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U.S. public health officials have been told to stop working with the World Health Organization (WHO), effective immediately.
A CDC official, John Nkengasong, MSc, PhD, sent a memo to senior leaders at the agency on Sunday night telling them that all staff who work with the WHO must immediately stop their collaborations and “await further guidance.”
Experts said the sudden stoppage was a surprise and would set back work on investigating and trying to stop outbreaks of Marburg virus and mpox in Africa, as well as brewing global threats. It also comes as health authorities around the world are monitoring bird flu outbreaks among U.S. livestock.
The Associated Press viewed a copy of Nkengasong’s memo, which said the stop-work policy applied to “all CDC staff engaging with WHO through technical working groups, coordinating centers, advisory boards, cooperative agreements, or other means — in person or virtual.” It also says CDC staff are not allowed to visit WHO offices.
President Trump last week issued an executive order to begin the process of withdrawing the U.S. from WHO, but that did not take immediate effect. Leaving WHO requires the approval of Congress and that the U.S. meets its financial obligations for the current fiscal year. The U.S. also must provide a 1-year notice.
His administration also told federal health agencies to stop most communications with the public through at least the end of the month.
“Stopping communications and meetings with WHO is a big problem,” said Jeffrey Klausner, MD, MPH, a University of Southern California public health expert who collaborates with WHO on work against sexually transmitted infections.
“People thought there would be a slow withdrawal. This has really caught everyone with their pants down,” said Klausner, who said he learned of it from someone at CDC.
“Talking to WHO is a two-way street,” he added, noting that the two agencies benefit from each other’s expertise. The collaboration allows the U.S. to learn about new tests, new treatments, and emerging outbreaks — information “which can help us protect Americans abroad and at home,” Klausner said.
The CDC details nearly 30 people to WHO and sends many millions of dollars to it through cooperative agreements. The U.S. agency also has some of the world’s leading experts in infectious diseases and public health threats, and the two agencies’ staffers are in daily contact about health dangers and how to stop them.
The collaboration halt isn’t the only global health effect of Trump’s executive orders. Last week, the president froze spending on another critical program, PEPFAR, or the President’s Emergency Plan for AIDS Relief.
The anti-HIV program is credited with saving 25 million lives, including those of 5.5 million children, since it was started by Republican President George W. Bush. It was included in a Trump administration freeze on foreign aid spending slated to last at least 3 months.
PEPFAR provides HIV medication to more than 20 million people “and stopping its funding essentially stops their HIV treatment,” International AIDS Society President Beatriz Grinsztejn, MD, PhD, said in a statement. “If that happens, people are going to die and HIV will resurge.”
A U.S. health official confirmed that the CDC was stopping its work with WHO. The person was not authorized to talk about the memo and spoke on condition of anonymity.
A WHO spokesperson referred questions about the withdrawal to U.S. officials.
Officials at HHS didn’t immediately respond to an emailed request for comment. And CDC officials didn’t respond to the AP’s request to speak with Nkengasong about the memo.

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The White House budget office ordered a pause to all grants and loans disbursed by the federal government. (Washington Post)
The acting NIH director told scientists that clinical trials could continue, despite a pause in communications about their work. (NBC News)
Senior officials at U.S. Agency for International Development, including leaders overseeing global health aid, were put on paid leave in response to what an official characterized as resistance to President Donald Trump’s policy. (New York Times)
Have the Trump administration’s changes at federal health agencies affected you? Contact MedPage Today here to tell your story.
Here’s what Robert F. Kennedy Jr., Trump’s pick to lead HHS, might face in his nomination hearings this week. (KFF Health News)
The Wall Street Journal’s editorial board came out in opposition to Kennedy. (The Hill)
Kennedy said he’s open to seizing drug patents in a closed-door meeting with Senate Finance Committee staffers. (Politico)
Heart disease remains a leading cause of death, fueled by increases in risk factors like obesity and high blood pressure. (Circulation)
The shortage of immediate-release mixed amphetamine salts (Adderall) to treat attention-deficit hyperactivity disorder may have prompted a scramble towards alternative stimulants for kids. (American Academy of Pediatrics)
Trump said he would consider rejoining the World Health Organization, but said that they “would have to clean it up.” (Reuters)
China says it’s “extremely unlikely” that the COVID-19 pandemic was caused by a lab leak, as the CIA recently said. (The Hill)
While a bird flu pandemic in humans is not inevitable, recent developments seem worrisome. (New York Times)
The first U.S. outbreak of H5N9, a strain of bird flu rarer than H5N1, was reported on a California duck farm. (Reuters)
An infectious disease expert warned that windblown bird poop may transit the virus. (CBS News)
In South Carolina, bird flu is being blamed for soaring eggs prices of $9 a dozen. (The Post and Courier)
Acting HHS head Dorothy Fink, MD, said the agency will review government programs to ensure taxpayer dollars aren’t being used for elective abortions.
Trump signed executive orders to reinstate military service members who were dismissed for not getting vaccinated and eliminate “gender radicalism” in the military. (ABC News)
A cancer patient had her arm suddenly amputated. Her open-casket funeral for the arm went viral. (USA Today)

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Some oncologists suggest that, for certain early cancers not at risk of spreading, the term “cancer” should be avoided.A diagnosis is more than words on a page. It’s everything that comes with it: the doctor’s tone of voice, a gentle touch of the hand, the pauses left so the patient can digest the news. All of these details subtly impart how you should think about the label that you’ve just been given.But one diagnostic word in particular threatens to derail any rational discussion of its meaning: cancer.“‘Cancer’ is just this panic word,” said Laura Scherer, a social psychologist at the University of Colorado who studies how doctors communicate risk. Patients compare hearing the term to “getting hit by a truck, like they can’t process anything that comes after,” she said.Kirsten McCaffery, a health researcher and psychologist at the University of Sydney’s School of Public Health, added, “That ‘cancer’ label is kind of an anxiety bomb that goes off for patients.”That’s why some oncologists argue that, for certain early cancers that aren’t at risk of spreading, the medical profession should do away with the word altogether.At the heart of the debate is the common breast cancer diagnosis DCIS, or ductal carcinoma in situ. The phrase, which describes cancer cells confined to the lining of the milk ducts, is somewhat of an oxymoron. The National Cancer Institute defines cancer as cells that, if left untreated, will grow uncontrollably and spread to other parts of the body; “in situ,” however, means limited to one place.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.

Over the past year, Muanema Fakira noticed something odd about the eyes of her 1-year-old daughter Sumaya. Her left eye was cloudy. It did not gleam with curiosity or glint in the sun. When the problem persisted, Ms. Fakira made the rounds to health clinics in their town in central Mozambique. Doctors said they could not help.But they knew of someone who could, if Ms. Fakira could take Sumaya, now 2, on a 100-mile journey to the coast.The family made the trip to the city of Quelimane, where Dr. Isaac Vasco da Gama examined Sumaya’s eyes and quickly diagnosed a congenital cataract.Ms. Fakira was skeptical — cataracts are for old people, she said. But Dr. da Gama explained that an infection at birth, or shortly after, can cause cataracts in children. The condition is particularly worrying because vision problems affect the development of a child’s physical function. But the good news, he said, was that the problem can be solved with a simple surgery, one he does a dozen times a week at Quelimane Central Hospital.This was particularly lucky for Sumaya because Dr. da Gama is one of just three pediatric ophthalmologists in Mozambique, a country of 30 million people.Dr. Isaac Vasco da Gama checking on 3-year-old Edilson, who was recovering from a retinoblastoma removed from his right eye at Quelimane Central Hospital.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.

4 hours agoSharon BarbourBBC North East & Cumbria health correspondent

Water bead toys have the potential to cause not only intestinal obstruction in children who ingest them, but also neurotoxicity, a case study suggested.
A 13-month-old female who was previously healthy presented to the emergency department with vomiting, lethargy, and weight loss over several weeks along with insomnia and facial dermatitis, reported a group led by Ashley Haugen, of the nonprofit advocacy organization That Water Bead Lady and the mother of the patient.
During an exploratory laparotomy, a mass consisting of water beads was removed from the child’s distal small intestine, Haugen and colleagues noted in Pediatrics.
Following removal of the mass, the patient’s facial dermatitis resolved. However, her speech along with gross and fine motor, sensory, and neurological functions continued to worsen. A second surgical procedure removed multiple fragments of water bead material from the child’s large intestine.
“This is an essential area for pediatric medical awareness because the dangers of water beads extend beyond what is commonly understood,” Haugen told MedPage Today in an email. “While physical obstructions are often the focus, the potential chemical toxicity of water beads, including neurotoxic and systemic effects have been largely overlooked.”
These beads are made of polymerized acrylamide monomer, which can be toxic at high levels. And they can clump together into a gelatinous mass.
“In cases where beads remain in the body for prolonged periods, chemical exposure could exacerbate the injury even beyond the physical obstruction,” Haugen added. “The material may contain residual monomers, degrade over time, impact digestive tract function, or disrupt gut microbiota — factors that cannot be fully replicated in testing or reliably predicted. Our paper highlights the importance of clinicians recognizing the duality of risk — both physical and chemical — which is often overlooked and should be an integral part of the clinical evaluation process.”
Along with marketing to children generally as toys, water bead sales are also targeted to children with autism and sensory processing disorders as sensory-based therapies, noted Patrick Reeves, MD, and Eric Pasman, MD, both of the Uniformed Services University of the Health Sciences in Bethesda, Maryland, in a commentary accompanying the case study in Pediatrics
“Without [pending] consumer protections, pediatrics should counsel families, including those at high risk based on age or developmental status, on the dangers of water bead ingestion,” they wrote. “There must be continued advocacy with the [Consumer Product Safety Commission] to mitigate the dangers posed by water beads.”
Overall, reports of children swallowing water beads have risen in the last decade, according to a systematic review presented at the American Academy of Pediatrics’ annual meeting in Orlando in September. And members of the American Medical Association House of Delegates also have called attention to reported injuries from the products.
In the case study by Haugen and colleagues, the patient had a normal developmental trajectory prior to water bead ingestion, meeting standard milestones like walking and speaking, as well as normal hearing.
However, at age 17 months, 3 months after surgical removal of the water bead mass, the patient’s pediatrician and medical records indicated that she demonstrated the following: motor incoordination, tremor, myoclonus, muscle weakness (minimal use of right hand), extremity hypotonia, gait abnormality, expressive receptive language delay, sensory processing issues with temperature and resistance to items touching feet and hands, delayed problem solving, and abnormal hearing.
Meanwhile, the patient’s brain MRI and chromosomal microarray were normal, “ruling out structural and genetic etiology,” Haugen and colleagues reported. And her parents confirmed with the water bead retailer and manufacturer that the products were made of polyacrylamide.
Because the patient’s symptoms and clinical progression were consistent with acrylamide exposure, her developmental pediatrician made a presumptive diagnosis of encephalopathy associated with acrylamide toxicity.
At age 20 months (6 months after surgery), formal assessment indicated the patient’s gross motor age was 18 months, her fine motor age was 16 months, her receptive language age was 10 months, and expressive language age was 12 months. And at 22 months of chronological age, histopathology of the colon showed mild eosinophilic inflammation and lymphoid aggregates consistent with an immune response.
Starting at age 17 months, the patient received specialized skills training four times per month for more than 3 months, which was aimed at addressing lack of coordination and fine motor skill challenges. Starting at 22 months, the patient received speech therapy eight times per month. And the patient also was initiated on a low-dose regimen of the sodium channel blocker oxcarbazepine (Trileptal) to mitigate hyperexcitability of damaged nerves.
At around 6 years of age, the patient was recommended to start 20 to 30 minutes of speech therapy five times a week and to get special education services in a general education setting to address functional deficits. At 8 years of age, the patient had made significant progress and speech therapy dropped to twice a week.
Limitations of the case study included lack of free acrylamide monomer blood level measurement, which is typically available only in research contexts, Haugen and colleagues noted. And “significant delay” between surgical intervention and identification of exposure “further precluded the possibility of obtaining accurate measurements.”

Jennifer Henderson joined MedPage Today as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.

Disclosures
Haugen is president of the nonprofit advocacy organization That Water Bead Lady and mother of the patient described in the case study. Neither co-authors of the case study nor authors of the accompanying commentary reported any relevant conflicts of interest.

Primary Source
Pediatrics
Source Reference: Haugen A, et al “Intestinal obstruction and neurotoxicity associated with water bead ingestion” Pediatrics 2025; DOI: 10.1542/peds.2023-065575.

Secondary Source
Pediatrics
Source Reference: Reeves PT, Pasman EA “Risks of water bead ingestion” Pediatrics 2025; DOI: 10.1542/peds.2024-069447.

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14 minutes agoAnnabel RackhamHealth reporter, BBC News

PEPFAR’s computer systems also are being taken offline, a sign that the program may not return, as Republican critics had hoped.The Trump administration has instructed organizations in other countries to stop disbursing H.I.V. medications purchased with U.S. aid, even if the drugs have already been obtained and are sitting in local clinics.The directive is part of a broader freeze on foreign aid initiated last week. It includes the President’s Emergency Plan for AIDS Relief, the global health program started by George W. Bush that is credited with saving more than 25 million lives worldwide.The administration had already moved to stop PEPFAR funding from moving to clinics, hospitals and other organizations in low-income countries.Appointments are being canceled, and patients are being turned away from clinics, according to people with knowledge of the situation who feared retribution if they spoke publicly. Many people with H.I.V. are facing abrupt interruptions to their treatment.But most federal officials are also under strict orders not to communicate with external partners, leading to confusion and anxiety, according to several people with knowledge of the situation.U.S. officials have also been told to stop providing technical assistance to national ministries of health.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.

Coca-Cola has recalled its drinks in some countries across Europe because they contain “higher levels” of a chemical called chlorate.

A biomarker signature using brain activity measurements predicted pain sensitivity.The signature combined sensorimotor peak alpha frequency and corticomotor excitability.The study involved 150 people who received nerve injections to test prolonged pain.

A novel biomarker signature that assessed cortical activity predicted individual pain sensitivity, the PREDICT validation study showed.
The signature consisted of two measures: sensorimotor peak alpha frequency (PAF) and corticomotor excitability (CME). In the training set, it correctly classified study participants with high or low pain sensitivity with an area under the curve (AUC) of 1.00.
In the test set, the signature had an AUC of 0.88 (95% CI 0.78-0.99), reported David Seminowicz, PhD, of the University of Western Ontario in London, Canada, and co-authors in JAMA Neurology.
Results were reproduced across a range of parameters. The PAF and CME biomarkers showed good to excellent test-retest reliability.
“The combination of biomarker accuracy, reproducibility, reliability, and pain model validity suggests high potential for clinical translation, particularly in predicting the transition from acute to chronic pain,” Seminowicz and colleagues wrote.
PAF is the dominant sensorimotor cortical oscillation in the 8-12 Hz (alpha) range. CME is the efficacy of relaying signals from the primary motor cortex to peripheral muscles. Previous work showed that slower PAF before pain onset and reduced CME during prolonged pain were associated with more pain, while faster PAF and increased CME were associated with less pain.
“Given that individuals who experience higher pain in the early stages of a prolonged pain episode (e.g., postsurgery) are more likely to develop chronic pain in the future, slow PAF before an anticipated prolonged pain episode and/or CME depression during the acute stages of pain could be predictors for the transition to chronic pain,” the researchers noted.
Identifying objective biomarkers to track pain severity has been dubbed “the holy grail” of pain neuroscience, observed Prasad Shirvalkar, MD, PhD, of the University of California San Francisco, and Christopher Rozell, PhD, of the Georgia Institute of Technology in Atlanta, in an accompanying editorial.
“While pain is among the most fundamental, ubiquitous, and adaptive experiences that can befall an organism, there is still a murky understanding of how pain is generated in the nervous system,” they noted. The consensus on mechanisms underlying chronic pain — pain that persists for more than 3 months, which affects 21% of U.S. adults — is even less clear.
The PAF and CME signature “will likely have broad applicability across many medical fields,” Shirvalkar and Rozell said. “If successfully translated into clinical practice, biomarkers that predict a transition to chronic pain would have a tremendous impact for the treatment of millions of individuals.”
Advances in pain biomarkers also need to incorporate advances in global neuroethics guidance and address ethical concerns about pain treatment, the editorialists pointed out. “We must take care to ensure that quantitative measures do not supplant lived experience reports, introduce distrust in the physician-patient relationship, set unrealistic patient expectations, or exacerbate existing inequalities in pain treatment across this vulnerable population,” they wrote.
The PREDICT validation study included 150 people (100 in the training set, and 50 in the test set) who were given an injection of nerve growth factor into the right masseter muscle on day 0 and day 2 to induce prolonged jaw pain that lasted up to 4 weeks.
Participants were healthy adults recruited in Australia with a mean age of 25. They had no history of chronic pain or a neurological or psychiatric condition, and 84 participants (56%) were men.
The research aimed to determine whether individuals could be accurately classified as having high or low pain sensitivity based on baseline PAF and CME readings. The researchers used electroencephalography to assess PAF and transcranial magnetic stimulation with resulting evoked potentials to assess CME on day 0, day 2, and day 5.
The primary outcomes were jaw pain on chewing and yawning. Pain sensitivity was assessed twice daily from day 1 through day 30 through self-reported pain scores.
Seminowicz and colleagues used five machine learning models on the training set. Of these, the winning classifier was logistic regression. Including sex and pain catastrophizing as covariates did not improve model performance.
The study assessed healthy participants using an experimental pain model; results may not apply to other people or other circumstances, the researchers acknowledged.

Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures
This project was funded by the National Institutes of Health (NIH).Seminowicz and one co-author reported having a patent issued for peak alpha frequency through the University of Maryland in Baltimore. No other disclosures were reported.Shirvalkar reported relationships with the NIH, Medtronic, QuantalX, and a patent pending for closed-loop deep brain stimulation for chronic pain. Rozell reported personal fees from Motif Neurotech and a patent pending for a system to identify transitions in brain states for depression.

Primary Source
JAMA Neurology
Source Reference: Chowdhury NS, et al “Predicting individual pain sensitivity using a novel cortical biomarker signature” JAMA Neurol 2025; DOI: 10.1001/jamaneurol.2024.4857.

Secondary Source
JAMA Neurology
Source Reference: Shirvalkar P, Rozell CJ “Brain biomarkers for pain sensitivity” JAMA Neurol 2025; DOI: 10.1001/jamaneurol.2024.4743.

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