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    A Bird Flu Pandemic Would Be One of the Most Foreseeable Catastrophes in History

    Almost five years after Covid blew into our lives, the main thing standing between us and the next global pandemic is luck. And with the advent of flu season, that luck may well be running out.The H5N1 avian flu, having mutated its way across species, is raging out of control among the nation’s cattle, infecting roughly a third of the dairy herds in California alone. Farmworkers have so far avoided tragedy, as the virus has not yet acquired the genetic tools to spread among humans. But seasonal flu will vastly increase the chances of that outcome. As the colder weather drives us all indoors to our poorly ventilated houses and workplaces, we will be undertaking an extraordinary gamble that the nation is in no way prepared for.All that would be more than bad enough, but we face these threats gravely hobbled by the Biden administration’s failure — one might even say refusal — to respond adequately to this disease or to prepare us for viral outbreaks that may follow. And the United States just registered its first known case of an exceptionally severe strain of Mpox.As bad as the Biden administration has been on pandemic prevention, of course, it’s about to be replaced by something far worse. Robert F. Kennedy Jr., Donald Trump’s pick to lead the nation’s vast public health agency, has already stated he would not prioritize research or vaccine distribution were we to face another pandemic. Kennedy may even be hastening its arrival through his advocacy for raw milk, which can carry high levels of the H5N1 virus and is considered a possible vector for its transmission.We might be fine. Viruses don’t always manage to adapt to new species, despite all the opportunities. But if there is a bird flu pandemic soon, it will be among the most foreseeable catastrophes in history.Devastating influenza pandemics arise throughout the ages because the virus is always looking for a way in, shape shifting to jump among species in ever novel forms. Flu viruses have a special trick: If two different types infect the same host — a farmworker with regular flu who also gets H5N1 from a cow — they can swap whole segments of their RNA, potentially creating an entirely new and deadly virus that has the ability to spread among humans. It’s likely that the 1918 influenza pandemic, for example, started as a flu virus of avian origin that passed through a pig in eastern Kansas. From there it likely infected its first human victim before circling the globe on a deadly journey that killed more people than World War I.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Dr Martin Makary Chosen to Head the FDA

    President-elect Donald J. Trump announced on Friday that he would nominate Dr. Martin A. Makary, a Johns Hopkins University surgeon with a contrarian streak, to be commissioner of the Food and Drug Administration.In a post on social media, Mr. Trump said: “F.D.A. has lost the trust of Americans and lost sight of its primary goal as a regulator.” He said that Dr. Makary would work under Robert F. Kennedy Jr., the president-elect’s choice for the cabinet-level role as health secretary, to “properly evaluate harmful chemicals poisoning our nation’s food supply and drugs.”“I am confident that Dr. Makary, having dedicated his career to high-quality, lower-cost care will restore the F.D.A. to the gold standard of scientific research and cut the bureaucratic red tape at the agency to make sure Americans get the medical cures and treatments they deserve,” Mr. Trump said in a statement.Mr. Trump announced two other top health picks on Friday evening as well. He chose Dr. Dave Weldon, a physician and former congressman from Florida, to lead the Centers for Disease Control and Prevention.For years, Dr. Weldon championed the notion that thimerosal, a preservative once used widely in vaccines, caused an explosion of autism cases around the world. In 2007, he backed a bill proposing to take vaccine safety research out of the hands of the C.D.C. Health officials reject the idea that research shows any link between thimerosal and autism.Mr. Trump also put forward Dr. Janette Nesheiwat, a physician and Fox News contributor, to be surgeon general. She worked caring for patients after Hurricane Katrina, an announcement from Mr. Trump said, and on the front lines of the Covid pandemic in New York City. She also markets vitamin B and vitamin C dietary supplements.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Salmonella Outbreak Prompts Egg Recall by Wisconsin Farm

    Officials said 65 people in nine states have been infected in the outbreak, which has been traced to an egg farm. No deaths have been reported.A salmonella outbreak that has sickened dozens of people in nine states prompted a recall of certain brands of eggs on Friday after officials said they traced the source of the infections to a farm in Wisconsin.State health officials said that 42 of the 65 people infected were in Wisconsin. Many people reported eating eggs at restaurants in the state before they got sick.Officials were able to trace the source of the eggs to Milo’s Poultry Farms of Bonduel, Wis., where they identified the outbreak strain in a packing facility and a hens egg-laying house, the U.S. Centers for Disease Control and Prevention said.All carton sizes and egg types produced at the farm, which either bear the label “Milo’s Poultry Farms” or “Tony’s Fresh Market,” were recalled by the farm, the U.S. Food and Drug Administration said.The eggs were distributed to retail stores and food service suppliers in Illinois, Michigan and Wisconsin, the F.D.A. said. The recall includes all expiration dates. The exact number of eggs recalled was not immediately available.No deaths have been reported in the outbreak, but 24 people were hospitalized. The first case was reported in late May, but most infections were reported in July and August, according to the C.D.C.The reported number of people infected is likely an undercount because it usually takes weeks to determine if an infection is part of an outbreak and because some people may recover without testing for the bacteria, the C.D.C. said.Aside from Wisconsin, infections were reported in California, Colorado, Illinois, Iowa, Michigan, Minnesota, Utah and Virginia. Illinois reported the second-highest number of infections with 11, followed by Minnesota, which reported three.The symptoms of the bacterial infection include diarrhea, fever and abdominal pain and usually begin within three days of ingesting the contaminated food, the F.D.A. said.Symptoms usually clear up within a week, but people with weakened immune systems, including young children and older adults, are more susceptible to severe, and sometimes fatal, infections, the F.D.A. said.The egg recall came after a deadly summer outbreak of listeria that prompted the recall of seven million pounds of Boar’s Head deli meat products.That outbreak has resulted in nine deaths and dozens of hospitalizations and the temporary shutdown of a Boar’s Head plant in Virginia, where inspectors had found black mold, water dripping over meat and dead flies. More

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    How a Crisis for Vultures Led to a Human Disaster: Half a Million Deaths

    The birds were accidentally poisoned in India. New research on what happened next shows how wildlife collapse can be deadly for people.To say that vultures are underappreciated would be putting it mildly. With their diet of carrion and their featherless heads, the birds are often viewed with disgust. But they have long provided a critical cleaning service by devouring the dead.Now, economists have put an excruciating figure on just how vital they can be: The sudden near-disappearance of vultures in India about two decades ago led to more than half a million excess human deaths over five years, according to a forthcoming study in the American Economic Review.Rotting livestock carcasses, no longer picked to the bones by vultures, polluted waterways and fed an increase in feral dogs, which can carry rabies. It was “a really huge negative sanitation shock,” said Anant Sudarshan, one of the study’s authors and an economics professor at the University of Warwick in England.The findings reveal the unintended consequences that can occur from the collapse of wildlife, especially animals known as keystone species for the outsize roles they play in their ecosystems. Increasingly, economists are seeking to measure such impacts.A study looking at the United States, for example, has suggested that the loss of ash trees to the invasive emerald ash borer increased deaths related to cardiovascular and respiratory illness. And in Wisconsin, researchers found that the presence of wolves reduced vehicle collisions with deer by about a quarter, creating an economic benefit that was 63 times greater than the cost of wolves killing livestock.“Biodiversity and ecosystem functioning do matter to human beings,” said Eyal Frank, an economist at the University of Chicago and one of the authors of the new vulture study. “And it’s not always the charismatic and fuzzy species.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Why Your Covid Symptoms Could Feel Different This Time

    Cases are rising across the United States. Here’s what to know about how symptoms of an infection can shift.By this point in the Covid-19 pandemic, most people have had at least one brush with the virus. Those of us who have been infected again (and again) may think we know the drill.But symptoms can vary from one infection to the next. The virus has felt like an entirely different illness each time I’ve tested positive: The first go-round, a fever flattened me. Once, I had barely any symptoms. The worst infection left me wrung-out on my couch, so exhausted I had to strain to pay attention to a podcast.“No two Covid infections really have behaved the same,” said Dr. Joseph Khabbaza, a pulmonary and critical care doctor at Cleveland Clinic.Generally speaking, the more immunity people build up from vaccination or infections, the milder symptoms of subsequent infections tend to be. But for an individual, there is no guarantee that a second infection will be less severe than the first.That’s partly because the virus has changed, developing into new variants. If you’re reinfected, that means the virus has evolved enough to slip past your immune defenses, said Dr. Davey Smith, an infectious disease specialist at the University of California, San Diego.Many Covid symptoms have stayed the same since 2020: fever, sore throat, coughing. But some have shifted. It used to be common for people to lose their sense of taste and smell when they got sick, for example, but that now seems to happen less frequently. Early in the pandemic, Dr. Khabbaza said, patients would tell him that their Covid infections felt like nothing they had experienced before. Now, he said, people often think they have a cold, and are shocked when they test positive.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    A Summer Guide to Covid Testing, Symptoms and Treatment

    Experts say cases could rise in the coming weeks. Here’s what to know about symptoms, testing and treatment.As the so-called “FLiRT” variants of the coronavirus continue to gain traction, doctors and researchers are bracing for a potential rise in cases this summer. KP.2, one of these variants, now accounts for 28.5 percent of cases, and data from the Centers for Disease Control and Prevention shows a small increase in Covid-related emergency room visits and positive tests.Here’s what to know about symptoms, testing and treatment if you do fall ill:Symptoms to watch out forThere’s no evidence that symptoms of the FLiRT variants and other recent strains are any different, said Aubree Gordon, an infectious disease epidemiologist at the University of Michigan.The symptoms still include sneezing, congestion, headaches, sore muscles, nausea or vomiting. Many people also report exhaustion and a general “blah” feeling.In general, the more immunity you’ve built up from vaccination or past infections, the milder your next bout with the virus is likely to be. (Though it’s possible to experience more intense symptoms with a new infection than you’ve had in past Covid cases.)The symptoms of Covid can look similar to those caused by allergies or other infections. The best way to tell the difference is to test.When (and how) to testIn an ideal world, experts said, people would take a Covid test as soon as they develop symptoms or learn they were exposed, and then test again a day or two later. But if you only have a limited number of at-home rapid tests, there are a few ways to maximize their usefulness: Test immediately if you have a fever and a cough, said Dr. Davey Smith, an infectious disease specialist at the University of California, San Diego.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Younger Adults Are Missing Early Warning Signs of Colon Cancer

    The LatestColorectal cancer rates are rapidly rising among adults in their 20s, 30s and 40s, and the most common warning sign for the disease is passing blood in the stool, according to a new scientific review.Rectal bleeding is associated with a fivefold increased risk of colorectal cancer, according to the new analysis, which looked at 81 studies that included nearly 25 million adults under 50 from around the world.Abdominal pain, changes in bowel habits and anemia are other common warning signs of the disease and should not be ignored, said the researchers, who published the paper on Thursday in the journal JAMA Network Open.A light micrograph of a colon biopsy from a colonoscopy.Choksawatdikorn/Science SourceWhy It MattersColon and rectal cancer rates have risen among younger adults as rates have declined among older people, who are far more likely to get colonoscopies that can catch cancers and precancerous lesions called polyps.But though millennials born around 1990 are at almost twice the risk of colon cancer compared with people born in the 1950s, and have a risk of rectal cancer that is four times as high, young people without a strong family history of colon cancer aren’t eligible for colonoscopies until the age of 45.Doctors may also miss the warning signs. Anecdotal evidence suggests that because physicians are less likely to suspect malignancies in younger people, they may attribute a symptom like rectal bleeding to a benign condition like hemorrhoids, rather than cancer, said Joshua Demb, a cancer epidemiologist at the University of California, San Diego, and one of the paper’s lead authors.From the time younger adults first go to a caregiver with a complaint about a symptom until they receive a diagnosis can take four to six months on average, the analysis found. Because the diagnosis is often delayed, younger adults tend to have more advanced disease that is harder to treat.“We need to facilitate early detection, and one way is identifying these red flags,” Dr. Demb said.What We Don’t KnowThe causal factors driving the rise in colon and rectal cancers in younger adults were not addressed in the new analysis, and are not well understood.Colorectal cancer has long been associated with obesity, smoking, a sedentary lifestyle, high alcohol intake and diets that are rich in red meat, processed food and sugary drinks.New research exploring the rapid rise in colorectal cancer in younger adults is examining other possible causes, including environmental exposures, changes in gut bacteria and the use of some medications, such as antibiotics. More

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    The Disease Detectives Trying to Keep the World Safe From Bird Flu

    As Dr. Sreyleak Luch drove to work the morning of Feb. 8, through busy sunbaked streets in Cambodia’s Mekong river delta, she played the overnight voice messages from her team. The condition of a 9-year-old boy she had been caring for had deteriorated sharply, and he had been intubated, one doctor reported. What, she wondered, could make the child so sick, so fast?“And then I just thought: H5N1,” she recalled. “It could be bird flu.”When she arrived at the airy yellow children’s ward at the provincial hospital in Kratie, she immediately asked the child’s father if the family had had contact with any sick or dead poultry. He admitted that their rooster had been found dead a few days before and that the family had eaten it.Dr. Luch told her colleagues her theory. Their responses ranged from dubious to incredulous: A human case of avian influenza had never been reported in their part of eastern Cambodia. They warned her that if she set off the bird flu warning system, many senior government officials might get involved. She risked looking foolish, or worse.Anxious but increasingly certain, Dr. Luch phoned the local public health department, located just across the street. Within minutes, a team arrived to collect a sample from the child, Virun Roeurn, for testing in a lab.By then, Virun’s distraught parents had lost faith in the hospital. They demanded that he be sent by ambulance to the capital, Phnom Penh. His flu swab sample traveled with him.Virun died on the journey. At 8 p.m., Cambodia’s National Public Health Laboratory confirmed Dr. Luch’s suspicion: He had died of highly pathogenic avian influenza.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More