A shortage of Zyn, a smokeless nicotine pouch that users tuck into their lips to get a buzz, has fueled a wave of social media outcry in recent weeks, amplified by a legal challenge that forced its parent company to halt online sales earlier this week.

Zyn has been around since 2014, but sales took off in the past year amid a wave of online creators (“Zynfluencers”) expressing their loyalty to the product alongside mentions from popular podcasters like Joe Rogan and the Nelk Boys.

The increased attention has helped fuel a sales boom: In April, Philip Morris, which acquired Zyn maker Swedish Match for $16 billion in 2022, reported shipments had soared 80% year over year to reach 131.6 million cans. Today, Zyn accounts for approximately 3 of every 4 purchases of oral smoke-free products, according to Tobacco Reporter, an industry publication.

In a statement, a Philip Morris spokesperson acknowledged that there was a “short-term inventory constraint” on Zyn that was “demand driven.”

“An increasing number of adult smokers are choosing Zyn as a better alternative than continued smoking,” the spokesperson said. “No regulatory or production issues have affected distribution.”

Online and in interviews with NBC News, Zyn users have voiced frustration with getting their hands on Zyn products.

“I’ve just kind of moved to another brand while they figure out the shortage problem, which isn’t ideal, but you know, it is the only thing you can do at this point,” said James Perkins, the CEO of a software startup and a Zyn user.

On TikTok, content creator Hayden Iverson called the shortage a “Zyndemic,” saying he would be rationing his Zyn cans. At the end of May, he said, he went to four different stores near his home in Boca Raton, Florida, but wasn’t able to find any of his preferred tins.

“They’ve always been easy to find, but now they’re a little bit harder to find,” he said in a phone interview.

Iverson’s video drew thousands of likes and hundreds of comments, many from people who said they’ve also encountered difficulty finding the product.

Some online Zyn fans have speculated about whether a March fire at a Swedish Match factory may have affected supply. At the time, a representative for the company reportedly told Swedish outlet Aftonbladet that there was not a risk of a shortage.

The Philip Morris spokesperson said Swedish Match, which directly manufactures Zyn, is currently making investments to expand and diversify U.S. production, including adding capacity at its Owensboro, Kentucky, facility.

The factory is also making process adjustments to increase production to help ensure consistent supply, which the spokesperson said would improve continuously over the next year.

And Philip Morris said it is working on constructing a new U.S. factory for Zyn production in 2025.

But users may still be waiting for some time before they feel improvements in availability. Earlier this month, Philip Morris CFO Emmanuel Babeau said supplies wouldn’t “be back to a normal situation” until the end of this year, according to Bloomberg News.

And while the company has said the vast majority of sales occur in stores, the recent announcement that it was halting shipments from the Zyn.com website in response to a subpoena from the District of Columbia has fueled further fears about how supplies could be affected.

Even as he awaits a resupply, Perkins said he remains loyal to the brand.

“Other brands are just very much trying to almost copy [Zyn] and hope for the best,” Perkins said. “A lot of them just don’t do a good job. The flavor is so intense that it’s just not pleasant in your mouth or the nicotine pouch itself is just poor quality.”

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Eli Lilly on Friday said it applied for U.S. approval of its weight loss drug Zepbound for the treatment of the most common sleep-related breathing disorder and expects regulators to make a decision as early as the end of the year.

If cleared by the Food and Drug Administration, the company plans to launch Zepbound for so-called obstructive sleep apnea “as quickly as we can” at the beginning of 2025, Patrik Jonsson, president of Eli Lilly diabetes and obesity, said in an interview.

Also on Friday, the company released additional data from two late-stage trials showing that Zepbound helped resolve obstructive sleep apnea, or OSA, in almost half of patients. Eli Lilly presented the new data from the trials at the American Diabetes Association’s 84th Scientific Sessions in Orlando, Florida, on Friday.

“We’re super excited. … I think it actually went beyond what most external experts were hoping for,” Jonsson said of the new data demonstrating that Zepbound can help resolve the disorder in some patients.

It adds to growing evidence that there could be further health benefits tied to a class of weight loss and diabetes treatments that have soared in popularity and slipped into shortages in the U.S. over the past year. The data also paves the way for Eli Lilly to gain broader insurance coverage for Zepbound, which, like other weight loss drugs, is not covered by many insurance plans.

The pharmaceutical giant in April released initial results from the two studies, which showed that Zepbound was more effective than a placebo at reducing the severity of OSA in patients with obesity after a year. 

OSA refers to interrupted breathing during sleep due to narrowed or blocked airways. An estimated 80 million patients in the U.S. experience the disease, Eli Lilly said in a press release. Around 20 million of those people have moderate-to-severe forms of the disease, but 85% of OSA cases go undiagnosed, according to Jonsson. 

OSA can lead to loud snoring and excessive daytime sleepiness, as well as contribute to serious complications, including stroke and heart failure. Patients with the condition have limited treatment options outside of wearing masks hooked up to cumbersome machines while sleeping that provide positive airway pressure, or PAP, to allow for normal breathing.

The first study examined the weekly injection in adults with moderate-to-severe OSA and obesity who were not on PAP therapy. The second trial tested Zepbound in adults with the same conditions, but those patients were on and planned on continuing PAP therapy. 

The new results showed that 43% of people in the first study and 51.5% of patients in the second trial who took the highest dose of Zepbound achieved “disease resolution,” according to a release. That compares with 14.9% and 13.6% of patients who took a placebo in the two trials, respectively. 

“This has huge impacts on patients’ lives,” Leonard Glass, senior vice president of medical affairs at Eli Lilly, diabetes and obesity, told CNBC. “Imagine not having to use a PAP machine, or not having to worry about waking up again in the middle of the night, or for your partners — not having to live with somebody with this condition.”

Researchers came to those conclusions by examining a so-called apnea-hypopnea index, or AHI, which records the number of times per hour a person’s breathing shows a restricted or completely blocked airway. The index is used to evaluate the severity of obstructive sleep apnea and the effectiveness of treatments for the condition. 

Disease resolution for OSA is defined as a patient having fewer than five AHI events per hour, according to Eli Lilly. It is also defined as a person having five to 14 AHI events per hour and scoring a certain number on a standard survey designed to measure excessive daytime sleepiness, the company said. 

Among other new data, the company said 62.3% of patients in the first trial who took Zepbound saw a greater than 50% reduction in AHI events, compared with 19.2% of those on placebo. Meanwhile, 74.3% of people in the second study who took Eli Lilly’s drug saw a more than 50% reduction in AHI, compared with 22.9% of participants who received a placebo.

Eli Lilly on Friday reiterated that Zepbound met the main goal of the trial, which was reducing AHI events. 

Zepbound led to an average of 27.4 fewer AHI events per hour at 52 weeks in people who were not on PAP machines. That compares to an average reduction of 4.8 events per hour for those who received a placebo in the first trial. 

The drug also led to an average of 30.4 fewer AHI events per hour at 52 weeks in patients who were on PAP machines, compared with an average reduction of six events per hour for people on the placebo in the second study.

Eli Lilly previously announced that the FDA granted Zepbound “fast track designation” for patients with moderate-to-severe OSA and obesity. The designation ensures that drugs intended to both treat a serious or life-threatening condition and fill an unmet medical need get reviewed more quickly.

“This is absurd,” Sanders said in an interview late Tuesday. “It is clear that Novo Nordisk is ripping off the American people.”

Novo Nordisk CEO Lars Fruergaard Jørgensen has agreed to testify in September over the pricing of the drugmaker’s hugely popular weight loss drugs, the Senate Committee on Health, Education, Labor and Pensions announced Friday.

It came three days after Sanders, who chairs the committee, threatened to hold a vote to subpoena Novo Nordisk President Doug Langa to provide testimony.

In a separate statement, a spokesperson for Novo Nordisk said that Jørgensen agreed after he and Sanders had “a productive call and agreed to find a mutually acceptable date for a hearing.”

Sanders said Tuesday that he is still working with Novo Nordisk to set an exact date for the hearing, but he expects it will be during the second week of September. He said his strategy for getting Novo Nordisk to reduce the cost of the drugs is simple: Put the company in the spotlight.

“I think enough public pressure may result in them lowering their prices substantially, which is obviously what my goal is,” the senator said. “This is a huge issue because it is likely that Ozempic and Wegovy may end up being the most lucrative product that the pharmaceutical industry has ever developed.” 

In April, the committee launched an investigation into Novo Nordisk’s pricing practices. It cited a report that found that Novo Nordisk charges around $1,300 a month for Wegovy in the U.S., even though the drug can be purchased for $186 a month in Denmark, $137 in Germany and $92 in the United Kingdom. Some patients in the U.S. have said that the higher prices of Ozempic and Wegovy have pushed them to unregulated, copycat drugs for weight loss.

In reality, there’s little Congress can do about the high cost of the weight loss drugs in the U.S. Novo Nordisk charging higher prices is partly a function of how the American patent system works. 

Drugmakers who develop new medications get to exclusively sell them on the U.S. market for a set period of time — typically 20 years. During this time, other companies can’t make generic versions of the drug, severely limiting competition. And unlike other countries, there is generally no direct pricing regulation on the drug by the federal government. 

The patent for semaglutide, the active ingredient in Ozempic and Wegovy, isn’t expected to expire until around 2031 at the earliest. 

When asked about prescription drug pricing in the U.S., Sanders responded, “This is the system, it’s a corrupt system.”

“It’s a system controlled by a large pharmaceutical industry, who makes massive amounts of campaign contributions,” he said. “And it’s a system which enables the drug companies to make huge profits, while 1 out of 4 Americans cannot afford to buy the prescription drugs that doctors prescribe.” 

Sanders said he knows Novo Nordisk likely isn’t the only one responsible for the high cost of the drugs. He said so-called pharmacy benefit managers, also known as middlemen, likely also make the cost of the drugs more expensive for people in the U.S. 

Sanders said Novo Nordisk had wanted other companies, including pharmacy benefit managers, on the panel in September, but he declined. 

“None of that negates the fact that they are charging us far, far more for the exact same product than they charge people in other countries,” he said. 

Novo Nordisk declined to provide an additional comment on Sanders’ remarks.

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Some people are turning to supplements to manage those issues rather than using treatments approved by the Food and Drug Administration, such as hormone therapy. But, experts say, menopause supplements aren’t necessarily helpful. And, in some cases, they can be dangerous.

The rising popularity of menopause supplements, experts say, highlights a lack of access to evidence-based options, rampant misinformation about hormone therapy and gaps in our knowledge about menopause — even among specialists.

Current menopause treatments

“The primary treatment — and the first-line treatment — should be hormone (estrogen) therapy, especially for moderate-to-severe menopause symptoms,” Dr. Anna Barbieri, assistant clinical professor in the department of obstetrics and gynecology at Mount Sinai School of Medicine, tells TODAY.com

“There is just nothing as effective and nothing that has as wide-ranging effects and benefits as hormone therapy,” Barbieri adds.

Effectively managing hot flashes, most often through hormone therapy, may have long-term health benefits, too, Dr. Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, tells TODAY.com.

Not only do hot flashes last seven years on average (and often longer for Black women), but we also know that “hot flashes are associated with cardiovascular disease, brain fog during perimenopause, potentially declines in cognitive function down the road and multiple other medical problems,” Streicher says.

However, some people should steer clear of hormone therapy due to other health conditions. That includes a current or past hormone receptor-positive cancer (primarily breast and endometrial cancers), as well as a history of stroke, blood clots or cardiovascular disease, Barbieri explains.

If someone can’t or prefers not to take hormone therapy, that’s where non-hormonal options come in. Those include the off-label use of antidepressant medications and the recently-approved drug fezolinetant.

There are also all kinds of lifestyle and behavior techniques people may use to stay generally healthy, whether or not those techniques directly help with hot flashes, Dr. Monica Christmas, associate professor and director of the Center for Women’s Integrated Health at The University of Chicago Medicine, tells TODAY.com.

That might include avoiding certain triggers (such as alcohol), cognitive behavioral therapy, maintaining good diet and exercise habits and even hypnosis, she says.

What doctors don’t want is for you to jump into taking supplements on your own.

“I cannot tell you how many times I have identified supplements people were using that where unnecessary, potentially harmful or interacting with other medications,” Barbieri says. “Or people who were using 25 supplements where they could just use hormone therapy.” 

Should you take menopause supplements?

There are a lot of reasons someone might want to try an over-the-counter supplement to manage menopause symptoms. Of course, there’s a wealth of options available on the internet — many with little or no evidence that they actually work, and some with evidence that they can be harmful.

“Most of them just haven’t been studied,” Streicher says. “But some of them we know absolutely are not safe to use.”

In its 2023 position statement on non-hormone therapies, the Menopause Society (formerly known as the North American Menopause Society) did not recommend any dietary supplement to manage menopause symptoms. For the majority of the supplements the group looked at, their conclusions were due to flawed studies, mixed results or an overall lack of evidence.

The experts TODAY.com spoke to generally agree, but take a more nuanced position: There can be a place for supplements in managing menopause symptoms, they say. But their usefulness depends on your symptoms, what other treatments you’re comfortable with and the specific supplements you’re using.

For Streicher, it makes sense to talk about supplements when patients have only mild symptoms, or if they have more intense symptoms and already take a prescription medication but want to try something on top of that.

A typical example for Barbieri might be a patient with breast cancer and sleep issues who can’t take hormone therapy. “If someone does not use medication for sleep, and lifestyle interventions don’t work, then we may turn to something like magnesium and l-theanine or inositol,” she says, which research shows are safe for patients with a history of breast cancer who cannot take hormone therapy.

Other people “feel that menopause is natural … and they just want to use certain lifestyle interventions and only feel comfortable with supplements no matter what,” Barbieri says. “That’s OK, I just need to know that.”

More than anything, experts say, the decision whether to take menopause supplements should be based on a knowledgeable provider having a genuine conversation with a patient about what really might work for them and their preferences. (edited) 

“As providers, we do need to be able to give good information and understand that (supplements are) going to be a preference of some people,” Christmas says. “And if it doesn’t work, (we need to be) respectful that maybe shoving hormone therapy down their throat still might not be the answer.”

Common ingredients in menopause supplements

There are a ton of supplements on the market, many of which contain proprietary blends of ingredients.

Additionally, supplements are not regulated by the FDA in the same way that pharmaceutical drugs are. It’s up to the supplement manufacturer and distributors to ensure the safety and correct labeling of their products, the FDA explains.

That’s why, if you’re going to use any supplements, the experts recommend looking for a label that indicates it has been third-party verified, which means you can be more confident that it actually contains the ingredients that it advertises. Specifically, Barbieri suggests looking for USP or GMP supplement certifications on a product.

And keep the placebo effect in mind, Christmas says. When you take something new, you might feel better initially. “But the placebo effect can’t be sustained,” Streicher says.

Here are a few common ingredients you may see in menopause supplements:

Vitamins and minerals

If someone is deficient in vitamins and minerals during menopause, supplements may be a good idea, experts say.

For instance, low levels of vitamin D are correlated with poor bone health and depression, Barbieri explains. “Because these are factors that are important for all of my menopausal patients, I will actually check vitamin D and will replace that — no question,” she says.

The same goes for vitamin B12 and ferritin (a form of iron) which women may not get enough of via food, particularly those following plant-based or vegetarian diets. “These are essential nutrients that are going to result in improved health and sense of well-being if someone is deficient in them,” Barbieri says.

If you think you could benefit from a supplement to treat a deficiency, talk to your doctor about testing first.

Isoflavones, phytoestrogens and “plant-based hormones”

Phytoestrogens are plant compounds that mimic estrogen when broken down in the body. Isoflavones are a type of phytoestrogen that comes from soybean products.

This is a major category of menopause supplements, but they are not safe for people avoiding hormone therapy due to their health histories, the experts say.

“If you have a history of an estrogen-derived cancer, like a breast cancer, you shouldn’t be taking (phytoestrogen supplements) either,” Christmas says. “Those are nuances that maybe people don’t think about when they see a supplement in the health food store or local pharmacy,” she adds.

For those interested in phytoestrogen supplements who have a low-risk health history, Streicher recommends looking into S-equol. “It’s the only one that really has science (behind it),” she says, “because it’s the active metabolite of soy, which is what’s been shown to actually potentially help with hot flashes.”

Just keep in mind that people’s experiences with these kinds of supplements vary widely, Streicher says, because people metabolize them differently.

While phytoestrogen supplements are not recommended for people avoiding hormone therapy, those patients generally are OK to eat phytoestrogens occurring naturally in food, such as soy, Barbieri explains.

What about general “plant-based hormone” products? Creams are often marketed with such language, Barbieri says, adding that they may contain a version of progesterone made in a lab using a compound in yams, she says. That language is aimed at people who want to feel natural by using that, but “plants do not have human hormones,” she stresses.

Black cohosh

“Black cohosh is commonly reported to help with hot flashes and night sweats, although it hasn’t been proven to do that,” Christmas says, “and it actually can increase liver enzymes.” 

If you have an underlying liver condition, you should steer clear of black cohosh she says. Or, if you decide to take it, “you should be monitored frequently with serology to make sure your liver function isn’t worsening,” Christmas adds.

St. Johns wort

Often advertised to help with hot flashes and depression, St. Johns wort can also interact with many other medications that can have an impact on someone’s health, Christmas says.

Combinations of herbs

Some products contain a huge blend of many types of botanical ingredients and may or may not actually list the ingredients, Streicher says. For instance, you don’t know what you’re getting with products labeled simply “Chinese herbs,” she says.

Before you try menopause supplements…

It’s tempting to just buy the bottle, but the experts discouraged trying a new supplement without talking to your doctor.

First, set up a doctor’s appointment just to talk about menopause. Resist the urge to simply tack a conversation about menopause onto the end of another appointment, Christmas says.

Making an appointment specifically for menopause symptoms “automatically sets a different tone,” she explains, and “it’s probably going to get you a little bit more time in front of that health care professional.” Ideally, this should be an in-depth and individualized discussion to go through your specific symptoms, what you’ve already tried and your treatment preferences.

Unfortunately, many doctors — even OB-GYN specialists — don’t receive much (if any) training in menopause, Streicher says.

So, if your doctor isn’t well-versed in menopause treatments, find a specialist. All the experts recommend starting by using this tool from the Menopause Society to find a menopause expert near you.

If you’re in a major city, you’ll likely be able to find someone pretty easily, Streicher says. But if not, telehealth consultation services like Midi and Gennev may be your best option. (Streicher provides educational work for Midi.)

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• A record number of mosquitoes are testing positive for West Nile virus in and around Las Vegas amid a surge in the area’s overall mosquito population.
• Local health officials are urging the public to take precautions to avoid getting bit.
• As climate change expands the reach of insect-borne diseases, Las Vegas’ situation is offering a case study.

A record-breaking number of mosquitoes in and around Las Vegas are carrying West Nile virus, sparking warnings from local health officials who say the public should take precautions to avoid getting bit. 

West Nile virus can cause fever, headaches, vomiting and diarrhea and is fatal in about 1 of 150 cases. There are no vaccines or medications to treat or prevent the mosquito-borne illness.

In recent weeks, 169 of over 24,000 pools of mosquitoes tested for West Nile virus returned positive — meaning at least one insect in the pool carried the disease — across 25 southern Nevada ZIP codes. The number of mosquitoes recorded and the tally of positive pools this early in the season break the area’s records for both metrics, set in 2019. 

“These are huge numbers of mosquitoes, and we’ve already identified a concerning number of them carrying the West Nile virus,”  said Vivek Raman, an environmental health supervisor for the Southern Nevada Health District.

Health officials have also identified six pools in the Las Vegas area that tested positive for St. Louis encephalitis virus, a mosquito-borne disease that can cause fatal inflammation of the brain.

For decades, climate scientists and public health officials have warned that climate change  could expand the reach of various infectious diseases, especially those spread by mosquitoes. Las Vegas’ exploding mosquito population and the local uptick in West Nile prevalence offers an important case study on how climate could affect human health.

Climate change increases average global temperatures and precipitation levels, fostering conditions that are ideal for mosquitoes, which breed in still, warm water. It also extends the length of warm periods, prolonging the active season for mosquitoes. These changes increase the risk of human exposure to diseases like West Nile virus, even in places that have never recorded cases before.

The first case of West Nile virus in Las Vegas was recorded in 2004 — five years after the United States’ first case was documented in 1999 in New York City. Las Vegas’ most recent West Nile outbreak occurred five years ago, resulting in 43 human cases. District health officials are concerned that this summer could be far worse.

In Nevada and much of the Southwest, springtime weather has become warmer and summertime heat waves have grown increasingly extreme over the last few decades. Las Vegas has seen average springtime temperatures rise by 6.2 F since 1970; this month, the city has already experienced a weeklong, record-breaking heat wave. 

Southern Nevada’s rising temperatures are creating favorable conditions for mosquitoes, said Nischay Mishra, an assistant professor of epidemiology at Columbia University. What’s more, ongoing drought conditions in the state, which have led to low water table levels throughout the Colorado River Basin, including in Lake Mead, may also be counterintuitively beneficial for the insects. 

“Mosquitoes typically thrive in wet and hot places,” Mishra said. “But in Nevada, as smaller bodies of water dry up, they create shallow waters that are ideal for mosquito breeding.”

Las Vegas’ mosquito surge has been giant: Last year, district health officials measured 6,000 mosquitos in traps across Clark County from April to June. This year, counts have already exceeded 24,000. 

The vast majority have been Culex mosquitoes, a primary vector for West Nile virus.  But another mosquito species that does not carry the virus, Aedes aegypti, has also become more common in Las Vegas.  Aedes was first spotted in the area in 2017, and Raman attributes its spread there to the impacts of climate change, as well.

Along with climate, human behavior plays an important role in the spread of vector-borne diseases. Aedes and Culex mosquitoes both thrive in the backyards of many Las Vegas homes — the former breed in small pools of water such as those left from sprinklers, while the latter often breed along the surface of unmaintained swimming pools.

Raman said the best way to avoid infection is to empty any open containers filled with water outside, maintain swimming pools, wear protective clothing and use bug spray to avoid getting bit.

Louise Ivers, a professor of global health and social medicine at Harvard Medical School and the director of its Global Health Institute, said situations like the one in Las Vegas will become more common as climate change continues to boost infectious disease globally. 

“We should expect to see new infectious diseases, old infectious diseases back again and a change in the patterns of exposure of existing infectious diseases like West Nile virus,” Ivers said. “Things that we used to do freely without worrying as much about protection from vectors like mosquitoes or ticks, we might not be able to do anymore.”

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PVWC said the advisory is effective immediately and will remain in place until further notice.

The areas impacted are:

• Clifton/Paterson: Lakeview Ave from Maryland Ave to E 3^rd St
• Clifton/Paterson: Marshall Street / Kuller Rd
• Clifton: Route 46 (Piaget Ave)
• Paterson: 21^st Ave going east to E 26^th St

Residents and businesses affected by the advisory must:

• Boil water before all use.
• Use alternate water sources, like bottled water, if boiling is not possible.

PVWC crews are actively working to address the issue and restore normal water service.

“We apologize for any inconvenience this may cause and appreciate your cooperation and understanding as we work safely and diligently to make necessary repairs,” PVWC said.

The FLiRT strains — which include KP.3, KP.2, and KP.1.1 — now account for more than half of all COVID-19 infections nationwide, according to the latest data from the U.S. Centers for Disease Control and Prevention.

These new variants, which scientists dubbed “FLiRT” after the locations of their spike protein mutations, have been circulating in the U.S. since the early spring. In April, KP.2 quickly overtook JN.1, the omicron subvariant that drove a surge in COVID cases this past winter.

In a matter of weeks, the KP.3 variant overtook KP.2 to become the most prevalent strain in the U.S., per the CDC.

During a two-week period ending on June 8, KP.3 made up an estimated 25% of cases in the U.S., up from about 9% in early May. After KP.3, the next most common variant is KP.2, another FLiRT variant that gained dominance in May and now accounts for about 22% of cases. It’s followed by LB.1, a JN.1 subvariant, and another FLiRT variant, KP.1.1.

Together, the FLiRT variants make up an estimated 55% of cases in the U.S.

Although hospitalizations are down and COVID-19 numbers are relatively low, there has been a small uptick in test positivity and emergency room visits, per the latest CDC data. These trends, along with previous summer waves, have stoked fears about a surge of infections this summer.

Scientists are warning that the FLiRT variants may be better at evading the immune system due to their spike protein mutations, and that waning immunity and poor uptake of the latest COVID-19 vaccine have created a more susceptible population.

Will there be another COVID-19 wave? What are the symptoms of the FLiRT variants? Are vaccines still effective? We spoke to experts to learn more.

What is KP.3?

KP.3 is one of the FLiRT variants — along with KP.2 and KP.1.1 — which are spinoffs of JN.1.11.1, a direct descendant of JN.1. They were initially detected in wastewater samples from across the country.

KP.3 and the other new variants have additional mutations that set them apart from JN.1 and appear to give them an advantage over previous variants, Dr. Albert Ko, infectious disease physician and professor of public health, epidemiology and medicine at Yale School of Public Health, tells TODAY.com.

The nickname “FLiRT” is based on the technical names for their mutations, according to the Infectious Disease Society of America.

Just like other COVID-19 strains that have gained dominance in the U.S. over the last year — JN.1, HV.1,  EG.5 aka Eris, and XBB.1.16 or Arcturus — the FLiRT variants part of the omicron family. 

The emergence of KP.3 and other FLiRT variants is the “same old story,” Andrew Pekosz, Ph.D., virologist at Johns Hopkins University, tells TODAY.com. The SARS-CoV-2 virus mutates and gives rise to a new, highly contagious variant, which becomes the dominant strain. “The timeline that it happens in, three to six months, is much faster than we see with other viruses like influenza,” says Pekosz.

Is KP.3 more transmissible?

“It’s still early days, but the initial impression is that this variant is rather transmissible,” Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, tells TODAY.com.

The proportion of cases caused by KP.3 is increasing, while the proportion caused by other variants is decreasing, which suggests the FLiRT variants have features that give it an advantage, the experts note.

Over 97% of people in the U.S. have natural or vaccine-induced antibodies against the the SARS-CoV-2 virus, per the CDC, but this immune protection fades over time.

Low vaccination rates and waning immunity create a vulnerable population, which may allow the FLiRT variants to take hold. Only time and more data will tell, the experts note.

Laboratory studies suggest that the FLiRT variants are mutated enough such that current vaccines and immunity from prior infection will only provide partial protection, says Schaffner. “We’ll have to see how true that is, but it appears, over time to be becoming a more prominent variant,” he adds.

“It’s still really early … but I don’t think we need to sound the alarm bells as of yet,” says Ko.

The state of COVID in the U.S.

It’s too soon to tell whether KP.3 and the FLiRT variants will cause a summer wave or surge, the experts note. However, it is clear that COVID-19 is still circulating and won’t be taking any time off.

“We’re seeing these infections year-round, at modulating levels. … We’re probably not at the stage yet where we’ll see COVID go away completely at any time of the year,” says Pekosz.

Test positivity, which is an early indicator of case levels, was 5.4% as of June 8, up 0.8% from the previous week but a sharp decline from a peak of about 12% in mid-January, per the CDC. (The CDC no longer tracks the total number of cases in the U.S.)

“We’re not seeing a lot of hospitalizations, and we’re certainly much lower than we were in the winter, so I’d say right now we’re at a low point, which is reassuring,” says Ko.

Wastewater data published by the CDC show that the viral activity level for COVID-19 is currently “low” — it was considered high or very high for most of January and February.

“It seems like transmission is pretty low right now, and that makes sense because usually the big peaks are in the winter, when people are inside and in more contact,” says Ko.

COVID-19 has caused summer waves in the past, the experts note, which are often smaller than the winter surges. “I don’t think that we’ll see any kind of massive surge in cases,” says Pekosz.

The seasonality of COVID-19 is something scientists are still trying to understand. But one thing is obvious: “This virus is now integrating itself into our population and our way of life,” says Schaffner.

Adds Ko: “I’m not expecting a large surge in the summer, but again, we have to be cautious and we have to follow the data. … We always have to be humble because SARS-CoV-2 has taught us a lot of new things.”

What are the symptoms of KP.3?

It is still too early to tell whether the symptoms of KP.3, KP.2 and other FLiRT variants are different from previous strains.

“The FLiRT variants are probably not going to create very distinctive symptoms. It looks at the moment to follow the other subvariants,” says Schaffner.

The symptoms of the FLiRT variants are similar to those caused by JN.1, which include:

• Sore throat
• Cough
• Fatigue
• Congestion
• Runny nose
• Headache
• Muscle aches
• Fever or chills
• New loss of sense of taste or smell
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhea

According to the CDC, the type and severity of symptoms a person experiences usually depend more on a person’s underlying health and immunity rather than the variant that caused the infection.

Similar to JN.1 and other omicron subvariants, the FLiRT variants seem to be causing milder infections, says Schaffer.

Do vaccines protect against KP.3?

Early laboratory studies indicate that the vaccines will continue to provide protection the FLiRT variants — “a little less protection, but not zero by any means,” says Schaffner.

As the virus mutates, it is becoming progressively different from the omicron strain targeted in the latest updated booster released in the fall of 2023. “We would expect that to happen, and we anticipate the plan is to have an updated vaccine in the fall available to everyone,” says Schaffner.

Advisers to the U.S. Food and Drug Administration met on Tuesday, June 5, to decide which strains to include in the updated COVID-19 vaccines for 2024–2025. The committee unanimously voted to recommend a monovalent vaccine targeting the JN.1 variant for this fall, the agency said in a press release.

Even if vaccines do not prevent infection, they can still offer some protection by preventing severe disease, hospitalization, and COVID-19 complications, TODAY.com previously reported.

“It’s still clear that the more severe cases that come into the emergency room predominate in people who either are not up to date on their vaccines or haven’t gotten a vaccine in a really long period of time,” says Pekosz.

Vaccination is especially important for the elderly, says Pekosz, which is why the CDC recently recommended adults ages 65 and older get an additional dose of the 2023-2024 updated COVID-19 vaccine.

Unfortunately, vaccination uptake is still poor, the experts note. “The vaccines are still showing signatures of effectiveness, but they’re not being utilized anywhere close to the level that they should be,” says Pekosz.

As of April 2024, only about 22% of adults and 14% of children have reported receiving the updated COVID-19 vaccine released in September 2023, according to the CDC.

All current PCR and at-home tests are recognizing KP.3 and other FLiRT variants, the experts note. (Though if you have symptoms of COVID and test negative, it’s a good idea to stay home to avoid potentially exposing other people, TODAY.com previously reported.

If you are using an at-home antigen test, always remember to check the expiration date and whether it’s been extended by the FDA.

“Antivirals (such as Paxlovid) are also working well. … There’s not any major signals of antiviral resistance in the population, which is a positive sign,” says Pekosz.

How to protect against KP.3 and FLiRT variants

While it’s too early to tell how the FLiRT variants will pan out this summer, people can always take steps to protect themselves and others against COVID-19.

The CDC recommends the following prevention strategies:

• Stay up to date with COVID-19 vaccines.
• Test for COVID-19 if you have symptoms or an exposure.
• Stay home when you are sick.
• Return to normal activities only after you have been fever-free and symptoms have been improving for at least 24 hours.
• Practice good hand hygiene.
• Improve ventilation.
• Wear a mask in crowded, indoor spaces.
• Practice social distancing.

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A study looked at how dust and debris from the aftermath of the World Trade Center attacks has affected the brain health of first responders.

Researchers from Stony Brook University found exposure to toxins at Ground Zero was associated with higher risk of dementia before the age of 65. That risk was much lower for those who were not exposed or who wore protective equipment.

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The study, which was comprised of more than 5,000 responders, adds to previous research showing 9/11 first responders show signs of cognitive impairment at about three times the rate of the general population.

Among those who participated, there were 228 responders under the age of 60 without dementia at the start of the study who developed the illness over the course of the next five years. That equates to 4.6% of responders in the study; lead author Sean Clouston said that in the general population, the incidence would only be about 0.5%.

Additionally, in responders who reported no dust exposure or those who wore protective equipment like masks and hazmat suits, about five or six out of every 1,000 in the study developed dementia each year. But for the responders who did not wear PPE and had reported doing things like digging through the World Trade Center debris, the dementia rates topped 42 per 1,000 people.

“This rate of dementia in those reporting many exposures and limited protection is not only statistically significant, it is alarming for a patient cohort that clearly shows a strong association between exposure and the incidence of dementia under the age of 65,” says Clouston. “Also, the rates remained statistically significant over the less exposed group even after adjusting for social, medical, and demographic factors.”

The CDC said four people have been hospitalized in the multi-state outbreak. The majority of people who faced the illness were children under five years old, the CDC said.

Symptoms of salmonella can include diarrhea, fever, and stomach cramps.

The CDC said people handing bearded dragons or their habitats should always wash their hands thoroughly with soap and water, and warned against kissing or snuggling a bearded dragon. Health officials said to avoid eating and drinking around the reptiles too and keeping them away from spaces where young children eat or play.

Bearded dragons are not recommended for families with children younger than five-years-old, people 65 years of age and older, or people with a weakened immune system, according to the CDC, which said people in those categories are more susceptible to illnesses from reptiles.

Four people have been sickened in New York. Other states impacted are: California, Georgia, Iowa, North Carolina. Ohio, Oklahoma, Tennessee and Texas.

Sen. Tammy Duckworth, a military veteran who has used the fertility treatment to have her two children, has championed the bill, called the Right to IVF Act. The bill would also expand access through insurance as well as for military members and veterans.

“These are real solutions that would help tens of thousands of Americans every year build the families of their dreams,” Duckworth, D-Ill., said this week.

But almost all Republicans voted against advancing the measure, ensuring that it fell short of the 60 votes needed. Instead, GOP senators offered their own, alternative legislation that would discourage states from enacting outright bans on the treatment. Democrats in turn blocked it Wednesday.

The overtly political back-and-forth, with no attempt at finding a legislative compromise, showed how quickly Congress has shifted into a campaign mindset five months out from the fall election.

As Schumer seeks to protect a narrow Senate majority and buoy Democrats’ hopes of holding the White House, he has sought to spotlight Republican intransigence to federal legislation that would guarantee women’s rights to reproductive care. Democrats have campaigned heavily on the issue ever since the 2022 Supreme Court decision that ended a federal right to abortion.

“The anti-abortion movement is not yet finished. Now that Roe is gone, they have set their sights to a new target — in vitro fertilization,” Schumer said on the Senate floor Thursday. “So today, the question before the Senate is very simple. Do we agree that Americans should be free to use IVF if they want to, yes or no?”

Schumer, a New York Democrat, also held a vote last week on legislation to protect access to contraception, but Republicans blocked it, arguing it was nothing more than a political stunt. Republicans have also blocked previous attempts to quickly pass IVF protections. They stressed that they support IVF and said Schumer was once again playing to the campaign trail with Thursday’s vote.

Democrats took to the Senate floor Thursday to make a series of speeches that highlighted personal stories of how people have been able to have children using IVF. They say Congress must protect access to the fertility treatment after the Supreme Court in 2022 allowed states to ban abortions and the Alabama Supreme Court in February ruled that frozen embryos can be considered children under state law. Several clinics in the state suspended IVF treatments until the state enacted a law to provide legal protections for IVF clinics.

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“After the Alabama Supreme Court ruled that a frozen embryo is the same, has the exact same rights as a living, breathing person, women who waited for months and spent tens of thousands of dollars and were days away from an IVF appointment were left to wonder if it was all for nothing when their treatment was abruptly canceled,” said Sen. Patty Murray, a Washington Democrat.

Senate Democrats said it showed how all types of reproductive care could be upended in many parts of the country after Roe v. Wade was overturned.

Most Republicans in Congress, meanwhile, have expressed support for IVF, but have also largely declined to tell states how to regulate reproductive care. Donald Trump, the presumptive Republican GOP presidential nominee, met with House lawmakers on Thursday morning and told them that abortion rules should be left to the states. He also said he supported exceptions for rape, incest and to save the life of the mother, according to Republicans in the meeting.

Republicans are seeking to come up with a response to voters’ concerns about access to abortion and reproductive care — an issue that is expected to figure largely in the November election. Following the Supreme Court’s ruling Thursday that preserved access to the abortion pill mifepristone, anti-abortion groups expressed dismay while most Republicans remained quiet.

In the Senate this week, Republicans highlighted their efforts to expand access to fertility treatments, yet stopped short of endorsing the Democratic plan.

Sen. Rick Scott, a Florida Republican, said in a floor speech this week that his daughter was currently receiving IVF treatment and spoke of a proposal to expand the flexibility of health savings accounts. Two other GOP Republicans, Sens. Katie Britt of Alabama and Ted Cruz of Texas, also tried to quickly pass a bill that would threaten to withhold Medicaid funding for states where IVF is banned.

Democrats blocked that bill on Wednesday.

Cruz, who is running for reelection in Texas, said it showed Democrats were making a “cynical political decision.”

“They don’t want to provide reassurance and comfort to millions of parents in America because instead, they want to spend millions of dollars running campaign ads suggesting the big, bad Republicans want to take away IVF,” he said in a speech on the Senate floor.

Democrats argued that the GOP bill was insufficient because it would still allow states to enact laws that grant embryos or fetuses the same rights as a person. Abortion opponents in over a dozen states have advanced legislation based on the concept of fetal rights.

Sen. Patty Murray, the Washington Democrat who objected to quickly passing the GOP bill, dismissed it as “nothing but a PR stunt.”

But Republicans also criticized the Democratic bill. Britt said it “extends far past IVF. It also treads on religious freedom and protection.”

In the wake of the Alabama Supreme Court ruling, Christians, who have been a driving force in the anti-abortion movement based on the belief life begins at or around conception, have wrestled with the fertility treatment. The Southern Baptist Convention this week approved a nonbinding resolution that cautioned couples about using IVF.

With the Senate deadlocked on the issue, advocates for access to the treatment said families would be left in uncertainty.

Jamie Heard, who lives in Birmingham and had to suspend her effort to have a second child using IVF when the state Supreme Court made its decision, said the ruling left her both scared and angry. She has been able to continue the treatment, yet spoke alongside other IVF advocates at the Capitol Wednesday to urge lawmakers to act.

“There are still a lot of questions that we have about how to move forward,” Heard said.

In an alert Wednesday to health care providers, the CDC said that a dozen people in eight states have gotten sick after eating the brand’s “microdosing” mushroom edibles. All but two needed to be hospitalized.

Symptoms included seizures, sedation, muscle stiffness, abdominal pain, abnormal heart rate and high or low blood pressure. None died, but several patients needed to be put on ventilators and were admitted to the intensive care unit, the CDC said. 

The actual scale of the outbreak may be even larger, according to Kait Brown, clinical managing director of America’s Poison Centers. Nationwide, poison centers have received 22 reports of illnesses potentially linked to Diamond Shruumz products and are seeing new cases every day, Brown said.

The CDC tally represents the most severe cases, she said, but poison centers are also aware of milder cases that were limited to gastrointestinal symptoms like nausea or vomiting, or feelings of sleepiness or light sedation.

Why are Diamond Shruumz potentially making people sick?

Diamond Shruumz says on its website that its products are meant for microdosing. Microdosing typically refers to consuming small amounts of psychoactive or hallucinogenic substances, enough to reap the benefits while minimizing more debilitating effects. 

However, the company also says on its website that its products don’t contain psychedelic substances. Several toxicology experts said the mushrooms listed as ingredients, such as lion’s mane or ashwagandha, don’t produce the potent effects that the company touts, like relaxation or euphoria.

“The mushrooms that they advertise that are in them are pretty innocuous and in a lot of other products that don’t make similar claims,” said Maryann Amirshahi, co-medical director of the National Capital Poison Center in Washington, D.C.

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The CDC said in its alert that products containing psychoactive ingredients, such as mushroom extracts, are becoming more available and are often sold as gummy candies, chocolate or other snack foods. Such products may contain “undisclosed ingredients, including illicit substances,” the CDC said, “or potentially harmful contaminants that are not approved for use in food.”

Diamond Shruumz did not respond to a request for comment.

“At this point, what is causing these symptoms in these products are still under investigation,” Brown said. “It does speak to the uncertainty about what is in the product that could make such a wide array of symptoms.”

Are mushroom chocolates regulated? 

The market for mushroom-based products such as coffee or chocolate has swelled in recent years, as has demand for edibles with psychoactive properties, though psychedelic mushrooms are largely illegal in the U.S..

Toxicology experts said Diamond Shruumz products likely fall under the category of a dietary supplement based on their listed ingredients and how they’re advertised.

Dietary supplements don’t require approval from the Food and Drug Administration before being sold to customers, though the agency mandates that companies that manufacture, package, label or store supplements test their ingredients and limit contamination.

“It’s not like a prescription medication where you have to prove safety and efficacy before you can sell it,” said Steven Dudley, director of the Arizona Poison and Drug Information Center.

“With supplements, really it’s the other way around where there has to be reports of harm for the powers that be to be able to step in and then issue recalls, take products off the market, et cetera.”

That lack of regulatory oversight means that quality control is “murky at best,” said Dr. Chris Hoyte, medical director of the Rocky Mountain Poison Center in Denver.

In the past, some dietary supplements have been found to contain undisclosed ingredients that may cause harm. For instance, the FDA warned last year that yellow oleander — a poisonous plant — was masquerading as supplements sold for purported weight loss benefits. 

Amirshahi said the makeup of dietary supplements can also vary from batch to batch, which in theory could explain why Diamond Shruumz customers had a range of symptoms.

“At low doses, you may see one thing and higher doses may see the other,” Amirshahi said. “So at lower doses, they may be kind of really agitated, off the rails, have high blood pressure, have a high heart rate — but if they start taking more and more of it, the effects actually change.”

Experts also said it’s possible that psychedelics were illegally added to the products, or that the chocolates and gummies contained other legal substances that weren’t disclosed.

“We don’t know if this is a bad batch issue,” Dudley said. “We don’t know if it’s more widespread than that. What we do know is that it’s causing harm, so we’d really urge the public to not use these products.”

The FDA said Tuesday that consumers should discard and refrain from eating any flavor of Diamond Shruumz chocolate bars, cones or gummies. In a statement, the agency added that it “will continue to monitor the marketplace to identify products that pose risks and will take action within our authorities against unlawful products in order to protect the public.”

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A year after New York Attorney General Letitia James secured the largest million-dollar multistate settlement agreement with JUUL for the company’s role in the uptick in youth vaping, it was announced Wednesday that New York City will receive $27.1 million of that settlement to reinvest in the young community and vaping prevention programs.

The State of New York will receive $112.7 million from this settlement which Attorney General James will distribute to every county, Board of Cooperative Educational Services, and the five largest cities in the state — New York City among the included — to support programs that will help reduce and prevent underage vaping as well as public education and public health research related to the topic.

Of the $27.1 million that New York City will receive from the settlement, nearly $15 million will go to the school district and $12 million to the city to support anti-vaping programs for the youth.

“JUUL created a nationwide public health crisis by sparking a wave of addiction among children,” James said. “Young people are suffering because JUUL built its business by marketing addictive e-cigarettes to kids. Thanks to our efforts to hold JUUL accountable, New York City will receive over $27 million for valuable programs to fight back against the youth vaping epidemic. Our children’s health is on the line, and these funds will be used for education, prevention, enforcement, and research to keep our kids safe.”

New York City Mayor Eric Adams thanked James for her efforts in securing this settlement for the city and pointed JUUL has caused many young people to become addicted.

“Today, we are taking millions in dollars from JUUL Labs and investing it directly into the community and in our youth through prevention, education, and enforcement efforts.” Adams said.

Another $16.4 million will go to fighting the spread of vaping among youths on Long Island. Suffolk County police recently targeted vape shops that sell flavored vapes to underaged children, resulting in arrests and penalties. On Wednesday, the county got $8.8 million for education, prevention and enforcement.

The settlement also required JUUL to make changes to its marketing including prohibiting targeting those underage, limiting retail and online purchases to prevent minors from gaining access, perform regular checks of retail stores that sell JUUL, among other requirements.

JUUL launched its e-cigarettes in 2015. Since then, according to the attorney general, vaping has caused more than 2,500 hospitalizations. In 2019, a 17-year-old boy from the Bronx died from a vaping-related illness, making him the first reported vaping-related death in the state, and the youngest vaping-related fatality in the country.

In 2019, James sued JUUL for misleading marketing and promoting vaping to minors. In April 2023, James secured the largest multistate settlement with JUUL.

“These funds secured by Attorney General James will go a long way to educate and inform New York children and families about the dangers of vaping and nicotine use, and help the countless New York youth who are addicted to vaping,” said Dorian Fuhrman and Meredith Berkman, Cofounders of Parents Against Vaping.

“I didn’t think much of it,” Salvador, now 21 of New Orleans, tells TODAY.com. “It was just getting bigger.”

As it grew, he worried that the mass was a sign something was seriously wrong. In the fall, he asked his mom about it, and she examined it. Concerned, she took Salvador to a hospital, and he eventually learned that he had stage 1 testicular cancer. He’s sharing his story so other young people with cancer feel less alone.

“Maybe someone will relate to it,” Salvador says. “Maybe somebody will find hope in my story.” 

A lump that keeps growing

Over the summer of 2020, Salvador noticed the bump but thought his body had just changed.

“I thought it was normal,” he says. Then it began growing, and he became worried. In October, he mentioned it to his mom, who believed they should visit the hospital.

“They did some scans. They did some checks,” Salvador recalls. “They said, ‘Yes, this is cancerous.’”

The doctors recommended removing both testicles, but Salvador’s mother balked at this. She hoped to someday have grandchildren and thought that this plan was too aggressive for her teen son. The two visited a doctor at Children’s Hospital of New Orleans for a second opinion. Doctors there shared some welcome news.

“They were like, ‘OK, we’re going to do the best to save one (testicle),’” Salvador recalls. “But the other one definitely has to come out.”

The doctor removed the testicle and several lymph nodes during surgery and diagnosed Salvador with stage 1 rhabdomyosarcoma, a type of soft tissue cancer that can occur in connective tissue or muscle, according to the National Cancer Institute.

“The biggest surgery was the one where they took out my lymph nodes,” he says. “They opened up the whole chest area, stomach area.”

Following that surgery, Salvador underwent radiation for a month and then eight months of chemotherapy with infusions once a week. Treatment felt tough at times.

“I lost my hair. I was nauseous,” he says. “I was pretty weak.”

Following the completion of chemotherapy, Salvador was cancer free. He had another surgery where they gave him a prosthetic testicle. While going through cancer treatment as a teen felt difficult, he was able to enjoy his final year in high school.

“(My) hair grew back,” he says. “My late senior year, everything went back to normal.” 

Testicular cancer

While Salvador’s cancer grew in his testicle, it’s not the same type of cancer often associated with testicular cancer diagnosis, such as the type that Lance Armstrong had, Dr. Pinki Prasad, oncologist and hematologist at Children’s Hospital New Orleans and one of Salvador’s doctors, tells TODAY.com.

“Ronal actually had a type of sarcoma, rhabdomyosarcoma, that can be found very often in the … testicular region,” she explains, adding that it’s more common in children than adults.

This type of cancer doesn’t have many noticeable symptoms other than a lump on the testicles — “usually painless, but it’s a bump that gets bigger with time and doesn’t get better,” Prasad says. “Sometimes it will be painful, and that’s what brings this to (their) attention.”

She estimates that, in 90% of cases of testicular rhabdomyosarcoma, a lump is the only sign. Prasad adds that “very rarely do we see pain with urination, blood in the urine.”

While Prasad says all pediatric cancers are considered rare, including testicular rhabdomyosarcoma, she urges boys to be aware of their bodies and say something if they notice any changes.

“Once they hit puberty, they should be checking their testicles at least once a month,” she says. “No one is going to know outside of them if there’s any changes, and so it’s really important for them to get used to knowing what’s normal for them.”

Treatment for testicular rhabdomyosarcoma includes surgery to remove the testicle with the cancer and lymph nodes, which can be followed by radiation and chemotherapy.

Like any cancer, patients diagnosed with rhabdomyosarcoma in early stages have good outcomes with lower risk of recurrence. Still, Prasad says doctors closely monitor people for several years.

“They resume their normal lives pretty quickly. They go back to school. They do all the things they want to do,” she says. “We do follow them for a very indefinite amount of time, and most of these patients are survivors.”  

With testicular cancer, people often feel hesitant to share symptoms with their family or doctor.

“There is a stigma,” Prasad says. “Most of these patients who have some sort of a testicular tumor do end up having a testicle removed, which can lead to some body issues.”

Prasad notes that prosthetic testicles are available, and more than half of her patients opt to have one. 

College and beyond

For years, Salvador hoped to become a doctor. After graduating from high school, he started college and is studying pre-med.

“I want to be a cardiologist,” he says. “When I was younger, I used to have a lot of heart issues, and I used to always see cardiologists. They always looked so happy.”

This summer, Salvador plans to work at his family’s business and read for fun. He hopes his story encourages others to be aware of their health.

“It’s important for everybody to learn about their bodies, how to examine it on their own,” he says. “It’s important to know how to take care of yourself.” 

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The drug, called medetomidine, is linked to a recent spate of deadly overdoses throughout the Midwest and Northeast. According to NBC News it dramatically slows down breathing, heart rate, blood pressure and decreases activity in the brain and spinal cord. It’s not meant for use in people.

“It’s really concerning, the types of contaminants that we are seeing,” said Dr. Natasha Bagdasarian, chief medical executive of the Michigan Department of Health and Human Services. “Drugs are becoming deadlier.”

Medetomidine is more potent than a similar animal sedative, xylazine, or “tranq,” that’s become widespread in the U.S. over the past several years.

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NPS Discovery, a group that researches illegal drugs, reported finding medetomidine in Maryland as early as July 2022.

It’s clear that the drug is now moving west: It was found during toxicology tests in three people in Michigan who died of drug overdoses, state health officials said Thursday. The cases occurred in separate parts of the state and are not linked.

Last month, health officials in Chicago linked medetomidine to an increase in overdoses — the first time it’d been detected in the city. The sedative was found in combination with opioids such as fentanyl, nitazenes and heroin, as well as with tranq and the anti-anxiety drug alprazolam (Xanax).

The Philadelphia Department of Public Health also reported in May that medetomidine had arrived in the city. It showed up last month in Pittsburgh, too.

People who take the drug can remain sedated for at least three hours, according to Philadelphia’s health alert.

Sporadic reports of the drug are expected to become more widespread as the drug continues to make its way nationwide, said Linda Cottler, director of the National Drug Early Warning System, which monitors emerging drug use trends.

Cottler’s team hasn’t seen rampant signs of medetomidine — yet.

“It’s like a drip, drip, drip until it kind of explodes,” said Cottler. “This is the way drugs travel.”

The rise of medetomidine comes as overdose deaths have fallen slightly. More than 107,000 people died of a drug overdose last year, down from about 111,000 in 2022, according to a recent report.

Medetomidine is particularly concerning because its effects can’t be reversed by drugs like Narcan, also called naloxone. And there are no test strips that can detect it.

“It does seem like the new trend is adding sedatives or tranquilizers and other types of nonopioid drugs to fentanyl, which makes opioid reversal much more complicated,” said Joseph Palamar, an associate professor in the section on tobacco, alcohol and drug use at NYU Langone in New York City, and deputy director of the National Drug Early Warning System. “How are you going to reverse an overdose with naloxone if this keeps you sedated?”

Still, experts continue to urge people to use naloxone in cases of overdose.

“Even though there is not a specific way to reverse medetomidine, we know that it has been found in conjunction with opioids like fentanyl,” Bagdasarian said. “Our primary goal here is to prevent overdose deaths, and as the drug supply becomes deadlier, we have to become more innovative and try to step a step ahead of the problem.”

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Researchers led by the Cleveland Clinic linked the low-calorie sugar substitute xylitol to an increased risk of heart attack, stroke or cardiovascular-related deaths, according to a study published today in the European Heart Journal.

Xylitol is a sugar alcohol that is found in small amounts in fruit and vegetables, and the human body also produces it. As an additive, it looks and tastes like sugar but has 40% fewer calories. It is used, at much higher concentrations than found in nature, in sugar-free gum, candies, toothpaste and baked goods. It can also be found in products labeled “keto-friendly,” particularly in Europe.

The same research team found a similar association last year to the popular sugar substitute erythritol. The use of sugar substitutes has increased significantly over the past decade as concerns about rising obesity rates mount.

“We’re throwing this stuff into our food pyramid, and the very people who are most likely to be consuming it are the ones who are most likely to be at risk” of heart attack and stroke, such as people with diabetes, said lead author Dr. Stanely Hazen, chair of cardiovascular and metabolic sciences at Cleveland Clinic’s Lerner Research Institute.

Many heart attacks and strokes occur in people who do not have known risk factors, like diabetes, high blood pressure or elevated cholesterol levels. The research team began studying sugar alcohols found naturally in the human body to see if the compounds might predict cardiovascular risk in these people.

In the study, the investigators measured the level of naturally occurring xylitol in the blood of more than 3,000 participants after overnight fasting. They found that people whose xylitol levels put them in the top 25% of the study group had approximately double the risk for heart attack, stroke or death over the next three years compared to people in the bottom quarter.

The researchers also wanted to understand the mechanism at work, so they fed xylitol to mice, added it to blood and plasma in a lab and gave a xylitol-containing drink to 10 healthy volunteers. In all these cases, xylitol seemed to activate platelets, which are the blood component that controls clotting, said Hazen. Blood clots are the leading cause of heart attack and stroke.

 “All it takes is xylitol to interact with platelets alone for a very brief period of time, a matter of minutes, and the platelet becomes supercharged and much more prone to clot,” Hazen said.

The next question is what causes naturally-occurring xylitol to be elevated in some people and how do you lower it, said Dr. Sadiya Khan, a cardiologist at Northwestern Medicine Bluhm Cardiovascular Institute and a professor of cardiovascular epidemiology at Northwestern Feinberg School of Medicine who was not involved in the new study.

Much more research needs to be done, said Hazen. In the meantime, he is telling patients to avoid eating xylitol and other sugar alcohols, whose spelling all end in ‘itol.’ Instead, he recommends using modest amounts of sugar, honey or fruit to sweeten food, adding that toothpaste and one stick of gum are probably not a problem because so little xylitol is ingested.

The report had key limitations. 

First, the study of naturally occurring xylitol in people’s blood was observational and can show only an association between the sugar alcohol and heart risk. It does not show that xylitol caused the higher incidence of heart attack, stroke or death.

Nevertheless, given the totality of the evidence presented in the paper, “it’s probably reasonable to limit intake of artificial sweeteners,” said Khan. “Perhaps the answer isn’t replacing sugar with artificial sweeteners but thinking about more high quality dietary components, like vegetables and fruits, as natural sugars.”

Artificial sweeteners shouldn’t be difficult to avoid, said Joanne Slavin, PhD, RDN, a professor of food science and nutrition at the University of Minnesota-Twin Cities. They are listed on the ingredient list of packaged goods.

“Would I say never eat xylitol?” asked Slavin, who had no connection to the study. For some people who struggle to reduce sugar in their diet, sugar substitutes are one tool, and it comes down to personal choice, she said. 

While Slavin found the study interesting and cause for some concern, she noted that sugar alcohols are expensive and are generally used in very small amounts in gum and sugar-free candies.

Another limitation of the study is that the participants whose xylitol levels in the blood were measured were at high risk for or had documented heart disease, and so the results may not apply to healthy individuals.

Still, many people in the general public share the characteristics of the study participants, said Hazen. 

“In middle-aged or older America, it’s common to have obesity and diabetes or high cholesterol or high blood pressure,” he said.

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Here’s a look at the case and the different types of bird flu.

WHAT HAPPENED IN THE MEXICO BIRD FLU CASE?

A 59-year-old man in Mexico who had been bedridden because of chronic health problems developed a fever, shortness of breath and diarrhea in April. He died a week later, and the World Health Organization this week reported it.

The WHO said it was the first time that version of bird flu — H5N2 — had been seen in a person.

WHAT’S BEEN HAPPENING IN THE U.S. WITH BIRD FLU?

A different version of bird flu — H5N1 — has been infecting poultry flocks over the last several years, leading to millions of birds being culled. It also has been spreading among all different kinds of animals around the world.

This year, that flu was detected in U.S. dairy farms. Dozens of herd have seen infections, most recently in Iowa and Minnesota.

The cow outbreak has been tied to three reported illnesses in farmworkers, one in Texas and two in Michigan. Each had only mild symptoms.

WHAT’S DO THE LETTERS AND NUMBERS MEAN IN BIRD FLU NAMES?

So-called influenza A viruses are the only viruses tied to human flu pandemics, so their appearance in animals and people is a concern. These viruses are divided into subtypes based on what kinds of proteins they have on their surface — hemagglutinin (H) and neuraminidase (N).

Scientists say there are 18 different “H” subtypes and 11 different “N” subtypes, and they appear in scores of combinations. H1N1 and H3N2 are common causes of seasonal flu among humans. There are many versions seen in animals as well.

H5N1, the version that has worried some U.S. scientists lately, historically has been seen mainly in birds, but has in recent years has spread to a wide variety of mammals.

WHAT IS H5N2?

H5N2 has long been seen in Mexican poultry, and farms vaccinate against it.

It’s also no stranger to the United States. An H5N2 outbreak hit a flock of 7,000 chickens in south-central Texas in 2004, the first time in two decades a dangerous-to-poultry avian flu appeared in the U.S.

H5N2 also was mainly responsible for a wave outbreaks at U.S. commercial poultry farms in 2014 and 2015.

HOW DANGEROUS IS H5N2?

Over the years, H5N2 has teetered between being considered a mild threat to birds and a severe threat, but it hasn’t been considered much of a human threat at all.

A decade ago, researchers used mice and ferrets to study the strain afflicting U.S. poultry at the time, and concluded it was less likely to spread and less lethal than H5N1. Officials also said there was no evidence it was spreading among people.

Rare cases of animal infections are reported each year, so it’s not unexpected that a person was diagnosed with H5N2.

“If you’re a glass half full kind of person, you’d say, ‘This is the system doing exactly what it’s supposed to do: detecting and documenting these rare human infections, where years ago we were stumbling in the dark,’” said Matthew Ferrari, director of Penn State’s Center for Infectious Disease Dynamics.

Indeed, Mexico Health Secretary Jorge Alcocer said kidney and respiratory failure — not the virus — actually caused the man’s death.

Some experts said it is noteworthy that it’s not known how he caught the man caught H5N2.

“The fact there was no reported contact (with an infected bird) does raise the possibility that he was infected by someone else who visited him, but it’s premature to jump to those conclusions,” said Richard Webby, a flu researcher at St. Jude Children’s Research Hospital in Memphis.

WHAT ABOUT OTHER TYPES OF BIRD FLU?

At this point, H5N2 is still considered a minor threat compared to some of the other kinds of bird flu out there. Most human illnesses have been attributed to H7N9, H5N6 and H5N1 bird flu viruses.

From early 2013 through October 2017, five outbreaks of H7N9 were blamed for killing more than 600 people in China. And at least 18 people in China died during an outbreak of H5N6 in 2021, according to the U.S. Centers for Disease Control and Prevention.

H5N1 was first identified in 1959, but didn’t really began to worry health officials until a Hong Kong outbreak in 1997 that involved severe human illnesses and deaths.

H5N1 cases have continued since then, the vast majority of them involving direct contact between people and infected animals. Globally, more than 460 human deaths have been identified since 2003, according to WHO statistics that suggest it can kill as many as half of the people reported to be infected.

Like other viruses, H5N1 as evolved over time, spawning newer versions of itself. In the last few years, the predominant version of the virus has spread quickly among a wide range of animals, but counts of human fatalities have slowed.

Associated Press writer María Verza in Mexico City contributed to this story.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The WHO said it wasn’t clear how the man became infected, although H5N2 has been reported in poultry in Mexico.

There are numerous types of bird flu. H5N2 is not the same strain that has infected multiple dairy cow herds in the U.S. That strain is called H5N1 and three farmworkers have gotten mild infections.

Other bird flu varieties have killed people across the world in previous years, including 18 people in China during an outbreak of H5N6 in 2021, according to a timeline of bird flu outbreaks from the U.S. Centers for Disease Control and Prevention.

Mexican health officials alerted the WHO that a 59-year-old man who died in a Mexico City hospital had the virus despite no known exposure to poultry or other animals.

According to family members, the WHO release said, the patient had been bedridden for unrelated reasons before developing a fever, shortness of breath and diarrhea on April 17. Mexico’s public health department said in a statement that he had underlying ailments, including chronic kidney failure, diabetes and high blood pressure.

Hospital care was sought on April 24 and the man died the same day.

Initial tests showed an unidentified type of flu that subsequent weeks of lab testing confirmed was H5N2.

The WHO said the risk to people in Mexico is low, and that no further human cases have been discovered so far despite testing people who came in contact with the deceased at home and in the hospital.

There had been three poultry outbreaks of H5N2 in nearby parts of Mexico in March but authorities haven’t been able to find a connection. Mexican officials also are monitoring birds near a shallow lake on the outskirts of Mexico City.

Whenever bird flu circulates in poultry, there is a risk that people in close contact with flocks can become infected. Health authorities are closely watching for any signs that the viruses are evolving to spread easily from person to person, and experts are concerned as more mammal species contract bird flu viruses.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Centers for Disease Control and Prevention said it has received reports of 162 people who fell ill as a result of the salmonella strain tied to cucumbers, with 54 of those individuals hospitalized. In the tri-state, New York has reported 19 people sick, while there have been three in New Jersey and two in Connecticut, the CDC found.

Pennsylvania has had the most cases reported, with 27 people falling ill.

No deaths have been reported as a result of the salmonella poisonings, according to the CDC.

Earlier in the week, the U.S. Food and Drug Administration recalled whole cucumbers shipped to 14 states by Fresh Start Produce, a Florida-based company, from May 17-21. New York, New Jersey and Pennsylvania were among the states where the cucumbers were sent.

The FDA and CDC were conducting further tests on a wider sample of cucumbers to see if the same strain of salmonella is causing the wider outbreak.

Fresh Start Produce said the affected produce was “unlikely” to have made it to store shelves, though customers should check with their places of purchase to determine whether the recall impacts their produce. The recalled cucumbers should no longer be in stores, the CDC said, and the recall did not cover English or mini cucumbers.

Salmonella symptoms

Those who infected with the salmonella bacteria will likely experience diarrhea, fever and stomach cramps. Symptoms will typically begin from six hours to six days after ingesting the bacteria, according to the CDC. Most people recover without any special treatment after four to seven days.

Some people, especially those under the age of 5 or over the age of 65, or with weakened immune systems, could experience more severe illnesses that could call for medical treatment or hospitalization.

Testing detected salmonella in a cucumber distributed by Fresh Start Produce, of Delray Beach, Florida, which last week recalled whole cucumbers shipped to certain states from May 17 to May 21, according to the Centers for Disease Control and Prevention. Further testing is underway to see if that strain of salmonella is causing the outbreak. The produce should no longer be available in stores.

The CDC received reports of 162 people sickened with salmonella potentially tied to the cucumbers in 25 states and Washington, D.C., between March 11 and May 16. At least 54 people were hospitalized, the agency said. No deaths were reported.

Consumers should not eat recalled cucumbers. People who bought cucumbers recently should check with the store where they purchased them to see if they’re part of the recall. Wash items and surfaces that may have been in contact with the produce using hot, soapy water or a dishwasher.

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The CDC and the U.S. Food and Drug Administration also are investigating an outbreak of a second type of salmonella that has sickened at least 158 people in nearly two dozen states to see whether it’s connected to the same food. The outbreaks share several similarities, the agencies said.

Salmonella can cause symptoms that begin six hours to six days after ingesting the bacteria and include diarrhea, fever and stomach cramps. Most people recover without treatment within a week, but young children, people older than 65 and those with weakened immune systems can become seriously ill.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The case report, published Wednesday in JAMA Dermatology by doctors at NYU Langone Health in New York City, comes as clinicians worldwide increasingly say they’re having trouble treating fungal infections.

“We think a lot about antibacterial resistance, but this is a very important time for us to think about anti-fungus resistance,” said Mahmoud Ghannoum, a professor of dermatology at the Case Western Reserve University School of Medicine in Cleveland. He was not involved with the new report.

The new case involves a New York City man in his 30s who reported having sex with multiple men during a trip to England, Greece and California. When he got home, he developed a red, itchy rash on his legs and across his groin and buttocks.

Tests revealed he had a sexually transmitted fungus, called Trichophyton mentagrophytes type VII. It is the first time the fungus has been identified in the U.S. Last year, doctors in France reported 13 such cases. Twelve of those patients were men who have sex with men.

The American man’s infection responded to standard anti-fungal medications but ultimately took four and a half months to heal fully.

He was put on fluconazole for four weeks without improvement, then six weeks of terbinafine and approximately eight additional weeks of itraconazole. All are oral anti-fungals.

He did not have any other infections that could have made the problem worse.

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Dr. Avrom Caplan, an assistant professor of dermatology at the NYU Grossman School of Medicine and author of the new report, said the case should raise awareness but not cause alarm in the general public.

“There’s no evidence that this is widespread, or that this is something that people really need to be worried about,” he said. “But if people are having itchy eruptions in areas like the groin, and it’s not getting better, see a doctor.”

Rash may look like eczema

While the infection was most likely transmitted through sexual contact, Caplan couldn’t rule out the possibility that the man acquired the fungus at a sauna he’d visited two months prior to his symptoms. The man said his sexual partners did not show any signs of ringworm.

Caplan said the rash may look more like an eczema flare than typical ringworm infections that form in circles. The infection is not life-threatening, but can cause permanent scarring.

He previously identified the first two cases of a different ringworm infection in 2023. Those infections, caused by Trichophyton indotineae, are not considered STIs but are drug-resistant and highly contagious.

Since then, Caplan’s team at NYU Langone Health has identified a total of 11 cases of Trichophyton indotineae ringworm in both men and women in New York City.

The new case report is “notable” said Jeremy Gold, a medical epidemiologist at the Centers for Disease Control and Prevention. He stressed that doctors should consider fungi along with viruses and bacteria as a potential cause of sexually transmitted disease.

“Oftentimes, what happens is that these patients receive multiple courses of antibacterial drugs which are not going to make the fungus better,” he said. “Clinicians should keep this in mind so that patients can get appropriate care.” He was not involved in the new case report.

Caplan also encouraged people to speak up and seek out treatment. For now, Trichophyton mentagrophytes type VII is treatable.

“If you have a rash or lesions on your skin that aren’t getting better, and you think it might be ringworm,” he said, “see your doctor.”

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“It wasn’t a terribly hard workout,” the 49-year-old from Avon Lake, Ohio, recalls to TODAY.com. “But after, my triceps and my biceps and my chest were all incredibly sore.”

Worried, Prewitt’s trainer brought over a sports medicine doctor, who advised Prewitt to go to urgent care. His wife, Meredith, packed their kids in the car and rushed to pick him up. She missed the exit for urgent care but noticed they were right by a hospital. She glanced at her husband, who was gray and cold, and rushed him to the emergency room. This was fortunate as Prewitt was having a heart attack.

“I had one single artery that was completely blocked,” he says. “The artery is the left anterior descending artery … the widow maker.”

‘Picture of health’

Over the years, Prewitt enjoyed exercise, running hundreds of 5Ks, two marathons and participating in CrossFit. He doesn’t drink or use drugs, and eats a healthy diet and prioritizes sleep.

“I am often thought of as a picture of health,” he says. “I do all the things you’re supposed to do.”

For the year leading up to the heart attack, Prewitt felt good for the most part, but he did notice that he was easily fatigued. He chalked it up to his age and parenthood.

“I didn’t know if this is what (nearing) 50 (felt) like,” Prewitt says. “I’ve got two young boys who are 9 and 6, and was finding myself at the end of my workday a little tired and sometimes having to need a break before we go play baseball or kick a soccer ball around the yard.”

Just to be safe, he visited his doctor and had bloodwork done three times. The most recent was a month before his heart attack.

“I had no markers of any kind. My total cholesterol seemed to be OK,” he says. “I had no real health issues other than being tired.”  

For Christmas, his wife bought him a five-pack of sessions with a trainer, and Prewitt scheduled his first one immediately. After the workout, he explained the sensation he felt in his arms and chest to the trainer, who felt worried and found a doctor. That doctor recommended that Prewitt have someone drive him to an urgent care to get his heart checked.

“I call my wife to come pick me up, which in and of itself is a miracle. I’m pretty bullheaded,” he says. “I’m not one to take advice.”

On the way to the clinic, they got lost.

“She missed the exit for the urgent care and gets off the highway, and I’m slumped over in my seat,” Prewitt explains. “She’d never seen anyone this gray, and she grabbed my hand. It was ice cold. My heart had stopped.”

Across the street, though, Meredith saw Cleveland Clinic’s Avon Hospital at Richard E. Jacobs campus.

“She ran three red lights and pulled over to the ER and ran inside,” he says. “A bunch of health care workers came out, pulled me out of the car, brought me back to work on me.”

For 20 minutes, Prewitt received CPR and a dozen defibrillator shocks as the staff tried to get his heart back into a steady rhythm. After they stabilized him, they sent him to another Cleveland Clinic facility with a cardiac catheterization laboratory. Testing showed that Prewitt had a widow maker heart attack.

“I was able to be brought back,” Prewitt says, adding that he regained consciousness about 24 hours later.

Widow maker heart attack

When the left anterior artery has a blockage, what’s known as a widow maker heart attack can occur. In younger patients like Prewitt, there might not be any symptoms.

“About 30% of patients don’t have any previous symptoms, but they suddenly drop dead,” Dr. Emad Nukta, a cardiologist at Cleveland Clinic, tells TODAY.com. “We see that mostly with the younger patients rather than the older patients, and that’s where the term of widow maker comes from.”

Sometimes patients have subtle symptoms, such as fatigue, that they might not think of as a sign of something being wrong.

“The worst one is the one where they really did not have symptoms. They were not aware of anything,” Nukta says. “They were exercising or working out, lifting weights or on a treadmill, and suddenly they drop dead.”

Symptoms can include:

• A feeling like indigestion
• Arm or neck pain
• Chest pain

Nukta says often a heart attack comes with extreme pain, but that’s not always the case.

“There’s a major misconception. They think pain is something like real burning or severe pain,” he says. “But chest pain is really not that severe pain. It’s uneasy pressure like pain, squeezing pain.”  

People with lifestyle behaviors that increase the risks of their arteries hardening, called atherosclerosis, are at greater risk of experiencing a widow maker, Nukta says. Risk factors include:

• Being a smoker
• Having high blood pressure
• Having high cholesterol
• Having a family history of heart attack
• Having diabetes

He says it’s important for patients to know their family history to understand if they’re at risk of a widow maker. After having a heart attack, most patients need to continue seeing a cardiologist.

“I will tell my patients if you have a cardiac event, you’re stuck with me,” he says. “You will always be a heart patient.” 

‘A very blessed life’

While Prewitt knew that one of his grandfathers underwent two bypass surgeries, he did not realize his other grandfather died at age 49 of a widow maker heart attack.

“My lesson to all the people I’ve told this to is that you might think that you’re doing all the right things, but if you are unaware of your genetic history, you need to find out and also let your general practitioner know,” he says. 

Prewitt takes several medications now to support his heart and keep his artery open. He recently finished cardiac rehabilitation.

“By the end of 12 weeks, I was running nine-minute miles for a good distance,” he says. “I have no restrictions. A month ago, I was in Universal (Studios) with my wife and my boys and rode some rollercoasters. I continue to run and lift weights.”

This experience has taught Prewitt the importance of healthy habits, and he encourages others to “take their health very seriously.”

“There are health markers or genetic things that are coded in you that you cannot run away from,” he says. “Through knowledge and proactive medical care, you can identify these things early enough and be able to do something about it before it becomes a real event.”

Having a heart attack caused Prewitt to re-examine his life.

“It’s incredibly painful to think about my young boys going through life without their father,” he says. “For the majority of my life, I’ve been terrified of dying. Have I done enough? Have I lived enough, lived the type of life that I want to? And after this event I am not fearful of dying anymore. … I’ve lived a very blessed life.”

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Last week, NYC health officials released a brand new, “first of its kind” report that digs into the mental health of the millions of people that make up the country’s biggest city.

“The State of Mental Health of New Yorkers” details an overview of what mental health looks like for the city’s population up to and following the COVID-19 pandemic.

“What we see in the data is that mental health is neither static nor homogenous. We see a deep crisis in some communities, while observing relative wellness in others,” said Health Commissioner Dr. Ashwin Vasan.

In a city of over 8 million people, nearly one in every five adults living in New York City has been diagnosed with anxiety, the report tabulated. Roughly one in every four adults experiences a mental health disorder — that is in line with the national average, the report points out.

And while the majority of adults with a diagnosis was able to get treatment, roughly a third had their needs go unmet. Treatment access, the report points out, varies between communities, with Asian New Yorkers “accessing care the least.”

The report also digs into the pandemic, which worsened feelings of loneliness and grief. Before the pandemic, roughly 5% of New Yorkers said they experienced serious psychological distress. That figure jumped to around 14% two years ago, before dipping back down to 8% in 2023.

“We also see an evolving post-COVID-19 picture of New Yorkers recovering from some of the worst impacts of the pandemic and longer-term effects still developing,” Dr. Vasan added.

A startling part of the report found that a majority of New Yorkers don’t have a person in their life to turn to for regular emotional support.

“Adults who personally witnessed or experienced violence in their neighborhood, or who encountered rodents on their street, lacked heat in the most recent winter or recently saw mold in their home were more likely to experience serious psychological distress than adults who had not,” the health department said last week.

When it comes to the younger generations living in the Big Apple, Latino, Black and white kids (ages 3-13) were more likely than Asian kids to report “severe psychological distress.”

In a recent survey conducted last year, 48% of teenagers reported feeling depressive symptoms ranging from mild to severe. The vast majority, however, reported feeling high levels of resilience. Frequent coping mechanisms include listening to music and using social media.

The report also looked into substance use. Apparently, New Yorkers still favor alcohol to cannabis. The percentage of residents using cannabis sat at round 23% last year, compared to 45% who reported drinking.

At 35 weeks pregnant, Arango’s OBGYN discovered that her unborn baby had developed a rare blood vessel abnormality inside his brain.

In Spanish, Arango said her world came crashing down because the prognosis was very bad. 

“Baby Lucas had something called a vein of Galen malformation. That’s a direct connection in the brain where there’s a large pouch that connects the arteries to the veins,” said Dr. Robert Starke, the co-director of endovascular neurosurgery at Jackson Memorial Hospital, and a UHealth-University of Miami Health System neurosurgeon and neuroradiologist. “The problem with that is there is high shunting of blood flow back to the heart, which tends to cause heart failure, lung failure and it also doesn’t allow the brain to develop normally.”

“A baby can have bleeding in the brain, but the worst is that the heart can fail and if the heart fails, then the baby can die,” said Dr. Rodrigo Ruano, the director of UHealth Jackson Fetal Care Center and division chief of UHealth Jackson Maternal-Fetal Medicine.

The survival rate for babies born with this rare condition is very low, so Arango was referred to Dr. Starke and Dr. Ruano.

Arango said she was worried about the procedure, but then made the emergency decision to give her baby a fighting chance.

Along with their team of specialists across multiple disciplines, Dr. Ruano and Dr. Starke performed the first ever in-utero embolization reported in Florida at Holtz Children’s Hospital. 

“We have a new idea that potentially if we treat these babies while they’re still in the womb, we can reverse problems in the heart and the lungs and also give the brain more time to develop normally,” Dr. Starke said.

The procedure was also only one of five cases performed so far in the United States. 

“We use a long needle with ultrasound to go directly into the mother’s abdomen and into that vein, and then we can go in with a tiny little straw and place coils to block the malformation and reduce the flow,” Dr. Starke said.

After the surgery, Arango gave birth to a healthy baby boy via C-section. Lucas is thriving and growing thanks to the life-saving efforts of these doctors. 

“Why is this baby a miracle? Because we did the procedure in utero and then the baby was born at 39 weeks term by C-section to protect the head and the baby stayed in the NICU just for a week. Usually, those babies stay there for many months, so that’s a miracle,” Dr. Ruano said.

Arango said she is immensely grateful to her doctors and in love with her miracle baby.

So-called ghost poops have gone viral on TikTok, where you can find countless videos of people talking about the mysterious fecal phenomenon.

Typically, when we go No. 2, we see some evidence in the toilet bowl or on toilet paper. When you could’ve sworn you passed stool but there’s no sign of it, you may have had a “ghost poop.”

While “ghost poop” isn’t a term you’ll find in the medical literature, “patients definitely are interested in talking about ghost poops and ask me about this commonly,” Dr. Felice Schnoll-Sussman, gastroenterologist and professor of clinical medicine at Weill Cornell Medicine, tells TODAY.com.

What is a ghost poop?

According to social media and gastroenterologists, a ghost poop can refer to a few different bowel-related phenomena:

• The sensation of needing to poop, which ends up being gas
• A stool that sinks to the bottom of the toilet and disappears
• A stool that leaves no trace on toilet paper after wiping

In most cases, pooping is a well-orchestrated and coordinated movement, Dr. Rabia De Latour, gastroenterologist at NYU Langone Health, tells TODAY.com. The nerves in our rectum, our brain and the anal sphincter muscles all work together to release stool at the right time.

“The sphincters in our rectum are incredibly intelligent and sensitive parts of our body,” says De Latour. This part of the body can actually distinguish between air, liquid and solid and selectively let one thing out and not the other, she adds.

During defecation, “the rectum senses pressure from stool that has entered it and lets your body (and brain) know it’s time to defecate,” says De Latour. The anal sphincter muscles then push the stool out of the anus in a controlled way, says De Latour.

Sometimes, the bowel movement we sense coming isn’t poop at all — it’s gas. You may feel the sensation of needing to go No. 2, sit on the toilet, and try to push but nothing comes out, says De Latour. During this type of phantom poop, your body and brain gear up for a bowel movement without actually having one.

Another type of ghost poop is one that passes quickly and sinks to the bottom of the toilet and disappears before you can see it. You may go to flush and realize there’s no sign of stool in the bowl.

“It is so well-formed and you pass it so easily that you barely even know,” says Schnoll-Sussman. All stool will eventually sink, she adds, but some are heavier and sink immediately.

The final type of ghost poop, sometimes called a ghost wipe, is poop that leaves no visible residue on toilet paper after wiping, or no trace after washing — no matter your preferred post-poop hygiene method, you can’t find any evidence afterwards.

What causes ghost poops?

There are several explanations for why you might experience each type of ghost poop, according to the experts.

The body can normally distinguish between stool and gas and which it’s letting out, De Latour notes. However, sometimes too much gas can build up in the rectum and feel like stool or tension, which may give your brain the cue to sit on the toilet.

The rectum feels full, “and the sphincters get stimulated, and you do pass something, but it’s just air,” says Schnoll-Sussman.

This can occur after eating too many gas-causing foods, says De Latour, or simply from being bloated. Excess gas in the intestines can also be caused by constipation, digestive disorders, bacterial imbalances and food intolerances, the experts note.

Looking at the second definition of ghost poops, whether a stool floats or sinks has a lot more to do with what we eat, says Schnoll-Sussman. “When we have diets that are higher in fiber, they can make the bowel movement more formed, so it can go straight down the toilet,” she adds. Non-absorbable or undigested food such as seeds or corn can also make the stool heavier.

“That’s perfectly normal. … Waste is supposed to be dense,” says De Latour.

Stool that floats often contains more fat or gas, says Schnoll-Sussman. This may occur if someone has a high fat diet or their body can’t absorb fat appropriately, she adds. Gassy, floating stool can also result from excess gas in the digestive tract.

Sometimes, whether a stool sinks and disappears is more about the aim and the architecture of the toilet, the experts say.

When wiping after a poop, it’s normal for some remnants of a bowel movement to remain in or on the anus, the experts note, which can usually be removed with a few wipes with toilet paper or a quick wash. But when a bowel movement leaves no residue or trace after wiping, this generally just means the stool is very well-formed, firm, and easily passed, the experts note.

The texture of stool and how much you need to wipe can depend on a few factors: fiber intake, gut health, the amount of water and other nutrients absorbed from stool in the large intestine, and how well the anal sphincter muscles function, Schnoll-Sussman explains.

Are ghost poops healthy?

A stool that is easily passed, disappears to the bottom of the toilet, and leaves no trace after wiping, is nothing to worry about. In fact, it is probably a good sign, the experts note.

“If (someone) has a bowel movement and it’s so clean and well-formed that it doesn’t leave any residue and just sinks, that is actually a very healthy bowel movement,” says De Latour.

But if you regularly feel like you need to go No. 2 but aren’t able to go or are only passing gas, it may be time to see a doctor. While it could be something as simple as excess gas in the digestive tract, these types of phantom poops could be a sign of a health problem.

Tenesmus is the urge to pass a bowel movement without being able to defecate, says De Latour. “You still feel like there’s something in there, but nothing is coming out of the rectal vault,” De Latour adds.

This often results from inflammation in the rectum, which can mess up the signaling between the nerves and our brain, De Latour adds. Potential causes include inflammatory bowel disease, Crohn’s, colorectal polyps, and anal cancer, per the Cleveland Clinic.

In most cases, a ghost poop is nothing to be spooked by — but always talk to your doctor if you have questions or concerns, or notice sudden changes in your bowel habits.

Other poop problems to look out for

Health care professionals use a tool called the the Bristol Stool Chart to classify poop into seven different types based on shape and consistency, per the Cleveland Clinic.

“You want it to be in the middle of that chart (type 3 or 4), a nice sausage-shaped firm stool,” says De Latour.

Abnormal shape or consistency

Types 1 and 2 usually are a sign of constipation. Stool should not be too hard, which can cause straining. Continually having type 5 poops could be a sign of bowel issues due to lack of fiber, and types 6 and 7, diarrehea, usually indicate an illness or other digestive issue.

Excess wiping

If you find yourself wiping endlessly after going No. 2, this could be due to excess tissue in the rectum, which can be caused by severe inflammation, hemorrhoids, anal skin tags and other conditions, says Schnoll-Sussman.

“These can make it a bit more challenging (to defecate), and allow the remnants of the bowel movement to become stuck and need to be wiped off,” Schnoll-Sussman adds.

Persistent loose stool

Loose stools, also known as diarrhea, also tend to leave more of a mess, De Latour explains. It’s normal for most people to pass loose stools from time to time, but severe or persistent loose stools could be a sign of viral or bacterial infection, digestive disorders, and other health problems.

Reduced control over bowel movements

Pelvic floor dysfunction, rectal nerve issues, and weakened anal sphincter muscles can also impact continence, or our control over bowel movements, and how much stool or residue is left behind, the experts note.

Blood or pain

No matter how much you have to wipe, never ignore blood or pain, says De Latour.

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“I thought it was sun poisoning,” she said. 

She woke that night in a sweat and spent the hours alternately burning up then freezing. In the morning, her eyes were sore and her lymph nodes were swollen. For the following week, there was nothing to do but sleep, stay hydrated and wait for the body aches that give the illness the moniker “break-bone fever” to pass.

Latin America is experiencing its worst dengue fever outbreak on record. Case numbers in the first 4 ½ months of 2024 are already 238% higher than they were by this time last year, which itself ended with a record 4.1 million cases, according to the Pan American Health Organization. Cases are more than 400% higher than the five-year average.

An unusually wet and warm summer season brought by the El Niño weather pattern has created ideal conditions for the mosquitoes that spread dengue to hatch en masse and carry higher amounts of the virus.

Experts warn this could be a preview of what dengue fever will look like in the future. Climate change is creating unusually balmy conditions, which are already expanding the range of mosquito-borne diseases.

“That’s concerning for places where dengue hasn’t occurred before in recent history: North America and Europe,” said Dr. Albert Ko, a professor of epidemiology of microbial diseases at the Yale School of Public Health.

Dengue is a viral fever caused by four different viruses and spread through mosquito bites. It’s common in many tropical regions across the globe, but has begun to appear in more temperate climates. The mosquitoes that carry dengue fever, Aedes aegypti are now regularly found in the southern parts of the U.S., but recently, the insects have been found as far north as the Bay Area and Washington, D.C. One 2019 study predicted an additional 2 billion people will be at risk for dengue fever by 2080.

“We are definitely worried,” Ko said.

Why are dengue cases rising around the world?

Dengue outbreaks have historically occurred in the Americas every three to four years, said Dr. Gabriela Paz-Bailey, dengue branch chief in the division of vector-borne diseases at the Centers for Disease Control and Prevention. “But now we are seeing them every year,” she said.

Part of the reason for that is tied to climate change.

A warming climate expands the mosquitoes’ habitat and allows them to breed all year long, rather than only in the warmer months. The hotter temperatures also cause the viruses to replicate faster, meaning mosquitoes end up carrying many more viral copies, increasing the likelihood that a person will become infected if bitten.

“We are also seeing dengue cause outbreaks at times when they usually don’t occur,” Ko said.

South America’s dengue cases weren’t just unusually high this year, but they also came unusually early in the season. Similarly, Puerto Rico, a place where dengue outbreaks can occur in the summer and fall, declared a public health emergency in late March after the U.S. territory was overtaken by dengue fever cases and more than 400 people were hospitalized.

In recent years, the epidemic has spread to parts of southern Brazil and northern Argentina, where dengue hasn’t previously been a big problem, Ko said.

“That gives us a snapshot of what we may see here in North America in the coming decades,” Ko said.

How would dengue get a foothold in the U.S.?

The fact that Aedes aegypti mosquitoes are found in places outside their normal range doesn’t mean the mosquitoes are carrying dengue viruses, but those first insects are a warning of what may be to come, Ko added

Locally transmitted dengue fever infections — meaning the infected person didn’t get sick abroad — are still rare in the continental U.S., but have recently been seen for the first time in some states. Last October, California health officials reported the state’s first case of locally transmitted dengue in Pasadena. Local transmission has also occurred in Arizona, Florida and the southern coast of Texas. Last summer brought record-breaking heat waves to Europe, where cases of local dengue transmission were seen in France, Italy and Spain.

“I think this means dengue will become more common,” said Paz-Bailey, adding that the main concern is still the significant increase in cases where the virus is already endemic.

This summer, she does not expect to see significant dengue outbreaks on the U.S. mainland, but she said there is likely to be some people who travel to regions that have higher-than-usual cases and bring the virus back home.

“Travel-associated cases do result in small chains of outbreaks,” Paz-Bailey said.

Humans are reservoirs for dengue, so in order to have widespread transmission, enough people must be infected for the mosquitoes to reliably bite someone with the virus so that they can spread it to another person.

“That’s why we’re seeing an outbreak of dengue in Puerto Rico right now,” said Michael von Fricken, director of the One Health Center of Excellence at the University of Florida in Gainesville. “They’ve reached this tipping point where there are enough infected humans that they’re subsequently infecting other mosquitoes that are continuing to transmit disease.”

Florida has logged 176 dengue cases so far this year, the vast majority in people who were infected in other countries, most frequently Brazil or Cuba. The Florida Health Department has recorded only seven cases of locally transmitted dengue transmission in the state so far this year. In all of 2023, the department documented 173 locally transmitted cases, most of them in Miami-Dade County.

What are the symptoms of dengue fever?

Dengue fever is caused by four viruses, so a person can be infected four times in their lifetime. Only about 1 in 4 people are symptomatic the first time they’re infected, according to the CDC.

Ko said a person’s initial symptoms are usually a fever and headaches. Fatigue, nausea, vomiting, a rash that looks like measles, as well as the extremely painful body aches.

Most people recover in a week or two, but about 1 in 20 people develop severe dengue, which can be fatal. The more times a person is infected with dengue, the higher risk they are for complications.

“After you’ve had your first exposure, your risk of having dengue hemorrhagic fever or severe symptoms increases exponentially,” Von Fricken said. Dengue also becomes deadlier with each infection.

While the U.S. does have a dengue vaccine, it’s approved only for children ages 9 to 16 who live in places where dengue is endemic, including Puerto Rico, American Samoa or the U.S. Virgin Islands.

What’s more, children can get the vaccine only if they’ve previously had a dengue infection. That’s because if a person were to get vaccinated and then get their first dengue infection, they still run the risk of getting very sick, just as someone gets sicker from their second infection. Since most Americans have not had dengue, “that vaccine is not very useful” for most, Ko said.

There’s no specific drug to treat dengue. Instead, doctors just aim to treat the symptoms and keep the patient comfortable until the virus runs its course. That means resting and drinking a lot of fluids. Ko said people should try to take acetaminophen (Tylenol) for pain and fever if they can, since nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen and aspirin, can make bleeding worse if someone develops hemorrhagic dengue, in which their blood vessels are damaged and become leaky.

Paz-Bailey said it’s important for people traveling to places with dengue to stay in places with air conditioning when possible, use insect-repellant and wear long sleeves and pants to avoid mosquito bites.

Bed nets can be helpful, but the mosquitoes that carry dengue typically bite during the day, so they may be less helpful than they are at preventing other mosquito-borne diseases like malaria, Ko said.

At home, people can make their yards less appealing to mosquitos by reducing the amount of standing water, especially after a bout of rain.

“It’s difficult to control the mosquito population, so we need to hit it with all we have and layer our strategies,” Paz-Bailey said. “No single strategy will be good enough.”

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Sunscreen is a must-have for those outdoor activities under the sun. By reflecting or absorbing the sun’s ultraviolet (UV) rays, sunscreen can save you from developing a painful case of sunburn and help keep your skin healthy in the long run. Most skin cancers are caused by too much exposure to UV rays, according to the American Cancer Society.

While sunscreen doesn’t completely block all UV rays, it’s still an important tool in protecting your skin from sun damage.

So, how do you go about picking the right sunscreen? Here are five tips:

1. Use broad-spectrum sunscreen

Make sure your sunscreen is labeled as “broad spectrum,” which means it offers protection against both UVA and UVB rays.

Only broad-spectrum sunscreens with a sun protection factor (SPF) of 15 or higher can state that they protect against skin cancer and early skin aging, per the American Cancer Society.

2. Go with an SPF of 30 or higher

The American Cancer Society recommends using sunscreen with an SPF of at least 30. SPF denotes a sunscreen’s level of protection against UVB rays, which are the main cause of sunburn.

“When applying an SPF 30 sunscreen correctly, you get the equivalent of 1 minute of UVB rays for each 30 minutes you spend in the sun,” the American Cancer Society explains. “So, 1 hour in the sun wearing SPF 30 sunscreen is the same as spending 2 minutes totally unprotected.”

There are sunscreens with SPFs above 100, but it’s important to remember there isn’t a number that offers complete protection. The difference in protection level also becomes smaller as the SPF number increases. SPF 15 sunscreens filter out roughly 93% of UVB rays compared to roughly 97% with SPF 30, roughly 98% with SPF 50 and roughly 99% with SPF 100.

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3. Pick a water-resistant sunscreen

The American Cancer Society says a sunscreen can’t be billed as “waterproof” or “sweatproof” because those are misleading terms. But there are sunscreens that are water resistant. Water-resistant sunscreens have to say whether they protect the skin for 40 or 80 minutes of swimming or sweating.

The CDC recommends applying a thick layer of sunscreen at least 20 minutes before going outside. Reapplying at least every two hours and each time you get out of the water or sweat heavily are other recommended practices.

4. Don’t just rely on other products that offer SPF protection

There are products like concealers and moisturizers that feature protection against UV rays. But Cleveland Clinic dermatologist Amy Kassouf still suggests using sunscreen, as other products with a built-in SPF may not offer enough protection.

“We put on just as much as we feel we can spread easily, then we’re off to the races. So, we don’t usually get the full protection listed on the label,” Kassouf said, via Health.ClevelandClinic.org.

“Apply sunscreen with at least SPF 30 and makeup with SPF 30. Together, they’ll add up to the protection you need.”

Kassouf advises to apply sunscreen first before other facial products.

5. Apply even if you have darker skin

The darkest skin tone provides only the equivalent of SPF 13, according to the Skin Cancer Foundation. So while those with darker skin may have more natural protection against UV rays compared to those with lighter skin, the risk for sun damage remains.

Sunscreen shouldn’t be the only way you protect your skin from the sun, either. The American Cancer Society also recommends seeking shade, covering your skin with clothing, wearing a hat and sporting sunglasses that block UV rays.

U.S. health officials are monitoring and preparing to combat bird flu in humans, even as they emphasize that the risk to the general public remains low. 

A strain of bird flu called H5N1 has been confirmed in dairy cows across nine U.S. states, as well as in two people, amid a global outbreak among poultry and other animals. The latest case was announced Wednesday in a dairy farm worker in Michigan. A child in Australia was also recently infected with bird flu, the country announced Tuesday.

H5N1 has been spreading among more animal species worldwide since 2020, but its detection in U.S. livestock earlier this year was a twist health officials did not expect. In rare cases, bird flu viruses spread to humans and can cause mild to severe symptoms that can require hospitalization. 

There is currently no evidence that H5N1 is spreading from person to person. The Centers for Disease Control and Prevention has also said the risk of infection is higher among farmworkers than in the general population. 

Still, the U.S. government, along with state and local health departments, are monitoring new and emerging infections among humans and animals. Federal agencies in the U.S. and elsewhere have also tracked the H5N1 virus for years to monitor its evolution. 

The U.S. government has long stockpiled vaccines and drugs to be used in a possible bird flu pandemic. Last week, it started the process of preparing nearly 5 million doses of vaccines expected to be well-matched against H5N1, among other efforts to respond, the Health and Human Services Department confirmed to CNBC. 

Some infectious disease experts told CNBC the U.S. government appears to be generally prepared if bird flu begins to spread more widely and easily to humans, especially compared with how equipped the country was for the Covid pandemic. The experts said most of the necessary tools are already on hand but the government must ensure it deploys them effectively, if needed. 

“There’s a lot of pieces that are already in place that help us understand that we can respond to this faster,” said Dr. Andrew Pekosz, a professor at the Johns Hopkins Bloomberg School of Public Health. “As is always the case, though, it’s about the efficiency of our responses, right? We know what we can do. We just have to be able to do it effectively.”

The latest human infection, in the Michigan dairy worker, is not a surprise, according to both experts and the government. The CDC said Wednesday that similar cases in humans could be identified because high levels of the virus have been found in raw milk from infected cows.

Millions of vaccine doses

The U.S. government currently has two vaccine virus candidates that it believes are a good match for H5N1. Those candidates are weakened versions of a virus that trigger a protective immune response against it in the body and can be used to produce vaccines.

Both of the candidates are already available to manufacturers, according to the CDC. The government last week started the process of manufacturing 4.8 million doses of those human vaccines in case they are needed, HHS confirmed. 

Pekosz called those doses a “first line of defense in case we do see some human-to-human transmission.” He said that number is enough to stem an outbreak in its early stages, which could include vaccinating farm workers and some health-care workers. 

But he said far more are needed for the more than 300 million people in the U.S. if the virus spreads widely among humans. 

“Five million doesn’t really get us very far. It’s just a quick start,” Pekosz said. 

U.S. health officials said May 1 that the government could ship more than 100 million doses of human bird flu vaccines within three to four months if needed, NBC News reported. 

Notably, people will need two doses of a vaccine, meaning that 100 million doses is enough for only 50 million people. That suggests the U.S. would need roughly 600 million shots if it wanted to vaccinate the entire population. 

The government faces a difficult decision on how many shots to prepare, especially since it takes a few months to make them.

“It’s either too little or too much. For example, if you make too much food, then a lot of food goes to waste,” said Dr. Peter Chin-Hong, an infectious disease physician at UCSF Health. “That’s really the whole big conundrum now with a vaccine whenever you have a potential threat. It’s the high cost and high-risk aspects.”

Chin-Hong said misinformation and vaccine hesitancy after Covid makes that decision all the more challenging. But he said he believes “you can never really invest too much” in preparing for potential pandemics, especially at a time when climate change, population growth and other factors make them increasingly likely to happen.

The Food and Drug Administration would need to approve bird flu vaccines before they roll out. But Pekosz said that will likely be a “rapid procedure” since the FDA is accustomed to clearing seasonal flu vaccines, which are made using the same manufacturing process as bird flu shots. 

Potential mRNA shots

U.S. health officials are also in talks with messenger RNA vaccine makers about potential bird flu shots for humans. Few details have been shared about those negotiations, but HHS said a final announcement is expected soon. 

Unlike traditional flu shots, mRNA works by teaching cells to produce a harmless piece of a virus, which triggers an immune response against certain diseases. It is the same technology both Pfizer and Moderna have used in their Covid vaccines. 

Chin-Hong said mRNA vaccines could be updated more quickly to match the currently circulating strains of the bird flu. But he said those vaccines have their own challenges, such as needing to be stored at extremely cold temperatures.

In a statement to CNBC, Moderna confirmed that it is involved in negotiations with the government regarding its experimental pandemic influenza shot, mRNA-1018. It targets the exact strain of the virus responsible for the outbreak in dairy cattle. 

The biotech company began testing that shot in an early- to mid-stage trial last summer.

Pfizer declined to confirm negotiations with the government. The company said it is continuing to monitor the spread of H5N1 and study its mRNA-based pandemic influenza vaccine candidates in an early trial. 

Virus surveillance and treatments

The CDC and its partners, including state and local health departments, use multiple surveillance systems to monitor seasonal influenza and other illnesses. They also have specialized methods to detect and monitor new flu viruses. 

Seasonal influenza spreads mostly among humans with predictable peaks during the year, while bird flu spreads mostly among wild birds and other animals.

The CDC said it is looking for the spread of H5N1 to or among people in areas where the virus has been identified in animals or humans. So far, the agency has found “no indicators of unusual influenza activity in people,” including H5N1, according to an update on the agency’s site from last week. 

The CDC also performs ongoing analyses of seasonal and new influenza viruses to identify genetic changes that might allow for them to cause more serious infections in humans, spread more easily to and between people or become less susceptible to vaccines and drugs.

While there is robust testing on the federal, state and local levels, it is far more difficult for an average person to self-screen and get diagnosed for bird flu like they can for Covid, Chin-Hong said. That’s “the big barrier, particularly in the populations that are getting affected now,” he said.

Chin-Hong is referring to farm workers, a large share of whom are immigrants, who may struggle to navigate the U.S. health system due to language barriers and health-care access. 

If people do contract the virus, there are a few FDA-approved antiviral drugs for seasonal flu that can be used for bird flu. That includes Tamiflu, which is an oral prescription medication that should be taken within 48 hours of experiencing symptoms. 

A Texas dairy farm worker who was diagnosed with bird flu in March was treated with an antiviral drug and recovered, according to a CDC report.

But Pekosz said the antiviral drugs in the nation’s stockpile are likely not enough for the vast majority of the population, so manufacturers may be asked to scale up supply.

The average person can protect themselves from bird flu by avoiding any living or dead animals that might be infected, such as livestock or chickens, according to Francesca Torriani, infectious disease specialist with UC San Diego Health.

People who need to make contact with those animals should wear the appropriate mask and eye protection and wash their hands afterward.

Torriani added that pasteurized milk and cheese are likely safer to consume than raw dairy products since the pasteurization process kills harmful bacteria.