The oldest known person alive can hardly see, is very hard of hearing, has been largely bed-bound for the last year and has not left her small second-storey flat in Verbania on the shores of Lake Maggiore in northern Italy for over two decades.
But her doctor, Carlo Bava, said his patient remained alert and continued to have a reasonable quality of life.
Bava told AFP she was very aware of all the fuss being made about her reaching the latest milestone in a remarkable life that began on November 29th, 1899.
“She is very lucid, very present,” Bava said. “She was very happy and honoured to get a telegram of congratulations this morning from President (Sergio) Mattarella.
“There was a television crew there and she got flowers. She had dressed up and she was very proud. She posed for a photographer and even asked if her hair looked good.
“So I think you can say she is on good form.”
No veggies, thanks
Morano has reached a ripe old age despite an extraordinarily tough life, even by the standards of many of her contemporaries, and following a diet that flouts almost every piece of established medical wisdom.
“I eat two eggs a day, and that's it. And cookies. But I do not eat much because I have no teeth,” she told AFP in an interview last month. She has long eschewed vegetables and her consumption of fruit is limited to the occasional handful of grapes or snacks of apple puree.
Her prodigious egg habit started when she was diagnosed with anaemia at 20 and a doctor told her to start eating two raw and one cooked every day: a habit she maintained until her appetite began to ebb slightly around the age of 110.
When she still had teeth, she was also fond of chomping chicken and lean raw steak.
Along with her fondness for pure protein, she has always had a sweet tooth, meaning visitors were usually advised to come bearing gifts of Colomba, a cake rich in egg and butter that Italians associate with Easter, or Pannetone and Pandoro, traditional Christmas treats of a similar ilk.
Very strong character
But it wasn't clear if she would be enjoying any of the birthday cake she received on Tuesday.
“The last time I ate a little, but then I did not feel good,” she confided to AFP last month.
Bava suspects that Morano has thrived despite her unusual diet, not because of it.
“I think her secret is genetic. All of her family lived very a very long time,” the doctor said. “The diet she has had would have destroyed the liver of most people. But with Emma, I think she could even eaten pebbles and she would still have lived a very long time.
“What might be more important is that she has always had a very strong strong character. It has always been her who decides what she does or doesn't do.”
Morano herself has attributed her longevity to having the courage to take the life-changing decision of leaving a violent husband in 1938, shortly after the death in infancy of their son, her only child.
It was always an unhappy marriage. Years before, her true love had gone off to fight in World War I and not come back.
Leaving a husband was no easy thing to do in the Church-dominated Italy of the 1930s and Morano worked in a factory producing jute sacks to support herself.
“Back then, the workers in those factories were constantly breathing in dust and yet her lungs are fine – that's genetics,” said Bava.
By Angus MacKinnon