Tag Archives: Children

Kentucky tornado killed dozen children, including two-month-old

By Cheney Orr

MAYFIELD, Ky. (Reuters) – The barrage of tornadoes that tore through Kentucky and surrounding states killed a dozen children, including a 2-month-old infant, Governor Andy Beshear said on Tuesday.

A total of 74 people died in Kentucky, with the oldest victim at 98 years old. Eight people have yet to be identified.

Beshear said the storms produced “the strongest set of tornadoes that we have ever seen in Kentucky and what we believe will probably be one of the most devastating tornado events in U.S. history.”

The fatalities included eight at a candle factory in Mayfield, Kentucky, that was reduced to rubble. Deaths at the candle factory were initially feared to be much higher, but a company spokesman said on Monday that the remaining 102 workers on duty at the time are alive and have been accounted for.

“If you saw it in person, you would believe that’s a miracle,” Beshear said of the fact that only eight were killed at candle factory.

(Reporting by Cheney Orr in Mayfield, Kentucky, and Peter Szekely in New York; Editing by Lisa Shumaker)

Over 900,000 U.S. kids to get first COVID-19 shot by end of Wed -White House

WASHINGTON (Reuters) -Over 900,000 U.S. children aged 5-11 are expected to have received their first COVID-19 vaccine shot by the end of Wednesday, White House COVID-19 coordinator Jeff Zients said, as the government ramped up vaccinations of younger children.

The United States on Wednesday began administering Pfizer/BioNTech’s COVID-19 vaccine to children ages 5 to 11, the latest group to become eligible for the shots that provide protection against the illness to recipients and those around them.

“While our program is just fully up and running this week, by the end of the day today, we estimate that over 900,000 kids aged five through 11 will have already gotten their first shot,” Zients said during a briefing with reporters.

The figure comes from a White House analysis of available data from pharmaceutical partners, some states, and localities, Zients said, adding the CDC has not yet collected the full tally.

COVID-19 is the largest vaccine-preventable killer of children in that age group, with 66 children dying from it over the past year, U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said at the same briefing.

The seven-day average of total COVID-19 cases in the U.S. was flat at about 73,300 over the past week, she said, with the hospitalization rate also flat at 5,000 a day. The seven-day average of daily deaths fell 11% to around 1,000 per day.

(Reporting by Susan Heavey, Alexandra Alper, and Ahmed Aboulenein; Editing by Nick Zieminski and David Gregorio)

U.S. begins effort to vaccinate young children against COVID-19

By Carl O’Donnell and Maria Caspani

(Reuters) -The United States on Wednesday began administering the COVID-19 vaccine to children ages 5 to 11, the latest group to become eligible for the shots that provide protection against the illness to recipients and those around them.

On Tuesday, the U.S. Centers for Disease Control and Prevention recommended the Pfizer Inc/BioNTech SE shot for broad use in that age group.

Only a limited number of the 15 million shots being distributed now will be available on Wednesday. They are expected to be more widely accessible at pediatrician’s offices, children’s hospitals and pharmacies next week.

The big national pharmacy chains, Walgreens Boots Alliance, CVS Health and Rite Aid are among those offering appointments for this weekend.

Virginia Commonwealth University Health received the vaccine on Tuesday but will probably not start administering it until next week because of logistics and safety protocols, Director of Pharmacy Services Rodney Stilner told Reuters.

“For us to be able to receive the vaccine and even start today would just be like, almost impossible,” he said.

While about 58% of Americans are fully vaccinated against COVID-19, some 28 million children under 12 have not been eligible until now.

The 10-microgram shot of the Pfizer/BioNTech vaccine authorized for school-age kids – a third the strength given to adolescents and adults – offers protection from the Delta variant of the virus that has led to thousands of pediatric hospitalizations.

‘MUCH EASIER, MUCH SAFER’

The vaccine, shown to be more than 90% effective at preventing symptomatic infection in children, also provides an avenue for fewer quarantines or school closures and more normal activities and freedoms.

“I think it’s going to make the issue of schools much easier, much safer,” White House chief medical adviser Dr. Anthony Fauci said in an interview with CNN on Wednesday.

Still, it remains unclear how many parents will jump at the chance. Even many who have been vaccinated themselves are more divided over whether to vaccinate their own younger children, given that severe COVID-19 is much less common for them.

There were no new safety issues in Pfizer’s study of the vaccine in thousands of children, but there is also no long-term data for its use.

The U.S. Food and Drug Administration authorized the Pfizer/ BioNTech vaccine for children aged 5 to 11 years on Friday. A few other countries, including China, are already vaccinating children. The European Union and Canadian regulators are currently considering Pfizer’s application for the vaccine in this younger age group.

So far, only Pfizer’s shot has been authorized for use in the United States for those under age 16.

Moderna Inc has delayed its request for authorization for its vaccine for children aged 6 to 11 and is waiting on an FDA review of safety data in connection with its application for 12- to 17-year old’s.

The states with the highest adult COVID-19 vaccination rates are preparing bigger pushes to get children inoculated than states where hesitancy remains strong, potentially widening the gaps in protection nationwide, public health officials and experts said.

COVID-19 vaccines have emerged as yet another issue exposing deep political fault lines in the United States that led to opposing stances on vaccinations, face covering and other pandemic restrictions in various parts of the country.

California, New York and Washington state, all led by Democratic governors who have promoted vaccination and mask-wearing, are setting up mobile sites and high-volume vaccination clinics for children, spokespeople for the public health departments of those states said.

California has also mandated that school-age children get a COVID-19 vaccine once their age group is eligible, a measure being considered in New York and Washington.

Republican state governors have largely resisted measures such as mask mandates or vaccine requirements in workplaces, schools and public venues. More than a dozen states, including Florida and Texas, have tried to block schools from imposing such requirements themselves.

(Reporting by Carl O’Donnell; additional reporting and writing by Maria Caspani; Editing by Caroline Humer, Jonathan Oatis and Bill Berkrot)

Mexico to give papers to children, pregnant women in migrant caravan

MEXICO CITY (Reuters) – Mexico said on Thursday it would give humanitarian visas to children and pregnant women in a migrant caravan moving north from southern Mexico, adopting a softer approach to the task of containing migrant flows than at times taken recently.

Lasting a year, the visas grant migrants access to public services like healthcare, as well as the ability to work.

Thousands of migrants from Central America and the Caribbean last weekend began traveling slowly from the southern border in a bid to reach the United States or Mexico City.

According to a Reuters witness, the majority of the latest caravan members are families with young children.

A major caravan moving through Mexico last month met with often heavy-handed resistance from Mexican authorities, sparking complaints about their tactics and even condemnation from President Andres Manuel Lopez Obrador.

As recently as Saturday, some 400 law enforcement officers in anti-riot gear tried to block the caravan’s path at a highway checkpoint in the city of Tapachula near the Guatemalan border.

One family, including small children, was knocked to the ground in the struggle.

Still, a Mexican official told Reuters authorities did not want to become embroiled in violent confrontations due to the number of children and pregnant women in the caravan.

The latest caravan comes amid record numbers of apprehensions by U.S. Customs and Border Protection and growing criticism of U.S. President Joe Biden from Republicans, who say he has not done enough to curb illegal immigration.

(Reporting by Jake Kincaid; Editing by Dave Graham and Marguerita Choy)

U.S. FDA advisers weigh Pfizer/BioNTech COVID-19 vaccine in children

By Manas Mishra and Michael Erman

(Reuters) -An expert panel will weigh authorization of Pfizer Inc and BioNTech’s COVID-19 vaccine for U.S. children aged 5 to 11 on Tuesday as it prepares to vote on a recommendation for the federal Food and Drug Administration.

An authorization is an important regulatory step toward reaching about 28 million children of these ages, most of them back in school for in-person learning.

The FDA need not follow the advice of its outside experts, but usually does.

While children rarely become seriously ill or die from COVID-19, some develop complications, and COVID-19 cases in unvaccinated children have risen due to the contagious Delta variant.

The age group is “far from being spared from the harm of COVID-19,” with the virus now one of the top 10 causes of deaths in American children, FDA official Peter Marks told the panel. He said there had been close to 100 deaths in that age group so far, and 1.9 million infections.

“In addition, infections have caused many school closures and disrupted the education and socialization of children,” he said.

FDA staff, in documents posted before the meeting, said the likely vaccine benefits in that age group clearly outweigh the potential harms, including the rare risk of heart inflammation.

Only a few other countries, including China, Cuba and the United Arab Emirates, have cleared COVID-19 vaccines for children in this age group and younger.

Since May, the World Health Organization has been urging rich countries to reconsider plans to vaccinate children and instead donate COVID-19 shots to the COVAX scheme for poorer countries.

The advisers are expected to pay close attention to the rate of the rare cases of heart inflammation called myocarditis that have been linked to both the Pfizer/BioNTech and Moderna vaccine, particularly in young men.

Pfizer and BioNTech are seeking clearance for a lower, 10-microgram dose version of the vaccine in children, versus 30 micrograms for everyone over the age of 12. The shot has been authorized for ages 12-15 since May and cleared for everyone over 16 since December.

The companies have said their vaccine showed 90.7% efficacy against the coronavirus in a clinical trial of children aged 5 to 11.

After the FDA, a panel to the U.S. Centers for Disease Control and Prevention will make a recommendation on the administration of the vaccine. The director of the agency will make the final call.

Top U.S. infectious disease expert Anthony Fauci said on Sunday that it was likely the vaccine will be available to children in the first week or two of November.

If the number of myocarditis cases in the younger age group turns out to be similar to that in 12- to 15-year-olds, the hospitalizations prevented for COVID-19 would outnumber those prevented for myocarditis in most scenarios analyzed, FDA staff reviewers said.

“No matter what size of the safety database, there will always be uncertainties regarding benefits and risks, including for example, the risk of vaccine-associated myocarditis,” said Doran Fink, the FDA’s deputy director for vaccine development.

These uncertainties have to be addressed in surveillance data and studies following authorization, Fink told the panel.

Pediatric vaccinations are an important public health tool to prevent infectious diseases, even ones that do not cause high rates of mortality or hospitalization for children.

(Reporting by Manas Mishra in Bengaluru and Michael Erman in New Jersey; Editing by Caroline Humer, Richard Chang and Jonathan Oatis)

Children with mild COVID-19 may not develop antibodies; oral vaccine booster shows promise in monkey study

By Nancy Lapid

(Reuters) – The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that have yet to be certified by peer review.

Children with mild COVID-19 may lack antibodies afterward

Children who contract a mild case of COVID-19 may not develop antibodies to the virus afterward, a study from Australia suggests. Researchers compared 57 children and 51 adults with mild COVID-19 or asymptomatic infections. Only 37% of children appeared to develop antibodies, compared to 76% of adults – even though viral loads were similar in the two groups, researchers found. Children’s bodies also did not appear to produce second-line cellular immune responses to the virus in the same way as adults, said study leader Paul Licciardi of Murdoch Children’s Research Institute in Melbourne. The participants in the study were all infected in 2020, his team reported on Monday on medRxiv ahead of peer review. “Whether this also happens for the current circulating variant (Delta) requires further investigation, as well as studies to understand why children are less likely to produce antibody responses following SARS-CoV-2 infection,” Licciardi said. “Whether this means children are susceptible to re-infection is not known.”

Experimental oral COVID-19 vaccine shows promise in monkeys

A COVID-19 booster vaccine that can be given by mouth to people who already have antibodies from vaccination or prior infection has yielded promising results in monkeys and is likely to be tested soon in humans, according to the company developing it. The oral booster uses traditional vaccine technology in which a harmless carrier virus delivers coronavirus proteins into cells on the surface of the tongue, or lining of the cheeks and throat, stimulating production of antibodies that can block the virus before it gets a foothold in the body, said Dr. Stephen Russell, chief executive of Vyriad in Rochester, Minnesota, who led the study. “Not only would an oral COVID-19 vaccine be more convenient and acceptable… but it might also lead to better immunity because it is being administered to the site where the COVID-19 virus typically comes into the body,” he added. In monkeys at one week after vaccinations, antibody levels increased by nearly 100-fold, with no side effects, Russell said. A report of the study posted on Monday on bioRxiv ahead of peer review says Vyriad is working with the U.S. Food and Drug Administration to plan human trials.

Plants may be useful in vaccine production

Plants could someday be used to produce COVID-19 vaccines, according to researchers who are developing a nasal spray vaccine. Vaccines work by delivering antigens, which are replicas of pieces of virus or bacteria that train the immune system to recognize the invader and defend against it. Vaccine antigens are typically produced in cells from mammals, but previous studies have suggested that producing them in tobacco-related Nicotiana benthamiana plants would be less expensive and safer. In the current lab study, posted on Monday on bioRxiv ahead of peer review, COVID-19 survivors’ antibodies recognized and responded to the coronavirus antigen produced in the plants “in the same way that they recognize a standard antigen produced in mammalian cells,” said study leader Allyson MacLean of the University of Ottawa. The intra-nasal vaccine is not meant to replace conventional (injected) vaccines, but rather to add another layer of protection by stimulating immune system protection in the airways, where the virus first attaches itself,” MacLean said. “We imagine the nasal-spray being used to top-up immune protection when traveling or going to events with large numbers of people.”

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

Damascus bomb kills 14, then army shells fall on rebel area killing 12

DAMASCUS/AMMAN (Reuters) – A blast on an army bus in Damascus on Wednesday killed 14 people, state media reported, the deadliest bombing in the Syrian capital in years, quickly followed by army shelling in rebel-held Idlib which rescue workers said killed 12 people.

The bus carrying troops was blown up near a bridge in the center of Damascus. A military source quoted by state media said two bombs had been attached to the vehicle in advance. Army engineers defused a third.

Syrian state TV posted images of the charred bus, and rescue workers could be seen removing body parts. A number of people were wounded, state media said.

About an hour after the bus blast, shells rained down on Ariha in Idlib in the northwest of the country, one of the last areas still held by rebels fighting against President Bashar al-Assad.

Four children and a teacher on their way to school were among those confirmed killed, the U.N. children’s agency UNICEF said. The Syrian Observatory for Human Rights, a monitoring group, called it the deadliest attack on Idlib since March 2020. Rescue workers said at least 30 people were wounded.

“The numbers of children injured and killed continue to increase,” UNICEF said in a statement.

In an apparent third incident, Iran’s state-run Al-Alam TV reported a blast during maintenance at a Syrian army ammunition depot that killed five people and injured four on the road between the cities of Homs and Hama. It did not identify those killed. Iranian forces have backed the Syrian government.

A decade of conflict in Syria has killed hundreds of thousands of people, although major fighting has mostly died down in recent years with the government of Assad now in control of nearly all major cities and towns.

There was no immediate claim of responsibility for the Damascus bombing, and the Syrian army and state media were silent about the subsequent shelling of Idlib.

Attacks in Damascus have been rare since the army crushed rebel enclaves around the city with backing from Russia and Iran-backed forces in 2018.

Dozens of people were killed in Damascus in 2017 in several suicide attacks claimed by jihadists, including two against police stations which Islamic State said it carried out.

Islamic State militants still operate in the deserts of central and eastern Syria, where they have mounted several attacks this year on army vehicles.

U.N.-backed efforts to reach a political settlement to the war, which have so far made little progress, took a step forward on Sunday when the U.N. envoy said the government and opposition had agreed to draft a new constitution.

(Reporting by Suleiman al-Khalidi in Amman and Jonathan Spicer in Turkey; Writing by Maher Chmaytelli/Tom Perry; Editing by Angus MacSwan)

WHO backs rollout of malaria vaccine for African children

By Maggie Fick and Aaron Ross

NAIROBI (Reuters) -The World Health Organization (WHO) said on Wednesday the only approved vaccine against malaria should be widely given to African children, potentially marking a major advance against a disease that kills hundreds of thousands of people annually.

The WHO recommendation is for RTS,S – or Mosquirix – a vaccine developed by British drugmaker GlaxoSmithKline.

Since 2019, 2.3 million doses of Mosquirix have been administered to infants in Ghana, Kenya and Malawi in a large-scale pilot program coordinated by the WHO. The majority of those whom the disease kills are aged under five.

That program followed a decade of clinical trials in seven African countries.

“This is a vaccine developed in Africa by African scientists and we’re very proud,” said WHO director-general Tedros Adhanom Ghebreyesus.

“Using this vaccine in addition to existing tools to prevent malaria could save tens of thousands of young lives each year,” he added, referring to anti-malaria measures like bed nets and spraying.

Malaria is far more deadly than COVID-19 in Africa. It killed 386,000 Africans in 2019, according to a WHO estimate, compared with 212,000 confirmed deaths from COVID-19 in the past 18 months.

The WHO says 94% of malaria cases and deaths occur in Africa, a continent of 1.3 billion people. The preventable disease is caused by parasites transmitted to people by the bites of infected mosquitoes; symptoms include fever, vomiting and fatigue.

The vaccine’s effectiveness at preventing severe cases of malaria in children is only around 30%, but it is the only approved vaccine. The European Union’s drugs regulator approved it in 2015, saying its benefits outweighed the risks.

“This is how we fight malaria, layering imperfect tools on top of each other,” said Ashley Birkett, who leads global malaria vaccine work at Path, a non-profit global health organization that has funded the development of the vaccine with GSK and the three-country pilot.

Another vaccine against malaria, developed by scientists at Britain’s University of Oxford and called R21/Matrix-M, showed up to 77% efficacy in a year-long study involving 450 children in Burkina Faso, researchers said in April, but it is still in the trial stages.

GSK also welcomed the WHO recommendation.

“This long-awaited landmark decision can reinvigorate the fight against malaria in the region at a time when progress on malaria control has stalled,” Thomas Breuer, Chief Global Health Officer, said in a statement.

GSK shares held steady in New York following the announcement, which came after the close of trading in its London-listed shares.

FUNDING CHALLENGE

The recommendation was jointly announced in Geneva by the WHO’s top advisory bodies for malaria and immunization, the Malaria Policy Advisory Group and the Strategic Advisory Group of Experts on Immunization.

Experts said the challenge now would be mobilizing financing for production and distribution of the vaccine to some of the world’s poorest countries.

GSK has to date committed to produce 15 million doses of Mosquirix annually, in addition to the 10 million doses donated to the WHO pilot programs, up to 2028 at a cost of production plus no more than 5% margin.

A global market study led by the WHO this year projected demand for a malaria vaccine would be 50 to 110 million doses per year by 2030 if it is deployed in areas with moderate to high transmission of the disease.

The GAVI vaccine alliance, a global public-private partnership, will consider in December whether and how to finance the vaccination program.

“As we’ve seen from the COVID vaccine, where there is political will, there is funding available to ensure that vaccines are scaled to the level they are needed,” said Kate O’Brien, Director of WHO’s Department of Immunization, Vaccines and Biologicals.

A source familiar with planning for the vaccine’s development said the price per dose was not yet set, but would be confirmed after GAVI’s funding decision and once there is a clear sense of demand for the vaccine.

The WHO’s decision had personal meaning for Dr. Rose Jalong’o, a vaccinology specialist at the Kenyan health ministry.

“I suffered from malaria as a child and during my internship, and during my clinical years I attended to children in hospital because of severe malaria who needed blood transfusion and unfortunately some of them died.”

“It’s a disease I have grown up with and, seeing all this in my lifetime, it’s an exciting time.”

(Reporting by Maggie Fick in Nairobi and Aaron Ross in Dakar; Editing by Katharine Houreld, Mark Potter and Emelia Sithole-Matarise)

More contagious Delta variant makes people sicker; oral drug shows promise in treating COVID-19 pneumonia

By Nancy Lapid

(Reuters) – The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that have yet to be certified by peer review.

Delta variant makes people sicker

The Delta variant of the coronavirus is known to be more easily transmissible than earlier versions, and now a large UK study suggests it also makes people sicker. Researchers analyzed data on 43,338 patients infected with either the Alpha or the Delta variant. Overall, roughly three quarters were unvaccinated, and half were under age 31. After accounting for patients’ underlying risk factors, researchers found that unvaccinated patients were 132% more likely to be hospitalized if they were infected with Delta than with Alpha. Vaccinated patients may also be more likely to require hospitalization with a Delta infection, but data for those patients was less clear, according to a report published on Friday in The Lancet Infectious Diseases. The results “suggest that outbreaks of the Delta variant in unvaccinated populations might lead to a greater burden on healthcare services than the Alpha variant,” the researchers concluded.

Oral drug shows promise against COVID-19 pneumonia

Severely ill patients with COVID-19 pneumonia who received the experimental oral drug opaganib developed by RedHill Biopharma required less extra oxygen and were able to leave the hospital sooner than patients receiving a placebo in a small randomized trial, researchers reported on Sunday on medRxiv ahead of peer review. Within 14 days after enrolling in the study, 50.0% of patients taking opaganib no longer needed oxygen, compared to 22.2% of patients in the placebo group. In addition, 86.4% of opaganib-treated patients had been discharged, versus 55.6% in the placebo group. On Thursday, RedHill announced that opaganib strongly inhibits the Delta variant of the coronavirus in test tube experiments. The drug is believed to exert its antiviral effect by inhibiting sphingosine kinase-2 (SK2), a key enzyme in cells that may be recruited by the virus to support its replication, the company said. Based on the initial 42-patient trial conducted last year, RedHill Biopharma launched a much larger randomized trial in patients hospitalized with severe COVID-19 pneumonia. The last of the 475 patients in that late-stage study has now completed treatment and some of the data should be available soon, the company said last week.

Seizure in children may signal COVID-19

Seizures may be the only symptom of COVID-19 in some children, a new report cautions. Children tend to get sick from COVID-19 far less often than adults, and their symptoms are usually not severe, mainly consisting of fever and mild respiratory issues, although more have become ill with emergence of the Delta variant. Among 175 children who came to an Israeli emergency room and were diagnosed with COVID-19, 11 were brought to the hospital because of seizures, researchers reported on Saturday in the medical journal Seizure. Only seven had previously been diagnosed with a neurological disorder, and only six had fever. All 11 made full recoveries. While seizures have not been a frequently reported problem in adults with COVID-19, they “may be the main manifestation of acute COVID-19 in children,” even without fever and without a history of epilepsy, the study authors said. In some hospitals, they point out, only children with flu-like symptoms or close contact with a confirmed COVID-19 patient get tested for the coronavirus. Medical personnel should be aware that children with seizures should be tested, too, they said.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

U.S. coronavirus hospitalizations hit eight-month high over 100,000

By Anurag Maan

(Reuters) -The number of coronavirus patients in U.S. hospitals has breached 100,000, the highest level in eight months, according to the Department of Health and Human Services, as a resurgence of COVID-19 spurred by the highly contagious Delta variant strains the nation’s health care system.

A total of 101,433 COVID patients were hospitalized, according to data published on Friday morning.

U.S. COVID-19 hospitalizations have more than doubled in the past month. Over the past week, more than 500 people with COVID were admitted to hospitals each hour on average, according to data from the Centers for Disease Control and Prevention.

The United States reached its all-time peak for hospitalizations on Jan. 14 when there were over 142,000 coronavirus-infected patients in hospital beds, according to HHS.

As the vaccination campaign expanded in early 2021, hospitalizations fell and hit a 2021 low of 16,000 on in late June.

However, COVID-19 admissions rose suddenly in July as the Delta variant became the dominant strain. The U.S. South is the epicenter of the latest outbreak but hospitalizations are rising nationwide.

Florida has the highest number of COVID-19 hospitalized patients, followed by Texas and California, according to data from the U.S. Department of Health and Human Services. More than 95% of intensive care beds are currently occupied in Alabama, Florida and Georgia.

The Delta variant, which is rapidly spreading among mostly the unvaccinated U.S. population, has also sent a record number of children to hospital. There are currently over 2,000 confirmed and suspected pediatric COVID-19 hospitalizations, according to HHS.

Three states – California, Florida and Texas – amount to about 32% of the total confirmed and suspected pediatric COVID-19 hospitalizations in the United States.

Children currently make up about 2.3% of the nation’s COVID-19 hospitalizations. Kids under 12 are not eligible to receive the vaccine.

The country is hoping for vaccine authorization for younger children by autumn with the Pfizer Inc vaccine.

Dr. Anthony Fauci, the nation’s top infectious disease expert, said this week that the nation could get COVID-19 under control by early next year if vaccinations ramp up.

The United States has given at least one dose of vaccine to about 61% of its population, according to the CDC.

The United States, which leads the world in the most deaths and cases, has reported 38.5 million infections and over 634,000 deaths since the pandemic began last year, according to a Reuters tally.

(Reporting by Anurag Maan in Bengaluru; Editing by Lisa Shumaker and Michael Perry)