Across Europe, rivers aren’t flooding when they used to.

Long-term changes in temperature and precipitation are making some rivers flood days, weeks or even months earlier than they did 50 years ago, and pushing flooding in other areas much later, researchers report August 11 in Science. Those changes could impact people, wildlife and farms near rivers.

Previous studies have shown that climate change is likely to increase the severity and frequency of coastal floods, but it can be tricky to concretely link river flooding to climate change, says Günter Blöschl, a hydrologist at the Vienna University of Technology who led the study.
Coastal flooding is worsened largely by one overriding variable that can be tracked: sea level rise. But river flooding is affected by a complex set of factors, says Rob Moore, a policy analyst at the Natural Resources Defense Council in Chicago who specializes in water issues. Both the timing and quantity of precipitation matter, as does the type of soil and whether it’s dry or already waterlogged when rain hits. What’s more, changes in land use around a river or engineering projects such as dams that change river flow can also affect flood risk — but aren’t necessarily related to the climate.
So instead of tracking the size or frequency of river floods, the researchers examined the seasonal timing of those floods. That measurement is less impacted by factors that have nothing to do with climate. Blöschl worked with researchers from 38 countries to analyze hydrological data collected at 4,262 sites across Europe from 1960 to 2010.

Flood season shifted as much as 13 days earlier or nine days later per decade, the researchers found. Over the entire study period, that shift added up to floods in some regions occurring, in the most extreme cases, as much as 65 days earlier or 45 days later. The biggest changes were in Western Europe, where a quarter of the monitoring sites recorded flood timing shifts of more than 36 days over the 50-year period. Elsewhere, effects were more moderate, though still measurable: In northeastern Europe and the area around the North Sea, for instance, more than half of the stations showed shifts of more than 8 days.
The effect varies substantially by region because not all parts of Europe experience the same sorts of floods, says Blöschl. In southern Sweden and the Baltics, floods are mostly driven by snowmelt. Warmer local temperatures make the snow melt earlier in the spring, shifting flood season up, too. In southern England, on the other hand, heavy autumn rains saturate the soil, and subsequent winter deluges can cause flooding. Flood season there is driven by when the soil gets too waterlogged to take in more moisture.

The study shows that flood timing has changed, but does not address specific consequences. It’s clear, though, that off-season flooding could have far-reaching effects, especially if these trends continue. Animals that rely on river conditions at a certain time of year in order to breed or find food could be affected by surprise floods. Out-of-season floods or unexpected dry spells could damage crops.

Plus, people are less prepared when big floods happen off-season, says Moore. While a comprehensive study like this one hasn’t been done in the United States, floods are occurring at unusual times here, too, he notes. Moore cites devastating floods that swelled the upper Mississippi River to a record size in December 2015 — not the time of year when the river is expected to overflow its banks. That flooding, combined with tornadoes spurred by the same storm system, killed more than 50 people and caused almost $2 billion in damage.

Just a stab in the dark, but you’ve probably heard: There is a total solar eclipse today, August 21.

For the first time since 1979, the moon’s shadow will zip across the continental United States. The shadow will travel from Oregon to South Carolina in a swift 92 minutes. For those in the path of totality, total darkness will last only a couple of minutes. There and elsewhere in most of the United States, the moon will partially block the sun for around three hours.
If you don’t already have plans to travel to the 115-kilometer-or-so-wide path of totality, well, you’re probably too late. But here are some links to help you experience the eclipse, whether or not you’re able to see it in person.

The eclipse will be visible in all of North America — as well as in Central America and a small part of South America. Wondering what you’ll see where you live? Check out this interactive map from NASA or this cool tool from Vox.

Still need eclipse glasses? While many retailers have been sold out for days, some organizations are handing out free glasses at eclipse-watching events. Check your local TV/newspaper/radio stations’ newsfeeds for the latest. Make sure your glasses are safe.

No eclipse glasses? Never fear! You can still see the moon eclipsing the sun by making a pinhole projector or a box projector. Or just let sunlight shine through something that has holes, like a colander or Ritz Cracker (look at the ground to see the shape of the shadow the holes cast).

Watching with kids? Check out Growth Curve blogger Laura Sanders’ tips for protecting little ones’ eyes during the eclipse.
Which reminds me: Whatever you do, don’t look directly at the sun. Permanent damage to your eyes may result. If you’re in the path of totality, officials say it’s OK to look directly at the sun once the moon completely blocks it. But that’s very brief, so be prepared to quickly look away or shield your eyes once the moon slips out of total alignment.

Want to do more with your eclipse experience? It’s not too late to participate in a citizen science project.

Stuck indoors, or out of totality? Watch the livestream. NASA’s programming begins at noon Eastern on NASA TV, which you can watch at this link or right here:
Want some tunes to go along with it? The NASA interns made an eclipse playlist. There are also several Spotify playlists around, like this one from WXPN, this from the Washington Post and this one from the Boston Globe.

If all this excitement has you fancying a future in eclipse chasing, check out our interactive map of the next 15 total solar eclipses.

And let’s not forget that there will be a ton of science going on during the eclipse. Here are the big questions physicists and astronomers will seek to answer today.

Still want more? Follow us on Facebook and on Twitter for eclipse updates and RT’s of our correspondents in totality. Watch as the Science News team takes over the Society for Science & the Public’s Snapchat (Society4Science). And come back to Science News later today for a report from our astronomy writer, Lisa Grossman, who is spending the day in Casper, Wyo., with a research team that’s studying the sun’s wispy atmosphere, the corona.

A Neandertal child whose partial skeleton dates to around 49,000 years ago grew at the same pace as children do today, with a couple of exceptions. Growth of the child’s spine and brain lagged, a new study finds.

It’s unclear, though, whether developmental slowing in those parts of the body applied only to Neandertals or to Stone Age Homo sapiens as well. If so, environmental conditions at the time — which are currently hard to specify — may have reduced the pace of physical development similarly in both Homo species.
This ancient youngster died at 7.7 years of age, say paleoanthropologist Antonio Rosas of the National Museum of Natural Sciences in Madrid and colleagues. The scientists estimated the child’s age by counting microscopic enamel layers that accumulated daily as a molar tooth formed.

Previous excavations uncovered the child’s remains, as well as fossils of 12 other Neandertals, at a cave site in northwestern Spain called El Sidrόn.

Much — but not all —of the Neandertal child’s skeleton had matured to a point expected for present-day youngsters of the same age, the scientists report in the Sept. 22 Science. But bones at the top and in the middle of the spine had not fully fused, corresponding to a stage of development typical of 4- to 6- year-olds today. Also, the ancient child’s brain was still growing at an age when living humans’ brains have nearly or fully reached adult size. Signs of bone tissue being reshaped on the inner surface of the child’s braincase pointed to ongoing brain expansion. Rosas’ team calculated that the youngster’s brain volume was about 87.5 percent of that expected, on average, for Neandertal adults.

Neandertals’ slightly larger brains relative to people today may have required more energy, and thus more time, to grow, the researchers suggest. And they suspect that the growth of Neandertals’ bigger torsos, and perhaps spinal cords, slowed the extinct species’ backbone development in late childhood.

Rosas’ new study “reinforces what should have been apparent for some time — that Neandertal growth rates and patterns, except for those related to well-known differences in [skeletal shape], rarely differ from modern human variations,” says paleoanthropologist Erik Trinkaus of Washington University in St. Louis.

But researchers need to compare the El Sidrόn child to fossils of H. sapiens youngsters from the same time or later in the Stone Age, Trinkaus adds. Relative to kids today, ancient human youth may display slower growth rates comparable to those of the Neandertal child, he suspects.

Subtle cosmic vibrations kicked up by swirling black holes have captured the public imagination — and the minds of the physics Nobel Prize committee members, too.

Three scientists who laid the groundwork for the first direct detection of gravitational waves have won the Nobel Prize in physics. Rainer Weiss of MIT, and Kip Thorne and Barry Barish, both of Caltech, will share the 9-million-Swedish-kronor (about $1.1 million) prize, with half going to Weiss and the remainder split between Thorne and Barish.
Though researchers often wait decades for Nobel recognition, the observation of gravitational waves was so monumental that the scientists were honored less than two years after the discovery’s announcement.

“These detections were so compelling and earth shattering…. Why wait?” says Clifford Will of the University of Florida in Gainesville, who was not directly involved with the discovery. “It’s fabulous. Absolutely fabulous.”

Weiss, Thorne and Barish are pioneers of the Laser Interferometer Gravitational Wave Observatory, or LIGO. On February 11, 2016, LIGO scientists announced they had spotted gravitational waves produced by a pair of merging black holes. This first-ever detection generated a frenzy of excitement among physicists and garnered front-page headlines around the world.

LIGO’s observation of gravitational waves directly confirmed a 100-year-old prediction of Einstein’s general theory of relativity — that rapidly accelerating massive objects stretch and squeeze spacetime, producing ripples that travel outward from the source (SN: 3/5/16, p. 22).
“If Einstein was still alive, it would be absolutely wonderful to go to him and tell him about the discovery. He would be very pleased, I’m sure of it,” Weiss said during a news conference at MIT a few hours after he got word of the win. “But then to tell him what the discovery was, that it was a black hole, he would have been absolutely flabbergasted because he didn’t believe in them.”

As enthusiastic team members clad in LIGO-themed T-shirts celebrated the discovery, Weiss stressed that the discovery was a group effort. “I’m a symbol of that. It’s not all on my shoulders, this thing,” he said, citing the large collaboration of scientists whose work led up to LIGO’s detection.

Physicists anticipate that LIGO will spark an entirely new field of astronomy, in which scientists survey the universe by feeling for its tremors. “It will allow us to see the parts of the universe that were not revealed to us before,” says LIGO team member Carlos Lousto of the Rochester Institute of Technology in New York.

LIGO’s first incarnation, which officially began collecting data in 2002 and ran intermittently until 2010, yielded no hints of gravitational waves. After years of upgrades, the souped-up detectors, known as Advanced LIGO, began searching for spacetime ripples in 2015. Almost as soon as the detectors were turned on — even before scientific data-taking had formally begun — scientists detected the minuscule undulations of their first black hole collision. Those ripples, spotted on September 14, 2015, journeyed to Earth from 1.3 billion light-years away, where they were produced by two colossal black holes that spiraled inward and merged into one (SN: 3/5/16, p. 6).

Quivers from those converging black holes, when converted into an audio signal, made a tell-tale sound called a “chirp,” reminiscent of a bird’s cry. The particulars of that signature reveal details of the collision. “The beauty of the symphony is in what you can extract from the tiny wiggles, or the wiggles on tops of wiggles, in that signal,” Thorne said at an Oct. 3 news conference at Caltech.
Since that first detection, scientists have observed three more black hole collisions. And additional gravitational ripples may already be in the bag: It’s rumored that LIGO scientists have also detected a smashup of neutron stars (SN Online: 8/25/17). In fact, Weiss teased an announcement to come on October 16.

An astounding feat of engineering, LIGO consists of two enormous L-shaped detectors that stretch across the wooded landscape of Livingston, La., and the desert of Hanford, Wash. Each detector boasts two 4-kilometer-long arms through which laser light bounces back and forth between mirrors.

Gravitational waves passing through a detector stretch one arm while shortening the other. LIGO compares the arms’ sizes using the laser light to measure length differences a tiny fraction of the size of a proton. Gravitational waves should produce signals in the two distant detectors nearly simultaneously, helping scientists to rule out spurious signals that can be caused by events as mundane as a truck bouncing along nearby.

“LIGO is probably one of the best and most amazing instruments ever built by mankind,” Barish said at the Caltech news conference. But building it was a risky endeavor: No one had previously attempted anything like it, and no one could say for sure whether the effort would succeed. “What’s fundamental is you have to be willing to take risks to do great things,” Barish said.

In August, LIGO’s two detectors teamed up with the similarly designed Virgo detector near Pisa, Italy (SN Online: 8/1/17). The latest gravitational wave sighting, made on August 14, showed up in all three detectors almost simultaneously, which allowed scientists to pinpoint the region of space in which the black holes resided more precisely than ever before (SN Online: 9/27/17).

Weiss spent decades on the project, beginning with nascent scribbles on scraps of paper and early prototypes. In the 1960s, Weiss came up with the idea for a laser gravitational wave detector while teaching a class on general relativity. (Other researchers had independently proposed the technique as well.) He refined that idea and built a small, prototype detector, establishing the basic blueprint that would eventually evolve into LIGO.
Inspired by a conversation with Weiss, Thorne, who had been studying theoretical aspects of gravitational waves, assembled a team to work on the technique at Caltech in the ’70s. (Thorne was a 1958 semifinalist in the Science Talent Search, a program of the Society for Science & the Public, which publishes Science News.)

Another LIGO founder, Ronald Drever, died in March. Drever, who had been working on gravitational wave detectors at the University of Glasgow, joined Thorne at Caltech in 1979. Weiss and Drever each worked individually on prototypes, before Weiss officially teamed up with Thorne and Drever in 1984 to create LIGO (SN: 3/5/16, p. 24). Drever did live to hear of the first detection, Will says, but “it’s sad that he didn’t live to see it all.”

Barish joined the project later, becoming director of LIGO in 1994. He stayed in that role for more than 10 years, elevating LIGO from scientists’ daydreams into reality. Barish oversaw construction and commissioning of the detectors, as well as initial gravitational wave searches. “He entered the experiment in a crucial moment, when it was necessary to bring the experiment to a different level, make it a big collaboration,” says Alessandra Buonanno of the Max Planck Institute for Gravitational Physics in Potsdam, Germany.

Speculation that LIGO would nab a Nobel began as soon as the discovery was announced. So the collaboration was not surprised by the honor. “We were certainly expecting this to happen,” says LIGO team member Manuela Campanelli of the Rochester Institute of Technology. Still, the lack of surprise didn’t dampen the mood of festivity. “I feel in a dream,” says Buonanno.

LIGO and Virgo are currently in a shutdown period while scientists tinker with the detectors to improve their sensitivity. The gravitational wave hunt will resume next year. Besides black hole mergers and neutron star smashups, in the future, scientists might also spot waves from an exploding star, known as a supernova. Upcoming detectors might sense trembles generated in the Big Bang, providing a glimpse of the universe’s beginnings.

And scientists may even find new phenomena that they haven’t predicted. “I await expectantly some huge surprises in the coming years,” Thorne said.

A mysterious group of microbes may be controlling the fate of carbon in the dark depths of the world’s oceans.

Nitrospinae bacteria, which use the nitrogen compound nitrite to “fix” inorganic carbon dioxide into sugars and other compounds for food and reproduction, are responsible for 15 to 45 percent of such carbon fixation in the western North Atlantic Ocean, researchers report in the Nov. 24 Science. If these microbes are present in similar abundances around the world — and some data suggest that the bacteria are — those rates may be global, the team adds.
The total amount of carbon that Nitrospinae fix is small when compared with carbon fixation on land by organisms such as plants or in the sunlit part of the ocean, says Maria Pachiadaki, a microbial ecologist at Bigelow Laboratory for Ocean Sciences in East Boothbay, Maine, who is lead author on the new study. “But it seems to be of major importance to the productivity and health of the 90 percent of the ocean that is too deep and too dark for photosynthesis.” These bacteria likely form the base of the food web in much of this enigmatic realm, she says.

Oceans cover more than two-thirds of Earth’s surface, and most of those waters are in the dark. In the shallow, sunlit part of the ocean, microscopic organisms called phytoplankton fix carbon dioxide through photosynthesis. But in the deep ocean where sunlight doesn’t penetrate, microbes that use chemical energy derived from compounds such as ammonium or hydrogen sulfide are the engines of that part of the carbon cycle.

Little has been known about which microbes are primarily responsible for this dark ocean carbon fixation. The likeliest candidates were a group of ammonium-oxidizing archaea (single-celled organisms similar to bacteria) known as Thaumarchaeota because they are the most abundant microbes in the dark ocean.

But there was no direct proof that these archaea are the main fixers in those waters, says Pachiadaki. In fact, previous studies of carbon fixation in these depths suggested that ammonium-oxidizers weren’t performing the task quickly enough to match observations, she says. “The energy gained from ammonium oxidation is not enough to explain the amount of the carbon fixed in the dark ocean.”
She and colleagues suspected that a different group of microbes might be bearing the brunt of the task. Nitrospinae bacteria that use the chemical compound nitrite were known to be abundant in at least some parts of the dark ocean, but the microbes weren’t well studied. So Pachiadaki’s team analyzed 3,463 genomes, or genetic blueprints, of single-celled organisms found in 39 seawater samples collected in the western North Atlantic Ocean, at depths ranging from “twilight” regions below about 200 meters to the ocean’s deepest zone below 9,000 meters. The team identified Nitrospinae as the most abundant bacteria, particularly in the twilight zone. Although still less abundant than the ammonium-oxidizing Thaumarchaeota, the nitrite-oxidizers are much more efficient at fixing carbon, requiring only a tiny amount of available nitrite.

And although scientists knew that these bacteria use nitrite to produce energy, the new study showed that the compound is the primary source of energy for the microbes. Marine microbiologist Frank Stewart of Georgia Tech in Atlanta says the study “exemplifies how advances in genomic methods can generate hypotheses about metabolism and ecology.” These findings suggest that scientists need to rethink how energy and materials cycle in the dark ocean, he says. “While this ocean realm remains underexplored, studies like this are models for how to close our knowledge gap.”

One of the strangest things about growing a human being inside your body is the alien sensation of his movements. It’s wild to realize that these internal jabs and pushes are the work of someone else’s nervous system, skeleton and muscles. Someone with his own distinct, mysterious agenda that often includes taekwondoing your uterus as you try to sleep.

Around the 10-week mark, babies start to bend their heads and necks, followed by full-body wiggles, limb movement and breathing around 15 weeks. These earliest movements are usually undetectable by pregnant women, particularly first-timers who may not recognize the flutters until 16 to 25 weeks of pregnancy. These movements can be exciting and bizarre, not to mention uncomfortable. But for the developing baby, these kicks are really important, helping to sculpt muscles, bones and joints.
While pregnant women can certainly sense a jab, scientists have largely been left in the dark about how normal fetuses move. “It’s extremely difficult to investigate fetal movements in detail in humans,” says Stefaan Verbruggen, a bioengineer formerly at Imperial College London who recently moved to Columbia University in New York.

Now, using relatively new MRI measurements of entire fetuses wiggling in utero, researchers have tracked these kicks across women’s pregnancies. The results, published January 24 in the Journal of the Royal Society Interface, offer the clearest look yet at fetal kicking and provide hints about why these moves are so important.
Along with bioengineer Niamh Nowlan, of ICL, and colleagues, Verbruggen analyzed videos of fetal kicks caught on MRI scans. These scans, from multiple pregnant women, included clear leg kicks at 20, 25, 30 and 35 weeks gestation. Other MRI scans provided anatomical details about bones, joints and leg sizes. With sophisticated math and computational models, the researchers could estimate the strengths of the kicks, as well as the mechanical effects, such as stresses and strains, that those kicks put on fetal bones and joints.
Kicks ramped up and became more forceful from 20 to 30 weeks, the researchers found. During this time, kicks shifted the wall of the uterus by about 11 millimeters on average, the team found. But by 35 weeks, kick force had declined, and the uterus moved less with each kick, only about 4 millimeters on average. (By this stage, things are getting pretty tight and tissues might be stretched taut, so this decrease makes sense.) Yet even with this apparent drop in force, the stresses experienced by the fetus during kicks kept increasing, even until 35 weeks. Increasing pressure on the leg bones and joints probably help the fetus grow, the researchers write.

Other work has found that the mechanical effects of movement can stimulate bone growth, which is why weight-bearing exercises, such as brisk walking and step aerobics, are often recommended for people with osteoporosis. In animal studies, stationary chick and mouse fetuses have abnormal bones and joints, suggesting that movement is crucial to proper development.

The results highlight the importance of the right kinds of movements for fetuses’ growth. Babies born prematurely can sometimes have joint disorders. It’s possible that bone growth and joints are affected when babies finish developing in an environment dominated by gravity, instead of the springy, tight confines of a uterus. Even in utero position might have an effect. Head-up breech babies, for instance, have a higher risk of a certain hip disorder, a link that hints at a relationship between an altered kicking ground and development. In fact, the researchers are now looking at the relationship between fetal movements and skeletal stress and strain in these select groups.

Mechanical forces in utero might have long-lasting repercussions. Abnormal joint shapes are thought to increase the risk of osteoarthritis, says Verbruggen, “which means that how you move in the womb before you’re even born can affect your health much later in life.”

There’s a lot more work to do before scientists fully understand the effects of fetal movements, especially those in less than ideal circumstances. But by putting hard numbers to squirmy wiggles, this new study is kicking things off right.

It’s another record for SpaceX. At 3:50 p.m. Eastern on February 6, the private spaceflight company launched the Falcon Heavy rocket for the first time.

The Heavy — essentially three SpaceX Falcon 9 rocket boosters strapped together — is the most powerful rocket launched since the Saturn V, which shot astronauts to the moon during the Apollo program. SpaceX hopes to use the Heavy to send humans into space. The company is developing another rocket, dubbed the BFR, to eventually send people to Mars.
Another first for this launch: the synchronized return of two of the boosters. (The third, from the center core, didn’t descend properly, and instead of landing on a droneship, it hit the ocean at 300 mph.) Part of SpaceX’s program is to reuse rockets, which brings down the cost of space launches. The company has successfully landed the cores of its Falcon 9 rockets 21 times and reflew a rocket six times. The company landed a previously used rocket for the first time in March.

But the cargo for today’s launch is aimed at another planet. The rocket carried SpaceX CEO Elon Musk’s red Tesla Roadster with “Space Oddity” by David Bowie playing on the stereo. It is now heading toward Mars.

“I love the thought of a car drifting apparently endlessly through space and perhaps being discovered by an alien race millions of years in the future,” Musk tweeted in December.
Editor’s note: This story was updated on February 7 to update the status of the booster landings, and again on February 9 to correct the rocket that SpaceX hopes to use to send people to Mars. The company intends to use its BFR rocket, not the Falcon Heavy.

A fungus that recently evolved to infect humans is spreading rapidly in health care facilities in the United States and becoming harder to treat, a study from the U.S. Centers for Disease Control and Prevention finds.

Candida auris infections were first detected in the United States in 2013. Each year since, the number of people infected — though still small — has increased dramatically. In 2016, the fungus sickened 53 people. In 2021, the deadly fungus infected 1,471 people, nearly twice the 756 cases from the year before, researchers report March 21 in Annals of Internal Medicine. What’s more, the team found, the fungus is becoming resistant to antifungal drugs.
The rise of cases and antifungal resistance is “concerning,” says microbiologist and immunologist Arturo Casadevall, who studies fungal infections. “You worry because [the study] is telling you what could be a harbinger of things to come.” Casadevall, of Johns Hopkins Bloomberg School of Public Health, was not involved in the CDC study.

In tests of people at high risk of infection, researchers also found 4,041 individuals who carried the fungus in 2021 but were not sick at the time. A small percentage of carriers may later get sick from the fungus, says Meghan Lyman, a medical epidemiologist in the CDC’s Mycotic Diseases Branch in Atlanta, possibly developing bloodstream infections that carry a high risk of death.

Starting in 2012, C. auris infections popped up suddenly in hospitals on three continents, probably evolving to grow at human body temperature as a result of climate change (SN: 7/26/19). The fungus, typically detected through blood or urine tests, usually infects people in health care settings such as hospitals, rehabilitation facilities and long-term care homes. Because people who get infected are often already sick, it can be hard to tell whether symptoms such as fevers are from the existing illness or an infection.
Those most at risk of infection include people who are ill; those who have catheters, breathing or feeding tubes or other invasive medical devices; and those who have repeated or long stays in health care facilities. Healthy people are usually not infected but can spread the fungus to others by contact with contaminated surfaces, including gowns and gloves worn by health care workers, Lyman says.

Growing drug resistance
Infections can be treated with antifungal drugs. But Lyman and colleagues found that the fungus is becoming resistant to an important class of such medications called echinocandins. These drugs are used as both the first line and the last line of defense against C. auris, says Casadevall.

Before 2020, six people were known to have echinocandin-resistant infections and four other people had infections resistant to all three class of existing antifungal drugs. That resistance developed during treatment using echinocandin. None of those cases passed the resistant strain to others. But in 2021, 19 people were diagnosed with echinocandin-resistant infections and seven with infections resistant to multiple drugs.

More concerning, one outbreak in Washington, D.C., and another in Texas suggested people could transmit the drug-resistant infections to each other. “Patients who had never been on echinocandins were getting these resistant strains,” Lyman says.

Some health care facilities have been able to identify cases early and prevent outbreaks. “We’re obviously very concerned,” Lyman says, “but we are encouraged by these facilities that have had success at containing it.” Using those facilities’ infection control measures may help limit cases of C. auris, she says, as well as reducing spread other fungal, bacterial and viral pathogens.

The patient arrived at the hospital one hot night in Masi-Manimba, an agricultural town unfurled along the Democratic Republic of the Congo’s Lukula River.

He couldn’t speak, he couldn’t walk, he was conscious but “barely could make … gestures,” says Béatrice Kasita, a nurse who was there when he came in. She remembers his deformed posture, how his body curved into a fetal position.

He was also unusually drowsy — a telltale sign of his illness. The patient, a 27-year-old man, had been brought in by a medical team screening villagers for sleeping sickness, a deadly parasitic disease spread via the bite of a blood-feeding fly.
Since the first case report in the late 14th century, the illness has ebbed and flowed in sub-Saharan Africa. Across the continent, the predominant form of sleeping sickness shows up in about two dozen countries, most cases now occurring in the DRC. The disease is a nightmarish scourge that can maim the brain and ultimately kill. But today, cases hover near an all-time low. In 2021, the World Health Organization reported just 747 cases of the predominant form, down from more than 37,000 in 1998.

That precipitous plunge came out of decades of work, millions of screenings, spinal taps upon spinal taps, toxic treatments and the rapid rise of safer though often burdensome ones, countless IV infusions, long hospital days and nights, medicine lugged to remote villages, and communities on constant alert for sleeping sickness’s insidious symptoms.

Now, a promising drug has fanned hope for halting transmission of the disease. Called acoziborole, the drug is taken by mouth in just a single dose. Kasita’s patient, who arrived at the hospital in June 2017, was among the first to try it.

Her hospital is one of 10 clinical trial sites in the DRC and Guinea working to test the drug with the Drugs for Neglected Diseases initiative, or DNDi, a nonprofit organization based in Geneva. In a small trial reported last year, the drug appeared to be safe and effective. A larger trial is ongoing, with results expected by the end of this year.
If the findings hold up, the drug would be “a game changer,” says Emmanuel Bottieau, an infectious disease specialist at the Institute of Tropical Medicine in Antwerp, Belgium, who is not involved with the clinical trial. A single-dose medication is “really a dream for us, coming from such a long history of very difficult or toxic or cumbersome treatments.”

But he and others know that even a game-changing drug doesn’t guarantee a win. The dominant form of sleeping sickness is on a short list of neglected tropical diseases the WHO is targeting for elimination by 2030. That means bringing cases in certain areas down to zero knowing that some control efforts may still be required. Vastly harder to achieve is disease eradication, where cases worldwide stay parked at zero permanently. (To date, just a single human infectious disease — smallpox — has been eradicated.)
Even elimination is no easy task — and can get harder as you approach the finish line. “We are advancing very well,” says José Ramón Franco, a WHO medical officer based in Geneva, “but we [haven’t] reached the last mile.”

Still, tiptoeing along the edges of optimism, some, like Kasita, are finding moments to cheer. For the severely ill patient, her team initially wondered if acoziborole would work. “Are we really going to help him with this single-dose treatment?”

Two weeks later, he could stand, with some support, and had started speaking again, a radical recovery. Kasita smiles widely as she remembers it. Watching him heal “was a great pleasure,” she says.

The symptoms of sleeping sickness
About 400 kilometers to the west of Masi-Manimba, physician Wilfried Mutombo Kalonji is preparing to visit Kasita’s hospital. Afterward, he’ll hit up hospitals in Idiofa, Bagata and then Bandundu, three other acoziborole clinical trial sites in the DRC. To reach the sites, Mutombo will travel by boat, plane, car and motorbike. He’ll stay in both modern hotels and hotels without running water or electricity. Then, he’ll return home to Kinshasa, the DRC’s bustling capital. It’s a great and noisy city, he grins, with people playing music in the streets and “many, many, many traffic jams.”

In Kinshasa, Roi Baudouin hospital is one of the DNDi’s acoziborole trial sites. Mutombo has been organizing logistics and ensuring that each site has what it needs to treat and monitor patients. That includes generators for electricity, an internet connection, medical equipment and trained clinical trial staff.

Mutombo has worked with sleeping sickness patients since 2004. Two weeks after finishing his medical training in Kasaï province, he shipped out to Kasansa, becoming the only medical doctor in a village of about 11,000 people. In Kasansa, which lies in western DRC, north of the Angola border, sleeping sickness was then, and still remains, endemic.

The disease, also called human African trypanosomiasis, is caused by a single-celled, ruffle-edged parasite that worms its way into the brain. One subspecies, Trypanosoma brucei gambiense, causes the vast majority of cases and tends to plague western and central Africa. Another, T.b. rhodesiense occurs in the eastern and southern parts of the continent and causes a more rapid, acute illness with far fewer cases in people.
Both subspecies can ride in the guts and glands of tsetse flies, which often buzz near bodies of water; many of Mutombo’s patients in Kasansa were fishers or farmers. When the fly bites, the parasite enters the bloodstream. From there, it can get picked up again when other flies feed, shuttling from insects to humans in a disease-spreading cycle.

In the blood, T.b. gambiense sparks a slow-burning illness that can begin with a fever and, if left untreated, end with death. As the parasite multiplies, lymph nodes enlarge and the head, muscles and joints ache. Patients can also become intensely itchy, scratching hard enough to damage the skin, Kasita says.

When the parasite slips past the blood-brain barrier, patients enter the second stage of the disease. No one knows exactly where the parasite lodges in the brain, but neurological symptoms can vary. Doctors and nurses describe a range of distressing and bizarre behaviors. One common behavior gives the illness its name. Somehow, the parasite reverses people’s sleep/wake cycle. “They will sleep a lot during the day, and at night, they will be up, watching,” Kasita says.

Patients can also feel depressed and confused, neglect to care for themselves, hallucinate or experience logorrhea, words cascading from lips in nonsensical streams. In some infected people, personalities can swing like a wrecking ball. Jacques Pépin, an infectious disease specialist at the University of Sherbrooke in Canada, worked with sleeping sickness patients in the 1980s and remembers one who suddenly threw a large rock at his head.

Such outbursts can be scary for patients and families, says Antoine Tarral, a pharmacologist and infectious disease physician who works with Mutombo and led the DNDi’s sleeping sickness program for 10 years. Fear of the disease can prompt villages to reject infected individuals, he says.

Sleeping sickness carries a social stigma that makes people feel like outcasts, Mutombo agrees. “This disease is terrible.” When he first began treating patients, he says, “I was doing my best to make them feel like human beings.”

But for decades, available treatments were terrible, too.
Sleeping sickness has a history of terrible treatments
For most of treatment history, injected or intravenous drugs were the only option for sleeping sickness. They could cure patients, but only if doctors administered them in time. And when cases advanced to the second stage, medical staff had to switch tactics. For patients, that meant a spinal tap to confirm diagnosis followed by different drugs.

Until the late 2000s, the most-used treatment for advanced gambiense sleeping sickness was the highly toxic melarsoprol. The drug is derived from arsenic (and it’s still the leading treatment for advanced rhodesiense cases). Medical staff administered the drug for 10 days via daily intravenous infusions that burned entering patients’ veins, Mutombo says. The treatment could also be lethal, killing some 5 percent of patients.

Mutombo grows somber remembering two of his patients who died, young men he tried to cure in Kasansa. “That was a very bad experience,” he says. “When patients come to the hospital, they come to receive a treatment, not to die … [from] the drug we gave them.”

But doctors didn’t have a lot of options. Without melarsoprol, patients with serious cases faced near-certain death.

Not long after his patients died, Mutombo heard that the DNDi was launching a project on a new, less toxic treatment for advanced cases. He jumped at the chance, applied to be an investigator and joined the project in 2006. The new treatment, called NECT, combined eflornithine, an IV drug developed for cancer, with the oral drug nifurtimox. Eflornithine was already being used to treat sleeping sickness, but required dozens of infusions, and nifurtimox was a treatment for Chagas disease.

In 2009, after a clinical trial and the WHO’s endorsement, NECT took off, rocketing past melarsoprol or eflornithine alone as the first-line treatment for advanced sleeping sickness. But NECT had some logistical snafus, Mutombo says. It wasn’t easy to transport, for one. Treatment for four patients came in 40-kilogram packages that had to be trucked over bad roads into rural areas that lacked medical workers. “That was a problem with NECT,” Mutombo says. “It was effective, but it was heavy and needed trained staff.”

Less than a decade later, Mutombo, Tarral and their DNDi colleagues debuted an easier alternative. Fexinidazole, at long last, was a drug doctors could deliver exclusively via pills rather than an IV. It’s not perfect — it’s administered by a nurse, patients need to take it for 10 days and it’s not best for the most severe cases (for these, the WHO still recommends NECT). But easy-to-use oral drugs lower the burden on health systems, Mutombo says. Medical staff could more easily bring treatments to remote patients. And that brought scientists one step closer to sleeping sickness’s elimination.
A new drug could help bring cases to zero
Acoziborole, the drug now being tested in clinical trials, may be another big step in the right direction. Just one dose cured some 95 percent of patients with late-stage infections, Mutombo, Tarral and colleagues reported November 29 in the Lancet Infectious Diseases. That’s comparable to treatment with NECT. “Acoziborole is one solution to manage this disease,” Tarral says.

Not only does the drug seem to be effective, but “it’s given orally … and it needs to be given only once,” says the University of Sherbrooke’s Pépin, who was not involved with the trial but wrote an opinion piece that appeared alongside the new report.

Yet, as Pépin points out, the acoziborole study has some limitations. The scientists tested the drug in just 208 patients, so no one knows if serious adverse effects might occur in larger populations. And the study wasn’t performed like the classic gold-standard clinical trial, with patients randomly assigned into different groups receiving different interventions.

Tarral acknowledges these drawbacks, which he says were due to low participant numbers. The researchers included only people with video-confirmed parasitic infections, which required years of searching for patients across 10 hospitals in two different countries.

“It’s not the standard approach, but that was the only possible approach,” Pépin says. “They did what could be done with the number of cases that are occurring now.”

The study’s promising results spurred a new, larger trial that will include 1,200 participants. This time, the team is enrolling people with positive antibody blood tests even if the parasite’s presence hasn’t been confirmed. Many of these participants may not actually be sick, says Veerle Lejon, a scientist at the French National Research Institute for Sustainable Development in Montpellier who was not involved in developing the drug but is collaborating with the DNDi on evaluating sleeping sickness diagnostics.

What this trial will offer, she says, is a raft of new data that will help determine the drug’s safety.
The challenges of eliminating an infectious disease
Even if acoziborole gets the green light, stamping out sleeping sickness isn’t a sure bet.

Eliminating an infectious disease is a slippery task. Success can, paradoxically, churn out new challenges. When case numbers dip low enough, for instance, interest in the disease can wane. Donors move money to other public health priorities, and once-robust control programs wither.

That happened for sleeping sickness in the 1960s, the last time cases dropped. Over the next few decades, cases ratcheted up, and epidemics broke out in Angola, the DRC and South Sudan. “Control of the disease was neglected, and then slowly, the disease came back,” says WHO medical officer Franco.

A doubled-down effort to find cases and treat them with ever-improving drugs got sleeping sickness under control again, with case numbers cratering to their low point today. But that level of surveillance is not sustainable, Franco says.
Health care workers can also lose knowledge of how to recognize the disease as they encounter fewer and fewer infected individuals, says Jennifer Palmer, a medical anthropologist at the London School of Hygiene and Tropical Medicine. “The challenge is really in making sure that people are aware that sleeping sickness is still a problem,” she says. In a small study in South Sudan, reported in 2020, Palmer and colleagues found that lay people encouraging people in the community to get tested accounted for more than half of detected cases.

Still, getting patients tested and treated can depend on whether they’re able to safely travel to health facilities. With the threat of violence in South Sudan and armed conflict in eastern DRC, the fate of sleeping sickness may also be shaped by the whims of war.

Even if every infected person was promptly found and treated, the disease-causing parasite would likely linger in wild and domestic animals. Scientists have found T.b. gambiense, for instance, in dogs, pigs, goats and sheep. No one knows the role infected animals play in reigniting outbreaks in humans.

Though the road to elimination may still be rocky, the patients Kasita and others are treating in Masi-Manimba and beyond offer a lesson for those working on disease elimination: Don’t give up too soon. Maybe the world won’t reach zero sleeping sickness cases by 2030, Lejon says, “but I think we should really give it a try,” she says. “We have momentum at this moment to do it.”

Mutombo echoes her enthusiasm. In less than 20 years, new drugs have completely overhauled patient care, he says. “We’ve made a great change in less than one generation…. Now, we expect that elimination is within reach.”

Discoveries on the island of Borneo illustrate that cave art emerged in Southeast Asia as early as in Western Europe, and with comparable complexity, researchers say.

A limestone cave in eastern Borneo features a reddish-orange painting of a horned animal, possibly a type of wild cattle that may have been found on the island at the time. The painting dates to at least 40,000 years ago, concludes a team led by archaeologist Maxime Aubert of Griffith University in Southport, Australia. This creature represents the oldest known example of a painted figure anywhere in the world, the scientists report online November 7 in Nature.
The same cave walls contain two hand outlines framed in reddish orange pigment that were made at least 37,200 years ago and a similar hand stencil with a maximum age of 51,800 years.

Three nearby caves display instances of a second rock art style that appeared around 20,000 years ago, the investigators say. Examples include purple-hued, humanlike figures and hand stencils, some decorated with lines or dots. Painted lines link some hand stencils to others.

Age estimates rest on analyses of uranium in mineral deposits that had formed over and underneath parts of each cave painting. Scientists used known decay rates of radioactive uranium in these deposits to calculate maximum and minimum dates for the paintings.

Aubert’s group previously used this technique, called uranium-series dating, to calculate that people on the nearby Indonesian island of Sulawesi created hand stencils on cave walls nearly 40,000 years ago (SN: 11/15/14, p. 6).
“Cave art could have potentially been exported from Borneo to Sulawesi and all the way to Papua and Australia,” Aubert says. Australian cave paintings of humanlike figures resemble those found on Borneo, he says. But the ages of the Australian finds remain uncertain.

No Southeast Asian cave paintings have been found from when humans first arrived in the region, between 70,000 and 60,000 years ago. At that time and up to the end of the last Ice Age around 10,000 years ago, Borneo formed mainland Eurasia’s easternmost tip thanks to lowered sea levels.

Those first Southeast Asians may have created cave art that hasn’t been discovered, Aubert says. Or, small groups of early colonizers may not have painted on cave walls until their populations expanded, leading to more complex social and ritual behaviors. It’s also possible that another human migration from elsewhere in Asia brought rock art to Borneo roughly 50,000 years ago.
Whatever the case, “Western European and Southeast Asian cave art seem to first appear at about the same time and with remarkable similarities,” says archaeologist Sue O’Connor of Australian National University in Canberra, who did not participate in the new study.
Other investigators have used the uranium-series technique to date a painted red disk in a Spanish cave to at least 40,800 years ago (SN: 7/28/12, p. 15). Another report this year suggested that Neandertals painted abstract shapes and hand stencils on the walls of several Spanish caves at least 64,800 years ago (SN: 3/17/18, p. 6).

Aubert’s team has criticized that study, saying the researchers may have unintentionally dated mineral deposits that are much older than the artworks. If so, humans rather than Neandertals could have created the Spanish cave art.

Meanwhile, scientists who conducted the Neandertal cave art study express their own doubts about the reliability of dates for the Borneo paintings. Descriptions of sampled mineral deposits from the Borneo caves leave it unclear whether, for example, Aubert’s group dated the horned animal figure or adjacent paint remnants of some other, unidentified figure, says archaeologist João Zilhão of the University of Barcelona.

Zilhão and Neandertal paper coauthor Paul Pettitt of Durham University in England don’t doubt that cave painting emerged in Southeast Asia at least 40,000 years ago. But they and Aubert’s team disagree about how to collect mineral samples for dating rock art.