Category: Infection

A Maryland resident was hospitalized with malaria after contracting the disease locally — a first in more than 40 years, Maryland Department of Health officials said Friday. Malaria is caused by a parasite transmitted through mosquito bites. The Health Department did not say precisely where the patient was exposed to malaria, but officials said the person lives in the National Capital Region, which includes Prince George’s, Montgomery, Charles and Frederick counties. The patient, who was not identified by age or gender, has been discharged and sent home to recover, officials said. “Malaria can be very dangerous and even fatal if it is not treated, but early treatment reduces the chances of complications,” Deputy Secretary for Public Health Services Nilesh Kalyanaraman said in a statement. “We urge the public to take precautions against mosquito bites, and if you develop symptoms after traveling abroad, seek urgent medical care.” Locally contracted malaria cases have also been reported in Florida and Texas this year for the first time in decades, raising concerns that the disease could return to areas where it has long been considered eradicated. Malaria was declared “eliminated” in the United States in 1951, and the World Health Organization designated the country “malaria free” in 1970. Some scientists have warned that rising temperatures caused by climate change may help spread malaria by expanding the mosquito’s natural territory, something a recent study showed is already happening in parts of Africa. Climate change may make it easier for mosquitoes to spread malaria The locally transmitted case in Maryland reported Friday came from a different strain of parasite than the recent cases in Florida and Texas, a Health Department official said. The Maryland case was caused by a parasite called P. falciparum, while the cases in Florida and Texas came from a parasite called P. vivax. Share this articleShare People can prevent mosquito bites by using an insect repellent that contains DEET, wearing loosefitting, long-sleeved clothing, closing windows and doors or covering them with screens, and emptying standing water at least once a week to prevent mosquitoes from laying eggs. Malaria symptoms typically appear seven to 30 days after a bite from an infectious mosquito, the state Health Department said. Patients may develop fever, chills, headache, body aches and fatigue. Anyone experiencing those symptoms who may have been exposed to malaria should seek urgent medical care, officials said. Maryland typically reports about 200 travel-related cases of malaria each year, and there are more than 2,000 cases reported in the United States annually, but for decades all of those cases occurred in people who had recently visited areas of the world where the disease is more common. What to know about malaria after rare cases are found in Florida, Texas Maryland has long been home to the Anopheles mosquito, which can spread the parasite that causes malaria from person to person. David Blythe, director of the Maryland Department of Health’s Infectious Disease Epidemiology and Outbreak Response Bureau, said the state had eradicated locally contracted infections because of mosquito control efforts that significantly reduced the public’s exposure to the Anopheles mosquito. Blythe said one way malaria could be reintroduced to Maryland is by someone who contracted the parasite in another country and brought it back to the state. If a local mosquito bit that person in Maryland and then bit a second person, it could spread the parasite. Travelers who know they could be exposed to malaria-spreading mosquitoes in another country can get preventive drugs from their physician to reduce the chances that they contract the disease and spread it to others.

Infections with Vibrio vulnificus are rare, especially in the Northeast. But a few recent cases suggest that precautions are wise for some wading into the water. The News With Labor Day and the start of a new school year looming, throngs of New Yorkers will head to the beach this weekend, braving traffic, sunburns, maybe sharks — and Vibrio vulnificus, a nasty, flesh-eating bacteria that thrives in warm seas and brackish water. Since the beginning of July, four people in the greater New York area have been infected with the bacteria, including three who have died, according to health officials in New York and Connecticut. Two of the people sickened in Connecticut had been exposed to saltwater or brackish water in the Long Island Sound. One had eaten raw oysters, which can become infected with the bacteria during warm spells. (The cause of the fourth infection, which killed a Suffolk County resident, is not known.) “If we were having this conversation 15 years ago, we’d be talking about infections along the Gulf Coast,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University School of Medicine. “But now these infections are creeping up the East Coast.” The bacteria Vibrio vulnificus is related to the type that causes cholera.Janice Haney Carr/Centers for Disease Control and Prevention The Back Story: An infection that surprises beachgoers. It’s not clear whether the appearance of these cases farther north than usual may be a result of better diagnosis or to warming waters associated with climate change. The illness, technically called vibriosis, may be caused by infection with several related bacteria. Among the worst is V. vulnificus, which is relatively rare but can be deadly for those who are vulnerable, with survival rates as low as 33 percent, according to one scientific paper. The bacterium spreads most commonly in two ways. When people swim in waters contaminated with V. vulnificus, an open sore or cut can provide an entry point for the organism. From there it spreads, becoming a so-called flesh-eating infection that extends quickly beyond the wound into healthy tissue. Then it may spill over into the bloodstream, causing a life-threatening condition called sepsis. The bacterium also spreads when people who are immunocompromised or have liver disease eat raw oysters that are contaminated. Physicians warn patients with these conditions against eating raw oysters, which become infected by seawater they filter for food. Older people are generally at greater risk. The three patients who fell ill in Connecticut were all over age 60. People who take medications to reduce stomach acid may also be more likely to get infected or to develop complications following infection. If you’re among the vulnerable, wear shoes that protect against cuts and scrapes when you’re in salty or brackish water. Wear protective gloves when handling raw seafood. Avoid swimming in the ocean if you have a cut, scrape or other abrasion that might let in the bacterium. What to Watch: The bacterium seizes on openings. Vibriosis causes a wide range of symptoms, including diarrhea and stomach cramps, vomiting, fever, chills, ear infections and wound infections. The intestinal problems occur more quickly in people who have ingested the bacterium, usually by eating raw oysters. Ear and wound infections will become red, swollen and extremely painful over a bit more time. Blisters filled with clear liquid may appear on the skin. Symptoms usually appear within 12 to 24 hours of exposure, and people should seek medical care as soon as possible. Tell doctors about the exposure: The infection can spread quickly if left untreated. “If the wound starts to look red, puffy and painful, or has a discharge, or redness spreading beyond the edges of the wound, you need to get medical attention right away,” Dr. Schaffner said. “Don’t try to tough it out and wait to see if it gets worse tomorrow.” A lab test is needed to make the diagnosis. Treatment involves antibiotics and supportive care, but surgery may be required to clean out an infected wound and stop the spread of the infection. Your Beach Weekend: The vulnerable should exercise caution. Consider avoiding the water, and not even walking on the beach or wading, if you have an open wound, including one from a recent surgical operation or piercing or tattoo. An open wound means any cut, scrape or other abrasion that might allow the bacterium into your body. If there is a chance your wound could come into contact with saltwater or brackish water, marine life, or raw or undercooked seafood while you’re cooking, swimming, fishing, boating or walking on the beach, cover the open wound with a waterproof bandage. If a wound or cut does comes into contact with brackish water or saltwater, raw seafood or its juices, wash it thoroughly with soap and water. If you develop a skin infection, let your health provider know quickly — this is an infection that can spread rapidly. What’s Next: Watch for the infection in unexpected places. Climate change will test all of us in unexpected ways. Vibrio infection is something Americans living in the Northeast may need to watch for now. If you have cancer, are immunocompromised, have liver disease or take drugs to lower stomach acid, doctors say you should not eat raw or undercooked oysters or other raw or undercooked shellfish. (Of course, the same is true for pregnant women.) If you’re handling raw shellfish, wash your hands thoroughly with soap and water afterward.

It may feel like pandemic déjà vu: New Covid-19 variants are afoot, and hospitalizations are again on the rise. Eris recently became the most prevalent Covid variant, but now international health officials have their eyes on a new variant of concern. The latest strain — called BA.2.86 — has so far been detected only in the US, Denmark and Israel. It’s caught the attention of the US Centers for Disease Control and Prevention and the World Health Organization, which are closely monitoring the situation. For now, experts aren’t too concerned. 1. What is BA.2.86? The strain was first spotted by virus trackers in mid-August. Not much is known yet about how it stacks up against other variants. It appears to be a descendant of the BA.2 variant that first emerged in early 2022, but this lineage has more than 30 mutations on its spike protein, which helps the virus latch onto cells and cause infection. That could make it better at evading immunity from vaccines and past infections. 2. What about Eris? Eris, formally called EG.5, is a descendant of a group of coronavirus strains labeled XBB. These are all offshoots of the omicron variant, which arose in late 2021. EG.5 made up an estimated 17.4% of global cases in the week ending July 23, according to the WHO, up from only 7.6% four weeks earlier. It recently became the most common strain in the US, according to estimates by the CDC. 3. How concerning are the new variants? Eris poses a low risk to global public health, the WHO said. Although it’s growing in prevalence in comparison with other strains and appears to be better at evading the body’s immune defenses, there’s no evidence it causes more severe disease or can spread more easily than other versions of Covid. Pfizer Inc. and Moderna Inc. have both said that their updated Covid vaccines, formulated to target the variant known as XBB.1.5, protected against Eris in early studies. As for BA.2.86, its mutations give it “all the hallmark features of something that could take off,” said Kristian Andersen, a Scripps Research immunologist and microbiologist. However, it’s too early to tell. 4. What symptoms does it cause? Share this articleShare The symptoms of Eris and other variants seem to be the same as those caused by previous strains, according to Thomas Russo, chief of the Division of Infectious Diseases at the University of Buffalo’s medical school. Common ones include a runny nose, headache, fatigue, a sore throat and sneezing. People who are older, have compromised immune systems or suffer from multiple other conditions are at higher risk for more severe effects. These may include lower respiratory disease, chest pain and shortness of breath. The virus still kills hundreds of people each week in the US, so it’s important to get tested if you think you may be infected. 5. What’s causing a rise in US hospitalizations? The number of people admitted to the hospital with Covid-19 is on the rise for the first time this year in the US, and wastewater data has also shown cases ticking up. Hospitalizations are up in multiple other countries as well. But there’s no evidence linking increased hospitalizations to new strains, the WHO says. Experts point to other likely culprits: Extreme heat is driving gatherings indoors, where the coronavirus spreads more easily. Also, with the pandemic over, people are traveling again and no longer wearing masks. And for many people, it’s been months since they last got a vaccine or contracted the virus, meaning their immunity against infection is waning. 6. Is the US prepared for a rise in Covid-19? The US has scaled back its response to Covid-19. The government no longer purchases vaccines and treatments for the public, and free tests aren’t as widely available. Still, experts say the US isn’t likely to see the kind of surge in cases that upended life in the early years of the pandemic. Because of vaccination and prior infections, the population has widespread protection from severe disease, and therapies like Pfizer’s Paxlovid antiviral drug can reduce the risk of hospitalization and death if they’re taken early on. Even after recent increases, hospital admissions are lower than at at any other point since at least August 2020, according to CDC data. 7. What can you do to protect yourself? New booster vaccines will be available later this year, and experts say they’re especially important for vulnerable people. If you’re at higher risk and you’re going to be in a situation where exposure is likely, such as a large gathering, Russo says you can consider getting a booster shot of one of the older vaccines that are already on the market. In any case, masks help protect against infection. Pharmacies still offer Covid-19 testing services and sell at-home tests. If you’re at high risk and you develop symptoms, a test can help determine whether you should start taking Paxlovid. More stories like this are available on bloomberg.com ©2023 Bloomberg L.P.

Sat, 19 Aug 2023 09:35:34 GMT (1692437734646) 55c58b1fa74010023bca747d4191e371d8d95a2f 987079a68c49a092641e253415432e4dfc51b5a6 by Stephanie Becerra Sat, August 19th 2023, 2:55 AM UTC Image of Barton Springs Pool infected tree and separate healthy pecan tree. (Photo: Austin Parks & Recreation) Loading …

TAMPA, Fla. (WFLA) — Five people are confirmed dead in the Tampa Bay area due to a rare, flesh-eating bacteria in the waters. According to Florida Health, Vibrio vulnificus is a bacterium that naturally occurs in warm, brackish seawater and requires salt. Ivermectin still not effective or approved for COVID-19 treatment, FDA says There have been 25 reported cases and five deaths since January 2023. “Living in Florida, being around the marine environment, we need to be aware of what it is,” said Dr. Eric Shamas, an emergency medicine physician at Bayfront Health St. Petersburg. There are two confirmed deaths in Hillsborough County, one in Sarasota County, one in Polk County, and one in Pasco County. In 2022, there were 74 total cases and 17 deaths. Most occurred in Lee County after Hurricane Ian’s waters flooded the community. According to Florida Health, a person can get infected with Vibrio vulnificus when eating raw shellfish, particularly oysters, and entering seawater with an open wound, especially in the summer months Opioids, obesity now ranked as top public health threats in new poll “Whenever you have a break in the skin and you’re in a marine environment then theoretically you’re at risk,” Shamas said. “It’s very important to keep in mind these severe infections are very rare.” Health officials warn citizens to not enter the water if they have fresh cuts or scrapes, as the bacteria can enter the bloodstream rather quickly. Bloodstream infections are fatal 50 percent of the time. “If you have wounds, maybe stay out of the water,” Shamas said. “If you suffer a cut while in the water, just wash it out very thoroughly with soap and water. Monitor your symptoms and follow up with your doctor if you have any questions.” Common symptoms of the flesh-eating bacteria include vomiting, diarrhea, abdominal pain, and infection of the skin (if there is an open wound). Those with healthy immune systems are likely to experience a mild infection. Rare use of power: Why a wedding photographer with a clean record was held in jail for a year, but never charged Those with weakened immune systems, or have chronic liver disease, are more prone to serious and life-threatening illnesses with symptoms like fever, chills, decreased blood pressure, septic shock, and blistering skin lesions. To prevent Vibrio vulnificus infections, avoid eating raw shellfish and oysters, cook shellfish thoroughly, avoid cross-contamination of cooked seafood and raw seafood, avoid exposure of open wounds or broken skin to warm salt or brackish water, and wear protective clothing when handling raw shellfish. Seek medical help right away if you believe you may have an infection. For more information on care and treatment specifics, visit the CDC’s website. Close Modal Suggest a Correction Suggest a Correction

Doctors have issued a warning about an alarming sign on your hands that could be a symptom of a silent killer. Endocarditis, a rare and potentially fatal infection of the inner lining of the heart, is usually caused by bacteria entering the blood and travelling to the heart, the British Heart Foundation says. While symptoms can range from night sweats to swelling in your feet, another sign could be on your palms. If you spot any red or purple marks on your palms or fingers, you may need to seek the advice of a GP. Endocarditis is very rare in people with normal hearts who have no other risk factors but the symptoms have sometimes been known to start suddenly and are severe – in some cases it can even be fatal. Although the heart is usually well protected against infection, it may be easier for bacteria to bypass the immune system in people who have: an artificial heart valve congenital heart disease hypertrophic cardiomyopathy – where the heart muscle cells have enlarged and the walls of the heart chambers thicken damaged heart valves had endocarditis before. Other symptoms of endocarditis The initial symptoms of endocarditis are similar to flu and include a high temperature, chills, headache, joint and muscle pain. Without treatment, the infection damages the heart valves and disrupts the normal flow of blood through the heart. Endocarditis is treated with a course of antibiotics given via a drip and you’ll need to be admitted to hospital for this. It’s also possible to have surgery to repair or replace a damaged valve or to drain any abscesses. The NHS warns that endocarditis is a serious illness, especially if complications develop. Early diagnosis and treatment is vital to improve the outlook for the condition. Marks and Spencer launches summer sale and there’s huge savings on kids’ clothing

Here’s our weekly round-up of what illnesses are spreading the most in Metro Detroit communities, according to our local doctors and hospitals. Wayne County — Bee stings, infected bug bites, hand foot & mouth disease, seasonal allergies, asthma flare-ups, strep throat, COVID Dr. Kevin Dazy — Pediatrician, Children’s Hospital of Michigan “We continue to see kids with croup and hand-foot-mouth symptoms of rash and mouth sores. Once hand-foot-mouth starts going around, we expect the numbers of kids with the virus to grow. Right now, though, all thoughts are on back-to-school. Parents should be working on getting their kids updated on vaccines to ensure their children are protected against preventable disease. We see too many families who deal with these preventable diseases when their child is hospitalized or dealing with issues that were completely avoidable saying, ‘I wish I would have gotten those vaccinations.’ Now’s the time. “ Dr. Tiffany Widner — Pediatrician, Children’s Hospital of Michigan “We are seeing allergic reactions to bug bites, hand foot mouth, viral infections including viral URIs (cold symptoms) and contact dermatitis from environmental exposures (the name for rashes that can be associated with things like poison ivy, grasses, etc). We also are still seeing a lot of allergy and asthma complaints. In terms of back to school, I would recommend that parents turn their school forms in to their physicians as soon as possible, if they haven’t done it already. Also keep in mind that we are unable to complete forms if the child hasn’t been seen in the past year. Parents should consider the COVID19 vaccine as numbers are creeping up, and children in school will be at risk for contracting the illness. Also, remember the flu vaccine will be coming out next month. And now is the time to start putting all of the children back on a regular sleep schedule prior to the start of school.” Oakland County — Bee stings, infected bug bites, summer rashes, hand foot and mouth disease, seasonal allergies, asthma flare-ups, COVID, ear infections Dr. Steven McGraw — Chair of Emergency Medicine, Ascension Providence Hospital, Southfield Campus “I’m still seeing LOTS of bee stings. Some are rather serious and if people are allergic, make certain to have epi-pens available. Bees and wasps get aggressive during this time of year. I’m seeing some patients with COVID-19. It’s still lower than before, but coming back.” Dr. Jennifer Stevenson — Division Head, Fairlane Emergency Department Senior Staff Physician Department of Emergency Medicine Henry Ford Hospital, Fairlane “The number of strep cases continues to blow my mind! We’re also definitely seeing an uptick in COVID-19 cases. Generally speaking, those who are younger without medical problems are faring well. We have seen an increase in COVID-19 hospital admissions in those with co-morbidities. In addition, there’s been some hand-foot-mouth in the community. We’re also seeing a lot of allergic reactions. I think the bees get a little feisty this time of year. Those who are allergic should be sure to have their epi pens on hand!” Sarah Rauner — Pediatric nurse practitioner, Emergency Center, Corewell Health’s Beaumont Hospital, Troy “We are continuing to see some summer time rashes and bug bites that can become infected. Hand foot and mouth disease has made an appearance as well. Less vomiting and diarrhea lately however COVID has picked up a little bit. Keep washing your hands in preparation for the fall and school!” Dr. Susan Bork — Director of Operations, Emergency Center, Corewell Health’s Beaumont Hospital, Royal Oak “We are seeing an uptick in gastroenteritis cases with symptoms of vomiting and diarrhea, as well as sore throats and hand, foot and mouth infections. There has been a slight increase in mild COVID cases and no major changes in allergies.” Caroline Morris, PA-C — Henry Ford-GoHealth Urgent Care Centers “Presently we are seeing an increase in flu-like symptoms that are neither the flu or COVID-19, but rather a really bad cold (rhinovirus). We are still seeing an increase in COVID-19 cases currently that seem to present with fatigue cough and sore throat. We’re also seeing a lot of sporting injuries that include dislocated fingers, wrist, hand, knee and ankle injuries.” Dr. Rena Daiza — Primary Care Physician, Henry Ford Medical Center Bloomfield Twp. “With the weather changes this week, I am seeing a lot of allergies and asthma flares. Asthma can often overlap symptoms with upper respiratory illnesses, so people should be sure to test for respiratory illnesses like COVID-19. An upper respiratory illness should be suspected if usual remedies for asthma and allergies are not helping symptoms.” Emergency Department at Henry Ford West Bloomfield Hospital “I am seeing a lot of a lot of pain complaints (abdominal, flank and headache). We have had some allergic reactions from bees and peanut butter allergies. Falls and shortness of breath are also some of the top complaints.” Washtenaw County — Sore throats, COVID, infected bug bites, summer rashes Monroe County — Stomach viruses, sore throats, pink eye, swimmer’s ear Macomb County — Bee stings, infected bug bites, poison ivy, seasonal allergies, eye infections, sore throats Dr. Matthew Steck — Emergency physician at McLaren Macomb “There has been a noticeable increase in the prevalence of water incidents, including injuries and near-drowning, prompting the ER to urge extra caution when in and around water. Across all ages and patient populations, various orthopedic and soft tissue injuries continue to be the most common reason to seek care in the emergency and trauma center. Following a brief uptick in viral infections causing upper respiratory infections and a lingering cough, those cases have tapered off. Though an increase in cases has been reported on, there has not been a significant increase in the prevalence of COVID-19 diagnoses. “ Livingston County — Increase in rabies treatment due to bat exposures

Mariia Zotova/Getty Images Three people have died in New York and Connecticut after coming into contact with the Vibrio vulnificus bacteria, which can cause a rare but severe infection, according to health officials. In Connecticut, two people who died likely got the Vibrio vulnificus infection (vibriosis) after swimming in salt or brackish water in the Long Island Sound with open wounds. A third person in the state, who was hospitalized but has not died, was infected after eating raw oysters from an out-of-state establishment. The death in New York’s Suffolk County is still being investigated to determine where the bacteria was encountered, according to a news release from the state’s department of health. Health officials in both states are now warning residents and providers to be aware of the possibility of vibriosis, and to swim in seawater and eat raw seafood with caution. “While rare, the vibrio bacteria has unfortunately made it to this region and can be extraordinarily dangerous,” New York Governor Kathy Hochul said in a news release. “As we investigate further, it is critical that all New Yorkers stay vigilant and take responsible precautions to keep themselves and their loved ones safe, including protecting open wounds from seawater and for those with compromised immune systems, avoiding raw or undercooked shellfish which may carry the bacteria.” Here’s what to know about vibriosis, and how best to protect yourself. Vibriosis is a bacterial infection caused by several species of Vibrio bacteria. In these recent cases, Vibrio vulnificus bacteria is the culprit. It’s estimated that vibriosis causes 800,000 illnesses and 100 deaths in the U.S. each year, and results from people consuming raw or undercooked seafood, or exposing an open wound to seawater. Most infections occur when the weather is warm—between May and October. Though most people who are immunocompetent will have a mild case of vibriosis,Vibrio vulnificus bacteria in particular can cause life-threatening wound infections that can lead to necrotizing fasciitis, which is why it’s commonly referred to as a “flesh-eating bacteria,” according to William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine. The Centers for Disease Control and Prevention report that people with Vibrio vulnificus infections often require intensive care or limb amputations. An estimated 1 in 5 people with the infection die, often with a day or two. Though anyone can get vibriosis through a wound or via eating raw seafood, there are some people who may be more likely to get an infection and have it turn severe, including people who have a weakened immune system, liver disease, or are taking medication to lower stomach acid levels. How a Vibrio vulnificus infection presents depends on how it was acquired—whether it was through eating raw or undercooked oysters or shellfish, or if the bacteria gets into an open wound, according to Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security. If it’s ingested, people can expect to have some gastrointestinal symptoms that typically start within 24 hours of eating the contaminated food and can last approximately three days. Those symptoms include: Watery diarrhea Abdominal cramping Nausea and vomiting Fever and chills Vibrio vulnificus infections can also cause more severe illness when ingested, leading to bloodstream infections and severe blistering skin lesions. If Vibrio vulnificus gets into an open wound, it can cause a life-threatening infection that can spread throughout the entire body. The symptoms of a wound infected by the Vibrio vulnificus bacteria include: Fever Redness Pain Swelling Warmth Discoloration Discharge (leaking fluids from the wound) People are typically diagnosed with vibriosis if Vibrio bacteria are found in their wound, blood, or stool. People with a gastrointestinal case of vibriosis may not need any treatment other than supportive care; in more severe cases, infections are treated with antibiotics, and potentially amputation to remove dead or infected tissue. Since you can get vibriosis from raw or undercooked seafood—particularly raw oysters and shellfish—the only way to fully cook seafood to kill the bacteria. (The CDC notes that neither hot sauce nor lemon will kill Vibrio bacteria; drinking alcohol while eating oysters won’t kill it either). You also can’t tell if an oyster or other seafood contains the harmful bacteria just by look, smell, or taste. People who are healthy or immunocompetent may be able to eat oysters without much of a risk, but some people are much more likely to get an infection or severe complication, including people who: Have liver disease, cancer, diabetes, HIV, or thalassemia (an inherited blood disorder) Receive immune-suppressing therapy Take medicine to decrease stomach acid levels Have had recent stomach surgery Regarding wound infections from Vibrio vulnificus, the best way to reduce your chances is to stay out of saltwater or brackish water (a mix of fresh and saltwater) if you have any kind of open wound, which includes recent piercings, tattoos, or surgeries. You can also get a Vibrio wound infection if it comes into contact with raw or undercooked seafood or its juices. “If you’re immunocompromised and have a new injury that hasn’t healed, stay out of the water,” Dr. Schaffner said. “This is the time to relax in the sun instead.” If you must go into saltwater or brackish water with an open wound, you should cover with a waterproof bandage, and then wash wounds and cuts thoroughly with soap and water after any potential contact.

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TAIPEI, Taiwan — China will no longer require a negative COVID-19 test result for incoming travelers starting Wednesday, a milestone in its reopening to the rest of the world after a three-year isolation that began with the country’s borders closing in March 2020. Foreign Ministry spokesperson Wang Wenbin announced the change at a briefing in Beijing on Monday. China in January ended quarantine requirements for its citizens traveling from abroad, and over the past few months has gradually expanded the list of countries that Chinese people can travel to and increased the number of international flights. Beijing ended its tough domestic “zero COVID” policy only in December, after years of draconian curbs that at times included full-city lockdowns and lengthy quarantines for people who were infected. The restrictions slowed the world’s second-largest economy, leading to rising unemployment and rare instances of unrest. As part of those measures, incoming travelers were required to isolate for weeks at government-designated hotels. Protests in major cities including Beijing, Shanghai, Guangzhou and Nanjing erupted in November over the COVID curbs, in the most direct challenge to the Communist Party’s rule since the Tiananmen protests of 1989. In early December, authorities abruptly scrapped most COVID controls, ushering in a wave of infections that overwhelmed hospitals and morgues. A U.S. federally funded study this month found the abrupt dismantling of the “zero COVID” policy may have led to nearly 2 million excess deaths in the following two months. That number greatly exceeds official estimates of 60,000 deaths within a month of the lifting of the curbs. During the years of “zero COVID,” local authorities occasionally imposed snap lockdowns in attempts to isolate infections. People were trapped inside offices and apartment buildings. In some cases widely discussed on social media, authorities sealed residents’ doors with wires and bolts to try to stop the virus from spreading. From April until June last year, the city of Shanghai locked down its 25 million residents in one of the world’s largest pandemic-related mass lockdowns. Residents were required to take frequent PCR tests and had to rely on government food supplies, often described as insufficient. Throughout the pandemic, Beijing touted its “zero COVID” policy -– and the initial relatively low number of infections -– as an example of the superiority of China’s political system over that of Western democracies. ___ Associated Press news assistant Caroline Chen in Beijing contributed to this report.