people who were trapped to call for rescuers and not tread floodwaters, warning they can be dangerous due to live wires, sewage, sharp objects and other debris.

In Georgia, an electrical utility group warned of “catastrophic” damage to utility infrastructure, with more than 100 high-voltage transmission lines damaged. And officials in South Carolina, where more than 40% of customers were without power, said crews had to cut their way through debris just to determine what was still standing in some places.

The hurricane came ashore near the mouth of the Aucilla River, about 30 kilometers northwest of where Hurricane Idalia hit last year at nearly the same ferocity. Florida Governor Ron DeSantis said the damage from Helene appears to be greater than the combined effects of Idalia and Hurricane Debby in August.

The destruction extended far beyond Florida.

Historic flooding expected

A mudslide in the Appalachian Mountains washed out part of an interstate highway at the North Carolina-Tennessee state line.

Another slide hit homes in North Carolina, and occupants had to wait more than four hours to be rescued, said Ryan Cole, the emergency services assistant director in Buncombe County. His 911 center received more than 3,300 calls in eight hours Friday.

“This is something that we’re going to be dealing with for many days and weeks to come,” Cole said.

Forecasters warned of flooding in North Carolina that could be worse than anything seen in the past century. The Connecticut Army National Guard sent a helicopter to help.

Helene was the eighth named storm of the Atlantic hurricane season, which began June 1. The National Oceanic and Atmospheric Administration has predicted an above-average season this year because of record-warm ocean temperatures.
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PREK TAKEO, Cambodia — The Mekong River is a lifeline for millions in the six countries it traverses on its way from its headwaters to the sea, sustaining the world’s largest inland fishery and abundant rice paddies on Vietnam’s Mekong Delta.

Cambodia’s plan to build a massive canal linking the Mekong to a port on on its own coast on the Gulf of Thailand is raising alarm that the project could devastate the river’s natural flood systems, worsening droughts and depriving farmers on the delta of the nutrient-rich silt that has made Vietnam the world’s third-largest rice exporter.

Cambodia hopes that the $1.7 billion Funan Techo canal, being built with Chinese help, will support its ambition to export directly from factories along the Mekong without relying on Vietnam, connecting the capital Phnom Penh with Kep province on Cambodia’s southern coast.

At an August 5 groundbreaking ceremony, Cambodian Prime Minister Hun Manet said the canal will be built “no matter what the cost.” By reducing costs of shipping to Cambodia’s only deep-sea port, at Sihanoukville, the canal will promote, “national prestige, the territorial integrity and the development of Cambodia,” he said.

Along with those promises comes peril. Here is a closer look.

The threat to the Mekong

The Mekong River flows from China through Myanmar, Thailand, Laos, Cambodia and Vietnam. It supports a fishery that accounts for 15% of the global inland catch, worth more than $11 billion annually, according to the nonprofit World Wildlife Fund. Flooding during the wet season makes the Mekong Delta one of the world’s most productive farm regions.

The river already has been disrupted by dams built upstream in Laos and China that restrict the amount of water flowing downstream, while rising seas are gnawing away at the southern edges of the climate-vulnerable Mekong Delta.

Brian Eyler, director of the Washington-based Stimson Center’s Southeast Asia Program, warns that high embankments along the 100-meter-wide, 5.4-meter-deep canal will prevent silt-laden floodwater from flowing downstream to Vietnam. That could worsen drought in Vietnam’s rice bowl and Cambodia’s floodplains, an area stretching over roughly 1,300-square kilometers.

The view from Vietnam’s rice bowl

A drier Mekong Delta is a concern for Vietnam’s agricultural sector, which powers 12% of its economy. The southwestern provinces of An Giang and Kien Giang would likely be most impacted. The delta’s latticework of rivers crisscrossing green fields is vital for Vietnam’s own plans of growing “high quality, low emission rice” on 1 million hectares of farmland by 2030. The aim is to cut earth-warming greenhouse gases, lower production costs and increase farmers’ profits.

Water from the river is “essential” not just for Vietnam’s more than 100 million people but also for global food security, said Nguyen Van Nhut, director of rice export company Hoang Minh Nhat.

Vietnam’s exports of 8.3 million metric tons of rice in 2023 accounted for 15% of global exports. Most was grown in the Mekong Delta. The amount of silt being deposited by the river has already dropped and further disruptions will worsen salinity in the area, hurting farming, Nhat said.

“This will be a major concern for the agriculture sector of the Mekong delta,” he said.

Cambodia’s view

Cambodia says the canal is a “tributary project” that will connect to the Bassac River near Phnom Penh. President Hun Sen claimed on social media platform X that this means there would be “no impact on the flow of the Mekong River.”

But blueprints show the canal will connect to the Mekong’s mainstream and in any case the Bassac consists entirely of water from the Mekong, Eyler said.

Cambodian authorities are downplaying the potential environmental impacts of the project. “This is their logic-defying basis for justifying no impact to the Mekong River,” he said.

A document submitted in August 2023 to the Mekong River Commission — an organization formed for cooperation on issues regarding the Mekong — does not mention using water from the canal for irrigation, though Cambodia has since said it plans to do so. The Stimson Center added it was “logical” that irrigation would be needed during dry months, but that would require negotiating an agreement with the other Mekong countries.

The Mekong River Commission told The Associated Press all major projects on the Mekong River “should be assessed for their potential transboundary impacts.” It said it was providing technical support to “increase transparency and cooperation among concerned countries.”

Sun Chanthol, the Cambodian deputy prime minister who oversees the project, didn’t respond to a request for comments.

Nationalistic rhetoric and tense neighbors

Cambodia has rejected criticism of the canal, which is widely seen as an effort by the country’s ruling elite to curry support for Prime Minister Hun Manet, who succeeded his father Hun Sen, who led Cambodia for 38 years.

The canal is to be built jointly by Chinese state-owned construction giant China Road and Bridge Corporation and Cambodian companies. But it is enveloped in nationalistic rhetoric. The canal would provide Cambodia a “nose to breathe through” by reducing its dependence on Vietnam, Hun Sen has said.

Vietnam has avoided openly criticizing its neighbor, instead communicating its concerns quietly. Vietnamese Foreign Ministry spokesperson Pham Thu Hang said at a press conference in May that Hanoi had asked Cambodia to share information and assess the environmental impacts of the project to “ensure the harmony of interests” of Mekong countries.

Many Cambodians remain suspicious of Vietnam’s intentions, believing it may want to annex Cambodian territory. Given the contentious past between the two countries, bigger and richer Vietnam is taking care not to appear to be impinging on Cambodian sovereignty, said Nguyen Khac Giang, an analyst at Singapore’s ISEAS-Yusof Ishak Institute.

“Although in Vietnam, there are big concerns,” he said.

Lost in Cambodia’s nationalistic rhetoric are the concerns of people like Sok Koeun, 57, who may lose her home.

The tin-roofed cottage where she has lived with her family since 1980 is right where the canal is due to be built. The river provides her with fish to feed her family when she struggles to get by selling sugarcane juice and recycling plastic cans.

No one has been in touch, she says, to answer her mounting questions: Will she get compensated? Will she get land? Or cash? Where will they go?

“I only learned about it (the canal) just now,” she said.
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Abuja, Nigeria — Leaders in Africa say the fight against malaria on the continent is facing significant funding gaps due to the ongoing global financial crisis and the impact of climate change.

African leaders this week met in New York on the sidelines of the United Nations General Assembly and called for a concerted effort to avert a funding crisis they say could set back decades of progress in the fight against malaria.

The African Leaders Malaria Alliance, or ALMA, which hosted the high-level meeting, said if malaria funding continues to shrink, there will be an expected additional 112 million cases and some 280,000 deaths by the year 2029.

Africa already accounts for an estimated 236 million malaria cases — or 95% of the global total — and 97% of deaths. Nigeria accounts for nearly a third of that burden.

Guinea-Bissau President Umaro Sissoco Embalo, who serves as chair of ALMA, said that Africa stands at a critical moment in the fight against malaria.

“We must act urgently to protect lifesaving malaria intervention,” he said. “This is very important because our target is to finish with malaria in Africa.”

Experts said Africa needs up to $6.3 billion in malaria funding annually to eliminate the disease and called for continued support for malaria financing within the global funding framework.

ALMA also said the impact of climate change and growing resistance to insecticide and antimalarials are further hampering progress against the disease in Africa.

Ngashi Ngongo, head of the Executive Office at the Africa Union, said, “Achieving the elimination of malaria alongside progress toward other endemic diseases such as HIV and TB will lay the foundation for reducing Africa’s disease burden and further propel the achievement of universal health coverage on the continent.

“This progress is essential for strengthening health systems, and it is a necessity as we prepare for future pandemics, which are inevitable,” he said.

Following the World Health Organization’s approval last year, the first malaria vaccines are being introduced into routine child immunization schedules across Africa.

And on Thursday in New York, Nigerian health authorities signed a deal with U.S.-based drone company Zipline to use artificial intelligence-powered drones to expand access to medical supplies, including blood and vaccines.

Abdu Muktar, who is the national coordinator of Nigeria’s Unlocking Healthcare Value-Chain Initiative, commended the “very bold agenda” for producing health care products locally.

“But now we also have to be able to deliver,” he said. “What Zipline is doing is using technology to make sure you deliver. You’ll be able to reduce wastage in whatever it is — vaccines, therapeutics. You’ll be able to be accountable. … You are able to reach more people.”

In 2022, governments of malaria-endemic countries contributed about $1.5 billion toward combatting the disease.
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