Dhaka, Oct 24 (AP/UNB) - A severe viral outbreak at a New Jersey rehabilitation center for "medically fragile children" has left six youngsters dead and 12 others sick, the state Health Department said Tuesday.
There have been 18 cases of adenovirus at the Wanaque Center for Nursing and Rehabilitation in Haskell, about 30 miles (50 kilometers) northwest of New York, the New Jersey Health Department said in a statement.
The Centers for Disease Control and Prevention said in an email that it is providing technical assistance to the state. In the past 10 years, cases of severe illness and death from the type of infection found at the facility have been reported in the United States, said CDC spokeswoman Kate Fowlie in an email, though it's unclear how many deaths there have been.
The strain afflicting the children is usually associated with acute respiratory illness, according to the CDC, which on its website instructs health workers to report unusual clusters to state or local health departments.
The Health Department didn't release the ages of the victims or address the severity of the illness in the other dozen cases.
The six deaths happened this month, according to Health Department spokeswoman Donna Leusner.
The facility was instructed not to admit new patients until the outbreak ends, and the Health Department said the number of new cases appears to be decreasing.
Dr. William Schaffner, an infectious disease professor at Vanderbilt University Medical Center, said these kinds of fatalities are not common, but they're known to happen.
"Here I think you have this kind of nasty combination of very fragile children and this particularly aggressive virus," he said.
The strain in the New Jersey outbreak is No. 7 and is affecting "medically fragile" children with severely compromised immune systems, according to the Health Department. It has been associated with communal living and can be more severe
A scientific paper cited by the CDC reported that a 1998 outbreak of type 7 adenovirus at a pediatric chronic-care facility in Chicago claimed the lives of eight patients. The 2001 paper said civilian outbreaks of the type 7 infection had not been frequently reported because of a lack of lab resources, and that the full impact on chronic-care facilities and hospitals is likely underestimated.
In New Jersey, a team was at the center Tuesday and Sunday and found "minor handwashing deficiencies," the Health Department said.
"The Health Department is continuing to work closely with the facility on infection control issues," the department said in a statement.
The center helps educate "medically fragile children," according to its website. Messages left with the center were not returned.
Gov. Phil Murphy said in a statement that he was "heartbroken" about the deaths and that he had been briefed by the health commissioner, Dr. Shereef Elnahal, who told him that the department is on site and trying to prevent the virus from spreading further.
"I am confident that the steps being taken by state and local officials will minimize the impact to all those who remain at the facility, including patients and employee," Murphy said.
Adenoviruses often cause mild illness, particularly in young children, but people with weakened immune systems are at risk of getting severely sick, according to the CDC.
Washington, Oct 23 (AP/UNB) — President Donald Trump declared Monday the U.S. will begin cutting aid to three Central American countries he accused of failing to stop thousands of migrants heading for the U.S. border. But across his administration there was no indication of any action in response to what he tweeted was a "National Emergy."
For hours on Monday, White House officials were unable to provide an explanation for the president's threats, which reflected both his apparent frustration with the migrant caravan and his determination to transform it into Republican election gains. Federal agencies said they'd received no guidance on the president's declaration, issued as he attempts to make illegal immigration a focus of next month's midterm elections.
If Trump should follow through with his threat to end or greatly reduce U.S. aid, that could worsen the poverty and violence that are a root cause of the migration he has been railing against, critics said.
Trump tweeted, "Sadly, it looks like Mexico's Police and Military are unable to stop the Caravan heading to the Southern Border of the United States." He added without evidence that "criminals and unknown Middle Easterners are mixed in."
"I have alerted Border Patrol and Military that this is a National Emergy," he wrote. "Must change laws!"
Associated Press journalists traveling with the caravan for more than a week have spoken with Hondurans, Guatemalans and Salvadorans but have not met any of the "Middle Easterners" that Trump claimed had "mixed in" with the Central American migrants. It was clear, though, that more migrants were continuing to join the caravan.
Trump's tweets marked the latest escalation of his efforts to thrust immigration politics into the national conversation in the closing weeks of the congressional elections. He and his senior aides have long believed the issue — which was a centerpiece of his winning presidential campaign — is key to revving up his base and motivating GOP voters to turn out in November.
"Blame the Democrats," he wrote. "Remember the midterms."
At a campaign rally in Houston on Monday night, he falsely accused Democrats of "encouraging millions of illegal aliens to break our laws, violate our borders and overwhelm our nation."
Trump for months has sought to use foreign aid as a cudgel more broadly, threatening to withhold humanitarian and other aid from "enemies of America" and using it to pressure foreign governments to bend to his will. On Monday, he said he would be making good on his threat.
"Guatemala, Honduras and El Salvador were not able to do the job of stopping people from leaving their country and coming illegally to the U.S. We will now begin cutting off, or substantially reducing, the massive foreign aid routinely given to them," he wrote.
He added later at the White House: "We have been giving so much money to so many different countries for so long that it's not fair and it's not good. And then when we ask them to keep their people in their country, they're unable to do it."
However, it was unclear whether the president's tweets had any policy implications.
A Pentagon spokesman, Army Lt. Col. Jamie Davis, said the Pentagon had received no new orders to provide troops for border security. And a State Department official said the agency had not been given any instructions on eliminating or reducing aid to Central American countries.
Last April, Defense Secretary James Mattis authorized up to 4,000 members of the National Guard to help the Department of Homeland Security with southern border security, and approximately 2,100 were sent under the control of border state governors. That number, Davis said, has not changed.
The Pentagon also said it was going ahead with plans to include Honduras among the South American nations that will be visited this fall by the USNS Comfort, a hospital ship that Mattis has dispatched to help relieve stress on medical care systems as a result of refugee flows from Venezuela. The Comfort began treating patients in Ecuador on Monday and is scheduled to make stops in Peru, Colombia and Honduras, according to Pentagon spokesman Col. Rob Manning.
"The deployment reflects the United States' enduring promise of friendship, partnership and solidarity with the Americas," Manning said.
Asked what the administration was doing to operationalize the president's tweet, White House spokeswoman Sarah Huckabee Sanders told reporters Monday evening that "we're continuing to look at all options on the table."
"The president wants to make sure we're doing everything we can to secure and protect our borders and that's exactly what he's been talking about," she said.
It is Congress, not the president, that appropriates aid money. The White House would have to notify Congress if it wanted to cut or reallocate aid, which could delay or complicate the process.
Rep. Eliot Engel, the top-ranking Democrat on the House Foreign Affairs Committee, said Monday that "my colleagues and I will not stand idly by as this administration ignores congressional intent."
The three countries received about $500 million from the U.S. in fiscal year 2017. That money funds programs that promote economic development and education, as well as supporting democracy and human rights, among other issues. It was not immediately clear how much money Trump now hopes to cut, though the administration already had been pushing to reduce the government's global aid and foreign operations budget by about 30 percent for fiscal 2019 that began Oct 1.
Paul O'Brien, the vice president for policy and advocacy at Oxfam America, said that any attempts to decrease aid to the Central American countries would be "devastating" since the U.S. is a key investor in the region, funding programs on issues ranging from workforce development to reducing violence and improving human rights. In addition, other investors look to the U.S. as a guide.
"If you take that money away or you make it unpredictable, you're actually going to foster the very conditions that are driving people toward migration," said O'Brien, who accused Trump of "essentially seeking to use migrants as a political chip."
Last month, Vice President Mike Pence said that over the last year alone more than 225,000 people from the three Central American countries had attempted to illegally enter the United States, accounting for more than half of those apprehended at the southern border.
Cutting aid could also undermine what the Trump administration has identified as a key foreign policy goal: challenging China's emergence as a strategic rival in the region.
The governments of Guatemala, Honduras and El Salvador did not immediately respond to Trump's threat. Jimmy Morales, president of Guatemala, planned to travel to Tecun Uman on his country's border with Mexico late Monday.
On a three-day campaign swing to Western states last week, Trump raised alarm over thousands of migrants traveling through Mexico to the U.S. and threatened to seal off the U.S.-Mexico border if they weren't stopped.
As the migrants continued their northward march about 900 miles (1,450 kilometers) from the U.S. border, Trump blamed Democrats for their movement — despite the fact that Republicans currently control the White House, the House and Senate.
"Every time you see a Caravan, or people illegally coming, or attempting to come, into our Country illegally, think of and blame the Democrats for not giving us the votes to change our pathetic Immigration Laws!" he wrote.
Associated Press writers Robert Burns, Matthew Pennington and Matthew Lee contributed to this report.
Buffalo,Oct 23 (AP/UNB) — When thousands of others fled the struggling Rust Belt city of Buffalo, refugees poured in to fill to void and invigorate the economy.
Blighted blocks were tidied up by new arrivals from Iraq. Shops selling Ethiopian cuisine opened and employers snapped up workers from Myanmar and South Sudan. More than 12,000 refugees arrived in the area in 10 years, helping stymie decades of dizzying population loss.
But as the Trump administration throttles the flow of refugees into the United States and the president increases his anti-immigration rhetoric ahead of the midterm elections, Buffalo and other cities that rely on the new arrivals are beginning to feel the pinch.
"The number of refugees coming into Buffalo now is stalled and that hurts not only my business, but other businesses in town," said Larry Christ, chief operating officer of lighting manufacturer LiteLab, where six languages are spoken on the assembly floor. "Like a car, you need gas to fuel movement forward."
Big, burgeoning cities like San Diego and Dallas accept more refugees, but their arrival can resonate more in smaller, shrinking cities like Buffalo and Syracuse. This old steel and shipping hub had been locked in a long, losing struggle to keep people from leaving for places with less snow and more jobs.
Enter refugees and immigrants.
Refugees relocated with the help of four separate agencies settle into empty homes and fill jobs at hotels, restaurants and factories. Buffalo, a city that lost more than half its population since its post-war peak of around 580,000, is now hovering close to 260,000 people.
"We buy a house that is very old, so we get it cheaper in this way," said Nadeen Yousef, who fled from Iraq with her husband and four children in 2006. "And we fix it every year."
Yousef spoke from her booth at the West Side Bazaar, a retail space that was packed on a recent day with a lunch-time crowd buying halal food, bubble tea and dim sum served by refugee operators. The bazaar serves as an incubator for refugee and immigrant entrepreneurs, some of whom open their own shops selling food from Laos or clothes from Africa.
Yousef comes in after her 5 a.m. shift at a supermarket bakery to spend the afternoon selling handcrafted macrame products and international clothes.
The refugee reduction comes as some 7,200 Central American migrants in Mexico continue their trek toward the U.S. border. President Donald Trump has seized on the moment to renewed Twitter attacks against Democrats on for what he has called "pathetic" immigration laws.
Trump last year cited national security in slashing the annual cap on refugee arrivals to the U.S. from 110,000 to a historically low 45,000. Only 22,491 refugees entered the country last year amid a tougher review process.
The effect in the Buffalo region has been dramatic.
A metropolitan area that welcomed 1,934 refugees two years ago took in 686 last year and is on track to receive fewer than 450 people this year, according to an analysis of refugee placement data by the Fiscal Policy Institute. Arrivals could dip more this coming year now that the Trump administration lowered the refugee cap again for this budget year, to 30,000.
Refugees can cost money for localities in the short term, though there's research showing they pay more in taxes than they receive in benefits over years. Some local politicians have criticized refugees' cost and the potential security risk of hosting people from Syria.
But support for refugees is broad in Buffalo, a Democrat-dominated city. The Buffalo metropolitan area's growth rate has lagged behind the national average. But more single-family homes are selling for more money compared to earlier this decade.
There are multiple reasons for the uptick, but many see refugees as a crucial cog for growth.
"We need this influx of refugees or we just become a flat economy again," said Democratic state Assemblyman Sean Ryan.
The agencies in Buffalo help refugees learn English, find housing and land jobs. At the International Institute of Buffalo, Caitlin Monan recently prepped a room full of recent arrivals for questions they might face during job interviews. She handed out a worksheet that listed such questions as: Tell me about yourself? Do you have transportation?
"These are questions that every single interviewer will ask," Monan told the class. "These are good to practice."
Employers like Christ at Litelab and Avanti Advanced Manufacturing owner Jim Wei say they've had success with the refugees they hired. Christ recalled one applicant who was so committed, he biked to a job interview in snowy February. And more than a quarter of the high-end lighting company's 153 employees are refugees.
Litelab assembly floor worker Majid Al Iessa once helped the U.S. Army in Iraq before fleeing the war-torn country. Now his two children are in school and he has a home in the suburbs.
"I like Buffalo," he said, then laughs. "Just the snow is too hard."
Wei and Christ are among city employers having a tougher time filling jobs. Landlord Michael Maywalt, who credits refugees with helping renew the city's Black Rock neighborhood, is noticing fewer refugee families seeking to rent his properties.
Christ is still filling jobs and Maywalt is still renting apartments. But there's a palpable sense of concern among refugee advocates about the sustainability of Buffalo's modest resurgence.
"What I worry about is," said International Institute executive director Eva Hassett, "Where are the people who are going to take the jobs, start the businesses and buy the houses?"
Al-Tanf, Oct 23 (AP/UNB) — The top U.S. commander for the Middle East made an unannounced visit Monday to a key military outpost in southern Syria, pressing the need for a continued U.S. presence there to root out remaining Islamic State fighters and serve as leverage against growing Iranian activity in the region.
Striding through the rocky and dusty al-Tanf garrison, Army Gen. Joseph Votel said the outpost near the Iraq and Jordan borders still serves an important purpose even though U.S. and coalition troops have "largely eliminated" the Islamic State group from the area. But he said the overall mission has not shifted into a counter-Iran campaign.
"We have a defeat ISIS mission," said Votel, referring to the Islamic State group. "But I do recognize that our presence, our development of partners and relationships down here does have an indirect effect on some of the malign activities that Iran and their various proxies and surrogates would like to pursue down here."
An Associated Press reporter and journalists from two other media organizations accompanied Votel, head of U.S. Central Command, to the garrison. It was the first time that media members gained access to the garrison, which opened in 2015. For security reasons, his visit couldn't be disclosed until after he left the country.
Votel's visit to the base underscored the dual role it plays because of its strategic location.
There are 200 to 300 U.S. and coalition troops there to train and accompany local Syrian opposition forces on patrols to counter the IS group. The base is also located on a vital road linking Iranian-backed forces from Tehran all the way to southern Lebanon — and Israel's doorstep.
The military will not say how many of the troops are U.S., but they appeared to make up a significant portion.
Because of its location, the base represents what some believe is a key bargaining chip in the campaign to bring peace to Syria and to decrease, if not eliminate, the Iranian presence from the country.
Israel and the United States have demanded the withdrawal of all Iranian forces from Syria. But Russian President Vladimir Putin has warned that any talks about the withdrawal of Iranian forces would be contingent on providing security guarantees for Syria. Syrian leaders, meanwhile, have called for the withdrawal of U.S. troops from the Tanf area.
So, even as forces at the border base focus on the IS fight, they are seen as a military line in the sand against Iran's campaign to strengthen its hold on Syria.
A full withdrawal of Iranian-backed forces from Syria is unlikely, since Tehran and its proxies, including the Lebanese Hezbollah, have consolidated ground across southern Syria. Iran has repeatedly insisted that it only has advisers in Syria, but Tehran is now believed to command up to 80,000 Shiite militia fighters and paramilitary forces in Syria.
And Iran and Russia have given Syrian President Bashar Assad crucial military and political assistance as his regime has recaptured around 60 percent of the country.
Messages from President Donald Trump's administration on the U.S. role in Syria have been mixed, with Trump saying both that he wanted to get U.S. troops out and that stopping Iran's malign influence in the region is a priority. More broadly, the U.S. sees its military presence in Syria as a pressure point, to drive a political transition in the war-ravaged country.
Votel acknowledged the military's role in the ongoing push for a political settlement, saying that "a key part of our job is to ensure that our diplomats have the maximum amount of leverage to do their jobs. And holding terrain — whether it's al-Tanf or anywhere else — I think, provides leverage."
Still, he and other military leaders at the base focused on the IS fight on Monday, as troops trained members of the Maghawir al-Thawra, or MAT, a Syrian opposition group that numbers about 300.
Along the dirt berm that encircles the outpost, about 10 MAT soldiers were lying on the ground Monday morning, peering through the scopes of their M-16 rifles and firing at targets as part of a training day. U.S. Army Special Forces soldiers looked on and hollered out instructions.
Col. Muhannad al Tala, leader of the MAT troops, said through an interpreter that he wants the coalition troops to stay and to continue to go out on patrols with his forces to battle IS.
Standing on the Baghdad Damascus Highway, which cuts through the base, Tala said that while his main mission is IS, he believes his troops must protect people in the region from any force moving through, including Iran.
At his feet as he spoke were dozens of shell casings — a testament to the live-fire training that his troops have done along the outer perimeter.
Inside the coalition section of the garrison, bombed-out concrete structures, precariously held up by leaning columns scarred by artillery blasts, provided a grim reminder of earlier fights to take the outpost back from IS control.
Votel, who spent about six hours at the base, warned against counting IS out too fast.
He said the base provides a critical location where troops can watch for IS members fleeing the fierce fighting against the U.S.-led coalition in the Middle Euphrates Rivers Valley. The MAT, and coalition troops that accompany them on patrols, can help ensure that IS is not able to regroup and set up a headquarters in southern Syria.
And IS fighters fleeing the U.S.-led coalition from the final main combat in the Middle Euphrates River Valley are finding refuge in the sprawling deserts and scattered villages across southern Syria.
"I think the challenge for us is to keep the pressure on them," said Votel, adding that if the coalition doesn't keep IS on the run, the group gets the opportunity to reorganize and reconstitute their insurgent networks.
Houston, Oct 23 (AP/UNB) — President Donald Trump escalated his immigration rhetoric at a midterm rally in Texas on Monday, falsely accusing Democrats of "encouraging millions of illegal aliens to break our laws, violate our borders and overwhelm our nation."
With weeks to go before Election Day, Trump is seeking to drive Republican turnout with his hard-line immigration policies. He cast the November choice in stark terms before the Houston rally for Republican Sen. Ted Cruz, saying Democrats "have launched an assault on the sovereignty of our country."
Trump spoke before a massive crowd on behalf of his former foe, who faces a strong challenge from Democratic Rep. Beto O'Rourke. When the two competed in the 2016 Republican presidential primary, Trump would frequently deride his rival as "Lyin' Ted" but said in Texas that their relationship had come a long way.
"Nobody has helped me more with your tax cut, with your regulation," Trump said, also attacking O'Rourke, as a "stone-cold phony."
With the midterms drawing near, Trump has emphasized immigration, targeting a migrant caravan heading to the U.S. southern border. The president's focus on immigration politics comes as he seeks to counter Democratic enthusiasm in November. Trump believes that his campaign pledges, including his much vaunted — and still-unfulfilled — promise to quickly build a U.S.-Mexico border wall, are still rallying cries.
Trump is betting that his latest focus will further erode the enthusiasm gap that began to close during the debate over Brett Kavanaugh, Trump's nominee for the Supreme Court. But the approach offers both risks and rewards.
The hard-line rhetoric may be popular among the red-state rural Republicans who will play an outsized role in the top Senate contests. But it may further alienate the moderate Republicans and women in the overwhelmingly suburban races that will decide the House majority — including several in Texas, California and Florida that feature large Hispanic populations.
On Monday night, Trump called the caravan an "assault on our country" and suggested, without citing evidence, that "Democrats had something to do with it." He added: "We need a wall built fast."
Earlier Monday, Trump said the U.S. will begin "cutting off, or substantially reducing" aid to three Central American nations because of the caravan.
In Texas, an enthusiastic crowd packed into Houston's Toyota Center, wearing red Make America Great Again hats and waving signs, including some with the president's new catchphrase, "Jobs vs. Mobs."
Speaking before Trump took the stage, Cruz made clear that their conflict was behind them and that the two were working together. His biggest applause came when he predicted that "in 2020, Donald Trump will be overwhelmingly re-elected."
A series of elected state officials were among the warmup speakers, as well as Trump's daughter-in-law Lara Trump and son Eric Trump, who told the audience that "we are driving the Democrats absolutely nuts."
Trump gleefully used his latest attack line against Democrats, saying, "Democrats produce mobs, Republicans produce jobs." He declared Democrats would be a "big risk to the American family," and went after some of his favorite targets, including Democratic House Minority Leader Nancy Pelosi, California Rep. Maxine Waters, New Jersey Sen. Cory Booker and Massachusetts Sen. Elizabeth Warren.
The president stressed tax cuts, the strong economy and the hurricane response in the state. He repeated his pledge for a new middle-income tax cut of about 10 percent, though he offered few details on the plan. Trump said they would be "putting it in" next week, though Congress is not in session.
Trump also criticized so-called globalists, declaring, "You know what I am? I'm a nationalist."
Trump's Texas stop is part of a campaign blitz that is expected to last until Election Day.
Although political relationships tend to be fluid, Trump's appearance for Cruz is notable, given that the two were bitter enemies during the 2016 primaries. After Trump insulted Cruz's wife and father, and Cruz refused to endorse Trump at the Republican convention, it was far from clear that the two would ever put it all behind them.
But they started rebuilding in the closing days of the campaign and have worked together since Trump took the White House.
The White House views Cruz as a loyal vote for his agenda. Trump promised he would come to Texas after the Senate race grew closer than expected, with O'Rourke out-fundraising Cruz and drawing large and enthusiastic crowds around the state. Cruz, who is leading O'Rourke in the polls, said over the summer that he would welcome Trump's support, though he has brushed off any suggestion he'd need Trump to win.
During the 2016 Republican primary, Trump assailed Cruz as a liar and "dishonest politician," insulted his wife's appearance and promoted unsubstantiated claims that Cruz's father had links to President John F. Kennedy's assassin, Lee Harvey Oswald.
Trump on Monday did not voice any second thoughts about labeling Cruz the son of a presidential killer, telling reporters, "I don't regret anything."
Cruz gave back as good as he got in 2016. He savaged Trump as a "pathological liar," an "amoral bully" and a "sniveling coward." After Cruz lost the primary, he gave a speech at the Republican National Convention in which he did not endorse Trump and instead called on Republicans to "vote your conscience," drawing boos from the crowd. But he announced his support about a month before Election Day — and won points in Trump's camp for not withdrawing after the "Access Hollywood" tape was released in which Trump bragged about groping women. Associated Press writer Steve Peoples contributed to this report from New York.