The Trump administration changed course on Tuesday, deciding to keep the government's free COVID test program running, just minutes before the website, COVIDtests.gov, was set to shut down.

Earlier that day, The Washington Post reported that officials were preparing to end the program and possibly destroy tens of millions of unused tests worth more than a half-billion dollars.

But 12 minutes before the shutdown, Andrew Nixon, a spokesman for the Department of Health and Human Services (HHS), announced the site would remain active.

“With COVID-19 infections decreasing after a winter peak, we are in the process of regular discussions on closing this round of the COVID-19 test ordering program. At this point, the program is still open, and we will share additional updates as needed,” he said in a statement.

Internal documents showed that HHS officials had been debating two options: Disposing of more than 160 million COVID tests, or continuing to ship them to U.S. households. The stockpile is maintained by the Administration for Strategic Preparedness and Response (ASPR).

Only a small fraction of the tests had expired, and tens of thousands were still being ordered daily, Dawn O’Connell, an ASPR chief under the Biden administration, told The Post.

“It’s expensive to stockpile these tests,” she said. “Destruction costs a significant amount of money, but hanging on to them costs a significant amount of money.”

The reversal followed concerns from public health experts about losing a valuable tool during flu season and future COVID surges.

In his first days back in office, President Donald Trump rescinded many of former President Joe Biden’s COVID-related executive orders, including one aimed at expanding national testing strategy.

“The virus is not posing a major public health threat now,” said Dr. Ashish Jha, who led the White House COVID response from March 2022 to April 2023 under Biden.

Jha, now the dean of Brown University School of Public Health, told The Post that trashing the tests “feels like an act of self-destruction here. It’s going to be expensive. And it takes away a tool that the administration would want to use in the scenario that we get a highly immune-evasive variant."

While COVID cases have decreased after the winter peak, experts warn that free testing remains critical to control infection.

“Destroying an asset that was paid for by the American people, that doesn’t make any sense,” said Dr. Tom Inglesby, who was White House national coordinator for COVID testing from the end of 2021 to April 2022. He's now the director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health.

In the event of a resurgence, “we need to be able to figure out who is sick, who is not sick, who needs medicine, who is, in fact, contagious, who may be someone who’s vulnerable," Inglesby told The Post. "These diagnostics really help you make really good decisions, help families make good decisions about how to stay healthy.”

ASPR has distributed more than 2 billion free tests since January 2020, including 900 million sent directly to households through COVIDtests.gov, in partnership with the U.S. Postal Service.

The program has been paused and restarted many times, including seven shutdowns since its launch.

Most recently, it was paused in March 2024 and reopened in September right before the winter respiratory illness season.

More information

The U.S. Food and Drug Administration has more on at-home over-the-counter COVID tests.

SOURCE: The Washington Post, media report, Feb. 18, 2025

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During the week of Jan. 26 through Feb. 1, 2025, flu activity remained elevated in the United States, with 43 states reporting high or very high outpatient respiratory illness activity, according to FluView, a weekly influenza surveillance report prepared by the Influenza Division of the U.S. Centers for Disease Control and Prevention.

During this week, of the 4,377 viruses reported by public health laboratories, 4,264 and 113 were influenza A and B, respectively. Of the 3,458 influenza A viruses subtyped, 53.7 percent were influenza A(H1N1)pdm09 and 46.3 percent were A(H3N2); there were no reports of A(H5). There was one reported case of human infection with an influenza A(H1N2) variant.

The proportion of outpatient visits for respiratory illness was 7.8 percent, remaining above the national baseline for the 10th consecutive week. Two percent of overall deaths were attributed to influenza. Ten pediatric deaths associated with seasonal influenza were reported, bringing the 2024-2025 season total to 57 pediatric deaths.

There have been at least 24 million influenza illnesses, 310,000 hospitalizations, and 13,000 deaths so far this influenza season.

"CDC recommends that everyone ages 6 months and older get an annual influenza vaccine," according to a statement from the agency. "There are prescription flu antiviral drugs that can treat flu illness; those should be started as early as possible and are especially important for patients at higher risk for severe illness."

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The Trump administration has made some concessions to the halt placed on distributions of global HIV treatments via the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), according to The New York Times.

Secretary of State Marco Rubio announced the waiver on Tuesday; however, exactly what it covers remains unclear. While the waiver does allow for the resumption of distributing HIV medications, the freeze on other services, including the distribution of preventive drugs, is still thought to be in place.

PEPFAR, a $7.5 billion program under the governance of the State Department, was due for a five-year reauthorization in 2023. After avoiding a Republican effort to end the program, it was renewed for one year, according to The Times. Data on the U.S. Centers for Disease Control and Prevention website indicate that more than 1 million Americans are living with HIV, with more than 30,000 becoming infected each year.

Americans would face serious consequences if PEPFAR is defunded, The Times reported. Without the availability of HIV medications in other countries, there is a higher risk for HIV developing resistance to current medications. Large populations of immunocompromised people could lead to easier spread of other pathogens, including dangerous COVID variants. Trials conducted with PEPFAR support have provided insight into the importance of early treatment of HIV, managing pregnancy and the virus, and preexposure prophylaxis and long-acting antiretrovirals.

"We can very rapidly return to where the pandemic is exploding, like it was back in the 1980s," Steve Deeks, M.D., an HIV expert at the University of California, San Francisco, told The Times. "This really cannot happen."

The New York Times Article

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The U.S. Department of Health and Human Services (HHS) is awarding the pharmaceutical company Moderna $590 million to continue developing a vaccine to protect against bird flu.

This funding, announced Friday by Moderna, builds on the $176 million it received from HHS last year to support earlier stages of vaccine research.

Moderna’s vaccine is designed to target H5 and H7 avian influenza viruses.

The company plans to move into phase 3 clinical trials to test the vaccine in a larger group of people after receiving positive results in earlier phases. It said those findings will be shared at an upcoming scientific conference.

“Avian flu variants have proven to be particularly unpredictable and dangerous to humans in the past," outgoing HHS secretary Xavier Becerra said in a statement, who added that the response had been a top priority for HHS and the Biden administration.

“Accelerating the development of new vaccines will allow us to stay ahead and ensure that Americans have the tools they need to stay safe,” he continued.

Avian influenza, commonly known as bird flu, refers to several types of influenza that typically infect birds. But certain variants, such as H5N1, have raised alarm among health officials because they can occasionally infect humans.

Over the past several months, dozens of people in the U.S. have been sickened by the virus, including the first reported human death from bird flu in Louisiana earlier this month.

While the U.S. already has vaccines against H5 viruses in its Strategic National Stockpile, they are based on older technology. Moderna’s new mRNA-based vaccine aims to offer a more effective option.

"The project will provide additional support for late-stage development and licensure of pre-pandemic mRNA-based vaccines," Moderna said in a news release. "The agreement will also support the expansion of clinical studies for up to five additional subtypes of pandemic influenza."

Under the Biden administration, HHS also pledged more than $300 million to improve bird flu surveillance, testing, hospital preparedness, and public awareness.

While most recent cases of H5N1 have involved animal-to-animal transmission, federal health officials emphasize the importance of staying vigilant and working together to protect human and animal health.

The U.S. Centers for Disease Control and Prevention considers the current risk of bird flu to the public to be low, as there is still no evidence of human-to-human transmission. But experts warn that it is important to keep investing in monitoring and vaccine development to stay ahead of possible threats.

More information

The U.S. Centers for Disease Control and Prevention (CDC) has more on the current bird flu situation.

SOURCE: U.S. Department of Health and Human Services, news release, Jan. 17, 2025; Moderna, news release, Jan. 17, 2025; CNN

Copyright © 2020 HealthDay. All rights reserved.

Fifteen candidate genetic variants account for only 0.40 percent of variation in opioid use disorder (OUD) risk, according to a study published online Jan. 9 in JAMA Network Open.

Christal N. Davis, Ph.D., from the Crescenz Veterans Affairs Medical Center in Philadelphia, and colleagues examined the utility of 15 genetic variants from an algorithm intended to predict OUD risk in a case-control study using electronic health record data, which were accrued from 452,664 participants with opioid exposure in the Million Veteran Program across the United States.

The researchers found that the 15 candidate genes accounted for 0.40 percent of the variation in OUD risk, while age and sex accounted for 3.27 percent of the variation. Using the 15 variants as predictive factors, the ensemble machine learning model correctly classified 52.83 percent of individuals in an independent testing sample.

"Findings of this case-control study suggest that candidate genetic variants from the approved genetic risk algorithm do not meet standards of reasonable clinical efficacy in assessing risk of opioid use disorder," the authors write. "Because genetic risk models in psychiatry will continue to emerge and could prove clinically useful, it is crucial that researchers and regulatory agencies adopt rigorous standards for developing and evaluating them prior to their application in clinical settings."

Several authors disclosed ties to the biopharmaceutical industry; several authors reported holding relevant patents or having patents pending.

Abstract/Full Text

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The prevalence and burden of post-acute sequelae of COVID-19 (PASC) has decreased over time in health care workers, according to a study published online Nov. 12 in Infection.

Tamara Dörr, M.D., from the Cantonal Hospital St. Gallen in Switzerland, and colleagues assessed the burden and course of PASC in health care workers during a 30-month period. The analysis included survey responses from 1,704 health care workers.

The researchers found that 30.7 percent reported one or more PASC symptom in October 2023, with 6.7 percent reporting having PASC currently or in the past. Compared with other variants, PASC symptoms were most common after Wild-type infection. More than one in seven (15 percent) indicated relevant/severe restrictions in their daily activities and nearly three-quarters (74 percent) tried at least one measure against their symptoms, with 81 percent reporting having benefitted. 

"Our data show a steady and continuing decrease of PASC prevalence and burden in a health care worker population of predominantly female, and previously healthy individuals over the course of 30 months," the authors write. "Choice and benefit of therapeutic measures vary considerably; however, recovery rate is high after 30 months and seems to be time-dependent."

Abstract/Full Text

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Smoking behavior seems to not have a causal effect on chronic kidney disease (CKD) risk in White individuals, according to a study published online Nov. 4 in Health Data Science.

In a traditional observational study, Zhilong Zhang, from the Peking University Health Science Center in Beijing, and colleagues used data from the U.K. Biobank cohort for adults aged 40 to 69 years to examine the associations between smoking indices, including smoking status and lifetime smoking index, and incident CKD stages 3 to 5. A potential causal effect was then estimated using Mendelian randomization (MR) approaches. The causal associations with CKD stages 3 to 5 were examined in one-sample MR using genetic variants associated with lifetime smoking index among 344,255 U.K. Biobank participants with White British ancestry. The findings were validated by a two-sample MR analysis using information from the Chronic Kidney Disease Genetics Consortium genome-wide association study.

The researchers found that both smoking status and lifetime smoking index were associated with a higher risk for incident CKD in the traditional observational study (hazard ratios, 1.26 and 1.22, respectively). However, in one- and two-sample MR analyses, no causal association was seen between lifetime smoking index and CKD. The genetic instruments were validated by statistical tests; similar results to the main model were seen in all sensitivity analyses.

"Given the substantial evidence linking smoking to CKD, further mediation analysis is needed to understand the intricate mechanisms between smoking behavior and CKD," the authors write. "Such an analysis is essential for generating valuable insights that can inform and enhance public health strategies focused on mitigating CKD risk factors and improving overall kidney health."

One author reported being deputy editor of Health Data Science.

Abstract/Full Text

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For patients with neurodevelopmental disorders (NDDs), a genomics-informed model can provide clinical benefits, directly affecting management, according to a study published online Dec. 18 in Genetics in Medicine.

Aaron D. Besterman, M.D., from the University of California San Diego, and colleagues performed a retrospective study of 316 patients from a genomics-informed multidisciplinary, neuropsychiatric specialty clinic to examine the impact on diagnosis and management of patients with NDDs.

The researchers found that 41.8 percent of the 246 patients who underwent genetic testing had a pathogenic or likely pathogenic variant. Sixty-two different genetic diagnoses were identified: 12 diagnoses were shared by two or more patients and 50 diagnoses were in only single patients. In all patients with a pathogenic or likely pathogenic variant, genetic diagnoses resulted in direct changes to clinical management, including cascade testing, family counseling, medication changes, clinical trial referral, medical surveillance, and specialty referrals (30.6, 22.2, 13.9, 2.8, 30.6, and 69.4 percent, respectively).

"Genomics-informed education and care for NDDs should be inclusive and adaptable because the number of identifiable neurogenetic conditions continues to grow and precision treatments for many neurogenetic disorders are under development," the authors write.

One author disclosed ties to Mirum Pharmaceuticals.

Abstract/Full Text

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The annual San Antonio Breast Cancer Symposium was held from Dec. 10 to 13 in San Antonio. Attendees included medical oncologists, radiation oncologists, researchers, and other health care professionals. The conference highlighted recent advances in the risk, diagnosis, treatment, and prevention of breast cancer, and presentations focused on emerging treatments in hard-to-treat patient populations, including patients with metastatic breast cancer.

As part of the BIG 2-04 MRC SUPREMO phase 3 clinical trial, Ian Kunkler, M.B., B.Chir., of the University of Edinburgh in the United Kingdom, and colleagues found that chest wall irradiation may be omitted among patients with intermediate-risk breast cancer who have undergone mastectomy.

For the study, patients were randomly assigned to receive chest wall irradiation after mastectomy or to omit chest wall irradiation after mastectomy. The researchers found that postmastectomy radiotherapy to the chest wall among women with one to three positive axillary nodes after an axillary clearance or negative on an axillary clearance, axillary node sample, or sentinel node biopsy was not associated with an improvement in 10-year overall survival. The investigators also found that postmastectomy radiotherapy reduced chest wall recurrence by less than 2 percent at 10 years. Furthermore, the approach did not have an impact on metastasis-free survival.

"Postmastectomy radiotherapy National Institute for Health and Care Excellence guidelines currently recommend radiotherapy in women with one to three positive nodes after mastectomy," Kunkler said. "So, our results should change guidelines and practice internationally."

Press Release

As part of the phase 3 COMET study, Ann Partridge, M.D., M.P.H., of the Dana-Farber Cancer Institute and Harvard Medical School in Boston, and colleagues found that active monitoring is a reasonable approach for the management of patients with grade 1 or 2, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative low-risk ductal carcinoma in situ (DCIS), with no evidence of a higher incidence of microinvasive or invasive disease.

For the study, patients were randomly assigned to either undergo active monitoring or receive guideline-concordant care consisting of surgery with or without adjuvant radiation. During a two-year period, the authors assessed quality of life, anxiety, depression, worries about DCIS, and symptom trajectories via surveys that employed validated quality-of-life measures. Patients filled out surveys prior to randomization, at six months, at one year, and after two years.

The researchers found that the overall lived experience of women randomly assigned to active monitoring was similar to that of those selected to follow the current guideline for care, which is surgery with or without radiation. During the two years of follow-up, health-related quality of life, anxiety, depression, worry, and symptom trajectories were comparable regardless of the treatment received.

"If longer-term follow-up supports the safety of active management from a cancer outcome standpoint, this approach could be considered as an option for women with this condition," Partridge said. "It is critical that we understand how women feel when they are living with an active-monitoring approach and how it impacts their overall quality of life, psychosocial health, worries about DCIS, anxiety and depression, and other related symptoms. These data are reassuring in that respect."

Press Release

In the multicenter, double-blind OlympiA study, Judy E. Garber, M.D., of the Dana-Farber Cancer Institute in Boston, and colleagues provided further support for the benefits of olaparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, among patients with high-risk, HER2-negative breast cancer with germline mutations in BRCA1 or BRCA2.

The authors randomly assigned 1,836 patients with BRCA-positive, HER2-negative breast cancer (1:1) to receive either olaparib or placebo for one year following completion of chemotherapy, surgery, and radiation.

The researchers found that after a median follow-up of 6.1 years, patients with high-risk, BRCA-positive breast cancer who received olaparib after standard treatment continued to have better survival outcomes than those who received placebo. The continued demonstration of the efficacy of olaparib in breast cancer patients who carry pathogenic variants in BRCA1/2 makes it important to identify these individuals when they begin their treatment, the authors noted.

"The ongoing data from the OlympiA trial are reassuring in the observations of persistent and increasing benefits in the follow-up phases, improving not only recurrence, but also overall survival. Benefits are demonstrated in both triple-negative breast cancer as well as hormone receptor-positive tumors, despite the shortened follow-up and smaller numbers in the estrogen receptor-positive group," Garber said. "These data also highlight the safety of olaparib and, therefore, the possibility of moving PARP inhibitors to the treatment of BRCA-associated breast cancers that are lower risk."

The study was supported by AstraZeneca and Merck, the manufacturers of olaparib.

Press Release

SABCS: Chest Wall Irradiation Does Not Impact Survival in Breast Cancer

MONDAY, Dec. 16, 2024 (HealthDay News) -- For patients with intermediate-risk breast cancer, chest wall irradiation after mastectomy does not influence 10-year overall survival, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.

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SABCS: Risk-Reducing Surgery Improves Outcomes in Young Breast Cancer Patients With BRCA Mutations

MONDAY, Dec. 16, 2024 (HealthDay News) -- Risk-reducing mastectomy and salpingo-oophorectomy are both associated with significant improvements in outcomes among young BRCA carriers with breast cancer, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.

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SABCS: Adding Camrelizumab to Neoadjuvant Chemo Beneficial in TNBC

FRIDAY, Dec. 13, 2024 (HealthDay News) -- The addition of camrelizumab to neoadjuvant chemotherapy improves pathological complete response for patients with early or locally advanced triple-negative breast cancer, according to a study published online Dec. 13 in the Journal of the American Medical Association to coincide with the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.

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SABCS: Active Monitoring Noninferior to Guideline Care for Ductal Carcinoma in Situ

FRIDAY, Dec. 13, 2024 (HealthDay News) -- For patients with ductal carcinoma in situ, active monitoring is noninferior to guideline-concordant care that involves surgery with or without adjuvant radiation, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.

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SABCS: Omission of Axillary Staging Noninferior for Node-Negative Breast Cancer

FRIDAY, Dec. 13, 2024 (HealthDay News) -- Omission of surgical axillary staging is noninferior to sentinel lymph-node biopsy for patients with clinically node-negative, T1 or T2 invasive breast cancer, according to a study published online Dec. 12 in the New England Journal of Medicine to coincide with the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.

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SABCS: Imlunestrant Tied to Improved PFS for ER-Positive, HER2-Negative Breast Cancer With ESR1 Mutations

THURSDAY, Dec. 12, 2024 (HealthDay News) -- For patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer, imlunestrant leads to significantly longer progression-free survival among those with ESR1 mutations, according to a study published online Dec. 11 in the New England Journal of Medicine to coincide with the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.

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Risk-reducing mastectomy (RRM) and salpingo-oophorectomy (RRSO) are both associated with significant improvements in outcomes among young BRCA carriers with breast cancer, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 10 to 13 in San Antonio.

Matteo Lambertini, M.D., Ph.D., from the University of Genova-IRCCS Policlinico San Martino Hospital in Genoa, Italy, and colleagues investigated the association between RRM and/or RRSO and survival outcomes among young BRCA carriers with breast cancer. The analysis included 5,292 women with germline BRCA1 and/or BRCA2 pathogenic variants diagnosed with stage I to III invasive breast cancer at 40 years of age or younger (2000 through 2020).

The researchers found that during a median follow-up of 8.2 years, RRM and RRSO were both associated with improved outcomes. Patients who underwent RRM had a 35 percent lower risk for death and a 42 percent lower risk for breast cancer recurrence or second primary malignancy, while those who underwent RRSO had a 42 percent lower risk for death and a 32 percent lower risk for breast cancer recurrence or second primary malignancy. For RRM, improved outcomes were seen whether or not the germline BRCA mutation was present in the BRCA1 or BRCA2 gene; however, for RRSO, overall survival varied, with a greater survival benefit seen for patients with germline mutations in BRCA1 than in BRCA2 (56 and 15 percent lower risk for death, respectively). For patients undergoing RRSO, the greatest survival benefits were seen for triple-negative and hormone receptor-positive breast cancers (56 and 20 percent lower risk for death, respectively). Among patients who underwent both surgeries and those who had only one surgery, overall survival was similar.

"These findings are critical for improving the counseling of young BRCA carriers with breast cancer on cancer risk management strategies," the authors write.

One author disclosed ties to the pharmaceutical industry.

Press Release

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There is a U-shaped association between alcohol consumption and coronary heart disease (CHD) and type 2 diabetes (T2D) but no evidence for a causal association, according to a study published online Nov. 24 in Alcohol: Clinical and Experimental Research.

Rachel L. Kember, Ph.D., from Crescenz Veterans Affairs Medical Center in Philadelphia, and colleagues conducted two retrospective nested case-control studies of 33,053 CHD and 28,278 T2D cases matched to five controls each to examine observed and genetically proxied associations between alcohol consumption and the incidence of CHD and T2D in African Americans (AAs), European Americans (EAs), and Hispanic Americans (HAs). Alcohol exposure was estimated using the Alcohol Use Disorders Identification Test-Consumption score closest in time prior to the index date. Mendelian randomization analyses used a single variant in ADH1B or a genetic score as instrumental variables.

The researchers found a U-shaped association of alcohol consumption with CHD and T2D risk in an observational analysis. In Mendelian randomization analyses, there was no association for ADH1B genotype-predicted (in AAs, EAs, and HAs) nor genetic score-predicted (in EAs) alcohol consumption with CHD risk. There was also no association for T2D with alcohol consumption predicted by the ADH1B genotype (in AAs, EAs, or HAs) or genetic score (in EAs). There was no association between alcohol consumption and cardiometabolic diseases in multivariable Mendelian randomization analyses adjusted for the effects of blood pressure and smoking.

"Our results suggest that, as has been shown in larger population groups, there are not beneficial effects of moderate alcohol consumption on cardiometabolic disease," the authors write.

One author disclosed ties to relevant organizations.

Abstract/Full Text

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A nationwide, couple-based reproductive carrier screening program has demonstrated feasibility in informing reproductive decision-making, according to a study published in the Nov. 21 issue of the New England Journal of Medicine.

Edwin P. Kirk, M.B., B.S., Ph.D., from the Sydney Children's Hospital, and colleagues examined the feasibility, acceptability, and outcomes of a nationwide, couple-based genetic carrier screening program in Australia. Screening was offered to persons before pregnancy or early in pregnancy. The reproductive couples were provided with results obtained from testing at least 1,281 genes.

The researchers found that 90.7 percent of the 10,038 reproductive couples enrolled in the study completed screening and 1.9 percent were newly identified as having an increased chance of having a child with a genetic condition identified in screening. The conditions involved pathogenic variants in 90 different genes, 74.3 percent of which were autosomal recessive. To avoid having an affected child, 76.6 percent of the couples with a newly identified increased chance had used or planned to use reproductive interventions three months after receipt of the results. Compared with those with a low chance, those newly identified as having an increased chance had greater anxiety. In all result groups, the level of decisional regret was low; screening was perceived as acceptable in 98.9 percent of participants.

"Couple-based carrier screening, before pregnancy or early in pregnancy, is a feasible way to deliver reproductive genetic carrier screening involving a large panel of genes to a geographically dispersed and diverse population," the authors write.

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Four cases of the more infectious variant of mpox have been reported in the U.K., making it the first cluster of infections that have surfaced outside of Africa.

British authorities announced the first case in that country last week, saying the person was being treated at a London hospital after recently traveling to countries in Africa where there are ongoing outbreaks.

"This is the first time we have detected this clade of mpox in the U.K., though other cases have been confirmed abroad," Susan Hopkins, chief medical adviser at the UK Health Security Agency, said in a health alert issued at the time. "The risk to the UK population remains low, and we are working rapidly to trace close contacts and reduce the risk of any potential spread."

This week, the agency issued an update saying it has identified three more cases in people who lived in the same home as the first patient. They are now being treated at a hospital in London.

“Mpox is very infectious in households with close contact, and so it is not unexpected to see further cases within the same household,” Hopkins noted in the updated alert.

Still, health officials at the National Health Service (NHS) said that they are ready to do more if needed.

"While the risk of catching mpox in the UK remains low, if required the NHS has plans in place to expand the rollout of vaccines quickly in line with supply," Steve Russell, NHS national director for vaccination and screening, noted in the health alert.

This new variant of mpox was first detected earlier this year in eastern Congo. It has also caused outbreaks in Burundi, Kenya, Rwanda and Uganda, while single cases in travelers have been reported in Sweden, India, Germany and Thailand, the Associated Press reported.

To date, there have been about 43,000 suspected cases of mpox in Africa, including more than 1,000 deaths, mostly in Congo, the AP said.

In response to the ongoing outbreak, the World Health Organization announced on Wednesday that it had allocated 899,900 vaccine doses to the nine African countries that are struggling mightily with the spread of mpox.

"In recent weeks, limited vaccination has begun in the Democratic Republic of the Congo and Rwanda," the WHO said in its announcement. "This allocation to the 9 countries marks a significant step towards a coordinated and targeted deployment of vaccines to stop the mpox outbreaks."

In an early sign that the outbreak in Africa might be ebbing, some health officials reported earlier this week that case counts seem to be stabilizing in the Congo, the epicenter of the outbreak.

The World Health Organization first declared the mpox outbreak a global health emergency in August, but recent WHO data has shown the Congo has reported about 200 to 300 lab-confirmed mpox cases every week, down from nearly 400 cases a week in July, the AP reported.

Still, the WHO acknowledged that only 40% to 50% of suspected infections in Congo were being tested and the virus continues to spread elsewhere on the continent, the AP reported.

While doctors are encouraged by the drop in infections in some parts of Congo, they are worried by the small number of vaccine doses the central African nation has received so far to fight the outbreak, the AP reported. WHO has estimated that only 50,000 people have been immunized in Congo, which has a population of 110 million.

“If we miss this opportunity, the likelihood of another significant outbreak increases substantially,” Dr. Zakary Rhissa, who heads operations in Congo for the charity Alima, told the AP.

The Africa Centers for Disease Control and Prevention has estimated Congo needs at least 3 million mpox vaccines to stop the virus, and another 7 million are needed for the rest of the continent.

“We’ve seen how past outbreaks, such as the one in Nigeria in 2017, can lead to larger global events if not effectively contained,” Rhissa noted. That 2017 Nigerian outbreak triggered the 2022 global outbreak of mpox that affected more than 100 countries.

In this latest outbreak, less than half of the people who are most at risk in the Congo have been vaccinated, Heather Kerr, Congo director for the International Rescue Committee, told the AP.

“We only have a tiny amount of vaccines, and nothing for the kids,” she said.

What's most worrying about the new outbreak is that the death rate linked to the new strain of the disease appears higher: About 3 percent of those infected have died, instead of the 0.2 percent observed in the 2022 outbreak.

In 2023, scientists discovered that the mpox virus has gained mutations allowing it to spread more easily between people. Sexual transmission, often through heterosexual prostitution, is a main conduit for infection in Africa.

Dr. Nicole Lurie is executive director for preparedness and response at the Coalition for Epidemic Preparedness Innovations, a nonprofit that finances vaccine development.

Speaking to the New York Times recently, she said, “this outbreak has been smoldering for quite a long time, and we continually have missed opportunities to shut it down. I’m really glad that everybody is now paying attention and focusing their efforts on this.”

More information

Find out more about mpox at the U.S. Centers for Disease Control and Prevention.

SOURCE: UK Health Security Agency, health alert, Nov. 6, 2024; Associated Press; WHO, news releases, Nov. 6, 2024 and Aug. 26, 2024; New York Times

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Female pediatricians earn about 93 percent of what male pediatricians earn, according to a study published online Oct. 29 in Pediatrics.

Mary Pat Frintner, M.S.P.H., from the American Academy of Pediatrics in Itasca, Illinois, and colleagues used data from the Pediatrician Life and Career Experience Study (PLACES), a national longitudinal study, to examine pediatrician-reported income from 2017 to 2022. The adjusted differences in male and female pediatricians' annual income were estimated for each survey year.

From 2017 to 2022, PLACES participation ranged from 83.6 to 75.5 percent, respectively. The researchers found that the unadjusted mean annual income was $237,168 in 2022: $220,374 and $284,286 for female and male pediatricians, respectively. Female pediatrician income was about 93 percent of male pediatrician income after adjusting for key characteristics, a gap of about $11,000 annually. Income increased across years, but the year-sex interaction was not significant, indicating no change in the female-male income disparity. An increased portion of continuous full-time work, work hours, and time in administrative work were three time-variant characteristics associated with increased income over time.

"This disparity includes adjustments for characteristics in which female and male pediatricians' careers differ, such as clinical focus and hours worked, and did not worsen or improve over the years," the authors write. "With more female physicians in the workforce, the findings can be important to understanding overall physician earnings."

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An increase in total cereal intake and total cheese intake may reduce the risk for gastroesophageal reflux disease (GERD), according to a study published online Sept. 6 in the European Journal of Nutrition.

Xingwu Liu, M.D., from the First Hospital of China Medical University in Shenyang, and colleagues performed a two-step Mendelian randomization analysis to obtain causal estimates of dietary factors and blood lipids on GERD. Independent genetic variants associated with 13 kinds of dietary factors and five kinds of blood lipids were selected as instrumental variables. The summary statistics for GERD included 129,080 cases and 473,524 controls.

The researchers found that genetically predicted total pork intake, total bread intake, total cereal intake, and total cheese intake were associated with GERD risk in the inverse variance weighted analysis. After adjustment for smoking, alcohol consumption, use of calcium channel blockers, body mass index, physical activity levels, and biological sex, a negative association persisted between total cereal intake and total cheese intake with the risk for GERD, but the associations for total pork intake and total bread intake disappeared. There was a negative correlation for the concentration of low-density lipoprotein cholesterol (LDL-C) with total cheese intake, with LDL-C mediating 2.27 percent of the association.

"These results showed the significance of dietary factors as well as blood lipids in the prevention of GERD," the authors write. "Therefore, early dietary management and blood lipid control should be carried out to prevent the occurrence of GERD."

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The free COVID-19 tests promised by the U.S. government are now available.

"U.S. households will be eligible to order four free COVID-19 tests at COVIDTests.gov," according to the U.S. Department of Health and Human Services. "The COVID-19 tests will detect current COVID-19 variants and can be used through the end of the year."

More than 900 million such tests have already been distributed to help people get tested and treated earlier and to perhaps keep them from spreading COVID-19 to others.

"At-home COVID tests can be taken at home or in other locations and typically provide results within 30 minutes or less," according to the HHS. "COVID tests can be administered to both vaccinated and unvaccinated individuals."

Testing may come in handy as gatherings for Halloween, Thanksgiving, and Christmas push people into close proximity.

"The best plan going into this winter is for everyone to remain vigilant, to use the tools we have: vaccines, testing, treatment against the illnesses responsible for the majority of fall and winter deaths and hospitalizations," Mandy Cohen, M.D., director of the U.S. Centers for Disease Control and Prevention, said Friday, CNN reported.

As for vaccines, the latest, strain-specific formulation of COVID-19 vaccine is now available, in both the RNA form (Moderna and Pfizer) or the Novavax protein-based alternative. The mRNA vaccines target the KP.2 "FLiRT" variant, which has been a dominant strain since late spring, while the Novavax shot targets JN.1, which is still around but perhaps less dominant than in months past.

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For patients with hemophilia B, fidanacogene elaparvovec, an adeno-associated virus (AAV) gene-therapy vector for hemophilia B containing a high-activity human factor IX variant, is superior to prophylaxis, according to a study published in the Sept. 26 issue of the New England Journal of Medicine.

Adam Cuker, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues conducted a phase 3 open-label study of fidanacogene elaparvovec at a dose of 5×1011 vector genome copies/kg of body weight in men aged 18 to 65 years with hemophilia B and a factor IX level of 2 percent or less; all men had received at least six months of therapy with prophylactic factor IX concentrate. Overall, 316 men underwent screening for the lead-in study; 204 were not eligible.

The researchers found that 44 of the 45 participants who received fidanacogene elaparvovec completed at least 15 months of follow-up. There was a 71 percent decrease observed in the annualized rate of bleeding for all bleeding episodes, from 4.42 at baseline to 1.28 after gene therapy. This result demonstrated the noninferiority and superiority of fidanacogene elaparvovec to prophylaxis. Based on a one-stage SynthASil assay, the mean factor IX activity was 26.9 percent at 15 months. Overall, 62 percent of participants received glucocorticoids for increased aminotransferase levels or decreased factor IX levels, with initiation between 11 and 123 days.

"The findings of this phase 3 study showed that fidanacogene elaparvovec had a favorable benefit-risk profile providing efficacy at one of the lowest doses of AAV-based gene therapy studied for hemophilia B," the authors write.

The study was funded by Pfizer, the manufacturer of fidanacogene elaparvovec.

Abstract/Full Text (subscription or payment may be required)

Copyright © 2020 HealthDay. All rights reserved.

The U.S. government is offering another round of free COVID-19 tests, which will be available by the end of September.

"U.S. households will be eligible to order four free COVID-19 tests at COVIDTests.gov," according to the U.S. Department of Health and Human Services. "The COVID-19 tests will detect current COVID-19 variants and can be used through the end of the year."

More than 900 million such tests have already been distributed to help people get tested and treated earlier and to perhaps keep them from spreading COVID-19 to others.

"At-home COVID tests can be taken at home or in other locations and typically provide results within 30 minutes or less," according to the HHS. "COVID tests can be administered to both vaccinated and unvaccinated individuals."

Testing may come in handy as gatherings for Halloween, Thanksgiving, and Christmas push people into close proximity.

"The best plan going into this winter is for everyone to remain vigilant, to use the tools we have: vaccines, testing, treatment against the illnesses responsible for the majority of fall and winter deaths and hospitalizations," Mandy Cohen, M.D., director of the U.S. Centers for Disease Control and Prevention, said Friday, CNN reported.

As for vaccines, the latest, strain-specific formulation of COVID-19 vaccine is now available, in both the RNA form (Moderna and Pfizer) or the Novavax protein-based alternative. The mRNA vaccines target the KP.2 "FLiRT" variant, which has been a dominant strain since late spring, while the Novavax shot targets JN.1, which is still around but perhaps less dominant than in months past.

More Information

Copyright © 2020 HealthDay. All rights reserved.