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A bipartisan Senate bill aims to strengthen the pharmaceutical supply chain by prioritizing U.S. and allied countries' drug manufacturing. The bill, known as the RAPID Reserve Act, seeks to address the shortage of over 295 medications in the U.S. by requiring the Department of Health and Human Services to award contracts for generic drug manufacturing to U.S.-based companies or members of the Organization for Economic Cooperation and Development. The legislation also aims to reduce dependence on foreign providers and ensure the U.S. is better prepared for future health threats.

A bipartisan Senate bill, the Fentanyl Safe Testing and Overdose Prevention Act, aims to increase access to fentanyl test strips to address the rising number of opioid overdoses in the U.S. The bill clarifies the federal drug paraphernalia statute to exclude test strips, potentially lifesaving tools that can identify fentanyl or xylazine in drugs before consumption. The legislation is seen as a preventive measure to reduce overdose deaths caused by synthetic opioids, and supporters hope it will signal states to consider decriminalizing the test strips.

A Texas man, Michael Kohlhof, contracted a severe case of typhus from a flea bite, resulting in the amputation of his hands and parts of his feet due to dry gangrene from sepsis. Typhus is caused by bacteria spread by fleas, lice, and chiggers, and though rare in the United States, it has been detected in warm regions such as Southern California, Hawaii, and Texas. Kohlhof's family created a GoFundMe to support his treatment, as he does not have health insurance.

A Georgia resident has tragically died from a rare brain-eating amoeba, Naegleria fowleri, after swimming in a freshwater lake or pond, as reported by the Georgia Department of Public Health. This follows other recent cases, including a 2-year-old boy from Nevada who also succumbed to the amoeba, possibly from exposure at a natural hot spring, and a man in Florida who died after using tap water to rinse his sinuses. While the risk of infection is low, health officials advise recreational water users to be cautious and limit water entry into the nose to reduce the risk of infection, as the disease progresses rapidly and can be fatal.

The family of a woman who died after consuming kratom, an herb with opioid-like effects, has been awarded $11 million in a wrongful death lawsuit against the company that sold the substance. Kratom operates in a grey area of the law and is often sold online or at convenience stores and gas stations. The herb has been linked to life-threatening side effects, and the FDA has warned against its use due to potential health hazards. Despite being used by around 1.7 million Americans in 2021, kratom has been associated with a relatively small number of overdose deaths, and its benefits and risks are still not fully understood. The lawsuit highlights the need for increased regulatory oversight of kratom in the US.

Bronny James, the son of NBA legend LeBron James, has been released from the hospital after suffering a sudden cardiac arrest on the basketball floor. He received swift and effective attention from the USC athletics' medical staff when the medical emergency occurred, and doctors at Cedars-Sinai Medical Center credited their quick response for his successful treatment. The James family expressed gratitude for the outpouring of love and support from the community and stated that Bronny is resting and doing well.

• The recent incidents involving Bronny James and Damar Hamlin have brought attention to the heightened risk of sudden cardiac arrest in Black male athletes. A 2020 study found that Black male NCAA Division I basketball players had the highest incidence rate of sudden cardiac arrest and death among athletes aged 11 to 29. Factors contributing to this risk may include genetics, lifestyle, and the nature of the sports they play. Cardiologists are calling for more intensive screening programs for Black male athletes to address this issue.
• Cardiac arrest is a life-threatening condition that occurs when the heart stops beating and stops pumping blood to vital organs. It can happen suddenly and without warning, even in young and seemingly healthy individuals. While the exact incidence of cardiac arrest among athletes is not known, it is estimated to be between 1 in 50,000 and 1 in 100,000 per year for young athletes. Prompt recognition and CPR are crucial for increasing the chances of survival in cases of cardiac arrest. The focus should be on learning how to recognize cardiac arrest and promptly applying treatment, including CPR.

Richard Kovacs, a sports cardiologist and the chief medical officer at the American College of Cardiology: “We look at sports as having a static and dynamic component,” Kovacs said. “We look at sports as having long-term endurance efforts versus short-term bursts — and basketball is a combination of all of the above. The prognosis and what happens next, and can they return to play, depends on a very, very clear-cut diagnosis of what’s wrong, and why did this happen in the first place? If there was a sudden unexpected death in your family, whatever the circumstances — during competition or an unexplained drowning accident — can be a hint there’s a familial tendency towards sudden cardiac arrest,” Kovacs said.

The power of music in treating dementia has gained attention in recent years. Researchers are exploring the cognitive health effects of music, silence, and sounds on individuals with dementia. Music therapy, involving listening to music or singing, has shown promise in improving cognitive function, quality of life, and reducing depression in people with dementia. Additionally, music can trigger memories, enhance mood and behavior, and promote interconnection with caregivers and others. While further research is needed, the therapeutic potential of music offers hope in improving the lives of individuals living with dementia.

Mosquitoes that carry West Nile virus are becoming resistant to insecticides, raising concerns among federal health officials. NBC News got rare access to the federal health agency's insect lab in Colorado where scientists study the spread of mosquitoes and the illnesses they carry.

Key takeaways

• West Nile virus, transmitted to humans by infected Culex mosquitoes, can cause severe illness, and the recent combination of an unusually wet season and intense heat waves is increasing mosquito populations.
  
  
• At the Centers for Disease Control and Prevention's insect lab in Colorado, scientists have found that the mosquitoes are living longer when exposed to insecticides, reducing the effectiveness of mass sprays used for control.
  
  
• While the disease has not reached record levels, more mosquitoes could lead to more human cases of West Nile in the coming weeks. The CDC recommends using repellents with DEET or picaridin and taking precautions to avoid mosquito bites.

By the digits

• 69: So far in 2023, there have been 69 human cases of West Nile in the U.S., according to the CDC.
  
  
• 9,862: It's nowhere near a record; there were 9,862 cases in 2003.
  
  
• 149: In Maricopa County, Arizona, for example, 149 mosquito traps have tested positive for West Nile so far this year, compared with eight in 2022.
  
  
• 1999: Since West Nile was first detected in the United States in 1999, it's become the most common mosquito-borne illness in the country.
  
  
• 1/150: One in 150 people with West Nile virus have serious complications, including death.

Is There a Doctor in the House?

A 27-year-old man comes to the office with his wife because of a recent episode of loss of muscle control. He says, "I was at a reception, someone told a joke, and when I laughed, my legs collapsed!" His wife says that he recovered in a few seconds, and he did not lose consciousness. He has a long history of sleepiness, and he is able to go to sleep quickly. He usually awakens feeling refreshed after a short nap. He has no history of similar episodes or hallucinations. There is no family history of similar problems. Vital signs are normal.

Physical examination shows no abnormalities. Which of the following is the most likely diagnosis?

Research from the Centers for Disease Control and Prevention (CDC) reveals that many doctors lack awareness and knowledge of alphagal syndrome, a tick-borne illness that can cause a potentially life-threatening allergy to red meat. At least 42% of the 1,500 doctors surveyed had never heard of the syndrome, leading to delayed diagnoses and gaps in understanding the true number of cases. Alpha-gal syndrome is caused by the alpha-gal sugar molecule transmitted through tick bites, leading to allergic reactions from consuming red meat and, in some cases, dairy and other byproducts from animals like cows, deer, pigs, and goats.

Alcohol-related deaths are on the rise in the United States, with the mortality rate increasing faster among women than men, according to a study published in JAMA Network Open. Over two decades of data from the Centers for Disease Control and Prevention (CDC) show a 14.7% increase in alcohol-related mortality among women, compared to a 12.5% increase among men. Women's bodies metabolize alcohol differently than men's, leading to a higher concentration of the toxic substance and a shorter time between drinking and developing medical complications.

New drugs for Alzheimer's disease that target the toxic protein beta amyloid may be less effective for Black patients, leading to concerns about disparities in treatment outcomes. Clinical trials for Leqembi and donanemab revealed that Black participants were screened out at higher rates due to insufficient amyloid levels, potentially indicating that Alzheimer's in Black populations may be driven by different factors. The findings highlight the need for a better understanding of Alzheimer's in diverse populations to ensure equitable and effective treatments for those at risk.

Young adults in their 20s are the third-most likely age group to be injured from falling down stairs, with new research identifying specific risky behaviors that lead to such falls. The study, conducted at Purdue University, found that women were more likely than men to exhibit risky behaviors such as not using handrails and carrying objects while walking down stairs. Neglecting to look at one's feet while walking was identified as a particular risk factor for falls, with more than 69% of participants exhibiting two or more risky behaviors.

Thank you for reading! More next week,

My best wishes for a productive and idea-filled week ahead. Thanks for your ongoing efforts to improve the lives of the patients we all serve. Please send any news, comments, suggestions and ideas to hello@morningmed.email.

Quiz answer: The correct answer is A) "Narcolepsy"

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