Health officials say that recalls of onions — the suspected source of the contamination — would help lessen the risk to consumers. Other major fast-food chains have also stopped offering onions.The number of people hospitalized from the E. coli outbreak linked to raw onions on McDonald’s Quarter Pounder hamburgers has more than doubled, and those reporting they have been sickened rose to 75, the Centers for Disease Control and Prevention reported on Friday.Illnesses of people ranging in age from 13 to 88 were reported in 13 states. Additionally, the C.D.C. said a second person had developed the life-threatening condition associated with E. coli called hemolytic uremic syndrome.While cases had been originally clustered in the Mountain West, updated data from the C.D.C. now shows cases in Michigan, Washington and Oregon. It is still unclear whether those people ate at McDonald’s in their home states or stopped at one of the restaurants while traveling.One older person in Colorado has died in the outbreak. The C.D.C. said the most recent illness occurred on Oct. 10, although the agency said more cases could be reported because it can take three to four weeks to determine whether an illness is part of the outbreak.Federal health officials said they hoped the risk to consumers would now be lower because onions have been recalled in many of those states, and many other fast-food chains including Taco Bell, KFC, Pizza Hut and Burger King also decided to stop offering onions in their menu items as a precautionary measure.News of the outbreak broke this week when the C.D.C. issued a food safety alert, as McDonald’s pulled its Quarter Pounders from locations in 10 states.The fast-food chain and the Food and Drug Administration have said preliminary investigations indicated that the raw, slivered onions served mainly atop the popular quarter-pound beef patties were a “likely source of contamination.” McDonald’s has also stopped providing fresh onions on its other burger items in the region.McDonald’s identified Taylor Farms as its onion supplier in the Mountain West and that company has since recalled several yellow onion products — slivered, diced and whole — because of “potential E. coli contamination.”Taylor Farms, a major fruit and vegetable supplier, did not respond to repeated requests for comment.Other restaurants that were customers and received the recalled onions have been notified and asked to remove the vegetables, the C.D.C. said.McDonald’s has halted sales of Quarter Pounders at restaurants in Colorado, Kansas, Utah, Wyoming, Idaho, Iowa, Missouri, Montana, Nebraska, Nevada, New Mexico and Oklahoma. Other hamburger items are not affected by the outbreak, the company emphasized.Regulators are still investigating whether the ground beef in the Quarter Pounder patties could have been a source of the bacteria.One lawsuit has already been filed by a resident who became sick after eating at a McDonald’s in Colorado, according to the law firm Ron Simon and Associates. That state has the higher number of cases, 26, the C.D.C. said, with Montana at 13 and Nebraska 11.

The body’s cooling defenses fail at lower “wet bulb” temperatures than scientists had estimated.Last month was the second-hottest September ever recorded; it came after the world’s warmest summer ever, in a year that is on track to be the most searing in recorded history.There’s only so much the human body can take. Heat killed 60,000 people in Europe alone in 2022, and at least 55,000 people in Russia in 2010. Now, growing research suggests that humans may be more vulnerable to rising temperatures than scientists had previously believed.“It’s scary as hell,” said Matthew Huber, director of the Institute for a Sustainable Future at Purdue University.In 2010, Dr. Huber and Steven Sherwood, a climate scientist at the University of New South Wales in Australia, first proposed a limit to how much heat the body could handle.They knew that humidity impedes evaporation and reduces the body’s ability to cool itself by sweating. And sweat is critical: It’s responsible for up to 80 percent of heat loss from the body. So the researchers turned to a measurement that accounts for this effect, called wet bulb temperature, or Tw.A wet bulb thermometer is essentially a thermometer wrapped in a damp wad of cotton. As water evaporates it cools the bulb, which makes it a convenient proxy for the way that sweating cools the body.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.

Federal officials have celebrated a striking drop in drug overdoses across the country. But state-level data shows that Black people are suffering significantly worse outcomes than white people.Overdose deaths across the country decreased by more than 12 percent between May 2023 and May 2024, according to new federal data, a major development in the nation’s efforts to combat the effects of fentanyl. The decrease continued a trend observed in recent months, and was the largest on record, the White House said last week.But a new analysis from Georgetown University researchers tells a more complicated story about a health crisis still claiming about 100,000 lives every year. In 22 states that track drug overdoses by race and ethnicity, the number of fatal overdoses among Black Americans typically increased between 2022 and 2023, while deadly overdoses among white Americans often decreased, the researchers found.The findings reveal a continuation of what federal and state health officials have described as a two-track epidemic, with white Americans experiencing better outcomes and Black Americans struggling to keep up. As overdose deaths rose to record levels in recent years, rates among Black and Native Americans were higher. But the more recent data goes further in showing how sharply the experiences of drug users have diverged by race.In Arizona, for instance, fatal drug overdoses among white people decreased by more than 2 percent, while overdoses among Black people increased by roughly a third. In Michigan, deadly drug overdoses among white people decreased by 12 percent, and increased among Black people by 6 percent. In Maine, fatal overdoses dropped by about 20 percent among white people but rose by over 40 percent among Black people.In states where decreases were found in both groups, they were typically smaller for Black Americans. In states where increases were found in both groups, they were often greater for Black people. And in places that tracked overdoses among Native and Hispanic Americans, similar disparities arose.Drug policy experts said that the new data underscored how public health strategies for drug addiction were still being applied unevenly, with deadly consequences. Naloxone, the overdose-reversing medication, has been harder to find for some Black Americans, as have addiction treatments.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.

Climate change, civil conflict and growing resistance to insecticides and treatments are all contributing to an alarming spread of cases.Malaria infection rates are soaring in Ethiopia, where a combination of armed conflict, climate change and mosquitoes’ growing resistance to drugs and insecticides has accelerated the spread of a disease the country once thought it was bringing under control.More than 6.1 million malaria cases, and 1,038 deaths, have been recorded in the country this year through the end of September, compared with 4.5 million cases, and 469 deaths, for all of 2023. Worse, cases are likely to soar far higher in the next couple of months because peak malaria season, driven by seasonal rains, begins in September and runs through the end of the year.“We’re backsliding so fast — we’ve gone back a decade,” said Fitsum Tadesse, the lead scientist overseeing the malaria program at the Armauer Hansen Research Institute in Addis Ababa, the capital of the country.The malaria surge in Ethiopia could prove to be a harbinger for other countries in the region, where the same underlying biological factors exist, and war and climate change are making more people vulnerable.Dr. Tadesse believes some of the rise in cases in Ethiopia is due to growing drug resistance: The parasites that cause malaria in East Africa are increasingly resistant to treatments that have long been the bedrock of the response.At the same time, mosquitoes are becoming more resistant to the insecticides that are used on protective bed nets and in indoor spraying programs. And they have evolved to evade diagnosis by some of the most common malaria tests.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.

BBCPioneering surgery to remove large brain tumours through the eyebrows of patients has been successfully carried out in Scotland.

Medicare — the federally funded health care program — has been in place since 1965. Since then, an expanding array of Medicare Advantage plans has become available. In 2024, the typical beneficiary could choose from 36 Advantage plans that included prescription drug coverage; for 2025, they’ll face an average of 34. (A reduction isn’t necessarily bad; too much choice can be paralyzing, research has shown.)Medicare Advantage plans, like traditional Medicare, are funded by the federal government, but they are offered though private insurance companies, which receive a set payment for each enrollee. The idea is to help control costs by allowing these insurers, which must cover the same services as traditional Medicare, to keep some of the federal payment as profit if they can provide care less expensively.The biggest providers of Advantage plans are Humana and UnitedHealthcare; they and other insurers market aggressively to persuade seniors to sign up or switch plans. A Senate report found that some companies’ practices were deceptive; for example, marketing firms have sent Medicare beneficiaries mailers made to look like government websites or letters. Medicare has issued regulations to reduce the confusion. But the marketing blitz has paid off for insurers. The proportion of eligible Medicare beneficiaries enrolled in Medicare Advantage plans has hit 54 percent, an all-time high.Bill Clark/CQ Roll Call, via Associated PressThe programs operate quite differently, and the health and financial consequences can be dramatic. Each has, well, advantages — and disadvantages.Jeannie Fuglesten Biniek, associate director at KFF, the health policy organization formerly known as the Kaiser Family Foundation, is a co-author of a recent literature review comparing Medicare Advantage and traditional Medicare. One important finding, Dr. Fuglesten Biniek said: “Both Medicare Advantage and traditional Medicare beneficiaries reported that they were satisfied with their care — a large majority in both groups.”Advantage plans offer simplicity. “It’s one-stop shopping,” she said. “You get your drug plan included, and you don’t need a separate supplemental policy.” Traditional Medicare beneficiaries often buy such supplemental insurance, known as Medigap policies, to cover out-of-pocket expenses like deductibles and coinsurance.Medicare Advantage may appear cheaper, too, because many plans charge low monthly premiums or none at all. Unlike traditional Medicare, Advantage plans also cap out-of-pocket expenses. Next year, you’ll pay no more than $9,350 in in-network expenses, excluding drugs — or $14,000 with the kind of plan that permits you to also use out-of-network providers at higher costs (called P.P.O.s, or preferred provider organizations).But the majority of Advantage plans don’t allow that choice. “Most plans operate like an H.M.O. — you can only go to contracted providers,” said David Lipschutz, co-director of the Center for Medicare Advocacy.Advantage enrollees may also be drawn to the plan by benefits that traditional Medicare can’t offer. “Vision, dental and hearing are the most popular,” Mr. Lipschutz said. Many plans also include gym memberships, transportation or certain over-the-counter items, though some are now scaling back such extras.“We caution people to look at what the scope of the benefits actually are,” he said. “They can be limited, or not available to everyone in the plan. Dental care might cover one cleaning and that’s it, or it may be broader.” Most Advantage enrollees who use these benefits still wind up paying most dental, vision or hearing costs out-of-pocket. One big disadvantage is that insurers require “prior authorization,” or approval in advance, for many procedures, drugs or facilities.“Your doctor or the facility says that you need more care” — in a hospital or nursing home, perhaps — “but the plan says, ‘No, five days, or a week, two weeks, is fine,’” said David Lipschutz, co-director of the Center for Medicare Advocacy. Then you must either forgo care or pay out-of-pocket.Advantage participants who are denied care can appeal, and in 2022 those who did had their denials reversed 83 percent of the time, according to an analysis by KFF. But only about 10 percent of beneficiaries or providers filed appeals, “which means there’s a lot of necessary care that enrollees are going without,” Mr. Lipschutz said.A report in 2022 by the inspector general’s office of the Department of Health and Human Services determined that 13 percent of services denied by Advantage plans met Medicare coverage rules and would have been approved under traditional Medicare.The Commonwealth Fund reported this year that Advantage enrollees were more likely to experience delays in getting care (22 percent) than those enrolled in traditional Medicare (13 percent), because of Advantage policies requiring prior authorization.And 12 percent of Advantage beneficiaries couldn’t afford care because of co-payments or deductibles, compared with 7 percent of those with traditional Medicare.Advantage plans can also prove problematic if you are traveling or spending part of each year away from home. If you live in Philadelphia but get sick in Florida, for example, all local providers may be out of network. Check to see how the plan you’re using or considering treats such situations.Justin Sullivan/Getty Images“The big pro is that there are no networks,” Jeannie Fuglesten Biniek, associate director at KFF, formerly the Kaiser Family Foundation, said of traditional Medicare. “You can see any doctor that accepts Medicare,” as most do, and use any hospital or clinic. Traditional Medicare beneficiaries also largely avoid the delays and frustrations of prior authorization requirements.But traditional Medicare sets no cap on out-of-pocket expenses, and its 20 percent co-pay can add up quickly for hospitalizations or expensive tests and procedures. So most beneficiaries either buy a supplemental Medigap policy to cover out-of-pocket expenses, or have supplementary coverage through an employer or Medicaid.Medigap policies are not inexpensive; in 2023 they averaged from $191 to $267 a month, KFF reported.A KFF literature review found that traditional Medicare beneficiaries experienced fewer cost problems than did Advantage beneficiaries if they had supplementary Medigap policies. But if they didn’t, Medicare beneficiaries were more likely to report issues like delaying care for cost reasons or having trouble with paying medical bills.Traditional Medicare also provides somewhat better access to high-quality hospitals and nursing homes. David Meyers, a health services researcher at Brown University, and his colleagues have been tracking differences between original Medicare and Medicare Advantage for years, using data from millions of people.The team has found that Advantage beneficiaries are 10 percent less likely to use the highest-quality hospitals, 4 percent to 8 percent less likely to be admitted to the highest-quality nursing homes, and half as likely to use the highest-rated cancer centers for complex cancer surgeries, compared with similar patients in the same counties or ZIP codes.What’s more, some Medicare Advantage plans have narrow provider networks, compared with those available through traditional Medicare, Dr. Meyers and his colleagues have reported.Some Advantage plans offer limited access to primary care doctors and to dialysis centers. Doctors who treat higher numbers of complex patients with greater social and medical risks are less available than through traditional Medicare.Johns Hopkins researchers reported in 2023 that most Advantage plans also offered narrow networks of psychiatrists, enrolling fewer than a quarter of those practicing in a service area.“Providers are starting to push back more on Medicare Advantage plans, and that leads to fewer providers — hospitals, doctors’ groups — willing to contract with Advantage plans,” said David Lipschutz, co-director of the Center for Medicare Advocacy.Generally, patients with high needs — people who were frail, limited in activities of daily living or had chronic conditions — were more apt to switch to traditional Medicare, especially in the final year of life, than those who were not high-need, Dr. Meyers and his colleagues have found.“When you’re healthier, you may run into fewer of the limitations of networks and prior authorization,” he said. “When you have more complex needs, you come up against those more frequently.”Another downside to traditional Medicare, though, is that it does not include drug coverage. For that, you need a separate Part D plan.Kenny Holston for The New York TimesHere’s where major policy shifts affecting Medicare Part D, which covers prescription drugs, make comparison shopping especially important in 2025. Advantage plans usually include drug coverage; in traditional Medicare, you must buy a separate Part D plan. But the changes will affect both.The most evident, through the Biden administration’s Inflation Reduction Act, is a $2,000 cap on out-of-pocket payments. “That’s a pretty big change in the level of financial protection it provides,” said Juliette Cubanski, deputy director of the program on Medicare policy at KFF, formerly the Kaiser Family Foundation.Moreover, the law mandates that after beneficiaries reach the $2,000 cap, insurers must now pay 60 percent of remaining drug costs, up from 20 percent.That means that “plans have stronger incentives to control costs,” Dr. Cubanski said. They are responding in various ways, increasing premiums or deductibles, reducing benefits and changing formularies, the lists of drugs that plans will cover.A few companies have withdrawn from the market entirely. But Medicare protections will keep premiums from skyrocketing, at least for the next few years.In 2024, beneficiaries could typically choose between 21 stand-alone Part D plans, at prices that ranged from $1 to $108 a month and averaged $43 for policies available nationwide, according to KFF analyses. In 2025, there will be 15 in most regions.They typically have a annual deductible, $590 in 2025. You pay that amount out-of-pocket before coverage kicks in.Then, a Part D plan, either stand-alone or as part of a Medicare Advantage plan, usually establishes five tiers of drugs with different coinsurance payments for each, from low-cost generics to brand names to high-priced specialty meds.To keep consumer costs reasonable during this transition, Medicare has started a demonstration program for stand-alone Part D plans. “The maximum premium increase people will see for stand-alone coverage is $35” per month, Dr. Cubanski said. If Medicare hadn’t taken action, “premium increases certainly would have been larger.”Some plans will not increase premiums that much; some will charge less than in 2024. The demonstration program, which nearly all Part D insurers are participating in, will remain in effect through 2027.Comparing plan formularies is always a complicated process. “Plans make choices about which drugs they cover and which they don’t,” Dr. Cubanski said.Different plans cover different drugs (which can change from year to year) and place them in different pricing tiers. To make comparisons more dizzying, certain pharmacy chains are “preferred” by certain plans, so you could pay more at CVS than at Walmart for the same drug, or vice versa.Because of the $2,000 out-of-pocket cap, formularies matter more than ever. Consider the injectable weight-loss medication Wegovy, for instance. “If your plan covers it, you won’t pay more than $2,000” a year, Dr. Cubanski said. “If you’re enrolled in a plan that doesn’t cover that drug, you pay the full out-of-pocket cost,” which could exceed $15,000.Next year will also bring the voluntary Medicare Prescription Payment Plan, offered by all Part D plans. It allows beneficiaries to pay their out-of-pocket drug costs in monthly installments instead of all at once.Part D beneficiaries with diabetes should already be saving money on insulin, since last year Medicare began capping prices at $35 a month. Beneficiaries taking expensive drugs may save more in 2026, because Medicare now negotiates prices with drug makers. It announced negotiated prices for 10 medications starting in 2026, with up to 15 more slated in each of the following two years, and up to 20 annually thereafter — another provision of the Inflation Reduction Act.Most adult vaccines are free for Medicare beneficiaries.You can, but be careful.Switching between Medicare Advantage plans is fairly easy. But switching from traditional Medicare to an Advantage plan can cause a major problem: You relinquish your Medigap policy, if you had one. (Medigap is a separate insurance plan that covers out-of-pocket expenses like deductibles and co-insurance.)Then, if you later become dissatisfied and want to switch back from Advantage to traditional Medicare, you may not be able to replace that policy. With some exceptions, Medigap insurers can deny your application or charge high prices based on factors like pre-existing conditions.“Many people think they can try out Medicare Advantage for a while, but it’s not a two-way street,” said David Lipschutz, co-director of the Center for Medicare Advocacy.Except in four states that guarantee Medigap coverage at set prices — New York, Massachusetts, Connecticut and Maine — “it’s one type of insurance that can discriminate against you based on your health,” he said.Pablo Martinez Monsivais/Associated PressYou will find plenty of information on the Medicare.gov website, including the Part D plan finder, where you can input the drugs you take to see which plan gives you the best, most economical coverage. The toll-free 1-800-MEDICARE number can also assist you.Perhaps the best resources, however, are the federally funded State Health Insurance Assistance Programs, where trained volunteers help consumers assess both Medicare and drug plans.These programs “are unbiased and don’t have a pecuniary interest in your decision making,” said David Lipschutz, co-director of the Center for Medicare Advocacy.But their appointments tend to fill up quickly at this time of year, and the annual open enrollment period ends on Dec. 7. Don’t delay.

Getty ImagesPeople are being told not to ignore an itchy rash, with GPs in England reporting a spike in scabies – the highly infectious skin infestation.

Two people sharing a home caught the virus without known exposure to animals. More than 30 human cases have been reported in the United States.A Missouri resident who shared a home with a patient hospitalized with bird flu in August was also infected with the virus, federal officials reported on Thursday.But symptomatic health care workers who cared for the hospitalized patient were not infected, testing showed. The news eased worries among researchers that the virus, H5N1, had gained the ability to spread more efficiently among people.Still, the number of human cases is rising in the United States. California said this week that it had confirmed 15 human cases of bird flu. Washington State has reported two poultry workers who are infected and five others presumed to be positive.There are 31 confirmed cases in the country, but experts have said the figure is likely to be an undercount. “Additional cases may be found as investigations continue,” Dr. Nirav Shah, the principal deputy director of the Centers for Disease Control and Prevention, said at a news briefing on Thursday.“The identification of these additional cases of H5 in people with exposures to infected animals does not change C.D.C. risk assessment for the general public, which continues to be low,” he said.The poultry workers in Washington State were infected with a version of the virus that is distinct from the one circulating in dairy cattle, he added.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.

Officials said the onions served atop the popular hamburger were the likely source of an E. coli outbreak that has killed one person and sickened many others.One day after a multistate E. Coli outbreak linked to McDonald’s Quarter Pounder hamburgers was publicized, a major supplier of onions in that region has issued a recall.Though federal regulators have not confirmed the source of the outbreak, which has so far killed one person and sickened 49, initial investigations have suggested that the fresh slivered onions served mainly atop the Quarter Pounder were a “likely source of contamination.”Taylor Farms, the sole supplier of those onions to the affected McDonald’s locations in 10 states, issued a recall Wednesday of several yellow onion products because of “potential E. coli contamination,” according to a notice from U.S. Foods, which distributes the products to many restaurants.The notice instructed restaurants to immediately stop serving the specified onions — diced, peeled and whole — and destroy them.The items were voluntarily recalled by Taylor Farms Colorado out of an “abundance of caution,” a spokeswoman for U.S. Foods said in an email. Taylor Farms did not immediately respond to requests for comment.McDonald’s and the Food and Drug Administration said preliminary reviews linked the outbreak to those slivered onions, but health officials and McDonald’s said they had not ruled out possible contamination of the quarter-pound beef patties used for the popular menu item. The Department of Agriculture and the Centers for Disease Control and Prevention are also investigating the source of the contamination.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 agency endorsed additional doses for people at high risk.The Centers for Disease Control and Prevention on Wednesday expanded its Covid vaccine recommendations, urging some people to get additional doses of the updated shots.The agency said that people 65 and older and those who are moderately or severely immunocompromised should receive a second dose of the vaccines that rolled out this fall six months after their first shot. Under the new guidelines, people with compromised immune systems also have the flexibility to get three or more doses of the updated vaccine, in consultation with their health care providers. This group includes people with advanced H.I.V. infection and those undergoing chemotherapy or receiving some therapies for autoimmune conditions, said Dr. Donald Dumford, an infectious disease doctor at the Cleveland Clinic.The move makes it easier for those most at risk for dying or becoming very sick from Covid to get additional protection.“If the person is willing to get it, great — we now have the green light to give it to them, in no uncertain terms,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center.Not everyone, of course, will be willing: Covid vaccine uptake has remained stubbornly low over the last few years. As of Oct. 12, only around 12 percent of adults reported receiving an updated vaccine, according to data from the C.D.C.The vaccines are well matched against the variants that are currently circulating, offering some defense against infection and curbing a person’s risk of hospitalization or death from the virus. Vaccines also reduce a person’s chances of developing long Covid. But immunity wanes over time.“There’s just a greater need than ever to have a more durable strategy, vaccination-wise,” said Dr. Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center in Chicago.Covid poses a particular challenge because the virus spreads year-round, spiking in unpredictable waves; it’s difficult to sustain protection, especially among people with compromised immune systems. The C.D.C.’s new recommendations signal a shift in how the medical community thinks about vaccinations, Dr. Schaffner said.“This is not a way we usually give vaccines,” he said. But, he added, “we have to move into this new way of providing vaccine protection.”