Four new cases of avian influenza were detected in farmworkers in Washington state this week, the latest in a drumbeat of human infections cropping up across the U.S. as the virus continues to spread among farm animals. 

Washington is the sixth state to report human cases of bird flu, which has spread rampantly in wild birds, poultry and cattle. Assuming the Centers for Disease Control and Prevention confirms the state’s positive tests, they will bring the U.S. tally to at least 31.

Flu experts said the risk of a broader outbreak among humans will continue to simmer if the virus remains uncontrolled in animals.

“The longer this virus hangs out in the environment, the more animals it spills over into, the more it changes in ways we don’t understand or predict, the more concerned we are going to be that this becomes the next global pandemic,” said Dr. Amber Itle, the Washington state veterinarian.

For now, however, health officials maintain that the virus has not made key genetic changes that would allow it to spread between people. 

“There is no evidence of any sustained human transmission. And that is a key milestone for all of us. It’s a key trigger for all of us. That’s when we really start to say, ‘Oh, something that’s markedly different about this virus,’” Dr. Umair Shah, Washington’s health secretary, said at a news conference Sunday. 

A CDC spokesperson said Tuesday morning that a federal team was being deployed to Washington and that risk to the public remained low. 

However, the virus is a growing concern for farmworkers on the front lines. The four latest cases were among workers who had culled birds at a commercial egg farm where an outbreak of avian influenza was reported in chickens.

Shah said the workers were part of a contract crew tasked with depopulating — or euthanizing — all chickens at the farm in Franklin County, in southeastern Washington, which had more than 800,000 birds. Itle said the workers wore full protective equipment: suits made of Tyvek, goggles and respirators. 

“It’s hot, it’s dusty. It’s a lot of birds in close proximity, and we’re getting a lot of viral exposure,” she said.

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The four people who tested positive after that work reported mild respiratory symptoms and conjunctivitis, or pink eye — symptoms now understood to be common when people are infected. None of the workers were hospitalized. 

Dr. Richard Webby, director of the World Health Organization Collaborating Center for Studies on the Ecology of Influenza in Animals and Birds, said the Washington cases represented “more of the same” in a pattern observed across the U.S. as workers tasked with culling sick animals have fallen ill. 

However, one human case — in Missouri — has puzzled researchers and health officials, because that person did not have contact with animals. It is not clear how the person was exposed, and results of further tests that could offer clues are still pending, according to the CDC. Six health workers exposed to the patient reported respiratory symptoms.

Webby said the virus’ spread in cows for the past 10 months has raised experts’ level of concern because cows are mammals and interact with humans frequently. That increases the likelihood the virus could mutate to pass from person to person. 

“Just because it hasn’t happened in 10 months … it doesn’t mean it can’t,” said Webby, an infectious disease researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee. 

Research suggests that incredible amounts of virus are shed in infected cows’ mammary glands, so the virus could spread through raw milk. (Milk sold in grocery stores is pasteurized, which inactivates the virus.) 

At the same time, the U.S. is preparing for flu season, when circulation of common influenza viruses increases in fall and winter. If two influenza viruses share the same host, they can share genetic information and mutate more quickly.

“You don’t want people affected with the seasonal flu virus to get a virus from animals and for those viruses to potentially recombine,” said Dr. Peter Rabinowitz, a professor of environmental and occupational health sciences at the University of Washington and the director of its Center for One Health Research.

Rabinowitz added that it is important to improve protection protocols for farmworkers and encourage them to get their flu shots. 

“This is a wakeup call. We need to do a better job of protecting workers,” he said.

Itle said cases in poultry were not unexpected in Washington state, because migrating birds passed through during summer and early fall. Recently, owls and other birds of prey were found dead, suggesting some wild animals had been stricken with the virus. 

Wild birds can spread the virus to farms through direct contact with poultry or livestock or via droppings, saliva or feed.  

More than 103 million birds have been sickened, killed or culled in the current bird flu outbreak, according to CDC statistics. The virus has been detected in poultry in 48 states. 

The CDC says 330 dairy herds have been affected. 

Washington has not had an outbreak among dairy producers, Itle said, but dairy farms there are now testing weekly.

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A new analysis of breathing data from 52 volunteers over a 24-hour period revealed that people with a normal sense of smell had little spikes, or “sniffs,” during each breath that were not seen in those with no sense of smell, according to the report published in Nature Communications on Tuesday.  

People can be born with no sense of smell, a condition called anosmia, or they can acquire it, as has been the case with many who had a Covid infection.

The volunteers in the study without the ability to detect odors were all born with the condition.

Nearly 1 in 4 people have anosmia, according to National Institutes of Health estimates. Experts say that number is likely an undercount.

A 2023 report determined that more than 60% of people diagnosed with Covid developed anosmia. About 72% of those completely regained their sense of smell, while about a quarter partially got their sense of smell back. Nearly 4% of people after Covid infection didn’t recover their ability to smell.

Even for those in the 4%, there may still be hope, since some get their sense of smell back as late as three years after their infection, experts say. There are treatments that may help, such as smell training or a procedure known as a stellate ganglion block.

The main takeaway from the study is better insight into some of the mental issues that some Covid patients who have lost their sense of smell experience, said the study’s lead author, Lior Gorodisky, a Ph.D. candidate in the brain sciences department at the Weizmann Institute of Science in Rehovot, Israel.   

The differences in breathing between those who can smell and those who can’t are pretty significant. “We are now also able to identify lifelong anosmia just based on the respiratory pattern,” Gorodisky said in an email.

The little inhalations during a breath, known as the “sniff response,” are something that most of us experience unconsciously every day, Gorodisky said. Those little sniffs tell our brains about good and bad smells. “When you go to a bakery or a flower field, once your brain has sensed the good smell of a pastry or a flower, you immediately take a deeper breath,” Gorodisky said.

To determine whether having anosmia might affect respiration, the researchers supplied the 52 volunteers with nasal devices that would monitor breathing as they went about their days.

Previous research has linked anosmia to a wide variety of negative outcomes, ranging from dulled emotions and depression to a shortened lifespan, the authors noted.

Although people in the study with anosmia had had it their entire lives, the researchers believe their findings will apply to others who developed the condition.

Losing the ability to detect odors can lead to impaired memory of events linked to specific smells, Gorodisky said. Because of that, it can take away the joy from daily activities such as eating and socializing with friends and family. 

As for shortened lifespans, that could be due at least in part to people not smelling odors that could indicate danger, such as smoke, Gorodisky said.

A study published in August found that people who lost their sense of smell as a result of Covid had behavioral, functional and structural brain changes.

The number of people with smell dysfunction are “vastly underestimated, said Valentina Parma, assistant director at the Monell Chemical Senses Center in Philadelphia.

She called the new study a “very first step.”

“We are piecing together more reasons why we need to pay more attention to the sense of smell,” said Parma, who was not involved with the new research.

The value of the sense of smell is often underappreciated.

“For the majority of the world, smell is an afterthought,” Parma said. “Covid helped bring it into the mainstream. It was a game changer.”

Currently, health care providers often don’t ask about or test for anosmia, Parma said. And that needs to change since its development later in life has been linked to the start of a number of serious disorders, including Alzheimer’s and Parkinson’s, she said.

The findings underscore the importance of testing for anosmia and finding treatments, said otolaryngologist Dr. Jonathan Overdevest at the Columbia University Irving Medical Center in New York City. 

Researchers also need to work out the details of how losing one’s sense of smell might affect other aspects of health, Overdevest said. “One thing we do know is that a portion of the brain affected earliest by Alzheimer’s is in charge of the sense of smell,” he added.

Brain scanning studies have shown that the sense of smell connects with many aspects of thinking, said Benjamin tenOever, chair of the department of microbiology at the New York University Langone Medical Center in New York City.

If there is an odor from a noxious fume, “the neurons in the nose tell the brain that there is something dangerous to avoid,” tenOever said. “And when there is a pleasant smell, the brain tells the nose to increase the amount of air inhaled. It’s not something that’s done consciously, but instead, the brain is hardwired to do it.”

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As CVS and Walgreens shutter hundreds of stores nationwide to shore up profits and investor sentiment, Walmart said Tuesday that it is offering a new option for customers: Delivering prescriptions to their doorsteps.

The nation’s largest retailer said deliveries are now available in six states: Arkansas, Missouri, New York, Nevada, South Carolina and Wisconsin. The company said in a news release that it expects to deliver prescriptions in 49 states by the end of January. Prescription deliveries will not be available in North Dakota due to state laws, Walmart said.

The prescription delivery service is another example of how Walmart is trying to outmatch competitors on convenience along with low prices. With the new service, customers can get a mix of items dropped off during the same delivery, such as a box of tissues, blanket or chicken noodle soup.

Walmart’s new delivery offering could be another blow to drugstore chains, which are falling out of favor with consumers in a trend that has hit their profits and stock prices and forced them to reconsider their strategies. Still, it is unclear how much market share Walmart could win from CVS and Walgreens, both of which offer same-day, one-day and two-day prescription deliveries.

Tom Ward, chief e-commerce officer for Walmart U.S., said the company added pharmacy deliveries because of shopper demand.

“This is actually the number one service requested by our customers,” he said.

He said Walmart tested the deliveries in several states and saw that customers took advantage of getting a mix of items, including the prescription, in a single delivery.

Walmart’s delivery service will be available for new prescriptions and refills, the company said. It will cost $9.95 for a delivery, the standard price for Walmart doorstep deliveries, but will be free for members of Walmart+, the company’s membership program.

Health insurance plans will be applied to the transaction, like they would in the store, the company said.

The deliveries will come with a few more safety steps than Walmart’s other deliveries, the company said: Medications will be put into tamper-evident packaging. Customers can track orders in real time through Walmart’s app or website and get a photo in the app or by email when the prescription is delivered. And when a customer orders a new prescription and chooses delivery, they are prompted to do a consultation with the pharmacy by phone.

Most of Walmart’s annual revenue in the U.S. – nearly 60% – comes from groceries, but health and wellness is a growing category for the company, according to the retailer’s most recent annual filing for the fiscal year that ended Jan. 31. Health and wellness accounts for about 12% of its annual revenue in the U.S. It includes pharmacy, over-the-counter drugs and other medical products, optical services and other clinical services.

A new challenge for drugstores

As of Monday’s close, shares of Walmart were up around 54% for the year. Meanwhile, shares of CVS were down roughly 26% so far this year, while shares of Walgreens were down nearly 60%.

CVS is the top U.S. pharmacy in terms of prescription drug revenue, holding more than 25% of the market share in 2023, according to Statista data released in March. Walgreens trailed behind with nearly 15% of that share last year, while Walmart held just 5% of that share.

CVS and Walgreens are grappling with falling reimbursement rates for prescription drugs. Inflation, softer consumer spending and competition from Amazon, big-box retailers and grocery stores are making it difficult for them to turn a profit at the front of the store, which carries cleaning supplies, beauty products and pantry staples, among other items.

CVS CEO Karen Lynch left the company and was replaced by David Joyner last week, as CVS faces pressure from Wall Street and, more recently, an activist investor to turn around its business. On top of the leadership shakeup, CVS plans to cut $2 billion in expenses over several years. That includes slashing less than 1% of its workforce, or roughly 2,900 jobs, on the corporate side of its business.

The company is also wrapping up a three-year plan to close 900 of its stores, with 851 locations closed as of August.

Walgreens is similarly cutting costs, announcing last week that it will close roughly 1,200 stores over the next three years, which includes 500 in fiscal 2025 alone. The chain has around 8,700 locations in the U.S., a quarter of which it says are unprofitable.

Walmart has faced its own financial challenges on the health-care side of the business. The discounter planned to bring its low-price spin to health care by opening clinics that offered doctor, dentist and therapy appointments for less.

Yet in the spring, Walmart shuttered all of the clinics, saying in a news release at the time that it couldn’t operate a profitable business because of “the challenging reimbursement environment and escalating operating costs.”

Soon after the mammogram, Huang said she felt a lump under her armpit and began experiencing flu-like symptoms. Four months later, she was diagnosed with triple-negative breast cancer, one of the most aggressive forms of the disease.

“As Asian Americans, we don’t have a prevention mindset and tend to only go to hospital when we’re sick,” said Huang, now 59 and an advocate for early screening among Asian American women.

Since 2000, breast cancer incidence among Asian American and Pacific Islander women under 50 years old has increased by 50%, more than 2% every year since 2012, according to a new report from the American Cancer Society.

AAPI women in this age cohort had the second-lowest rate of breast cancer among all racial groups in 2000. They now have the highest rate alongside white women, about 86 per 100,000, NBC News reports.

“Breast cancer is still more common the older we get, but it’s alarming to see younger women being diagnosed,” said Dr. Helen Chew, director of the clinical breast cancer program at UC Davis Health.

Breast cancer has risen sharply among younger Asian American women in the past quarter century due in part to acculturation and greater awareness around screenings, though experts say more research is required to determine exact causes for specific ethnic groups.

Asian women like Huang have a higher prevalence of dense breasts, meaning there are more glands and tissue than fat, than women of other races, likely due to genetic factors and lower body mass indexes, experts say. And women with dense breasts are four times as likely to develop breast cancer as those with fatty breasts, an issue experts say needs more awareness.

One possible reason for the spike in breast cancer incidence among AAPI women is increased westernization, or the adoption of lifestyle choices not endemic to Asia, said Scarlett Lin Gomez, an epidemiologist at the University of California, San Francisco, who’s leading the first long-term study of cancer among Asian Americans.

“Established risk factors for breast cancer have typically been more common in westernized and industrialized countries,” Gomez said, noting that the increase in breast cancer among women in Asia has been linked to economic development and practices such as delayed childbearing, eating a Western diet high in refined grains and trans fats, growing alcohol consumption and the use of hormone therapy.

Late pregnancies may increase the risk of breast cancer because breast cells have more time to accumulate genetic damage as a woman ages, and hormonal changes during pregnancy can stimulate the growth of damaged cells.

Asian women who immigrate to the U.S. are more than twice as likely to develop breast cancer than U.S.-born Asian women, a trend that Gomez said could be associated with the higher socioeconomic status and education level of more recent immigrants.

Women from higher socioeconomic classes, Gomez said, tend to have “more risk factors for breast cancer, especially as they are coming from Asia, where we have been seeing very rapidly increasing rates of breast cancer.”

Since Asian Americans are such a heterogeneous group, Chew said, incidence and mortality rates vary widely among different ethnic groups. Korean, Chinese, Filipina and South Asian American women face the highest risk of breast cancer. Most Asian American women, including Chinese and Japanese Americans, are less likely to die from breast cancer than white women, but the mortality rates for Filipina and Pacific Islander women are 30% higher.

Socioeconomic status and education level, which vary widely between Asian Indians and Pacific Islanders or Southeast Asians, could explain these disparities in breast cancer incidence and mortality, Chew said.

“Breast cancer is the only cancer with such vast disparities among AAPIs,” Chew said, noting that researchers would have to conduct long-term studies on each subgroup to find answers. “You wonder if it has to do with education and class. Is it biology? Is it cultural? It’s hard to know.”

Among younger Asian American women, Gomez said, rising obesity rates, increased access to screenings, and environmental exposure to chemicals like PFAS can be “early indicators of the onset of cancer.” On the other hand, she said, younger generations may carry traits that make them especially vulnerable: Gen Xers and millennials are more likely to be diagnosed with 17 types of cancer, half of which had been declining in older adults. Experts have pointed to obesity, a more sedentary lifestyle and chemical exposures as common risk factors.

Gomez said it’s notable that the increase in breast cancer among younger Asian American women is evident across all stages of disease, an indication the trend is not entirely attributable to screenings. She and other researchers at UCSF are studying unique and emerging risk factors in Asian American women who may be predisposed to breast cancer.“We’re hypothesizing something related to stress, maybe due to living, work or discrimination,” Gomez said.

The mortality rate for Asian American women under 50 years old has not dropped in the past two decades, even though the death rate among all women has fallen by 30%. Studies have shown that Asian American women may be prone to a more aggressive type of breast cancer, caused by the HER2/neu protein, than women from other racial groups.

AAPI women collectively have among the lowest screening rates, which experts say may have contributed to a stabilizing, rather than falling, mortality rate. At the same time, the stigma around cancer is still widespread within the diaspora, as well as the culturally embedded belief that consulting a doctor is only necessary when the pain is unbearable.

Disaggregating data is key to understanding what’s driving the rapid rise in breast cancer among Asian women, Chew said.

“There has to be a better effort at categorizing patients and not just lumping groups into ‘Asian America’ umbrella,” she said. “Recent immigrants from Southeast Asian countries are different from Japanese Americans who have been here for generations.”

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Drug overdose deaths fell 12.7% in the 12 months ending in May, according to preliminary data released Wednesday by the Centers for Disease Control and Prevention.

“This is the largest recorded reduction in overdose deaths,” White House officials said in a statement. “And the sixth consecutive month of reported decreases in predicted 12-month total numbers of drug overdose deaths.”

It’s also the first time since early 2021 that the number of estimated drug overdose deaths for a 12-month period fell below 100,000, to 98,820.

It’s categorically good news. It’s also a bit puzzling to the public health experts who have been working for years to stop the upward trajectory of opioid deaths, driven primarily by fentanyl.

In Cleveland, for example, monthly overdose deaths in the first three months of this year fell by 40% compared to last year, according to the city’s public health director, Dr. David Margolius.

It’s unclear what prompted the sudden, unexpected decline. Overdose reduction strategies like increased availability of Narcan, a rescue medication that can reverse opioid overdoses, were in use long before the abrupt drop.

“We’ve been doing the things we’re doing for over 10 years. I’d love to say it’s finally working,” said Dr. Joan Papp, an emergency physician at Cleveland’s MetroHealth Medical Center. “But boy, I don’t know. I wish I knew so I could bottle it.”

One potential factor at play: People are no longer using drugs in isolation as they did during the height of the pandemic. Now, they’re more likely to use around other people who could call 911 or give a dose of Narcan.

A continuing trend?

Forty-one states saw decreases in drug overdose deaths in the 12 months ending May, according to the latest CDC data.

“For the first time since at least 2018, national data for 2023 showed a decline in overdose deaths compared to the previous year,” Chrissie Juliano, executive director of the Big Cities Health Coalition, a group that represents health officials from the nation’s largest cities, said during a media briefing Thursday. “Provisional 2024 national data continues this trend.”

Even the nation’s largest metropolitan area — New York City — saw a small but measurable drop.

In 2023, 3,046 people in the city died of a drug overdose, according to its health officials. That’s a 1% decrease from 2022 and the city’s first drop in overdose deaths since 2018.

Dr. Ashwin Vasan, commissioner of New York City Department of Health and Mental Hygiene who is leaving office Friday, said during the briefing that he was “cautiously and humbly excited” about the city’s latest drug overdose numbers.

Officials in Seattle echoed the national trend.

“For the first time in several years, we’re starting to see a significant decrease in overdose deaths,” Brad Finegood, who oversees overdose and addiction programs in Seattle, said during Thursday’s briefing.

The city logged 22% fewer overdose deaths in the first nine months of this year compared to last year. The number of nonfatal overdoses fell, as well, he said.

“That represents an extremely significant decline,” Finegood said.

He said that in Seattle, about 85% of people who use drugs carry Narcan.

“While we know that they can’t reverse their own overdose, they’re often the first one on the scene and able to reverse an overdose that could be fatal, to bring somebody back to life,” he said.

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“When the ride is an hour or an hour and a half of mostly freeway driving, people tend to tell you what they’re going through,” she said.

Drivers such as Carr have become a critical part of the medical transportation system in Georgia, as well as in Washington, D.C., Mississippi, Arizona, and elsewhere. While some patients use transportation companies solely dedicated to medical rides or nonemergency ambulance rides to get to their appointments, the San Francisco-based ride-hailing companies Uber and Lyft are also ferrying people to emergency rooms, kidney dialysis, cancer care, physical therapy, and other medical visits.

But Georgia ride-hail drivers aren’t only serving patients living in Atlanta or its sprawling suburbs. When rural Georgians are too sick to drive themselves, Uber or Lyft is often one of the only ways to reach medical care in the state capital.

Rural hospital closures in Georgia have meant people battling cancer and other serious illnesses must now commute two or more hours to treatment facilities in Atlanta, said Bryan Miller, director of psychosocial support services at the Atlanta Cancer Care Foundation, a medical practice offshoot that seeks to alleviate financial burdens for cancer patients and their families.

From April 2022 to April 2024, Lyft drivers completed thousands of rides that were greater than 50 miles each way and that began or ended at Atlanta-area medical treatment centers, including the Winship Cancer Institute of Emory University and Emory University Hospital Midtown, according to Lyft.

While 75% of those trips were under 100 miles, the company said, 21% of them were between 100 and 200 miles and 4% were over 200, showing that even Georgians who live hours away from metro Atlanta rely on the ride-hail platform to reach medical care there.

Uber Health global head Zachary Clark declined to provide comparable ridership data. Uber Health is a division of Uber that organizes medical transportation for some Medicaid and Medicare recipients, health care workers, prescription drug delivery, and others seeking reimbursement for medical-related Uber rides, according to Uber’s website.

Lyft also has a health care division, offering programs such as Lyft Assisted and Lyft Concierge to coordinate rides for patients.

Nationwide, some insurance companies and cancer treatment centers, plus Medicare Advantage and state Medicaid plans, pay for such ride-hailing services, often with the goal of reducing missed appointments, according to Krisda Chaiyachati, an adjunct assistant professor at the University of Pennsylvania medical school.

In 2024, 36% of individual Medicare Advantage plans and 88% of special needs plans offered transportation services, said Jeannie Fuglesten Biniek, associate director of Medicare policy at KFF, the health policy research, polling, and news organization that includes KFF Health News. A special needs plan provides extra benefits to Medicare recipients who have severe and chronic diseases or certain other health care needs, or who also have Medicaid.

And Medicaid — the federal-state government safety net insurance plan for those with low incomes or disabilities — paid for up to 4 million beneficiaries to use nonemergency medical transportation services annually from 2018 through 2021, according to a Department of Health and Human Services report. Patients residing in rural areas used ride-hailing and other nonemergency transportation providers at the highest rates, the report said.

The estimated total federal and state investment in nonemergency medical transportation was approximately $5 billion in 2019, according to a study by the Texas A&M University Transportation Institute.

Even with some insurance covering trips or charities offering ride credits, social workers say, many ailing patients are still left without a ride. Nationwide, 21% of adults without access to a vehicle or public transit went without needed medical care in 2022, according to a study by the Robert Wood Johnson Foundation. People who lacked access to a vehicle but had access to public transit were less likely to skip needed care.

The data analytics company Geotab ranked Atlanta as tied for second worst in the nation when it comes to the accessibility of its public transportation network.

“The ability to get to a doctor’s appointment can be a barrier to care,” said Rochelle Schube, a cancer support group facilitator in Atlanta. “If I give a patient $250 in Uber cards and they live far away, that gets spent quickly.”

The fact that Uber and Lyft are harder to come by in rural America compounds the lack of medical access in those areas. “When you move to rural areas — which you could argue have a higher need — you see fewer services,” Chaiyachati said.

Finding drivers who are able and willing to provide medical transportation can be a challenge. The Atlanta-based start-up MedTrans Go connects patients and health care providers with vetted drivers, many offering wheelchair or stretcher rides, in Georgia and 16 other states. Many of its drivers have medical training, walk patients to and from medical facilities or their homes, and can handle complex situations for vulnerable patients, said Dana Weeks, the company’s co-founder and CEO.

The company’s app can also dispatch directly to Uber or Lyft for patients who do not need specialized assistance, she said.

Uber and Lyft trips can save patients and insurers money, costing a fraction of the typical fee for an ambulance ride, said David Slusky, an economics professor at the University of Kansas who has studied the impact of ride-hailing services on medicine.

But instead of all of that, argued Timothy Crimmins, a history professor emeritus at Georgia State University and a former director of the school’s neighborhood-studies center, the best solution would be for Georgia to expand Medicaid, so more rural hospitals would be able to remain open and Georgians could seek medical care close to home.

The decision by Georgia lawmakers to not accept a federally funded expansion of Medicaid has left more than 1.4 million Georgians without health insurance, according to KFF — and that hurts rural hospitals when those patients use the medical facilities and cannot pay their bills. In Georgia, 10 rural hospitals have either closed or ceased their inpatient care operations since 2010, according to a 2024 report from health care consultant Chartis, and 18 more are in danger of shuttering.

Until more patients are insured, Crimmins said, the state should subsidize Uber and Lyft trips for less prosperous Georgians who need help reaching medical care in Atlanta. “We might be talking about $100 to $150 round-trip,” he said. “That can be subsidized.”

Still, ferrying around patients is not for every ride-hail driver. Damian Durand said his Chevrolet Equinox SUV is large enough to accommodate a medical passenger requiring a wheelchair, but he isn’t paid extra to transport those with medical needs. He said some of his recent passengers in Atlanta have been Medicaid recipients with mental health conditions or disabilities.

“It can be stressful,” he said. “I do feel like Uber and Lyft are trying to catch me off guard. When I can see that the ride is going to the hospital, I try to avoid or cancel the ride.”

While Durand’s experience with medical transport has been mostly negative, Carr loves the work and appreciates being able to help older Georgians, who she said often tip her well. For her, ride-hail work remains a good option even when it entails medical calls.

“It’s not stressful for me,” she said. “I worked a good 20 years in customer service. For me, human connection is important. I tried to work from home, and I really didn’t like it. I prefer this because I can connect with people.”

As a professional dream interpreter and the author of “The Alchemy of Your Dreams,” I help people come to insights about recurrent patterns and symbols that pop up in their dreams, like snakes.

All dreams are gifts, even the ones that scare you (see: snakes). Every night when we sleep, we are gifted with the opportunity to receive guidance, creative ideas and positive solutions through our dreams.

Dreams have been proven to help regulate negative emotion and offer up healing. In a previous interview with TODAY.com, Adriane Soehner, Ph.D., assistant professor of psychiatry at the University of Pittsburgh and the director of the Pitt Sleep, Affective Neuroscience, and Development Lab, said dreams have a “functional” purpose, aiding with “memory, emotional processing and sensory processing.”

Now, this isn’t to say that all of your dreams will feel easy, or a nightly narrative of bliss and pleasure. That’s because our dreams help to guard against self-deception and in doing so, they often pack a metaphoric punch, encouraging you to ask: What is the message I’m not hearing? The “thing” that I’m not seeing? The path I’m afraid to follow? The feeling I’m unwilling to feel?

The snake I am unwilling to see?

If you’re simply seeing snakes everywhere once you go to sleep, there’s no need to worry. Here’s what to know if one slithers into your subconscious.

What do snakes in dreams mean?

Snakes are both universal and personal symbols. From the ouroboros (a snake eating its own tail in a circle like shape) to the cosmic rainbow serpent, snake dreams can alert you to your state of consciousness and well-being, as well as the greater mysteries of life.  

Snakes in dreams are a call to focus on healing, transformation and change

Snakes are symbols of transformation and change. The Asclepius rod, a rod that has two snakes intertwining it, is a common sign for medical institutes because snakes have long been associated with healing.

So, if you dream of a snake in your house, you may need to focus on change, healing and transformation. Periods of change and adjustment often lead to life altering transformations although the process can feel emotionally intense.

Sometimes, you have to let go of what was, in order to let something new and better in. And a snake dream may just come to you in order to remind you of your innate ability to do just that.

Snakes in dreams also indicate it may be time to make a swift move

Snakes shed their skin in one go. If you dream of a snake in this manner, it may symbolize that you need to shed a pattern, belief, or identity that is no longer serving you, in order to move through life more easily.

A dream like this also tells you that this can happen in one swoop movement — just like a snake sheds its skin easily so can you! Ask yourself—what do I need to release in order to transform into a healthier, happier version of me and can I allow these changes to happen with ease?

The dreamer will have to look at their own spiritual beliefs and ask themselves what the next right path is. It may be a calling to some type of initiation and learning.

Understanding different snake dream scenarios

What does it mean if a snake chases, attacks or bites you in a dream?

II the snake in your dream was threatening or biting you then this type of dream may indicate that you need to pay attention to your relationships and partnerships.

As well as your own relationship to your instincts. Do you trust your gut? Are your instincts on sharp form? Have you let something poisonous into your life (unhealthy habits/beliefs/behaviors or people)? If so, the solution to something venomous is to remove the poisonous ‘thing’ from your life. No one needs toxicity in their life, and we all have to address our own negative behaviors too.

What does it mean to dream of a specific snake species, like a constrictor or rattle snake?

If a very specific type of snake shows up in your dream, you can take that as a sign to research that kind of particular snake. For example: a rattle snake asks you to see what is ‘rattling’ in your life? It is a dream message that is rattling you awake — it is saying that you need to pay attention and remain alert!

On the other hand, a boa constrictor could symbolize a situation in which you feel like something is squeezing the life out of you. And like all dreams, both in waking life and sleep, you are the key player. Focus on bringing your awareness to the here-and-now so that you can make conscious, helpful, and positive decisions that will serve you and those around you.

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The outing in the western region of the state in November 2023 culminated in a presumed outbreak of trichinellosis, a rare parasitic disease linked to wild game meat, the CDC said in the report published last week.

Trichinellosis occurs when people eat undercooked or raw meat harboring dormant roundworm larvae, the report said.

Cooking wild game meat to an internal temperature of at least 165 degrees Fahrenheit is necessary to kill  the parasitic infection, the CDC said.

Of the 34 people surveyed who attended the gathering, 65 percent reported eating bear meat. Among the 10 likely cases, nine patients had facial swelling, six had muscle aches and pains, and four had fevers, the CDC said.

On November 29, 2023, the North Carolina Division of Public Health was alerted to a suspected case of trichinellosis in western North Carolina, according to the CDC.

Trichinellosis caused by eating undercooked bear meat, although rare, is not unheard of in the U.S.

An outbreak occurred in July 2022 during a nine-person family reunion in South Dakota after people ate kebabs made of bear meat.

One family member brought meat to the reunion from a black bear hunted in Canada. The meat had been frozen in a freezer for more than a month.

The family made kebabs with the thawed meat, alongside grilled vegetables. According to the CDC, the family had trouble determining whether the kebabs were fully cooked, because the meat was dark in color. So it was unintentionally served and eaten rare.

At least six family members developed symptoms such as fevers, headache, stomach pain, diarrhea, muscle pain and swelling around the eyes, the CDC said.

From January 2016 to December 2022, the CDC identified seven trichinellosis outbreaks in the U.S. involving 35 probable or confirmed cases. Most were linked to bear meat.

NBC News’ Aria Bendix contributed.

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The second most important finding is whether her breasts are dense.

Since early September, a new U.S. rule requires mammography centers to inform women about their breast density — information that isn’t entirely new for some women because many states already had similar requirements.

Here’s what to know about why breast density is important.

Are dense breasts bad?

No, dense breasts are not bad. In fact, they’re quite normal. About 40% of women ages 40 and older have dense breasts.

Women of all shapes and sizes can have dense breasts. It has nothing to do with breast firmness. And it only matters in the world of breast cancer screening, said Dr. Ethan Cohen of MD Anderson Cancer Center in Houston.

With the new rule, “there are going to be a lot of questions to a lot of doctors and there’s going to be a lot of Googling, which is OK. But we want to make sure that people don’t panic,” Cohen said.

How is breast density determined?

Doctors who review mammograms have a system for classifying breast density.

There are four categories. The least dense category means the breasts are almost all fatty tissue. The most dense category means the breasts are mostly glandular and fibrous tissue.

Breasts are considered dense in two of the four categories: “heterogeneously dense” or “extremely dense.” The other two categories are considered not dense.

Dr. Brian Dontchos of the Seattle-based Fred Hutchinson Cancer Center said the classification can vary depending on the doctor reading the mammogram “because it’s somewhat subjective.”

Why am I being told I have dense breasts?

Two reasons: For one, dense breasts make it more difficult to see cancer on an X-ray image, which is what a mammogram is.

“The dense tissue looks white on a mammogram and cancer also looks white on a mammogram,” said Dr. Wendie Berg of the University of Pittsburgh School of Medicine and chief scientific adviser to DenseBreast-info.org. “It’s like trying to see a snowball in a blizzard.”

Second, women with dense breast tissue are at a slightly higher risk of developing breast cancer because cancers are more likely to arise in glandular and fibrous tissue.

Reassuringly, women with dense breasts are no more likely to die from breast cancer compared to other women.

What am I supposed to do?

If you find out you have dense breasts, talk to your doctor about your family history of breast cancer and whether you should have additional screening with ultrasound or MRI, said Dr. Georgia Spear of Endeavor Health/NorthShore University Health System in the Chicago area.

Researchers are studying better ways to detect cancer in women with dense breasts. So far, there’s not enough evidence for a broad recommendation for additional screening. The U.S. Preventive Services Task Force called for more research in this area when it updated its breast cancer screening recommendations earlier this year.

Do I still need a mammogram?

Yes, women with dense breasts should get regular mammograms, which is still the gold standard for finding cancer early. Age 40 is when mammograms should start for women, transgender men and nonbinary people at average risk.

“We don’t want to replace the mammogram,” Spear said. “We want to add to it by adding a specific other test.”

Will insurance cover additional screening?

For now, that depends on your insurance, although a bill has been introduced in Congress to require insurers to cover additional screening for women with dense breasts.

Additional screening can be expensive — from $250 to $1,000 out of pocket, so that’s a barrier for many women.

“Every woman should have equal opportunity to have their cancer found early when it’s easily treated,” Berg said. “That’s the bottom line.”

___

A comparison of blood pressure readings taken while people held their arms three different ways  — leaning on a desk, resting on the lap or hanging by the side of the body — showed certain positions could lead to a significant increase in systolic pressure, the upper number in a blood pressure reading, according to the study published Monday in JAMA Internal Medicine. Systolic refers to the amount of pressure in a person’s arteries, when the heart sends blood throughout the body.

The size of the difference, nearly 7 points in the arm dangling position, was a surprise, said the study’s senior author, Dr. Tammy Brady, a pediatrician and epidemiologist and medical director of the pediatric hypertension program at the Johns Hopkins Children’s Center.

The researchers weren’t sure what to expect prior to running their experiment. “There was a chance that arm position was not important,” she said.

“One of my hopes is that this will help inform patients as to how to do this on their own and also to tell their health care provider the right way,” Brady said. “Patients should be empowered to make sure the blood pressure measurement is accurate.”

The American Heart Association recommends that a patient’s arm should be supported to get an accurate reading. The guidelines also say: 

• Avoid caffeine, exercise and smoking for 30 minutes. 
• The blood pressure cuff should be positioned at mid-heart level.
• The patient’s feet should be flat on the floor, with the back supported. 

Nearly half of U.S. adults have high blood pressure,  which occurs when the measured force of blood flowing through blood vessels is higher than what is considered normal: less than 120 systolic pressure and less than 80 diastolic. Diastolic is the pressure in the arteries between heart beats. Hypertension often causes minimal symptoms but untreated it can increase  the risk for stroke, heart attack and other serious cardiovascular conditions.

To learn whether arm position made a difference in blood pressure readings, Brady and her colleagues recruited 133 adults, 78% of them Black and 52% female. The study volunteers’ ages ranged from 18 to 80. 

While all the participants had blood pressure measured in each of the three arm positions, they were randomly assigned to one of six possible groups that differed by the order in which the positions were assumed.

The researchers found that when people had their arms hanging by their sides during the reading, their systolic pressure was 6.5 points higher than when their arms were resting on a desk, while the diastolic blood pressure — the bottom number — was 4.4 points higher than in the supported condition. 

Similarly when people’s arms were on their laps, the systolic blood pressure was 3.9 points higher than when their arms were supported by a desktop, while the diastolic pressure was 4 points higher than in the supported condition.

Those differences can lead to more diagnoses of hypertension and patients being prescribed medications they don’t need.

For example, if a person’s actual blood pressure is 134, and blood pressure is measured on a dangling arm, the reading could end up over 140, which is considered to be stage 2 hypertension.

Mispositioning of a patient’s arm “unfortunately is a common experience,” said Dr. Karyn Singer, an assistant professor of medicine at New York University and assistant vice president of chronic disease and prevention at NYC Health + Hospitals. “As a patient, I’ve been there.”

The study provides a “piece of evidence that is really critical,” said Singer, who was not affiliated with the new research. “Until now it hasn’t been clear how much arm position changes blood pressure readings.”

Singer’s main message for patients: “Be aware of the proper blood pressure measuring technique and to advocate for themselves if they think the blood pressure reading is higher than they think it should be.”    

As a patient, Dr. Megan Kamath has also had similar experiences at different health care settings and different offices.

“There is a pretty significant difference in blood pressure readings depending on arm position,” said Kamath, a cardiologist at UCLA Health.

“This is a fascinating study,” said Kamath, who was not involved with the research. “What I took from reading it was, wow, with a simple study design these researchers found some important real world implications that can make the difference between a patient being treated for hypertension or not.”

Patients who receive blood pressure lowering medication that they don’t need may experience side effects, such as lightheadedness, dizziness, fatigue and blurry vision, Singer said.

Dr. Matthew Tomey, a cardiologist at Mount Sinai Fuster Heart Hospital in New York City, said the findings support a patient asking for a doctor to measure blood pressure the “right way.”  

The differences found by the researchers can be enough to move someone from one blood pressure category to another, said Tomey, who was not part of the new study.

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“I never anticipated that breast cancer was necessarily going to be a part of my story,” the former E! News host tells TODAY.com. “It didn’t run in my family. I didn’t know anybody with breast cancer.”

Weeks passed as Guerrero, now 44, waited for her results, and that delay gave her a false sense that she was healthy. But then she received a call from her doctor.

“The reason it had taken so long was because it was a very rare form of breast cancer called angiosarcoma,” she explains. “They had to send it out for second and third and fourth opinions before they finally recognized that this was a very rare, aggressive cancer.”

Routine screening leads to early diagnosis

As a journalist, Guerrero often covered stories about breast cancer and encouraged viewers to undergo regular mammograms as part of breast cancer awareness month in October. When she turned 40, she knew it was important to follow the advice she gave others and started regularly undergoing screening.

“Every October that came around, it was like, ‘Make sure that you go get your mammograms,’” she says. “I tried to do it around my birthday, just as a gift to myself.” After she had a mammogram in 2022, she received a call asking her to come in for more tests, which included a biopsy. She was surprised but assumed it had to do with the fact that she has dense breasts, which can make it harder for mammograms to detect cancer. So, she wasn’t too worried about the follow-ups.

Doctors told her she should receive the results “in just a couple of days.” But weeks passed without any word.

“I was like, ‘This is really strange. It usually doesn’t take this long to get a diagnosis,’” she says. “I thought if there was something serious, they would’ve called me.”

When her doctor finally called, Guerrero learned she had an angiosarcoma in her breast in January 2023. Doctors did not stage her cancer, and she notes it was discovered “pretty early on.”

An angiosarcoma develops in the cells that line the blood or lymph vessels, according to the American Cancer Society. This rare cancer accounts for 0.1% to 0.2% of all breast cancers, per Johns Hopkins Medicine. It’s aggressive and spreads quickly.

“It was whiplash,” she says. “I got the diagnosis, and my breast surgeon said, ‘What is of most importance is that we get this out of you as quickly as possible because it is a very aggressive form of breast cancer.’ And so immediately within a few weeks, I was having a lumpectomy.”

Doctors hoped that they only had to remove the cancerous mass. But after surgery, they realized that they were unable to remove the tumor without leaving some cancer cells.

“It was about a robin-sized egg of cancer that they removed,” Guerrero says. “On the very outer parts of what they removed, there was still cancer cells detected, which means they didn’t know how much further it had gone in.”

Her doctors thought a mastectomy would assure that they had removed all the cancer, so she returned to surgery a week later to remove her entire right breast.

“It was all fast tracked,” she says. “With this mastectomy, we have removed the cancer. But the only way to be absolutely sure it is (gone) is if we do radiation.”

For six weeks, Guerrero underwent radiation every day.

“I’ve described this as walking through molasses. I was living these two realities. One the one hand, I was still going to work. I was still at home,” she says. “There would be moments were I’m like, ‘I have cancer right now. I’m living with breast cancer and I’m living with a rare form of breast cancer that could kill me.’”

Breast cancer in Hispanic women

While Hispanic and Latina women are about 25% less likely to be diagnosed with breast cancer than non-Hispanic white women, they are more likely to receive an aggressive breast cancer diagnosis at a younger age, according to the Breast Cancer Research Foundation. What’s more, they often receive late-stage diagnoses. 

The reason for these disparities are complicated. Doctors offer BRCA mutation screen less frequently for Hispanic women, and these women are also less likely to undergo regular mammogram screenings due to lack of insurance, access to doctors and preventative care, the Breast Cancer Research Foundation notes.

Documenting her experience

With the help of her husband, Gibby Cevallos, Guerrero made a short film documenting her experience with breast cancer called “Walking Through Molasses.”

“I was going through my treatment, and I felt isolated. One of my comfort places is as a journalist. It’s telling stories,” she says. “I recorded a lot of my testimonials and things I was going through as I was going through them. And I’m so grateful that I did.”

Rewatching her videos helped her remember forgotten feelings.

“It’s very raw,” she says. “It’s a 15-minute short on my experience of breast cancer told through this weird space I was in at the time.”

Guerrera is now cancer-free and visits her doctor every six months for scans to make sure the cancer hasn’t returned. To her, it’s important to share her story to raise awareness of breast cancer for women of color.

“For my women of color, my Latinas … it’s proven over and over again that we don’t go in for early detection that we aren’t aware of the risks of breast cancer to our bodies and so we ignore them,” Guerrero says. 

She also wants everyone to understand the important of screening.

“I just hope that people will realize that I really didn’t think this was going to happen to me and then it did,” Guerrero says. “I want people to acknowledge that it can also happen to them. But they can go on and live, if they go and get their mammograms.”

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Antibody blood test results, which will come back later this month, officials said, are needed to answer that question. Since most of the seven people weren’t tested for bird flu, it’s not yet known whether any of them were infected with the virus or another pathogen.

The Missouri patient, who didn’t have known contact with poultry or dairy cows, was hospitalized in August with underlying medical conditions. 

On a call with reporters Friday, Dr. Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases, said officials were able to retroactively track the patient’s movements during their time in the hospital in August and identify health care workers who were exposed and potentially at risk.

After the patient was hospitalized, Daskalaskis said, doctors tested the individual for influenza, a result that came back positive, and gave the patient Tamiflu. After the positive flu result, health care workers started using more personal protective gear around the patient.

Separately, as part of routine flu surveillance and not because doctors suspected anything unusual in the patient’s case, the hospital sent the patient’s flu sample to be tested for H5, which is the bird flu virus strain. 

The positive H5 result triggered the investigation. Officials found that during the patient’s time at the hospital, 112 health care workers had interacted with them. Six developed respiratory symptoms. The other close contact who developed symptoms was a household contact. All have recovered.

Among the 112 workers, 18 were considered to have had higher risk interactions because they occurred before the patient tested positive for flu and therefore before “droplet precautions” were taken to protect workers from infection, Daskalaskis said. 

The remaining 94 interacted with the patient after the precautions were in place. Normally, he said, these health care workers wouldn’t be considered “exposed,” but the agency pursued them anyway “out of an abundance of caution.”

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said that even if the health care workers interacted with the patient after precautions were in place, it doesn’t rule out the possibility that they were infected with bird flu. The virus can be transmitted through aerosols, particles smaller than droplets that can suspend the air for long periods of time. 

Osterholm said he would be “very surprised,” however, if any of the sick health care workers had bird flu, given that officials had a very hard time getting viable virus from the patient.

Still, he said, the lack of information isn’t helping matters. 

“Unfortunately, just to delay getting the confirmatory information has led people to speculate that this is a cluster of H5N1,” he said. “It builds suspense that somehow there’s something we don’t know.” 

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One of the sick health workers tested negative for influenza, Daskalakis said, suggesting that their symptoms weren’t related to bird flu. Blood tests, however, will need to help rule out the remaining five health workers as their symptoms were only discovered after the investigation began. 

Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security in Baltimore, said that while the investigation’s findings shed more light on the patient’s interactions with health care workers, there are still unanswered questions about those who became ill.

For example, it remains unclear whether the health care workers became sick on the same day they met the patient, the following day or several days later.

After exposure to the bird flu virus, people typically develop symptoms within 3 to 5 days. Depending on the timing of symptom onset, it’s possible that the workers could have been sick with a different virus, such as Covid.

“Timing would be helpful,” Rivers said. “If the dates were very commensurate with transmission then that would raise concern.” 

Daskalakis shared a similar sentiment on Friday’s call.

“We are in the middle of respiratory season,” he said. 

All of that additional information on the health workers will be secondary to the blood tests results, Rivers said, and whether they show signs of a previous infection. 

“It would be notable, because the Missouri bird patient didn’t have any known exposures, and so already there is a mysterious circumstance that could be concerning,” she said. “If human to human transmission were confirmed that would be the first instance in the United States. H5 has been circulating for a long time in wild animals.”

The H5N1 bird flu outbreak in dairy cows has infected 254 herds across 14 states as of Thursday, according to the CDC.

Since March, there have been a total of 16 cases in humans, including two cases reported in California dairy workers on Thursday. Those two cases are not related, the CDC said.

With the exception of the Missouri patient, all human cases have been in dairy or poultry workers. All have recovered.

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Both cases are located in the Central Valley region, and both patients had contact with dairy cattle that had been infected with H5 bird flu.

There is no known link between the two cases.

The two patients are said to be experiencing mild symptoms, including conjunctivitis. They are not hospitalized for the virus.

While the risk to the general public remains low, those who interacted with infected animals, including dairy or poultry farm workers, are at higher risk of getting bird flu. The animal-to-human spread of the virus is rare.

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Public health officials also assure that pasteurized milk and dairy products are safe to consume as pasteurization inactivates the bird flu virus.

Those who work with farm animals should wear personal protective equipment or PPE, such as N95 masks, face shields, goggles and gloves, the public health department said. 

The share of kids exempted from vaccine requirements rose to 3.3%, up from 3% the year before. Meanwhile, 92.7% of kindergartners got their required shots, which is a little lower than the previous two years. Before the COVID-19 pandemic the vaccination rate was 95%, the coverage level that makes it unlikely that a single infection will spark a disease cluster or outbreak.

The changes may seem slight but are significant, translating to about 80,000 kids not getting vaccinated, health officials say.

The rates help explain a worrisome creep in cases of whooping cough, measles and other vaccine-preventable diseases, said Dr. Raynard Washington, chair of the Big Cities Health Coalition, which represents 35 large metropolitan public health departments.

“We all have been challenged with emerging outbreaks … across the country,” said Washington, the director of the health department serving Charlotte, North Carolina.

The Centers for Disease Control and Prevention data show that coverage with MMR, DTaP, polio and chickenpox vaccines decreased in more than 30 states among kindergartners for the 2023-2024 school year, Washington noted.

Public health officials focus on vaccination rates for kindergartners because schools can be cauldrons for germs and launching pads for community outbreaks.

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For years, those rates were high, thanks largely to school attendance mandates that required key vaccinations. All U.S. states and territories require that children attending child care centers and schools be vaccinated against a number of diseases, including, measles, mumps, polio, tetanus, whooping cough and chickenpox.

All states allow exemptions for children with medical conditions that prevent them from receiving certain vaccines. And most also permit exemptions for religious or other nonmedical reasons.

In the last decade, the percentage of kindergartners with medical exemptions has held steady, at about 0.2%. But the percentage with nonmedical exemptions has inched up, lifting the overall exemption rate from 1.6% in the 2011-2012 school year to more than twice that last year.

The rates can be influenced by state laws or policies that make it harder or easier to obtain exemptions, and by local attitudes among families and doctors about the need to get children vaccinated. For example, according to the CDC data, 14.3% of kindergartners had an exemption to one or more vaccines in Idaho. But fewer than 1% did in Connecticut and Mississippi.

Within states, clustering of unvaccinated kids can be even more concentrated in particular communities or schools, said Noel Brewer, a University of North Carolina professor of health behavior.

“People who are skeptical (about vaccinees) tend to live close to one another and create the conditions for a breakthrough of measles and other diseases,” he said.

The slide in vaccination rates was not unexpected. Online misinformation and the political schism that emerged around COVID-19 vaccines have led more parents to question the routine childhood vaccinations that they used to automatically accept, experts say.

A decrease has already been reported in Louisville, Kentucky — a city that has been celebrated as a vaccination success story. And a CDC report last week noted a decline in vaccination rates for 2-year-olds.

Measles and whooping cough cases are at their highest levels since 2019, and there are still three months left in the year. And 200 flu-associated pediatric deaths were reported in the 2023-2024 season, the most since 2009.

Charlotte’s Mecklenburg County this year saw North Carolina’s first measles case since 2018. Mecklenburg also saw 19 whooping cough infections and three people with mumps earlier this year, said Washington, who noted the county usually sees none.

Increases in international travel and people moving to the Charlotte area from other countries raises the risk of introduction of vaccine-preventable diseases, “so it’s concerning when you start to lose coverage of vaccines among your population,” Washington said.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The new report shows that breast cancer mortality has decreased by 44% since the late 1980s, according to NBC News. Rates of breast cancer, however, have increased by 1% every year since 2012. In younger women, rates have increased at a faster clip — by about 1.4% every year since 2021.

“That is very alarming because we know that screening only starts at age 40,” said Dr. Sonya Reid, a breast medical oncologist at Vanderbilt University Medical Center, who was not involved with the report. “It’s not just one racial or ethnic group affected, we are seeing it across the board, so it’s hard to link it to ancestral or genetic factors alone.”

Still, the report showed differences among groups. Among Asian American and Pacific Islander women under 50, breast cancer diagnoses have increased by 50% since 2000. Breast cancer rates in AAPI women younger than 50 are now higher than those in Black, Hispanic and American Indian and Alaska Native women of the same age group. In 2000, AAPI women under 50 had the second-lowest rates of breast cancer. 

The reason why more women younger than 50 are getting breast cancer is not clear, but Reid said it’s likely due to modifiable risk factors such as environmental exposures in food, air or water, rising rates of obesity and sedentary lifestyles — the same risk factors thought to be causing higher rates of colorectal cancer in younger people. 

Dr. Wendy Wilcox, chief women’s health officer at New York City Health + Hospitals, said that it’s likely not just one factor alone is driving the increase in younger breast cancer diagnoses.

“There are all sorts of ideas we can throw out as to the reasons why, but until it’s studied we won’t know for sure,” Wilcox said. 

The report also highlighted a stark racial disparity that has persisted for decades — Black women are still more likely to die of any type of breast cancer than white women.

“To see a 44% decrease in mortality is incredibly gratifying, but these gains have not been seen equally in all populations,” Dr. William Dahut, chief scientific officer for the American Cancer Society, said during a media briefing on Monday. 

This was not always the case, he said: In 1970, Black and white women had the same mortality rates for breast cancer. Today, Black women are 5% less likely to get breast cancer than white women, but are nearly 40% more likely to die from the disease. The American Cancer Society researchers noted that this disparity is seen in even the most treatable types of breast cancer. 

“For a long time, the community had thought the disparity is largely due to the higher rates of triple-negative breast cancer, but this shows Black women are more likely to die from all subtypes of breast cancer,” Reid said. “These advances that we have seen are really due to improvements in therapeutic advances and early detection, and we know if there are inequities in access to these improvements, we will see a widening in these disparities.”

American Indian and Alaska Native women have a 10% lower chance of getting breast cancer than white women, but are 6% more likely to die from it, the report found. Just over 50% of these women over 40 had gotten a mammogram in the past two years, compared to nearly 70% of white women. The report also found that Hispanic women are also less likely to be screened than white women. 

Compared to white women, Asian American and Pacific Islanders, American Indian and Alaska Natives, Black and Hispanic women are all more likely to develop breast cancer at a younger age, the report found. However, AAPI and Hispanic women have similar mortality rates to white women. 

To close disparities, the nation will have to expand access to early screening and the best cancer treatments, Wilcox said. 

“Health care dollars are not allocated equitably across everyone in our country,” she said. 

Even for those with insurance, coverage varies greatly, and a person’s ability to take off work for a mammogram or care and whether they live near a cancer center also play key roles in access, Wilcox said. Each person’s family and personal history and genetics will also determine when they should start screening for breast cancer. 

“Moving forward, we really need to make sure we have wide access to effective treatments for all of our patients,” Reid said. “We have seen that despite more effective drugs, the racial disparity gap has not budged. Another drug is not going to do it.”

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On Sunday, Gov. Gavin Newsom signed SB 729 into law, which requires large group health care service plans to provide coverage for the diagnosis and treatment of infertility and fertility services, including a maximum of three egg retrievals with unlimited embryo transfers.

The new law is also a win for members of the LGBTQ+ community and same-sex couples who want to have children. It broadens the definition of “infertility” to include a person’s inability to reproduce either as an individual or with their partner without medical intervention.

The law is expected to impact millions of Californians.

Dr. Don Royster, of the Southern California Center for Reproductive Medicine in Newport, says he expects more families to seek care now that fertility treatments and IVF will be more affordable for many.

“We would probably estimate 15% of our families have some sort of fertility coverage,” Dr. Royster told NBC4. “Sometimes, it’s limited to just the diagnostic portion of their evaluation, all the way through IVF is that’s necessary. And as when we as fertility providers see families that can’t seek care because they can’t afford it, it’s very disheartening.”

Without insurance, the treatments could cost tens of thousands of dollars.

The law will go into effect in July 2025 for those who qualify. You can read the text of the law here.

One out of 3 Gen Z men in the U.S. are turning to social media for their health information, according to a recent survey from the Cleveland Clinic.

The survey polled 1,000 U.S. men ages 18 and older over the summer and compared the health concerns of American men from different generations.

“While all generations agree that healthcare providers are a top source for health information and advice, use of other sources varies by age,” according to Cleveland Clinic. “Gen Z men are most likely of all generations to turn to social media.”

Fact-checking health advice online is important, according to experts who spoke to CNBC Make It in April of this year. Here are four signs they shared for spotting health misinformation online.

4 signs of medical misinformation online

“So often when we see people fall for false information, they just haven’t taken even a second to do some of these basic checks,” said Dr. Seema Yasmin, author of “What The Fact?!: Finding the Truth in All the Noise,” a guide for media literacy.

Here are a few indicators that a post online is sharing health misinformation, according to Yasmin and Deen Freelon, professor at the Annenberg School for Communication at the University of Pennsylvania.

1. It sounds too good to be true: You should question the accuracy of any health information that includes words like “cure, 100% effective [and] guaranteed,” Yasmin said.
2. It plays at your emotions: Health information posts that prompt emotional responses can be designed that way “to get us to fall for lies,” and share them with others, Yasmin noted. “Falsehoods are often designed to provoke a reaction.”
3. It’s selling a cure that you’ve never heard of, that isn’t backed by science: If you come across a social media post that’s promoting an alternative cure for a condition, Freelon said you should be skeptical about its credibility and double-check that it’s being shared by a reputable health organization. “There are lots of people who have business models that are built on this,” Freelon said.
4. It seems made up: If it “seems a little bit ridiculous, or [like] science fiction really,” then that’s a red flag, Freelon said. “The sorts of things that start to fall apart, when you start asking even the most basic questions.”

Yasmin and Freelon suggest always identifying the source of health information that you come across online. Think about if the source is “really the person who should be speaking on this topic,” Yasmin said, or if they have “a long track record of distributing medically dubious information,” Freelon said.

You should always seek out trusted news sources for health information like the Centers for Disease Control and Prevention or state health organizations and check to see if they’re reporting similar claims to what you’ve seen online.

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The Food and Drug Administration on Thursday approved Bristol Myers Squibb‘s highly anticipated schizophrenia drug Cobenfy, the first novel type of treatment for the debilitating, chronic mental disorder in more than seven decades. 

Schizophrenia affects how a person thinks, feels and behaves, and can cause paranoia, delusions, hallucinations, and changes in emotions, movements and behavior. Those symptoms can disrupt a patient’s everyday life, making it difficult to go to school or work, socialize and complete other daily activities. Most people are diagnosed in their late teens to early 30s.

Bristol Myers Squibb expects the twice-daily pill, which will be sold under the brand name Cobenfy, to be available in late October, executives told CNBC. The drug is a badly needed new option for the nearly 3 million adults in the U.S. living with schizophrenia, some medical experts say.

Only 1.6 million of those patients are treated for the condition, and 75% of them stop taking existing medications in the first 18 months because they struggle to find treatments that are effective or easy for them to tolerate, according to the drugmaker. 

Cobenfy could also be a huge long-term sales opportunity for Bristol Myers Squibb, which faces pressure to offset the potential loss of revenue from top-selling treatments that will see their patents expire. The drug comes from the company’s whopping $14 billion acquisition of biotech company Karuna Therapeutics at the end of last year. 

In a July research note, Guggenheim analysts said they view Cobenfy as a “longer-term multi-billion dollar opportunity” for the company. But they said the drug will likely have a slow launch, so it may not meaningfully contribute to Bristol Myers Squibb’s top line in 2024 and 2025. 

“I think there’s potentially a really transformational moment in how we treat and talk about schizophrenia. And what you have is, unfortunately, an often disadvantaged population that doesn’t get the attention they deserve from a research and health-care perspective,” Andrew Miller, founder and former president of research and development of Karuna Therapeutics and now an advisor to Bristol Myers Squibb, told CNBC.

“I think the most important moment is going to be five or 10 years from now, when we look back and say we’ve actually made a difference,” he continued. “We’ve helped people, we’ve improved outcomes, we’ve provided caregivers and physicians with another tool that they can use.”

Cobenfy will cost $1,850 for a month’s supply or $22,500 annually before insurance and other rebates, Bristol Myers Squibb executives said.

They said that pricing is in line with existing branded oral schizophrenia treatments and that they expect most patients, particularly those enrolled in Medicare and Medicaid plans, to have minimal out-of-pocket costs for the drug. Around 80% of patients living with the condition are covered by government insurance, according to Bristol Myers Squibb.

The company intends to launch a program aimed at helping patients afford Cobenfy, executives added. 

It’s still unclear how much that program will increase access for people without insurance.

Cobenfy will have to compete with some existing schizophrenia drugs – called antipsychotic treatments – with lower list prices, particularly generic copycats of branded treatments. For example, patients without insurance can get the generic version of an antipsychotic treatment called Abilify for as little as $16 for 30 once-daily tablets with free coupons from GoodRx.

Existing schizophrenia drugs work by directly blocking the dopamine receptors in the brain to generally improve symptoms in patients. 

But they come with a long list of serious potential side effects that can cause patients to stop treatment, including weight gain, excessive fatigue and involuntary, uncontrollable movements. Roughly a third of people with schizophrenia are also resistant to conventional antipsychotic treatments, according to WebMD.

Cobenfy is the first treatment approved from a new class of drugs that do not directly block dopamine to improve symptoms of schizophrenia, Dr. Samit Hirawat, Bristol Myers Squibb’s chief medical officer, told CNBC. 

He said one part of Cobenfy is a drug called xanomeline, which activates certain so-called muscarinic receptors in the brain to decrease dopamine activity without causing the side effects associated with antipsychotics. The second part of Cobenfy is called trospium, which reduces the gastrointestinal side effects linked to xanomeline, such as nausea, vomiting, diarrhea and constipation. 

“The majority of these patients have already cycled through one or two of these products,” Adam Lenkowsky, Bristol Myers Squibb’s chief commercialization officer, told CNBC. “So the enthusiasm that we’re hearing from physicians is the opportunity to have a patient go onto treatment without seeing the side effects but also getting unprecedented like efficacy.” 

Lenkowsky said the company expects Cobenfy to eventually become the standard treatment for schizophrenia as physicians learn more about the drug and get more comfortable with prescribing it to patients. 

But the price could limit use of the drug to patients who have already tried and failed with other existing treatments, said Nina Vadiei, clinical associate professor of pharmacotherapy and translational sciences at the University of Texas at Austin College of Pharmacy.

“If it were up to me, I wouldn’t necessarily say we have to try X number of antipsychotics first. But I know from experience in a hospital setting that that is probably what’s going to have to happen because of cost, mainly,” said Vadiei, a clinical psychiatric pharmacist who sees patients with schizophrenia at San Antonio State Hospital.”

Trial results and upcoming research

The approval was based on data from three clinical trials comparing Cobenfy to a placebo, as well as two longer-term studies that examined how safe and tolerable the drug is for up to one year. Cobenfy met the main goal of the three trials, significantly decreasing symptoms of schizophrenia compared with a placebo, according to Bristol Myers Squibb. 

In the studies, Cobenfy mostly led to mild to moderate side effects, which were mainly gastrointestinal and dissipated over time, Miller said.

Bristol Myers Squibb said Thursday’s approval for schizophrenia may only be the beginning for Cobenfy.

For example, the company has ongoing late-stage clinical trials examining Cobenfy’s potential in treating Alzheimer’s disease patients with psychosis. Bristol Myers Squibb said it expects to release data from those studies in 2026. 

The company also plans to study Cobenfy’s potential to treat bipolar mania and irritability associated with autism. 

“When we think about Cobenfy, we think about it as multiple indications packed in one product … because we are really developing the drug not only for schizophrenia but six other indications,” Hirawat said, referring to other potential uses for the drug. 

— CNBC’s Angelica Peebles contributed to this report.

His request was granted, and he later pleaded not guilty to the charges. The criminal charges filed in July are the latest legal woes facing Mowlavi, who also goes by “Dr Laguna.”

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His license to practice is currently restricted by the Medical Board of California following the death of a patient in 2018.

In January 2023, Laguna Beach police raided his practice, removing boxes and computers from his surgical center.

In June 2023, The Orange County DA filed a civil suit alleging unlawful business practices and unlawful transactions made for the purpose of avoiding financial liability, noting before Mowlavi filed for bankruptcy, he “transferred approximately $13,000,000 of real estate and personal property assets to his spouse.”

That case is on hold until the criminal case is resolved.

Earlier this year a civil suit involving more than 30 former patients settled for $6 million, according to court records. 

The medical board has also filed a new accusation against Mowlavi involving the care and treatment of 4 patients. That hearing is set for March of next year.

Dr Mowlavi’s next court appearance on the criminal charges is scheduled for Dec. 11.

Four new cases of avian influenza were detected in farmworkers in Washington state this week, the latest in a drumbeat of human infections cropping up across the U.S. as the virus continues to spread among farm animals. 

Washington is the sixth state to report human cases of bird flu, which has spread rampantly in wild birds, poultry and cattle. Assuming the Centers for Disease Control and Prevention confirms the state’s positive tests, they will bring the U.S. tally to at least 31.

Flu experts said the risk of a broader outbreak among humans will continue to simmer if the virus remains uncontrolled in animals.

“The longer this virus hangs out in the environment, the more animals it spills over into, the more it changes in ways we don’t understand or predict, the more concerned we are going to be that this becomes the next global pandemic,” said Dr. Amber Itle, the Washington state veterinarian.

For now, however, health officials maintain that the virus has not made key genetic changes that would allow it to spread between people. 

“There is no evidence of any sustained human transmission. And that is a key milestone for all of us. It’s a key trigger for all of us. That’s when we really start to say, ‘Oh, something that’s markedly different about this virus,’” Dr. Umair Shah, Washington’s health secretary, said at a news conference Sunday. 

A CDC spokesperson said Tuesday morning that a federal team was being deployed to Washington and that risk to the public remained low. 

However, the virus is a growing concern for farmworkers on the front lines. The four latest cases were among workers who had culled birds at a commercial egg farm where an outbreak of avian influenza was reported in chickens.

Shah said the workers were part of a contract crew tasked with depopulating — or euthanizing — all chickens at the farm in Franklin County, in southeastern Washington, which had more than 800,000 birds. Itle said the workers wore full protective equipment: suits made of Tyvek, goggles and respirators. 

“It’s hot, it’s dusty. It’s a lot of birds in close proximity, and we’re getting a lot of viral exposure,” she said.

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The four people who tested positive after that work reported mild respiratory symptoms and conjunctivitis, or pink eye — symptoms now understood to be common when people are infected. None of the workers were hospitalized. 

Dr. Richard Webby, director of the World Health Organization Collaborating Center for Studies on the Ecology of Influenza in Animals and Birds, said the Washington cases represented “more of the same” in a pattern observed across the U.S. as workers tasked with culling sick animals have fallen ill. 

However, one human case — in Missouri — has puzzled researchers and health officials, because that person did not have contact with animals. It is not clear how the person was exposed, and results of further tests that could offer clues are still pending, according to the CDC. Six health workers exposed to the patient reported respiratory symptoms.

Webby said the virus’ spread in cows for the past 10 months has raised experts’ level of concern because cows are mammals and interact with humans frequently. That increases the likelihood the virus could mutate to pass from person to person. 

“Just because it hasn’t happened in 10 months … it doesn’t mean it can’t,” said Webby, an infectious disease researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee. 

Research suggests that incredible amounts of virus are shed in infected cows’ mammary glands, so the virus could spread through raw milk. (Milk sold in grocery stores is pasteurized, which inactivates the virus.) 

At the same time, the U.S. is preparing for flu season, when circulation of common influenza viruses increases in fall and winter. If two influenza viruses share the same host, they can share genetic information and mutate more quickly.

“You don’t want people affected with the seasonal flu virus to get a virus from animals and for those viruses to potentially recombine,” said Dr. Peter Rabinowitz, a professor of environmental and occupational health sciences at the University of Washington and the director of its Center for One Health Research.

Rabinowitz added that it is important to improve protection protocols for farmworkers and encourage them to get their flu shots. 

“This is a wakeup call. We need to do a better job of protecting workers,” he said.

Itle said cases in poultry were not unexpected in Washington state, because migrating birds passed through during summer and early fall. Recently, owls and other birds of prey were found dead, suggesting some wild animals had been stricken with the virus. 

Wild birds can spread the virus to farms through direct contact with poultry or livestock or via droppings, saliva or feed.  

More than 103 million birds have been sickened, killed or culled in the current bird flu outbreak, according to CDC statistics. The virus has been detected in poultry in 48 states. 

The CDC says 330 dairy herds have been affected. 

Washington has not had an outbreak among dairy producers, Itle said, but dairy farms there are now testing weekly.

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An analysis of data from more than 8,000 adults in the U.S. revealed that 14% had low iron blood levels, a condition known as absolute iron deficiency, while 15% had the right iron levels but their bodies couldn’t use the essential mineral properly, known as functional iron deficiency, according to the report published Tuesday in JAMA Network Open.

Doctors don’t typically screen adults for iron deficiency, which is why the condition has been overlooked in many people.

The researchers weren’t surprised at the results, however. There had been hints in other studies suggesting iron deficiency might be more widespread than doctors assume. 

“This is a common yet underappreciated public health problem,” said study co-author Leo Buckley, a clinical pharmacology specialist at Brigham and Women’s Hospital in Boston. “What’s unique about our study is we were looking at regular people who would not otherwise have been screened or tested.” 

Hematologist Dr. Andrew Eisenberger, an associate professor of medicine at the Columbia University Vagelos College of Physicians and Surgeons, said that while iron deficiency “is almost never life-threatening, it’s a tremendous quality of life thing.”

“Tens of millions of people in the U.S. are basically running on fumes either because there isn’t enough fuel in the tank or because the tank isn’t connecting to the engine well,” said Eisenberger, who was not involved with the new research. “In our society we are hardwired to be at peak performance. With this tremendous prevalence of iron deficiency, so many people can’t do their best.”

He hopes the study raises awareness among doctors and patients of how common the problem is.

Although doctors frequently screen for anemia — where a person has too few red blood cells due to low levels of iron — in routine blood tests, people can have enough red blood cells but still have an iron deficiency that leads to symptoms. 

“This is an incredibly preventable disease,” Eisenberger said. “So many people come to me who have had this problem for years and years and years, but their doctors have missed it, ignored it or just didn’t know what to do about it. People suffer tremendously. It’s one of the most satisfying things to take care of because people’s quality of life markedly improves.”

For the new study, the Brigham and Women’s Hospital researchers examined health information from the National Health and Nutrition Examination Survey collected between 2017 and 2021 from 8,021 adults. The average age of the participants was 48. 

None of the participants had a health condition that is typically associated with iron deficiency, such as anemia, kidney disease, heart failure and pregnancy.

Even with the high numbers of people in the study with iron issues, Buckley doesn’t believe everyone should be screened. He suggests that doctors focus on people with iron deficiency symptoms, such as fatigue and brain fog, and those at high risk for deficiency, such as pregnant women.

Who is at risk for low iron?

The biggest risk factor for iron deficiency is being female.

Pregnant women are especially at risk. “The average pregnant woman needs 1,000 to 1,500 milligrams of additional iron,” Eisenberger said, adding that many women don’t have their iron levels checked till late in pregnancy. “At that point, there’s not enough time to fix it before the woman delivers and the fetus has spent the entire pregnancy with not enough iron.”

Low iron levels in a pregnant woman have been associated with long-term cognitive impairment in children, small size at birth and early delivery, Eisenberger said.

Postpartum women are also at risk of iron deficiency, said Dr. Johanna Contreras, an advanced heart failure and transplant cardiologist at the Mount Sinai Fuster Heart Hospital in New York City.

Moreover, bleeding during menstruation can leave women and girls iron depleted, especially among those who have heavy periods. That’s because the lost blood takes large amounts of iron with it.

The rates of iron deficiency between men and women are more similar after the age of menopause, experts said.

Both women and men can develop functional iron deficiency if they have an inflammatory condition, such as rheumatoid arthritis, said Dr. Hossein Ardehali, director of the Cardiovascular and Renal Research Institute – Center for Molecular Cardiology at the Northwestern University Feinberg School of Medicine.

Sources of nutritional iron

Certain types of diets, such as vegetarian and vegan, can also leave people short on iron, said Ardehali, who was not involved with the new study.

The best food source of iron is red meat, which contains heme, Ardehali said, adding that it can be hard to get enough iron in a diet without meat.  

According to Ardehali, other than meat, good dietary sources of iron include:

• Seafood
• Shellfish
• Beans
• Dark green leafy vegetables like spinach
• Raisins
• Apricots
• Iron-fortified foods, such as cereals 

Research has yet to prove these kinds of iron deficiency can lead to serious long-term health consequences. There are other possible risks.

“Severe anemia can lead people to pass out and hit their heads, have a stroke, or have a heart attack,” Eisenberger said. “This is exceptionally rare. Usually people are so worn down they come to the ER or their doctor’s office before this happens.”

While not the cause, iron deficiency can be a sign of some serious health problems, such as bleeding in the digestive tract, or even colorectal cancer, Ardehali said.

In general, “functional iron deficiency can be a marker for bad health, such as heart failure,” he added.

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Jill Biden made the announcement at this year’s Clinton Global Initiative annual meeting in New York, moments before the organization honored President Joe Biden with the 2024 Clinton Global Citizen Award.

“He’s provided a playbook for getting things done,” former President Bill Clinton, said as he presented the award. “We honor him today, not just for what he’s accomplished, but for the way he has done it.”

President Biden, standing next to his wife, former Secretary of State Hillary Clinton and Clinton Foundation Vice Chair Chelsea Clinton, joked, “This is what you call being trapped.”

In his short remarks, he then called Jill Biden’s announcement one of the most substantial of his administration.

The additional government spending will mainly come from the Department of Defense, which provides medical care to more than 230,000 active duty military women and nearly 2 million military retirees, as well as their family members. The research will focus on why these women experience endocrine, hematological and other immunity-related disorders twice as often as men.

“Women are really hungry for this kind of information,” Jill Biden said. “We don’t have the answers.”

Another change will take effect next week, with a new policy that includes women’s health at every step of the research funded by Congressionally Directed Medical Research Programs, which funded 751 grants last year to study Alzheimer’s disease, multiple sclerosis, lupus, orthopedic and musculoskeletal injuries, and various cancers.

The commitment was among the largest of the more than 100 expected at the two-day meeting of political, business and philanthropic leaders gathering to address some of the world’s most pressing issues. The Clintons have set this year’s theme as “What’s Working,” a way to look for potential solutions and effective programs in tumultuous times.

“You don’t look at a problem and say, ‘That’s impossible,” Bill Clinton said in his opening remarks. “You don’t just throw up your hands. You roll up your sleeves.”

An example of that strategy came from the announcement that a wide-ranging group of 15 nonprofits, humanitarian aid organizations and other funders will join forces to address the humanitarian crisis in Sudan following more than a year of conflict.

The Coalition for Mutual Aid in Sudan – which includes The Bill & Melinda Gates Foundation, Global Giving, Global Fund for Women, and The Unitarian Universalist Service Committee — will donate at least $2 million to mutual aid groups in the country by the end of the year. It also pledged to raise another $4.5 million for those groups within the next two years.

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Patricia McIlreavy, president of the Center for Disaster Philanthropy, which has been representing the coalition, said that, while much more aid is needed, the collaboration and problem-solving of the group is an important step forward.

“It gets us started,” McIlreavy told The Associated Press. “And it models the behavior you want to see from others. If you wait until it’s the perfect opportunity, you’ve missed many of the opportunities that were good enough.”

World Food Program director Cindy McCain said earlier this month that “ Sudan’s nearly a forgotten crisis ” and that 25 million people there already face acute hunger. Last week, the top United Nations humanitarian official said fighting is escalating in the conflict that began in April 2023 when long-simmering tensions between Sudan’s military and paramilitary leaders broke out in the capital Khartoum and spread to other regions. The U.N. says more than 14,000 people have been killed and 33,000 injured.

“With ongoing impediments to a large-scale international aid response, Sudanese community groups have become the primary frontline responders and are currently the most effective means of reaching millions on the brink of starvation,” Patricia McIlreavy, president of the Center for Disaster Philanthropy, said in a prepared statement on behalf of the coalition. “With so many lives on the line, the imperative to support local aid efforts in Sudan has never been more urgent.”

The Center for Disaster Philanthropy says more than 12 million people have been forced from their homes in Sudan, creating what is now the world’s largest displacement and hunger crisis. The danger from the conflict has prevented most international aid agencies from delivering supplies to those in need.

Greg Milne, the Clinton Global Initiative CEO who convened a panel in April to raise awareness and support for the Sudanese people, said the new coalition is an example of what bringing organizations from varied sectors can do.

“We know strong, diverse partnerships can help address often overlooked and even dire challenges, and develop unexpected and innovative solutions,” he said.

Philanthropic leaders, including Bill Gates, World Central Kitchen founder Jose Andres, Open Society Foundations President Binaifer Nowrojee, and Rockefeller Foundation President Raj Shah will share information about their work during CGI, as will Prince Harry, who will discuss the launch of The Archewell Foundation Parents’ Network, which supports parents of children harmed online. In his Tuesday appearance, the Duke of Sussex will also address his work with the World Health Organization and others to reduce violence against children, an issue he and his wife Meghan outlined on a recent trip to Colombia.

Brazilian President Luiz Inacio Lula da Silva, Barbados Prime Minister Mia Mottley, Kosovo President Vjosa Osmani Sadriu, and Latvian President Edgars Rinkevics are set to address the conference, as are CEOs from Pfizer, Mastercard, IKEA, Pinterest, Sanofi and Chobani.

_____

U.S. households will be able to order as many as four nasal swab tests at COVIDTests.gov when the federal program reopens. The U.S. Health and Human Services agency overseeing the program has not yet given an exact date when ordering can begin.

An agency spokesperson has said the tests will detect current virus strains and can be ordered ahead of the holiday season, when families and friends gather for celebrations.

U.S. regulators last month approved an updated COVID-19 vaccine that is designed to combat the recent virus strains and, hopefully, forthcoming winter ones, as well. The Centers for Disease Control and Prevention already has recommended this fall’s shot for everyone age 6 months and older.

While most Americans have some degree of immunity from prior infections or vaccinations or both, that protection wanes. Last fall’s shots targeted a different part of the coronavirus family tree, a strain that’s no longer circulating.

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For decades, strict rules required most methadone patients to line up at special clinics every morning to sip their daily dose of the liquid medicine while being watched. The rules, built on distrust of people in the grip of opioid addiction, were meant to prevent overdoses and diversion — the illicit selling or sharing of methadone.

The COVID-19 pandemic changed the risk calculation. To prevent the spread of the coronavirus at crowded clinics, emergency rules allowed patients to take methadone unsupervised at home.

Research showed the looser practice was safe. Overdose deaths and drug diversion didn’t increase. And people stayed in treatment longer.

With evidence mounting, the U.S. government made the changes permanent early this year. Oct. 2 is the date when clinics must comply with the new rules — unless they’re in a state with more restrictive regulations.

Alabama — where about 7,000 people take methadone for opioid use disorder — plans to align with the new flexible rules, said Nicole Walden, a state official overseeing substance use services.

“This is a step toward the country — and everybody — saying this is not a bad thing,” Walden said. “People don’t have to show up every day to get a medication that can help save their lives.”

Is methadone an opioid?

Methadone, an opioid itself, can be dangerous in large amounts. When taken correctly, it can stop drug cravings without causing a high. Numerous studies have shown it reduces the risk of overdose and the spread of hepatitis C and HIV. But it cannot be prescribed for opioid addiction outside of the nation’s 2,100 methadone clinics, which on a given day treat nearly 500,000 U.S. patients with the drug.

The new federal rules allow stable patients to take home 28 days’ worth of methadone. Colorado, New York and Massachusetts are among states taking steps to update their rules to align with the new flexibility. Some others have not, including West Virginia and Tennessee — the states with the nation’s highest drug overdose death rates.

“Where you live matters,” said University of Arizona researcher Beth Meyerson, who studies methadone policy.

Phoenix resident Irene Garnett, 44, would welcome more take-home methadone doses. Her clinic now requires her to come in twice a week, even though she’s been a patient there more than 10 years, “which is just bonkers,” she said.

Garnett, who works as a grant manager for a harm reduction agency, lives 25 minutes away from the clinic. She said 28 days of take-home methadone, the maximum allowed under the new federal rules, would give her more freedom to travel and a “more normal quality of life.”

“This is the only medication where you have to disrupt your life by going someplace every day,” she said.

Under the new rules, which Arizona plans to embrace, clinics will have broad discretion about which people qualify for take-home doses. Ideally, such decisions will be made jointly between doctors and patients. But money will play a role too, experts said.

Frances McGaffey, who researches substance use treatments for the nonprofit Pew Charitable Trusts, said payments to clinics are sometimes tied to in-person dosing, which can discourage take-home treatment.

“States should be looking at their payment policy and see what kind of care they’re incentivizing,” she said.

In Arizona, clinics now get $15 per in-person dose from the state’s Medicaid program vs. about $4 per take-home dose. The state is considering options including making those amounts equal or adopting what’s called “bundled payment,” a model that reflects the overall cost of treatment.

New York’s Medicaid program uses a bundled payment model so there’s no financial incentive for in-person dosing.

Longtime methadone patient David Frank, a 52-year-old New York University sociologist, gets four weeks of take-home methadone in wafer form from his clinic.

“I never in a million years could have gone back to school, got my Ph.D., done research or taught — any of that stuff — if I had to go to a clinic every day,” Frank said. “It’s night and day in terms of your ability to live a stable, happy, quality life.”

A movement to ‘liberate methadone’

The methadone clinic system dates to 1974, when the U.S. saw fewer than 7,000 overdose deaths a year. Some longtime patients — including Garnett and Frank — are organizing a movement to “liberate methadone” as annual overdose deaths now top 107,000. They support legislation to allow addiction specialist physicians to prescribe methadone and pharmacies to fill those prescriptions.

The new federal rules don’t go that far, but they include other changes, such as:

— In states that adopt the rules, methadone treatment can start faster. People will no longer need to demonstrate a one-year history of opioid addiction.

— Counseling can be optional instead of mandatory.

— Telehealth can be used to assess patients, improving access for rural residents.

— Nurse practitioners and physician assistants — not just doctors — can start people on methadone.

“It really is up to states to adopt these changes in order to increase access to care,” said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence.

Tennessee officials have drafted new rules that are stricter than the federal government’s. The state’s proposal would increase random urine drug screening, make counseling mandatory for many patients and obligate clinics to hire pharmacists if they want to dispense take-home doses.

The state’s proposed rules “are duplicative, contradictory, prescriptive, rigid, and written in a way that seeks to punish versus heal people living with an opioid use disorder,” wrote Zac Talbott, who operates four methadone clinics in Tennessee, Georgia and North Carolina.

In states that do adopt the federal rules, the changes will be a heavy lift for some clinics, experts said. Some clinic leaders may disagree with the patient-centered philosophy behind the changes. Some may balk at the legal liability that goes with judgment calls about which people can safely take methadone at home.

“Not all opioid treatment programs are created equal,” said Linda Hurley, CEO of Rhode Island’s oldest methadone program, CODAC Behavioral Healthcare.

Clinics are used to operating within a highly restrictive environment, said Meyerson, the University of Arizona researcher.

“We have regulated them into a corner for years,” Meyerson said. The new rules allow the clinics to put the well-being of patients at the center of care.

“The question is,” she said, “can they do it?”

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Ava Pulaski, who was visiting Southern California, was one of the customers who fell ill after eating at Madre! restaurant in the northern Los Angeles County community.

“I went online, to leave a bad review, actually, and I saw everyone else’s,” said Pulaski. “I was like, ok, this is a serious issue.”

The restaurant’s owner told NBCLA a customer called him on Wednesday and said they tested positive for salmonella. Chef and owner Ivan Vasquez said he called the health department, which issued a notice of temporary closure due to the health hazard.

“It’s unfortunate that this happened at our restaurant,” Vasquez said. “We’re going to be working really hard with the health department with full transparency.”

A source of the contamination was not immediately identified. The restaurant will remain closed until that happens and sanitization is complete.

Salmonella can be contracted from contaminated food or by coming into contact with people and animals who are sick. Symptoms include gastrointestinal problems.

The health department offered the following tips to prevent its spread.

• Wash your hands after you use the bathroom or change a diaper.
• Wash all fruits and vegetables before eating them.
• Wrap fresh meats, poultry, and seafood in plastic bags at the market to prevent their liquids from dripping on other foods.
• Use a meat thermometer to check the inside temperature of meats to make sure they are fully cooked.
• Immediately wash cutting boards and counters used to prepare raw foods to avoid spreading the germs to other foods.
• Avoid eating raw eggs and foods that contains uncooked eggs (i.e. cookie dough, homemade ice cream, tiramisu, eggnog).
• If you have salmonella, don’t prepare food for others until your diarrhea has stopped.

The approval means that tens of thousands of women diagnosed with early-stage breast cancer will have access to a medication that can help prevent their cancer from coming back. 

“Depending on your risks and everything, up to 30% of breast cancers can come back,” said Dr. Eleonora Teplinsky, head of breast and gynecologic medical oncology at Valley Health System in New Jersey. “If it comes back as stage four, then while we have treatment, it’s not curable. People die from that cancer.”

In a phase 3 clinical trial from the drugmaker Novartis, Kisqali reduced the risk of a patient’s breast cancer coming back by 25% after three years when given in addition to standard treatments, which can include chemotherapy, surgery and radiation followed by hormone therapy.

After four years, Kisqali reduced the risk by 28.5%, according to an updated analysis presented Monday at the European Society for Medical Oncology conference in Barcelona.

“We want to do everything that we can to incrementally decrease the chances of this cancer coming back,” said Dr. Vandana Abramson who is the co-leader of the Breast Cancer Research Program at the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee. “So if a patient was already at a potentially 10% risk of the cancer coming back, this would decrease it further, down to 7%.” 

Until now, only Verzenio, another drug in the same class, was approved to reduce the risk of a patient’s early breast cancer returning, but it was only for people with a very high risk of recurrence. Kisqali, on the other hand, will be available to a much broader group of patients, whose disease may not be as aggressive at the time of diagnosis. 

It may also cause fewer side effects, Teplinksy said.

The expanded approval is for patients with HR-positive, HER2-negative breast cancer, the most common form of the disease. It’s for stage two and three diagnoses, meaning the cancer hasn’t spread beyond the breast or nearby lymph nodes.

It comes as rates of breast cancer are increasing in younger women: From 2000 to 2019, rates of breast cancer in women ages 20 to 49 increased by 15.6% according to a study published earlier this year in JAMA Network Open. 

Nikki Odum, 42, was diagnosed with breast cancer when she was 36 years old.

“The first thing that I thought of was, ‘I’m not ready to die, so what do I gotta do?’” said Odum, of Smyrna, Tennessee.

After she had a double mastectomy, chemotherapy and radiation, her doctor, Denise Yardley, asked if she wanted to join the clinical trial for Kisqali. “It was a no-brainer for me. I was like, ‘Game on, let’s do it,’” Odum said.

Yardley, the associate director of breast cancer research at the Sarah Cannon Research Institute in Nashville, was one of the clinical trial investigators. Patients in the trial either took the standard hormone therapy or took Kisqali plus hormone therapy for three years after they completed their main treatment regimen. 

Throughout the trial, patients were monitored for side effects such as low white blood cell count and elevated liver enzymes, Yardley said. 

If someone experienced a side effect, “typically we would hold a drug, take care of the symptom and re-initiate. If it recurs, then we would do a dose reduction,” she said. About 20% of participants who got Kisqali dropped out of the trial for those reasons. 

Odum was part of the group that took Kisqali plus hormone therapy. At one point, she developed a rash over her body and had to pause treatment. 

Even so, she said “for me, Kisqali was something that was a bonus. It’s something that I know in my heart helped me.”

The drug’s effects were studied for three years in the trial, however breast cancer can recur decades after diagnosis. 

“It would be nice to still see additional longer follow-up data to see if we are impacting just rates of early recurrences, or will we also have an impact on late recurrences?” said Dr. Komal Jhaveri, a breast medical oncologist at Memorial Sloan Kettering Cancer Center in New York.

Abramson, of the Vanderbilt-Ingram Cancer Center, noted that the drug is not cheap. 

“The cost, out-of-pocket, if you’re taking it for the entire three years, would be close to $300,000-400,000,” she said.

With the expanded approval, it’s more likely that insurance plans will offer coverage for the treatment, so patients would not have to pay the out-of-pocket cost, but that can impose costs on the health care system as a whole.  

“Some of the criticisms of the study have been: well, it was only a 3% benefit,” Teplinsky said. “Three percent more patients benefit. What does that mean? But I think that’s then up to the patient to decide what they want to do. It’s important for them to have the option.”

For Odum, the peace of mind that the medication granted her was worth it. 

“You’re always going to be faced with the fact every single day that you have had breast cancer,” she said.  “I know that I’m doing everything I can to continue to live.”

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This is one of them: Drinking several cups of caffeinated coffee or tea a day may protect against Type 2 diabetes, coronary heart disease and stroke, NBC reports.

The findings, published Tuesday in the Journal of Clinical Endocrinology & Metabolism, add to existing research suggesting that daily coffee drinkers have better heart health than nondrinkers — provided they don’t drink too much caffeine.

“Caffeine intake at different doses could have different health effects,” the study’s co-lead author Chaofu Ke, an associate professor in the department of epidemiology and biostatistics at Soochow University in China, wrote in an email. 

Ke and a group of researchers in China and Sweden analyzed the coffee and tea drinking habits of 188,000 people ages 37 to 73 from the U.K. Biobank, a large database that contains anonymous health information, who had completed questionnaires about their beverage intake over the past 24 hours. They also looked at responses from about 172,000 people who specified that they drank caffeinated coffee or tea. None of them had a history of cardiometabolic disease — defined by a diagnosis of at least two of the three conditions: Type 2 diabetes, coronary heart disease or stroke — when the study began. 

The researchers followed up with the participants after about 12 years.

Drinking two to three cups of coffee or up to three cups of tea a day was the sweet spot, the researchers found.  

People who consumed about 200 to 300 milligrams of caffeine daily had a lower risk of cardiometabolic disease, compared to people who drank less than 100 mg a day. Coffee drinkers, in particular, had the lowest risk — a nearly 50% reduction — while people who got the 200 to 300 milligrams of caffeine from tea or a mix of both beverages were about 40% less likely to develop cardiometabolic disease. For tea drinkers, cardiometabolic risk decreased the most for those who drank up to three cups daily, but the benefits tapered off after that. 

Even for people who consumed more than 400 mg of caffeine a day — just 4% of the study’s caffeine drinkers — the stimulant didn’t appear to have negative consequences for their cardiometabolic health. 

And among those who did eventually develop cardiometabolic disease, drinking moderate amounts of coffee every day was still associated with lower risk of developing another cardiometabolic disease. 

Moderate caffeine intake was also associated with certain metabolites — compounds produced when the body digests foods and drinks — that are linked to better heart health.

“Moderate caffeine intake may regulate levels of these metabolites,” Ke said. 

Dr. Luke Laffin, co-director of the Center for Blood Pressure Disorders at Cleveland Clinic, said that the findings need to be taken in context.

“It can give us an idea, but we can’t draw any conclusions,” said Laffin, who wasn’t involved with the research. “Everything in moderation is probably the best way to do it. If someone is having a couple cups of coffee a day, this suggests that dose might be protective.”

However, some types of heart disease can make caffeine intake more dangerous, he said. 

“Too many cups of coffee can raise blood pressure in someone who already has hypertension,” Laffin said. 

Studies have also shown a link between high caffeine intake and a greater risk of dementia and stroke. Other studies have shown positive links between caffeine and kidney health, Type 2 diabetes and heart failure. 

Dr. Stephen Kopecky, a preventative cardiologist at the Mayo Clinic in Rochester, Minnesota, said that, in addition to a person’s underlying health issues, the way a person consumes caffeine likely makes a big difference in how it affects their health. 

“The message I don’t want to get out there is that caffeine is good, so let’s take more of it. We have never found that taking what is good in the diet and putting it in a pill is equally beneficial,” Kopecky said. 

An important caveat of the study is that it only included people who regularly drank coffee or green or black tea, all of which contain hundreds or thousands of chemical compounds, only one of them being caffeine. 

“It’s likely all of these components that have an impact, but they have to be together,” Kopecky said.

Although the researchers did adjust for some heart disease factors, such as smoking, obesity, exercise and diet, a lot remains unknown about what other habits they may have in addition to drinking caffeine, which could affect their risk. 

“It’s hard to do a study that controls for everything,” Laffin said, adding that a daily cup of coffee is just fine for most people. 

Kopecky agreed, adding that consuming caffeine in energy drinks, which often have added sugar, artificial sweeteners and other additives, or caffeine shots, is definitely something to avoid. 

And when it comes to tea and coffee, keep it simple. 

“People need to be scrupulous about what else is in their coffee aside from caffeine,” Laffin said. 

“If you are going to your favorite coffee shop and ordering a coffee with whipped cream and sugary syrup, you’re consuming a lot of calories, which can contribute to cardiometabolic disease.”

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The Senate vote was Democrats’ latest attempt to force Republicans into a defensive stance on women’s health issues and highlight policy differences between Vice President Kamala Harris and former President Donald Trump in the presidential race, especially as Trump has called himself a “leader on IVF.”

The 51-44 vote was short of the 60 votes needed to move forward on the bill, with only two Republicans voting in favor. Democrats say Republicans who insist they support IVF are being hypocritical because they won’t support legislation guaranteeing a right to it.

“They say they support IVF — here you go, vote on this,” said Illinois Sen. Tammy Duckworth, the bill’s lead sponsor and a military veteran who has used the fertility treatment to have her two children.

The Democratic push started earlier this year after the Alabama Supreme Court ruled that frozen embryos can be considered children under state law. Several clinics in the state suspended IVF treatments until the GOP-led legislature rushed to enact a law to provide legal protections for the clinics.

Democrats quickly capitalized, holding a vote in June on Duckworth’s bill and warning that the U.S. Supreme Court could go after the procedure next after it overturned the right to an abortion in 2022.

The bill would establish a nationwide right for patients to access IVF and other assisted reproductive technologies and a right for doctors and insurance companies to provide it, an effort to pre-empt state efforts to limit the services. It would also require more health insurers to cover it and expand coverage for military service members and veterans.

In a statement after the vote, Harris said Republicans in Congress “have once again made clear that they will not protect access to the fertility treatments many couples need to fulfill their dream of having a child.”

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Republicans argued that the federal government shouldn’t tell states what to do and that the bill was an unserious effort. Only Republican Sens. Susan Collins of Maine and Lisa Murkowski of Alaska voted with Democrats to move forward on the bill both times.

Meanwhile, Republicans have scrambled to counter Democrats on the issue, with many making clear that they support IVF treatments. Trump last month announced plans, without additional details, to require health insurance companies or the federal government to pay for the fertility treatment.

In his debate with Harris earlier this month, Trump said he was a “leader” on the issue and talked about the “very negative” decision by the Alabama court that was later reversed by the legislature.

South Dakota Sen. John Thune, the No. 2 Senate Republican, said that Democrats are trying to create a political issue “where there isn’t one.”

“Let me remind everybody that Republicans support IVF, full stop,” Thune said just before the vote.

The issue has threatened to become a vulnerability for Republicans as some state laws passed by their party grant legal personhood not only to fetuses but to any embryos that are destroyed in the IVF process. Ahead of its convention this summer, the Republican Party adopted a policy platform that supports states establishing fetal personhood through the Constitution’s 14th Amendment, which grants equal protection under the law to all American citizens. The platform also encourages supporting IVF but does not explain how the party plans to do so.

Republicans have tried to push alternatives on the issue, including legislation that would discourage states from enacting explicit bans on the treatment, but those bills have been blocked by Democrats who say they are not enough.

Sen. Rick Scott, a Florida Republican, said in a floor speech then that his daughter was currently receiving IVF treatment and proposed to expand the flexibility of health savings accounts. Republican Sens. Katie Britt of Alabama and Ted Cruz of Texas have tried to pass a bill that would threaten to withhold Medicaid funding for states where IVF is banned.

Cruz, who is running for reelection in Texas, said Democrats were holding the vote to “stoke baseless fears about IVF and push their broader political agenda.”

Four new cases of avian influenza were detected in farmworkers in Washington state this week, the latest in a drumbeat of human infections cropping up across the U.S. as the virus continues to spread among farm animals. 

Washington is the sixth state to report human cases of bird flu, which has spread rampantly in wild birds, poultry and cattle. Assuming the Centers for Disease Control and Prevention confirms the state’s positive tests, they will bring the U.S. tally to at least 31.

Flu experts said the risk of a broader outbreak among humans will continue to simmer if the virus remains uncontrolled in animals.

“The longer this virus hangs out in the environment, the more animals it spills over into, the more it changes in ways we don’t understand or predict, the more concerned we are going to be that this becomes the next global pandemic,” said Dr. Amber Itle, the Washington state veterinarian.

For now, however, health officials maintain that the virus has not made key genetic changes that would allow it to spread between people. 

“There is no evidence of any sustained human transmission. And that is a key milestone for all of us. It’s a key trigger for all of us. That’s when we really start to say, ‘Oh, something that’s markedly different about this virus,’” Dr. Umair Shah, Washington’s health secretary, said at a news conference Sunday. 

A CDC spokesperson said Tuesday morning that a federal team was being deployed to Washington and that risk to the public remained low. 

However, the virus is a growing concern for farmworkers on the front lines. The four latest cases were among workers who had culled birds at a commercial egg farm where an outbreak of avian influenza was reported in chickens.

Shah said the workers were part of a contract crew tasked with depopulating — or euthanizing — all chickens at the farm in Franklin County, in southeastern Washington, which had more than 800,000 birds. Itle said the workers wore full protective equipment: suits made of Tyvek, goggles and respirators. 

“It’s hot, it’s dusty. It’s a lot of birds in close proximity, and we’re getting a lot of viral exposure,” she said.

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The four people who tested positive after that work reported mild respiratory symptoms and conjunctivitis, or pink eye — symptoms now understood to be common when people are infected. None of the workers were hospitalized. 

Dr. Richard Webby, director of the World Health Organization Collaborating Center for Studies on the Ecology of Influenza in Animals and Birds, said the Washington cases represented “more of the same” in a pattern observed across the U.S. as workers tasked with culling sick animals have fallen ill. 

However, one human case — in Missouri — has puzzled researchers and health officials, because that person did not have contact with animals. It is not clear how the person was exposed, and results of further tests that could offer clues are still pending, according to the CDC. Six health workers exposed to the patient reported respiratory symptoms.

Webby said the virus’ spread in cows for the past 10 months has raised experts’ level of concern because cows are mammals and interact with humans frequently. That increases the likelihood the virus could mutate to pass from person to person. 

“Just because it hasn’t happened in 10 months … it doesn’t mean it can’t,” said Webby, an infectious disease researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee. 

Research suggests that incredible amounts of virus are shed in infected cows’ mammary glands, so the virus could spread through raw milk. (Milk sold in grocery stores is pasteurized, which inactivates the virus.) 

At the same time, the U.S. is preparing for flu season, when circulation of common influenza viruses increases in fall and winter. If two influenza viruses share the same host, they can share genetic information and mutate more quickly.

“You don’t want people affected with the seasonal flu virus to get a virus from animals and for those viruses to potentially recombine,” said Dr. Peter Rabinowitz, a professor of environmental and occupational health sciences at the University of Washington and the director of its Center for One Health Research.

Rabinowitz added that it is important to improve protection protocols for farmworkers and encourage them to get their flu shots. 

“This is a wakeup call. We need to do a better job of protecting workers,” he said.

Itle said cases in poultry were not unexpected in Washington state, because migrating birds passed through during summer and early fall. Recently, owls and other birds of prey were found dead, suggesting some wild animals had been stricken with the virus. 

Wild birds can spread the virus to farms through direct contact with poultry or livestock or via droppings, saliva or feed.  

More than 103 million birds have been sickened, killed or culled in the current bird flu outbreak, according to CDC statistics. The virus has been detected in poultry in 48 states. 

The CDC says 330 dairy herds have been affected. 

Washington has not had an outbreak among dairy producers, Itle said, but dairy farms there are now testing weekly.

This story first appeared on NBCNews.com. More from NBC News:

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This story uses functionality that may not work in our app. Click here to open the story in your web browser.

Four new cases of avian influenza were detected in farmworkers in Washington state this week, the latest in a drumbeat of human infections cropping up across the U.S. as the virus continues to spread among farm animals. 

Washington is the sixth state to report human cases of bird flu, which has spread rampantly in wild birds, poultry and cattle. Assuming the Centers for Disease Control and Prevention confirms the state’s positive tests, they will bring the U.S. tally to at least 31.

Flu experts said the risk of a broader outbreak among humans will continue to simmer if the virus remains uncontrolled in animals.

“The longer this virus hangs out in the environment, the more animals it spills over into, the more it changes in ways we don’t understand or predict, the more concerned we are going to be that this becomes the next global pandemic,” said Dr. Amber Itle, the Washington state veterinarian.

For now, however, health officials maintain that the virus has not made key genetic changes that would allow it to spread between people. 

“There is no evidence of any sustained human transmission. And that is a key milestone for all of us. It’s a key trigger for all of us. That’s when we really start to say, ‘Oh, something that’s markedly different about this virus,’” Dr. Umair Shah, Washington’s health secretary, said at a news conference Sunday. 

A CDC spokesperson said Tuesday morning that a federal team was being deployed to Washington and that risk to the public remained low. 

However, the virus is a growing concern for farmworkers on the front lines. The four latest cases were among workers who had culled birds at a commercial egg farm where an outbreak of avian influenza was reported in chickens.

Shah said the workers were part of a contract crew tasked with depopulating — or euthanizing — all chickens at the farm in Franklin County, in southeastern Washington, which had more than 800,000 birds. Itle said the workers wore full protective equipment: suits made of Tyvek, goggles and respirators. 

“It’s hot, it’s dusty. It’s a lot of birds in close proximity, and we’re getting a lot of viral exposure,” she said.

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The four people who tested positive after that work reported mild respiratory symptoms and conjunctivitis, or pink eye — symptoms now understood to be common when people are infected. None of the workers were hospitalized. 

Dr. Richard Webby, director of the World Health Organization Collaborating Center for Studies on the Ecology of Influenza in Animals and Birds, said the Washington cases represented “more of the same” in a pattern observed across the U.S. as workers tasked with culling sick animals have fallen ill. 

However, one human case — in Missouri — has puzzled researchers and health officials, because that person did not have contact with animals. It is not clear how the person was exposed, and results of further tests that could offer clues are still pending, according to the CDC. Six health workers exposed to the patient reported respiratory symptoms.

Webby said the virus’ spread in cows for the past 10 months has raised experts’ level of concern because cows are mammals and interact with humans frequently. That increases the likelihood the virus could mutate to pass from person to person. 

“Just because it hasn’t happened in 10 months … it doesn’t mean it can’t,” said Webby, an infectious disease researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee. 

Research suggests that incredible amounts of virus are shed in infected cows’ mammary glands, so the virus could spread through raw milk. (Milk sold in grocery stores is pasteurized, which inactivates the virus.) 

At the same time, the U.S. is preparing for flu season, when circulation of common influenza viruses increases in fall and winter. If two influenza viruses share the same host, they can share genetic information and mutate more quickly.

“You don’t want people affected with the seasonal flu virus to get a virus from animals and for those viruses to potentially recombine,” said Dr. Peter Rabinowitz, a professor of environmental and occupational health sciences at the University of Washington and the director of its Center for One Health Research.

Rabinowitz added that it is important to improve protection protocols for farmworkers and encourage them to get their flu shots. 

“This is a wakeup call. We need to do a better job of protecting workers,” he said.

Itle said cases in poultry were not unexpected in Washington state, because migrating birds passed through during summer and early fall. Recently, owls and other birds of prey were found dead, suggesting some wild animals had been stricken with the virus. 

Wild birds can spread the virus to farms through direct contact with poultry or livestock or via droppings, saliva or feed.  

More than 103 million birds have been sickened, killed or culled in the current bird flu outbreak, according to CDC statistics. The virus has been detected in poultry in 48 states. 

The CDC says 330 dairy herds have been affected. 

Washington has not had an outbreak among dairy producers, Itle said, but dairy farms there are now testing weekly.

This story first appeared on NBCNews.com. More from NBC News:

• E. coli outbreak linked to McDonald’s Quarter Pounders in multiple states
• Half of all global food threatened by growing water crisis, report says
• Meteorologists say they're facing pushback like never before, despite highly accurate forecasts

This story uses functionality that may not work in our app. Click here to open the story in your web browser.

As chaplain for the men’s team for 30 years, she’s famous as the “basketball nun” — stealing the show and people’s hearts when the Loyola Ramblers made it to the Final Four at the 2018 NCAA basketball tournament.

Known simply as Sister Jean, she leads the team in a pre-game prayer before matches and serves as a good luck charm. Enthusiastic, uplifting and knowledgeable about basketball, “she’s like another coach,” one of the players told the Chicago Tribune. “She knows her stuff.”

Born on Aug. 21, 1919, the centenarian continues to work at least five days a week, commuting from her apartment to campus via shuttle bus, and offering advice, support and hugs to students in her office. She uses an iPad, a computer and is active on email, but it’s the personal connection with young people that matters most.

“I love every bit of it. … It just makes me very joyful,” Sister Jean tells TODAY.com. “I don’t consider it really working. I just have so much fun. These students are a joy to work with. I learn so much from them, and I know they learn from me.”

She celebrated her 105th birthday with seven parties organized by the university, students and the assisted living community where she resides.

The nun is a member of the Sisters of Charity of the Blessed Virgin Mary. She’s spent her life working as a teacher, administrator and principal. She’s also coached basketball and other sports.

“I feel fine” at 105, Sister Jean says. “I eat well, I sleep well and hopefully I pray well.”

Here are some of the secrets of her longevity:

Be around young people

“I love being around young people. They keep me alive, healthy, and vibrant,” she writes in her memoir, “Wake Up With Purpose!: What I’ve Learned in My First Hundred Years.”

“My interactions with those students are why I’ve never regretted not having children of my own.”

Never retire

Sister Jean actually did try retirement in 1994 at age 75, but found she didn’t want to give up working — a sentiment common among people who live extraordinarily long lives.

That same year, she was asked to be the chaplain for the men’s basketball team, which became “the most transformational and transcendent position of my life,” she writes in her book.

Given the team’s schedule, she sometimes works until 9:30 at night and on the weekends. She’ll be attending every home game this year.

“There’s more work for me to do. I don’t like to sit around. I just like talking to people or doing something good for others,” she says as fall activities get underway at the university. “We’re going to be very busy, but that’s fun.”

It’s important to have a purpose in life, but since people spend so much time at work, they should make a change if they don’t like their job or career, she advises.

Keep moving forward

Sister Jean is comfortable with modern technology, stays on top of the news and calls adaptability her “superpower.”

“If you’re not moving forward, you’re going to get left behind real quick,” she writes in her book.

The nun calls herself the queen of the selfie since so many people want a photo with her. It makes them happy, so she’s happy to do it, she says.

Inherit great genes

The centenarian believes a lot of her longevity comes from her father’s side of the family. He lived to be 95, and several of his siblings made it to a similar age.

“When my 95 came along, I thought, ‘I’ve got to really get ready to go to God.’ But I’m still here,” she says.

Wake up and go to sleep joyfully

If you don’t take care of yourself, you can’t take care of anybody else, Sister Jean says. It’s important to set aside quiet time for prayer and reflection to take care of the mind, she adds in her book.

The nun wakes up at 5 a.m. and pauses for a 30-minute meditation.

Then at night, she takes time to think about all the good things she did that day.

“I still go to bed every night with a smile on my face, gratitude in my heart, and love in my soul,” she writes in her book.

Eat in moderation

Sister Jean says she eats pretty much everything, but not too much of anything.

Lunch is her heavier meal, and then she eats more lightly at dinner time, opting for soup and a salad or a sandwich.

She used to be very careful about her diet when she was younger, but has taken a more relaxed approach in recent years.

“Perhaps I don’t watch my diet so much at breakfast. Sometimes I have eggs and bacon and toast,” the centenarian notes.

“But I think to myself, I’m 105, what difference does it make?”

For her birthday, Sister Jean enjoyed chicken fricassee, homemade noodles, peas and pound cake — the meal she always asked her mom to make for her special day.

Stay positive and joyful

Sister Jean says she’s never been depressed and believes it takes too much energy to be stressed out.

She credits her good mental health to her parents, who created a happy home for her, and her two brothers even when times were tough during the Great Depression — a warmth that has always stayed with her. They also fostered her love of sports, which she calls the best teacher of teamwork.

“I learned a lot of that from my mom and dad. They were so positive all the time,” she says.

“They told us that we could really do things if we really tried, and I certainly believe that.”

Her parents and brothers have died, but she talks to them all the time. “I know they hear me in heaven,” she writes.

This article first appeared on TODAY.com. Read more from TODAY here:

• Woman, 24, had a heart attack — EMTs told her it was just a panic attack
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Liraglutide lowered body mass, slowed weight gain and improved health markers in kids ages 6 through 11, according to research presented Tuesday at a medical conference and published in the New England Journal of Medicine.

Based on the results of the trial, drugmaker Novo Nordisk has asked U.S. regulators to expand use of the medication for kids in that age group, a company spokesperson said Tuesday. If approved, the drug would be the first authorized to treat the most common type of obesity that affects more than 20% of U.S. kids ages 6 through 11, according to the U.S. Centers for Disease Control and Prevention.

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news Sep 10

Healthy Returns: More than 50 million privately insured adults could be eligible for GLP-1 drugs

“To date, children have had virtually no options for treating obesity,” said Dr. Claudia Fox, a pediatric obesity expert at the University of Minnesota who led the study. “They have been told to ‘try harder’ with diet and exercise.”

Side effects were common among those given the drug, particularly gastrointestinal effects such as nausea, vomiting and diarrhea. And experts said doctors and parents would need to carefully consider those risks and the lack of data about the long-term use of such drugs in young kids.

“Having a medication for that age group, if approved, would be a really nice tool to have, but we’re also going to have to be careful about how widely we start using it,” said Dr. Melissa Crocker, a pediatric obesity specialist at Boston Children’s Hospital who wasn’t involved in the study. “And I would answer that differently at 6 than I would at 11.”

Liraglutide is in a class of so-called GLP-1 drugs that include blockbuster medications like Wegovy and Mounjaro. The medications mimic hormones that affect appetite, feelings of fullness and digestion. It’s taken as a daily injection and is approved under the brand name Victoza to treat diabetes in adults and children ages 10 and older and as Saxenda to treat obesity in adults and children ages 12 to 17.

The new study, paid for by Novo Nordisk, included 82 children with a mean age of 10 and a baseline weight of about 155 pounds (70 kilograms). The average starting BMI was 31, above the threshold for childhood obesity. More than half the children had obesity-related health problems such as insulin resistance, asthma or early puberty. The results were presented at the annual meeting of the European Association for the Study of Diabetes in Madrid.

In the trial, 56 children received daily injections of up to 3 milligrams of liraglutide for nearly 13 months, while 26 got dummy medications. The kids were followed for six months afterward.

All the children received individual counseling to help them follow a plan that called for a healthy diet and 60 minutes a day of moderate to high-intensity exercise.

Researchers found that kids who took the drug for more than a year reduced their body mass index — a measure of height and weight that can account for a child’s natural growth – by 5.8%. Children who received the dummy medication saw their BMI increase by 1.6%.

At the same time, children who received the drug slowed weight gain to 1.6% of their body weight during that period, compared with a 10% gain for those who got sham drugs.

The study found that 46% of kids who got the drug lowered their BMI by at least 5%, an amount that has been linked to improvements in health problems tied to obesity. In kids who received placebo, 9% met that mark. Lower measures of blood pressure and blood sugar were detected in children who received the drug, researchers noted.

Side effects, mostly mild to moderate, were reported in nearly 90% of both groups of participants. Gastrointestinal side effects including nausea and vomiting were reported in 80% of kids who received the drug, compared with 54% who received sham medications. Serious side effects were reported in seven children using liraglutide and two who took placebo. Six participants taking the drug left the trial because of the side effects, while no one taking placebo stopped treatment.

In the six-month follow-up, children in both groups who stopped treatment increased BMI and gained weight, the study found. The trial has been extended to include more treatment and follow up, with results expected in 2027.

Fox receives research funding from Novo Nordisk and drugmaker Eli Lilly paid directly to her institution. Those companies are also conducting trials with more powerful weekly injections of Novo’s Wegovy and Lilly’s Zepbound in kids as young as 6.

Dr. Alaina Vidmar, a pediatric obesity specialist at Children’s Hospital Los Angeles who wasn’t involved in the new study, said she has used liraglutide off-label to treat young kids and would welcome approval of the drug to increase flexibility and access.

The drug treats the underlying physiology of obesity, which is a complex, chronic disease that can occur at any age. Early use can prevent obesity and life-threatening health problems from extending into the teen years — and adulthood.

“We want these kids to have long, healthy lives,” Vidmar said. “The sooner that we can start, the more likely we can stop them from getting early onset diabetes, early onset heart disease, sleep apnea, all of those things. Doing nothing is not the right answer.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

This is the 14th person in the U.S. sickened with bird flu since March, when the virus was detected in cows, after infecting wild birds and mammals worldwide. One other person was infected in 2022.

The risk to the general public remains low, U.S. Centers for Disease Control and Prevention officials said in a statement. No unusual flu activity has been detected in the U.S., including in Missouri, officials said.

The latest case was confirmed after the person, an adult, was hospitalized on Aug. 22 with other medical conditions, officials with the Missouri Department of Health and Senior Services said in a statement.

The person tested positive for influenza A, and CDC officials later confirmed it to be bird flu. The person received antiviral medication and has since recovered and gone home, health officials said. It’s not clear whether the hospitalization was caused by the bird flu infection or the person’s existing health conditions, said Lisa Cox, a spokesperson for the Missouri health department.

Bird flu

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Health officials didn’t release the person’s name, age or hometown. No close contacts of the person have been infected, CDC officials said.

The case raises questions about how the person was exposed to the virus. All the previous U.S. infections were among people who worked around cows and poultry.

Bird flu has been detected in nearly 200 dairy herds in 14 states, but not in Missouri, according to the Agriculture Department. Bird flu has also been found in commercial and backyard flocks and in wild birds. The person did not report drinking raw milk, which can contain live virus, Cox said.

The investigation is continuing, officials said.

It’s the first case detected through routine influenza surveillance rather than through targeted efforts to identify people infected with bird flu through exposure to infected cows and poultry, officials said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Black women are more than three times as likely to die from pregnancy or childbirth as white women in Oklahoma, which consistently ranks among the worst states in the nation for maternal mortality.

“Tulsa is suffering,” said Corrina Jackson, who heads up a local version of the federal Healthy Start program, coordinating needed care and helping women through their pregnancies. “We’re talking about lives here.”

Across the nation, programs at all levels of government — federal, state and local — have the same goals to reduce maternal mortality and erase the race gap. None has all the answers, but many are making headway in their communities and paving the way for other places.

Jackson’s project is one of more than 100 funded through Healthy Start, which gave out $105 million nationally in grants this year. Officials call Healthy Start an essential part of the Biden administration’s plan for addressing maternal health.

Other approaches to the crisis include California halving its maternal mortality rate through an organization that shares the best ways to treat common causes of maternal death and New York City expanding access to midwives and doulas two years ago. Several states passed laws this year aiming to improve maternal health, including a sweeping measure in Massachusetts. And last week, the U.S. Department of Health and Human Services announced more than $568 million in funding to improve maternal health through efforts such as home visiting services and better identifying and preventing pregnancy-related deaths.

Locally and nationally, “we need to really identify the birthing people who are at potentially the greatest risk,” New York City health commissioner Dr. Ashwin Vasan said, “and then wrap our arms around them throughout their pregnancies.”

A Healthy Start in Tulsa

Besides coordinating prenatal and postpartum care — which experts say is crucial for keeping moms alive — local Healthy Start projects provide pregnancy and parenting education and referrals to services for things like depression or domestic violence. The local efforts also involve women’s partners and kids up to 18 months. And they focus on issues that influence health, such as getting transportation to appointments.

“You try to get them in their first trimester and then work with them to delivery day, and then we also work with the babies to make sure that they reach their milestones,” Jackson said.

Jackson got help from the local Urban League as a single mom, and felt called to give back to her community. She’s been with Healthy Start for more than 25 years, first through Tulsa’s health department and recently through a nonprofit she started that received about $1 million in federal funds this fiscal year.

“I’m just like a mom to this program,” Jackson said.

Oklahoma overall has a maternal mortality rate of about 30 per 100,000 live births, significantly higher than the national average of about 23. But in Jackson’s quarter-century tenure, she said, there have been no maternal deaths among clients.

Pivotal to Healthy Start’s success are care coordinators like Krystal Keener, a social worker based at Oklahoma State University’s obstetrics and gynecology clinic, where clients get prenatal care. One of her responsibilities is to educate clients about health issues, like how to spot the signs of preeclampsia or how much bleeding is too much after delivery.

She also helps with practical matters: Many clients don’t have cars, so they call Keener when they need a ride to a prenatal visit, and she assists in scheduling one.

With doctors, Keener serves as a patient advocate. On a recent afternoon, Keener sat in on a prenatal appointment for Areana Coles. A single mom, Coles was joined by her 5-year-old daughter, who was born prematurely and spent time in intensive care.

Coles, 25, said Healthy Start is “probably the best thing that’s happened in this pregnancy.” She called Keener “an angel.”

Together they navigated several recent medical concerns, including dehydration and low potassium levels that put Coles in the hospital.

With Coles’ due date approaching, Keener talked about what to watch for around delivery and shortly after, like blood clots and postpartum depression. She advised Coles to take care of herself and “give yourself credit for small things you do.”

During an ultrasound a few minutes later, Coles watched Dr. Jacob Lenz point to her unborn baby’s eyes, mouth, hand and heart. He printed an image of the scan, which Coles immediately showed her daughter.

Keener said she’s gratified that Coles would not be giving birth prematurely this time.

“You made it to term – yay!” she told her client.

Coles smiled. “My body can do it!”

Improving medical care

While programs like Healthy Start focus on individual patient needs, other efforts manage the overall quality of medical care.

California has the lowest maternal mortality in the nation — 10.5 per 100,000 live births, less than half the national rate. But that wasn’t the case before it created a “maternal quality care collaborative” in 2006.

Founded at Stanford University’s medical school in partnership with the state, it brings together people from every hospital with a maternity unit to share best practices on how to deal with issues that could lead to maternal injury or death, like high blood pressure, cardiovascular disease and sepsis.

“When you look at the rate of maternal death in the United States compared to California, they basically ran neck-and-neck until it was established,” said Dr. Amanda Williams, clinical innovation adviser for the collaborative. “At that time they totally separated and California started going down. The rest of the country started going up.”

In the collaborative, hospitals get toolkits full of materials such as care guidelines in multiple formats, articles on best practices and slide sets that spell out what to do in medical emergencies, how to set up medical teams and what supplies to keep on the unit. The collaborative also tackles issues such as improving obstetric care by integrating midwives and doulas – whose services are covered by the state’s Medicaid program.

At first, some doctors resisted the effort, figuring they knew best, Williams said, but there’s much less pushback now that the collaborative has proven its value.

MemorialCare Miller Children’s & Women’s Hospital Long Beach started participating around 2010. The collaborative helps “vet through all the research that’s out there,” said Shari Kelly, executive director of perinatal services. “It’s just so important to really understand how we as health care providers can make a difference.”

For example, if a woman loses a certain amount of blood after a vaginal delivery, “we know to activate what we call here a ‘code crimson,’ which brings blood to the bedside,” Kelly said. “We can act fast and stop any potential hemorrhage.”

She said the collaborative has also helped reduce racial inequities — bringing down the rate of cesarean sections among Black moms, for example.

In July, U.S. Centers for Medicare & Medicaid Services proposed a similar initiative to California’s, focused on the quality of maternal care nationwide: the first baseline health and safety requirements for maternal emergency and obstetric services in hospitals.

A community perspective

Experts said getting maternal mortality under control at a national level requires tailoring solutions to individual communities, which is easier when programs are locally run.

New York City has a goal of reducing maternal mortality overall — and specifically achieving a 10% drop in Black maternal mortality by 2030. Statewide, Black residents are about four times more likely to die from pregnancy or childbirth than white residents.

The city is starting with, among others, low-income residents and those living in public housing. The New Family Home Visits Initiative gives pregnant people and those who’ve given birth visits from professionals such as nurses, midwives, doulas and lactation consultants. Vasan said more than 12,000 families have gotten visits since 2022.

Nurse Shinda Cover-Bowen works for the initiative’s Nurse Family Partnership, which has her visiting some families for 2 1/2 years, well beyond the pregnancy and birth. She said “that consistency of someone being there for you and listening to you and guiding you on your mother’s journey is priceless.”

Being grounded in the local community — and its history — is also crucial for Healthy Start projects. The lingering effects of racism are evident in Tulsa, where in 1921, white residents are estimated to have killed 100-300 Black people and destroyed homes, churches, schools and businesses in the Greenwood section. That’s where Jackson lives now, and where health disparities persist.

Being relatable is valuable for Black women, who may distrust the health care system, Jackson said. Plus, knowing the community makes it possible to work closely with other local agencies to meet people’s needs.

Denise Jones, who enrolled in Healthy Start in February, has struggled with anxiety, depression and drug addiction, but has been sober since April.

In mid-July, baby items filled her room — a crib, a bassinet, tiny clothes hanging neatly in a closet — in anticipation of her child’s arrival. Jones, 32, flipped through a baby book, pointing to a sonogram of her son Levi, who would be born within a couple of weeks.

She said she feels healthy and blessed by the help she’s gotten from Healthy Start and Madonna House, a transitional living program run by Catholic Charities of Eastern Oklahoma.

“I have professionals that are working with me and give me support. I didn’t have that with my other pregnancies,” she said. “I’m at one with my baby and I’m able to focus.”

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Associated Press data journalist Nicky Forster in New York contributed to this report.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Food and Drug Administration authorized Novavax‘s updated protein-based Covid vaccine for emergency use in people ages 12 and up on Friday, paving the way for the shot to compete with Pfizer and Moderna‘s jabs this fall and winter. 

Novavax’s vaccine targets the highly contagious omicron subvariant JN.1, which began circulating widely in the U.S. earlier this year. JN.1 only accounted for 0.2% of cases circulating nationwide as of this week, according to the latest Centers for Disease Control and Prevention data. 

Novavax manufactures protein-based vaccines, which cannot be quickly updated to target another strain of the virus.

Despite that, the biotech company has noted that its shot provides protection against descendants of JN.1 that are currently dominant in the U.S., including KP.2.3, KP.3, KP.3.1.1 and LB.1.

“Our updated vaccine targets JN.1, the ‘parent strain’ of currently circulating variants, and has shown robust cross-reactivity against JN.1 lineage viruses,” Novavax CEO John Jacobs said in a statement.

Novavax said it expects its shot to be “broadly available” in thousands of locations across the U.S., including retail and independent pharmacies and regional grocers.

Shares of Novavax rose more than 8% on Friday following the announcement. 

The FDA’s decision comes only a week after it approved a new round of messenger RNA shots from Pfizer and Moderna, which both target another offshoot of JN.1 called KP.2. Last year, the agency authorized Novavax’s shot nearly a month after clearing vaccines from its rivals, putting the company at a disadvantage. 

Public health officials see Novavax’s vaccine as a valuable alternative for people who don’t want to take mRNA shots from Pfizer and Moderna, which use a newer vaccine method to teach cells how to make proteins that trigger an immune response against Covid. Novavax’s shot, meanwhile, fends off the virus with protein-based technology, a decades-old method used in routine vaccinations against hepatitis B and shingles.

It’s unclear how many people will get a new Covid shot this fall and winter. 

Only around 22.5% of U.S. adults received the latest round of shots that came out last fall, according to CDC data through early May. 

Wright, a Purple Heart recipient and a retired U.S. Army Staff Sergeant, received in-patient treatment in 2013 for post-traumatic stress disorder and anxiety.

“I wasn’t participating with them because I didn’t trust them,” Wright tells TODAY.com of his care team.

He eventually decided to start doodling during sessions to pass the time.

“Next thing you know, they were like the meeting is over. And I’m like, ‘OK, that’s crazy. It went by so fast.’ And they were like, ‘Today was a great day for you. You were talking. You were expressing yourself.’ I found out the whole time I was drawing, I was talking and engaging with the people,” Wright recalls.

After he completed his in-patient care, Wright says he went to get a tattoo. He had a good experience with the artist, who was also a friend who encouraged him to become a tattoo artist.

“Maybe I can do this,” Wright remembers thinking to himself. “I knew (that) I knew how to draw. I’ve been drawing since I was probably 2 years old. I bought a little kit. Never turned around.”

Wright has more than 100 tattoos himself and has given out thousands to people across the country to advance his mission of bringing mental wellness through tattoos.

His business, Marzmade Mobile Tattoo Studio, is based in New Jersey. He has a parlor in his home and a converted bus he uses to bring tattoos to people. He’s also on TV, with appearances in “Power Book III: Raising Kanan” and “Black Ink Crew: Chicago.”

Wright is among a cohort of veterans living with PTSD and anxiety. A 2024 study published in the Journal of Psychiatric Research estimated that 3 in 10 U.S. veterans report anxiety symptoms. According to the U.S. Department of Veterans Affairs, that 7% of veterans experience PTSD at some point in their lives.

For fellow veterans, Wright offers free tattoos so they can experience the lightbulb moment he did through art. He has given away more than 1,000 tattoos to them.

“I saw the correlation of tattooing and trauma, and I know about the trauma we have, especially when we get out,” Wright says. “I have tattoos over battle scars, and I’ve also tattooed over battle scars.”

Wright says most of the veterans he inks get tattoos in honor of their military service, and they trade war stories during the session.

“I can talk to you about the things you’re going through because I’ve been through it … as well as giving you a dope tattoo,” he adds.

Wright’s approach is clinically sound, experts say.

‘Reintegrate that painful memory’

Chase Cassine, a licensed clinical social worker in New Orleans who has worked with veterans, describes Wright’s work as “reintegration through tattoo therapy.”

“This is beneficial to both the tattoo artist and the person receiving the tattoo,” Cassine tells TODAY.com

“The tattoo is a symbol. The tattoo can also symbolize being a part of a group, being a part of a status, being able to commemorate a memory. But, also in that memory may be (another) painful memory. So you talk about what has happened and you can reintegrate that painful memory to a meaningful memory as a way to take back your power,” Cassine explains.

Tattoo therapy with Wright was particularly effective for Matt Davies, a Navy veteran who received a tattoo from Wright in 2020. Davies, who lives with PTSD, says he previously saw licensed therapists whom he did not find helpful.

“It felt more comfortable to talk with Daniel about the things that had happened to me than … with a licensed therapist because most therapists that you go to with the VA have no military background, so you’re speaking one language and they’re speaking another,” Davies says.

“It does get frustrating when you’re trying to convey what is happening, and you’re using terms that only a service member would use,” Davis adds. “This makes the ability to talk about it so much easier.”

‘Mimicking wartime adrenaline’

There’s also the physical side of getting a tattoo that helps, Wright and Cassine say.

“In the process of (getting) that tattoo, your adrenaline is so high that it’s mimicking wartime adrenaline,” Wright says. “When you were in wartime, you saw things. You smelled things. You heard things. Just think about it like this lid was opened and all of these smells and sensory things were put into your jar, and then it closed when you left wartime. And you’ve never had that much adrenaline to open it up again. I’m giving you that adrenaline to open a jar, and we’re talking about it to help release it.”

Davies says tattoo therapy helped him unlock “answers” he hadn’t previously known.

“When I went to meet with Daniel, we started talking about our time in the service, which led into a deeper conversation as to the things that we miss, the traumas that are associated with being in the service and also acclimating to life outside of the military,” Davies says.

“I believe my session was around five hours long, and we talked the entire time. It was very profound because I was able to finally feel like I got answers and not feel so alone or isolated with my feelings,” Davies adds.

Raising awareness of tattoo therapy

Wright mainly uses social media and digital platforms to advertise the free tattoos that he offers veterans. He has interested veterans enter a raffle and the winner gets the tattoo.

Davies says social media is how he heard about Wright. Davies won the raffle and they “hit if off” from there.

Cassine says tattoo therapy is a novel way to have impactful mental health conversations that actually land with the person.

“It may not be traditional, and sometimes we’ve got to get out of that framework, too. They have found therapeutic ways to help them cope with stress, with faith, with love, with trauma — tattoo therapy, speaking therapy, all these different things,” Cassine says.

There are other shops offering tattoo therapy, such as Tattoo Therapy BK and Therapy Ink NYC.

But Wright appears to be one of the only artists offering free tattoos for veterans.

“Everybody says the military is a band of brothers and sisters, and that is true,” Wright says. “But, when you get out or retire, it’s like you’re out of sight, out of mind. Everybody forgets about you. It’s not the same camaraderie you had every day. And that is one of the biggest traumas we deal with. I started bridging that gap.”

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She has firm rules about sugar, alcohol, cold drinks and ice cream.

Staten, who resides in El Paso, Texas, is cheerful and energetic when a reporter calls.

“I feel like I’m 16 years old,” she tells TODAY.com with a laugh. “I’m doing fine, honey.”

Born on June 17, 1918, Staten has lived in her apartment for more than 40 years, says her daughter, Rosie Lyles, who lives across the hall from her mom in the same apartment building. The arrangement allows her to take care of the centenarian whenever she needs her.

“She’s got her own place, and I’ve got mine. Everybody needs their own place,” Lyles, 80, tells TODAY.com.

Other than some vision problems, Staten is doing well, her daughter says. A pacemaker helps keep her heartbeat steady. She cooked for herself until a few years ago, but has found it more difficult recently. She loves food and enjoys the meals Lyles prepares for her.

“I have a good appetite,” Staten says, lighting up when certain foods, like beans, are mentioned. “Oh, honey, that’s my favorite,” she exclaims.

Staten was born near Austin, Texas, then moved to El Paso to enjoy the lower humidity there. Longevity runs in her family: she has a sister who is 104 years old.

The centenarian used to be “a professional cook for rich people,” so she has lots of experience with healthy, good food, Lyles says.

Much of her longevity advice is centered around diet. Here are Staten’s simple longevity tips:

Fill your diet with fruits and vegetables

Staten likes to eat carrots, broccoli, fresh greens and spinach — all vegetables with powerful health benefits.

Carrots contain lots of beta-carotene, fiber and antioxidants. Broccoli may protect against cancer, benefit the heart and promote digestive health. Leafy greens, such as spinach, are among the healthiest vegetables for the heart.

She also loves watermelon and cantaloupe.

Watermelon has more lycopene — an anti-inflammatory antioxidant — than any other fruit or vegetable. Lycopene has been studied for its role in lowering blood pressure and is considered a heart-healthy fruit.

Cantaloupe contains lots of beta-carotene and vitamin C, both antioxidants that protect against cellular damage.

Staten eats healthy sources of protein, such as chicken and fish. She likes some meat on her plate, but not too much.

Avoid sugar

The centenarian doesn’t eat any sugar and doesn’t like sweets. If she needs a sweetener, she uses a sugar-free option.

“Sugar is not good,” she says. “It can give you diabetes.”

Dozens of adverse health effects are tied to high sugar consumption, including high blood pressure, obesity, stroke, gout, cancer, asthma, depression and early death, studies have found.

Enjoy beans

Pinto beans are one of Staten’s favorite foods.

“People who live the longest, healthiest lives tend to eat half a cup to a cup of beans daily,” Samantha Cassetty, a registered dietitian based in New York City, previously told TODAY.com.

Indeed, beans are a staple in the Blue Zones, places around the world where people live extraordinarily long lives.

Beans are an excellent source of plant-based protein and fiber. They also contain vitamins, minerals and other nutrients.

Avoid greasy food

“My mom doesn’t like greasy food,” Lyles says.

Cardiologists agree, warning that a greasy, salty dish can undo all the nutritious choices people make at other mealtimes.

Eating fatty or sugary snacks alters brain activity and creates lasting preferences for these unhealthy items, a study found.

Enjoy tea

“I drink a lot of tea,” Staten says. “I try to get the tea that has no sugar in it.”

That’s a smart way of drinking it, dietitians say. Tea is a superfood, providing antioxidants, especially green tea, followed by yellow, oolong, Puer, black and white tea.

Unsweetened tea contains virtually no calories or fat.

Staten also drinks plenty of water, which is important for the body to function well.

Her personal rule is to never drink cold water because she believes it’s not good for her health. Ice water can decrease heart rate, studies have found. Very cold beverages can trigger atrial fibrillation in some people, researchers note.

Go for a walk

Staten used to walk a lot, Lyles says. Her options are more limited now because of her worsening eyesight, but she still walks around her apartment and with her daughter’s help.

Walking just 30 minutes a day decreases the risk of severe cardiovascular disease and dementia, studies have found. It can improve mood, sleep quality and mobility.

“Walking is an ideal option in terms of physical activity. It requires no specialized skill — everyone knows how to walk. It’s low impact and safe,” Dr. Cedric Bryant, president and chief science officer of the American Council on Exercise, previously told TODAY.com.

Enjoy an indulgence once in a while

The centenarian occasionally eats a little ice cream.

“I like it, but I never eat too much ice cream,” she says. “Every now and then, you can have a little ice cream, but not much.”

She also hardly ever drinks soda, but has one occasionally. It has to be sugar-free and she dilutes it with water.

Avoid alcohol

Staten doesn’t drink any alcohol. Lyles has encouraged her to drink a little wine after reading about studies that previously indicated it’s good for the heart, but the centenarian says she doesn’t want any.

The health impact of alcohol continues to be studied.

There is an association between drinking alcohol and a lower risk of heart disease because of the way alcohol impacts the brain’s response to stress, a recent study found.

But no level of alcohol consumption is safe for health, the World Health Organization warns, noting alcohol causes at least seven types of cancer.

Live an honest life

Staten likes everybody and believes in treating everyone the same, her daughter says.

“She’s straight up with people,” Lyles notes. “(She believes) the way to live a long life is obey your mother and father, and love your sisters and brothers.”

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Four new cases of avian influenza were detected in farmworkers in Washington state this week, the latest in a drumbeat of human infections cropping up across the U.S. as the virus continues to spread among farm animals. 

Washington is the sixth state to report human cases of bird flu, which has spread rampantly in wild birds, poultry and cattle. Assuming the Centers for Disease Control and Prevention confirms the state’s positive tests, they will bring the U.S. tally to at least 31.

Flu experts said the risk of a broader outbreak among humans will continue to simmer if the virus remains uncontrolled in animals.

“The longer this virus hangs out in the environment, the more animals it spills over into, the more it changes in ways we don’t understand or predict, the more concerned we are going to be that this becomes the next global pandemic,” said Dr. Amber Itle, the Washington state veterinarian.

For now, however, health officials maintain that the virus has not made key genetic changes that would allow it to spread between people. 

“There is no evidence of any sustained human transmission. And that is a key milestone for all of us. It’s a key trigger for all of us. That’s when we really start to say, ‘Oh, something that’s markedly different about this virus,’” Dr. Umair Shah, Washington’s health secretary, said at a news conference Sunday. 

A CDC spokesperson said Tuesday morning that a federal team was being deployed to Washington and that risk to the public remained low. 

However, the virus is a growing concern for farmworkers on the front lines. The four latest cases were among workers who had culled birds at a commercial egg farm where an outbreak of avian influenza was reported in chickens.

Shah said the workers were part of a contract crew tasked with depopulating — or euthanizing — all chickens at the farm in Franklin County, in southeastern Washington, which had more than 800,000 birds. Itle said the workers wore full protective equipment: suits made of Tyvek, goggles and respirators. 

“It’s hot, it’s dusty. It’s a lot of birds in close proximity, and we’re getting a lot of viral exposure,” she said.

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Is bird flu spreading in people? Without blood test results, officials can't say.

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A bird flu outbreak is spreading among cows in the US. Scientists are hunting for answers

The four people who tested positive after that work reported mild respiratory symptoms and conjunctivitis, or pink eye — symptoms now understood to be common when people are infected. None of the workers were hospitalized. 

Dr. Richard Webby, director of the World Health Organization Collaborating Center for Studies on the Ecology of Influenza in Animals and Birds, said the Washington cases represented “more of the same” in a pattern observed across the U.S. as workers tasked with culling sick animals have fallen ill. 

However, one human case — in Missouri — has puzzled researchers and health officials, because that person did not have contact with animals. It is not clear how the person was exposed, and results of further tests that could offer clues are still pending, according to the CDC. Six health workers exposed to the patient reported respiratory symptoms.

Webby said the virus’ spread in cows for the past 10 months has raised experts’ level of concern because cows are mammals and interact with humans frequently. That increases the likelihood the virus could mutate to pass from person to person. 

“Just because it hasn’t happened in 10 months … it doesn’t mean it can’t,” said Webby, an infectious disease researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee. 

Research suggests that incredible amounts of virus are shed in infected cows’ mammary glands, so the virus could spread through raw milk. (Milk sold in grocery stores is pasteurized, which inactivates the virus.) 

At the same time, the U.S. is preparing for flu season, when circulation of common influenza viruses increases in fall and winter. If two influenza viruses share the same host, they can share genetic information and mutate more quickly.

“You don’t want people affected with the seasonal flu virus to get a virus from animals and for those viruses to potentially recombine,” said Dr. Peter Rabinowitz, a professor of environmental and occupational health sciences at the University of Washington and the director of its Center for One Health Research.

Rabinowitz added that it is important to improve protection protocols for farmworkers and encourage them to get their flu shots. 

“This is a wakeup call. We need to do a better job of protecting workers,” he said.

Itle said cases in poultry were not unexpected in Washington state, because migrating birds passed through during summer and early fall. Recently, owls and other birds of prey were found dead, suggesting some wild animals had been stricken with the virus. 

Wild birds can spread the virus to farms through direct contact with poultry or livestock or via droppings, saliva or feed.  

More than 103 million birds have been sickened, killed or culled in the current bird flu outbreak, according to CDC statistics. The virus has been detected in poultry in 48 states. 

The CDC says 330 dairy herds have been affected. 

Washington has not had an outbreak among dairy producers, Itle said, but dairy farms there are now testing weekly.

This story first appeared on NBCNews.com. More from NBC News:

• E. coli outbreak linked to McDonald’s Quarter Pounders in multiple states
• Half of all global food threatened by growing water crisis, report says
• Meteorologists say they're facing pushback like never before, despite highly accurate forecasts

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The study tracked 30 years of living kidney donation and found that by 2022, fewer than 1 of every 10,000 donors died within three months of the surgery. Transplant centers have been using older data – citing a risk of 3 deaths per 10,000 living donors – in counseling donors about potentially deadly surgical complications.

“The last decade has become a lot more safe in the operating room for living donors,” said Dr. Dorry Segev, a transplant surgeon at NYU Langone Health. He co-authored the study published in the journal JAMA.

Newer surgical techniques are the key reason, said Segev, calling for guideline updates to reflect those safety improvements – and maybe increase interest in living donation.

He often finds transplant recipients more worried about potential risks to their donors than the would-be donors themselves.

“For them, this is even more reassuring to allow their friends or family to donate on their behalf,” Segev said.

Thousands of people die each year waiting for an organ transplant. It’s possible for living donors to give a one of their two kidneys or part of a liver, the only organ that regenerates.

With nearly 90,000 people on the U.S. list for a kidney transplant, finding a living donor not only shortens the yearslong wait — those organs also tend to survive longer than ones from deceased donors.

Yet last year, just 6,290 of the nation’s more than 27,000 kidney transplants came from living donors, the most since before the pandemic. Safety isn’t the only barrier to living donation. So is awareness, as many patients are reluctant to ask. And while the recipient’s insurance covers medical bills, some donors face expenses such as travel or lost wages as they recover.

The NYU team analyzed U.S. records of more than 164,000 living kidney donations from 1993 through 2022 and found 36 post-surgical deaths. Most at risk were male donors and those with a history of high blood pressure.

Only five of those deaths occurred since 2013. That period coincided with U.S. transplant centers switching to minimally invasive kidney removal as well as adopting a better way to stop renal artery bleeding, Segev said.

“Over time, it’s a safe operation that’s become even safer,” important for would-be donors to know, said Dr. Amit Tevar of the University of Pittsburgh Medical Center, who wasn’t involved in the study.

But there are long-term risks to consider, too, he stressed — including whether a donor’s remaining kidney is expected to last the rest of their life.

The risk of a donor later experiencing kidney failure also is small and depends on such factors as obesity, high blood pressure, smoking and family history of kidney disease. Risk calculators help doctors determine a potential donor’s likelihood of later-in-life trouble, and transplant centers may have slightly different eligibility criteria.

“There’s no such thing as a moderate- or high-risk donor — either you’re perfect or you’re not,” is how Tevar puts the decision to accept or turn away a potential donor.

Doctors once thought young adults were the ideal living donor. But Segev said there’s a shift toward more older living donors because it’s easier to correctly predict that they won’t outlive their remaining kidney.

If a living donor later experiences kidney failure, they get priority for a transplant, he noted.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Four new cases of avian influenza were detected in farmworkers in Washington state this week, the latest in a drumbeat of human infections cropping up across the U.S. as the virus continues to spread among farm animals. 

Washington is the sixth state to report human cases of bird flu, which has spread rampantly in wild birds, poultry and cattle. Assuming the Centers for Disease Control and Prevention confirms the state’s positive tests, they will bring the U.S. tally to at least 31.

Flu experts said the risk of a broader outbreak among humans will continue to simmer if the virus remains uncontrolled in animals.

“The longer this virus hangs out in the environment, the more animals it spills over into, the more it changes in ways we don’t understand or predict, the more concerned we are going to be that this becomes the next global pandemic,” said Dr. Amber Itle, the Washington state veterinarian.

For now, however, health officials maintain that the virus has not made key genetic changes that would allow it to spread between people. 

“There is no evidence of any sustained human transmission. And that is a key milestone for all of us. It’s a key trigger for all of us. That’s when we really start to say, ‘Oh, something that’s markedly different about this virus,’” Dr. Umair Shah, Washington’s health secretary, said at a news conference Sunday. 

A CDC spokesperson said Tuesday morning that a federal team was being deployed to Washington and that risk to the public remained low. 

However, the virus is a growing concern for farmworkers on the front lines. The four latest cases were among workers who had culled birds at a commercial egg farm where an outbreak of avian influenza was reported in chickens.

Shah said the workers were part of a contract crew tasked with depopulating — or euthanizing — all chickens at the farm in Franklin County, in southeastern Washington, which had more than 800,000 birds. Itle said the workers wore full protective equipment: suits made of Tyvek, goggles and respirators. 

“It’s hot, it’s dusty. It’s a lot of birds in close proximity, and we’re getting a lot of viral exposure,” she said.

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The four people who tested positive after that work reported mild respiratory symptoms and conjunctivitis, or pink eye — symptoms now understood to be common when people are infected. None of the workers were hospitalized. 

Dr. Richard Webby, director of the World Health Organization Collaborating Center for Studies on the Ecology of Influenza in Animals and Birds, said the Washington cases represented “more of the same” in a pattern observed across the U.S. as workers tasked with culling sick animals have fallen ill. 

However, one human case — in Missouri — has puzzled researchers and health officials, because that person did not have contact with animals. It is not clear how the person was exposed, and results of further tests that could offer clues are still pending, according to the CDC. Six health workers exposed to the patient reported respiratory symptoms.

Webby said the virus’ spread in cows for the past 10 months has raised experts’ level of concern because cows are mammals and interact with humans frequently. That increases the likelihood the virus could mutate to pass from person to person. 

“Just because it hasn’t happened in 10 months … it doesn’t mean it can’t,” said Webby, an infectious disease researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee. 

Research suggests that incredible amounts of virus are shed in infected cows’ mammary glands, so the virus could spread through raw milk. (Milk sold in grocery stores is pasteurized, which inactivates the virus.) 

At the same time, the U.S. is preparing for flu season, when circulation of common influenza viruses increases in fall and winter. If two influenza viruses share the same host, they can share genetic information and mutate more quickly.

“You don’t want people affected with the seasonal flu virus to get a virus from animals and for those viruses to potentially recombine,” said Dr. Peter Rabinowitz, a professor of environmental and occupational health sciences at the University of Washington and the director of its Center for One Health Research.

Rabinowitz added that it is important to improve protection protocols for farmworkers and encourage them to get their flu shots. 

“This is a wakeup call. We need to do a better job of protecting workers,” he said.

Itle said cases in poultry were not unexpected in Washington state, because migrating birds passed through during summer and early fall. Recently, owls and other birds of prey were found dead, suggesting some wild animals had been stricken with the virus. 

Wild birds can spread the virus to farms through direct contact with poultry or livestock or via droppings, saliva or feed.  

More than 103 million birds have been sickened, killed or culled in the current bird flu outbreak, according to CDC statistics. The virus has been detected in poultry in 48 states. 

The CDC says 330 dairy herds have been affected. 

Washington has not had an outbreak among dairy producers, Itle said, but dairy farms there are now testing weekly.

This story first appeared on NBCNews.com. More from NBC News:

• E. coli outbreak linked to McDonald’s Quarter Pounders in multiple states
• Half of all global food threatened by growing water crisis, report says
• Meteorologists say they're facing pushback like never before, despite highly accurate forecasts

This story uses functionality that may not work in our app. Click here to open the story in your web browser.

The NBC4 I-Team and Telemundo 52 Investiga have been looking into the increasing number of silicosis cases in California. Silicosis is a lung disease affecting stone-cutting workers working with engineered or artificial stone.

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Cesar Gonzalez says he felt like the floor was being pulled from under him last December when he was diagnosed with silicosis.

“To be honest, I wanted to scream. I wanted to cry,” he said.

According to doctors, silicosis is caused by inhaling silica dust from working with artificial stone used in kitchen and bathroom countertops.

“You feel like you’re trapped in your own body,” Gonzalez said of his condition.

Cesar says he started working at a shop cutting engineered stone when he was 18. At 36, he is now connected to an oxygen tank and waiting for a lung transplant, while also trying to get worker’s compensation from his employer.

But when he tried to contact his employer, he said neither he nor his attorney could get an answer about coverage.

“We believe that there is no worker’s compensation insurance coverage, and as such, we will probably have to join a state agency to cover worker’s compensation benefits,” Gary Rodich, of Rodich Law, said.

Worker’s compensation insurance covers employee expenses resulting from accidents and illnesses caused in their places of employment. But Rodich has discovered some employers in the stone-cutting industry aren’t keeping up with their coverage, which he says is illegal. And, in other cases, the silicosis diagnosis is denied from coverage.

“We’ve got several of these cases, almost all of them have been denied by the worker’s compensation insurance carrier,” Rodich added.

These types of cases have now gotten the attention of California Insurance Commissioner Ricardo Lara.

“So we first noticed that there was some delays in granting worker’s comp rights to some of the silicosis patients through your reporting, actually,” Lara said.

Lara tells us our reporting prompted him to write a letter to the Worker’s Compensation Insurance Rating Bureau requesting a detailed study on silicosis claims across the state.

He wants answers to questions like the number of silicosis cases filed in the past 10 years and the average medical costs related to these claims. He says all employers in the state must offer some form of worker’s compensation coverage.

“Worker’s comp in California is critical to protect our workers. Everybody can access worker’s comp. Even our undocumented community is something we’re very proud of because we know that we keep all our workers healthy, it contributes to their own economic wellbeing, but it contributes to the overall wellbeing of our economy here in California,” Lara said.

The NBC4 I-Team reached out to Cesar’s most recent employer in North Hollywood, listed on a legal claim provided to us by his attorney, requesting information about worker’s compensation coverage. Despite several attempts, neither our partners at Telemundo 52 Investiga or the I-Team received a response.

We also searched on the state’s workers compensation insurance rating bureau webpage, where anyone can see if an employer has workers comp insurance. No information about the business came up.

Rodich says he wants more to be done on the state level – beyond the proposed study.

We have been tracking cases of silicosis related to engineered stone in California and more continue to be identified. As of Aug. 15, the state’s department of public health tells the I-Team there are 176 of these types of cases in the state. Sixty percent are Los Angeles County residents, according to our analysis of the data.

TikTokers have seized on the treat’s mouthwatering colors and popularized a quick method involving the microwave. They promise the signature glassy coating with only a couple of ingredients and in just five minutes, but doctors in multiple countries are speaking out to warn parents of an uptick in burns, some severe enough to require skin grafts.

In order to reach the “hard crack” stage for that shiny coating, sugar must be heated to at least 300 F, much hotter than just boiling water. And, because it is sticky and viscous, it can result in prolonged skin contact that may make a scalding injury much more dangerous.

Surgeon Dr. Colleen Ryan of Boston hospital Shriners Children’s said in an Aug. 14 press release that they recently saw two patients with just this injury in the space of only two weeks, and that international word of mouth among doctors is reporting multiple cases of deep burns occurring with the technique shown on social media.

Australian food scientist and dietitian Ann Reardon of How to Cook That is sounding the alarm as well, in a YouTube video explaining the potential dangers of using an appliance that can only accommodate plastic or glass, for a recipe that should be made in a heatproof metal pan. As she shows in the video, even microwave-safe plastic containers can collapse or leak molten sugar at those high temperatures. Other injuries, she reports, could result if a superheated glass container is moved from the microwave to a cold kitchen counter, where the temperature shift can cause shattering.

Does this mean that gorgeous homemade tanghulu is out of reach? Although it must be done with proper equipment and appropriate supervision, working with sugar syrup is absolutely possible in a home kitchen — if you know the right tricks.

When we caught up with content creator Emmy Cho of Emmymade to ask about her own tanghulu attempt, she recounted something of a journey to getting the glassy texture just right.

“It’s so beautiful and catches people’s eyes, but for me, it was a real lesson in sugar chemistry,” Cho told TODAY.com. Her first attempt seized up, but she found the key was adding corn syrup, which interferes with the organization of the sucrose molecules into crystals. She also found that you really do have to heat it to that scorching 300 F to get that characteristic crunch.

Cho reiterates the messages that sugar syrups should never be made in the microwave, and that kids must have supervision even if using a metal pan on the stovetop.

“I think I kind of equate it to deep-fat frying,” she says, “but even more dangerous, because it’s sticky.”

That said, she hopes parents will take this warning to heart by seeking out ways to include their children in meal preparation, safely.

“I’m all for experimenting!” Cho says. “You have to teach your kids how to cook, both so they are capable and for their long term health.” She suggests “finding their interest point,” noting that while one of her kids enjoys helping cook entire meals with her, the other is more interested in the math of weighing baking ingredients. She has taken a gradual approach to making sure they know their way around the kitchen.

“It’s small steps — first they had to make their own breakfast, and then later they had to pack their snacks.” These days, they’re responsible for making their own lunches in addition to participating in dinner prep.

That time spent together will lead to the competence that can help prevent kitchen accidents like burns.

You could even make her new fried chicken version of tanghulu: “Glass KFC.” As Cho always says, “Take a big bite!” —  just don’t use the microwave.

This story first appeared on TODAY.com. More from TODAY:

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Fauci, who also served as the chief medical adviser for the Biden administration, was sent home on Saturday and is now recovering, according to his spokesperson. He is expected to fully recover.

The virus first entered the U.S. in 1999, and it has become the leading cause of mosquito-borne disease in the country, per the CDC. 

According to the Department of Health and Human Services, the West Nile virus (WNV) is the most common mosquito-borne disease in the US, and around 2,205 cases are reported each year.

But what is the West Nile virus and what are its symptoms? Here’s what to know

What is the West Nile Virus?

The West Nile virus is a disease that most commonly spreads through mosquito bites, according to the Centers for Disease Control and Prevention.

The virus was first detected in the U.S. in 1999 after two men in New York City tested positive for the virus, which it is believed first arrived in the country through an infected mosquito or bird.

So far, over 200 cases of West Nile have been detected nationwide in 2024, according to CDC data.

What are the symptoms of West Nile virus?

Approximately 80% of the people infected with WNV will not develop any symptoms. 20% will experience mild flu-like symptoms such as fever and less than 1% will develop severe long-term effects which sometimes can be deadly, according to HHS.

The symptoms include:

• Body aches
• Diarrhea
• Fever
• Headache
• Vomiting

Among the most serious complications are meningitis, paralysis or death.

When do West Nile symptoms start to show?

Symptoms generally appear between two to 14 days after being bitten but sometimes it could be several weeks before symptoms show up in immunocompromised people, according to the CDC.

How to cure West Nile virus?

According to the CDC, there is no specific treatment for West Nile virus though doctors usually recommend pain medication for headaches and antiemetic therapy and rehydration to treat nausea and vomiting.

How to protect yourself from West Nile virus?

The best way to protect yourself from West Nile is to dress in loose-fitting clothing that covers arms and legs when outside. Using air conditioning and adding screens to open doors and windows is also recommended.

Fauci, 83, who was chief medical adviser to President Joe Biden, became a household name during the Covid pandemic. Fauci left as director of the National Institute of Allergy and Infectious Diseases in 2022.

“Tony Fauci has been hospitalized with a case of West Nile virus. He is now home and is recovering,” a spokesperson said in a statement Saturday.

He is expected to make a full recovery.

West Nile virus is commonly spread through infected mosquitos, and there is no vaccine or treatment. As of Aug. 24, there were 216 human West Nile cases reported in 33 states. Of those cases, 142 were neuroinvasive, meaning people developed a severe form of the disease such as inflammation of the brain or the membranes surrounding the brain and spinal cord. These cases typically require hospitalization.

Several hundred to several thousand cases are reported in the United States each year. Most cases are reported in August and September.

Disease experts said that more West Nile virus had been circulating this summer than was expected, with at least seven states having confirmed human cases by June 25. A record-breaking number of mosquitoes in and around Las Vegas were found to have been carrying the virus earlier this year.

This article first appeared on NBCNews.com. Read more from NBC News here:

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My life has demanded a certain amount of courage. I was born in Cleveland, Ohio, in 1922, shortly after the start of Prohibition. My father, who was a bootlegger, got into a turf war with the mafia, and he was killed in our driveway when I was just two years old. 

I got married a month after my 19th birthday and went straight from my mother’s home to my husband’s. Three kids and 25 years later, I left that unhappy marriage and loved being out on my own.

In my 40s, I had my first experience of supporting myself and being myself. I started writing for newspapers and later, after I remarried, had the luxury of writing novels full time. 

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Today, as a 101-year-old in Austin, I’m living the kind of life I feel fortunate to have. I still do things I love — like publishing my ninth book earlier this year, spending time with people I love, and reading. It’s a quieter life than I had as a younger woman, but these years are good ones. I wish more people my age knew that. 

Here are eight lessons I’ve learned that have helped me live a long, happy life: 

1. Don’t ever believe you’re ‘done’

Some cultural ideas are good, but many are wrong. People give up on their lives much too early. 

When your mind focuses on what the culture teaches us — that we’re done when we get past a certain age — it gets into our sense of self. If our sense of self is to be alone and sad and useless when we are 70, 80, 90, whatever, we believe it. And that’s really dangerous. 

People have gifts that they may not know they have, and it may take a lifetime to find them. 

2. Talk to friends of all ages

My friends are a wonderful source of wisdom, energy and authenticity. 

I have a few friends that are two and three generations younger. I’ve learned from them, and I think they’ve learned from me. Each decade teaches us something else. 

There’s a huge difference between being 30 or 40 and being 90 or 100. And yet, when we come together, it can be fabulous because we all have much to teach each other. It gives us another way to think about things.

When I get together with my friends, we mostly talk. Talk is exhilarating when it’s good.

3. Let little things make your day

It’s not the top of the mountain that makes us happy. It’s the small pleasures. 

Our culture often tells us that if you want to be successful, it’s a big thing. It’s a big effort. It’s about big returns. But that doesn’t work. I don’t even know if the mountaintop exists, but small pleasures do exist, and they can be dynamite. 

We have to understand ourselves so that we can be authentic and find the little things that make us happy. For me, one is reading. Another is being with people I care deeply about — which can be family or friends. It’s a phone call, a visit, an idea, a worry shared. 

4. Have the courage to be authentic

Courage is probably, for me, the bottom line. It takes courage to look at yourself clearly, to know yourself, and to be authentic. 

But it gives you energy, confidence, and an understanding of yourself and others. In the long run, I believe that being authentic — disagreeing with someone, for example — makes even difficult relationships stronger. 

Being authentic doesn’t come easily. It takes some work to learn about yourself. But it’s worth it.

5. Do things you love

When I’m writing, I feel different. I feel better. I feel happier, I feel more centered. I feel more confident. Other writers I know tell me they feel the same thing. There’s really something magical about creative work. Of course, it’s not magic; it’s an expression of the human soul.

The pleasures you get from doing something creative that you love are tied to parts of the self that are not always available or conscious. 

It goes back to knowing yourself and being authentic. The way I get that is by writing. For someone else it might be painting or dancing. Sometimes I’ll come back and I’ll see something I wrote and think, “That’s good.” That means it opened my unconscious. That’s where the gems are.

6. Move your body, rest your mind

For about seven years, I’ve worked out with a trainer twice a week. For a 101-year-old, I’m strong. I can lift 10-pound weights and get up off a chair holding the weights. I’m so proud of that.

When I had pneumonia and I was in the hospital, someone there told me that my exercising probably saved my life. So it isn’t just a good idea — it’s essential.

At the same time, you have to get a lot of rest. The brain needs rest in order to rejuvenate.

7. Don’t get stuck in negativity

Negative thinking is common, and it’s a killer.

Why do some people feel optimistic and some, no matter what they say, it comes out negative? It’s how we’re born, I believe. We come into the world optimists or pessimists. Some people have such difficult times in their lives. If a pessimist would say, “Why me?” I would say, “Why not?”

It’s very hard to overcome negative thinking, but to the extent that we can, we need to acknowledge the positive and try to move forward with optimism.

8. Do what you know you need to do

As I’ve gotten older, I’ve often been asked, “What’s your secret?” I don’t have a secret.

Longevity is what everyone knows to be true. We all know: Exercise, good diet, a healthy personal relationship with a partner, an understanding of yourself, a career that’s good for you — these are the keys to a happy life. 

But there’s a gap between what we know and what we do. The problem for so many people is doing it. And that’s more mysterious than I can explain.

This as-told-to interview has been edited.

Babette Hughes is a writer who recently published her ninth book, “Lessons in Evil,” at the age of 101. She was born in Cleveland, Ohio, and grew up in the time of Prohibition and bootleggers. Though she’d previously published a memoir titled “Lost and Found,” she didn’t publish her first novel, “The Hat,” until 2015. She lives in Austin.

Stav Ziv is a contributors editor at CNBC Make It.

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NBC 5 Responds found some surprising and potentially harmful chemicals lurking in some of the more popular brands of dental floss.

Dentists assert flossing makes a huge difference – and that isn’t changing.

But the findings from a new Consumer Reports analysis of what’s in your dental floss might have you thinking twice about the type of floss you’re using.

“Some dental flosses use PFAS chemicals for a smoother glide,” said Catherine Roberts with Consumer Reports. “However, these ‘forever chemicals’ have been linked to various health issues and environmental concerns. Some flosses also contain undisclosed flavors and are made of plastic.”

Consumer Reports and MADE SAFE, a nonprofit focused on product safety and sustainability, recently analyzed ingredients in a variety of flosses.

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Ten flosses either failed to disclose their ingredients, contained PFAS, or included other components linked to health concerns, posing higher risks to consumers.

Three flosses stood out as favorites because they contain safer and more sustainable ingredients.

While companies aren’t required to disclose all ingredients in dental floss, Tom’s of Maine, Dental Lace, Cocofloss and Nudge provided Consumer Reports with complete ingredient lists and confirmed they don’t intentionally add PFAS to their products.

Procter & Gamble, makers of oral-b glide, confirmed that their floss contains PTFE, a type of PFAS, citing its performance benefits. However, they maintain it’s safe and free of certain phased-out PFAS.

The Humble Co. provided partial information, confirming PFAS-free status, but gave incomplete flavor details.

The other companies did not respond to Consumer Reports’ inquiries or answer questions.

For people who hate flossing with string, how about a water flosser?

“Water flossers, like Waterpik, work well for removing food debris,” Roberts said. “And although they may not be quite as effective as string floss at scraping away bacteria, they’re a great option for people who dislike string floss or find it difficult to use.”

Remember, the best flossing method is the one you’ll use regularly.

Consumer Reports recommends choosing flosses that are coated with natural substances like beeswax or plant-based waxes and look for floss made from biodegradable materials like silk or cotton and are either unflavored or flavored using disclosed, natural ingredients.

The 17-year-old stood up during his father’s speech and said, “That’s my dad,” later adding, “I love you, Dad.”

The governor and his wife, Gwen Walz, revealed in a People interview that their son was diagnosed with nonverbal learning disability as a teenager.

A 2020 study estimated that as many as 2.9 million children and adolescents in North America have nonverbal learning disability, or NVLD, which affects a person’s spatial-visual skills.

The number of people who receive a diagnosis is likely much smaller than those living with the disability, said Santhosh Girirajan, the T. Ming Chu professor of biochemistry and molecular biology and professor of genomics at Penn State.

“These individuals are very intelligent and articulate well verbally, but they are typically clumsy with motor and spatial coordination,” he told NBC News. “It’s called a learning disorder because there are a lot of cues other than verbal cues that are necessary for us to keep information in our memory.”

People with NVLD often struggle with visual-spatial skills, such as reading a map, following directions, identifying mathematical patterns, remembering how to navigate spaces or fitting blocks together. Social situations can also be difficult. 

“Body language and some of the things we think about with day-to-day social norms, they may not be able to catch those,” Girirajan said.

Unlike other learning disabilities such as dyslexia, signs of the disability typically don’t become apparent until adolescence. 

Early in elementary school, learning is focused largely on memorization — learning words or performing straightforward mathematical equations, at which people with NVLD typically excel. Social skills are also more concrete, such as playing a game of tag at recess. 

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“But as you get older, there’s a lot more subtlety, like sarcasm, that you have to understand in social interactions, that these kids might not understand,” said Laura Phillips, senior director and senior neuropsychologist of the Learning and Development Center at the Child Mind Institute, a nonprofit organization in New York.

In her own practice, she typically sees adolescents with NVLD, who usually have an average or above average IQ, when school demands more integrated knowledge and executive functioning, such as reading comprehension or integrating learning between subjects. They also usually seek help for something else, usually anxiety or depression, which are common among people with NVLD. 

Sometimes misdiagnosed as autism

Amy Margolis, director of the Environment, Brain, and Behavior Lab at Columbia University, is part of a group of researchers that is beginning to call the disability “developmental visual-spatial disorder” in an effort to better describe how it affects people who have it.

People with NVLD are “very much verbal,” Margolis said, contrary to what the name suggests.

The learning disability is sometimes misdiagnosed as autism spectrum disorder. Margolis led a 2019 study that found that although kids with autism spectrum disorder and NVLD often have overlapping traits, the underlying neurobiology — that is, what’s happening in their brains to cause these traits — is unique between the two conditions.

Margolis is trying to get NVLD recognized by the DSM-5, the handbook health care providers use to diagnose mental health conditions. Without such official recognition, people with NVLD can struggle to get the resources they need, such as special class placements or extra support in school.

“Without an officially recognized diagnosis, it’s hard for parents to understand how to seek information, and then communicate to other people what kinds of things might be challenging for their kid,” Phillips said, adding that widespread awareness is key to helping these families navigate NVLD.

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“That was terrifying,” Michael Storch, 37, of Glencoe, Illinois, tells TODAY.com. “I’m not exaggerating about 60 medical professionals came onto our floor … rushing towards our room.”

Rachel Storch, 36, experienced an amniotic fluid embolism, “a rare but unpredictable and usually catastrophic obstetric emergency,” says Dr. David Ouyang. Suddenly, Michael Storch felt unsure his wife would survive.

“(A staff member) said, ‘You need to call whoever you think needs to be in here in case of the worst,’” he recalls. “I still didn’t understand how serious things were.”

A history of uterine scarring

When Rachel Storch gave birth to the couple’s first daughter, Olivia, on January 22, 2020, everything went “smoothly.”

“They did have trouble getting the placenta out,” Rachel Storch says. “All was fine. I ended up going home.”

Only two days later, though, she experienced “terrible cramps,” that felt like contractions that caused her to writhe in pain on the apartment floor. Later she passed huge blood clots. She visited her doctor, who sent her home by saying that sometimes things like that happened after delivery. As her bleeding increased, she worried.

“I thought something was wrong,” she says. “It was three weeks later to the day that I ended up in the emergency room. I needed back-to-back D&Cs for a retained placenta.”

After the first dilation and curettage (D&C), a procedure that helps doctors remove tissue from the uterus, Rachel Storch started bleeding heavier and doctors needed to perform a second one using ultrasound guidance to slow the hemorrhaging.

“I had a balloon in (my uterus) to stop the bleeding,” she says. “They were measuring how much blood I was losing every 30 minutes to an hour that I was there for the next 24 hours. It was definitely scary.” Once she was stable, she was able to go home and she started recovering. About a year later, though, she experienced more problems and underwent a saline ultrasound where doctors discovered a band of scar tissue encircling her uterus.

A specialist found that scar tissue encased 70% of her uterus and she underwent a surgery to remove it. About a month later and with her doctor’s encouragement, Rachel and Michael Storch tried to get pregnant a second time and they did. But at six weeks, Rachel Storch had a miscarriage.

“We went back to the doctor, she said, ‘All of this scar tissue was back,’ so she removed it again,” Rachel Storch says.

The couple decided to pursue IVF and surrogacy because doctors were unsure if Rachel Storch could get pregnant again. In the meantime, she had to undergo two more procedures to remove excessive scar tissue.

The couple eventually had four viable embryos in September 2022 when they began searching for a surrogate. By March 2023, they matched with one soon after Rachel Storch underwent one final procedure to remove scar tissue from her uterus. In August, they had their first embryo transfer, and it was successful. But just a week prior, the couple received some surprising news.

“I found out I was pregnant,” Rachel Storch says. “We just couldn’t believe it. We didn’t think it was real.”

With her history of miscarriage and scar tissue on her uterus, the couple was anxious about this pregnancy. They later learned from a doctor that he thought there was a “1% chance this (pregnancy) would stick.” But still Rachel Storch’s pregnancy continued normally while her surrogate’s pregnancy also went well. Neither experienced high blood pressure, gestational diabetes or any complications and the babies looked healthy.

“We actually didn’t tell my surrogate until I was 20 weeks because I just couldn’t believe it,” she says.

A rare pregnancy complication

Rachel Storch was due April 27, 2024, and their surrogate was due May 16. Doctors planned to induce both labors. When Rachel Storch arrived on April 22 for her induction, she had no reason to believe anything unusual would occur — even with her past health troubles. Her pregnancy wasn’t even considered high risk.

Yet still, she doesn’t remember anything after she told doctors she was struggling to breathe. Outside of her room, Michael Storch worried about his wife’s life.

“We didn’t really understand what was going on,” he says. “For two hours we were just getting periodic updates. Those were kind of terrifying.” 

Later the couple learned that Rachel Storch “had no pulse or heartbeat for 30 seconds,” also known as cardiac arrest, while giving birth.  

“The doctor knew immediately what went wrong,” she says. “They immediately started giving me blood.”

Doctors recognized that Rachel Storch experienced an amniotic fluid embolism, which is “like having an allergic reaction,” after amniotic fluid enters the mom’s bloodstream, she says.

“They said it’s completely unpredictable and completely random,” she says. “They also said there’s no treatment, so doctors are basically just responding to your symptoms.”

Ouyang, Rachel Storch’s doctor and division director of maternal-fetal medicine at Endeavor Health, where she was treated, was performing a C-section when he saw staff rush to her room. He suspected she was experiencing an amniotic fluid embolism, what’s considered an emergency.  

“When amniotic fluid enters the patient’s circulation (it) essentially triggers an overreaction of the immune system, similar to an allergic reaction,” he tells TODAY.com. “The reaction causes two life-threatening events. First the heart and lungs fail, and second, the body’s clotting system goes into disarray, causing severe and persistent bleeding.”

It’s “exceedingly rare,” Ouyang says. “You’re literally more likely to be struck by lightning twice.”

Still, there is no way to identify people at risk of experiencing an amniotic fluid embolism.

“There’s not really objective measures to identify if someone’s going to have it,” he says. “Because we don’t know why it occurs, we can’t do testing (to predict it).”

The staff needed to help Rachel Storch deliver her baby while stabilizing her health. Nurses and residents took turns preforming CPR while the baby was crowing and then doctors used a suction to remove the baby. Then doctors placed Rachel Storch a ventilator and ECMO, a machine that works for the heart and lungs so they can recuperate. But they struggled to control her hemorrhaging.

“She was losing so much blood,” Michael Storch says. “The blood was all being retained in her belly.”

Doctors found 7 liters of blood in her abdomen. They needed to operate on her, but it was risky.

“It was becoming life threatening because it was putting so much pressure on all of her organs,” Michael Storch says. “She wasn’t strong enough … the surgeon basically told me, ‘We’re in between a rock and a hard place. We have to take the blood out of her body. We don’t know if she can (survive).’”

Surgeons found the source of the bleeding, a laceration in her liver, and they stopped that bleeding. Throughout her 18-day stay in the hospital, Rachel Storch received 70 units of blood. Following surgery, Rachel Storch steadily gained strength. Six days after delivery, doctors took her off ECMO and she stayed on the ventilator for an additional day.

As she regained consciousness she experienced “really crazy hallucinations,” and saw people who weren’t there. It wasn’t until she was transferred out of the ICU two days later that she started remembering. Still, her short-term memory remained spotty.

“I didn’t know that I went to the hospital to have a baby,” she says. “I didn’t even know about the baby.”

That baby, Sydney, was healthy and she visited her mom in the ICU.

“When Rachel was a little more stable, we started bringing Sydney,” Michael Storch says. “They were really powerful (visits).”

Sydney rested on Rachel Storch even if she couldn’t hold her or do skin-to-skin thanks to the wires and tubes her mom still needed. Still, the family believes the contact helped steady her blood pressure. On May 9, Rachel Storch moved to a rehabilitation hospital. This too was complicated since Michael Storch had to be with their surrogate who was being induced and later delivered baby, Remi.

“She got put in the NICU (neonatal intensive care unit) for 10 days,” Rachel Storch says. “It was just a lot. Michael was running between me at rehab, our 4-year-old who was at home, and then Remi who was at the NICU in (another) hospital.”

Going home

Doctors thought Rachel Storch would need to be at in-patient rehabilitation for up to three weeks. But she treated it like “boot camp” because she wanted to go home to her family.

“I went to PT and then I was so exhausted I slept in my chair and then I’d go to (occupation therapy) and then rest and then go back to PT,” she says. “It was intense. But it was good.”

After a week on May 16, Rachel Storch returned home while Remi was still in the hospital. Their eldest daughter, Olivia, 4, had a dance recital that Rachel Storch was excited to see. After that, they picked up Remi from the hospital on May 19.

“It’s pretty surreal to be all home together,” she says. “I still have limitations. I’m exhausted. But I’ve recovered pretty quickly. Sometimes it’s hard to remember where we were a few weeks ago.” 

The couple treats Sydney and Remi “like twins.”

“They’re just 18 days apart,” Rachel Storch says. “It’s funny at this age we’re able to see the difference a few weeks makes.”

The couple feels grateful that the staff “recognized immediately what happened” and worked to save Rachel Storch’s life.

“Just spreading awareness and helping other doctors and hospitals learn can hopefully save other women’s lives,” she says.

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Doctors are trying to figure out why it’s becoming increasingly common: Colorectal cancer rates among younger people are rising by 1% to 2% every year.

It’s a lesser-known and less-funded cancer, which is why one survivor is sharing his story – in hopes that his ordeal can help save someone else.

Survivor only noticed 1 symptom of his colorectal cancer

For Jeff Harris, a diagnosis of stage-three colorectal cancer at just 40 came as a huge surprise.

The husband and father of two was shocked because he showed almost no signs of serious illness – except one concerning symptom that is common among colon cancer patients.

“I felt fine. I had rectal bleeding one day. That was significant and was something… I was like, ‘That’s not good,’” he said.

A colonoscopy showed a large mass on his colon.

“Time kind of stood still,” he recalled.

He soon went in for surgery, which revealed his cancer wasn’t just in his colon.

“Woke up from surgery and my surgeon said, ‘Well, everything was fine, except it was more in your rectum than it was your colon. So, it was kind of just kind of both. Rectosigmoid junction,” he said, referring to a zone where the rectum and colon meet.

After surgery came chemotherapy. He did 10 rounds of infusions, 28 rounds of radiation and oral chemotherapy. Today, his scans show no evidence of disease.

‘Alarming’: Why are colorectal cancers becoming more common?

Harris is not alone. He’s met many folks much younger than him – even in their late 20s and early 30s – who have colorectal cancer.

“Some of them, you know, aren’t with us today. So, it’s alarming,” he said.

John Marshall, the chief medical officer at Lombardi Comprehensive Cancer Center, is among doctors trying to figure out why colorectal cancer rates are on the rise among younger people.

The leading theory relates to the bacteria that grow in the mouths and guts of all humans. Everyone has their own “microbiome” made up of bacteria and other microbes that can be helpful or harmful to their health.

“We evolved over time to include bacteria in our mouths and our GI [gastrointestinal] tracts. Think of it as your own personal soil,” Marshall said. “So, our leading theory is: Just like we’re changing our air and we’re changing our water with the world around us, we are probably also changing the world inside of us, our own microbiome.”

Colorectal cancers show up in different locations than colon cancers.

“They’re all in that bottom part of the question mark of the colon,” Marshall said. “Whereas normal, older colon cancer can be seen anywhere throughout the colon.”

Colorectal cancer symptoms and screening: ‘Don’t worry about the colonoscopy’

According to the Colorectal Cancer Alliance, the most common symptom is no symptom at all.

Colorectal cancer symptoms could include blood in your stool, a change in bowel habits, abdominal pain, weakness or fatigue and weight loss.

“There’s still stigma around it because people don’t want to talk about colons, rectums, poops and all that,” Harris said.

It’s important to talk about the signs of colorectal cancer. Reluctance to talk about a sensitive area of the body can slow the process of getting diagnosed and treated.

Routine screenings can help identify potential cancer in earlier stages when it’s easier to treat. Doctors may even be able to remove concerning polyps – small tissue growths – before they turn cancerous, according to the American Cancer Society.

Doctors say everyone should begin screenings for colon cancer when they’re 45, regardless of whether they have symptoms or not. People who have a family history of the disease or other risk factors should get screenings even earlier in life.

Screenings can be done with a traditional colonoscopy, but there are less invasive options.

“I will tell anybody that has any kind of symptoms. Get it checked out. Don’t worry about the colonoscopy. It’s not bad. Colonoscopy is a walk in the park compared to cancer treatment,” Harris said.

Dr. Marshall says it’s important to figure out what’s going on – and figure it out fast.

The Colorectal Cancer Alliance has advice on how to talk to your doctor about screenings. There’s also information on financial help for people who can’t afford screenings.

Colorectal cancer prevention

Dr. Marshall says the colorectal cancer trend is scary. His best advice?

“It really comes back to a Mediterranean diet. A little less meat. It’s not evil, but less of it. Lots of fruits, nuts, little coffee chaser. And keep moving, keep exercising,” he said.

Other lifestyle changes that can help include minimizing processed foods.

Fundraiser planned in Potomac, Maryland

In 2022, Harris rang the hospital bell marking that he’s cancer-free. Since then, he’s shown no evidence of disease.

Now, he is focused on living, spreading the word and fundraising.

The Colorectal Cancer Alliance is hoping to raise much-needed funds to research the disease.

They’re holding the first-ever Contactors Against Cancer golf tournament on Aug. 25-26, 2024, at Avenel Farm in Potomac, Maryland. Edwin McCain and Ryan Cabrera will be part of the two-day event. Here’s more information.

In January, Elmo had asked X users a seemingly innocent question: “Elmo is just checking in! How is everybody doing?” — only to be met with declarations of “existential dread,” mental burnout and general disenchantment with daily life.

The dreary responses inspired Sesame Workshop, the nonprofit behind “Sesame Street,” to undertake a survey project focusing on the “state of well-being in America.”

Conducted in partnership with consulting and market research firm The Harris Poll, “The State of Well-Being Report” interviewed 2,012 members of the U.S. population ages 16 and older in May. The survey was published Tuesday.

When asked about what they prioritize when it comes to the future of well-being, the majority of the participants found mental health nearly as important as economic stability, according to the findings.

“We could not have predicted the overwhelming response that followed Elmo’s post,” Samantha Maltin, chief marketing and brand officer of Sesame Workshop, said in a news release, adding that the Muppet’s post drew millions of responses. “As Elmo’s viral moment and this new study indicate, the most pressing issue facing American families right now is mental health and emotional well-being.”

0 seconds of 1 minute, 28 secondsVolume 89%

A third of parents and half of teens also said mental health issues significantly affect their well-being, with many parents citing lack of access to high-quality education and consequences of the Covid-19 pandemic as sources of negative impact.

Other common stressors on well-being reported in the survey include physical health, the effects of climate change, lack of a strong network of friends or family, and racism or discrimination.

When Elmo’s innocent question went viral in January, the official X account for “Sesame Street” shared a link to mental health resources.

Aaron Bisman, the vice president of audience development at Sesame Workshop, told NBC News at the time that “leveraging the interest in Elmo’s tweet” to share resources for emotional well-being is “exactly what Sesame Workshop was created to do.”

Despite all the apparent doom and gloom online, the survey also reported a glimmer of hope for the next generation of Americans: 67% of those interviewed said they wish their parents had been more honest about their own mental health struggles, including 79% of parents.

A majority of Gen Z and millennials — as well as 71% of educators surveyed — also said that they believe schools “should focus on social and emotional skills just as much as academics.”

While there appears to be a significant gap between the percentage of participants who believe they themselves practice kindness (93%) and those who believe the average American is kind (55%), a vast majority of people surveyed said it’s important to promote kindness in society.

In an appearance in February on NBC’s “TODAY” show, Elmo shared a message of empathy and urged people to check in on their friends.

“It’s important to remember that we all have a lot of feelings, and that’s OK,” the furry red Muppet said. “It’s good to know what feeling you’re having, and if you’re feeling sad or worried or confused, then you have to talk to someone that you love and trust, and it’s good to talk about it.”

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