Plans for a new chippy have come up against a health board’s demands for fruit and veg on the menu.

Both patients were dairy workers whose illnesses were mild. Investigators are continuing to evaluate the contacts of a Missouri patient who had no exposure to animals.Two more people were diagnosed with bird flu this week, even as scientists in Missouri continued to investigate a possible cluster of infections in that state, federal health officials said at a news briefing on Friday.In California, two farmworkers who were exposed to infected dairy cattle at different farms tested positive for the virus, called H5N1, state health officials said on Thursday. Those cases bring the total this year to 16, not including those under investigation.The cases do not come as a surprise, because the number of infected herds in California has risen to 56 from 16 two weeks ago, said Dr. Nirav Shah, the principal deputy director at the Centers for Disease Control and Prevention.“As there are more herds that test positive, there are more workers who are exposed, and where there are more workers who are exposed, the chances of human infection increase,” he said. The risk to the public remains low, he added.Still, experts said that the appearance of H5N1 in multiple states was worrisome. Flu viruses are adept at acquiring new abilities by swapping their genes. As the flu season swings in, even one person who becomes infected with both bird flu and the seasonal flu virus could help H5N1 to gain the ability to spread as readily among people as seasonal flu does.Given the many variables, it’s difficult to gauge the true risk of the virus mutating into a more contagious form, said Jesse Bloom, an evolutionary biologist at the Fred Hutchinson Cancer Center in Seattle.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.

Getty ImagesA trial to let women with worrying breast cancer symptoms book appointments directly with diagnostic clinics without going to see their GP first is being planned in one region of England.

The World Health Organization (WHO) has approved the first diagnostic test for mpox where the results can be immediately known, saying it could prove pivotal in helping to stop the rising global cases of the deadly virus.

A growing number of marijuana users in the U.S. are experiencing severe health problems like these.As marijuana legalization spreads across the country, people are consuming more of the drug, more often and at ever-higher potencies. Most of the tens of millions of people using marijuana, for health benefits or for fun, don’t experience problems. But a growing number, mainly heavy users, have experienced addiction, psychosis and other harmful effects, The New York Times found.“Cannabis is a lot of things at once,” said Dr. Kevin Gray, a psychiatrist and specialist in bio-behavioral medicine at Medical University of South Carolina Health. “It can be medically therapeutic. It also can be highly problematic.”In interviews and surveys, hundreds of people told The Times about serious — sometimes frightening — symptoms that they were stunned to learn could be caused by cannabis. Here are some of their stories.Cannabinoid Hyperemesis Syndrome‘A Real Danger’David Krumholtz, an actor known for films like “10 Things I Hate About You” and TV shows like “Numb3rs,” resumed smoking marijuana in 2016, after a decade-long break. Within months, he started to experience cycles of intense nausea and vomiting — a sometimes debilitating condition called cannabinoid hyperemesis syndrome. It can lead to dehydration, seizures, kidney failure, cardiac arrest and even death in rare instances.He lost 100 pounds and was in and out of emergency departments. At home in New Jersey, he would spend 10 hours at a time in hot baths, which for unknown reasons can temporarily relieve symptoms.David Krumholtz said the symptoms he suffered nearly cost him his dream job.Michelle V. Agins/The New York TimesWe 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.

There are lots of reasons your mood might tank at night. Here’s how to address the bedtime blues.It’s not uncommon for our minds to unleash a torrent of difficult feelings under the cover of darkness: sadness and negative thoughts may surface at night, making sleep hard to come by.On social media and elsewhere people often refer to this as “nighttime depression.” But is that really a thing? And if so, why do some people get blue at night?Feeling down after dusk doesn’t necessarily mean that you have a mental health condition, experts said. Understanding why it happens can help you take steps to feel better.What is nighttime depression?Nighttime depression is a colloquial term for depressive symptoms that either appear or worsen late at night. It is not itself a diagnosis.While anxiety can also ramp up at night, and tends to make people feel agitated, tense and restless, nighttime depression is best characterized as a low mood. “It’s a sense of sadness,” said Dr. Theresa Miskimen Rivera, a clinical professor of psychiatry at Rutgers University and president-elect of the American Psychiatric Association. “It’s that feeling of: There’s no joy. My life is so blah.” 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.

The drug, legal in much of the country, is widely seen as nonaddictive and safe. For some users, these assumptions are dangerously wrong.In midcoast Maine, a pediatrician sees teenagers so dependent on cannabis that they consume it practically all day, every day — “a remarkably scary amount,” she said.From Washington State to West Virginia, psychiatrists treat rising numbers of people whose use of the drug has brought on delusions, paranoia and other symptoms of psychosis.And in the emergency departments of small community hospitals and large academic medical centers alike, physicians encounter patients with severe vomiting induced by the drug — a potentially devastating condition that once was rare but now, they say, is common. “Those patients look so sick,” said a doctor in Ohio, who described them “writhing around in pain.”As marijuana legalization has accelerated across the country, doctors are contending with the effects of an explosion in the use of the drug and its intensity. A $33 billion industry has taken root, turning out an ever-expanding range of cannabis products so intoxicating they bear little resemblance to the marijuana available a generation ago. Tens of millions of Americans use the drug, for medical or recreational purposes — most of them without problems.But with more people consuming more potent cannabis more often, a growing number, mostly chronic users, are enduring serious health consequences.The accumulating harm is broader and more severe than previously reported. And gaps in state regulations, limited public health messaging and federal restraints on research have left many consumers, government officials and even medical practitioners in the dark about such outcomes.

Proposals to give terminally ill people in England and Wales the right to choose to end their life are to be introduced in Parliament this month.

The health secretary is expected to urge GPs in England to end collective action and warn it will “only punish patients” in a speech on Friday.

In Rwanda, 11 deaths have been reported from this rare but deadly disease. Two people tested negative in Germany this week.Rwanda is in the midst of an outbreak of Marburg virus disease, a hemorrhagic fever with a high fatality rate that has killed 11 people there this year.The disease has been found in multiple African countries over the last several decades but never before in Rwanda, in east-central Africa. It was first detected in the country in late September, and since then, 36 cases have been reported, according to the health ministry of Rwanda.This week, the authorities in Germany closed part of Hamburg’s central train station after a medical student and his companion reported feeling ill. The medical student had had contact with an infected patient while in Rwanda. Both people in Germany tested negative for Marburg, the authorities announced this week, emphasizing that there was no risk to the public.Here’s what we know about the disease.What is Marburg virus disease?Marburg was first detected in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in the German cities of Marburg and Frankfurt and in Belgrade, in what is now Serbia. The cases were linked to African green monkeys that had been imported from Uganda. Other cases were later found in Angola, the Democratic Republic of Congo, Ghana, Kenya, South Africa and Uganda, according to the World Health Organization.The Marburg virus is the pathogen that causes the disease in humans.A colorized scanning of an electron micrograph shows Marburg virus particles (in blue), both budding and attached to the surface of infected cells (in yellow).Image Point FR/National Institutes of Health/National Institute of Allergy and Infectious Diseases/BSIP/Universal Images Group via Getty ImagesThe disease is clinically similar to Ebola in its spread, symptoms and progression, although it is caused by a different virus, according to the W.H.O.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.