Missouri Reports Bird Flu in a Patient Without a Known Risk

Previous human infections occurred in workers on farms. But community transmission of the virus remains unlikely for now, experts said.Officials in Missouri on Friday identified the first American infected with bird flu who had no known exposure to the infected animals or birds that have been plaguing the nation’s farms for more than six months.The case brings this year’s number of human bird-flu infections to 14. Previous human cases were all acquired from interactions with infected dairy cattle or poultry. The new patient raises the unsettling possibility that the virus, called H5N1, may be spreading undetected among people.How the person became infected is unknown, but Missouri health officials said they are trying to pinpoint the source.“The route of transmission is going to determine how much more escalated the risk of the disease is to the general public,” said Dr. Nahid Bhadelia, director of Center on Emerging Infectious Diseases at Boston University.The case was picked up by routine seasonal flu surveillance conducted in Missouri, where the person was hospitalized, and not during an investigation on a farm. The state has not reported any infections on its cattle farms, but has detected the virus in some commercial and backyard flocks, as well as in wild birds.Since March, the bird flu virus has been found in nearly 200 dairy herds in 14 states, although testing has not been conducted widely enough to gauge the full spread. California, the nation’s largest milk producer, found bird flu in three cattle herds last week.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.

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Vyvanse Production Increased by D.E.A. Amid A.D.H.D. Medication Shortage

The D.E.A. is increasing its quota for the popular stimulant as patients still struggle to fill prescriptions.Patients and caregivers have struggled for two years to find stimulant medications like Adderall, Vyvanse and Concerta to treat attention deficit hyperactivity disorder. Some spend hours each month going from pharmacy to pharmacy to find a drug, while others are forced to switch to a different brand or formulation, or go without medication for weeks.This week the Drug Enforcement Administration announced a potential solution: It is raising the amount of lisdexamfetamine (Vyvanse) that can be produced by U.S. manufacturers this year by nearly 24 percent to meet demand in the United States and abroad.Vyvanse is an amphetamine that has been approved for use in children and adults with A.D.H.D. and has become commonly prescribed after the generic version was introduced last year. According to the D.E.A., the latest data shows that demand for the drug has been rising globally. But right now every manufacturer of generic Vyvanse listed on the Food and Drug Administration website is experiencing a shortage.Many health care providers who specialize in treating patients with A.D.H.D. said that the D.E.A.’s decision was a positive development but that it was unclear just how much of an effect it might have on the shortage.“Obviously it’s not going to solve the problem completely,” said Ami Norris-Brilliant, clinical director of the Division of A.D.H.D., Learning Disorders, and Related Disorders at the Icahn School of Medicine at Mount Sinai in New York City. “But I think anything that helps increase drug availability is a good thing.”It is not the first time that the D.E.A. has increased production quotas for A.D.H.D. drugs. Last year it announced a new 2023 limit for methylphenidate, which is used to make drugs like Ritalin and Concerta, raising the allotted amount by 27 percent for 2023. The drug remains in shortage, however, in the extended release formulation.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.

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Time to Say Goodbye to the B.M.I.?

Researchers have long faulted the body mass index as an unreliable indicator of health. A replacement has been gaining support: the body roundness index.Move over, body mass index. Make room for roundness — to be precise, the body roundness index.The body mass index, or B.M.I., is a ratio of height to weight that has long been used as a medical screening tool. It is one of the most widely used health metrics but also one of the most reviled, because it is used to label people overweight, obese or extremely obese.The classifications have been questioned by athletes like the American Olympic rugby player Ilona Maher, whose B.M.I. of 30 technically puts her on the cusp of obesity. “But alas,” she said on Instagram, addressing online trolls who tried to shame her about her weight, “I’m going to the Olympics and you’re not.”Advocates for overweight individuals and people of color note that the formula was developed nearly 200 years ago and based exclusively on data from men, most of them white, and that it was never intended for medical screening. A Black nutritionist once called it the “bull**** measure index.”Even physicians have weighed in on the shortcomings of B.M.I. The American Medical Association warned last year that B.M.I. is an imperfect metric that doesn’t account for racial, ethnic, age, sex and gender diversity. It can’t differentiate between individuals who carry a lot of muscle and those with fat in all the wrong places.“Based on B.M.I., Arnold Schwarzenegger when he was a bodybuilder would have been categorized as obese and needing to lose weight,” said Dr. Wajahat Mehal, director of the Metabolic Health and Weight Loss Program at Yale University.“But as soon as you measured his waist, you’d see, ‘Oh, it’s 32 inches.’”So welcome a new metric: the body roundness index. B.R.I. is just what it sounds like — a measure of how round or circlelike you are, using a formula that takes into account height and waist, but not weight.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.

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Surprising New Research Links Infant Mortality to Crashing Bat Populations

Without bats to eat insects, farmers turned to more pesticides, a study found. That appears to have increased infant deaths.The connections are commonsense but the conclusion is shocking.Bats eat insects. When a fatal disease hit bats, farmers used more pesticides to protect crops. And that, according to a new study, led to an increase in infant mortality.According to the research, published Thursday in the journal Science, farmers in affected U.S. counties increased their use of insecticides by 31 percent when bat populations declined. In those places, infant mortality rose by an estimated 8 percent.“It’s a seminal piece,” said Carmen Messerlian, a reproductive epidemiologist at Harvard who was not involved with the research. “I actually think it’s groundbreaking.”The new study tested various alternatives to see if something else could have driven the increase: Unemployment or drug overdoses, for example. Nothing else was found to cause it.Dr. Messerlian, who studies how the environment affects fertility, pregnancy and child health, said a growing body of research is showing health effects from toxic chemicals in our environment, even if scientists can’t put their fingers on the causal links.“If we were to reduce the population-level exposure today, we would save lives,” she said. “It’s as easy as that.”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.

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Teenage E-Cigarette Use Continues to Decline

The percentage of middle and high school students reporting that they vaped tobacco products dropped to about a third of those students reporting use of e-cigarettes at a vaping peak in 2019, a new survey shows.The number of teenagers who reported using e-cigarettes in 2024 has tumbled from a worrisome peak reached five years ago, raising hopes among public health officials for a sustained reversal in vaping trends among teens.In an annual survey conducted from January through May in schools across the nation, fewer than 8 percent of high school students reported using e-cigarettes in the past month.That’s far lower than the apex, in 2019, when more than 27 percent of high school students who took the same survey reported that they vaped — and an estimated 500,000 fewer adolescents than last year.The data is from the National Youth Tobacco Survey, a questionnaire filled out by thousands of middle and high school students that is administered each year by the Food and Drug Administration and the Centers for Disease Control and Prevention. Overall, it found that just under 6 percent of middle and high school students reported vaping in the last month, down from nearly 8 percent among those surveyed last year. Use among high school students largely accounted for this year’s decline; middle school use stayed fairly steady.“I want to be unequivocally clear that this continued decline in e-cigarette use among our nation’s youth is a monumental public health win,” Brian King, the director of the F.D.A.’s tobacco division, said during a news briefing.Public health experts said the decline in teenage vaping may be due to several factors, including city and state flavored tobacco bans, a blitz of enforcement against sellers of flavored vapes and three public messaging campaigns aimed at young people about the dangers of vaping.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.

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