Fewer people came forward for their flu vaccine last year and if the same happens again the UK could be in for a worse winter, health officials are warning.

BBC / October Films“It almost looked like she was walking on clouds that day,” says Maren Sheldon, twin sister of the late breast cancer campaigner, Kris Hallenga.

The death, which was reported on Friday, is only the fifth fatal human rabies case in Minnesota since 1975, health officials said.A patient who was exposed to a bat in western Minnesota this year died from rabies this week, becoming the fifth person since 1975 to die from the treatable disease in the state, health officials said on Friday.The Minnesota Department of Health said in a statement that it was still investigating the death, and did not explicitly say that a bat had caused the rabies but confirmed that the patient was exposed to a bat in July.The U.S. Centers for Disease Control and Prevention confirmed the patient’s rabies diagnosis earlier this month. The Minnesota Department of Health said there was not a public health risk.Fewer than 10 rabies deaths are reported annually in the United States, according to the C.D.C., and 70 percent of those deaths are attributed to exposure to bats.Previous human cases in Minnesota — all of which were fatal — were recorded in 1917, 1964, 1975, 2000, 2007 and 2021, according to the department.“If left untreated, rabies is almost always fatal,” the department said. “Rabies treatment has proven to be nearly 100 percent effective at preventing the disease after an exposure, but it must be started before symptoms of rabies appear.”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.

A pet trust designates a new guardian for companion animals and sets aside funds for their care. Better yet, it’s legally binding.In 2016, Tracy Jennings received shocking news: A lifelong friend, a woman who had a farm with animals great and small, had died suddenly in an accident.A circle of grieving friends hastily arranged new homes for the woman’s beloved animals, including three older horses. But just two weeks after her death, her family had the horses euthanized.“It was very sad, a real kick in the head,” Ms. Jennings said. “But we had no legal rights, and she had nothing in writing.”Ms. Jennings, 66, a semiretired landscape designer, lives on a 10-acre farm in Buffalo, Minn., and has her own menagerie: five cats, a golden retriever, two horses and a donkey named Niles. They would not meet a similar fate, she decided.“There’s nothing sadder than seeing pets wind up at a shelter because the older person who cared for them has died,” she said.She had a lawyer draw up a pet trust, a legal document specifying who will care for her animals when she dies or becomes unable to do so herself. Her trust provides money to cover veterinary bills, food, grooming, boarding and unexpected expenses. It specifies which vet to use. Attached guidelines impart care instructions, including particular foods and animals’ “personality characteristics.”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.

Specialized viewfinders installed across state parks let visitors with red-green colorblindness see more distinct colors.Like so many other leaf-peeping enthusiasts, Tim Yates ventured out to Virginia’s Smith Mountain Lake State Park late this summer to see the early whispers of the fall foliage, which would soon give way to bright bursts of orange and red.But for Mr. Yates, it was a rare opportunity to see the leaves, whether they were just beginning to turn or in their full glory.For his entire life, Mr. Yates, 56, has been red-green colorblind, meaning his eyes have trouble distinguishing between certain hues. For him, the leaf-peeping experience can be relatively muted.“Clothes or flowers and a lot of different stuff, I just never really knew the color,” Mr. Yates, a retired beverage salesman from Bedford County, Va., said. “In school, I always struggled with colors.”But at Smith Mountain Lake, which is an hour outside Roanoke, Va., new specialized viewfinders allow Mr. Yates and others like him to appreciate the scarlets and golds on oak and maple trees from a distance. This year, the state park system was the first in the nation to install the red-green colorblind viewfinders at all of its locations, according to a statement from Virginia State Parks. Each one is equipped with lenses that expand the visible ranges of the fall displays.“I could actually see the red and distinguish the colors,” Mr. Yates said.The viewfinders went through a trial run and were installed at all Virginia state parks. Virginia State ParksWe 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.

Federal regulators spent billions of dollars to avoid a spike in costs for older Americans that could have been politically damaging to the presidential campaign of Vice President Kamala Harris.The Biden administration on Friday announced that next year older Americans would face lower average monthly premiums for their prescription drugs, a feat achieved by pouring billions of dollars into subsidies for insurers. The move avoided a potential minefield of higher costs affecting the nation’s most stalwart voters weeks before the presidential election.In a savvy response to the specter of huge spikes in costs, administration officials decided months ago to funnel money from a Medicare trust fund to offset rate increases that could have cost millions of people hundreds of dollars more a year.Premiums would have gone up largely because of a $2,000 annual cap on out-of-pocket spending, and other changes to Medicare under President Biden’s signature legislative accomplishment, the Inflation Reduction Act.Higher premiums could have been politically damaging to the presidential campaign of Vice President Kamala Harris, and threatened one of the Biden-Harris administration’s most important talking points — its success in lowering patients’ drug costs. The reality is that when patients pay less at the pharmacy counter, somebody has to foot the bill.Republicans have sharply criticized the administration’s offset plan, known as a demonstration, since it was announced in July, calling it a nakedly political ploy meant to sway votes and saying it would offer only temporary relief to older people.“The administration came up with this Part D demo in order to shovel billions of dollars more into the program to mask the huge premium increases that would be coming next year without it,” Joe Grogan, a senior White House official under former President Donald J. Trump, said in an interview.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.

Seven people in contact with a patient hospitalized with bird flu also developed symptoms, the C.D.C. reported. Some are undergoing further tests.A possible cluster of bird-flu infections in Missouri has grown to include eight people, in what may be the first examples of person-to-person transmission in the United States, the Centers for Disease Control and Prevention reported on Friday.If confirmed, the cases in Missouri could indicate that the virus may have acquired the ability to infect people more easily. Worldwide, clusters of bird flu among people are extremely rare. Most cases have resulted from close contact with infected birds.Health officials in Missouri initially identified a patient with bird flu who was hospitalized last month with unusual symptoms. The patient may have infected one household member and six health care workers, all of whom developed symptoms, according to the C.D.C.Investigators have not yet confirmed whether any of those seven individuals were infected with the virus, called H5N1, leaving open the possibility that they had Covid or some other illness with flulike symptoms.Still, the news alarmed experts.“We should be very concerned at this point,” said Dr. James Lawler, co-director of the University of Nebraska’s Global Center for Health Security.“Nobody should be hitting the panic button yet, but we should really be devoting a lot of resources into figuring out what’s going on.”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.

Shares of the company, one of the largest chains of for-profit psychiatric hospitals, were down 25 percent at one point.Acadia Healthcare, one of the country’s largest chains of for-profit psychiatric hospitals, is facing a fresh round of federal investigations into how the company admits patients and bills for their stay, the company disclosed on Friday.The company, which operates more than 50 psychiatric hospitals nationwide and gets much of its revenue from government insurance programs, said that federal prosecutors in Manhattan this week requested information from the company and that it also received subpoenas from a federal grand jury in Missouri. Acadia said it expected to receive similar inquiries from the Securities and Exchange Commission.The news rattled investors. Acadia’s stock price fell more than 25 percent on Friday morning before trimming some losses.The federal investigations followed a recent New York Times investigation that found that Acadia was holding patients against their will in ways that appeared to violate state laws. The Times reported that some patients arrived at emergency rooms seeking routine mental health care but then were sent to Acadia facilities and locked in.The Times investigation was based on official complaints, court records and interviews with dozens of current and former Acadia employees, as well as patients who found themselves trapped inside the company’s facilities.The news of the federal investigations came a day after the Justice Department announced that Acadia had agreed to pay nearly $20 million to settle claims that it had defrauded government health insurers by holding patients longer than medically necessary and admitting people who didn’t need to be there. Once patients entered its facilities, the government said, Acadia failed to provide therapy and kept staffing dangerously low, leading to assaults and suicides.Under the settlement, Acadia agreed to pay the federal government as well as four states — Florida, Georgia, Michigan and Nevada — to resolve allegations that the company had violated state laws.Acadia did not admit wrongdoing in that case, which covered conduct from 2014 through 2017.Acadia said on Friday that the new round of federal subpoenas and information requests were related to its admissions, length of stay and billing practices and that the company was fully “cooperating with authorities.” It added that the company “cannot speculate on whether the outcome of these investigations will have any impact on its business or operations.”Acadia also said that the experiences of patients described in The Times article were “completely inconsistent with Acadia’s policies” and that “all decisions on patient care, including whether treatment is necessary and for how long, are made by licensed physicians” and follow the law.The Times reported on Thursday that several former Acadia employees in Georgia and Missouri have recently been interviewed by agents from the F.B.I. and the inspector general’s office of the Health and Human Services Department.

The birth defects were more likely, but still very uncommon, in infants conceived through certain fertility treatments, a large study found.Major heart defects are more common — but still rare — in babies conceived through certain fertility treatments, including in vitro fertilization, researchers reported on Thursday in the largest study of its kind.The research, which included medical records of more than seven million Nordic children, also bolstered evidence that I.V.F. is associated with a small but significant uptick in birth abnormalities.“It’s an increased risk, but the absolute risk is very small,” said Dr. Ulla-Britt Wennerholm, the senior author of the paper and a professor of obstetrics and gynecology at the University of Gothenburg in Sweden.“I think that’s a reassuring finding, actually.”The study focused on children born between 1984 and 2015 in Denmark, Sweden, Norway and Finland as a result of a class of fertility treatments called assisted reproductive technology, the most common of which is I.V.F.The risk of a major heart defect was about 36 percent higher in this group than in children who were naturally conceived. But the defects were still uncommon: Less than 2 percent of infants conceived through A.R.T. were born with major heart defects.The risk of heart defects didn’t change based on whether the parents underwent I.C.S.I., a procedure in which sperm is injected into an egg, or I.V.F., which allows the sperm to penetrate the egg naturally in a lab dish.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 ImagesThe doctors’ union, the BMA, says it will take “a neutral position” on the recommendations of a landmark review into care for children and young people with gender identity issues.