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THE HAGUE – A cruise ship at the center of a deadly hantavirus outbreak is undergoing further cleaning before it returns to its home port, the company that operates it said Tuesday.

In a written statement, Oceanwide Expeditions said the extra work is being carried out on the advice of the GGD local health authority in the port city of Rotterdam, where the vessel returned early last week. It’s home port is in nearby Vlissingen in the southern Netherlands.

“Based on their inspection findings, GGD has advised additional cleaning,” the cruise company said. “Following completion of this work, GGD will conduct a final inspection before the vessel can depart from Rotterdam.”

It did not elaborate on why extra cleaning was required and the health authority did not immediately have a comment on the reason it asked for the additional measures.

Yvonne van Duijnhoven, the director of public health in Rotterdam, said when the Hondius arrived in the city’s sprawling port eight days ago that it would likely take three days to clean and disinfect the vessel.

In a message posted Sunday on X, World Health Organization Director-General Tedros Adhanom Ghebreyesus said so far, 12 hantavirus cases and three deaths have been reported to the organization, with no deaths reported since May 2.

“All passengers and crew remain in quarantine and under close monitoring to ensure they receive care if needed. The situation is stable for now. We continue to remain vigilant and in close contact with all relevant governments,” he added.

Hantaviruses usually spread when people inhale contaminated residue of rodent droppings. But the hantavirus that has caused the current outbreak, called the Andes virus, may be able to spread between people in rare cases. The risk to the general public from the cruise ship outbreak is low, according to public health officials.

Oceanwide Expeditions had previously said it didn’t foresee any changes to the Hondius’ operations. The ship had an Arctic cruise setting sail from Keflavik, Iceland, on May 29. But in Tuesday’s statement, the company said that “all voyages from 13 June onwards will proceed as scheduled. No further disruption to the sailing schedule of m/v Hondius is expected.”

TUCSON, Ariz. – Carol Ross can’t stop smiling at dance practice as she shouts out the steps of a routine to members of her tap and jazz troupe for women age 50 and older.

“I’ve been dancing my whole life, it’s the best,” said Ross, who founded the Rodeo City Wreckettes group 23 years ago at an age when many people are getting ready for retirement.

Now 87, Ross and her husband and lifelong dance partner John, 89, have long known what more older adults are now discovering: Moving to music is one of the best ways to stay healthy. Medical professionals say it doesn’t matter if it’s Western line dancing, ballroom steps, salsa, tap, Zumba at the gym, or with a group like the Wreckettes.

“Dancing is one of the most powerful activities for older people,” said Julio Loya, a nurse and geriatric program coordinator at the Tucson Medical Center.

Why dancing helps balance, strength and more

Dance, like other exercise, can help people lose weight, get stronger, reduce fall risk, increase mobility and flexibility, and even improve brain health.

“ It engages their brain, it changes their mood, and it connects them socially while getting them moving,” said Loya. “And it’s fun. Everybody has a good time.”

Dr. Tom Johnson, a gerontologist at the UC Health Seniors Clinic in Aurora, Colorado, said he remembers one man in particular whose passion for dance was so strong that he willed himself to attend one last class before he died in his late 80s.

“His No. 1 priority was that he danced until the day that he died,” Johnson said of his patient.

Johnson said dance can improve the balance of his patients at the clinic, which serves about 2,500 people 75 and older a year.

He said older patients can benefit from adding two to three dance sessions to the 150 minutes of aerobic exercise he recommends for them each week, because dancing often involves movements that help with balance, such as walking backward or standing on one foot.

Meeting people by dancing together

The Wreckettes practice their routines during two-hour sessions at least twice a week in a rented dance studio.

After studying ballet as a girl, then moving on to everything from ballroom to tap as an adult, Ross said it made sense to keep dancing when she and her husband moved from Philadelphia to retire in Tucson.

John Ross is a key part of the Wreckettes’ routines, typically joining his wife for at least one number. At one recent practice, it was a saucy saunter to Merle Haggard’s “Let’s Chase Each Other Around the Room.”

“I learned early on that dancing was a great way to attract the chicks,” joked John Ross, who slid across the floor like a much younger man.

Wreckettes member Cindy Soffrin said that watching her mother suffer as she aged convinced her to stay active as she got older.

“My mom was sedentary the last 20 years of her life. It was pretty rough,” said Soffrin, 74.

For 67-year-old Gail Kowalski, joining the Wreckettes three years ago meant finding new friends after her husband died and she moved from Utah to Tucson.

“Plus, it’s so dang fun,” Kowalski said.

The fun of performing

The Wreckettes perform throughout the year, from holiday events to rodeo shows, dressing up in a series of matching sparkly costumes.

But they all said what they love the most is being hired by retirement homes to perform for memory care patients. Wreckette members take turns picking a favorite charity to donate their earnings.

“When we first arrive, people will be distracted or sleeping,” said Soffrin. “But once the music comes on, they perk up right away.”

A similar dance group for older women in Las Vegas, the Vegas Golden Gals, also performs at retirement homes, said Cheryl Cortez, the group’s president. They add pompoms to their routines.

“I must now know close to 40 routines,” said Cortez, 69. “And that alone has to be great for the memory.”

How to begin dancing when you’re older

If you want to start moving to music, here are some tips from health professionals and dance instructors:

BEFORE STARTING: Check with your health provider before starting a dance or any exercise program. Choose something simple to start, like line dancing rather than intricate tango steps.

FIND A CLASS: Check with a YMCA, parks and recreation department, or senior or community center. Community colleges often have dance classes, sometimes tailored for older people. Local dance studios and YouTube videos are other options. If you have Medicare Advantage insurance with the Silver Sneakers benefit, find out if your local gym has Zumba or other dance classes you can attend for free.

BEFORE THE SESSION: Dress comfortably for easy movement, and warm up and stretch before class.

MOST IMPORTANTLY: Have fun! You are doing great things for your mind and body.

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For more AP stories about healthy aging, go to https://apnews.com/hub/aging

WASHINGTON – President Donald Trump is scheduled to get a medical exam on Tuesday, putting his health under renewed public scrutiny after he has worked to dismiss concerns over his age and stamina.

The 79-year-old president is scheduled to visit Walter Reed National Military Medical Center for what the White House described as annual preventative medical and dental checkups. It will be Trump’s fourth publicly disclosed medical exam since he returned to office for a second term, and comes as he tries to project strength ahead of midterm elections that will test his sway with voters.

For decades, administrations have released selected results from presidential physicals, offering the public a glimpse at the commander-in-chief’s health. But the results are filtered through the White House and must be approved by the president, raising questions about what the public does and doesn’t get to see.

Trump turns 80 next month and was the oldest person elected U.S. president. His predecessor, former President Joe Biden, was 82 when he left office, dropping out of the 2024 presidential race because of widespread concerns he was too old for the job.

A Washington Post/ABC News/Ipsos poll conducted in April found that less than half of U.S. adults think Trump has the mental sharpness or physical health to serve effectively as president.

“I think concern for the president’s physical health is probably at an all-time high, and I think advanced physical age is the No. 1 concern,” said Dr. Jeffrey Kuhlman, who served as a White House physician for more than a decade under former presidents Barack Obama, George W. Bush and Bill Clinton.

For a president of Trump’s age, a complete physical would be expected to include advanced heart testing, screening for common cancers and a cognitive assessment, along with basics like height, weight and blood pressure, Kuhlman said.

The White House has not disclosed what the visit will entail, but expressed confidence in what it will show.

“President Trump is the sharpest and most accessible President in American history who is working nonstop to solve problems and deliver on his promises, and he remains in excellent health,” White House spokesperson Davis Ingle said in a statement.

No law requiring presidents to disclose their medical records

In the weeks leading up to his visit, Trump has been saying he feels as good as he did five decades ago — even as he jokes about his fondness for fast food and his minimal exercise regimen. Yet he’s also sensitive to perceptions about his age, noting that he takes extra caution descending the steps from Air Force One to avoid headlines about a stumble.

There is no formal law requiring presidents to publicize their health records, and the degree of transparency has varied by administration. Trump’s past reports have been criticized for offering scant detail and reporting statistics that some medical experts eyed with skepticism.

At public appearances, Trump is often seen wearing makeup to conceal bruising on his hands, which the White House attributes to handshaking and regular aspirin use. He has sometimes appeared drowsy during meetings and closed his eyes for long stretches, though he denies having fallen asleep.

Trump often boasts of having “aced” cognitive tests while frequently deriding Biden, who faced questions about his mental acuity. Some of Trump’s previous physicals have included the Montreal Cognitive Assessment, used to screen for dementia and cognitive impairment. His physicians reported a score of 30 out of 30 for Trump at 2018 and 2025 checkups.

Yet critics have pointed to Trump’s meandering speeches and sometimes bellicose rhetoric as evidence of cognitive decline.

Last month, a statement from more than 30 neurologists, psychiatrists and other medical experts — who acknowledged they’ve never examined him — said Trump was mentally unfit to serve and warned of an “increasingly dangerous decline” in his behavior based on what they called “objectively observable signs of serious medical concern.″

“Any so-called medical professionals engaging in armchair diagnosis or false speculation for political purposes are clearly breaking the Hippocratic Oath they’ve sworn to,” Ingle said.

Just like any other patient, presidents get to choose what’s disclosed about their health, said Sara Rosenthal, a bioethicist at the University of Kentucky who studies presidential health. Questions about transparency have become more acute as America elects aging presidents like Trump and Biden, she said.

“I think we can expect very little disclosure about the true health status of any president unless they’re in perfect health,” said Rosenthal, who has suggested an independent medical organization to review and report on the health of the president and those in the line of succession.

‘Nothing should be hidden’

Trump’s first medical report in his second term was released last April. In July, he was diagnosed with chronic venous insufficiency, a common condition in older adults that causes blood to pool in his veins. Photographs have shown the president with swollen feet, ankles, and calves, described by the White House as a symptom of chronic venous insufficiency leading to “mild swelling” in his lower legs.

Following his last publicly disclosed exam, described as a routine follow-up last October, Trump’s physician issued a one-page summary saying the president was in “exceptional health” without divulging many specific results.

The frequency of Trump’s medical checkups is not uncommon for someone his age, according to S. Jay Olshansky of the University of Illinois-Chicago, who has studied the health of past presidents. It’s part of a strategy to catch problems while they’re still treatable, Olshansky said.

Olshansky says the public deserves to see more than White House medical summaries that “may be subject to editorial discretion.” Full, unredacted medical records should be made public, he said: “Nothing should be hidden.”

The White House has not said whether Trump’s visit will include any procedures that may require anesthesia. Trump’s last colon exam was in 2024 and recommended a follow-up in three years.

If Trump were given anesthesia, Vice President JD Vance would be expected to assume temporary control of the office under the 25th Amendment. That last happened in 2021 when Vice President Kamala Harris was briefly sworn in while Biden had a colonoscopy. Former President George W. Bush twice turned over power to Vice President Dick Cheney.

BUNIA – Every time Vanny Birungi, a volunteer with the Red Cross in eastern Congo, goes out to raise awareness about the latest Ebola outbreak as suspected cases near 1,000, she faces a double threat.

One is the rare Bundibugyo type of Ebola, with no vaccine or treatment. The other is the anger and suspicion of residents who have pelted her with stones and verbal abuse in Bunia, a city at the heart of the outbreak.

“We continue to tell them that the disease is out there. Some accept, and others don’t,” Birungi told The Associated Press on Monday as she and colleagues spoke with groups of people in a working-class neighborhood under the scorching sun.

Aid workers are especially at risk in this volatile region where residents, like Birungi, have long been under threat of armed groups that have killed thousands of people and displaced many more in recent years.

Trust is hard to find among the traumatized population that is wary of outsiders, even those trying desperately to contain the rapidly spreading outbreak that experts say was discovered weeks late. Surveillance for such diseases has been weakened by U.S. and other aid cuts.

“These people should stop bothering us. They just want to get rich. Let’s not forget that Ebola is a white man’s invention,” declared Pierre Basola, a 56-year-old resident of Bunia, who added: “Stop talking to me anyway.”

Cases are nearing 1,000 but health centers are burned

Three times in the past week, healthcare facilities have been attacked. On Sunday, angry young men stormed a hospital treating Ebola patients, forcing medical staff to evacuate them as gunfire rang out.

On Saturday, a group of residents set fire to a tent for suspected and confirmed Ebola cases run by Doctors Without Borders in Mongbwalu, and more than a dozen people suspected to have the virus fled. On Thursday, a center in Rwampara was burned after relatives were barred from retrieving the body of a man suspected to have Ebola.

Anger is amplified as virus prevention practices keep loved ones from handling bodies in final rites following an illness some have described as sudden and dramatic, with vomiting and bleeding.

The Ebola virus is spread through close contact with sick or deceased patients’ bodily fluids, such as sweat, blood, feces or vomit. Experts say healthcare workers and family members caring for patients face the highest risk.

“Trust is almost as important as the health response, because if you get this massive distrust in the communities, they’re not going to go to the health centers,” said Heather Kerr, country director for the International Rescue Committee in Congo.

Armed conflict in the region poses another challenge. To travel from Bunia, the capital of Ituri province, to Mongbwalu, aid groups risk potential attacks in a region more than 1,000 kilometers (620 miles) from Congo’s capital, Kinshasa.

Meanwhile, the outbreak now has over 900 suspected cases and more than 220 suspected deaths, the director general of the World Health Organization, Tedros Adhanom Ghebreyesus, said Monday.

“We are now playing catch-up with a very fast-moving epidemic,” he said.

‘We leave everything to God’

Mado Nditamba, a 70-year-old Bunia resident, said she has seen students running away from aid workers.

“The last time Ebola came, it was not on the scale that we see today,” Nditamba said. “But this epidemic today is worse. We go to the doctors in the hospitals, but they also die. That’s what worries us. We don’t know what to do and we leave everything to God.”

Congo has had 17 Ebola outbreaks, and the WHO says the country is equipped to respond. But early tests in this outbreak were conducted for a more common type of Ebola, losing valuable time. Experts are still trying to determine when this outbreak began.

There are few places to test for this Bundibugyo type in a region where clinics can run on generators and a major airport serving as a humanitarian hub has been in the hands of rebels for over a year.

Health workers on the ground have told the AP they are underprepared and underprotected. Now an unknown number of responders have been infected, and some have died.

A Congolese doctor was reported dead on Sunday in Rwampara, Rubens Dhedgia, coordinator of the Ebola response in the region, told the AP. In neighboring Uganda, where a far smaller number of cases has begun to spread after Congolese traveled there, at least three health workers have been infected.

And perhaps most worryingly, the International Federation of Red Cross and Red Crescent Societies says three volunteers died in Mongbwalu after it believes they handled bodies on March 27 during work unrelated to Ebola.

If confirmed, that would significantly push back the timeline of the outbreak from the first confirmed death in late April in Bunia.

Some residents still believe Ebola is a myth

Even as at least one funeral home manager dusted off coffins for sale alongside a road in Bunia, experts reported a lack of trust among some residents of the region who do not believe the virus exists.

Action Aid, another of the international humanitarian groups responding, said a high level of skepticism and lack of understanding remains, citing residents it questioned in mid-May in Ituri province just after the outbreak was announced.

“The only way to go, as far as this particular virus is concerned, is community engagement,” said Yakubu Mohammed Saani, country director for Action Aid in Congo.

How that will be improved, and quickly, is still not clear. Meanwhile, both the WHO and Africa Centers for Disease Control and Prevention believe the outbreak is larger than the cases reported so far.

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Adetayo reported from Abuja, Nigeria. Associated Press writer Jean-Yves Kamale in Kinshasa, Congo, contributed.

KAMPALA – Ugandan health authorities on Monday reported two new Ebola cases, bringing the number of infections to seven.

All the cases are linked to the outbreak in neighboring Congo, which appears to have started several days or weeks before Congolese authorities declared it on May 15.

A 59-year-old Congolese man was admitted to a hospital in Kampala, the Ugandan capital, on May 11, and died three days later, before it was known he was suffering from the Ebola virus. Two other Congolese nationals who sought medical care in Uganda later tested positive for Ebola.

Ugandan health authorities on Saturday confirmed the first local infections: a driver and a health worker exposed to the Congolese patient who died on May 11. Two more health workers at a private hospital in Kampala have since tested positive, the Ministry of Health said Monday.

“Both patients have been admitted to the designated treatment unit and are now receiving care,” Dr. Charles Olaro, the national director of health services, said in a statement.

President Yoweri Museveni has urged Ugandans to “ stop shaking hands ” as part of measures to avoid infection. He also ordered the postponement of an annual religious event that attracts thousands of pilgrims, from Congo and elsewhere, who converge around a Catholic basilica just outside Kampala by June 3.

Other measures include the temporary suspension of all public transportation and flights between Congo and Uganda.

In Congo, suspected Ebola cases have topped 900, mainly in eastern Ituri province where the ongoing outbreak is centered, authorities said Sunday. The response has been hampered by fear, anger and frustration among locals including attacks on treatment centers, as well as distrust of authorities in a region long plagued by armed violence.

Congo has had more than a dozen Ebola outbreaks over the decades. Health experts say international aid cuts last year by the United States and other rich nations are devastating for eastern Congo because of the region’s unique problems.

Aid groups fighting this Ebola outbreak say they don’t have the equipment they need, such as face shields and suits to protect health workers from infection, testing kits, and body bags and other materials needed to safely bury the bodies of victims, which can be highly contagious.

The Bundibugyo type of Ebola virus responsible for the outbreak has no approved vaccine or treatment. The outbreak has been declared a global health emergency.

Tracing and isolating Ebola contacts is seen as key to stopping the spread of the disease, which usually manifests as hemorrhagic fever.

A family of fruit bats is believed to be the natural hosts of the viruses that cause Ebola, according to the World Health Organization. Ebola is spread by contact with the bodily fluids of an infected person or contaminated materials.

KINSHASA – Angry young men stormed a hospital treating Ebola patients at the heart of the latest outbreak of the disease in eastern Congo on Sunday evening, forcing the medical staff to scramble to evacuate the patients as gunfire rang out in the area.

It was not immediately known if anyone was hurt in the attack on the Monbgwalu General Hospital but Dr. Richard Lokudu, the hospital’s medical director, told The Associated Press the attackers demanded that two bodies of their kin be handed over to them.

There was gunfire and the medics were trying to evacuate the patients and the staff, Lokudu said over the phone.

“Monbgwalu General Hospital is on general alert,” he added. He did not have any further details of the unfolding turmoil.

The attack — the third in a week’s time on health care facilities where medical workers struggle with lack of resources to treat suspected Ebola cases — underlined the challenges of the outbreak, which the World Health Organization has declared a public health emergency of international concern.

Bodies of those who died of Ebola can be highly contagious and lead to further spread when people prepare them for burial and gather for funerals. ‘

In response to the outbreak, Congolese authorities have mandated that the dangerous work of burying suspected victims be managed wherever possible by authorities, which can be met by protests from families and friends. On Friday, the government said funeral wakes and gatherings of more than 50 people would be banned in northeastern Congo in an effort to curb the spread of the virus.

On Saturday, a group of residents of Mongbwalu attacked and set fire to a tent set up for suspected and confirmed Ebola cases by the Doctors Without Borders humanitarian group.

During that attack, 18 people with suspected Ebola infections left the facility and were now unaccounted for, Lokudu had said earlier.

On Thursday, another treatment center, in the town of Rwampara, was burned down after family members were banned from retrieving the body of a local man suspected to have died of Ebola.

WHO has said the outbreak poses a “very high” risk for Congo — up from a previous categorization of “high” — but that the risk of the disease spreading globally remains low.

Earlier on Sunday, the Congolese Ministry of Communication said on X that there were 904 suspected cases of Ebola, mostly in northeastern Ituri Province — a significant jump from the previously announced more than 700 suspected Ebola cases.

The ministry also said the total suspected Ebola deaths stood at 119, but the numbers it released separately for each region added up to 220. Officials could not immediately be reached to explain the discrepancy.

There is no available vaccine for the Bundibugyo virus, a rare type of Ebola, which spread undetected for weeks in Ituri following the first reported death — in late April in the town of Bunia, the provincial capital — while authorities tested for another, more common, Ebola virus and came up negative.

The International Federation of Red Cross and Red Crescent Societies said on Saturday that three of its volunteers had died from the outbreak in Mongbwalu. The agency said it believed the three healthcare workers contracted the virus on March 27 while handling dead bodies as part of a humanitarian mission unrelated to Ebola.

If confirmed, this would significantly push back the timeline of the outbreak.

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Pronczuk reported from Dakar, Senegal.

NEW YORK – Breta Meria Conole was in a state psychiatric hospital for more than two decades. But the reason why is a family mystery.

Debby Hannigan, her great grandniece, tried for years to access Conole’s medical records, because she thought they might hold clues to mental health issues in her family, including her oldest daughter’s depression.

Hannigan twice wrote to the state of New York for the records. The second time she included a supporting note from her daughter’s therapist, who said the details would help “to know their family medical history better.” Both times she was turned away.

Her experience is hardly unique.

Frustrated family members and others have been pushing for law changes in New York and other states that would allow the release of mental health records of long-dead ancestors. Their efforts have resulted in access policy changes in some states, including Massachusetts and Washington, but elsewhere reforms are happening slowly or not at all.

“It really does piss me off that we couldn’t just say, ‘Hey, we’re the descendants, here’s the proof, now tell us what you know!’” said Doug Clarke of Alfred, New York, who tried unsuccessfully to get records of a great-grandfather. The records might help explain the depression and bipolar syndrome seen in his generation of his family, he said.

Here’s a look at the problem and what people are doing about it.

The cruel history of state mental institutions

In the 1800s, the U.S. saw a boom in state institutions for the confinement of people with mental illness; every state had at least one by 1890. They were called lunatic or insane asylums, but the reasons for admission ranged from “brain fever” and “grief and anxiety” to “laziness,” “religious excitement” and ”desertion by husband,” according to historical records.

Conditions varied, but some asylums gained reputations as brutal, overcrowded warehouses where patients were neglected and restrained. Asylums gradually became psychiatric hospitals, but practices didn’t necessarily improve: In the 1900s, they were the settings of since-discredited treatments including lobotomies and induced comas.

But staff at the hospitals often took extensive notes, with detailed descriptions of patients and their symptoms. They also took photographs and had other materials, said Dr. Laurence Guttmacher, a former clinical director of one of New York’s state hospitals, the Rochester Psychiatric Center.

Records at some facilities were likely damaged, destroyed or lost through the years. And the surviving documents may not be well organized or cataloged. But a lot of information still exists, Guttmacher said.

“We had this incredibly rich trove of records” at the Rochester hospital, he said.

How old records can be helpful today

Such records have drawn the interest of some people whose families are struggling with depression, suicide or other issues.

“Would you want to know if your grandfather died of a heart attack?” said Dr. Christine Moutier, chief medical officer for the American Foundation for Suicide Prevention. “It’s information that you can use to understand how vigilant to be.”

An untold number of patients died at state hospitals, and some were buried in unmarked graves. Some families haven’t been able to establish when a relative died, let alone how, said Alexandra Lord, a historian writing a book about suicide in her family. She struggled to gain access to New York state records about her great-grandmother.

Guttmacher said: “About twice a month I would get a request from a family member to get access to records, to try to learn the story of their families.” State officials told him he couldn’t release that kind of information.

Patient privacy protections can last decades

A federal law enacted in 1996 protects the privacy of each patient’s health information, including diagnosed conditions and what care they received. The law, known as HIPAA, protects health information for 50 years after someone dies.

Some states have similar guidelines. Ohio law allows the closest living relative of a deceased patient to request information from state mental health facility records, and they can be requested by anyone 50 years after a patient’s death. Maine also offers fairly easy access to records dating back that far.

But many other states are more restrictive. New York allows such records to stay sealed “in perpetuity,” according to a statement from New York’s Office of Mental Health. Records can be released to patients and their immediate family members, but generally not to more distant descendants. They also have been released to medical professionals “with a justification,” and to historians who agree not to name individual patients, state officials say.

Massachusetts was similarly restrictive, but a reform push resulted in a new law last year that made public state hospital records that were at least 75 years old, plus records for people dead at least 50 years.

The change followed a report from a commission that discussed state institutions’ history of abuse and neglect, including patient sterilizations at a state hospital in Monson. One of the commission’s members, Alex Green, suggested the state’s nondisclosure of records amounted to a “cover-up” of the decades of abuse disabled people endured.

Now some are working to change New York’s law. This year, state Sen. Pat Fahy introduced a bill that designates records and information relating to a patient who has been deceased for 50 years or longer as historic records — no longer subject to privacy protections.

Fahy noted New York’s psychiatric facilities have their own troubled history. She cited the Willowbrook State School, a Staten Island facility where developmentally disabled children once lived in deplorable conditions.

“If the person is deceased, there should be an availability of these records to help give the family closure,” said Fahy, a Democrat from the Albany area. “Leaning from our history is one of the best ways to give us insight into how we do better in the future.”

How to find records on institutionalized ancestors

Families do have some other routes to information on ancestors’ mental health history, according to historians.

Online services such as Ancestry.com provide — for a price — access to old records, including census information that can reveal if someone was in a state institution at the time a census was taken.

Veterans’ military pension files have contained details on a person’s mental health.

Old newspapers were packed with items about residents, including about when people were sent to state institutions.

There may be many more people interested in family mental health history than is commonly realized, said Ryan Thibodeau, a St. John Fisher University researcher who has been involved in the push to change New York’s law. In the 1950s, at the peak of institutionalization in America, more than 500,000 people were in state hospitals.

“Their descendants are everywhere,” he said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

BUNIA – A tent used for treatment of the Ebola outbreak in eastern Congo was set on fire for the second time this week, and 18 people suspected of infection escaped, a local hospital director said Saturday.

Unidentified people arrived at the clinic in Mongbwalu, a town at the center of the outbreak of the Bundibugyo virus, a rare type of Ebola, on Friday night and set fire to a tent set up by the Doctors Without Borders charity for suspected and confirmed Ebola cases, Dr. Richard Lokudi, director of the Mongbwalu General Reference Hospital, told The Associated Press.

“We strongly condemn this act, as it caused panic among the staff of the Mongbwalu Referral Hospital and also resulted in the escape of 18 suspected cases into the community,” he said.

On Thursday, another treatment center in the town of Rwampara was burned down after family members were prohibited from retrieving the body of a local man.

The bodies of those who died of Ebola can be highly contagious and lead to further spread when people prepare them for burial and gather for funerals. The dangerous work of burying suspected victims is being managed wherever possible by authorities, which can be met by protests from families and friends.

A burial for Ebola patients in Bunia, another town within the outbreak zone, took place on Saturday under high security as tensions between health workers and the local community ran high.

Authorities in northeastern Congo on Friday banned funeral wakes and gatherings of more than 50 people in an effort to curb the spread of the virus. The World Health Organization said that the outbreak now poses a “very high” risk for Congo — up from a previous categorization of “high” — but that the risk of the disease spreading globally remains low.

WHO Director-General Tedros Adhanom Ghebreyesus said Friday that 82 cases and seven deaths have been confirmed in Congo, but that the outbreak is believed to be “much larger.”

There is no available vaccine for the Bundibugyo virus, which spread undetected for weeks in Congo’s Ituri province following the first known death while authorities tested for another, more common, Ebola virus and came up negative. There are now 750 suspected cases and 177 suspected deaths, though more are expected as surveillance expands.

Dr. Jean Kaseya, director-general of the Africa Centers for Disease Control and Prevention, said a response to the outbreak must include building trust with communities.

The International Federation of Red Cross and Red Crescent Societies said on Saturday that three of its volunteers had died from the outbreak in Mongbwalu. The agency said it believed the three healthcare workers contracted the virus while carrying out dead body management activities on March 27 as part of a humanitarian mission unrelated to Ebola.

This would significantly push back the timeline of the outbreak from the previous first confirmed death in late April in the town of Bunia, the capital of Ituri.

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McMakin reported from Dakar, Senegal.

CINCINNATI – The first time 5-year-old Calvin Owens went outside in more than a month, he met up with his canine friend Hadley on a hospital patio. Despite being tethered to equipment with wires and tubes, the little boy managed to stand up near his wheelchair long enough to toss her a ball.

He smiled as she ran to fetch it. Caregivers cheered.

“Look how good you’re doing!” said Hadley’s handler, Schellie Scott.

Such small victories and moments of joy are common whenever Hadley or one of the other three facility dogs at Cincinnati Children’s Hospital show up. These furry caregivers aren’t the typical therapy dogs volunteers bring to hospitals to comfort patients. They are specially trained, full-time working dogs that provide emotional support during stressful procedures, motivate kids to move around and make hospitals seem less scary. And experts say their ranks are growing at children’s hospitals across the nation.

A mounting body of research shows that even short interactions with facility dogs can improve children’s overall well-being, decrease the pain they feel and reduce signs of stress, like cortisol levels and blood pressure.

“These dogs are making a real difference,” said Kerri Rodriguez, director of the Human-Animal Bond Lab at the University of Arizona. “They can provide a little bit of normalcy, a little bit of comfort, in a really stressful, sterile environment that kids might not feel comfortable in.”

How hospital facility dog programs work

Although no one tracks the number of facility dogs in children’s hospitals, Rodriguez points to the continual growth of the annual Facility Dog Summit, where handlers and other participants network and where attendance nearly doubled from 2024 to 2025. Other types of hospitals also have full-time dogs, but experts say children’s hospitals account for most of the expansion in programs. One large nonprofit, Canine Assistants in Georgia, has a specific children’s hospital initiative through which it has placed more than 80 dogs nationally.

Dogs have been on the job for years at places such as Mount Sinai Kravis Children’s Hospital in New York, Norton Children’s in Louisville, Kentucky, and St. Louis Children’s Hospital. And new programs keep sprouting up. In March, Johns Hopkins Children’s Center in Maryland introduced its first two facility dogs.

Hospitals generally get the dogs from nonprofits. Organizations such as Canine Companions, where Cincinnati Children’s gets its dogs, breed, raise and train them, then place them with hospital staff members but still own them. Dogs and handlers live and work together.

Although hospitals don’t pay for the dogs, they’re responsible for costs such as food and veterinary care, which can add up, especially since most are larger breeds like Labradors or golden retrievers. Hospitals usually fundraise or seek grants to cover the costs.

Experts say the benefits of these sorts of “animal-assisted therapies” are clear. A 2022 study Rodriguez coauthored analyzed a survey conducted across 17 children’s hospitals. Pediatric health professionals described how facility dogs provided a comforting presence, built rapport, and normalized the hospital environment for children and families. A 2021 study in the Journal of Pediatric Nursing concluded that animal- assisted therapies were beneficial for controlling pain and blood pressure in children and teens. Other research also found these therapies reduce anxiety and pain and can even improve heart and lung function.

Facility dogs are allowed in more sensitive areas of the hospital than volunteer dogs, and sometimes serve particular hospital units. Opal, one of two St. Louis dogs, splits her time between the pediatric behavioral health unit and the child protection program.

No matter where the dogs work, keeping them clean is key.

Hadley, in Cincinnati, is bathed twice a month because she works in the cancer and blood diseases area, where kids might have reduced immunity. She gets even more baths, or cleanings with special wipes, if she’s potentially exposed to germs. Handlers use leashes and balls that can be easily cleaned, and people must sanitize their hands before and after touching the dogs.

If a patient is in isolation, the dog stays outside the room. The one exception is if a dying child wants a dog to be close. In those cases, caregivers say concerns about germs are outweighed by the need to ease fears and provide comfort.

A day in the life of a hospital facility dog

Hadley’s workday starts whenever her handler Scott — whose job as a child life assistant involves keeping patients’ lives as normal as possible — arrives at the hospital. Hadley mostly sees patients, but also gets breaks when she can just do what she wants.

On a recent morning, the Labrador-golden retriever mix raced around a grassy dog play area with her canine co-worker, Grover. While Grover is calm and chill, Hadley gets so excited she shakes her head to toss balls to herself.

“Hadley loves life,” Scott said. “Hadley lives big.”

Inside the hospital, the dogs get constant attention. For handlers, “it’s like being the assistant to a famous person,” joked Scott.

Signs of the dogs’ celebrity status are everywhere.

They appear on closed-circuit television shows filmed by the hospital and beamed into patient rooms. Photos of the dogs, themed for holidays or events, line the hallways. And there are mailboxes where kids can drop letters or pictures for the dogs and get replies.

Patients can also get trading cards for each dog with stats like breed and birthday, bandanas to decorate for their furry friend, or little stuffed dogs. Caregivers create books featuring the dogs to show kids about procedures or treatments they’re about to undergo.

Kids hospitalized for long stretches get to know the dogs well.

Aspen Franklin, a 14-year-old fighting a life-threatening immune disorder, has been coming to the hospital since she was a toddler and was recently hospitalized for weeks. At times, Hadley has snuggled beside her in bed.

“She has a calming presence,” Aspen said. “That is a comfort to me.”

Like other facility dogs, Hadley also helps her family cope. When Aspen’s younger brother Emory donated his cells for her bone marrow transplant, Hadley spent time with him — and other visiting siblings.

Having Hadley around “is really nice because they’re away from their animals at home,” said their mom, Brittney Franklin, whose family has two dogs and a cat.

Franklin recently watched as Aspen painted with Hadley. The dog couldn’t go in her room so soon after her transplant, so Aspen dabbed colors on a small canvas and handed it to Scott, who put it in a plastic bag and smeared peanut butter on top. Just outside the room, Hadley eagerly licked it up. A piece of abstract art emerged.

Hadley’s next patient was Calvin, the little boy she met on the patio. Calvin has a rare, severe type of childhood arthritis and recently had a bone marrow transplant. Though he could only stand for a few moments at a time, he made the effort repeatedly to play with Hadley.

“He’s such a strong little man,” Scott said.

After Calvin went inside, Hadley met up with 11-year-old Bethany Striggles, who recently finished a chemotherapy treatment for bone cancer. The girl hurled the ball all the way down the hallway, and Hadley bounded happily to retrieve and gently return it. Bethany rewarded her with an ice pop.

“She helps me exercise more,” Bethany said. “She’s energetic and happy and always likes to see me.”

But Hadley does eventually tire. When that happens, she goes back to an office affectionately known as her lair, where she has treats, toys and a big dog bed.

Above the bed is a bulletin board covered with drawings, photos and notes. One, written on orange construction paper, contains a small, pink handprint and the words: “Thank you for being my BEST FRIEND.”

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BUNIA – People set fire to an Ebola treatment center in a town at the heart of the outbreak in eastern Congo on Thursday after being stopped from retrieving the body of a local man, a witness and a senior police officer said, as fear and anger grow over a health crisis that doctors are struggling to contain.

The arson attack in Rwampara reflects the challenges of health workers trying to curb a rare Ebola virus by using stringent measures that might clash with local customs, such as burial rites. The disease has been spreading for weeks in a region lacking in adequate health facilities and where many people are on the move to escape armed conflicts.

The bodies of those who die from Ebola can be highly contagious and lead to further spread when people prepare bodies for burial and gather for funerals. The dangerous work of burying suspected victims is being managed wherever possible by authorities, which can be met by protests from victims’ families and friends.

Fear and anger grow

The center in Rwampara was burned by local youths who became angry while trying to retrieve the body of a friend who had apparently died of Ebola, according to a witness who spoke to The Associated Press by telephone.

“The police intervened to try to calm the situation, but unfortunately they were unsuccessful,” said Alexis Burata, a local student who said he was in the area. “The young people ended up setting fire to the center. That’s the situation.”

An AP journalist saw people break into the center and set fire to objects inside and also to what appeared to be the body of at least one suspected Ebola victim that was being stored there. Aid workers fled the treatment center in vehicles.

Deputy Senior Commissioner Jean Claude Mukendi, head of the public security department in Ituri Province, said the youths had not understood the protocols for burying a suspected Ebola victim.

“His family, friends, and other young people wanted to take his body home for a funeral even though the instructions from the authorities during this Ebola virus outbreak are clear,” Mukendi said. “All bodies must be buried according to the regulations.”

Hama Amadou, field coordinator for the humanitarian organization ALIMA, which had teams working at the center, said later that calm had been restored and that aid teams were continuing their work at the center.

The flash of anger underlined the complications faced by both Congolese authorities and an array of aid agencies trying to stem an outbreak that the World Health Organization has declared a public health emergency of international concern.

The outbreak is bigger than official figures show, WHO says

There were 160 suspected deaths and 671 suspected cases in Congo’s two provinces, Congolese authorities said on Thursday. Earlier in the week, the U.N. said there were two cases including one death in neighboring Uganda.

But the WHO has said the outbreak is almost certainly much larger and has also expressed concern over the speed of the spread.

“We are still in the phase where we are intensifying the investigation, searching for cases,” said Jean Kaseya, Director-General of the Africa Centers for Disease Control and Prevention. “I expect the number of cases to increase as surveillance becomes more and more rigorous.”

The risk of the outbreak spreading globally is low, the WHO has said, but high regionally with the Ituri Province at the center of the outbreak bordering Uganda and South Sudan.

Early detection of the virus is key in saving lives, but the region’s already weak health infrastructure and surveillance capacity has been further weakened by international aid cuts, experts say. There are over 920,000 internally displaced people in Ituri Province, according to the U.N.

Armed conflict in the region further complicates efforts to handle the crisis. Local leaders said an attack by militants linked to the Islamic State group killed at least 17 people on Tuesday in Alima, a village in Ituri.

Health workers and aid groups have said they are in dire need of more supplies and staff to respond. Also, there is no available vaccine or medicine for the Bundibugyo strain responsible for the outbreak.

An expert said this week it would be at least six to nine months before one would be available.

“The priority now is to act quickly and work closely with communities, as the coming days are critical,” said Ariel Kestens, the head of the International Federation of Red Cross and Red Crescent Societies delegation in Congo.

Ebola is highly contagious and spreads in people through contact with bodily fluids such as vomit, blood, feces or semen. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding.

It has spread to a new province

On Thursday, the M23 rebel group that controls parts of eastern Congo reported that a person had died of the disease near the city of Bukavu, some 500 kilometers (310 miles) south of the outbreak’s epicenter in Ituri Province.

It was the first case confirmed in South Kivu Province, and another case was reported there later in the day. Previously, cases had been reported only in Ituri and North Kivu provinces and in neighboring Uganda.

The virus spread undetected for weeks following the first known death in late April as Congolese health authorities tested for a different Ebola virus more commonly responsible for outbreaks in the country. Health officials have not yet found “patient zero,” according to the WHO.

The scale of the outbreak so far suggests it “started probably a couple of months ago,” said Anaïs Legand, a viral hemorrhagic fevers expert at the WHO.

The outbreak has had international repercussions

India and ​the ⁠African Union said Thursday that the ⁠India-Africa ⁠Forum Summit, scheduled to be held next week in ‌New ​Delhi, had been postponed due to ⁠the “evolving health situation in parts of Africa.”

On Wednesday, Congo’s soccer team canceled a three-day World Cup preparation training camp and a planned farewell to fans in the capital Kinshasa because of the Ebola outbreak.

The U.S. government has placed restrictions on any travelers who have visited Congo, Uganda or South Sudan in the previous 21 days, barring foreign visitors among them from entering the U.S. and requiring U.S. citizens and permanent residents to be diverted to Washington Dulles International Airport for screening.

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Pronczuk reported from Dakar, Senegal and Imray from Cape Town, South Africa. Associated Press writers Jamey Keaten in Geneva; Jean Yves Kamale in Kinshasa, Congo; and Wilson McMakin in Dakar, Senegal contributed to this report.

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