COVID-19 Coronavirus and other virus UK and World News Update 13th December 2024
World COVID Statistics: 776,947,553 officially reported cases and 7,076,993 losses of life.
The world is still officially losing around 500 people to COVID each week, despite only 102 countries still reporting regular figures to the World Health Organisation.
“We cannot talk about COVID in the past tense.
It’s still with us, it still causes acute disease and Long COVID, and it still kills.
The world might want to forget about COVID-19, but we cannot afford to.”
Dr Tedros, Head of WHO, at Wednesday's media briefing.
This time 5 years ago, the first severely ill patients in Wuhan, China, were about to be hospitalised.
Symptom onset for patient A was 1st December 2019, with 3 more patients by 10th December, and first hospitalisations around 17th.
"On that first confirmed case, none of his family members developed fever or any respiratory symptoms. He had not been to the Huanan seafood market and also no epidemiological link could be found between the first patient and later cases.
Chinese media later reported that there were earlier suspected infectections, going back to 17 November. Authorities did not publicly accept there was human-to-human transmission of the virus until 21 January."
Jim Reed, BBC Health Reporter.
5 years people... We all having been living a pandemic for 5 years.
If you are in the UK and eligible for this round of flu or COVID jabs, get them sorted right now, as the Winter drive ends on 20th December.
Flu and COVID - age 64 1/2 or over, certain health conditions, pregnant, live in a care home for older adults, frontline health and social care workers
Flu only - care home residents, carers and people who live with someone who has a weakened immune system. Children aged 2 or over.
Pneumococcal vaccine - 65 or over
RSV vaccine - pregnant or aged 75 to 79
My household have all been ill, it's not a surprise if you have too - the NHS is already under the sort of strain you expect from deep mid-Winter. Last week it was reported that 95% of the hospital beds in England were occupied, and the first weekly update on Winter NHS data shows a 352% increase in the number of people hospitalised in England with the flu compared to this time last year - up from an average daily figure of 243 to 1,099.
We also had almost 1,400 patients in hospital with COVID every day, despite not always testing for it any more.
Not only do we have the "tripledemic" of RSV, Flu and COVID, we also have hundreds of people in hospital with Norovirus - around twice as many as this time last year.
Flu doesn't usually peak until January, once we've all shared it round at Christmas, so it's bleak out there. We are being asked not to go to hospital unless we are really ill. Ring 111 and get advice before you go (unless a life is as risk, in which case don't delay and call 999 as normal).
We're all so ill... told you repeatedly catching COVID wasn't going to be a good thing...
If the UK is having a quad-demic, it looks like the USA might be having a quindemic. COVID-19, seasonal flu, Respiratory Syncytial Virus (RSV), Pertussis (whooping cough) and Mycoplasma Pneumonia (walking pneumonia). Fun times...
According to MSN "This time last year, WDOH (Washington Department of Health) reported 51 whooping cough cases. As of last week, the agency reported 1,193 cases".
If you thought COVID was fun, you'll love this...
The Democratic Republic of Congo is already having an horrific time as the centre of the Mpox epidemic (over 47,000 suspected cases and 1,000 suspected deaths) and now they have a nightmare scenario with an unknown disease - Disease X.
DRC is very poor. Their Health Ministry website is not secure, news is disjointed and healthcare is inaccessible to many. Sick people often stay home, and even deaths can go unrecorded.
DRC Disease X Timeline:
Tues 3rd Dec:
First reports given to The Associated Press by Remy Saki, the deputy governor of Kwango province, and Apollinaire Yumba, the provincial minister of health, said in SouthWestern DRC between 67 and 143 people had died from an unknown disease during November. Mr Yumba asked for international help.
The World Health Organisation had been alerted (on Sat 30th Nov) and a team was already in DRC to help collect samples for investigation.
Symptoms are given as mostly flu-like, with high fever, cough, breathing difficulties, body aches, severe headaches and anaemia. A local epidemiologist said women and children are worst affected.
Weds 4th Dec:
Official statement from DR Congo's Health Ministry said:
"Since October 24, 2024, a disease of still unknown origin has been spreading in Kwango province, specifically in the Panzi health zone. To date, this disease has caused the death of 79 people, most of whom are children over 15 years old (this was a typo), and has affected 376 individuals."
They asked the public to "remain calm, stay vigilant", and strictly adhere to preventive measures including basic hygiene, avoiding mass gatherings, reporting suspected cases or deaths and not handling the dead.
Thurs 5th Dec:
Congo’s health minister Samuel-Roger Kamba gave a press conference.
On Friday night the health ministry received an alert from local health officials and met next morning. An initial team was sent on Sunday and arrived Tuesday morning (it is over 400 km/250 miles through rough terrain). Direct communication is only possible via satellite phone.
There were 382 suspected cases and 71 deaths recorded between 10th and 25th of November (the African CDC quoted 79). 198 of those affected are children under 5, and 113 are aged 25 or older.
Access to healthcare is very limited and 40% of the population are malnourished, making them especially vulnerable.
Of those 71 deaths, only 27 people died in health centres - 17 from "respiratory distress" (problems with breathing), and 10 from lack of a blood transfusion for anaemia (which is heartbreaking). 21 of the 27 were under 10 years old. It is unknown whether the anaemia is caused by the disease or if the disease is occurring in addition to an anaemia condition such as malnutrition.
Mr Kamba answered questions:
- COVID is not suspected because the death rate is too high (7.5-8% of those receiving medical care)
- It's possible it is seasonal flu and other diseases simultaneously in a malnourished population
- At this point we can't rule out waterborne disease, a bacterial infection, or something transmitted through coughing
A man whose wife and 7 year old daughter died is quoted by media as saying: "high fever, vomiting and death"
DRC really does not have the infrastructure to deal with this.
Sun 8th Dec:
The World Health Organisation released a situation report. Samples were still not back and able to be tested.
"Between 24 October and 5 December 2024, Panzi health zone in Kwango Province of Democratic Republic of the Congo recorded 406 cases of an undiagnosed disease with symptoms of fever, headache, cough, runny nose and body ache. All severe cases were reported to be severely malnourished. Among the cases, 31 deaths have been registered." (Case Fatality Ratio or CFR of 7.6%)
Additional community cases are being investigated. Reported patients peaked in week ending 9th November.
In Panzi health zone (food insecurity, low vaccination, limited health staff and supplies):
Children aged 0-14 years - 64.3% of all reported cases
(0-59 months 53%, 5-9 years 7.4%, 10-14 years 3.9%)
Females 59.9% of the total cases.
Children 0-15 years - 71% of all reported deaths
(0-5 years 54.8%)
All severe cases were malnourished. There are 145 cases aged 15 and above, of which 9 died (CFR: 6.2%).
Symptoms are fever (96.5%), cough (87.9%), fatigue (60.9%) and a running nose (57.8%). "The main symptoms associated with death include difficulty in breathing, anaemia, and signs of acute malnutrition."
"Based on the current context of the affected area and the broad presentation of symptoms, a number of suspected diseases need to be ruled out through further investigations and laboratory testing. These include but are not limited to measles, influenza, acute pneumonia (respiratory tract infection), hemolytic uremic syndrome from E. coli, COVID-19, and malaria."
Meanwhile in Italy a recovered patient is suspected to have been ill with the same virus.
A 50 year old man who had been working in DRC (about 700 km from the Panzi area) had returned home and become ill. He was admitted to San Luca hospital on 22nd Nov with influenza symptoms, fever and anaemia, and discharged well on 3rd Dec.
He is not considered contagious, but has been recalled for investigations. The results are not yet known.
Mon 9th Dec
Update from the African CDC explaining the epicenter of the outbreak, Panzi Health Zone, is located approximately 700 km South East of the capital Kinshasa and the national reference laboratory (INRB), which has modern high tech equipment, including molecular diagnostic and sequencing equipment and a computer server for bioinformatic analysis.
Italy becomes the 4th country to heighten border security for arrivals from DRC.
Tues 10th Dec
Disaster really. It is announced that the samples were too degraded from their journey to be of use. Nothing could be tested, although rapid testing for malaria was completed and 80% tested positive. Teams are already on the ground and more samples will be brought as quickly as possible.
Jean Kaseya, the chief executive of Africa CDC:
"It is impossible for him to put in place an effective response without identifying the pathogen... I am the chief executive of Africa CDC. I'm a scientist. I trust the scientific evidence. I have about 416 cases, I have more than 70 deaths. As long as I don't know, through the labs, what's the problem, I don't let up the attention. When you run Africa CDC, you don't trust rumours, you trust the obvious. For now, I'm waiting for the evidence that will come from the tests."
And baaad news from North East of Kinshasa.... Teams from the Ministry of Public Health, Hygiene and Social Welfare were also asked to identify an epidemic of unknown origin in some territories of the province of Maï-Ndombé, South-West Democratic Republic of Congo.
Séverin Bamany, national deputy of Yumbi:
"I would like to inform the National Assembly that the same epidemic is raging towards the coast, especially in the territories of Bolobo, Yumbi and Lokolela but also in the surrounding islets.... This epidemic is manifested by high fevers, decreased blood, dehydration, dry coughs, accompanied by respiratory problems."
Professor Bamany said that in Yumbi, on December 7 alone, there were 14 deaths.
Weds 11th Dec
A second Italian who recently returned from DRC has been hospitalised with fever and other symptoms. The female patient returned on 29th November and "immediately" visited the hospital in Cosenza. She was discharged after staying overnight and is doing well.
Risk of onward spread is considered to be very low.
Thurs 12th Dec
An EU Commission spokesperson says they will convene a Health Security Committee meeting to coordinate the EU response as soon as they have more information on the unknown DRC virus.
The 'wait and see' response... The European Centre for Disease Prevention and Control (ECDC) already has a team in Kinshasa assisting with the Mpox response.
Fri 13th Dec
Today Africa CDC released an update on the situation in Panzi, Kwango Province, DRC, with updated figures to 9th December. To date:
Total 507 cases, 32 confirmed deaths in healthcare settings (average 6% CFR/mortality rate)
Female 357 cases, male 170 cases
0-5 years 225 cases (42.7%), 19 deaths (8.4% CFR)
5-9 years 134 cases (25.4%), 4 deaths (3% CFR)
10-25 years 48 cases (9%), 3 deaths (6.4% CFR)
Over 25 years 119 cases (22.8%) and 6 deaths (5% CFR)
Since 8th December there have been an additional 147 cases and 1 death. This is encouraging news, because it implies that identifying the problem, and sharing information about diagnosing illness and advised care may well be able to bring the mortality rate down considerably, even if it doesn't improve access to actual clinically-based treatment.
We still await the second batch of samples and test results...
Things that may or may not be related to DRC, but are certainly not right...
In what appears to have been an isolated incident and may have nothing to do with anything human happening in DRC right now, back in March 2024 an unknown disease swept through goats and pigs in an area North of Kwango Province (and South of Maï-Ndombé). This was reported by Flu Trackers, and the symptoms were "severe diarrhea and then coughing. After one or two days, the animal becomes very weak, as if paralyzed, and then death follows. As for pigs, their skins first become reddish, the animal loses its balance and succumbs".
An unknown illness has struck students at the Nigerian Military School in Zaria, Kaduna State. In less than 2 weeks 3 students have died and many more have been hospitalised, most reportedly in critical condition. News on this is scant to say the least, but parents are withdrawing their sons despite the school attempting to play it down as 'cardiovascular'. No-one official seems to be talking, but attempts to find out the cause are underway.
Reports by Wiwanitkit (2005 / 2013) and studies by Chen et al and Jie et al (2013) all found a link between H7N9 bird flu and anaemia. The prevalence in the last 2 studies was 42.9% (3 out of 7 patients) and all of the patients affected by anaemia died, but those unaffected did not.
It's an incredibly low number of people, and we can't be certain whether or not any had unidentified anaemia before they caught bird flu, or if it was caused directly by the bird flu infection, but it seems plausible that anaemia might have some clinical relationship to poor outcome.
I'm not saying this is related to what's happening in DRC, but it's possibly worth remembering...
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| Courtesy of Tern on Twitter / Bluesky |
UK Health Secretary Wes Streeting has taken Lord Darzi's report on the NHS very seriously and plans to recruit more GPs, as well as increasing hours for consultants. He recognises everyone is overwhelmed, and we are getting much more ill before we can get any help, increasing hospital stays and length of stay.
"Our 10-year health plan will deliver three big shifts in the focus of healthcare from hospital to community, analogue to digital, and sickness to prevention."
“We will refresh the NHS workforce plan to fit the transformed health service we will build over the next decade, so the NHS has the staff it needs to treat patients on time again.”
It's taken a long period of short-sightedness to get to this state of disrepair, no quick fixes this time - even if it makes the stats look good momentarily. The full 10 year plan will be released in Spring.
"California has secured a broad, voluntary recall of all Raw Farm, LLC raw milk and cream products due to possible bird flu contamination. Californians are strongly encouraged not to consume any raw milk or cream products in their possession or still on store shelves. Pasteurized milk remains safe to drink." (Previously only 2 batches were recalled.) They have also placed the farm under quarantine, suspending any new distribution of its raw milk, cream, kefir, butter and cheese products produced on or after November 27.
Much better safe than sorry...
And not a moment too soon, on 6th December the U.S. issued a federal order mandating that the national milk supply be tested for bird flu. Bulk testing, on a monthly or weekly basis, will begin rolling out on 16th December in California, Colorado, Michigan, Mississippi, Pennsylvania, and Oregon.
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| Courtesy of Helen Branswell, Stat News |
The toddler in Marin County, California, USA, who was suspected to have Avian Flu has tested negative in further tests. They went to the ER with a fever and flu symptoms, tested positive for Influenza Type A, and the parents said they had been drinking raw milk bought in a shop. It seemed an open and shut case, but apparently we will have to wait a while longer before confirming whether or not humans (like cats and mice) can catch bird flu from drinking infected raw milk.
Nine other Californian people who reported illness after drinking raw milk tested negative for flu.
As we go into flu season, this type of false alarm is likely to happen much more frequently. As standard now, the US CDC have asked that all positive flu type A results are sent for further testing to rule out Avian Flu.
Somewhat unsurprisingly lab testers at the California Animal Health & Food Safety Lab System (CAHFS) have been striking over understaffing and unsafe conditions. They're working very long hours to do all these H5N1 bird flu tests, and there are not enough staff or hours in the day to keep up...
The CDC has confirmed that the earlier Californian child who did test positive for bird flu had same strain from the dairy farm outbreak and a small number of wild bird cases (2.3.4.4b / B3.13). They are still trying to find out how it was caught, as the child had no known contact with infected animals.
The latest stats on H5N1 Avian Flu in the USA:
In the last 30 days there have been a staggeringly huge 339 new confirmed cases of cattle herds being infected across 2 states.
In total there are now 845 confirmed cases of cattle herds being infected across 16 states. (Plus 1 alpaca herd and 1 pig herd.)
58 humans have been confirmed infected (35 dairy, 21 poultry, 2 unknown). There are also 5 probable cases (2 dairy, 3 poultry).
2 of the probable cases may be in Arizona, which has very recently reported 2 human cases of H5N1 bird flu in people who were culling infected poultry. Sheesh... Both have mild symptoms thankfully.
BNO News have a possibly more up-to-date tracker which lists 64 human cases (plus 2 of unknown origin).
Add horses to the list of animals which can catch Avian Flu. Researchers regularly tested 2 groups of horses in Mongolia between July 2021 and October 2023 - 14 herds from wetland with lots of wild birds, and 10 herds from a dry area with few wild birds.
They found individual horses were regularly infected in both groups, despite their being no known outbreaks of Avian Flu in the local areas. The horses didn't display symptoms, so without the testing it's likely no-one would have realised. Sneaky... Of course now we have to wonder which other horses in the world have been catching bird flu secretly...
Timely... the UK Government have announced the launch of the Diagnostic Accelerator - a specialist team created to rapidly boost the country’s ability to diagnose and test for new and emerging infectious disease threats.
Their main job whenever a threat emerges will be to rapidly create tests such as lateral flow (LFDs), molecular point of care and polymerase chain reaction tests (PCRs). "Work is already underway to identify gaps in the UK’s diagnostic capabilities for notable pathogens within prioritised viral and bacterial families."
I'd imagine that will include Avian Flu, and as soon as we know what it is, Disease X from DRC.
Once and for all, let's lay this one to bed. Shi Zhengli, virologist from the Wuhan Institute in China, has released tons of data including the whole genomes of 56 new betacoronaviruses and some partial sequences, which were collected between 2004 and 2012, and were the ones being studied at the Wuhan lab in 2019. None are a direct genetic match or ancestor for SARS-COV-2 - the virus which causes COVID.
You can never prove a negative (you can't, it's impossible - you have to prove a positive. e.g. can't prove you didn't eat the cake, but can prove Jeff ate it or can prove you were somewhere else), however... this is more evidence to support that it was not a lab leak - either accidental or on purpose.
Meanwhile in Australia... If you ever felt bad because you lost your keys, it's just been announced The Public Health Virology Laboratory in Queensland lost 323 vials of deadly viruses in 2021. They didn't even realise until August 2023.
- 223 Lyssavirus (a type of rabies virus, with an almost 100% fatality rate)
- 98 Hendra virus (usually transmitted from horses to humans, 57% human fatality rate)
- 2 Hantavirus (usually spread by rodents, 35.4% human fatality rate)
The Ministry of Health is investigating, and it is most likely they were lost during transfer to a new freezer, and have either been destroyed or stolen.
This is not frozen chickens people. I thought we were living in Idiocracy, but apparently it's 12 Monkeys (spoiler: Bruce Willis is not going to come back in time and save us).
The brighter news is none of these viruses transmit well between humans, and it's been 3 years and nothing happened. It seems unlikely they'll ever be found now.
The UK and Australia have seen massive drops in cervical cancer rates since the introduction of HPV vaccinations, and now it's America's turn with the good news. In women under 25 deaths have dropped 62%.
The vaccine was introduced 15 years ago and women aged 35-44 are most likely to be diagnosed with cervical cancer, so just imagine how many lives it will have saved in another 10-20 years. Excellent news. Vaccination works.
It is the weekend, treat yourself!! You've held it together for 5 years of a pandemic - I think I for one deserve a drink, and so do you - raise a glass to yourself whether you do alcohol or not! This time of year is incredibly busy anyway, so take some time off from stress to laze in a warm bath, watch a heart-warming movie or go for a walk in the fresh air. If you are finding it overwhelming, remember to take life in small, manageable chunks. Make a list of the absolute must-haves, and work down from there. There's actually very little you HAVE TO do over the next couple of weeks, the rest is just glitter. Get the important stuff ticked off, and anything else becomes a lot easier, and a lot more fun.
I shall be taking Christmas off to spend with my loved ones. I hope you will also be spending time with your loved ones over the next few weeks. Because of the holidays and the current world situation I shall do a quick update post next Friday, and then I'll be off until the New Year... so until next week...
Wear A Hat, Remember to Ventilate Your House Regularly, Save The NHS...
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Sources:
https://www.worldometers.info/coronavirus/
https://coronavirus.data.gov.uk/
https://ourworldindata.org/covid-vaccinations
https://www.gov.uk/coronavirus
Images:
Africa CDC
Disease X update
Meningitis vaccination image UK GOV
WHO Heart attack signs image
Original image from Tern UK illnesses
H5N1 dashboard - Students For Health Security
https://www.shsorg.com/h5n1info
Get your jabs UK GOV image
Latest stats UK NHS flu rsv etc images
Nhs image
Helen Branswell H5N1 herds by state
Text:
Opening Remarks from Dr Tedros WHO media briefing:
https://bsky.app/profile/catinthehat.bsky.social/post/3lczrxaw36s2j
5 years of COVID
https://pmc.ncbi.nlm.nih.gov/articles/PMC7159299/
Winter jabs UK
Uk hospital pressure
Twindemic, tripledemic, quad-demic.
Willww have a decademic by 2030?
https://x.com/jim_reed/status/1864712081129275412?t=76QK5kg1vFY8LDic5H9QHQ&s=19
QuindemicUSA - Mycoplasma Pneumoniae (walkong pneumonia) and Whooping Cough
Quad-demic hospital beds England
https://www.theguardian.com/uk-news/2024/dec/05/warning-of-nhs-quad-demic-as-flu-and-covid-cases-rise-in-england?utm_source=dlvr.it&utm_medium=bluesky&CMP=bsky_gu
https://x.com/BBCHughPym/status/1864616930717413647
Scotland 13755 beds
https://www.opendata.nhs.scot/group/acute-hospital-activity?groups=acute-hospital-activity
England capacity tracker
Diagnostic accelerator Booster for infectious disease
https://www.gov.uk/government/news/diagnostic-accelerator-launched-to-speed-up-pandemic-preparedness
Wes Streeting plans mass expansion of GP services
Recall of raw milk products USA
https://bsky.app/profile/krutikakuppalli.bsky.social/post/3lchbqmyuxc2e
Bulk milk testing mandatory USA
Raw milk toddler H5N1
https://abcnews.go.com/Health/california-child-suspected-bird-flu-drinking-raw-milk/story?id=116675407
https://www.latimes.com/california/story/2024-12-07/possible-h5n1-case-in-marin-co-child-source-of-infection-unknown
Marin county child and flu v bird flu
https://x.com/HelenBranswell/status/1867345084963815536?t=k70jmivRUITlNvPK_ltntQ&s=09
Child 1 California
Child with H5N1
"To clarify, 2.3.4.4b encompasses both the strain on dairy farms **as well as other** wild bird spillovers in North America
B3.13 is the specific strain from the dairy farm outbreak"
Non sub version
https://archive.ph/mzLJC
Child strain dairy workers no known exposure - child 1
https://www.paho.org/en/documents/epidemiological-alert-human-cases-avian-influenza-ah5n1-americas-region-3-december-2024
https://bsky.app/profile/krutikakuppalli.bsky.social/post/3lcjarx5p5k2n
Californian H5N1 lab testers go on strike
Recall of raw products USA
https://bsky.app/profile/krutikakuppalli.bsky.social/post/3lchbqmyuxc2e
Bulk milk testing mandatory USA
H5N1 stats
https://www.paho.org/en/topics/avian-influenza
Probably Arizona
https://bnonews.com/index.php/human-cases-of-h5n1-bird-flu/
Horses H5N1
Wuhan Lab
data
Australia missing vials of death
Vials missing since 2021
https://x.com/ScMesab/status/1866620919743140151?t=CpQ8v_w8WCdGcA-VJ4lRRQ&s=19
https://x.com/nexta_tv/status/1866803904194719984?t=N0yMD9uBwPDZl8jDJnhZ9g&s=09
https://www.uptodate.com/contents/hantavirus-cardiopulmonary-syndrome/abstract/9
Cervical cancer USA
DRC Timeline Sources:
Tuesday 3rd Dec
https://www.newsweek.com/congo-reports-least-67-dead-unknown-disease-1994948
https://www.reuters.com/business/healthcare-pharmaceuticals/unknown-disease-kills-143-southwest-congo-local-authorities-say-2024-12-03/
Wednesday 4th Dec
PM WHO team in place
https://x.com/BNOFeed/status/1864316387897839681?t=qy5C3ujXNfI-qQbcelt6ig&s=19
Official report 4th December
Poisonings causing anaemia
Thursday 5th December
https://x.com/HelenBranswell/status/1864698806228623457?t=BUku_zF8rtroW915FbyiqA&s=19
https://www.the-sun.com/health/13030406/mystery-flu-like-disease-congo-children/
https://www.cidrap.umn.edu/misc-emerging-topics/lab-results-expected-soon-dr-congos-mystery-outbreak
Press conference in detail (thanks BNO)
Man with 7 year old and wife source link
Sunday 8th December
WHO report
Italian man
https://www.iltempo.it/attualita/2024/12/08/news/virus-congo-ultime-notizie-caso-sospetto-lucca-sintomi-venti-giorni-di-febbre-41088307/
https://m.jpost.com/science/science-around-the-world/article-832621
Monday 9th December
Update from African CDC
https://www.linternaute.com/actualite/sante/6821810-article-maladie-inconnue-republique-democratique-congo/
Tuesday 10th December
Samples too degraded to test
Kwango Province also has cases
WHO briefing in Geneva - no new news
10/12 Malaria tests positive
Drc tedros Geneva speech link
Wednesday 11th December
2nd Italian (female)
https://x.com/outbreakupdates/status/1866832931009802390?t=rbXiPcrjYiWOZMMBSIHKNA&s=09
Thursday 12th December
EU waiting for more information first
Friday 13th December
https://x.com/AfricaCDC/status/1867490388052779138?t=mdKJeB0hiBl1R7gav6-ShQ&s=19
Africa CDC broadcast (15 minutes)
______________________________________
Additional DRC background stories...
Deaths of livestock March 2024
Nigerian Military School, Zaria, Kaduna State
"strange illness" - many students are currently hospitalised at the Ahmadu Bello University Teaching Hospital
https://saharareporters.com/2024/12/06/death-toll-rises-three-strange-disease-outbreak-nigerian-military-school-others-remain
Anemia and H7N9 Bird Flu: A Forgotten Problem
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