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

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      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

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      Hilary Cass Says U.S. Doctors Are ‘Out of Date’ on Youth Gender Medicine

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      Dr. Hilary Cass published a landmark report that led to restrictions on youth gender care in Britain. U.S. health groups said it did not change their support of the care.After 30 years as one of England’s top pediatricians, Dr. Hilary Cass was hoping to begin her retirement by learning to play the saxophone.Instead, she took on a project that would throw her into an international fire: reviewing England’s treatment guidelines for the rapidly rising number of children with gender distress, known as dysphoria.At the time, in 2020, England’s sole youth gender clinic was in disarray. The waiting list had swelled, leaving many young patients waiting years for an appointment. Staff members who said they felt pressure to approve children for puberty-blocking drugs had filed whistle-blower complaints that had spilled into public view. And a former patient had sued the clinic, claiming that she had transitioned as a teenager “after a series of superficial conversations with social workers.”The National Health Service asked Dr. Cass, who had never treated children with gender dysphoria but had served as the president of the Royal College of Pediatrics and Child Health, to independently evaluate how the agency should proceed.Over the next four years, Dr. Cass commissioned systematic reviews of scientific studies on youth gender treatments and international guidelines of care. She also met with young patients and their families, transgender adults, people who had detransitioned, advocacy groups and clinicians.Her final report, published last month, concluded that the evidence supporting the use of puberty-blocking drugs and other hormonal medications in adolescents was “remarkably weak.” On her recommendation, the N.H.S. will no longer prescribe puberty blockers outside of clinical trials. Dr. Cass also recommended that testosterone and estrogen, which allow young people to develop the physical characteristics of the opposite sex, be prescribed with “extreme caution.”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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      Patient Dies Weeks After Kidney Transplant From Genetically Modified Pig

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      Richard Slayman received the historic procedure in March. The hospital said it had “no indication” his death was related to the transplant.Richard “Rick” Slayman, who made history at age 62 as the first person to receive a kidney from a genetically modified pig, has died about two months after the procedure.Massachusetts General Hospital, where Mr. Slayman had the operation, said in a statement on Saturday that its transplant team was “deeply saddened” at his death. The hospital said it had “no indication that it was the result of his recent transplant.”Mr. Slayman, who was Black, had end-stage kidney disease, a condition that affects more than 800,000 people in the United States, according to the federal government, with disproportionately higher rates among Black people.Surgeons performing the world’s first kidney transplant from a genetically modified pig into a living human in March.Michelle Rose/Massachusetts General Hospital, via Agence France-Presse — Getty ImagesThere are far too few kidneys available for donation. Nearly 90,000 people are on the national waiting list for a kidney.Mr. Slayman, a supervisor for the state transportation department from Weymouth, Mass., had received a human kidney in 2018. When it began to fail in 2023 and he developed congestive heart failure, his doctors suggested he try one from a modified pig.“I saw it not only as a way to help me, but a way to provide hope for the thousands of people who need a transplant to survive,” he said in a hospital news release in March.His surgery, which lasted four hours, was a medical milestone. For decades, proponents of so-called xenotransplantation have proposed replacing ailing human organs with those from animals. The main problem with the approach is the human immune system, which rejects animal tissue as foreign, often leading to serious complications.Recent advances in genetic engineering have allowed researchers to tweak the genes of the animal organs to make them more compatible with their recipients.The pig kidney that was transplanted into Mr. Slayman was engineered by eGenesis, a biotech company based in Cambridge, Mass. Scientists there removed three genes and added seven others to improve compatibility. The company also inactivated retroviruses that pigs carry and could be harmful to humans.“Mr. Slayman was a true pioneer,” eGenesis said in a statement on social media on Saturday. “His courage has helped to forge a path forward for current and future patients suffering from kidney failure.”Mr. Slayman was discharged from the hospital two weeks after his surgery, with “one of the cleanest bills of health I’ve had in a long time,” he said at the time.In a statement published by the hospital, Mr. Slayman’s family said he was kind, quick-witted and “fiercely dedicated to his family, friends and co-workers.” They said they had taken great comfort in knowing that his case had inspired so many people.“Millions of people worldwide have come to know Rick’s story,” they said in the statement. “We felt — and still feel — comforted by the optimism he provided patients desperately waiting for a transplant.” More

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      Widening Racial Disparities Underlie Rise in Child Deaths in the U.S.

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      New research finds that the death rate among Black youths soared by 37 percent, and among Native American youths by 22 percent, between 2014 and 2020, compared with less than 5 percent for white youths.The NewsThanks to advancements in medicine and insurance, mortality rates for children in the United States had been shrinking for decades. But last year, researchers uncovered a worrisome reversal: The child death rate was rising.Now, they have taken their analysis a step further. A new study, published Saturday in The Journal of the American Medical Association, revealed growing disparities in child death rates across racial and ethnic groups. Black and Native American youths ages 1 to 19 died at significantly higher rates than white youths — predominantly from injuries such as car accidents, homicides and suicides.Dr. Coleen Cunningham, chair of pediatrics at the University of California, Irvine, and the pediatrician in chief at Children’s Hospital of Orange County, who was not involved in the study, said the detailed analysis of the disparities documented “a sad and growing American tragedy.”“Almost all are preventable,” she said, “if we make it a priority.”Flowers for Karon Blake, 13, who was shot and killed in Washington, D.C., in January 2023. Gun-related deaths were two to four times higher among Black and Native American youth than among white youth.Carolyn Kaster/Associated PressSome Context: A frightening trend examined more closely.Researchers at Virginia Commonwealth University and Children’s Hospital of Richmond had previously revealed that mortality rates among children and adolescents had risen by 18 percent between 2019 and 2021. Deaths related to injuries had grown so dramatically that they eclipsed all public health gains.The group, seeking to drill deeper into the worrying trend, obtained death certificate data from the Centers for Disease Control and Prevention’s public WONDER database and stratified it by race, ethnicity and cause for children ages 1 to 19. They found that Black and American Indian/Alaska Native children were not only dying at significantly higher rates than white children but that the disparities — which had been improving until 2013 — were widening.The data also revealed that while the mortality rates for children overall took a turn for the worse around 2020, the rates for Black, Native American and Hispanic children had begun increasing much earlier, around 2014.Between 2014 and 2020, the death rates for Black children and teenagers rose by about 37 percent, and for Native American youths by about by about 22 percent — compared with less than 5 percent for white youths.“We knew we would find disparities, but certainly not this large,” said Dr. Steven Woolf, a professor of family medicine at the V.C.U. School of Medicine, who worked on the research. “We were shocked.”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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      Mental Health and Substance Use Disorders Often Go Untreated for Parents on Medicaid

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      The NewsFor parents struggling with mental health or substance use disorders, access to treatment can often mean the difference between keeping and losing their children. But a new analysis of health and child welfare records found that a significant portion of those who were eligible for Medicaid coverage for such treatment were not getting it.The analysis, published Friday by researchers at the nonprofit institute RTI International and the Department of Health and Human Services, found that fewer than half of parents on Medicaid who had substance use disorders and had been referred to authorities over suspicions of child abuse or neglect had received treatment.A temporary shelter in Brooklyn.Hiroko Masuike/The New York Times Some Context: Experts say bad situations can often be reversed with treatment.Both mental health and drug addiction crises have been roiling the country, and the effects of parental drug use and mental illness can quickly trickle down to their children. Public health experts say substance use disorders can incapacitate a previously diligent parent and lead to the involvement of child protective services.In 2021 alone, more than seven million children were referred to authorities over worries of maltreatment, according to a federal report, and more than 200,000 were removed from their homes. But research shows that when parents seek treatment for psychiatric and substance use disorders, they are far less likely to experience family separation.The Numbers: What the researchers found.To calculate treatment rates among parents on Medicaid, the health insurance program for low income people, Tami Mark, a health economist at RTI, who led the research, and her colleagues drew from a new publicly available data set that used de-identified social security numbers to link child welfare records in Florida and Kentucky with corresponding Medicaid claims records from 2020.For comparison, they also analyzed a random sample of Medicaid recipients who had no records in the child welfare system. (The study didn’t capture any counseling or medication given outside the Medicaid system, nor any cases of mental health or substance use disorders that were undiagnosed.)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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      The History Behind Arizona’s 160-Year-Old Abortion Ban

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      The state’s Supreme Court ruled that the 1864 law is enforceable today. Here is what led to its enactment.The 160-year-old Arizona abortion ban that was upheld on Tuesday by the state’s highest court was among a wave of anti-abortion laws propelled by some historical twists and turns that might seem surprising.For decades after the United States became a nation, abortion was legal until fetal movement could be felt, usually well into the second trimester. Movement, known as quickening, was the threshold because, in a time before pregnancy tests or ultrasounds, it was the clearest sign that a woman was pregnant.Before that point, “women could try to obtain an abortion without having to fear that it was illegal,” said Johanna Schoen, a professor of history at Rutgers University. After quickening, abortion providers could be charged with a misdemeanor.“I don’t think it was particularly stigmatized,” Dr. Schoen said. “I think what was stigmatized was maybe this idea that you were having sex outside of marriage, but of course, married women also ended their pregnancies.”Women would terminate pregnancies in several different ways, such as ingesting herbs or medicinal potions that were thought to induce a miscarriage, Dr. Schoen said. The herbs commonly used included pennyroyal and tansy. Another method involved inserting an object in the cervix to try to interrupt a pregnancy or terminate it by causing an infection, Dr. Schoen said.Since tools to determine early pregnancy did not yet exist, many women could honestly say that they were not sure if they were pregnant and were simply taking herbs to restore their menstrual period.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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      Large Scientific Review Confirms the Benefits of Physical Touch

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      Premature babies especially benefited from skin-to-skin contact, and women tended to respond more strongly than men did.A hug, a handshake, a therapeutic massage. A newborn lying on a mother’s bare chest.Physical touch can buoy well-being and lessen pain, depression and anxiety, according to a large new analysis of published research released on Monday in the journal Nature Human Behaviour.Researchers from Germany and the Netherlands systematically reviewed years of research on touch, strokes, hugs and rubs. They also combined data from 137 studies, which included nearly 13,000 adults, children and infants. Each study compared individuals who had been physically touched in some way over the course of an experiment — or had touched an object like a fuzzy stuffed toy — to similar individuals who had not.For example, one study showed that daily 20-minute gentle massages for six weeks in older people with dementia decreased aggressiveness and reduced the levels of a stress marker in the blood. Another found that massages boosted the mood of breast cancer patients. One study even showed that healthy young adults who caressed a robotic baby seal were happier, and felt less pain from a mild heat stimulus, than those who read an article about an astronomer.Positive effects were particularly noticeable in premature babies, who “massively improve” with skin-to-skin contact, said Frédéric Michon, a researcher at the Netherlands Institute for Neuroscience and one of the study’s authors.“There have been a lot of claims that touch is good, touch is healthy, touch is something that we all need,” said Rebecca Boehme, a neuroscientist at Linkoping University in Sweden, who reviewed the study for the journal. “But actually, nobody had looked at it from this broad, bird’s eye perspective.”The analysis revealed some interesting and sometimes mysterious patterns. Among adults, sick people showed greater mental health benefits from touch than healthy people did. Who was doing the touching — a familiar person or a health care worker — didn’t matter. But the source of the touch did matter to newborns.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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      Bacteria That Cause Meningitis Are Spreading Again, C.D.C. Warns

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      The NewsFederal officials are warning health care providers to be on the lookout for invasive meningococcal disease, a rare but potentially deadly illness that has increased in prevalence in recent years and requires prompt treatment with antibiotics to prevent long-term disability or death.Colonies of Neisseria meningitidis bacteria, which cause meningococcal disease.Brodsky/CDC, via Associated PressBy the Numbers: A rising fatality rate.The illness is caused by infection with a bacterium called Neisseria meningitidis. Last year, 422 cases of invasive meningococcal disease were reported in the United States, the highest number since 2014, according to the Centers for Disease Control and Prevention.But as of Monday, 143 cases have been reported to the C.D.C. so far this year, 62 more than the number of cases reported last year during the same period.The illness is extremely dangerous. Even with appropriate treatment, 10 to 15 percent of patients who develop meningococcal disease will die. Many recent cases were caused by an unusual strain of N. meningitidis called ST-1466. This strain caused 17 deaths among 94 patients whose outcomes are known, a fatality rate of 18 percent.Survivors of meningococcal disease may be left with long-term disability, deafness, amputations or brain damage.The Mystery: What’s causing the outbreaks?A majority of people affected in the recent outbreaks were Black people and adults ages 30 to 60.Others who are susceptible to the infection include people living with H.I.V., who account for 15 percent of patients; individuals who have had their spleens removed; people with sickle cell disease; and patients with certain rare immune conditions.A meningitis vaccine that protects against four of six N. meningitidis types — including group Y, which includes ST-1466 — is recommended for adolescents as well as those with medical conditions like H.I.V. Most older adults have not received the vaccine.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