Health News

Small study shows a possible reason some long COVID patients experience 'brain fog'

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(NEW YORK) -- According to a new study published in Nature Neuroscience, researchers at Trinity College in Ireland used blood tests to measure certain biological markers and specialized brain images to discover that long COVID patients with brain fog had more permeability or "leakiness" of their blood-brain barrier – offering the first biological evidence that this symptom may be due to underlying changes in the brain.

"A lot of long COVID symptoms, especially brain fog, are often written off as 'oh that’s all in your head' but this study is suggesting an actual biological mechanism behind it," Dr. Leah Croll, neurologist and assistant professor at Temple University, told ABC News. "Knowing this is real can be very validating for people who experience this symptom."

While this study is small, it could help inform ongoing research to better understand how to diagnose and treat long COVID that impacts millions of Americans. There is currently no test or treatment for this condition that can be disabling to those who have it.

In the study, researchers selected 32 patients who had COVID-19 in March or April of 2020 to undergo specialized brain imaging called a dynamic contrast-enhancing MRI – 10 had recovered from COVID-19, 11 had long COVID, and 11 had long COVID with brain fog. They found that the brain images showed more permeability or "leakiness" of the blood-brain barrier in patients who had long COVID with brain fog compared to the other groups. They also conducted cognitive tests and showed that six of the participants with brain fog had mild-to-moderate cognitive impairment and specifically showed problems with recall, executive functioning and word finding.

The researchers also measured blood markers of inflammation and blood clotting, and some markers related to the blood-brain barrier in 76 people who were hospitalized with an acute COVID-19 infection in March and April of 2020. It revealed that patients who specifically said they had brain fog with their acute infection had a statistically significant increase in a marker that is indirectly associated with blood-brain barrier dysfunction. Researchers say these findings suggests that inflammation impacting the blood-brain barrier may contribute to people experiencing brain fog with both acute and long COVID, but brain imaging was not done on the patients with an acute infection in the study.

There are limitations of the study. It was only done with a few people at one hospital in Ireland in the first stages of the COVID-19 pandemic before vaccines were available, so it may not be generalizable across all people who currently have long COVID, but it does provide new insights. More research is needed to confirm this finding and understand the implications of it, but experts say it may help researchers as better tests and treatments are developed for long COVID in the future.

"Right now, we're beginning to understand the biological underpinnings of COVID-related brain fog. Gaining that understanding is the vital first step we need to advance future research." Croll said. "I am hopeful that we are on a path towards effective tests and treatments, one study at a time."

Dr. Jade A Cobern, board-certified physician in pediatrics and preventive medicine, is a fellow of the ABC News Medical Unit.

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Children's MMR vaccine rate drops 2%, 250,000 kindergarteners vulnerable to measles: CDC

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(NEW YORK) -- National MMR coverage has dropped 2% from the 2019-2021 school year to the 2022-2023 school year, which means approximately 250,000 kindergartners are at risk for measles infection around the country, according to the Centers for Disease Control and Prevention.

The 93.1% rate during the 2022–23 school is 2% lower than the 95% rate in the 2019-2020 school year and leaves measles coverage below the national target of 95% for the third consecutive year.

Doctors said this nationwide trend is a concerning backdrop to measles outbreaks in Florida and Philadelphia so far this year.

Exemptions for school vaccines are also at an all-time high. Ten states now report exemptions that exceed 5%, which leaves both vaccinated and unvaccinated children vulnerable to disease outbreaks like measles, experts say.

As of Feb. 15, a total of 20 measles cases were reported by 11 jurisdictions across Arizona, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, New York City, Ohio, Pennsylvania, and Virginia, according to the CDC.

A current outbreak at an elementary school in Florida has led to six kids testing positive for measles so far, school officials said. Thirty-three out of 1,067 students at the school have not received any of the two doses of the MMR vaccine, Dr. Peter Licata, the Broward County Public Schools Superintendent, noted Wednesday during a board meeting. Health care professionals were first notified of a measles case, a third grader with no travel history, on Friday February 16.

"The absence of travel history in the measles cases suggests we are likely seeing local transmission, underscoring the serious risk to the community," Dr. John Brownstein, epidemiologist and Chief Innovation Officer at Boston Children's Hospital and ABC News contributor, told ABC News. "Measles is highly contagious, and with its long incubation period of 11 to 12 days, there's a high likelihood that more children are infected without showing symptoms yet. This situation is alarming and requires immediate public health intervention to prevent further spread."

If an unvaccinated child is exposed to measles, an MMR (measles, mumps and rubella) vaccine should be given as soon as possible. It is not harmful to get MMR vaccine after being exposed to measles and doing so could prevent later disease, according to the CDC. When the MMR vaccine is given within 72 hours of initially being exposed to measles, it may provide some protection against the disease, or help someone have milder illness.

Measles can be prevented with MMR vaccine, according to the CDC. The vaccine protects against three diseases: measles, mumps, and rubella. Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective. The first shot is recommended for kids 12-15 months old and the second is given at 4-6 years of age.

CDC data shows that an overwhelming majority of measles cases are typically among unvaccinated people. Nearly 90% of the 1,249 measles cases in 2019 - greatest number of cases reported since 1992 - were unvaccinated.

Dr. Jade A Cobern, MD, MPH, is a physician board-certified in pediatrics and preventive medicine, is a fellow of the ABC News Medical Unit.

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Nearly 3 million asthma attacks could be prevented among children with cleaner energy: Report

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(NEW YORK) -- Nearly three million asthma attacks in children could be prevented by 2050 if the United States transitioned to electric vehicles and clean power, according to a new report published Wednesday.

Researchers from the American Lung Association (ALA) say these goals would also avert millions of other respiratory symptoms and save hundreds of infant lives over the next two-and-a-half decades.

"That [zero-emission] future, it's really important for lung health, both because emissions from dirty sources of transportation and electricity are harming our lungs right now and also because it's critical for addressing climate change," Laura Kate Bender, assistant vice president of Nationwide Healthy Air for the ALA, told ABC News.

Asthma, which is chronic inflammation of the lung airways, affects about 4.6 million children in the U.S., according to the Centers for Disease Control and Prevention.

Symptoms -- including cough, tightness in the chest, shortness of breath and wheezing -- led to more than 270,000 emergency department visits and more than 27,000 hospital inpatient stays among children in 2020, the CDC said.

The report looked at the potential impacts if all new passenger cars sold were zero-emission by 2035, all new trucks were zero-emission by 2040 and the electric grid will be powered by clean, non-combustion energy by 2035.

By 2050, the U.S. would prevent up to 2.79 million pediatric asthma attacks and 147,000 pediatric acute bronchitis cases, the study said.

Additionally, there would be 2.67 million pediatric upper respiratory symptoms and 1.87 million pediatric lower respiratory symptoms prevented as well as 508 infant mortality cases.

Bender noted that children are at a greater risk, both from air pollution and from climate change. Their still-developing lungs are more likely to suffer life-long impacts from exposure to air pollution, researchers said.

The report also found that every state in the continental U.S. would see asthma attacks prevented among children with California seeing the biggest drop at more than 440,000.

These potential health benefits are just estimates and made under the assumption that certain wide-ranging climate goals are met, Bender said.

"We would call that ambitious but achievable," he added. "We know that there's a lot of progress already being made, both at the federal level and in many key states to get toward these goals."

She continued, "There's lots of investment happening across the country, in electricity, in electric vehicle infrastructure, and so we're using this report to call for more to call for the finalization of strong standards that help us get closer to the zero-emission future."

Bender said at the federal level, the U.S. Environmental Protection Agency is close to finalizing two new sets of standards, one that would make future cars and medium-duty vehicles cleaner and one that would make future heavy-duty vehicles, such as trucks and buses, more green.

Additionally, the ALA is encouraging state-level lawmakers to have their states adopt standards to transition to zero-emission vehicles.

"Climate change is a health emergency, but it's also a health opportunity," Bender said. "We know that we need to reduce these emissions from vehicles and electricity urgently to address the climate crisis, but it's also an opportunity because at the same time -- as we're switching away from those sources of greenhouse gas emissions -- we also can clean up the other pollution that comes from gas- and diesel-powered vehicles and from fossil fuel fire powered plants. So we really see this as a win-win."

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Sixth case of measles linked to Florida elementary school outbreak

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(NEW YORK) -- The number of measles cases linked to an elementary school outbreak in South Florida has risen to six.

The outbreak at Manatee Bay Elementary School in Weston -- 20 miles west of Fort Lauderdale and located in Broward County -- was first reported on Friday with the initial patient being a third-grade student without a history of travel, according to the Florida Department of Health (DOH).

On Tuesday, Broward County Public Schools was notified of one additional confirmed measles case at the elementary school, bringing the total number of confirmed cases to six, according to a statement from John Sullivan, chief communications and legislative affairs officer for Broward County Public Schools.

"We expect to receive further guidance from the Florida Department of Health tomorrow and will continue to keep the school and its families updated with the latest information," Sullivan said.

It's unclear what grade the other infected students are in as well as other identifying information about them including age, sex and race/ethnicity.

"The District is maintaining close coordination with the Health Department to address this ongoing situation," Sullivan said in a statement to ABC News.

"Over the weekend, the District took further preventive measures by conducting a deep cleaning of the school premises and replacing its air filters," the statement continued.

Sullivan added that the school's principal is "actively communicating with families, ensuring they are kept up to date with the latest information."

Measles was declared eliminated in the U.S. in 2000, meaning the disease "is no longer constantly present in this country." The dip in routine childhood vaccinations in recent years -- as well as travelers bringing measles into the country -- has resulted in outbreaks.

It's unclear if the students who contracted measles are unvaccinated. The current two-dose measles, mumps and rubella (MMR) vaccine recommended by the Centers for Disease Control and Prevention is 93% effective after one dose and 97% effective after two doses.

"It is very likely that this outbreak is among unvaccinated students, given that nearly 90% of measles cases in past outbreaks were among those not vaccinated," said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children's Hospital and an ABC News contributor. "This pattern aligns with historical data showing that measles primarily spreads among unvaccinated populations."

The first measles vaccine, a single-dose vaccine, was introduced in the U.S. in 1963. In the prior decade, there were 3 to 4 million cases annually, which led to 48,000 hospitalizations and 400 to 500 deaths.

While two doses of the MMR vaccine are required to attend public schools in Florida, parents are allowed to seek exemptions for religious reasons, according to the National Conference of State Legislatures.

In Florida, at least 90.6% of kindergartners were fully vaccinated with the MMR vaccine for the 2022-23 school year, according a November 2023 CDC report. However, at least 4.5% of children were exempted from one or more vaccines.

The overwhelming majority of cases in outbreaks are typically the unvaccinated. Nearly 90% of the 1,249 measles cases in 2019, which was the greatest number of cases reported since 1992, were people who were unvaccinated.

"DOH-Broward is continuously working with all partners, including Broward County Public Schools and local hospitals, to identify contacts that are at risk of transmission. Health care providers in the area have been notified," according to a weekend alert from the Florida DOH in Broward County.

Brownstein said it is very possible that the number of cases could rise because measles spreads rapidly among those who are not immune.

"An outbreak like this is very concerning because measles is a highly infectious disease that can lead to serious health complications, especially in children and immunocompromised individuals," he said. "It indicates potential gaps in herd immunity, which are vital to preventing the spread of such diseases."

Health officials said if anyone suspects or notices symptoms, to contact their health care provider to receive instructions on how to seek medical care without exposing others and to not visit the health department or a doctor's office without contacting officials ahead of time.

The Florida DOH did not immediately reply to ABC News' request for comment.

Weston is the most recent city in the U.S. to face a measles outbreak over the last few months.

Since December 2023, there have been eight confirmed cases in Philadelphia among unvaccinated individuals. Cases have also been identified in Delaware, New Jersey and Washington state, according to local reports.

ABC News' Youri Benadjaoud contributed to this report.

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Women get same exercise benefit as men, with less effort, study finds

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(NEW YORK) -- A new study not only confirms known research that regular physical activity can prolong life and lower a person's risk of dying, it also finds that women experience greater benefits from exercise than men do, at lower amounts of exercise.

Using findings from the Centers for Disease Control and Prevention's National Health Interview Survey, researchers analyzed data from 412,413 adults from between 1997 to 2017 to understand the degree of overall health benefit derived from physical activity.

Researchers found that men were more likely to engage in physical activity than women. However, women who engaged in regular physical activity had a 24% lower risk of dying from any cause compared to inactive women, while physically active men had a 15% lower risk compared to their inactive counterparts. Researchers further discovered that the most beneficial amount of moderate-to-vigorous physical activity -- for example, brisk walking or cycling -- was around five hours per week, though there was also benefit shown for women starting at half that weekly amount.

"It turns out women can get a lot more return for even a little bit of investment than they might realize," Dr. Susan Cheng, director of the Institute for Research on Healthy Aging in the Smidt Heart Institute and senior author of the study, told ABC News. "[A] little bit can go a really long way."

"When it comes to looking at the particular amounts, particularly with moderate-to-vigorous physical activity, women could get almost double the return for the same investment compared to male counterparts," Cheng added, calling the news "exciting and positive, especially for the really busy women out there who are juggling a lot of responsibilities both at work and at home."

Women also saw a more significant reduction in mortality risk after engaging in muscle-strengthening activity, such as weightlifting or core exercises, than men did -- 19% compared to 11%, respectively -- according to the study.

“This important study emphasizes the power of exercise for women,” Dr. Patricia Best, an interventional cardiologist and member of the Women’s Heart Clinic at Mayo Clinic in Rochester, Minnesota, told ABC News. 

Taking it one step further, Best notes that following a heart attack, “women have frequently been referred to cardiovascular rehab less than men, and this study helps to give credence to the importance of exercise in women."

Consistent with prior research, both aerobic and muscle-strengthening activities were associated with lower risk of dying from heart-related diseases.

"For exercise, we'd like to encourage our patients and folks in general to be as active as they can, be no matter how busy we all are. In general, we say that anything is better than nothing and more is better than less," Cheng told ABC News.

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Alabama Supreme Court ruling raises questions about IVF access

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(NEW YORK) -- Experts are speaking out after the Alabama Supreme Court ruled Friday that frozen embryos qualify as people under state law, a decision that critics say could threaten families' access to fertility treatments in the post-Roe era.

In an unprecedented decision, the state's highest court ruled that "unborn children are 'children' … without exception based on developmental stage, physical location, or any other ancillary characteristics."

Alabama Chief Justice Tom Parker quoted the Bible in a concurring opinion, citing the sanctity of unborn life.

Dr. Mamie McLean, an infertility specialist at Alabama Fertility in Birmingham, Alabama, told ABC News' Good Morning America the court's historic ruling could impact the future of in vitro fertilization treatments for those trying to access fertility treatments, adding that for her, the ruling left more open questions than answers.

"We're concerned that this ruling has far-reaching consequences for what we feel is safe to freeze and safe to discard," McLean said.

Doctors like McLean warn the ruling could block access to IVF, make the process more expensive, or lead to some clinics closing altogether because of legal risks.

"This ruling is so incomplete and it leaves those of us who are sitting face to face with patients ... with the inability to comment on what is safe and what is legal for them right now," McLean added.

The case on which the court ruled Friday involved two couples who sued a patient who had managed to access the freezer that stored frozen embryos at an Alabama fertility clinic. The patient picked up multiple embryos and accidentally dropped and destroyed them. The high court ruled that the patient could be held liable in a wrongful death lawsuit.

"We have kind of what is just a brand new landscape for the law," Jasmine Matlock, an attorney and founding partner of M&H Legal Services in Guntersville, Alabama, told GMA.

"At this point, there is no decision on when a physician or a clinic can conclude storing these embryos so they are potentially liable for the wrongful death of an embryo after the parents have passed," Matlock added.

Fertility treatments have been on the rise, according to the Pew Research Center, and in 2021, more than 238,000 families in the U.S. relied on IVF, according to the Centers for Disease Control and Prevention.

Multiple embryos are often frozen to increase the likelihood that one will successfully implant.

Alabama is one of 13 states that implemented a total ban on abortions in the wake of the U.S. Supreme Court's 2022 decision to overturn Roe v. Wade, which had protected the constitutional right to abortion.

The U.S. Supreme Court is also expected to rule on another case about abortion pill access in the coming months.

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Medical experts sound the alarm on growing diabetic amputations among Black patients

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(NEW YORK) -- In operating rooms across the country, more and more diabetics are receiving amputations due to complications from type-2 diabetes.

The life-altering procedures are more common among Black and Latino patients who are more likely to be diagnosed with the disease, according to health data.

Despite the grim figures, medical professionals said that diabetics can avoid losing a limb, but due to a lack of awareness of treatments, many minorities are missing out on this critical care.

"The reason I did not go to the doctor or anything, [is because] I didn't want to hear the doctor say 'We have to take your leg,'" Shelton Echols, a diabetic amputee, told ABC News.

Health experts, however, said that there is a new push to get the right medications and treatment to these patients earlier and avoid going under the knife.

Echols said that he was well aware of his diabetes and health problems but never really took action on it.

He said his hemoglobin A1C tests showed his levels were 14%, well above normal. A normal A1C is considered to be below 5.7%, according to medical experts.

"So I was playing Russian roulette with my life at the time because I was in denial," he said.

Things changed one day when Echols noticed a cut on his left leg that wasn't healing. Doctors discovered that his diabetes cut off circulation to his legs and they needed to amputate his left leg.

"I really had a sense of peace for the simple fact that I knew in my heart everything was my fault. Everything was my fault," Echols said.

His story is becoming far too common among Black and Latino diabetics, according to health data.

Complications from the disease, specifically peripheral artery disease (PAD), can cause decreased blood flow and lead to wounds that remain open, according to health experts. And it’s this complication that can lead to the affected limb needing to be severed.

The number of diagnosed diabetics nationwide is up more than 7%, since 2001, according to data from the National Institute of Diabetes and Digestive and Kidney Diseases.

Over that same period, the number of those people needing to have a limb removed has grown by 18%, the data showed. Roughly 154,000 toes, arms, legs, and feet are cut off every year, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Across all racial and ethnic groups, the number of diabetic Americans is rising, and so is the number of them needing amputations. But a health study published in September found Black and Latino diabetics are four times more likely to get an amputation than other ethnicities.

Dr. Richard Browne, a Charlotte, North Carolina-based cardiologist, told ABC News that one of the factors behind the problem is the fact that many Black patients are not getting the right information about their diabetes early on.

"Very often, their symptoms are ignored," Browne, who is also a senior medical executive at Johnson & Johnson, said.

Browne and his wife Lauren, who is also a physician, said they experienced this problem firsthand with Lauren's diabetic father.

Russel Nandlal was a boxing coach for world champion Julian "The Hawk" Jackson. Doctors had to amputate both of his legs and an arm before he died in 2003.

Browne said looking back, his father-in-law was not given options to treat his PAD.

"And I also feel that there is what we call unconscious bias, where sometimes you get in front of a patient and you make your own determination that, 'Hey, you know, maybe he can't come back three or four times for the appropriate care for his PAD. So I'm going to do him a favor and just amputate, delay and get it over with at this point,'" he said.

Richard and Lauren Browne said that with the right treatment severe amputations can be avoided altogether.

Six years ago, Jay Bradley Starks said he was told by a doctor that they needed to amputate below his left knee after a bout with frostbite led him to a surprise diagnosis of PAD.

Starks said he went to another physician, who was also Black, and he was able to just amputate his foot due to stents and diabetes medication.

"My surgeon had a great understanding of who I was, as opposed to the initial one. There was a class difference, a race difference, a socio-economic distance," Starks said.

"Controlling your A1C matters when you’re at the onset of the disease, you have an opportunity to do it," he added.

Among the medications Starks is taking is Ozempic, an FDA-approved drug that is prescribed for diabetes patients. The drug mimics a hormone in the body that makes you feel full.

The drug has been shown to drop blood sugar levels and one medical study found that Ozempic and similar drugs can lower the risk of amputations by as much as 50%.

Despite these advantages, medical experts say some Black diabetic patients are hesitant to use them.

Dr. Veronica Johnson told ABC News that many of her patients have a distrust of medications.

"Even though they're not insulin because of [some patients'] previous experiences and things that they found in the past or their family members who are placed on insulin and they were like, 'That's the end,'" she said.

Johnson and other doctors recommend a simple screening for all Diabetics concerned about losing a limb.

The ankle brachial index, or ABI test, compares the blood pressure in the upper and lower limbs If the differences are too great, then there’s a problem with circulation and doctors can advise a treatment.

The procedure is not covered by Medicaid or Medicare for patients who aren’t already showing symptoms. There are legislative efforts underway to try and change that.

Dr. Richard Browne has been traveling the country with Johnson & Johnson raising awareness of the issue and imploring Black patients to not wait on treatment before it gets too late. He said he hopes that when patients hear him and his personal family story, they will seek help.

"Quite frankly, there is evidence that if you are taken care of by someone who looks like you, you're more likely to comply with their recommendations," he said.

 

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FDA approves Xolair, first medicine for kids, adults with food allergies

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(NEW YORK) -- The U.S. Food and Drug Administration has approved Xolair as the first and only medicine for people with one or more food allergies after the clinical trial data for the injectable asthma medication showed it helped people curb food-related allergic reactions.

"The FDA approval is based on positive data from the Phase III OUtMATCH study," Genentech announced on Friday.

The study showed "a significantly higher proportion of food allergy patients as young as 1 year treated with Xolair could tolerate small amounts of peanut, milk, egg and cashew without an allergic reaction, compared to placebo."

"The FDA approval of Xolair for food allergies is meaningful to me on a personal level, not only as a physician, but as a patient and a parent of a child with food allergies, too," Dr. Larry Tsai, VP and global head of respiratory, allergy and infectious disease product development at Genentech told ABC News. "For the first time, people with one or more food allergies have a treatment option with Xolair that can help reduce allergic reactions that may occur with an accidental exposure."

Dr. Levi Garraway, Genentech's chief medical officer and head of Global Product Development, added in a press release that "Today’s approval builds on 20 years of patient experience and an established efficacy and safety profile since Xolair was first approved in allergic asthma ... We look forward to bringing this treatment to the food allergy community who have long awaited an advancement."

The studies first showed promising results in late December, experts at the time said they were hopeful that the injection would eventually win FDA approval as an allergy treatment for children.

Pharmaceutical developers Genentech and Novartis first announced in December 2023 that the FDA was prioritizing the review of its application for use of Omalizumab, an allergy-induced asthma medicine, in cases of accidental exposure to foods like peanuts, eggs or milk.

The small study, which needs more research before a potential FDA approval, combined with prior research points to how alternate use of the medication marketed as Xolair could potentially help to prevent allergic reactions in people who have multiple food allergies, especially anaphylaxis.

The federally funded trial backed by the National Institute of Allergy and Infectious Diseases is set to finish in 2026.

"Despite the significant and growing health burden from food allergies, treatment advances have been limited," Garraway, said in the December press release. "We are proud to partner with the National Institutes of Health and leading research institutions on this groundbreaking study. The FDA’s Priority Review designation acknowledges the unmet need for these patients, and we hope to make Xolair available to as many people as possible living with food allergies in the U.S."

Data from the trial, which looked at 165 kids and adolescents -- whose severity of reactions like hives or anaphylaxis was not included -- showed those who received Xolair were able to eat more foods they have sensitivities to without triggering an allergic reaction, compared to participants who received a placebo.

While the preliminary data shows potential for this drug in this off-label application, there is not yet enough evidence to determine how great the impact could be for people with food allergies.

A Genentech spokeswoman told ABC News in December that the FDA was expected to decide on approval in the first quarter of 2024. If approved, Xolair would be the first medicine to reduce allergic reactions to multiple foods following an accidental exposure.

Tsai, previously told "GMA" that because food allergies hit close to him, this study feels like a step in the right direction for treatment options.

"While I am a physician, I am also a parent of a child with severe food allergies," he said in an emailed statement. "I am all too familiar with the constant worry and fear that my child will have an accidental exposure at school or a friend's house. For the roughly 17 million children who live with food allergies, the current standard of care treatment is for children to avoid the foods they are allergic to, and to learn to recognize and treat symptoms upon exposure to an allergen."

Even with careful monitoring, he added that "accidental exposures are difficult to prevent and there is a significant need for new treatment options for children with food allergies."

"The positive results from the OUtMATCH study bring us one step closer to providing a new treatment option for children and adults impacted by food allergies," Tsai, who also has a food allergy himself, continued.

Updates for the trial on the Centers for Disease Control and Prevention website do not list how much more of the food participants were able to consume without having an allergic reaction.

The medication, marketed as Xolair, has been on the market since 2003 and helps treat chronic hives as well as chronic rhinosinusitis with nasal polyps -- an inflammatory sinus disease.

People who take Xolair for allergic asthma, typically take the medicine for approximately 10 months and while price varies based on indication and dose, the cost is approximately $3,663 a month. That price also varies depending on the frequency as well as a person’s weight and their serum IgE levels.

An earlier version of this story was originally published on Dec. 27, 2023.

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Amid rising measles cases, a new generation of doctors is being taught how to spot the disease

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(NEW YORK) -- Over the last several years, isolated outbreaks of measles have been popping up across the United States.

Most recently, between Dec. 1, 2023, and Jan. 23, 2024, there have been 23 confirmed cases of measles with infections reported in Pennsylvania, New Jersey, Delaware and the Washington, D.C. area.

Emergency medicine physicians and departments have to relearn how to rapidly detect and diagnose a disease that many have never had to treat before, only learning about it in school.

Measles was declared eliminated in the U.S. in 2000 because most Americans are vaccinated, and doctors told ABC News they and their colleagues may not even consider the disease as a possible diagnosis if a child comes in with a rash and a fever.

"The contemporary emergency physician or those in emergency departments, would they able to recognize measles initially the first time? And the answer is probably not," Dr. Nicholas Cozzi, EMS medical director at Rush University Medical Center in Chicago, told ABC News.

The state of measles in the U.S.

Measles is a very contagious disease with the Centers for Disease Control and Prevention (CDC) saying every individual infected by the virus can spread it to up to 10 close contacts if they are unprotected including not wearing a mask or not being vaccinated.

The incubation period of measles from exposure to early symptoms averages 11 to 12 days with first signs including a fever that can peak from 103 F to 105 F, cough, and conjunctivitis.

Next, the measles rash will follow, which lasts five to six days. It will begin at the hairline and then proceed downward to the hands and feet. The rash will typically fade in order of appearance with severe lesions maybe peeling off in scales, the CDC said.

About one in five people in the U.S. who get measles will be hospitalized. Measles can cause serious health complications, especially in children younger than age 5 including ear infections, diarrhea, pneumonia, encephalitis (inflammation of the brain), and even death, according to the CDC.

The first measles vaccine, a single-dose vaccine, was introduced in the U.S. in 1963. In the decade prior, there were three to four million cases annually, which led to 48,000 hospitalizations and 400 to 500 deaths.

The CDC currently recommends people receive two vaccine doses, the first at 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective, and two doses are 97% effective.

Although hospitalizations and deaths due to measles have dropped dramatically, vaccination rates have been lagging and outbreaks have popped up in unvaccinated or under-vaccinated pockets of the U.S.

"What we've seen due to the rise of international travel and international migration, as well as global declining immunization rates, is the resurgence of a once eradicated -- at the least in the United States -- disease, and that is measles," Cozzi said.

Doctors not recognizing measles

Despite measles being a once common childhood disease, most medical students, and even some emergency room doctors, have never seen measles or can recognize symptoms.

Doctors may remember what a textbook case of measles looks like but may also not be familiar with what a patient looks like in the early stages.

"Every medical student learns about measles during school, but that's very different than seeing it on a daily basis and kind of understanding the ins and outs of the disease," Dr. Keri Cohn, medical director of bioresponse and a pediatric emergency room physician at the Children's Hospital of Philadelphia, told ABC News.

"And so, the vast majority of physicians in the emergency room that I work with has never seen measles before," she continued. "And that is something that we've had to really kind of remind people, 'This is how it presents; these are the things that you're looking for.'"

Although Cohn has worked with measles cases before, due to past international work, she said she was surprised to be treating measles patients in Philadelphia.

Prior to the most recent outbreak in her city, which began in December, measles was not top of her list of possible diagnoses when a child visited the emergency room with certain symptoms.

"It is true that when a child comes in with fever and rash in Philadelphia, I'm not usually thinking about measles, and of course, in the setting of this outbreak, that has really changed the way that our physicians have thought about patients coming in with those symptoms," Cohn said.

Teaching a new generation about measles

To make sure emergency room doctors are prepared in case they encounter a measles patient, hospitals have been developing response plans.

At Cohn's hospital in Philadelphia, the bioersponse program had partnered with infection prevention and control, to develop a robust response.

"So the model is ... we bring a large group of experts together in all different facets throughout the hospital system to kind of address the needs of the families, the patients, the physicians, the staff who are working against this outbreak," she said.

Cohn has also worked to remind health care staff to take appropriate precautions such as making sure the patient is isolated and that staff entering the isolation room where N95s or a respirator with similar effectiveness.

In Cozzi's case, he recently co-authored a paper in a recent issue of the Journal of the American College of Emergency Physicians, which includes reminders of what early-stage cases of measles look like and guidance on what information needs to be shared within hours of suspected cases.

"We wanted every emergency physician across the country to understand what measles looks like, how it presents, the life-threatening causes of it, why we're seeing a resurgence, as well as the somewhat most of the deadly outcomes associated with it," he said.

He also encouraged health care workers, both in and outside the U.S., to consider measles if a child arrives at a hospital or a clinic with a fever and a rash.

"If we don't think of it, we're not going to diagnose it," Cozzi said. "If it's not on top of our mind, we're not going to consider it."

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Teen says he's 'doing great' after undergoing experimental sickle cell treatment

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(NEW YORK) -- Sixteen-year-old Jonathan Lubin loves basketball, playing the drums and going to the gym.

But until recently, his parents worried he wouldn't live to see the age of 40.

Lubin was born with sickle cell disease, a genetic illness that causes abnormal 'C'-shaped red blood cells that clog blood flow, causing severe pain episodes and organ damage.

More than two years ago, Lubin became one of the youngest patients to sign up for a still-experimental CRISPR gene editing therapy.

The treatment, which he received at New York-Presbyterian/Columbia, required chemotherapy and involved a complex months-long process of harvesting his own stem cells, editing them and then reintroducing them into his body.

But today, Lubin is able to do everyday activities that used to be risky.

The teen said he has not had a pain crisis or hospitalization in over two years, a stark contrast from his childhood, which has been characterized by hospital visits every few months.

"It's been about two years and I'm doing great," Lubin told "Good Morning America." "Overall, I'm just feeling way better."

For Lubin and other clinical trial volunteers, it's been a major transformation.

And researchers say that thanks to the bravery of these volunteers, the U.S. Food and Drug Administration recently approved two new gene-editing therapies for sickle cell disease, including the CRISPR-based therapy Lubin received.

The CRISPR-based gene therapy Lubin received is made by Vertex Pharmaceuticals, and developed in partnership with CRISPR Therapeutics. The FDA approved a second gene therapy made by bluebird bio.

Sickle cell disease is a genetic condition that affects approximately 100,000 Americans – primarily Black Americans with African ancestry, according to the Centers for Disease Control and Prevention.

Researchers estimate that roughly 20 to 25% of those with the disease are sick enough that they would be good candidates for the newly approved treatments, which were approved for people aged 12 and older.

Jimi Olaghere and Victoria Grey - both in their 30s - said they volunteered to have a chance to be better parents to their children. Both travelled out of state to be treated at Sarah Cannon Research Institute and HCA Healthcare's TriStar Centennial Children's Hospital in Nashville.

Prior to his treatment, Olaghere said he felt like he was "living in a nightmare" with frequent hospitalizations and pain crisis.

"Now I wake up, I get the kids ready for school," Olaghere said. "It is complete night and day. It is a completely different life."

But the sticker shock of both newly-approved treatments - both multi-million dollars - has raised questions about access.

Given the high cost of treating repeat pain crisis over the lifetime of a person with sickle cell disease, some insurance providers have opted to cover the new treatments.

And the Biden Administration has created a new access model for Medicaid patients, designed to lower the medication cost and improve access to gene therapy.

The program is set to begin in January 2025.

 

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FDA approves 1st medication to treat severe frostbite

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(WASHINGTON) -- The U.S. Food and Drug Administration approved the first medication to treat severe frostbite on Wednesday.

Aurlumyn, manufactured by Actelion Pharmaceuticals US, Inc., is an injection to treat severe frostbite in adults to reduce the risk of finger or toe amputation.

"This approval provides patients with the first-ever treatment option for severe frostbite," Dr. Norman Stockbridge, director of the division of cardiology and nephrology in the FDA's Center for Drug Evaluation and Research, said in a release. "Having this new option provides physicians with a tool that will help prevent the lifechanging amputation of one's frostbitten fingers or toes."

Frostbite is an injury that occurs when the skin and the underlying tissues are damaged by cold temperatures. Treatment typically involves placing the skin in warm water or placing blankets over affected skin area.

Frostbite typically occurs in three stages, with the final stage being severe frostbite, which results in numbness and skin that turns hard and black due to skin cells dying. Large blisters will appear on the skin a day or two after cold exposure and skin may be permanently damaged, according to the Cleveland Clinic.

If underlying tissues are frozen and blood flow has stopped, the frostbitten extremity may need to be amputated.

Iloprost is the active ingredient in Aurlumy and is a vasodilator, a type of drug that dilates vessels so blood can flow easily and prevents clotting. It was originally approved in 2004 for the treatment of pulmonary arterial hypertension.

In a controlled trial, researchers examined 47 adults with severe frostbite, all of whom received aspirin by vein and standard of care. They were separated into three groups.

The first group received the drug intravenously for six hours daily for up to six days. The two remaining groups received medications that are unapproved for frostbite. The second group was given those medications with iloprost and the third group without it.

The patients received bone scans seven days after their initial frostbite to predict the need for amputation of at least one finger or toe.

On the seventh day, none of the patients in the first group receiving iloprost alone had bone scans that indicated potentially needing an amputation compared to 19% of patients in group two and 60% of patients in group three.

Additionally, abnormalities in the bone scan were significantly lower in the groups receiving iloprost alone or the iloprost combination.

"Most patients had follow-up information on whether they subsequently underwent at least one finger or toe amputation," the FDA release said. "The need for amputation was consistent with the bone scan findings."

During the trial, the most common side effects of Aurlumyn included flushing, headache, nausea, vomiting, dizziness, heart palpations, increased heart rate and low blood pressure.

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COVID patients are 4.3 times more likely to develop chronic fatigue, CDC report finds

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(NEW YORK) -- COVID-19 patients are at least four times more likely to develop chronic fatigue than someone who has not had the virus, a new federal study published Wednesday suggests.

Researchers from the Centers for Disease Control and Prevention (CDC) looked at electronic health records from the University of Washington of more than 4,500 patients with confirmed COVID-19 between February 2020 and February 2021.

They were followed for a median of 11.4 months and their health data was compared with the data of more than 9,000 non-COVID-19 patients with similar characteristics.

Fatigue developed in 9% of the COVID patients, the team found. Among COVID-19 patients, the rate of new cases of fatigue was 10.2 per 100 person-years and the rate of new cases of chronic fatigue was 1.8 per 100 person-years.

Person-years is a type of measurement that multiplies the number of people in a study and the amount of time each person spends in a study. It is useful for evaluating risk.

Compared with non-COVID-19 patients, those who has tested positive were 68% at risk of fatigue and were 4.3 times more likely to develop chronic fatigue in the follow-up period, the study found.

Fatigue following COVID-19 infection was more common among women, older people and those who had other medical conditions including diabetes, chronic obstructive pulmonary disease and a history of mood disorders.

There was no strong evidence of racial or ethnic differences when it came to developing fatigue after COVID-19 except a slightly lower incidence among Black patients, results also showed.

Additionally, researchers found that patients with COVID-19 who developed fatigue after the infection had far worse outcomes such as hospitalization or death than patients without fatigue.

Among 434 COVID-19 patients in whom fatigue developed, 25.6% were hospitalized more than one time during the follow-up period compared to 13.6% of 4,155 patients without fatigue who were hospitalized.

What's more, COVID-19 patients with fatigue were at higher risk of dying. During the follow-up period, 5.3% with fatigue died compared to 2.3% of those without fatigue.

"Our data indicate that COVID-19 is associated with a significant increase in new fatigue diagnoses, and physicians should be aware that fatigue might occur or be newly recognized [more than] one year after acute COVID-19," the authors of the study wrote. "Future study is needed to better understand the possible association between fatigue and clinical outcomes."

The authors added that the high rates of fatigue "reinforce the need for public health actions to prevent infections, to provide clinical care to those in need, and to find effective treatments for post–acute COVID-19 fatigue."

The team said it also hopes that increased awareness of fatigue and other long COVID symptoms helps COVID patients seek early care when needed to reduce their risk.

The results build upon those seen in previous reports including a joint U.S.-U.K. study of electronic health records that found 12.8% of patients received a new fatigue diagnosis within six months of COVID-19 infection.

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Oregon resident catches rare bubonic plague, likely from their cat: Health officials

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(NEW YORK) -- A pet owner has caught a rare case of the bubonic plague, health officials in central Oregon say, and it's believed they may have caught it from their cat.

The Deschutes County Health Services confirmed the case of the plague in a local resident last week. The resident was likely "infected by their symptomatic pet cat," health officials said in a Feb. 7 press release.

"All close contacts of the resident and their pet have been contacted and provided medication to prevent illness," Dr. Richard Fawcett, Deschutes County health officer, said in the release.

The case is the first example of the bubonic plague in Oregon since 2015, according to the state's health authority, and plague is "rare" in the state.

Deschutes County Health officials said the case was "fortunately" identified and treated in its early stages, "posing little risk to the community."

"No additional cases of plague have emerged during the communicable disease investigation," health officials said in the release.

How does bubonic plague spread?

The plague spreads to humans or animals through a bite from an infected flea or by contact with an animal sick with the disease, according to the Oregon Health Authority.

To prevent the spread of the plague, Deschutes County Health Services urged residents to avoid all contact with rodents and their potential fleas, and to never touch sick, injured or dead rodents.

Residents should also not allow pets to approach sick or dead rodents or explore rodent burrows, county health officials said.

What are symptoms of bubonic plague?

Symptoms of plague usually begin in humans two to eight days after exposure to an infected animal or flea, according to the health authority.

Symptoms may include a sudden onset of fever, nausea, weakness, chills, muscle aches and/or visibly swollen lymph nodes called buboes, the state health authority said.

Is bubonic plague treatable?

The plague is a very serious illness but is treatable with antibiotics, usually taken for seven to 14 days, according to the Centers for Disease Control and Prevention. If left untreated, people can still die from the plague, the CDC says.

The bubonic plague dates back to the Middle Ages, when it killed millions in Europe, before the age of antibiotics. At the time, people didn't realize the plague was carried by the fleas who lived on rats.

According to the CDC, the plague was first introduced in the United States in 1900 by rat-infested steamships. It is most common in the western U.S.

In August 2020, a California resident tested positive for a case of the plague, marking the first human occurrence of the disease in the state in five years.

The resident in South Lake Tahoe who tested positive for the plague was an avid walker, and officials believed they may have been bitten by an infected flea while walking their dog along the Truckee River Corridor, El Dorado County said in a statement at the time.

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Forgetting dates doesn’t mean President Biden's decision-making or cognitive fitness is failing: Doctors

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(NEW YORK) -- In a special council report released last week, President Joe Biden was described as an "elderly man with a poor memory," but doctors say it’s impossible to use isolated examples to diagnose a memory problem, as memories can be impacted by more than aging, and memories don’t solely determine a person’s cognitive fitness.

The president has a team of medical professionals from a number of subspecialties including neurology who evaluated him last year and deemed him "fit to successfully execute the duties of the Presidency."

"There are different variables that have to be taken into account when you try and understand whether a slip up is worrisome or not," Dr. Leah Croll, board-certified neurologist, and assistant professor of neurology at Temple University, told ABC News.

This report has since sparked criticism of Biden’s memory, to which Biden has responded in an interview that, "my memory is fine." Adding that the most recent interviews with the special council were also in the immediate aftermath of the Oct. 7 Hamas terror attack in Israel when Biden said he was "in the middle of handling an international crisis."

ABC News spoke to several doctors in the field of medicine, neurology and psychiatry to understand how memory, aging and executive functioning relate, and they all agree that simply forgetting dates or timelines in the past does not imply anything specific about a person’s level of cognitive fitness, decision-making, judgement or executive functioning.

Doctors say a number of factors influence memory, independent of aging

"There are so many different factors that affect how well your memory and cognition are working in any given moment," Croll said.

These include things like stress, sleep, hunger, multi-tasking and situational circumstances that can act against someone’s memory, independent of their age.

"When we think about how someone's memory and cognition function in any given moment, the reality is that they don't function at a constant level," Croll said. "They're always changing and fluctuating depending on what factors or variables are on board at that time."

Dr. Louise Aronson, board-certified geriatrician, and professor of medicine at UCSF, told ABC News that internal processing functions like recalling specific memories naturally decline to an extent with age but can also be impaired by high-pressure situations.

Dr. Yalda Safai, a board-certified psychiatrist, told ABC News that memory lapses are different that memory problems and even in cases where memory problems exist, this cannot be used alone to determine cognitive fitness.

"Just because somebody has problems remembering things from the past, it doesn't mean they don't have the ability to make good decisions or it doesn't mean that their executive function is impaired with aging," Safai said.

Memory and cognitive evaluation require more extensive assessments

Doctors say isolated examples of memory lapses can’t replace more in-depth assessments of memory and cognitive functioning, and it’s more than just one assessment at one point in time and there is no one test to determine if a person is fit to hold office.

"If we could [just use isolated examples] we wouldn't need the detailed neurocognitive testing," Aronson said.

These assessments are extensive, may take multiple visits to fully complete and require a detailed history to fully understand and assess someone’s level of function.

Dr. Richard Isaacson, a preventive neurologist at the Institute of Neurodegenerative Diseases Florida, told ABC News, "it's impossible to accurately judge whether a brain change may be due to the normal aging process versus compared to a neurodegenerative disease or just due to a disease without a formal evaluation, examination, cognitive assessments, and when needed, brain imaging."

In these assessments, doctors are evaluating for any warning signs that show patterns of behavior or memory lapses that prevent them from carrying out their daily responsibilities.

"Things like being unable to do your finances and stay on top of your monthly bills or consistently having a pattern of memory problems that pose safety concerns," Croll said.

Doctors say there are some cognitive benefits of aging

"When people are younger, [in their] 20s and 30s, they often have worse impulse control and ability to integrate information," Aronson said.

Doctors say as people age, impulse control tends to improve, and they may better integrate more information into their decision-making.

"As we age, there are aspects of cognitive function, specifically related to judgment and wisdom that actually improve over time. And you know, when a person is seasoned and has experience dealing with complex problems, that experience may come in handy when either dealing under pressure or having to make a decision," Isaacson said.

"These [traits] can manifest as having a better handle on your reactions to various situations and being able to think before you act which can be extremely useful as we get older," Croll said. "Having wisdom from many lived experiences, of course, is another form of knowledge and cognitive fitness."

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What to know about rare virus Alaskapox after first fatal case

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(NEW YORK) -- An Alaska resident has died from complications of a relatively new and rare virus known as Alaskapox, according to a bulletin posted by Alaska state public health officials.  

The Alaskapox virus was first identified in Fairbanks, Alaska, in 2015, according to the Alaska Department of Health. Since then, there have been only seven cases reported in the state, according to the state health department.

This is the first case of an Alaskapox infection resulting in hospitalization and death ever reported. State public health officials noted the patient was an elderly man who was immunocompromised, putting him at higher risk for severe illness.

"Alaskapox remains rare," Dr. Joe McLaughlin, state epidemiologist and chief of the Alaska Division of Public Health Section of Epidemiology, told ABC News. "For the vast majority of people who may come in contact with this virus, the clinical course will likely be mild."

The virus typically occurs in small animals, commonly identified in voles and shrews, according to the Alaska State Department of Health. There have been no reports of human-to-human spread, according to the state health agency.

"There's no evidence so far [of] person-to-person transmission for the cases that have been identified," Julia Rogers, Ph.D., epidemic intelligence service officer at the Centers for Disease Control and Prevention embedded with the Alaska Department of Health, told ABC News.

“Given the rarity of Alaskapox and its generally mild course in healthy individuals, the risk to the general public remains low,” said John Brownstein, Ph.D., chief innovation officer at Boston Children's Hospital and an ABC News medical contributor.

It remains unclear how the deceased resident was infected with the virus. They lived alone in a forested area and reported caring for a stray cat, which later tested negative for the virus, according to the state’s bulletin, issued Friday.

“It could be that the cat was catching voles or shrews and eating them and then have viable virus in its claws, and that was the route of [infection], through a scratch,” McLaughlin said.

Over a span of six weeks, the patient had visited his doctor and local emergency room for a lesion and was prescribed antibiotic drugs, according to the bulletin. Eventually, as his situation deteriorated, he was hospitalized, where doctors sent in tests to the CDC, according to state health officials, which eventually identified the viral infection as Alaskapox. He succumbed to the virus a few weeks later, state health officials said.

“The most recent [fatal] case was in an elderly man that was immunocompromised, so his immune system was already not going to be able to handle infection,” Rogers said.

Public health officials in Alaska are recommending doctors become familiar with the signs and symptoms of the virus and consider testing for patients they may suspect contracted the illness.

What to look for

If patients develop lesions, they should avoid touching them and keep them dry and covered, while practicing good hand hygiene and avoid sharing cloth and linen with others, according to the state health department.

Those in regular contact with wildlife may need to take extra precautions, officials said.

“There's lots of things that you can pick up from wildlife animals, and just try to take the best precautions you can and be safe and hygienic with contact with them,” Rogers said.

Alaska public health officials hope awareness of the relatively new virus will allow for potential future cases to be identified easier.

“What we're expecting is that over time, as more clinicians become not only aware that Alaskapox virus is out there, but also aware of what to look for and how to actually test for it, that we are going to see more Alaskapox diagnoses in the months and years ahead,” McLaughlin said.

“The recent unfortunate death of an immunocompromised individual underscores the potential severity of Alaskapox in vulnerable populations, highlighting the critical need for heightened awareness and diagnostic readiness among health care providers,” Brownstein said.

“This case emphasizes the importance of monitoring wildlife diseases and their potential to impact human health, especially as human activities increasingly encroach on natural habitats,” Brownstein added.

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