(SAN ANTONIO) -- The basic training facility for the Air Force in San Antonio, Texas, is experiencing a flu outbreak following the end of mandatory vaccination for all service members.

As of Wednesday, there are at least 159 known cases among recruits and two hospitalizations at Joint Base San Antonio, two sources familiar with the matter told ABC News. One source told ABC News the number of cases and hospitalizations may be higher.

The outbreak comes after Defense Secretary Pete Hegseth announced in April that the annual flu vaccine would be optional for all U.S. military personnel, both active and reserve.  

Previously, the flu vaccine was mandatory, but the new policy is in line with a previous change of making the COVID-19 vaccine optional.

The Pentagon has granted the military services exceptions to the policy, so the flu vaccine can be required in certain cases.

An Air Force spokesperson confirmed the outbreak to ABC News and said in a statement that over the last three weeks there has been a "localized influenza outbreak among trainees at Basic Military Training."

"Medical professionals and Public Health officials have implemented mitigation measures to isolate and treat symptomatic trainees to reduce further exposure and continue to monitor the situation," the statement read. "Medical personnel are also monitoring trainees who were in close contact with sick members in case they become symptomatic."

The spokesperson said symptomatic trainees are receiving "the appropriate care" including antiviral medications such as Tamiflu.

"Once they are cleared by medical professionals they will return to training," the statement said.

Earlier this year, when Hegseth ended mandatory vaccination, he referred to the policy as "overly broad and not rational."

"Our new policy is simple: If you, an American warrior entrusted to defend this nation, believe that the flu vaccine is in your best interest, then you are free to take it; you should. But we will not force you," Hegseth said.

The sources told ABC News that there is 40% flu vaccination rate among recruits at the San Antonio base since the mandate was lifted. Previously, the rate was nearly 100%.

Chief Pentagon spokesman Sean Parnell told ABC News that the Defense Department recently granted exceptions to the policy for the Army, Navy, Air Force, National Security Agency (NSA) and Defense Health Agency (DHA) through the Under Secretary of Defense for Personnel and Readiness.

"The decisions were based upon thorough risk assessments and are designed to maximize operational readiness, lethality, and force generation, while safeguarding at-risk populations," Parnell said. "The Army, Navy, Air Force, NSA, and DHA are responsible for implementing the [exceptions to the policy]. The Department remains committed to the health and readiness of our warfighters and civilian personnel."

The annual flu vaccine is currently recommended to everyone over 6 months old between September and the start of November. Although the typical flu season ends by February or March, people can become infected at any time. 

People who travel internationally or live in group settings are at higher risk of transmitting and acquiring infectious diseases. 

Public health specialists have warned that military members may suffer unnecessary complications from the flu after the vaccination mandate was ended and fear that severe cases will continue to climb in subsequent flu seasons if preventive vaccinations aren't given to those most at risk. 

Evidence has shown that young recruits are much more vulnerable to severe infection from influenza compared to other service members, though lower than the general population due to the military having historically high immunization rates. 

A study published last year by the Defense Health Agency found that from the 2010-2011 to the 2023-2024 flu seasons, the highest rate of influenza hospitalizations among active service members were among those under the age of 25, especially young recruits. 

The flu vaccine has been required for the military since 1945, at the end of World War II, partly tied to the threat of biological warfare use by rival nations and as well as the devastation that the flu pandemic of 1918-1920 wreaked on U.S. troops, according to a 2022 analysis from Wright State University in Ohio and the U.S. Air Force.

It's estimated that between 20% and 40% of Army and Navy personnel fell ill, with more than 26,000 deaths among U.S. soldiers during the 1918-1920 flu pandemic.

After researchers noticed the effectiveness of the vaccine fading, the mandate was withdrawn in 1949. This was later found to be caused by abrupt and major changes to the flu virus -- and the mandate was reinstated in the early 1950s after the changes became "clearer and combatable," according to the analysis.

Compliance among military health care personnel has exceeded 95% in past years, compared to less than 75% among civilian health care personnel.

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(NEW YORK) -- Fewer than 49% of Americans can afford healthcare, the lowest rate since tracking began in 2021, according to Gallup data released Thursday.

In a single year, roughly 2.8 million people no longer identified as being “Cost Secure” meaning they could no longer afford access to quality care or pay for visits and prescriptions, according to the data. Worry about future healthcare costs, including visits and prescriptions, amongst Americans is also at an all-time high of over 40%, according to Gallup.

Gallup developed what it calls the "Healthcare Affordability Index," which is sponsored by West Health, in 2021 drawing on self‑reported experiences from nationally representative surveys. The latest data comes from a study conducted between October and December of 2025, according to Gallup and West Health.

Healthcare has become a financial burden across income levels, according to the new data. According to the index, one in three upper-middle income households ($120,00 to $180,000) are not cost secure, nor are one in five households earning above $180,000.  

Young adults, aged 18-29, have experienced the sharpest decline in ability to afford healthcare with those identifying as "cost secure" dropping 7 percentage points in a year.

Women continue to trail behind men when it comes to affording healthcare.

Between 2021 and 2024 the difference between men and women being able to afford care was 9% but in 2025 the gap widened to 15%, making it the largest gender gap in healthcare affordability on record.

Healthcare and inflation continue to rise with healthcare spending reaching $5.3 trillion in 2024. This, in part, is due to hospital prices increasing to 3.4% in 2024, the fastest rate increase since 2007, and insurance premiums going up by 20% after the expiration of subsidies under the Affordable Care Act.

With many Americans experiencing significant healthcare-related financial challenges, studies show that this can lead to significant consequences, including delaying or deferring care, leading to worse health overall.

Torie A. Livingston, MD, MPH, is a third-year pediatric resident physician at the University of Chicago and is a medical intern of the ABC News Medical Unit. 

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(NEW YORK) -- The American doctor who contracted Ebola in the Democratic Republic of Congo (DRC) has returned to the United States.

Dr. Peter Stafford; his wife, Dr. Rebekah Stafford; and their four children arrived safely on Monday, according to Serge, the international Christian missionary group that employs the couple.

"I am filled with gratitude to God for preserving my life, to all those who prayed on my behalf, and to the many medical providers who cared for me. I am feeling well and thankful to be reunited with Rebekah and the kids," Peter Stafford said in a statement. "Our prayers continue for those in Congo who are facing this devastating epidemic and for the ongoing efforts to control the disease."

Peter Stafford tested positive while working with patients in the DRC and was evacuated to Germany to receive specialty care. He was hospitalized at Charité University Hospital in Berlin.

Rebekah Stafford and their four children were also evacuated to Germany and moved into a separate space at the hospital as high-risk contacts.

The family was discharged from the hospital earlier this month and Peter Stafford has remained Ebola free since May 30, according to Serge. U.S. health authorities are in regular contact with Peter Stafford, Serge said.

"Our hearts remain deeply saddened for our Congolese friends and colleagues and those impacted by this outbreak," Matt Allison, executive director of Serge, said in a statement. "Our mission is more critical than ever as we mobilize medical support and resources to partners in the area."

Allison continued, "Thank you to those who have prayed and given sacrificially to this work. Also, we would like to express our immense gratitude to the many international organizations, governments, and partners who cared for the Stafford family and brought them home safely."

The outbreak was first detected in the DRC's northeastern province of Ituri, with cases officially confirmed by the health ministry on May 15. It marks the 17th outbreak of Ebola virus disease in the DRC, which is Africa's second-largest country and its fourth-most populous nation.

Congo's Health Minister Roger Kamba said during a press briefing on Monday evening that the DRC has now recorded 808 confirmed Ebola cases and 192 deaths. In neighboring Uganda, at least 19 cases -- mostly linked to travel -- and two deaths have been confirmed, according to the Ugandan health ministry.

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(NEW YORK) -- Health officials in the Democratic Republic of Congo (DRC) have reported a record one-day increase in Ebola cases since the current outbreak was first detected one month ago.

The DRC Ministry of Health reported 72 new confirmed Ebola cases on June 13, bringing the total number of cases to 782. Additionally, 29 deaths were recorded, bringing to 181 the number of fatalities that have occurred in the last month.

The majority of cases are still concentrated in three provinces in the northeast part of the country: Ituri, North Kivu and South Kivu. Two new health zones, Nia-Nia in Ituri and Mabalako in North Kivu, reported cases for the first time, increasing the number of affected health zones to 31, according to the Ministry of Health.

Contact tracing remains a concern. Health officials said only 56.5% of identified contacts have been followed up on, far below the desired 90%-95% target needed to contain the outbreak, according to the World Health Organization (WHO).

DRC health officials say they're still experiencing community hesitance as well as shortages of essential medicines and infection-control supplies.

Meanwhile, Uganda has reported 19 confirmed cases, in large part linked to cross-border transmission from the DRC, and two deaths, according to the World Health Organization.

Last week, United Nations agencies warned that children in the eastern DRC could become increasingly affected by the Ebola outbreak. The U.N. said it may be difficult to accurately track the number of children who may be affected by the outbreak due to inefficient surveillance.

Although most infections have been among adults, "as the outbreak evolves, we must be prepared for increasing household transmission which means we may see more children affected in the days ahead," Dr. Douglas Noble, UNICEF global lead for public health emergencies and global incident manager for Ebola, said on Friday.

"These are already very vulnerable children, so the capacity for this community to absorb any additional stressors was already stretched to breaking point," he said.

In past Ebola outbreaks in the DRC, children "made up a significant share of cases and an even greater share of deaths, with the youngest facing the highest fatality rates and many left orphaned or separated from caregivers," Noble said.

Meanwhile, the U.S. State Department recently announced plans to provide $50 million to the Coalition for Epidemic Preparedness Innovations (CEPI), which describes itself as "a global partnership working to accelerate the development of vaccines and other biologic countermeasures against epidemic and pandemic threats," to help develop vaccines and treatments against the Bundibugyo strain of Ebola that's driving the current outbreak.

The State Department further said it has committed more than $270 million directly to the Ebola response, with U.S.-funded partners screening more than 6,300 people in Ituri, supporting 100 health facilities and carrying out 200 safe burials.

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(GENEVA) -- The World Health Organization said on Thursday that the risk of Ebola transmission in Europe and World Cup host countries is low as the tournament gets ready to kick off across the U.S., Canada and Mexico.

Dr Hans Henri P. Kluge, WHO's regional director for Europe, said in a statement that there are currently no Ebola cases in North America or Europe amid an outbreak spreading in the Democratic Republic of Congo.

The DRC has recorded 676 confirmed cases as of Thursday morning, according to DRC's minister of health. In Uganda, there are 19 confirmed cases -- many of them travel-related -- and two deaths, the country's health officials said.

Kluge made reference to an Ebola patient who was treated in the European Region after being evacuated from the outbreak region.

An American physician, Dr. Peter Stafford, tested positive for Ebola after being exposed while treating patients at Nyankunde Hospital. Stafford, a medical missionary with the mission organization Serge, was transferred to Germany and treated at Berlin's Charite University Hospital.

His wife, Dr. Rebekah Stafford, and their four children were also transferred to the same hospital, where they were monitored in quarantine for 21 days as high-risk contacts.

Last week, the family was released from the hospital after Dr. Peter Stafford had no symptoms for more than 72 hours and a negative result in repeated PCR tests, Serge said.

"There is no reason to change your plans. Travel as normal, stay informed and enjoy the tournament," Kluge said.

Kluge said there are several reasons why the risk is low in other countries: most cases are in remote areas of the DRC, Ebola is not an airborne illness and it is spread through direct contact with the bodily fluids of a sick person.

Additionally, screening is in place before travel is allowed from affected regions and people are only infectious once visibly ill, according to Kluge.

The CDC has temporarily restricted entry to the U.S. for certain travelers who were recently in the DRC, Uganda or South Sudan. Currently, U.S. citizens and nationals may still enter but will undergo enhanced public health screenings.

Kludge said the WHO does not recommend travel restrictions, "though if you don't have to travel to the affected areas in the Democratic Republic of the Congo or Uganda, it is safer not to."

He added that it's important to challenge the stigma associated with Ebola patients and those from affected regions or African communities.

"The spread of Ebola is not determined by nationality or ethnicity," he said. "Stigma discourages people from seeking care and can make outbreaks harder to control. Stay informed, rely on trusted sources and treat others with understanding. With common sense and compassion, we can keep both people and the game safe."

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(GENEVA) -- The number of Ebola infections and deaths in the Democratic Republic of the Congo (DRC) and Uganda has “increased rapidly” since late May, the World Health Organization said Monday.

Since the last update from the WHO on May 29, an additional 390 confirmed cases including 74 confirmed deaths were reported. The increase in cases -- more than tripling the prior confirmed count -- is in part due to better testing and diagnosis abilities, the WHO said.

Cases continue to be reported in various parts of the DRC across 25 health zones, with some infections hundreds of miles away from the epicenter of the outbreak in the Ituri province.

The outbreak remains concentrated there.

As of June 6, there are a total of 515 confirmed cases and 91 deaths in the DRC. So far, 12 patients have recommended recovered there.

Over 5,000 people have been identified as contacts due to exposure from someone who was infected. Contact tracing efforts continue to be underway.

At least 16 of the infections reported so far were identified in health care workers.

Uganda has 19 confirmed cases as of June 6, an increase of 10 since the last update on May 29.

While the WHO assesses the risk of transmission in the Congo as "very high" and "high" in bordering countries, the risk to the rest of Africa and the world is "low."

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(NEW YORK) -- Measles cases in the United States have surpassed 2,000 for the second year in a row, according to data updated Friday from the Centers for Disease Control and Prevention (CDC).

So far in 2026, 2,030 confirmed cases have been recorded in 38 states and the District of Columbia, CDC data shows.

Cases have been confirmed in: Alaska, Arizona, California, Colorado, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, Wisconsin and Wyoming.

Just 10 measles cases were reported among international travelers so far this year, according to CDC data.

Last year, 2,288 confirmed measles cases were reported for all of 2025. Prior to this, measles cases had not surpassed 2,000 in the U.S. since 1992.

The U.S. also saw its first measles deaths in more than a decade last year, including two among unvaccinated school-aged children in Texas and one among an unvaccinated adult in New Mexico.

The majority of measles cases in 2026 have been confirmed among children and teenagers aged 19 and younger, according to the CDC.

About 92% of cases are among people who are unvaccinated or whose vaccination status is unknown, CDC data shows.

Meanwhile, 4% of cases are among those who have received just one dose of the measles, mumps, rubella (MMR) vaccine and 4% of cases are among those who received the recommended two doses, according to the CDC.

Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center in Nashville, referred to the latest figures as "very disappointing and very concerning."

"It indicates that an increasing number of parents are either postponing or withholding their children from vaccination, and this is very concerning because it permits this virus back now into in the United States to continue to spread and obviously to cause illness in the children affected," he told ABC News.

January 2026 marked one year since measles cases were first detected on Texas. It’s unclear if the cases confirmed on Jan. 20, 2025, are linked to those that have been found other states; if so, it would mean the U.S. has seen a year of continuous transmission.

If it's determined that the U.S. has experienced 12 months of continuous measles transmission, it could lead to a loss of the country's elimination status that was earned in 2000. Measles would once again be considered endemic or constantly circulating.

The review of the measles elimination status in the U.S., which is determined by the Pan-American Health Organization, will take place in November 2026.

Schaffner said the U.S.'s measles elimination status is threatened as a result of so many cases.

"Measles, because it's the most contagious virus, is like the canary in the coal mine; it's the alert that lets us know that we're also opening ourselves up to other transmissible diseases that vaccines could prevent," he said.

The CDC currently recommends that people receive two doses of the MMR vaccine, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective, and two doses are 97% effective against measles, the CDC says.

However, CDC data show vaccination rates have been lagging in recent years. During the 2024 to 2025 school year, 92.5% of kindergartners received the MMR vaccine, according to data. This is lower than the 92.7% seen the previous school year and the 95.2% seen in the 2019 to 2020 school year, prior to the COVID-19 pandemic.

Schaffner said that public health specialists need to listen carefully to parents who are skeptical or hesitant of getting their children vaccinated.

"Have them speak to their own family doctors and pediatricians, have those conversations, and our pediatricians and family doctors have to provide a level of comfort and reassurance," he said. "Facts are fundamental, but more importantly, these parents need reassurance and a level of comfort that what their doctors ... are recommending is in the best interest of their child and the communities in which their children live."

"These diseases are bad and can be really bad. The vaccines are good and really good," Schaffner added.

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(NEW YORK) -- New guidelines from the American Cancer Society are expanding colon cancer screening options beyond colonoscopies and established stool-based tests.

The recommendations still call for colorectal cancer screening in people at average risk starting at age 45 and continuing through age 75 for those with a life expectancy of 10 more years.

And colonoscopy is still considered the gold standard test.

But for the first time, the updated guidelines now include a blood-based screening test done in a doctor’s office. They also add new stool sample kits and a recently FDA-approved at-home test that looks for blood and different molecular markers in stool samples.

Experts note that offering more choices is critical to address gaps in screening for this highly preventable disease, which is most treatable when caught early.

“Individuals who decline or do not complete [testing] are probably a greater number than are actually appreciated,” Dr. William Dahut, chief scientific officer for the American Cancer Society, told ABC News. “And I think a lot of our data on colorectal screening probably overstates the number of people actually up to date on their screening guidelines.”

As the new guidelines point out, the most effective colorectal cancer screening test is the one people are willing to get. More than 20 million eligible Americans remain unscreened, according to the ACS.

While stool-based tests are reasonable options for most people, the new guidelines stress that the blood tests should be considered a last resort for people unable or unwilling to get any other form of testing because they are less likely to catch issues compared to other types of screening.

People who choose colonoscopy should be tested every 10 years. Other screening tests should be done every one, three, or five years, depending on the specific method selected.

These new guidelines come as colon cancer rates rise in younger adults across the US. ASC statistics show that 1 in 5 new colorectal cancer cases now occur in people younger than 55, up from about 1 in 10 in the mid-1990s.

“This is a disease that historically, we saw in older individuals, so people 50 and over or maybe even 60 and over. And now we are starting to see an inching up of incidents in people who are less than age 50,” Dr. Fola May, associate professor of medicine at the David Geffen School of Medicine at UCLA, told ABC News.

She said she hoped that having a range of choices would push more people to get tested.

The ACS likely wants to “make sure that patients understand that these tests can be done at home. So you don't need to take a day off of work. You don't need an escort, you don't need to have an invasive procedure,” May said.

The ACS advised people to work with a trusted healthcare provider to decide which test is best for them.

Dahut stressed that the recommendations apply only to people of average risk without symptoms and with no family or personal history of colorectal cancer. Consumers should check with their insurance provider to see which options their plan covers.

It’s important to be aware of the symptoms and take them seriously, he added.

“So if one has symptoms, blood in their stool, symptoms of obstruction, abdominal pain that's persistent or change in stool patterns, then they need to have a workup for those symptoms and not have a blood-based test like this or a stool-based test,” he said.

Ari Goldstein, MD, MPH, is a board-certified family physician and preventive medicine resident at Johns Hopkins Bloomberg School of Public Health

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(GENEVA, Switzerland) -- The head of the World Health Organization warned on Monday that a rapidly growing Ebola outbreak in the Democratic Republic of Congo and Uganda "will get worse before it gets better."

More than 900 cases and more than 220 deaths have been reported in the DRC, WHO Director-General Dr. Tedros Adhanom Ghebreyesus said during a virtual briefing. Of those totals, 101 cases and 10 deaths have been confirmed.

Additionally, there have been five travel-related cases and a death in Uganda, according to the WHO and the Uganda Ministry of Health.

"We are facing an extremely serious and difficult outbreak. It will get worse before it gets better," Tedros said on Monday. "But we know this virus, and we know how to stop it. We have stopped every previous Ebola outbreak, and we will stop this one, too."

Tedros said he wanted to echo comments made by South African President Cyril Ramaphosa about overcoming the outbreak with unity.

"The question is just how quickly we can do it, and how many more lives will be lost before we do," Tedros added.

Tedros' comments come amid a hospital in northeastern Congo facing growing tension as officials have trouble following safety rules following the death of a well-known religious leader.

Dr. Richard Lokudi, director of the Mongbwalu General Referral Hospital in Ituri province -- one of three provinces where the Ebola outbreak is concentrated -- told ABC News the facility is under heavy tension after the body of a confirmed Ebola victim, who was also a major religious figure in the region, was brought there.

Lokudi said that family members and groups of young people are demanding the body be returned.

Because the patient was a confirmed Ebola case, authorities are insisting on a "safe and dignified burial" under outbreak protocols, and the body is being temporarily kept at the hospital until burial on Monday.

Lokudi said police and military forces have been securing the hospital and firing warning shots to disperse protesters gathered outside.

He added that the gunfire around the hospital has left him exhausted and stressed.

Last week, Tedros classified the Ebola outbreak as a public health emergency of international concern -- one level below a pandemic in the United Nations agency's alert system.

The WHO continues to consider the national risk assessment as "very high" while the regional level risk remains "high" and the global risk level remains "low," Tedros said on Monday.

The outbreak has led to multiple countries, including the U.S., India, the U.K. and Australia, putting travel restrictions in place.

Entry to the U.S. is restricted to foreign travelers who have recently been in the DRC, Uganda and South Sudan.

Meanwhile, U.S. passport holders and U.S. nationals returning to the U.S. from the three countries will be funneled to Dulles Airport in Virginia to be screened for symptoms and interviewed about possible exposure.

Enhanced screening efforts have also begun at Hartsfield-Jackson Atlanta International Airport as of Saturday morning and efforts at George Bush Intercontinental Airport in Houston will begin late Tuesday.

Lawful permanent residents (green card holders) who have been in any of the three countries over the last 21 days are barred from entering the U.S. temporarily.

Tedros said on Monday that WHO teams are on the ground in the outbreak zones assisting with response including contact tracing, establishing treatment centers and infection prevention and control. Tedros added that he will be traveling to the DRC on Tuesday.

The WHO chief said that several aspects of this outbreak make it "especially challenging," including the delays in detecting the outbreak.

"[It] means that we are now playing catch-up with a very fast-moving epidemic," he said on Monday.

US doctor infected with Ebola critically ill but says he is 'cautiously optimistic'
He said that due to recent fighting in the provinces facing the brunt of the outbreak, it means tens of thousands of people are displaced and there is "significant distrust of outside authorities among the local population."

An additional challenge is that there are no approved vaccines or treatments for the strain of Ebola responsible for the outbreak: Bundibugyo virus.

Tedros said the WHO has recommended prioritizing two monoclonal antibodies to advance in clinical trials and recommended evaluating the antiviral obeldesivir in a clinical trial as post-exposure prophylaxis for those who are high-risk contacts.

ABC News' Eric M. Strauss contributed to this report.

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(NEW YORK) -- The Ebola outbreak in the eastern Democratic Republic of the Congo is "spreading rapidly," the head of the World Health Organization warned during a press briefing on Friday.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus warned that the U.N. health agency has upgraded its risk assessment for spread at the national level from "high" to "very high." At the regional level, the risk remains "high" while the global level is still "low."

There have been almost 750 suspected cases and 177 suspected deaths from Ebola in the DRC, the WHO said in a post on X.

So far, at least 82 cases of Ebola have been confirmed in DRC as well as seven deaths, but Tedros said "we know the epidemic in the DRC is much larger."

Tedros described the situation in Uganda as "stable" with two cases confirmed in people who traveled from the DRC, with one death.

The epicenter of the current outbreak is in a "highly insecure" area -- the DRC's eastern provinces of North Kivu and Ituri -- where ongoing armed conflict has sparked a displacement crisis, according to Tedros.

The WHO chief also acknowledged a "security incident" that took place Thursday in Ituri in which "medical tents and supplies were set on fire." He noted that building trust in the local communities is "critical."

The WHO's representative in the DRC, Dr. Anne Ancia, who appeared from the field via video link during the press briefing, said Thursday's incident "significantly jeopardized" the Ebola response operations her team is trying to initiate in the hotspot area.

She noted that there is still very low contact tracing in Ituri, particularly the city of Bunia, but that there was better contact tracing happening in North Kivu.

So far, one American has contracted Ebola in relation to the outbreak. Dr. Peter Stafford tested positive after treating patients in the eastern DRC.

He was evacuated to Germany and is currently being treated at Charite University Hospital in Berlin in an isolation ward, the hospital said.

Stafford's wife and children, who are considered high-risk contacts, are also at the hospital and are currently in quarantine in a separate section of ward. The family is symptom free, according to the hospital.

The hospital said that Stafford does not currently require intensive care but is "severely weakened" from his illness. 

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(PHILADELPHIA) -- Health officials in Philadelphia are recommending certain patients of a dental clinic accused of following "unsanitary practices" get tested for hepatitis and HIV due to potential exposures from April 2025 to May 2026, the city's Department of Public Health said in a statement this week.

Officials on Wednesday identified the dental clinic in Center City Philadelphia as Smiles at Rittenhouse Square, also called Smiles on the Square, and said it is now closed due to the dentist's temporary suspension. 

James Garrow, Philadelphia's deputy health commissioner, told ABC News the risk is believed to be low to patients at this time because they have yet to identify any associated cases of hepatitis or HIV linked to this dentist office.

"We don't have any known reason to say that the risk will be potentially high, but the fact of the matter is, when you are in a dentist office that's unsanitary, unsafe, the risk always exists," Garrow said. "So that's why we're really pushing folks who are patients there to get tested and make sure."

The sole dentist practicing at this office has since had their license temporarily suspended, state records show.

"On May 15, 2026, the State Board of Dentistry suspended Dr. Kirti Chopra's professional license in Pennsylvania because her continued practice of dentistry presents a clear and immediate danger to public health and safety," a Pennsylvania Department of State official said in a statement to ABC News. 

The alleged sanitary problems in the clinic were discovered during an unannounced site visit, the suspension order, reviewed by ABC News, said.

According to the order, the dentist allegedly admitted to investigators that used injectable medication vials were occasionally set aside for reuse on other patients and IV saline bags intended for single use were reused between patients.

Investigators said they identified multiple issues with sterilization and sanitation practices during the site visit that include finding dental instruments that were not properly sterile, handled with potentially contaminated gloves, and packaged in potentially contaminated pouches. 

They also reported finding dental handpieces that came into contact with blood and saliva left attached to patient equipment after use that should be sterilized between patients. 

The dentist's temporary suspension order concluded that these findings "place patients at risk for transmission of hepatitis C, hepatitis B, Human Immunodeficiency virus (HIV), as well as outbreaks of viral, bacterial or fungal infections."

Hepatitis viruses and HIV are spread through contact with infected blood or body fluids. Garrow said exposure at a dentist's office is "exceedingly rare" but it is possible to get infected if exposed through contaminated dental equipment.

"The fact of the matter is, if someone who is a patient there was exposed to one of these diseases... these are potentially life-changing chronic conditions," Garrow said.  

Doctors tell ABC News potentially impacted patients may need multiple blood tests, depending on the timing of a potential exposure. 

"If it's a recent exposure it would be a minimum of two or three blood draws to establish a baseline and then follow-up testing to determine seroconversion," Dr. George Diaz, a spokesperson for the Infectious Disease Society of America, told ABC News.

Doctors say hepatitis B is considered one of the more transmissible bloodborne viruses in healthcare settings when sterilization procedures aren't followed or if contaminated instruments are reused. 

The hepatitis B vaccine offers the best line of protection for a person who is exposed to this virus. 

"In this case, vaccination against Hepatitis B would be protective against exposures such as this," Diaz said. "Risk is virtually zero for those that are vaccinated."

There are no current vaccines to prevent HIV or hepatitis C. Treatment options vary for each virus, based on timing of exposure or infection.

According to Garrow, the health department is working to finalize a list of patients potentially at risk but due to the timeframe of potential exposure, he estimates that number "could be in the hundreds."

Garrow also said that there is another dental clinic in the same building with a similar name, Rittenhouse Smiles, that is not under investigation, and they are working on messaging to minimize patient confusion. 

Officials say people who are unsure about potential exposure or patients of Smiles at Rittenhouse Square should call 215-685-5488, a hotline the health department set up that is open between 8:30 a.m. and 5 p.m. ET, Monday through Friday. 

"Dr. Chopra is cooperating with the Department of Public Health and the Pennsylvania Department of State," a lawyer representing Chopra and Smiles at Rittenhouse Square said in a statement to 6ABC Philadelphia on Wednesday. "Dr. Chopra will continue working cooperatively with public-health officials regarding patient notification, testing recommendations, and any required infection-control remediation."

Mark Abdelmalek, MD is a medical contributor and investigative reporter for ABC News. Jade A. Cobern, MD, MPH, is a fellow of the ABC News Medical Unit. 

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(TEXAS) -- Texas health officials on Tuesday confirmed the state's first human West Nile virus case this year, an indication that mosquito season is beginning in the United States. 

Public health officials have been warning that rising temperatures have allowed mosquitoes to thrive, increasing the risk of the diseases that they spread, including West Nile. 

Last year, the U.S. reported 2,076 cases of West Nile across 47 states, according to data from the Centers for Disease Control and Prevention. Colorado had the highest number of cases (285), followed by Illinois, Texas, Minnesota and California.

The Texas Department of State Health Services said the patient was a resident of Harris County, which includes Houston, but no other information about the patient was made available.

"West Nile and other mosquito-borne illnesses are a fact of life in Texas in the warmer months, and all Texans should take precautions against mosquito bites to stay safe and healthy," Texas DSHS Commissioner Dr. Jennifer A. Shuford said in a press release. "By removing standing water around the home, people can eliminate mosquito breeding grounds and reduce insect populations in their area."

Since 1999, West Nile virus has killed about 2,900 Americans, according to the CDC. Cases are typically reported between June and October, historically peaking in August.

The virus is spread through the bite of an infected mosquito. Risk increases with older age, certain medical conditions -- such as cancer, high blood pressure and kidney disease -- and a weakened immune system. 

Symptoms include fever, headache, body aches, vomiting, diarrhea and a rash. Severe illness can affect the central nervous system and result in hospitalization or death, according to the CDC.

There is currently no vaccine that protects against West Nile virus, and preventing mosquito bites is the best way to protect yourself, the CDC says.

No specific treatments are available. Doctors recommend patients rest, drink fluids and take pain medication to help relieve some symptoms. People with severe illness may need to be hospitalized for supportive treatment, according to the CDC.

The CDC says most people infected with West Nile virus are believed to have lifelong immunity. However, some with weakened immune systems or certain conditions may have their immunity wane over time. 

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(NEW YORK) -- A deadly Ebola outbreak is continuing to spread in the Democratic Republic of Congo and Uganda, with officials on Tuesday saying there were more than 600 confirmed and suspected cases and more than 100 suspected deaths.

The World Health Organization (WHO) declared the outbreak a public health emergency of international concern, and at least one American in the DRC has tested positive, according to the Centers for Disease Control and Prevention (CDC).

Several public health experts told ABC News that while they agree with the CDC that the risk to the U.S. public is currently low, the outbreak is still concerning. They also expressed unease that the U.S. may not be prepared to adequately respond due to cuts to federal health agencies and its withdrawal from the WHO.

The experts noted cases have been found in remote regions of the DRC and Uganda, as well as urban areas, and the outbreak is growing rapidly. They added that although Ebola is a rare disease, it can be highly contagious and can lead to deadly consequences.

"We're worried that if this outbreak is not contained, that it could spread elsewhere on the continent, which could increase the risk of the virus spreading outside of the African continent," Dr. Jennifer Nuzzo, professor of epidemiology and director of the Pandemic Center at Brown University School of Public Health, told ABC News.

"Ebola is not as transmissible a virus as, say, a coronavirus ... and that's why I don't think that this will ever become a pandemic scenario, but it doesn't have to be a pandemic to be a worrisome situation," she added.

Americans affected by outbreak

On Monday, the CDC confirmed that least one American in the DRC contracted Ebola while working in the country.

Dr. Satish K. Pillai, incident manager for the CDC's Ebola response, told reporters that the individual developed symptoms over the weekend and tested positive late Sunday, adding that the patient and six other high-risk contacts were being moved to Germany for care and monitoring.

Serge, an international Christian missions organization, confirmed the patient is American medical missionary Dr. Peter Stafford, a board-certified general surgeon with a specialization in burn care, who was serving patients in the eastern DRC.

Pillai did not say if or when the Americans would be returning to the U.S., but experts say, even if the patient and contacts do, the risk level to the public does not change.

"We safely and effectively have [returned affected Americans home] many times before," Emily Smith, interim chair of the department of global health at the Milken Institute School of Public Health at George Washington University, told ABC News. "It's something we have good experience in and have always safely and effectively done. So, to me, no concerns about doing that."

Dr. Jesse Goodman, a professor of medicine and infectious disease at Georgetown University and former chief scientist at the Food and Drug Administration, said it is encouraging that when countries such as the DRC have experienced outbreaks in the past, they have not progressed to pandemic status.

"I think the most [the U.S.] would see is the kind of limited transmission that we've seen in the past because this virus almost always appears that transmission is from people who have symptoms," he told ABC News. "I think if there are cases that come to this country, I would expect limited transmission and think we have the capability to contain it."

During the 2014 Ebola outbreak, there were two cases of suspected transmission from a patient with Ebola to nurses caring for him. The CDC has established detailed infection prevention and control procedures for health facilities that suspect they have cases of Ebola.

U.S. may not be as connected to the global health community

Even with possible U.S. capability to contain Ebola domestically, the experts who spoke to ABC News said the U.S. is likely at a disadvantage when it comes to responding to several health crises both at home and abroad due to public health capacity cuts.

Last year, the State Department announced it would be taking over programs previously run by the U.S. Agency for International Development (USAID). Secretary of State Marco Rubio said the agency -- which oversaw foreign aid, disaster relief and international development programs -- would no longer be providing assistance to other countries.

In previous Ebola outbreaks, USAID provided millions of dollars and operational support in response, in addition to helping with preparedness activities in neighboring countries.

Additionally, earlier this year, the U.S. officially completed its withdrawal from the WHO, with federal officials saying at the time there are "plans" in place to work with organizations on surveillance, diagnostics and outbreak response to fill in gaps left by exiting the WHO.

Brown University's Nuzzo said the Ebola outbreak is the kind of situation public health experts warned about as USAID was gutted and the U.S. withdrew from the WHO.

"We warned that the United States would be flying blind, and it would be learning about deadly outbreaks late, and then it would be very difficult for the U.S. to respond because we would have fewer tools to do that,'" Nuzzo said. "The big worry here is that the outbreak wasn't declared until there were more than 200 suspected cases of the virus and that is very unusual. Usually, we get signals of an outbreak much earlier."

George Washington University's Smith concurred, "When we are talking about public health infrastructure and global health infrastructure, we're in a worse place today than we were two years ago."

Nuzzo also noted that the National Institute of Allergy and Infectious Diseases, an agency within the National Institutes of Health, ended research at its high containment lab in Fort Detrick, Maryland, due to "a safety stand-down" last year.

The lab was one of the few federal facilities studying Ebola and other deadly pathogens, which Nuzzo said could have been useful in understanding the virus and developing therapies for the recent outbreak.

"So now that we have Americans potentially exposed to a virus that's deadly, for which we have no vaccines or treatments, you can imagine how beneficial it would be to have a laboratory that can conduct world-class research to make sure we develop cures for this," Nuzzo said. "But we don't have it. So, we're basically behind the curve in being ready for this."

Goodman also said that the U.S. may not be as prepared because Health and Human Services Secretary Robert F. Kennedy Jr. has been actively shifting the department's focus away from infectious disease management and towards chronic illnesses.

During his confirmation hearings last year, Kennedy argued that too much federal funding has been "devoted" to "infectious disease and to drug development and very little to chronic diseases."

Goodman argued that there needs to be a focus on infectious diseases because of the threats they may pose to public health.

"I think the message here is these infectious disease, we may be done with them, but they're not done with us," he said. "There's a reason that so many of us work for so many years to be prepared for whatever the next thing is because we don't know what it is and we just need to be ready."

Kennedy told ABC News on Monday that his agency is addressing the recent hantavirus and Ebola outbreaks.

"Yeah, we're working on it," Kennedy replied when asked if he was worried about the outbreaks. Kennedy did not respond when asked what his message might be to Americans who are concerned about the diseases potentially spreading in the U.S.

On Sunday, the State Department issued "Level 4 -- Do not travel" advisories for Uganda and the DRC due to the outbreak.

Secretary of State Marco Rubio called the Ebola outbreak "concerning" while speaking to the press on Tuesday.

"The lead is obviously going to be CDC and the World Health Organization, which was a little late to identify this thing unfortunately," he said. "It's a little tough to get to because it's in a rural area. So it's a kind of confined and hard-to-get-to place, in a war-torn country, unfortunately. But we'll have more to announce on that. We're going to lean into that pretty heavy."

Nuzzo said she's worried that the U.S. hasn't built a public health system that acknowledges viral outbreaks as recurring threats, saying the U.S. has been caught off guard with previous incidents such as COVID-19.

"We don't do that with other recurring hazards you know; we don't try to build FEMA in the midst of a hurricane," Nuzzo said.

ABC News' Shannon Kingston contributed to this report.

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(WASHINGTON) -- Health and Human Services Secretary Robert F. Kennedy Jr. told ABC News on Monday that his agency is working to address the recent hantavirus and Ebola outbreaks, marking the first time he’s commented publicly on the Ebola outbreak since the Centers for Disease Control and Prevention (CDC) confirmed than an American had been infected with the virus in the Democratic Republic of the Congo (DRC).

“Yeah, we’re working on it,” Kennedy told ABC News when asked if he was worried about the outbreaks. The secretary’s comments come after the CDC said a “small number of Americans" are directly affected by the current Ebola outbreak in the DRC.

Kennedy did not respond when asked what his message might be to Americans who are concerned about the diseases potentially spreading in America. He told reporters in the Oval Office last week that the U.S. had the hantavirus outbreak “under control.”

“We have this under control and we're not worried about it,” he said at the White House’s maternal healthcare event on May 11th. Kennedy also noted that the CDC has been working on the outbreak since day one.

The CDC said there have been no confirmed hantavirus cases in the U.S. linked to the MV Hondius cruise ship and 18 passengers remain under observation at the University of Nebraska.

Meanwhile, Kennedy's brief comments about the outbreaks came following a roundtable event announcing nearly $1 billion in new funding to states to address PFAS in drinking water at the Environmental Protection Agency (EPA) on Monday.

The secretary has been on a midterm blitz recently, touting the administration's Make America Healthy Again (MAHA) movement during stops including Ohio and California.

At a subsequent event featuring Kennedy and other health leaders at the White House, Deputy Assistant to the President for Domestic Policy Heidi Overton stressed that “there are no cases of Ebola in America.”

Deputy Assistant to the President for Domestic Policy Heidi Overton stressed during the event that “there are no cases of Ebola in America.”

“We want to keep it that way and we are doing everything we can to support Americans in the region,” Overton added.

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(DOUGLAS COUNTY, Colo.) -- Colorado public health officials are investigating the death of an adult resident as a result of hantavirus.

The Colorado Department of Public Health and Environment and the Douglas County Health Department said the death is not linked to the outbreak on the MV Hondius cruise ship, which led to 11 confirmed and probable cases, including two confirmed deaths and one suspected death.

The individual lived in Douglas County -- located just south of Denver -- but information about the patient's name, age and sex were not immediately available. 

Health officials said the individual was infected by the Sin Nombre hantavirus, which is the most common cause of hantavirus pulmonary syndrome (HPS) in North America.

HPS symptoms typically appear from one to eight weeks after contact with the virus, with early signs including fever, fatigue and muscle aches, according to the Centers for Disease Control and Prevention. Half of HPS patients will experience headaches, chills, dizziness, nausea, vomiting, diarrhea and abdominal pain.'

Between four and 10 days after the initial phase of illness, symptoms including coughing, shortness of breath and tightness in the chest can emerge, the CDC said, adding that a patient's lungs can fill with fluid.

"Hantavirus infections caused by the Sin Nombre hantavirus occur regularly in Colorado, usually in the spring and summer, and can cause a severe and sometimes deadly respiratory disease," according to public health officials. "In Colorado, the deer mouse is the rodent species that most commonly exposes people to the virus. Avoiding exposure to rodents and their urine, feces, saliva, and nesting materials is the best way to prevent infection." 

According to the CDC, there were six cases of Hantavirus in Colorado from 2020 to 2023.

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(NEW YORK) -- Health experts tell ABC News that the current science behind the hantavirus that circulated throughout the MV Hondius does not show the same levels of transmission as with COVID-19, while acknowledging that the scenario may seem similar to the beginning of the 2020 pandemic.

"Our current understanding is that person-to-person transmission of Andes virus is relatively rare and generally associated with prolonged close contact," the current Centers for Disease Control and Prevention public health assessment said. "There is also no documented evidence of presymptomatic transmission."

Officials around the globe have taken major steps to prevent the spread of the hantavirus, and an American doctor who was onboard noted how conditions on the cruise ship may have helped the virus propagate.

In the U.S., the boat's 18 American passengers have been put in quarantine in Nebraska, while more than 40 people with exposure to the sick are being monitored to see if they develop the illness.

"In the vast majority of cases it happens when people breathe in mouse secretions," Dr. Emily Abdoler, a clinical associate professor of medicine at the University of Michigan, who specializes in infectious diseases, told ABC News.

"The Andes strain found in Chile and Argentina has the possibility of human-to-human transmission, but that's really more really close contact. It's not sharing the same household," she added. "It's more like sharing the same bed."

Dr. Stephen Kornfeld, an American oncologist who became the ship's de facto doctor after the Hondius' physician contracted the virus, initially received inconclusive results with samples taken from the ship but later tested negative.

Speaking to ABC News from his quarantine on Thursday, Kornfeld noted that conditions on the ship -- including ventilation and the size of rooms -- could have created a "complicated" situation for transmission while observing some social casual contact.

"If you do have casual contact, you're doing it repetitively," he said. "There were three rooms that we would gather in many times a day, often for an hour or an hour and a half, for lectures and discussions and meals. And I can just envision lots of frequent casual contacts, and perhaps over time that adds up to something more than just a single casual contact."

Abdoler, who helped diagnose a case of hantavirus in Michigan in 2021 -- the type we have in the U.S. that does not spread between people --said the benefit that medical professionals and agencies, such as the World Health Organization, have now is that the hantavirus has been researched for over 30 years. It is not a new virus. 

While the data around the Andes strain believed to have been on the boat is still limited given the rare number of cases outside of South America, Abdoler said there does not appear to be any indication that the transmission methods have changed for the Andes strain. 

ABC News medical contributor and epidemiologist Dr. John Brownstein concurred, saying that previous research suggests the hantavirus is a respiratory illness. That means germs can be coughed up, he noted, but it is not an aerosol-based virus.

"It's not like COVID or measles where it could linger in the air for some time," he said.

Brownstein added that the incubation period for the virus is long, and despite the lower risk for person-to-person transmission, it is critical that health officials stick to their policies to isolate and monitor anyone connected to the Hondius. Isolation can then be initiated if they become a positive case. 

 "Incubation can be anywhere from one to eight weeks," he noted.

During a news briefing Friday, WHO officials stressed that said there is no evidence so far that the virus has changed to become more transmissible or more severe.

Officials said transmission is believed to be based on several factors, including how infectious the patient is, the environment and whether protection and PPE was used.

On Friday, acting Centers for Disease Control and Prevention director Jay Bhattacharya told reporters no cases of hantavirus have been reported in the U.S.

There are now at least 10 cases that have been linked to the ship's outbreak. Two passengers died from the virus and a third death has been deemed probable by WHO.

Sixteen Hondius passengers, including Kornfeld, initially were flown to the quarantine center at the University of Nebraska Medical Center and had not shown any symptoms as of early Friday. Kornfeld had been placed in a biocontainment unit at the facility.

Two other American passengers were flown to Atlanta for "assessment and care," according to officials. They were later transferred to the quarantine unit in Nebraska on Friday.

The remainder of the passengers are in quarantine at home and are being monitored.

WHO warned more positive cases could still appear during quarantine because the virus' incubation period is long, but said that would not necessarily mean the outbreak is growing.

Abdoler noted that the fact that there have not been as many positive cases from the ship and their contacts shows that the data about the Andes transmission is holding up and there are no signs that the virus can spread as easily as other pathogens.

She noted that he is glad that the risk is being taken seriously and that those that have been exposed are being monitored. 

"My sense is that there is no really need to panic, but [WHO] is taking a very conservative approach to the outbreak and asking everyone to isolate during the intubation period," she said.

"I think it is good they are taking a conservative approach because there are unknowns, but I am not personally altering my personal practices of travel or how I go out," she added.

- ABC News' Dragana Jovanovic contributed to this report.

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(NEW YORK) - An Ebola outbreak has been confirmed in the Ituri province in Democratic Republic of the Congo, according to Africa Centres for Disease Control and Prevention.

As of the latest update, about 246 suspected cases and 65 deaths have been reported, mainly in Mongwalu and Rwampara health zones, officials said.

Africa CDC said that preliminary lab results from the Institut National de Recherche Biomédicale (INRB) have detected Ebola virus in 13 of 20 samples tested. Four deaths have been reported among laboratory-confirmed cases.

The latest outbreak comes around five months after Congo's last Ebola outbreak was declared over after more than 40 deaths.

“Africa CDC is closely monitoring the situation and convening an urgent high-level coordination meeting today with the DRC, Uganda, South Sudan and global partners to reinforce cross-border surveillance, preparedness and outbreak response efforts,” officials said in a statement Friday.

-ABC News' Rashid Haddou contributed to this report

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(WASHINGTON) -- Food and Drug Administration Commissioner Marty Makary intends to resign on Tuesday, two sources familiar with the matter told ABC News.

His departure was in the works after he clashed publicly with lawmakers, major pharmaceutical companies and President Donald Trump himself. He was scheduled to testify on Capitol Hill on Wednesday.

Trump was asked by reporters about Makary's possible resignation on Tuesday and signaled that Deputy Commissioner Kyle Diamanta would temporarily take on the role.

The president said, "Marty is a great guy," but added that he was "having some difficulty."  

"Everybody wants that job," Trump said.

The FDA and White House have not responded to requests for comment.

Makary, who is a surgeon by training, gained notoriety during the COVID-19 pandemic, arguing against masks for children and vaccine mandates, and criticizing the Centers for Disease Control and Prevention (CDC) for citing Israeli data in recommending boosters rather than conducting its own research.

Since taking office in March 2025, the commissioner has focused his efforts on reshaping vaccine policy in the U.S. and transforming American diets.

Makary appeared in a video on X alongside Kennedy when the secretary announced in May 2025 the removal of the COVID-19 vaccine from the CDC's immunization schedule for "healthy children and pregnant women."

"There's no evidence healthy kids need it today and most countries have stopped recommending it for children," Makary said at the time.

Last year, Makary appeared at a news conference announcing the HHS and FDA would be implementing a series of measures to phase out eight artificial food dyes and colorings from America's food supply by the end of 2026.

Makary said at the time that the agencies are looking to revoke authorization for two synthetic food colorings and to work with the food industry to eliminate six remaining synthetic dyes used in cereal, ice cream, snacks, yogurts and more -- claiming American children "have been living in a toxic soup of synthetic chemicals."

Makary also supported Kennedy's updated federal dietary guidelines earlier this year. The guidelines recommended that Americans limit highly processed foods and refined carbohydrates but also advocated for consuming red meat and full-fat dairy, a reversal of past nutrition guidance.

"For decades, we've been fed a corrupt food pyramid that has had a myopic focus on demonizing natural healthy saturated fats, telling you not to eat eggs and steak and ignoring a giant blind spot: refined carbohydrates, refined sugars, ultra-processed foods," Makary said. "In this new guidance, we are telling young people, kids, schools, you don't need to tiptoe around fat and dairy. ... You don't need to push low-fat milk to kids."

In early May, Trump criticized Makary for not moving quickly enough to ​approve flavored vape and nicotine products, according to a report from The Wall Street Journal.

Trump's advisers informed him that Makary was delaying the president's effort to "save" vaping," a pledge Trump made on social media during his presidential campaign, according to the Journal.

The FDA announced its first authorization of fruit-flavored electronic cigarettes intended for adult smokers on May 6. And last week, the FDA approved four new devices made by Glas, including classic menthol, fresh menthol, gold, and sapphire pods. "Gold" is mango flavored and "sapphire" is blueberry flavored.

The decision, which marked a significant policy shift from federal health officials, raised concerns from pediatrician groups and advocacy organizations about the potential impact on minors.

Makary had told ABC News' Linsey Davis in July, "There is not an approved vaping product in the United States that has one of these cutie-fruity flavors."

"What we're concerned about is kids who are starting vaping from scratch," he added. "I personally have met kids who know they're addicted, they don't want to be addicted, and they can't stop this addiction path that they're on."

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(LONDON) -- An epidemiologist from the World Health Organization (WHO) said Thursday that the suspected hantavirus cluster aboard a cruise ship is not the beginning of another COVID-19 pandemic.

Eight cases are currently being reported by the WHO, including five laboratory-confirmed cases and three suspected cases. Of those eight cases, three have died.

Dr. Maria Van Kerkhove, an infectious disease epidemiologist and acting director of epidemic and pandemic management at the WHO, was asked during a press conference what the difference was between this cluster and the early days of the COVID pandemic.

"I want to be unequivocal here. This is not SARS-CoV-2. This is not the start of a COVID pandemic. This is an outbreak that we see on a ship," Van Kerkhove said.

Van Kerkhove explained that hantavirus doesn't spread in the same way that coronaviruses do, but rather through "close, intimate contact." Most hantaviruses don't transmit from person to person.

"The actions that are being taken on board [the ship] are precautionary to prevent any onward spread," she added.

There appears to be one confirmed case and two suspected cases that have not been added to the WHO's official count yet.

Officials told ABC News a female individual, who was on a KLM flight with the Dutch female patient who later died, developed symptoms and was admitted to a hospital. Leiden University Medical Centre in the Netherlands confirmed on Thursday that the female patient has hantavirus and is receiving care.

Additionally, two Singapore residents who were on board the ship are currently being monitored. Singapore's Communicable Diseases Agency said it was notified of the individuals on May 4 and May 5.

"They have been isolated at the National Centre for Infectious Diseases, where they are being tested for hantavirus. The risk to the general public in Singapore is currently low," the agency said.

The agency added that test results are pending, with one resident having a runny nose and the other is asymptomatic.

Three deaths have been recorded so far, including a married Dutch couple. The 70-year-old male patient died on April 11, and his body was taken off the ship on the island of St. Helena on April 24. His 69-year-old wife disembarked on the same day, and her health rapidly deteriorated. She died at an emergency department in South Africa on April 26.

A third passenger, a German woman, presented with pneumonia symptoms starting on April 28, according to the WHO. The woman died on May 2 from causes not yet known, according to Oceanwide Expeditions, which operates the cruise ship.

The WHO said 29 people disembarked on St. Helena on the same day that the body of the Dutch male patient and his wife disembarked.

They traveled to 12 countries: Canada, Switzerland, Germany, Denmark, Great Britain, St. Kitts and Nevis, Netherlands, New Zealand, Singapore, Sweden, Turkey and the United States.

The disembarked guests have all been contacted by Oceanwide Expeditions. In the U.S., local authorities in three states -- Arizona, Georgia and California -- are monitoring the disembarked passengers and are conducting contact tracing, None have shown signs of illness at this time.

Anais Legend, technical lead for viral hemorrhagic fevers at WHO, said during the press conference on Thursday that "step-by-step guidance is being developed" for the disembarked passengers and that the WHO is coordinating with national authorities.

Anyone with any signs of symptoms will be isolated while other passengers have their risk exposure evaluated. 

Public health experts said they expected a more robust response from the Centers for Disease Control and Prevention (DC) and the National Institutes of Health.

"The CDC would typically be asked by WHO or by a country to help in technical assistance," Dr. Carlos del Rio, an H. Cliff Sauls distinguished professor of medicine at the Emory University School of Medicine, told reporters on Thursday.

Typically, CDC teams would be deployed to an area, he said, and the teams would perform contact tracing and interviews and conduct an outbreak investigation.

"I would envision by now, many, many days ago, we would have seen a team from CDC deployed to the area," he added.

Dr. Jeanna Marrazzo, CEO of the IDSA, added that she would have expected a CDC press briefing, an alert from the agency's Health Alert Network or information from the NIH on potential treatments in the pipeline that could receive emergency use authorization to help treat hantavirus patients.

Marrazzo said she is not aware that conservations about potential therpaies at NIH aren't happening but that it "doesn't give me a lot of assurance or reassurance that we are not hearing any of that."

The WHO said during Thursday's press briefing that the U.S. is coordinating with the global health agency in a technical capacity.

Because the cluster is limited and confined to a cruise ship, the "idea of sending messages across the world and panicking everyone is not required," said Dr. Abdirahman Mahmoud, director of the WHO's health emergency alert and response operations.

He added that the WHO is "informally" aware that contact tracing has been done of the U.S. passengers who disembarked last month and are back home.

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(LONDON and BELGRADE, Serbia) -- The total number of suspected hantavirus cases aboard a cruise ship has risen to five as global health authorities work to contain a potentially deadly cluster of the disease.

More than 100 passengers remain on the ship and the World Health Organization (WHO) is monitoring their health. Officials said that the "overall public health risk remains low" but that there may be some person-to-person spread.

The ship, the MV Hondius, which was off the coast of Africa in Cape Verde, is now en route to the Canary Islands after officials medically evacuated three people, including two in "serious condition."

Some passengers disembarked the ship before knowledge of the cluster and are back in their home countries. In some cases, authorities are advising those passengers to self-isolate.

In addition to the two patients who were evacuated, a third person, who is asymptomatic but a close contact of a German national who died on May 2, was also removed from the ship, WHO officials in Cape Verde told ABC News.

"WHO continues to work with the ship’s operators to closely monitor the health of passengers and crew, working with countries to support appropriate medical follow-up and evacuation where needed," Dr. Tedros Adhanom Ghebreyesus, the director-general of the WHO, said in a post on X on Wednesday, in which he confirmed the evacuations.

"Monitoring and follow-up for passengers on board and for those who have already disembarked has been initiated in collaboration with the ship’s operators and national health authorities," he continued.

Tedros added that "the overall public health risk remains low."

Health officials confirmed two additional cases of hantavirus among crewmembers, bringing the total confirmed cases to five.

The three previously confirmed hantavirus cases include a woman who disembarked and was on her way home from the Netherlands, a British national who is in critical but stable condition in a hospital in Johannesburg, and a passenger who traveled on the first leg of the voyage and is currently being treated at the University Hospital Zurich, according to Oceanwide Expeditions, which operates the ship. So far, three deaths have been recorded.

"Swiss authorities have confirmed a case of hantavirus identified in a passenger from the MV Hondius cruise ship," the WHO said on X on Wednesday. "He had responded to an email from the ship’s operator informing the passengers of the health event, and presented himself to a hospital in Zurich, Switzerland, and is receiving care."

The type of virus in this outbreak has been confirmed as Andes hantavirus by the National Institute for Communicable Diseases in South Africa and Geneva University Hospitals in Switzerland, the WHO said Wednesday. The Andes hantavirus historically has been shown to potentially transmit between people, according to the WHO.

Oceanwide Expeditions said of the three passengers who were evacuated from the ship, two are symptomatic and in serious condition and the third is asymptomatic but a close contact of a German national who died on May 2.

"In partnership with the RIVM (Dutch Institute for Public Health and Environment), Oceanwide Expeditions is expanding medical care on board with two infectious disease physicians, arriving today by plane from the Netherlands. This ensures that optimal medical care can be provided if necessary, during the next stage of this evolving situation," the company said in a statement.

Cape Verde officials said on Tuesday that the vessel was expected to sail to the Spanish island of Tenerife, but the president of the Canary Islands, a Spanish archipelago off the northwestern coast of Africa, said on Wednesday that the regional government was opposed to allowing the luxury cruise ship to dock in Tenerife. 

"This decision is not based on any technical criteria, nor is there sufficient information to reassure the public or guarantee their safety," President Fernando Clavijo told radio station COPE, according to Reuters.

Clavijo said on social media that he had requested a meeting with the Spanish prime minister to discuss the ship. He added that the Canary Islands "always acts with responsibility, but it cannot accept decisions taken behind the backs of the Canary Islands institutions and without sufficient information to the population."

Mónica García, Spain's minister of health, said once the ship arrives at the port of Granadilla de Abona in the Canary Islands, there will be a "joint screening and evacuation mechanism will be launched to repatriate all passengers," according to RTVE, a Spanish national public broadcaster.

“Unless their medical condition prevents it, all foreign passengers will be repatriated through the European civil protection mechanism, about which the Interior Minister will provide further details later," Garcia said in Spanish.

WHO officials earlier on Wednesday said the three evacuated people were to be transferred to planes bound for both the Netherlands and Tenerife, but later updated the plan so that all would be sent to the Netherlands, officials told ABC News.

ABC News' Othon Leyva contributed to this report.

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