Tag Archives: Malaria

Alert issued in Florida for Malaria

Luke 21:11 There will be great earthquakes, and in various places famines and pestilences. And there will be terrors and great signs from heaven.

Important Takeaways:

  • Malaria alert issued in Florida. Why infectious mosquitoes have led to statewide concern
  • Four people in Sarasota have fallen ill with malaria, and the Florida Department of Health has issued a statewide mosquito-borne illness alert, the department said this week. The U.S. Centers for Disease Control also has issued an alert after the Florida cases, and one case in Texas, are the first instances of locally transmitted malaria in the U.S. since 2003.
  • The four people in Sarasota who were ill after being bitten by infectious mosquitoes have all recovered. All four patients were infected with P. vivax malaria. According to state health officials, it is less fatal than other species.
  • Malaria symptoms include headaches, nausea, vomiting, sweating, fever and chills. Anyone experiencing these symptoms should seek medical help within 24 hours of symptoms, the state advised.

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Risk of Malaria back in the US for first time in 20 years

Malaria by Mosquito

Luke 21:11 There will be great earthquakes, and in various places famines and pestilences. And there will be terrors and great signs from heaven.

Important Takeaways:

  • Malaria, a potentially deadly disease caused by a mosquito-borne parasite, is making inroads into the US.
  • Five new cases of malaria — one in Texas and four in Florida — are alarming officials because they were locally acquired, meaning a mosquito in the US was carrying the parasite.
  • That hasn’t happened since 2003 in Palm Beach County, Florida, according to the Centers for Disease and Prevention.
  • Almost all cases of malaria now seen in the US are from people who traveled outside the country, where they were exposed to disease-carrying mosquitoes.
  • But these five new cases — seen in people who hadn’t traveled abroad — raise fears that local mosquitoes could be spreading the disease to other people.
  • But people with the parasite in their blood don’t always have symptoms, making it easy for the disease to spread when an asymptomatic person is bit.
  • Symptoms of malaria include fever, shaking, chills, headache, muscle aches, nausea, vomiting, diarrhea and tiredness, according to the CDC.
  • If it’s not treated promptly, the infection can cause jaundice, anemia, kidney failure, seizures, mental confusion, coma and death.

Read the original article by clicking here.

Floods cut off communities in South Sudan’s Unity state

By Denis Dumo

JUBA (Reuters) – Severe flooding has hit South Sudan’s northern state of Unity, cutting off communities from accessing supplies of food and other vital commodities, a state official said on Friday.

More than 700,000 people have been affected by the worst flooding in the country for nearly 60 years, the U.N. refugee agency UNHCR said in October, blaming climate change.

In Unity, which borders Sudan, the floods have left a trail of food shortages, caused malnutrition in children and increased the spread of diseases such as malaria, said Lam Tungwar Kueigwong, the state’s minister of land, housing and public utilities.

Oil from the fields in the region had contaminated the water, he said, leading to the death of domestic animals.

The suffering caused by the floods, including food shortages and illnesses, is putting pressure on the health facilities, said international charity Médecins Sans Frontières, which operates in the area.

“We are extremely concerned about malnutrition, with severe acute malnutrition levels two times the WHO threshold, and the number of children admitted to our hospital with severe malnutrition doubling since the start of the floods,” MSF said.

For Nyatuak Koang, a mother of three boys and two girls, that concern is all too real for her after the floods forced her to move twice.

“We don’t have anywhere to sleep, we don’t have any mosquito nets and we don’t have material to cover our house,” she said.

Nearly a decade after South Sudan gained independence following a war, it faces the threat of conflict, climate change and COVID-19, the outgoing head of the U.N. mission in the country said in March.

Nearly all the population depends on international food aid, and most basic services such as health and education are provided by the United Nations agencies and aid groups.

(Writing by Duncan Miriri; Editing by Angus MacSwan)

A Chilean tree holds hope for new vaccines – if supplies last

By Aislinn Laing and Allison Martell

CASABLANCA, Chile (Reuters) – Down a dusty farm track in Chilean wine country, behind a wooden gate wrapped in chains, forestry experts are nursing a plantation of saplings whose bark holds the promise of potent vaccines.

Quillay trees, technically known as Quillaja saponaria, are rare evergreens native to Chile that have long been used by the indigenous Mapuche people to make soap and medicine. In recent years, they have also been used to make a highly successful vaccine against shingles and the world’s first malaria vaccine, as well as foaming agents for products in the food, beverage and mining industries.

Now two saponin molecules, made from the bark of branches pruned from older trees in Chile’s forests, are being used for a COVID-19 vaccine developed by drugmaker Novavax Inc. The chemicals are used to make adjuvant, a substance that boosts the immune system.

Over the next two years, Maryland-based Novavax plans to produce billions of doses of the vaccine, mostly for low- and middle-income countries, which would make it one of the largest COVID-19 vaccine suppliers in the world.

With no reliable data on how many healthy quillay trees are left in Chile, experts and industry officials are divided on how quickly the supply of older trees will be depleted by rising demand. But nearly everyone agrees that industries relying on quillay extracts will at some point need to switch to plantation-grown trees or a lab-grown alternative.

A Reuters analysis of export data from trade data provider ImportGenius shows that the supply of older trees is under increasing pressure. Exports of quillay products more than tripled to more than 3,600 tonnes per year in the decade before the pandemic.

Ricardo San Martin, who developed the pruning and extraction process that created the modern quillay industry, said producers must immediately work toward making quillay products from younger, plantation-grown trees.

“My estimate four years ago was that we were heading towards the sustainability limit,” he said.

San Martin said he has toiled through the COVID-19 pandemic in the basement of his oceanfront cabin in Sea Ranch, California, to refine a process that could help produce saponins from leaves and twigs in order to maximize the yield.

“I am working as though this needs to be done yesterday,” said San Martin, who is also sponsoring a project in which drones would count quillay trees in remote and hard-to-access forests, to determine how many are left.

Quillay producers and their customers say the harvest can continue for now without decimating the supply of older trees.

“We continue to monitor the situation in Chile, in close collaboration with our supplier, but at this time we are confident in our supply,” Novavax said in a statement to Reuters. The company also said it was confident that uses such as “life-saving vaccines will be prioritized.”

The desert-plant extract company Desert King International Ltd, which runs the Casablanca plantation, is Novavax’s sole supplier of quillay extracts and Chile’s largest quillay exporter by far.

The company’s manager in Chile, Andres Gonzalez, told Reuters it is set to produce enough quillay extract from older trees to make up to 4.4 billion vaccine doses in 2022. With new supplies from privately owned native forests, they have enough raw material to meet demand for the rest of this year and part of next, he said.

Gonzalez said the company, where San Martin is a consultant, has built a new production plant and has the capacity to supply other interested pharmaceutical firms – all without harming the forests.

He acknowledged, however, that “at some point these native forests will come to an end.”

“We want to start having very productive plantations, and we are working on that,” he said.

A relatively small volume of quillay extract is required to make vaccines – just under one milligram per dose – but the supply is stretched by the demand from other industries. Quillay products are used, for instance, as a natural additive in animal feed, a biopesticide and an agent to reduce pollution in mining.

Individual quillay trees grow outside of Chile, but Chile is the only country where mature quillay is harvested from forests in large quantities.

AN ELUSIVE INGREDIENT

Novavax’s adjuvant, known as Matrix-M, contains two key saponin molecules. One of those, called QS-21, is more difficult to access because it is found mainly in trees that are at least 10 years old.

Among major pharmaceutical companies, only GlaxoSmithKline PLC and Novavax have bet heavily on QS-21, a relatively new pharmaceutical ingredient.

GSK’s highly successful vaccine against shingles, Shingrix, and several other promising experimental vaccines contain QS-21 supplied by Desert King. In a statement, GSK said it has “no specific challenges relating to sustainable supply” of QS-21.

The quillay-based adjuvant used in Shingrix is also part of the world’s first malaria vaccine, Mosquirix. Despite low efficacy, it was approved by European regulators in 2015 and recommended for pilot introduction by the WHO in 2016 because of dire need.

No other COVID-19 vaccine manufacturers are relying on quillay bark extracts. Some drugmakers are developing synthetic alternatives, but these could be years from regulatory approval. Switching out the ingredients in any existing vaccine would require new clinical studies to prove the product is safe and effective.

The Massachusetts-based pharmaceutical company Agenus stopped selling bark-derived QS-21 several years ago to focus full-time on trying to grow it from quillay plant cells in a laboratory.

“The shortage of QS-21 has been an issue for a while,” said Jason Paragas, Agenus vice president of strategic initiatives and growth exploration. “We saw it before COVID, and we made the hard decision that we had to change.”

Paragas said it is too soon to say when an alternative could be ready.

Entrepreneur Gaston Salinas said his Davis, California-based startup Botanical Solution Inc can already produce QS-21 from quillay tissue starting with seeds in the lab, and aims to eventually produce the chemical on a large scale to supply pharmaceutical companies.

“You cannot afford to over-exploit the native Chilean forest because of a desire to develop modern vaccines. You need to find other ways to develop your products, even if it’s something so important, ” he said.

AN EYE TOWARD THE FUTURE

Inside the gate of the carefully guarded Desert King plantation, gardeners carefully tend to the young trees using fertilizers and bountiful supplies of water. They were cloned from full-grown cousins whose dusty gray bark was especially rich in saponins.

If all goes well, the plantation could be producing for one customer in two to three years, according to Desert King’s business development manager Damian Hiley. He declined to name the company.

Desert King has its eye on future vaccines, some already in the works.

In early 2020, for instance, GSK licensed an experimental tuberculosis vaccine that contains GSK’s QS-21-based adjuvant to the Bill and Melinda Gates Medical Research Institute. It showed promising results in a mid-stage trial.

And in April, researchers at Oxford University announced that a new malaria vaccine containing Novavax’s Matrix-M adjuvant appeared to be highly effective in a trial involving 450 children in Burkina Faso.

Gustavo Cruz, a researcher at the University of Chile who worked with San Martin to industrialize production of quillay, said he generally trusts quillay producers to manage supply and demand. He is more worried about other threats – specifically drought and fire.

“The trees do eventually regrow,” he said, “but there comes a time when they don’t anymore.”

(Aislinn Laing reported from Casablanca; Allison Martell from Toronto. Additional reporting by Nivedita Balu in Bangalore. Editing by Caroline Humer, Peter Henderson and Julie Marquis)

More than 200,000 flee “apocalyptic” conflict in Central African Republic

By Emma Farge

GENEVA (Reuters) – More than 200,000 people have fled fighting in the Central African Republic (CAR) since violence erupted over a December election result, the U.N. refugee agency (UNHCR) said on Friday, with nearly half crossing into the Democratic Republic of Congo.

The CAR army, backed by U.N., Russian and Rwandan troops, has been battling rebels seeking to overturn a Dec. 27 vote in which President Faustin-Archange Touadera was declared the winner.

“Refugees have told UNHCR that they fled in panic when they heard gun shots, leaving their belongings behind,” spokesman Boris Cheshirkov told journalists in Geneva.

The nation of nearly five million people, larger than mainland France, Belgium and Luxemburg combined and rich in diamonds, timber and gold, has struggled to find stability since a 2013 rebellion ousted former president Francois Bozize.

The current fighting between a coalition of militias on the one side and the national army and its backers on the other was sparked by a Constitutional Court decision to bar Bozize’s candidacy in the Dec. 27 presidential election.

Former prime minister Martin Ziguele, who came third in the Dec. 21 election, said on Friday there was fighting across the country every day, preventing movement between towns, and pushing more people to flee.

“Everyone is focused on the main transport route between the capital and eastern Cameroon for supplies, but inside the country, there is no movement,” Ziguele told Reuters by phone from Bangui.

“I cannot leave Bangui and go 90 km (60 miles) without a heavily-armed army escort. Imagine then the population. Add the curfew and the state of emergency, it is really an apocalyptic situation,” Ziguele said.

SEX FOR FOOD

About 92,000 refugees have reached DRC and more than 13,000 have crossed into Cameroon, Chad and the Republic of Congo. The rest are displaced inside the Central African Republic, the UNHCR said.

Ongoing attacks has hampered humanitarian access and the main road used to bring supplies has been forced shut inside the country and many are now facing “dire conditions,” UNHCR’s Cheshirkov said.

Some of the displaced are so desperate they have agreed to sex in return for food, he added. Malaria, respiratory tract infections, and diarrhea have become common.

He also voiced concern about the reported presence of armed groups in the Batangafo and Bria camps for the displaced.

“Those armed groups are trying in some cases to restrict movements and in some cases forcibly recruit. So this is a very concerning situation,” he told the briefing.

Ziguele said that while a substantial increase in peacekeepers, as requested by the U.N. envoy in Bangui, was welcomed, a dialogue between all parties was urgently needed.

“A military surge is not the only solution to tackle the security, humanitarian and economic crisis that is threatening to put one of the world’s least developed countries into a complete coma,” he said.

(Reporting by Emma Farge, additional reporting by Bate Felix in Dakar; editing by Stephanie Nebehay and Philippa Fletcher)

Violence, floods in South Sudan’s Warrap state displace thousands

By Denis Dumo

WARRAP STATE, South Sudan (Reuters) – James Athian and his nine children have been living in a makeshift camp in South Sudan’s Warrap state for two months since floods destroyed their house.

Athian and his family are among the 377,300 people displaced by floods and violence in Warrap since July, the United Nations Office for the Co-ordination of Humanitarian Affairs said. Nationwide, more than one million people have been temporarily forced from their homes.

“I have nine children and every time they get sick of malaria. (There is) no food and no good place to sleep,” Athian told Reuters, standing near submerged houses in his village of Mangar Ajak.

Before the flooding, oil-producing South Sudan had already gone through five years of civil war, which ended in 2018 with a fragile peace deal.

The worst rains in living memory have meant that roughly half of South Sudan’s 78 counties have large swathes of land under water, the U.N. says.

Aleu Akol, 59, who has been at Mangar Ajak for one-and-a-half months, said people received aid from humanitarian organizations, but he had to find other means to supplement that.

“We fish in this water to survive because I don’t have work that can generate income. See, my legs are swelling from (being in) the water,” he said.

Attacks by bandits and ethnic militias are still common, compounding the effects of the floods.

“People are being killed randomly and insecurity is so bad that people were not able to cultivate (their crops) in May,” Moses Athian Paul, coordinator of the Relief and Rehabilitation Commission of Warrap’s Tonj County, said.

“If people don’t get food from the government of the World Food Program by February, many will die of hunger.”

(Writing by George Obulutsa; Editing by Mike Collett-White)

How a vaccine made of mosquito spit could help stop the next epidemic

By Clare Baldwin

(Reuters) – Five years ago, in an office complex with a giant sculpture of a mosquito just northwest of Phnom Penh, Jessica Manning struck on a novel idea. Rather than spend more years in what felt like a futile search for a malaria vaccine, she would take on all mosquito-borne pathogens at once.

Her idea revolved around mosquito spit.

A lab technician Nhek Sreynik works with mosquitoes, at a lab in Kompong Speu Province, in Cambodia, June 11, 2020. REUTERS/Chantha Lach

Building on the work of colleagues and other scientists, Manning, a clinical researcher for the U.S. National Institute of Allergy and Infectious Diseases, believed she could use pieces of mosquito saliva protein to build a universal vaccine.

The vaccine, if it pans out, would protect against all of the pathogens the insects inject into humans – malaria, dengue, chikungunya, Zika, yellow fever, West Nile, Mayaro viruses and anything else that may emerge.

“We need more innovative tools,” said Manning. A vaccine like this would be “the Holy Grail.”

On Thursday, The Lancet published the initial results of this work with her colleagues: the first-ever clinical trial of a mosquito spit vaccine in humans.

The trial showed that an Anopheles mosquito-based vaccine was safe and that it triggered antibody and cellular responses.

Michael McCracken, a researcher not involved in the study, called the initial results “foundational.”

“This is big, important work,” said McCracken, who studies immune responses to mosquito-borne viruses at the Walter Reed Army Institute of Research in Maryland. “Mosquitoes are arguably the deadliest animal on Earth.”

A boy sits in the pediatrics ward at Kampong Speu District Referral Hospital, at the beginning of a dengue, also called ‘breakbone fever’, epidemic in Krong Chbar Mon, Cambodia April 2019. Jessica Manning/Handout

Malaria alone kills more than 400,000 people each year, according to the World Health Organization. Those deaths occur mostly in poor countries that do not receive as much vaccine research and funding. Because of global warming, however, those mosquitoes that thrive in the tropics are moving into more countries each year.

The global disruption of the COVID-19 pandemic has brought a sharp focus to infectious diseases and vaccine research. One of the key areas of concern are pathogens transmitted by mosquitoes.

The novel coronavirus, believed to have originated in bats, has so far infected more than 7.4 million people and killed nearly 420,000 worldwide. The Asian Development Bank estimates the pandemic could cost the global economy as much as $8.8 trillion.

TARGETING THE CARRIER

Manning’s research is specific to mosquitoes but is an example of how scientists are broadening their thinking about how to tackle infectious diseases, and the new types of tools they are developing.

What Manning is looking for is called a vector-based vaccine. A vector is the living organism – like a mosquito – that transmits a pathogen such as malaria – between humans, or from animals to humans.

All existing vaccines for humans target a pathogen. Manning’s goes after the vector.

The idea is to train the body’s immune system to recognize the saliva proteins and mount a response that would weaken or prevent an infection.

Scientists have known for decades that mosquito spit helps establish mosquito-borne infections and enhance their severity. Just recently, scientists have begun to exploit this.

A study of macaque monkeys published in 2015 showed vaccination with sand fly saliva reduced leishmaniasis lesion size and parasite load. A study of mice published in 2018 showed immunization with Anopheles mosquito spit protected against malaria. Another mouse study published last year showed immunization with Aedes mosquito saliva improved survival against the Zika virus.

The study published in The Lancet was conducted in 2017.

The Phase I trial conducted at the National Institutes of Health Clinical Center in Bethesda, Maryland, tested for safety and side effects in 49 healthy volunteers.

Participants were randomly assigned to receive one of two versions of the vaccine or a placebo. After a few weeks, hungry mosquitoes were placed on the arms of study participants. The study measured immune response to the mosquito spit proteins but did not involve pathogens.

More trials are needed to determine the effect the mosquito spit vaccine would have against actual pathogens.

No systemic safety concerns were identified. One participant developed an 8-centimeter (3.15 inches) reddened area around the injection site and was treated with steroids and antihistamines.

“I’m not as worried about redness as I would be about something more systemic like fever, headache, muscle aches, nausea or vomiting,” said Stephen Thomas, an infectious disease expert at SUNY Upstate Medical University who was not involved with the study.

Thomas has previously worked on dengue vaccine programs for the U.S. Department of Defense and helped manage its response to Ebola and the Zika virus.

Another scientist at the University of Maryland is running a follow-up trial with more mosquito spit proteins and a different vaccine formulation.

Meanwhile, Manning has returned to Cambodia and is running a field study to identify vaccine-candidate spit proteins in Aedes mosquitoes. She also has a separate project sequencing the genomes of all pathogens found in Aedes and Culex mosquitoes, some of which can infect humans.

One worrying discovery so far? “They carry a ton of different viruses that we are only just discovering.”

(Reporting by Clare Baldwin; Editing by Elyse Tanouye and Bill Berkrot)

‘Fragile’ Africa prepares for high risk of coronavirus spread

By Juliette Jabkhiro and Kate Kelland

DAKAR/LONDON (Reuters) – An isolation ward stands ready at a hospital in Khartoum, Sudan. Laboratories in Senegal and Madagascar have the testing equipment they need. Passengers arriving at airports in Gambia, Cameroon and Guinea are being screened for fever and other viral symptoms.

Africa’s Centres for Disease Control and Prevention says it has activated its emergency operation centre in the face of what global health officials say is a high risk the coronavirus disease epidemic that began in China will spread to its borders.

On a poor continent where healthcare capacity is limited, early detection of any outbreak will be crucial.

The fear is great that a spreading epidemic of coronavirus infections will be hard to contain in countries where health systems are already overburdened with cases of Ebola, measles, malaria and other deadly infectious diseases.

“The key point is to limit transmission from affected countries and the second point is to ensure that we have the capacity to isolate and also to provide appropriate treatment to people that may be infected,” said Michel Yao, emergency operations program manager at the World Health Organization’s regional office for Africa in Brazzaville, Congo.

The Democratic Republic of Congo is barring its citizens from flying to China. Burkina Faso has asked Chinese citizens to delay travelling to Burkina, and is warning that they face quarantine if they do. Kenya, Tanzania and Rwanda have all suspended flights to China.

“What we are emphasising to all countries is that they should at least have early detection,” Yao said.

“We know how fragile the health system is on the African continent and these systems are already overwhelmed by many ongoing disease outbreaks, so for us it is critical to detect earlier to that we can prevent the spread.”

John Nkengasong, Africa’s CDC director, told a briefing in the Ethiopian capital Addis Ababa this week that the activation of the emergency operation centre would create a single incident system to manage the outbreak across the continent.

The Africa CDC will also hold a training workshop in Senegal for 15 African countries on laboratory diagnosis, he said.

The continent has more than doubled the number of laboratories now equipped to diagnose the viral infection, this week adding facilities in Ghana, Madagascar and Nigeria and to established testing labs in South Africa and Sierra Leone.

“By the end of the week we expect that an additional 24 countries (in Africa) will receive the reagents needed to conduct the tests and will have the test running,” a spokeswoman for the WHO’s Africa Region told Reuters.

(Additional reporting by Giulia Paravicini in Addis Ababa, Benoit Nyemba in Kinshasa, Thiam Ndiaga in Ouagadougou, Josiane Kouagheu in Douala, Pap Saine in Banjul and Saliou Samb in Conakry. Writing and reporting by Kate Kelland; Editing by Pravin Char)

Number of hungry children in Africa’s Sahel hits 10-year high

Rural women who have carried their malnourished children for days across the Sahel desert in search of [food] rush into an emergency feeding center in the town of Guidan Roumdji, southern Niger, July 1, 2005. [Niger's severe food crisis could have been prevented if the United Nations had a reserve fund to jump-start humanitarian aid while appeals for money were considered, a senior U.N. official said on July 19. Some 3.6 million people are in need of food, among them 800,000 malnourished children. About 150,000 may die unless food arrives quickly in the impoverished West African nation of 13 million.] Picture taken July 1, 2005. - PBEAHUNYKGE

By Umberto Bacchi

LONDON (Thomson Reuters Foundation) – The number of hungry children in West Africa’s Sahel region reached a 10-year high in 2018 due to poor rains, conflict and high food prices, the United Nations said on Friday.

More than 1.3 million children under the age of five suffered from severe malnutrition this year in the six worst hit countries in the semi-arid belt below the Sahara – a 50 percent increase on 2017, said the U.N. children’s agency UNICEF.

“When children suffer from severe acute malnutrition, they are more vulnerable to illnesses such as malaria and waterborne diseases,” Marie-Pierre Poirier, UNICEF regional director for West and Central Africa said in a statement.

Hunger is a recurrent scourge in the region, whose growing population grapples with high poverty rates and periodic droughts, the agency said.

This year the problem was particularly acute across Burkina Faso, Chad, Mali, Mauritania, Niger and Senegal, it added.

An estimated 6 million people did not have enough to eat across the region during the lean season, according to the U.N. food agency (FAO).

Pastoralist communities were among the worst hit because poor rains meant there was not enough vegetation for grazing, said Coumba Sow, the FAO’s regional coordinator for resilience.

The Sahel has only one growing season and if it goes poorly due to climate shocks or conflict people must survive on whatever they have until the next one.

Global warming exacerbates the problem by making rainfall more erratic, said Sow, adding the rains were late and suffered a prolonged break, causing many farmers to lose half their seeds.

U.N. agencies and local governments were currently evaluating production levels for the new season, she said.

“We still hope that we will be able to get some good results in harvest, but it is too early to say,” she told the Thomson Reuters Foundation.

(Reporting by Umberto Bacchi @UmbertoBacchi, Editing by Claire Cozens. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s and LGBT+ rights, human trafficking, property rights, and climate change. Visit http://news.trust.org)

Infant mortality and malaria soar in Venezuela, according to government data

Pregnant women lay on beds without sheets during their labour at a maternity hospital in Maracaibo, Venezuela June 19, 2015. REUTERS/Isaac Urrutia

By Alexandra Ulmer

CARACAS (Reuters) – Venezuela’s infant mortality rose 30 percent last year, maternal mortality shot up 65 percent and cases of malaria jumped 76 percent, according to government data, sharp increases reflecting how the country’s deep economic crisis has hammered at citizens’ health.

The statistics, issued on the ministry’s website after nearly two years of data silence from President Nicolas Maduro’s leftist government, also showed a jump in illnesses such as diphtheria and Zika. It was not immediately clear when the ministry posted the data, although local media reported on the statistics on Tuesday.

Recession and currency controls in the oil-exporting South American nation have slashed both local production and imports of foreign goods, and Venezuelans are facing shortages of everything from rice to vaccines. The opposition has organized weeks of protests against Maduro, accusing him of dictatorial rule and calling for elections.

In the health sector, doctors have emigrated in droves and patients have to settle for second-rate treatment or none at all. A leading pharmaceutical association has said roughly 85 percent of medicines are running short. Venezuelans often barter medicine, post pleas on social media, travel to neighboring countries if they can afford it, or line up for hours at pharmacies.

The Health Ministry had stopped releasing figures after July 2015, amid a wider data blackout. It was not clear why it published this latest batch of data.

Its statistics for 2016 showed infant mortality, or death of children aged 0-1, climbed 30.12 percent to 11,466 cases last year. The report cited neonatal sepsis, pneumonia, respiratory distress syndrome, and prematurity as the main causes.

Hospitals often lack basic equipment like incubators, and pregnant women are struggling to eat well, including taking folic acid, factors that can affect a baby’s health.

(To read the story on Venezuelan women seeking sterilizations as crisis sours child-rearing, click http://www.reuters.com/article/us-venezuela-sterilizations-idUSKCN10E1NK)

Maternal mortality, or death while pregnant or within 42 days of the end of a pregnancy, was also up, rising 65.79 percent to 756 deaths, the report said.

The Health Ministry did not respond to a request for further information. Maduro’s government says a coup-mongering elite is hoarding medicines to stoke unrest.

‘TURMOIL’

While Venezuelans are acutely aware of the country’s health issues, the ministry’s statistics bulletin shocked some in the medical community.

“The striking part is turmoil in almost all the categories that this bulletin addresses, with particularly significant increases in the infant and maternal health categories,” said Dr. Julio Castro, an infectious disease specialist and an outspoken critic of the government’s health policies.

Doctors say the health bulletins, meant to be released weekly, should be published in a timely fashion to alert medical practitioners to national trends and threats.

Venezuela, for instance, had controlled diphtheria, a bacterial infection that is fatal in 5 to 10 percent of cases, in the 1990s. Doctors last year sounded the alarm that it had returned, but the government initially said there were no proven cases and admonished those seeking to spread “panic.”

The data now shows diphtheria affected 324 people – up from no cases the previous year.

Diphtheria was once a major global cause of child death but is now increasingly rare thanks to immunizations, and its return showed how vulnerable the country is to health risks.

Reuters documented the case of a 9-year-old girl, Eliannys Vivas, who died of diphtheria earlier this year after being misdiagnosed with asthma, in part because there were no instruments to examine her throat, and shuttled around several run-down hospitals.

(For a story on “Venezuelan girl’s diphtheria death highlights country’s health crisis”, click http://www.reuters.com/article/us-venezuela-health-idUSKBN15P1DA)

There were also 240,613 cases of malaria last year, up 76.4 percent compared with 2015, with most cases of the mosquito-borne disease reported in the rough-and-tumble Bolivar state.

Cases of Zika rose to 59,348 from 71 in 2015, reflecting the spread of the mosquito-borne virus around Latin America last year. There was no data for likely Zika-linked microcephaly, where babies are born with small heads, although doctors say there have been at least several dozen cases.

(To read the story on “Amid government silence, Venezuela’s microcephaly babies struggle”, click http://www.reuters.com/article/us-health-zika-venezuela-idUSKBN12H1NY)

(Reporting by Alexandra Ulmer; Editing by Girish Gupta and Frances Kerry)