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The mpox strain spreading now is different from the one in 2022: Here's what to know

The World Health Organization’s decision to declare mpox a global public health emergency for the second time in two years may seem like déjà vu — but there are key differences between the strain that’s causing international concern now and the one that spread in 2022.

Mpox, formerly known as monkeypox, is a viral infection characterized by painful lesions. It’s spread by direct contact with an infected person, animal or contaminated items like clothing or bedding.

The virus is classified into two distinct groups: clade I and clade II. 

Clade II was responsible for the 2022 outbreak, which has led to around 100,000 cases worldwide . 

But now, a version of clade I has spread internationally. The outbreak started in January 2023 in the Democratic Republic of Congo, and has since reached 12 other countries in the region.

On Thursday, Sweden confirmed the first known infection of clade I outside Africa , though Swedish health officials said the person was infected while spending time in Africa. Health authorities in Pakistan also confirmed a case of mpox on Friday but have not identified the strain yet. 

Clade I is more transmissible than clade II and capable of being more severe, so infectious disease experts are concerned about further international spread.

“We should have learned a lesson from 2022 that an infection anywhere is potentially an infection everywhere,” said Anne Rimoin, an epidemiology professor at the University of California, Los Angeles Fielding School of Public Health.

How does this version of mpox spread?

Mpox has historically spread in a few ways. The first is through close, personal contact with an infected person, such as skin-to-skin contact with rashes or with saliva or mucus. The second is via contact with contaminated materials. And the third is contact with infected animals: hunting, trapping or cooking them, touching sick rodents or getting bitten or scratched. 

In 2022, the version of clade II that spread globally, dubbed clade IIb, was passed primarily through sexual contact, particularly among men who have sex with men.

In the Democratic Republic of Congo recently, clade Ib has also been spreading through sexual contact among female sex workers and men who have sex with men. Research that hasn’t yet been published or peer reviewed linked an outbreak in an eastern mining town in Congo to professional sex work in bars.

But that’s not the only way the virus is being transmitted. Dr. Stuart Isaacs, an associate professor of medicine at the University of Pennsylvania, said much of the spread of clade I could be due to exposure to animals and transmission within households, but limited surveillance in the regions where the virus is make it difficult to know for sure. 

Isaacs said there’s early evidence that clade Ib has certain “properties that are allowing it to spread more readily person to person.”

How severe are the recent cases?

In the past, outbreaks of clade I have been deadlier than clade 2, killing up to 10% of people who got sick . But more recent outbreaks have had lower death rates. Out of an estimated 22,000 cases in this outbreak in Congo , more than 1,200 people have died — which puts the fatality rate at just above 5%. 

By comparison, clade II outbreaks in Africa have generally had a mortality rate of around 1%, and just 0.2% of cases linked to the 2022 global outbreak were fatal.

Rimoin said the disease’s severity “can have less to do with the actual clade and more to do with route of transmission, the immune system of the individual, the source of the infection.” 

The threat in the U.S. could be milder than in Africa, according to Marc Siegel, an associate professor of medicine at the George Washington School of Medicine and Health Sciences.

“The underlying health conditions of the population in the DRC are probably contributing to the current case fatality rate,” he said, using the acronym for the Democratic Republic of Congo. “With less malnutrition and better access to health care resources, I would imagine that the case fatality rate will not be as high as we’re seeing in the DRC.”

Vaccines for mpox are also widely available in the U.S., following a major rollout effort in 2022. Two doses of the mpox vaccine or a previous clade II infection should protect against severe illness from clade I, the Department of Health and Human Service said Wednesday.

Do mpox symptoms differ between the clades?

Symptoms of the two mpox clades can be difficult to distinguish from each other.

The illness generally starts with a rash that progresses to small bumps on the skin, followed by blisters that fill with whitish fluid — a hallmark of the disease — and eventually scab over. People may also experience a fever, headache, muscle aches, back pain, low energy and swollen lymph nodes.

These symptoms often disappear on their own within a few weeks. But in severe cases, people may develop larger, more widespread lesions, secondary bacterial infections, pneumonia, heart inflammation or swelling of the brain. Immunocompromised people may develop atypical symptoms and have a greater risk of hospitalization and death. 

Historically, mpox lesions have tended to appear on the face, chest, palms of the hands and the soles of the feet. But during the 2022 outbreak, people frequently developed lesions around the genital and anal region or inside the mouth and throat, presumably because of how the virus was spreading at the time . The lesions were also fewer in number and less pronounced overall.

Some cases of this nature have also been detected in the current outbreak in Congo. 

“There is talk that there are more people that have lesions around the genitals this time around than previous clade I outbreaks,” said Amira Albert Roess, a professor of global health and epidemiology at George Mason University. “It’s going to take us some time to really understand what may be going on here.”

Aria Bendix is the breaking health reporter for NBC News Digital.

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Tracking Hurricane Ernesto

By William B. Davis ,  Madison Dong ,  Judson Jones ,  John Keefe and Bea Malsky

Ernesto was a Category 1 hurricane in the North Atlantic Ocean Monday morning Atlantic time, the National Hurricane Center said in its latest advisory .

The hurricane had sustained wind speeds of 85 miles per hour. Follow our coverage here .

What does the storm look like from above?

Satellite imagery can help determine the strength, size and cohesion of a storm. The stronger a storm becomes, the more likely an eye will form in the center. When the eye looks symmetrical, that often means the storm is not encountering anything to weaken it.

Ernesto is the fifth named storm to form in the Atlantic in 2024.

In late May, the National Oceanic and Atmospheric Administration predicted that there would be 17 to 25 named storms this year, an above-normal amount .

This season follows an overly active year, with 20 named storms — including an early storm later given the official name of “Unnamed.” It was the eighth year in a row to surpass the average of 14 named storms. Only one hurricane, Idalia, made landfall in the United States.

Typically, the El Niño pattern that was in force last season would have suppressed hurricanes and reduced the number of storms in a season. But in 2023, the warm ocean temperatures in the Atlantic blunted El Niño’s usual effect of thwarting storms.

The warm ocean temperatures that fueled last year’s season returned even warmer at the start of this season, raising forecasters’ confidence that there would be more storms this year. The heightened sea surface temperatures could also strengthen storms more rapidly than usual.

To make matters worse, the El Niño pattern present last year is also diminishing, most likely creating a more suitable atmosphere for storms to form and intensify.

Hurricanes need a calm environment to form, and, in the Atlantic, a strong El Niño increases the amount of wind shear — a change in wind speed and/or direction with height — which disrupts a storm's ability to coalesce. Without El Niño this year, clouds are more likely to tower to the tall heights needed to sustain a powerful cyclone.

Sources and notes

Tracking map Tracking data is from the National Hurricane Center. The map shows probabilities of at least 5 percent. The forecast is for up to five days, with that time span starting up to three hours before the reported time that the storm reaches its latest location. Wind speed probability data is not available north of 60.25 degrees north latitude.

Wind arrivals table Arrival times are generated from a New York Times analysis of National Hurricane Center data. Geographic locations use data from the U.S. Census Bureau and Natural Earth. Time zones are based on Google. The table shows predicted arrival times of sustained, damaging winds of 58 m.p.h. or more for select cities with a chance of such winds reaching them. If damaging winds reach a location, there is no more than a 10 percent chance that they will arrive before the “earliest reasonable” time and a 50 percent chance they will arrive before the “most likely” time.

Radar map Radar imagery is from the National Oceanic and Atmospheric Administration via Iowa State University. These mosaics are generated by combining individual radar stations that comprise the NEXRAD network.

Storm surge map Storm surge data is from the National Hurricane Center. Forecasts only include the United States Gulf and Atlantic coasts, Puerto Rico, and the U.S. Virgin Islands. The actual areas that could become flooded may differ from the areas shown on this map. This map accounts for tides, but not waves and not flooding caused by rainfall. The map also includes intertidal areas, which routinely flood during typical high tides.

Satellite map Imagery is from the National Oceanic and Atmospheric Administration.

Precipitation map Data for multi-day forecasts or observed rainfall totals are from the National Weather Service. The 1-day forecast is from the National Oceanic and Atmospheric Administration.

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The voyage of the Altar Stone: A Stonehenge mystery solved (maybe)

Researchers revealed that the long-mysterious Altar Stone at the heart of the world’s most famous prehistoric monument came from faraway Scotland.

LONDON — The world’s most famous prehistoric monument continues to surprise and amaze. Researchers on Wednesday revealed that the long-mysterious “Altar Stone” at the heart of Stonehenge came from faraway Scotland, raising tantalizing new questions about how — and why — a six-ton slab of sandstone made its way from north to south 5,000 years ago.

Aliens? Not likely, unless the government knows something we don’t. Could it have been deposited nearby by ice - age glaciers that covered Britain during the woolly mammoth Pleistocene? Probably not. The ice sheets in Scotland were moving north, not south, and so deposited their moraines in the opposite direction.

So we are left with two theories: that the Altar Stone was dragged 500 miles or more overland by our Neolithic forebears, before the invention of the wheel, across the high hills and through the dense forests of prehistoric Britain; or, as these scientists speculate, that the stone was ferried via sea by Stone Age mariners, a routing that “demonstrates a high level of societal organization with intra-Britain transport during the Neolithic period.”

Meaning? That Neolithic peoples were capable of delivering a Stone Age prehistoric FedEx package weighing 13,227 pounds from as far north as the Orkney Islands off the coast of Scotland to the Salisbury Plain southwest of present-day London, with the understanding that six tons is approximately the weight of a full-grown male African elephant.

Such a delivery might have taken a decade or more — but “just in time” is relative.

At this point, the scientists say your guess is about as good as theirs, which is why Stonehenge remains “a wonder of the world.”

The new research, led by scientists at Curtin University in Australia, is jaw-dropping — upending a century of geological inquiry to conclude that the Altar Stone, long believed to originate from Wales, actually hails from Scotland, and would have had to make a trip of 450 to 600 miles.

The stone must have meant a lot to the people back then. There is other evidence of other stones being moved from stone circle to stone circle.

“But this is a very, very long way,” said Heather Sebire, senior curator at Stonehenge for the group English Heritage. She called the new findings “amazing.”

What was Stonehenge — a burial site, a meeting place, an astronomical clock or a “computer”?

The Altar Stone has always been a spooky outlier, unique in its composition and its placement, and one of the most analyzed pieces of stone ever, a kind of moon rock for the archaeologist set.

You can visit it today. It lies at the center, the heart, of the stone circle but was found recumbent, lying flat, on the horizontal. When did it arrive? Maybe 2500 B.C. Could it have come to Stonehenge later? Sure, but the builders might have had to squeeze it into place.

Nobody knows whether the Altar Stone served as an altar, just as the nearby “ Slaughter Stone ” probably had nothing to do with sacrifice — human or otherwise. These were just the romantic (lurid) names that the early pearl-clutching antiquarians gave the rocks, imagining druids doing their nasty business to appease some unholy deities.

A 25-year-old PhD student named Anthony Clarke, who is originally from Wales and visited Stonehenge as a child, led the search for the provenance of the Altar Stone.

Clarke and colleagues examined two polished samples of the stone, each thinner than a strand of hair — and wow.

Robert Ixer, an archaeologist at University College London, an authority on the geology of Stonehenge and a co-author of the paper that appears in the journal Nature, said the team in Australia had just two samples of the Altar Stone to work with.

“But that was enough,” he told The Washington Post.

He called the new provenance of the Altar Stone “astonishing.” Ixer spent much of his career assuming the Altar Stone was from Wales, still a far distance, but not nearly as far away as Scotland.

So precious is the Neolithic monument, a World Heritage site, that it is no longer possible to take a hammer and chisel, as the Victorians and their predecessors did, and knock off a chunk to examine.

Ixer explained that the two samples in the research paper included one collected in the 1840s with a hammer, and a second from the 1920s, which was excavated at the site as a bit of detritus. And it is those two slivers that led researchers to a conclusion about the geographic provenance of the Altar Stone.

“They are both fragments of the Altar Stone with the exact same characteristics,” Ixer said.

The analysis of the Altar Stone was also overseen by Chris Kirkland at the Timescales of Mineral Systems Group within Curtin’s School of Earth and Planetary Sciences. The cutting-edge laboratory usually spends its time helping to look for iron ore and gold deposits.

In this case, the group used lasers to light and mass spectrometers to explore the individual grains in the Altar Stone sliver, paying most attention to the minerals apatite, rutile and zircon, which decays at a known rate and so becomes a kind of “geologic clock” for dating material.

They found the specific grains in the Altar Stone contained minerals that were as old as 2 billion years and others 450 million years old, which produced a kind of chemical fingerprint.

The geologists from Curtin say with 95 percent certainty that the Altar Stone is Old Red Sandstone from the Orcadian Basin in northeast Scotland, an area that stretches from the Orkney Islands to Inverness.

Two other stones make up most of the Stonehenge assemblage. The big sarsen stones, which form the upright posts and lintels in the postcards, the dramatic images of the monument, came from nearby quarries, not many miles away.

The others are called “bluestones,” which form the outer circle, and those stones came from quarries in Wales.

How all the sarsen and bluestones were moved remains a hotly debated topic — were they wrapped in willow baskets and rolled? Or pushed along on sleds, or rolled on logs, or just dragged by humans with rope and leather, maybe helped by oxen?

As for the Altar Stone, these researchers like a maritime route. They point out that Neolithic people introduced the common vole from continental Europe to Orkney. There is also evidence of the long-distance marine transport of cattle and quarried stone tools and pottery. Goods and animals crossed the English Channel way back then.

Researchers have found evidence of Neolithic dugout canoes — but mostly in rivers, not seaside. Seagoing rafts, perhaps boats with hulls lined with animal skins? That is a good guess, but there is little physical evidence on the shorelines because these kinds of materials decay quickly.

The geologists here say that more geologists will now work hard to pinpoint the exact place in Scotland where the Altar Stone came from — and they confess that another generation of archaeologists will puzzle to figure out how and why the stone was moved, perhaps never to know.

“As these things may be lost to history,” as Clarke said. Or maybe not.

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Breaking news, we spent $118k on a 9-month world cruise to see 65 countries: ‘have to be insane’.

A couple splashed out $118K on a nine-month cruise around the world – after realizing “life’s too short.”

Andrew Kenney, 27, and his wife, Ale, 29, set off on their epic cruise – calling at 150 ports in 65 countries – in December 2023.

The couple decided to embark on the mammoth trip after both of their dads passed away – not wanting to wait until they retired to travel.

So far, the couple have visited Australia, France, Greenland and the Bahamas on their “once in a lifetime trip” and say they’ve made friends for life onboard.

But the pair are not completely letting their hair down – Andrew has been doing freelance videography and Ale has been vlogging their journey.

Ale, a pharmacy technician, from Panama City, Florida, US, said: “Both of our fathers passed away when they were very young and didn’t get to do much traveling.

“After my dad passed away we said we hoped we would get to travel when we retire.

“But we thought that one of us might die before we get to travel so we decided to travel the world together.”

Andrew, a videographer and photographer, added: “It has been an incredible experience.

“If we can go now then why shouldn’t we?

“After we spoke to friends and family about it they said we should do it so here we are.”

Ale’s dad, Lynn Ellenburg, passed away aged 57 in 2021 after a short illness and Andrew’s dad, Chris Kenney, then 30, died when he was two years old in 1999

After her dad’s death, Ale said she saw an advert for the Royal Caribbean Ultimate World Cruise and brought it up to Andrew.

She said: “I brought it up as a joke because I thought you would have to be insane to go on a nine-month cruise.

“But, we started looking into it and the fact it was a full world cruise where we would hit seven continents and see the world wonders won us over.”

The couple set off on the cruise from Miami, Florida, on December 10, 2023.

They say that it has been a “once-in a-lifetime trip” and they hope to return to some of their favourite locations in the future.

She said: “The things we have experienced are what we read about or watched on TV.

“Like who gets to see the Great Wall of China or the Taj Mahal?

“We loved Japan, it was incredible the food was amazing and the people were super helpful and friendly.

“South Africa was beautiful and unlike anywhere we have ever been.

“French Polynesia is the most perfect place on the planet, we realised that this was a sample of places we will return to.”

By the time the cruise ends, Andrew and Ale will have been onboard for nine months.

They said they have been “surprised” by the community they have met on the ship.

Ale said: “I was not expecting the community on board, with us all being forced into these different circumstances we have found some lifelong friends.

“We have made a community with like-minded people who love to travel.

“It has been a whole level that I did not anticipate.”

The couple paid $59k each for their room and said it was “worth it.”

Andrew said: “You get three loads of laundry done every week, unlimited wifi, free food and drinks and get to see seven world wonders – all included in the price.

“They really packed it worth it, we knew if we had taken all these trips individually it would be more expensive.

“It is like you pay for your rent in advance for nine months.”

Andrew added: “I have been able to work on the shop as an editor and do filming for people who need it on board.

“There was a lot of preparation for us to come on board, we have managed to pack a lot of our travel into these nine months.

“We have the whole of our lives to work so we wanted to take this opportunity.”

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Ale added: “I am taking a break from work at the minute and doing more social media.

“I am managing some things back home but we are just enjoying our time together.”

Countries they are visiting: Seychelles Mauritius Reunion South Africa Namibia Angola Ghana Canary Islands Gibraltar Malta Bahamas Montenegro Malta France Spain Morocco Portugal Ireland Belgium England Denmark Germany Latvia Estonia Finland Sweden Lithuania Denmark Norway Australia Indonesia Philippines China Taiwan Japan South Korea Vietnam Malaysia Sri Lanka India UAE Greece Italy Slovenia Croatia Miami Coco Cay Cozumel Aruba Curacao Bonaire Barbados Grenada Brazil Uruguay Argentina Chile Peru Costa Rica Guatemala Mexico French Polynesia New Zealand

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