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MorningMed is the best way to keep up with the world of health and medicine through curated round-ups, useful insights and other practical resources.

U.S. health and agriculture officials have allocated nearly $200 million to address a bird flu outbreak affecting dairy cows in nine states, with over 40 herds affected. The funding includes $101 million for prevention, testing, and treatment efforts, and about $98 million to support individual farms in testing cattle and enhancing biosecurity measures. Dairy farmers will receive compensation for milk production losses, and incentives are provided for farm workers to participate in testing and workplace studies, aiming to mitigate reluctance among farmers and workers.

The US Food and Drug Administration (FDA) is contemplating a mandate for blood banks to adopt a new test capable of detecting malaria parasites in donors' blood, seeking input from its independent advisers on strategies to prevent transfusion-related malaria cases while ensuring blood donation accessibility. Although malaria isn't considered a significant threat to the US blood supply, approximately 28 million US residents travel annually to malaria-endemic regions worldwide, with concerns rising due to increasing travel and climate change potentially facilitating malaria spread within the US. The FDA recently approved the Cobas malaria test, capable of detecting malaria RNA and DNA in donor blood, acknowledging the potential severity of transfusion-transmitted malaria infections, which can be fatal.

A cyberattack on the Ascension health system, affecting 140 hospitals across 19 states in the US, led to ambulance diversions, delays in medical tests, and disrupted online access to patient records. While Ascension acknowledged "unusual activity" on its network, it refrained from confirming whether the attack involved ransomware or if any ransom was paid, engaging Mandiant, a leading cybersecurity responder, for assistance. The incident, exhibiting ransomware characteristics, prompted precautionary measures such as disconnecting electronic medical record systems to contain the spread.

A recent survey by KFF reveals that approximately 1 in 8 adults in the United States have used GLP-1 drugs such as Ozempic or Mounjaro, with around 6% of adults currently prescribed these medications, totaling over 15 million individuals. The demand for these drugs has surged, leading to shortages reported by the US Food and Drug Administration, particularly for Ozempic, Wegovy, and Mounjaro, as manufacturers struggle to keep pace. While most adults use GLP-1 drugs to manage chronic conditions like diabetes or heart disease, about 40% of respondents admit to using them solely for weight loss.

The U.S. government has implemented new regulations regarding the importation of dogs from other countries, aimed at preventing the spread of rabies. Effective August 1, these rules mandate that all dogs entering the country must be at least 6 months old, microchipped for rabies vaccination verification, and have completed a new CDC import form. These requirements apply to dogs brought in by breeders, rescue groups, or traveling with their U.S. owners. Additional restrictions and prerequisites may apply based on the dog's location in the previous six months, potentially including blood testing from CDC-approved labs. The regulations aim to address the evolving landscape of international pet travel, with approximately 1 million dogs entering the U.S. annually.

A recent study published in the journal Nature Medicine suggests that Alzheimer's disease may have a stronger genetic component than previously understood. The study sheds light on the role of the APOE4 gene, a well-known genetic factor linked to Alzheimer's.

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In recent years, the integration of technology into mental health treatment has garnered significant attention, especially in the realm of virtual reality (VR) and telehealth solutions. An emerging body of research, including a noteworthy study published in JMIR Mental Health, suggests that virtual reality therapies may offer benefits comparable to traditional telehealth sessions in managing and treating depression. This article delves into these findings, offering a detailed comparison and analysis of virtual reality treatments against existing telehealth methods.

The debate surrounding water fluoridation has intensified in communities across the United States, with some opting to end public water fluoridation programs. This trend, spurred by groups advocating for individual choice and fueled by misinformation, has led to concerns among dentists and public health experts.

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Is There a Doctor in the House?

A 7-year-old boy is brought to the emergency department by his mother because of a 2-day history of chest pressure and mild shortness of breath. He also has had intermittent fever for the past 2 weeks and a 2.3-kg (5-lb) weight loss during the past month. He has not had rhinorrhea, cough, or chest pain. Medical history is otherwise unremarkable and he takes no medications other than acetaminophen for fever. Vaccinations are up-todate. He appears mildly ill but is not in respiratory distress. Vital signs are temperature 37.5°C (99.5°F), pulse 100/min, respirations 20/min, and blood pressure 100/60 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 98%. Lungs are clear to auscultation. Cardiac examination discloses no abnormalities. Liver span is normal, and spleen tip is palpated at the left costal margin. Several 2 × 3-cm, nontender, nonmobile lymph nodes are noted in the inguinal canal and axillae. Chest x-ray is obtained and shown. When the patient returns from the radiology department, he is in moderate respiratory distress and reports chest pain.



Which of the following is the most likely explanation for this patient's worsening condition?

The study in the Proceedings of the National Academy of Sciences reveals how herpes viruses exploit cellular transport mechanisms to infiltrate the nervous system. Using time-lapse fluorescence imaging, the investigators tracked the movement of the herpes virus in infected nerve cells, uncovering how the virus orchestrates the timing of kinesin activation to ensure efficient infiltration into the nervous system. By artificially activating the motor protein prematurely, researchers were able to hinder the virus's ability to enter nerve cells, highlighting a potential target for therapeutic interventions.

A paper published in the New England Journal of Medicine reports that about 79% of participants in the BRILLIANCE trial, which assessed the effectiveness of the CRISPR-based gene editing treatment EDIT-101 for inherited retinal degeneration, experienced measurable vision improvement. This experimental treatment targets a mutation in the CEP290 gene, offering potential hope for individuals with Leber Congenital Amaurosis (LCA), Type 10, a rare condition lacking FDA-approved therapies. The study showcases promising outcomes, with 29% of participants experiencing clinically meaningful improvement in visual acuity without any serious adverse events related to the treatment.

A study conducted by nutritionists and medical researchers at the Harvard T.H. Chan School of Public Health, published in JAMA Network Open, indicates that daily consumption of olive oil may lower the risk of developing dementia. Analyzing data from two extensive health databases comprising over 60,000 women and 31,000 men, the researchers found that individuals who consumed at least 7 grams of olive oil daily were 28% less likely to die from dementia-related causes. The researchers suggest that olive oil's prominent role in this diet could be a significant contributing factor to its observed protective effects against dementia. Furthermore, they theorize that the anti-inflammatory properties of olive oil, when incorporated into a Mediterranean diet, may help reduce the risk of dementia by mitigating inflammation caused by various factors.

An international team of health and medical researchers, in collaboration with the WHO and economists, published a study in The Lancet estimating that vaccines have saved approximately 154 million lives over the past 50 years. Using mathematical and statistical modeling, the researchers assessed the impact of the Expanded Program on Immunization (EPI) initiated by the WHO in 1974, aimed at vaccinating children worldwide against common deadly diseases, which has since expanded to include 14 diseases. Children under the age of 1 benefited the most, with 101 million lives saved, and infant mortality rates have declined by 40% over the past five decades, largely due to vaccination programs.

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) "Airway compression"

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