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Kansas governor vetoes gender-affirming trans care ban

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(TOPEKA, Ks.) -- Kansas Gov. Laura Kelly, a Democrat, vetoed a ban on gender-affirming medical care for transgender youth in the state.

"This divisive legislation targets a small group of Kansans by placing government mandates on them and dictating to parents how to best raise and care for their children," said Kelly in a veto message on Friday. "I do not believe that is a conservative value, and it's certainly not a Kansas value."

She vetoed a similar bill almost one year ago, saying, "Companies have made it clear that they are not interested in doing business with states that discriminate against workers and their families."

She continued, "By stripping away rights from Kansans and opening the state up to expensive and unnecessary lawsuits, these bills would hurt our ability to continue breaking economic records and landing new business deals."

State GOP legislators may be able to override Kelly's veto.

The legislature would need a two-thirds vote to override the veto -- 84 in the House and 27 in the Senate. The Republican-backed bill has enough votes in the Senate to override the veto. In the House, two House Republicans who were previously registered as absent would need to also vote in favor of the bill to override the governor's veto.

This bill restricts puberty blockers, which trans minors may use to delay the development of gendered characteristics. Puberty blockers are reversible and widely used on children who experience puberty earlier than what is typical.

The bill also restricts hormone therapy, which older minors may use for desired changes to certain gendered characteristics that are less reversible, including their body, hair or voice. The bill also restricts surgeries, which physicians say are rare for minors and only done in severe cases.

However, the bill allows exceptions for these procedures on minors who are intersex, have ambiguous sex characteristics, or have disorders of sex development.

Health care providers who violate these provisions could be subject to civil action and have their license revoked if the bill is passed.

The bill also restricts state employees or state facilities from supporting a minor's social transitioning -- including a change in pronouns or name, how they are dressed, and more.

Supporters of gender-affirming care bans say gender-affirming care is harmful for minors. Some argue trans youth should wait until they're older to access gender-affirming care.

Kansas Senate President Ty Masterson, a Republican, applauded the legislation's passage through the legislature.

"The Senate took a firm stand in support of helping and not harming children by making it clear that radical transgender ideology and the mutilation of minors is not legal nor welcome in Kansas," Masterson said.

Critics of the gender-affirming care ban called the bill "more extreme and misinformed than similar bills in other parts of the country."

"In addition to depriving parents and families of medical freedom, this bill actually punishes teachers, doctors, nurses, and more for just doing their jobs by respecting and supporting Kansas kids, including transgender kids," said the ACLU of Kansas in a statement asking Kelly to veto the bill.

Transgender youth, often because of gender-related discrimination and gender dysphoria, are more likely to experience anxiety, depressed mood, and suicidal ideation and attempts, according to the Centers for Disease Control and Prevention.

A recent study in the New England Journal of Medicine found that hormone therapy can improve the mental health of transgender adolescents and teenagers.

Restrictions on access to gender-affirming care for transgender youth have been passed in at least 23 states, some of which have faced legal challenges that argue such bans violate the rights of the youth, their families and their medical providers. Gender-affirming care bans have been blocked in court in Arkansas, Idaho, Florida and Montana, but have been allowed in others.

According to the ACLU, more than 480 anti-LGBTQ bills have been introduced across the the U.S. At least 135 of those bills are no longer progressing through state legislatures, according to the ACLU.

Copyright © 2024, ABC Audio. All rights reserved.

Drug shortages hit record-high with hundreds in short supply: Pharmacists

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(NEW YORK) -- Drug shortages have reached an all-time high in the United States, pharmacists are warning.

During the first three months of 2024, there were 323 active medication shortages, according to the American Society of Health-System Pharmacists (ASHP) and Utah Drug Information Service. Previously, the record high was 320 shortages in 2014.

This ASHP started tracking shortages in 2001.

"All drug classes are vulnerable to shortage," Dr. Paul Abramowitz, CEO of ASHP, said in a statement. "Some of the most worrying shortages involve generic sterile injectable medications, including cancer chemotherapy drugs and emergency medications stored in hospital crash carts and procedural areas."

Last year, the American Cancer Society issued a warning that chemotherapy drugs had returned to the list of the top-five drug classes affected by shortages and warned this could have a devastating effect on patients.

Some hospitals and clinics reported being completely out of the medications. Doctors have been forced to either ration cancer drugs or triage which patients receive the drugs first.

Additionally, Abramowitz said there are ongoing national shortages for Attention-Deficit/Hyperactivity Disorder (ADHD) medications, which remain "an issue for clinicians and patients."

Among them is the ADHD prescription drug Adderall. The shortage began in late 2022 initially due to a delay from a manufacturer. As of early 2024, the shortage is now demand-driven, according to the U.S. Food and Drug Administration.

"The FDA can utilize different tools during a shortage to assist manufactures with increasing supply including expediting review of a supplement to add additional supply of active ingredients or adding additional capacity," an FDA official told ABC News in a statement earlier this year. "Unfortunately, we are not able to share specific actions, as they are considered commercial confidential information. "

Shortages of some drugs have been an ongoing problem in the U.S. for more than a decade and were recently exacerbated by the COVID-19 pandemic, according to a report by the Senate Homeland Security Committee in March 2023. Lack of necessary medication means patients have to get delayed treatments, substitutions or sometimes no treatment at all, the report found.

At a hearing of the House Ways and Means Committee earlier this year, expert witnesses -- practitioners, researchers and pharmaceutical company executives -- said drug shortages can hurt patients financially because they may turn to alternate products that can cost more.

ASHP said it is working with the federal government to advise HHS agencies on their response to shortages and on steps the trade group believes the federal government could take to alleviate the shortage, including Congress requiring manufacturers to be more transparent about any supply chain issues and to encourage greater diversity in the supply chain.

ASHP, however, said it had concerns about a proposal from the U.S. Department of Health & Human Services that would issue financial penalties for hospitals that lack the resources to stockpile medications.

"Much work remains to be done at the federal level to fix the root causes of drug shortages," Abramowitz said. "ASHP will continue to engage with policymakers regularly as we guide efforts to draft and pass new legislation to address drug shortages and continue to strongly advocate on behalf of our members for solutions that work."

ABC News' Kristina Abovyan and Youri Benadjaoud contributed to this report.

Copyright © 2024, ABC Audio. All rights reserved.

What the trans care recommendations from the NHS England report mean

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(LONDON) -- A new report commissioned by the National Health Service England advocates for further research on gender-affirming care for transgender youth and young adults.

Dr. Hillary Cass, a former president of the Royal College of Paediatrics and Child Health, was appointed by NHS England and NHS Improvement to chair the Independent Review of Gender Identity Services in 2020 amid a rise in referrals to NHS' gender services. Upon review, she advises "extreme caution" for the use of hormone therapies.

"It is absolutely right that children and young people, who may be dealing with a complex range of issues around their gender identity, get the best possible support and expertise throughout their care," Cass states in the report.

Around 2022, about 5,000 adolescents and children were referred to the NHS' gender services. The report estimated that roughly 20% of children and young people seen by the Gender Identity Development Service (GIDS) enter a hormone pathway -- roughly 1,000 people under 18 in England.

Following four years of data analysis, Cass concluded that "while a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices."

Cass continued: "The strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate," read the report.

Among her recommendations, she urged the NHS to increase the available workforce in this field, to work on setting up more regional outlets for care, increase investment in research on this care, and improve the quality of care to meet international guidelines.

Cass' review comes as the NHS continues to expand its children and young people's gender identity services across the country. The NHS has recently opened new children and young people's gender services based in London and the Northwest.

NHS England, the country's universal healthcare system, said the report is expected to guide and shape its use of gender affirming care in children and potentially impact youth patients in England accessing gender-affirming care.

The debate over transgender youth care
In an interview with The Guardian, Cass stated that her findings are not intended to undermine the validity of trans identities or challenge young people's right to transition but to improve the care they are receiving.

"We've let them down because the research isn't good enough and we haven't got good data," Cass told the news outlet. "The toxicity of the debate is perpetuated by adults, and that itself is unfair to the children who are caught in the middle of it. The children are being used as a football and this is a group that we should be showing more compassion to."

In the report, Cass argued that the knowledge and expertise of "experienced clinicians who have reached different conclusions about the best approach to care" has been "dismissed and invalidated" amid arguments concerning transgender care in youth.

Cass did not immediately respond to ABC News' request for comment.

Recommendations for trans youth care
Cass is calling for more thorough research that looks at the "characteristics, interventions and outcomes" of NHS gender service patients concerning puberty blockers and hormone therapy, particularly among children and adolescents.

The report's recommendations also urge caregivers to take an approach to care that considers young patients "holistically and not solely in terms of their gender-related distress."

The report notes that identity exploration is "a completely natural process during childhood and adolescence."

Cass recommends that pre-pubertal children and their families have early discussions about how parents can best support their child "in a balanced and non-judgemental way," which may include "psychological and psychopharmacological treatments" to manage distress associated with gender incongruence and co-occurring conditions.

In past interviews, U.S. physicians told ABC News, that patients, their physicians and their families often engage in a lengthy process of building a customized and individualized approach to care, meaning not every patient will receive any or every type of gender-affirming medical care option.

Cass' report states that evidence particularly for puberty blockers in children and adolescents is "weak" regarding the impact on "gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown."

The NHS has said it will halt routine use of puberty blockers as it prepares for a study into the practice later this year.

According to the Endocrine Society puberty blockers, as opposed to hormone therapy, temporarily pause puberty so patients have more time to explore their gender identity.

The report also recommends "extreme caution" for transgender youth from age 16 who take more permanent hormone therapies.

"There should be a clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18," the report's recommendations state.

Hormone therapy, according to the Endocrine Society, triggers physical changes like hair growth, muscle development, body fat and more, that can help better align the body with a person's gender identity. It's not unusual for patients to stop hormone therapy and decide that they have transitioned as far as they wish, physicians have told ABC News.

Cass' report asserts that there are many unknowns about the use of both puberty blockers and hormones for minors, "despite their longstanding use in the adult transgender population."

"The lack of long-term follow-up data on those commencing treatment at an earlier age means we have inadequate information about the range of outcomes for this group," the report states.

Cass recommends that NHS England facilities have procedures in place to follow up with 17 to 25-year-old patients "to ensure continuity of care and support at a potentially vulnerable stage in their journey," as well as allow for further data and research on transgender minors through the years.

Several British medical organizations, including British Psychological Society and the Royal College of Paediatrics and Child Health, commended the report's recommendations to expand the workforce and invest in further research to allow young people to make better informed decisions.

“Dr Cass and her team have produced a thought-provoking, detailed and wide-ranging list of recommendations, which will have implications for all professionals working with gender-questioning children and young people," said Dr Roman Raczka, of the British Psychological Society. "It will take time to carefully review and respond to the whole report, but I am sure that psychology, as a profession, will reflect and learn lessons from the review, its findings and recommendations."

Some groups expressed fears that the report will be misused by anti-transgender groups.

"All children have the right to access specialist effective care on time and must be afforded the privacy to make decisions that are appropriate for them in consultation with a specialist," said human rights group Amnesty International. "This review is being weaponised by people who revel in spreading disinformation and myths about healthcare for trans young people."

Transgender care for people under 18 has been a source of contention in both the United States and the United Kingdom. Legislation is being pushed across the U.S. by many Republican legislators focused on banning all medical care options like puberty blockers and hormone therapies for minors. Some argue that gender-affirming care is unsafe for youth, or that they should wait until they're older.

Gender-affirming medical does come with risks, according to the Endocrine Society, including impacts to bone mineral density, cholesterol levels, and blood clot risks. However, physicians have told ABC News that all medications, surgeries or vaccines come with some kind of risk.

Major national medical associations in the U.S., including the American Academy of Pediatrics, the American Medical Association, the American Academy of Child and Adolescent Psychiatry, and more than 20 others have argued that gender-affirming care is safe, effective, beneficial, and medically necessary.

The first-of-its-kind gender care clinic at Johns Hopkins Hospital in Maryland opened in the 1960s, using similar procedures still used today.

Some studies have shown that some gender-affirming options can have positive impacts on the mental health of transgender patients, who may experience gender-related stress.

Copyright © 2024, ABC Audio. All rights reserved.

What juice sodas, prebiotic beverages a nutritionist would actually drink and why

ABC News

(NEW YORK) -- From Whole Foods to corner bodegas, fizzy juice drinks from fruity seltzers to reduced-sugar sodas that boast prebiotic and digestive support have exploded in popularity.

But what are the actual benefits of these juices and sodas?

Registered dietitian and nutritionist Maya Feller joined ABC News' Good Morning America on Wednesday to weigh in on the canned beverage consumption trend.

"Flavored sparkling water like Spindrift is literally seltzer water and a splash of real fruit [juice, with] no sugar added or sugar substitutes," Feller said. "[Juice sodas] can have cane sugar and other juice concentrates."

Feller said that Spindrift and other similar sparkling water with real fruit is a great option for consumers looking to enjoy a zero-added-sugar soda alternative, and a good way to stay hydrated.

"Be mindful and intentional," she continued. "Choose the things that have no added sugar."

While juice sodas can be a better alternative to a sugary traditional soft drink, Feller encouraged people to "read the nutrition facts label, be an informed consumer and know what you're drinking."

According to the nutrition page for the popular prebiotic soda Poppi, the drink is a combination of sparking water, organic cane sugar and other juice concentrates, and each drink contains "5 grams of sugar or less."

Similarly, Olipop, a self-proclaimed "healthy" soda that contains prebiotics, plant fiber and botanicals, states on its website that the drinks contain just 2 to 5 grams of sugar.

When it comes to regular fruit juice like orange or apple juice, Feller reminded people to "opt for 100% juice, because there's no sugar added."

Feller recommends drinking just 4 ounces with a meal to "help slow down the sugar absorption into your bloodstream" and avoid a glucose spike.

As for the drinks that boast health support -- such as Olipop or Poppi -- Feller said to "tread lightly."

"I wouldn't say there's anything negative about it," she said, reiterating that it's "a good alternative to sugar sweetened beverages, [but] don't think you're doing yourself this health favor -- because many scientists don't actually agree with these health claims."

"Do your homework -- especially when these are claiming to be good for our health," she added. "When you're having a prebiotic soda, you are not actually adding any extreme nutrients to your overall day. If you want to have it, go for it."

Feller said that she will enjoy a prebiotic soda "once in a while," with the caveat that it's "an intentional and mindful choice."

Copyright © 2024, ABC Audio. All rights reserved.

Eight-year-old viral social media star raises awareness for ARFID through food tastings

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(NEW YORK) -- Eight-year-old Hannah is winning over audiences and raising awareness for a rare but serious disorder one bite at a time.

Hannah, along with her mother Michelle, has gone viral with her Instagram videos where she tries out little bits of certain food for the first time. She samples everything from mac and cheese to different yogurts, and ranks them on a scale from 1 to 10.

Some days honeydew melon has her fighting back tears; some days a taste of a sweet apple pear is followed by a smile.

The videos have been a form of therapy for Hannah, who suffers from avoidant restrictive food intake disorder, or ARFID, a disorder where a person is afraid of food to the point where they don't want to consume it.

Hannah told ABC News' Nightline that talking about her struggles and finding the right food has helped her push through.

"That helps motivate me," she said. "Whenever I'm trying food, I think about all the people that I'm helping."

Between 0.5% to 5% of children and adults in the general population have ARFID, which was added as an official diagnosis in feeding and eating disorders in 2013, according to the National Eating Disorders Association.

Some research suggests a possible connection with ARFID and conditions like Autism, ADHD and Anxiety, according to the American Psychiatric Association.

The condition is often confused with more common eating disorders like anorexia or bulimia, but ARFID is not about a person’s self-image or drive to be thin, according to mental health experts.

"The people that have this diagnosis have a fear of food, meaning a fear consuming food, [and] a fear of being around food. That can look like a fear of texture, [or] different aversions to smells. It can also present in a form of fear of choking, vomiting, or being allergic to the food," Danielle Gordon, a therapist who specializes in eating disorders, told Nightline.

Gordon diagnosed Hannah with ARFID after her parents sought solutions to her extra picky eating. Michelle told Nightline that they were growing concerned about Hannah's health.

"We noticed when she went to get her physicals at the doctors, and her growth was not increasing at the rate that it was supposed to. She ended up falling off of the growth chart eventually," she said. "Often times she couldn't even be in the same room with us when we were eating."

Gordon recommends exposure therapy to her ARFID patients and Michelle said it has greatly helped her daughter.

"She is on cloud nine," Michelle, who asked Nightline not to disclose her family's last name, said of Hannah. "She's very happy to, you know, prove to herself and prove to everybody else that's watching her that she can do it, and that she can overcome these challenges."

In January, Hannah and Michelle started Hannah's Instagram page and began "My ARFID Life," bringing in fans from around the world, including those who are also living with the condition.

They said they have received so many good comments from people who are also suffering from ARFID but didn't have an outlet for their feelings.

Cassidy Arvidson, 27, of Brooklyn, told Nightline that after she was diagnosed with ARFID three years ago she couldn't find anyone in the community who she could talk to about her struggle.

"ARFID affects my life every single day. It affects my life socially more than anything," she said. "And it is very exhausting dating, specifically. I really do not enjoy. And then other social events like going out with friends, meeting new people, work events."

Arvidson said she was touched and inspired by Hannah's posts.

"She is so brave in doing all the exposures that she does," she said.

Gordon and other advocates hope more can be done to shine a light on ARFID.

"I think that we need to do a better job as an eating disorder community to give ARFID as much of a spotlight as the other disorders," she said. "And even research-wise, we need to do more work around this area to really help people and provide proper treatment for all."

Copyright © 2024, ABC Audio. All rights reserved.

EPA announces first national standard limiting 'forever chemicals' in drinking water

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(NEW YORK) -- The Environmental Protection Agency on Wednesday announced a new rule mandating the first-ever national standard for the presence of so-called "forever chemicals" in drinking water.

The new standard limits six types of per- and polyfluoroalkyl substances, or PFAS, found in drinking water -- a move the EPA says will protect around 100 million people from exposure.

"Today, I'm extremely excited to announce that we are finalizing the first ever nationwide, legally enforceable drinking water standard for PFAS -- the most significant action on PFAS the EPA has ever taken," EPA Administrator Michael Regan said during a call with reporters. "This standard will reduce PFAS exposure to approximately 100 million people."

PFAS are a ubiquitous group of chemicals found in a host of industrial and personal products, including fire extinguishing foam, food packaging, dental floss and others, according to the EPA.

The chemicals break down very slowly, allowing them to build up in people, animals and the environment over time -- hence the nickname, "forever chemicals."

"This rule really is a breakout from where we've been for decades," Erik Olson, senior strategic director for health at the Natural Resources Defense Council, told ABC News. "Finally, we're seeing government start to take the PFAS crisis seriously."

The EPA says it expects 6% to 10% of the 66,000 public drinking water systems in the U.S. may have to reduce PFAS from their water systems to meet the new standard.

Under this rule, water systems across the country will have three years to monitor for these chemicals and an additional two years to implement new technology to reduce their PFAS levels.

One billion in funding from the Bipartisan Infrastructure Law will be available to help states and territories with testing and treatment for PFAS as they work to come into compliance over the next few years.

By reducing PFAS exposure for millions of Americans, the Biden administration says this new standard will also prevent severe illness and death for many Americans.

"One hundred million people will be healthier and safer because of this action," Regan said. "This action will prevent thousands of deaths and tens of thousands of serious illnesses."

PFAS exposure has been linked to increases in cholesterol, changes in liver enzymes and pregnancy complications like preeclampsia, among other issues, according to the Centers for Disease Control and Prevention.

"Every single person in the United States is walking around with PFAS in their bodies," Olson said. "The risks are very real. These EPA rules will start the process of controlling the risks from tap water."

The chemicals targeted by the EPA in this rule include five individual PFAS: PFOA, PFOS, PFNA, PFHxS, and HFPO-DA. These five are also known as "GenX Chemicals." The rule also targets mixtures of two or more of four PFAS: PFNA, PFHxS, PFBS, and "GenX chemicals."

Olson noted that a large area in North Carolina famously became polluted with GenX Chemicals after a chemical plant spent decades dumping PFAS into the Cape Fear River.

"There's still only six that EPA is regulating, which is a good step, but they are 14,000 of these PFAS," Olson said. "So, we're taking a bite out of the problem, but we really need to regulate this whole class of toxic chemicals together because if we keep regulating them a few at a time, we're just never going to get off the toxic treadmill and never going to catch up with all the new chemicals the industry keeps producing and exposing us to."

Some industry groups opposed the rule during its public comment period.

The American Chemistry Council released a statement last summer criticizing the EPA's plan, saying the assessment of health impacts the agency relied on for its analysis was flawed and that it underestimated the cost of compliance for water systems.

Biden administration officials say they expect continued opposition under the finalized standards, but that they designed the rule to withstand potential challenges.

"We feel very confident that we have designed a very durable rule, well within our statutory authority, that begins to protect people from harmful pollutants that are showing up in their drinking water," a senior administration official said. "This is something that we've done in concert with our sister agencies. It's a government wide effort, and we're very proud of the product that we are releasing today."

Copyright © 2024, ABC Audio. All rights reserved.

Boy, 12, describes four-year battle with 'invisible' disease of long COVID

Meredith Eubanks

(NEW YORK) -- Theo Huot de Saint-Albin was a 9-year-old elementary school student when he first contracted COVID-19 in July 2020, near the start of the coronavirus pandemic.

Four years later, as much of the world has moved on from the pandemic and resumed normal life, Theo, now nearly a teenager, is still battling the effects of long COVID.

"What happened directly after COVID-19 was worse than my actual COVID-19," Theo, now in seventh grade, told ABC News' Good Morning America. "For me, I have chronic migraines ... it doesn't mean the migraine is terrible every day. It's very unpredictable. It goes in waves. But it's always there. It never leaves."

Over the past four years, Theo has contracted COVID-19 a total of three times, and each case has been mild. It's what happens in the weeks and months after the COVID-19 diagnosis that he says has impacted his ability to learn, go to school and play with friends.

In addition to battling chronic migraines, Theo was also diagnosed with postural orthostatic tachycardia syndrome, or POTS, a blood circulation disorder that can cause dizziness, lightheadedness and a rapid heartbeat, according to the U.S. National Institute of Neurological Disorders and Stroke.

He said he also suffers from symptoms like muscle pain, extreme fatigue and brain fog, and takes around two dozen medications and supplements each day to help manage his symptoms.

"There's no real way to tell how I'm going to feel," Theo said, noting that some days he is able to go to school for only a half-day, while other days he feels closer to his pre-COVID-19 self, and still others he can't move beyond the couch all day.

"It's especially hard because it's 'invisible,'" Theo said of his long COVID diagnosis. "Sometimes it's hard to get people to believe you as well because they can empathize with something they know is there. 'Oh, you have a broken leg, I can see that. Wow, you can't walk. That must be tough.' But, your head hurts? 'I don't see a big bulge on your head. I don't see bandages wrapped around it.'"

An 'invisible' condition impacting potentially millions of kids

While battling long COVID can seem lonely, Theo is far from alone, data shows.

An analysis published in February in the journal Pediatrics reported that as many as 5.8 million children in the United States have developed long COVID, or between 10% to 20% of children who have contracted COVID-19.

Figures from the Centers for Disease Control and Prevention show a smaller but still noteworthy estimate of 1.3% of children in the U.S. having had long COVID as of 2022.

Long COVID is diagnosed when patients still have symptoms at least four weeks after they have cleared the infection, according to the CDC. In some cases, like Theo's, symptoms can be present for months or years.

It's not clear if long COVID symptoms last a lifetime. Many people eventually recover, but scientists are still working to understand who is most affected, and why.

Symptoms vary and can include fatigue, difficulty breathing, headaches, dizziness brain fog, joint and muscle pain and continued loss of taste and smell, according to the CDC.

In kids, symptoms of long COVID can also include rashes, diarrhea, heart issues and diabetes, according to the research published in Pediatrics.

Part of the complication with long COVID is there is no single test or bloodwork to diagnose it. Instead, doctors have to rule out other conditions and rely on patients to describe and track their symptoms, which can be difficult with kids.

For Theo, it took nearly two years for him to be diagnosed with long COVID, according to his mom Meredith Eubanks.

Eubanks said she was told "no" by doctors when she would ask if her son might have long COVID, and faced misdiagnoses along the way, like Lyme disease. Both she and Theo struggled to answer when asked roughly how many doctors he had seen over the past four years.

In April 2022, Eubanks said Theo was diagnosed with long COVID by an infectious disease group at a local children's hospital in Atlanta, where the family lives. But the hospital, according to Eubanks, had no answer to her question of "Now what?" in terms of treatments and rehabilitation.

For that, the family traveled over 600 miles to Baltimore, where Dr. Laura Malone, a pediatric neurologist, had established the Pediatric Post-COVID-19 Rehabilitation Clinic at the Kennedy Krieger Institute, a pediatric-focused nonprofit health organization affiliated with Johns Hopkins Medicine.

"They were the first place we got to where they were like, 'Here's a list of symptoms, and did you have any pre-COVID, and what did you have post-COVID?'" Eubanks said, recalling how Theo checked nearly all of the symptoms on the list. "I just remember that was such relief. It was just like, 'Oh, you know, they're recognizing this and it's official, and Theo is not alone.'"

Malone said she and her team at the Kennedy Krieger Institute established the clinic in the summer of 2020 as they saw reports of adults developing long COVID. As the pandemic continued, demand began to grow.

"Everybody was, early in the pandemic, very focused on hospitalized cases, and the sequela after people get care in the ICU or are very critically ill with the acute infection, and that's not generally what we see in pediatrics," Malone said. "Most children can have a relatively mild infection and then go on to develop long-term sequela. So, that took a little bit of time to recognize and for patients to seek care, both from their primary care doctors and then also from clinics like us."

As long COVID became more recognized, Malone said the clinic has seen steady demand from pediatric patients across the country, while she said other patients may go undiagnosed.

"You have to look at a lot of behavioral changes, especially in younger children, to say, 'Something seems off'.' So I do think that [long COVID] is probably a little bit under-recognized still," Malone said. "We do see that there can be a lot of resiliency in children, and so despite them sometimes maybe having the symptoms, they may not always bring it up to family members or doctors but rather just try and manage the symptoms, and it's only when it gets to be intolerable that sometimes it will present to more medical care."

Helping kids return to 'normal' life

Along with there being no diagnostic test for long COVID, there is also no cure for the condition. Much of what can be done for patients is symptom management, according to Malone.

For kids, she said that means helping them manage their symptoms so they can, at least to some degree, return to school and social activities.

"Participation in life and all the activities, including education, that kids are designed to be participating in is really important," Malone said. "One of our big focuses is to try to provide accommodations to get kids back into school, but meet them where they are, because they may not be able to do a full course load, or they may not be able to make it through the full day of school, but there is still benefit if they can go for an hour, and gradually increase that over time to getting them back into that sort of routine, and getting them back into the social aspects of school and the educational aspects."

Patients at the clinic see not only medical doctors like Malone, but a team of experts including behavioral and neuropsychologists, social workers, pain specialists and physical therapists.

Ellen Henning, Ph.D., a pediatric psychologist at the Kennedy Krieger Institute, said patients often struggle with anxiety and depression due to long COVID. She said new research is also suggesting that long COVID itself could be influencing mental health symptoms due to factors like inflammation in the brain and lower levels of serotonin.

"We learn new things constantly and we adjust as we as we go," Henning said. "We try to provide the best supports that we can and then we all are always integrating new knowledge and adjusting things as we need to."

In October, the clinic received a $5 million grant from the Department of Health and Human Services that it is using to help train school nurses and other community health care providers to identify long COVID in students and provide accommodations for students already diagnosed with the condition.

"We have a lot of families and children that say that they have to educate, sometimes, their providers and tell their doctors at home about what's going on and about long COVID," Malone said. "That can just be really exhausting for kid, so that's a big thing that we've been working on, and we're really proud of that."

Theo said while his long COVID symptoms continue, he has felt more at ease since receiving his diagnosis and as the condition becomes more recognized.

With the help of Malone and the team at the Kennedy Krieger Institute, Theo is back in school for periods of time and working on catching up with his classmates.

"We have a lot of hope," he said. "I know I'm going to finish school at some point. Maybe a little later than most people, but who knows. And I think I'm going to get better. With all the research that's going to come out, hopefully, something will help me more than anything else."

Copyright © 2024, ABC Audio. All rights reserved.

Some Aruba Aloe hand sanitizer, gel products recalled due to warnings of methanol contamination


(NEW YORK) -- Aruba Aloe Balm N.V. has issued a voluntary recall of some of its hand sanitizer products due to the presence of alcohol denatured with methanol, which poses significant health risks to consumers.

Forty lots of Aruba Aloe Hand Sanitizer Gel Alcohol 80% and Aruba Aloe Alcoholada Gel were found to have contained methanol, the company said Friday in a press release in conjunction with the U.S. Food and Drug Administration.

"Although all persons using these products on their hands are at risk, young children who accidentally ingest these products and adolescents and adults who drink these products as an alcohol (ethanol) substitute are most at risk for methanol poisoning," the company said in a statement.

The company said there have been no reported adverse events related to these products thus far, but methanol exposure can lead to severe consequences, including nausea, vomiting, headache, blurred vision, coma, seizures, permanent blindness, and even death.

Aruba Aloe Hand Sanitizer Gel comes in 12 fl oz (355 mL) dark green plastic bottles with a white label. The label reads in part, "ARUBA ALOE Hand Sanitizer GEL 80% Alcohol Made in Aruba World’s Finest Aloe" with the barcode 0 82252 03300 5. The recall affects specific lot numbers distributed between May 1, 2021, and Oct. 27, 2023.

Aruba Aloe Alcoholada Gel, used for pain relief and itching associated with minor burns, sunburn, insect bites, or minor skin irritations, comes in two sizes: 2.2 fl oz (65 mL) and 8.5 fl oz (251 mL) plastic bottles. The bottles have barcodes 0 82252 34030 1 and 0 82252 03120 9, respectively. Lot numbers for this product are also included in the recall, covering the same distribution period.

These products were sold exclusively online via the Aruba Aloe Balm N.V. website during the specified distribution timeframe.

ABC News' Good Morning America has reached out to Aruba Aloe Balm N.V. for further comment.

Aruba Aloe Balm N.V. has taken steps to notify customers who purchased these product lots via email and is offering a discount coupon for a future purchase as compensation. However, consumers with these recalled products are strongly advised to discontinue use immediately and dispose of them properly by taking them to your nearest Household Hazardous Waste Recycling & Disposal center.

Aruba Aloe Balm N.V. said in their release that those with concerns or questions regarding this recall and announcement can contact the company via email at

Additionally, consumers who have experienced any adverse reactions or quality problems associated with these products are encouraged to report them to the FDA's MedWatch Adverse Event Reporting program.

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About one-third of socially vulnerable women missing recommended mammograms: CDC

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(NEW YORK) -- Thousands of women between ages 50 and 74 are not receiving life-saving mammograms, according to new federal data.

Researchers from the Centers for Disease Control and Prevention looked at the prevalence of mammography use over a two-year period, in a report published Tuesday.

Mammography use varied by state and sociodemographics, but the study found the more health-related social needs (HRSNs) a woman had, the less likely she was to get a mammogram.

HRSNs are barriers that impact a person's health or health care access with examples, including food insecurity and lack of access to reliable transportation. These are sometimes referred to as social determinants of health (SDOHs).

For women between ages 50 and 74, mammography prevalence was 83.2% for women with no adverse SDOHs or HRSNs. However, among women in that age bracket with three or more SDOHs or HRSNs, the prevalence was 65.7%.

Social isolation, life dissatisfaction, lost or reduced hours of employment, being on food stamps, lack of reliable public transportation and cost barriers were all associated with not having had a mammogram within the previous two years.

The authors said this was consistent with findings from previous studies showing associations between lower mammography use and HRSNs, including lower educational attainment and income, not having a usual source of health care and being uninsured.

"We have to address these health-related social needs to help women get the mammograms they need," CDC Chief Medical Officer Dr. Debra Houry said in a statement. "Identifying these challenges and coordinating efforts between health care, social services, community organizations, and public health to help address these needs could improve efforts to increase breast cancer screening and ultimately save these tragic losses to families."

Breast cancer causes more than 40,000 deaths among women in the U.S. each year, according to the CDC. Breast cancer death rates have been decreasing, but the report noted this has not been equitable across all groups. For example, Black women and women with low incomes are more likely to die from breast cancer.

However, evidence has shown that mammograms reduce breast cancer deaths. A multi-national study published in 2020, led by Queen Mary University in London, found that women who participated in mammography screenings had a 41% reduced risk of dying of breast cancer within 10 years and a 25% reduction in the rate of advanced breast cancers.

The U.S. Preventive Services Task Force, the group of specialists that set national guidelines for preventive care in the US, currently had recommended women between ages 50 and 74 receive a mammogram every two years during the dates that were studied. The Task Force now recommends all women should get screened for breast cancer every other year, starting at age 40 with final guidelines expected shortly.

"If we are to achieve higher breast cancer screening for all women, we have to look at all the possible challenges women face in getting mammograms," said Lisa Richardson, director of the CDC's Division of Cancer Prevention and Control, in a statement. "Health care providers can now assess whether women have health-related social needs and help women get the services they need. Every woman should be able to get screened for breast cancer without barriers."

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Doctor explains new study on salt substitutes, plus swaps to decrease sodium

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(NEW YORK) -- A new study evaluating older adults with a high risk of heart attacks or strokes has found that salt substitutions may be linked to a lower risk of death, specifically from heart disease and stroke.

The study was a meta-analysis of several studies primarily based in Asia, where experts say cuisine and food culture likely make it easier to use salt substitutes. Here in the U.S., people get roughly 70% of their sodium intake from packaged and prepared foods -- not from table salt that's added to food when cooking, according to the American Heart Association.

Still, experts say the findings, published Tuesday in the journal Annals of Internal Medicine, could act as a helpful reminder about excess sodium content, and help people explore possible alternatives.

"The average American eats 3,400 milligrams of salt [per day]. The recommended amount is about 2,300 milligrams [per day]," ABC News medical correspondent Dr. Darien Sutton explained, citing the American Heart Association, which also encourages "an ideal limit of no more than 1,500 mg per day for most adults, especially for those with high blood pressure."

"More than 97% of people don't know how much -- or underestimate how much -- sodium is in their diet," Sutton said.

Diets high in sodium result in more than 2 million deaths around the world each year, according to the World Heath Organization.

Not all adults have an urgent medical need to replace salt in their diet. The new study was specific to people who have a higher risk of heart attacks and strokes. People with an elevated risk should talk to their doctor about ways to reduce salt in their diets. And the first step is often looking at the label on any packaged food.

For example, Sutton pointed to a bowl of Doritos tortilla chips, saying that just 12 contain "about 200 milligrams" of sodium.

"If you look at the actual bag, there's 15 servings in one of those regular bags," he said. "That equates to more than 3,000 milligrams of sodium. You have to make sure that you're mindful of your sodium, and the majority of it comes from processed food."

One recommendation Sutton shared is to "eat regular today, categorize or quantify how much sodium you are having and then, at the end of the day, figure out how to do better."

Additionally, he suggested being smart with nutritious ways to add flavor in lieu of salt.

"Most of the time if you remove the sodium from our food, most people won't recognize it, especially if you add other [ingredients]," he said suggesting substitutes such as paprika, ground pepper, onion powder, cinnamon, ginger or garlic.

This week's analysis laid out what many already know, Sutton said, which is that salt can harm our health.

"This was a meta analysis which involved a lot of different studies at once, looking at older populations in Asia, specifically who were at higher risk. And it found that reducing sodium for six months significantly reduced risk of heart disease, stroke and kidney disease," Sutton said. "You have to make sure you watch your sodium to help reduce your risk and improve your quality of life when you get older."

When it comes to adjusting one's salt intake, Sutton advised tracking how much you've had by writing it down and adding in more nutritional options.

"Potassium can help blunt the effect of sodium in our body, helping us manage our blood pressure," he said. "So, leafy greens, bananas, sweet potatoes, you want to add these products, have less processed foods and be mindful of your sodium."

ABC News' Sony Salzman contributed to this report.

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Harvard team makes solar eclipse accessible to visually impaired

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(CAMBRIDGE, Mass.) -- As many turn their eyes to the skies to watch the solar eclipse, some with vision impairment are turning their ears to a new gadget.

The LightSound is a 3D-printed device, about the size of a cell phone, which can register the changing brightness of light. It then turns that information into a variety of sounds using a process known as "sonification."

"Sonification is just taking data and converting it into sound," says Allyson Bieryla, an astronomer at Harvard University. Bieryla came up with the idea for the LightSound ahead of the 2017 solar eclipse, alongside Wanda Díaz-Merced, an astronomer and sonification researcher who is blind. Bieryla says the LightSound represents an effort to use sonification to make astronomy more accessible to those with physical impairments.

To do this, the LightSound emits a range of sounds based on the amount of light it receives, Bieryla tells ABC Audio.

"We have this Midi synthesizer board on the device that basically allows us to map different instruments to the data values."

A flute, for example, represents bright light. When it gets darker, Bieryla says "the midrange goes to a clarinet, and then in totality, or like a dark room or something, you might hear a clicking."

The LightSound's clicking slows down the darker its environment becomes.

"For totality, we really didn't want to distract with a lot of sound, so we chose, like, the absence of light, the absence of sound," says Bieryla. She says that's because totality - the brief moment when the moon completely obscures the sun - brings with it other environmental changes.

"A lot happens during totality," says Bieryla. "Temperature changes, people react, you know, insects and animals react."

Since 2017, Bieryla and her team have distributed hundreds of LightSound devices around the world. They say they've donated more than 200 devices in the lead-up to the 2024 eclipse, and feature instructions on their website that detail how to build a LightSound device at home.

"We don't want people to make a profit off of it," says Bieryla. "We want to give it to the community."

As for what's next, Bieryla says they're looking into ways to add haptics to the Lightsound, which would vibrate the device based on the amount of light it receives. It's intended, she says, to bring the eclipse experience to those who are both sight and hearing impaired.

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Florida's six-week abortion ban 'catastrophic for the region,' activist says

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(NEW YORK) -- Despite abortion being on the November ballot in Florida, pro-abortion groups say a six-week ban going into effect next month will have devastating consequences for women in the Southeast.

The Florida Supreme Court issued two decisions earlier this week, allowing a question on the November ballot that would enshrine abortion rights in the state's constitution and upholding the state's 15-week abortion ban. A trigger ban will now go into effect on May 1, prohibiting abortions at six-weeks gestation, before most women know they are pregnant.

Florida, despite its 15-week limit, has been a key point of access to women across the southeastern U.S. living in states that have ceased nearly all abortion services due to bans. At least 14 states have ceased nearly all abortions since the U.S. Supreme Court overturned Roe v. Wade, ending federal protections for abortion rights.

In Florida, the proportion of abortions provided to patients traveling from out of state increased from 5% in 2020 to 11% in 2023, according to the Guttmacher Institute.

In 2023, there were 8,940 more abortions in Florida compared to 2020 -- a 12% increase -- according to Guttmacher. Increased travel from out of state accounted for 58% of the state’s overall increase in abortions between 2020 and 2023.

A Woman's Choice, an abortion clinic with a location in Jacksonville, Florida, told ABC News that about half of the patients it sees every month are from out of state. The clinic would not disclose how many patients it treats at the Jacksonville location, but said it had a large increase in patients after neighboring states began enforcing abortion bans.

With Florida bordering Alabama and Georgia -- where there are severe restrictions -- the closest point of access for Floridians to get care past 12 weeks gestation is now Virginia or New Mexico, pro-abortion activists told ABC News.

Abortion care is allowed in North Carolina up to 12 weeks. However, one maternal fetal medicine specialist, who left the state due to the ban, told ABC News that providing care after 20 weeks was "fundamental to her practice" as she often diagnoses fetal anomalies sometime between 18 and 20 weeks gestation.

A Woman's Choice clinics, which has a facility in Danville, Virginia, says that location is over 500 miles from their Jacksonville clinic -- an over 8-hour drive each way.

And, there could still be more barriers for patients able to travel that far for care in Virginia.

"I'm not sure if the infrastructure [in Virginia] can accommodate all the influx of patients. It's something that I'm really concerned about and I know providers have been working incredibly hard to see as many patients as [they can] safely and compassionately," Amber Gavin, the vice president of advocacy and operations at A Woman's Choice, told ABC News.

"But I do think that folks fall through the cracks especially folks who are already marginalized in our healthcare system," Gavin said.

Impact of six-week bans

The six-week ban going into effect is "devastating" and "catastrophic for the region," Mini Timmaraju, the president and CEO of Reproductive Freedom for All, told ABC News.

"There is really no distinction between a six-week ban and a total ban on abortion," Timmaraju said.

According to Guttmacher, six-week bans have "massive impacts on abortion provision."

In South Carolina, the number of abortions provided in the formal health care system decreased by 71% after the state started enforcing the six-week ban on Aug. 23, 2023. The state provided 250 abortions in September 2023 compared to 870 in August 2023, according to Guttmacher.

After six-week bans took effect in Georgia and Texas, there was about a 50% decline in abortion caseloads, according to Guttmacher.

Despite exceptions that allow abortions in some cases -- which differs depending on the state -- and federal law which requires physicians to provide life-saving care to patients, many patients are unsure what kind of care they can receive.

Bans "create a lot of confusion and chaos for people seeking care" making it "a bit harder for people to access care, but it's also gonna be harder for people to navigate when they can access care," Candice Gibson, the director of state policy at Guttmacher, told ABC News.

"I think that there's going to be a great need to educate individuals on what their rights are and also how they can access care," Gibson said.

Americans United for Life, an anti-abortion group, said the court's decision was "reasonable" in walking back the notion that a privacy clause in the state's constitution provided protections for a right to abortion.

Asked about reports of patients unable to get care in line with exceptions to bans in Florida and other states, Americans United for Life said it is up to the legislature to "take a look at that issue."

"If it decides that the right to treatment for truly medically necessary abortions isn't sufficiently clear, it could legislate to protect that right," Steven Aden, the chief legal officer and general counsel at Americans United for Life told ABC News.

Aden said the group does not support exceptions in cases of fatal fetal anomalies, proposing "perinatal hospice" instead.

"We cannot license or permit any human being to end the life of a human being. Even if it's for purposes of compassion. That's also why we oppose assisted suicide," Aden said.

Care in Florida under the ban

A Woman's Choice told ABC News the abortion clinic has already had to turn away patients under the 15-week ban, calling a six-week ban "devastating."

"One of the reasons that this ban makes it one of the worst in the country is because Florida already has a state-mandatory delay law, forcing folks to wait 24 hours and it mandates two in-person trips to a clinic," Gavin said.

"If in a few weeks a patient comes to us -- let's say they come to us in June -- and they come in for their consult appointment and they measure at six-weeks pregnancy, we literally wouldn't be able to see them the next day for their actual abortion appointment because they'd be past the gestational limit," Gavin said.

For patients past the gestational limit, the clinic will have options: help from patient navigators who provide financial assistance for abortion costs, help finding care in another state or a referral to a pro-abortion adoption agency.

Gavin said it is also likely some Floridians will choose to take matters into their own hands and self manage their abortions, or they may be forced to carry their pregnancies to term. The clinic will remain open and offer a range of OB-GYN care including ultrasounds, HIV testing and STI testing.

Ballot Initiative

Pro-abortion groups and A Woman's Choice told ABC News they were optimistic about abortion access being restored through the November election.

In all six states where there have been abortion questions posed to voters -- including conservative state like Kansas -- they have chosen to protect abortion rights.

Voters also overwhelmingly support abortion access, according to Gibson, who called the ballot initiative a "critical fight."

A Woman's Choice, which actively participated in collecting signatures for the initiative, said it will be raising awareness about the ballot question, telling patients at their clinic to vote to protect and restore abortion in Florida. It will also be holding a rally.

The National Latina Institute for Reproductive Justice told ABC News that bans disproportionately impact their community, which are more likely to be uninsured. The group, part of the campaign for the ballot initiative, said it will work to ensure that information is available in Spanish, to help overcome language barriers.

Americans United for Life told ABC News the group does not support the issue being left up to "popular majority vote."

"We believe that the rights of minorities [in this case fetuses] shouldn't be subjected to the popular vote of the majority," Aden said.

"We hope that the people of the state of Florida will recognize that the proposed initiative is really an all-out regime of abortion on demand," Aden said.

Timmaraju called the ballot initiative the state's "best option at restoring access in the South," but warned that a question on the November ballot is not an option in all states.

"There's not that many states left where we can pursue a similar path," Timmaraju said.

"Not every state has a pathway to get on the ballot because it requires you to go through the legislature and a lot of these southern states need a supermajority of Republicans and are several [election] cycles away from being able to pull something like this off. But in Florida you can go directly to the people and get on the ballot," Timmaraju said.

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What you need to know about bird flu after person became infected in Texas

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(NEW YORK) -- Bird flu, also known as highly pathogenic avian influenza H5N1 virus, was first detected in 1996 among birds in China, according to the Centers for Disease Control and Prevention. One year later, an outbreak occurred in Hong Kong that resulted in 18 human cases, including six deaths, after the people were infected directly by birds.

In late 2021, a version of the virus arrived on U.S. shores and was detected in wild birds. Since February of 2022, the virus has been causing outbreaks in commercial poultry supply -- leaving over 80 million birds affected in nearly all states, according to the CDC. Nearly 10,000 wild birds have also been impacted.

While the virus is most common in birds it has more recently spread to some other animal populations such as harbor seals, mountain lions, raccoons, polar bears, red foxes, as well as striped skunks, according to the U.S. Department of Agriculture.

Rarely, the virus can infect humans after interacting with an animal. Most recently, a dairy worker in Texas was presumed to be infected by sick cattle, according to the CDC. This is the second human case ever to be reported in the U.S.

There has not been any spread of the virus between people in the U.S., according to CDC Director Dr. Mandy Cohen. The risk to the public remains low, she added.

A total of nearly 900 human cases have been identified since 2003, with about half dying from the infection, according to the World Health Organization. Almost all the human cases were linked to close contact with infected birds or contaminated environments.

"I want folks to know that for 20 years, the United States government has been preparing and trying to learn about avian flu," Cohen told ABC News.

The sick patient out of Texas reported eye redness as their only symptom and is recovering after isolating and being treated with an antiviral drug, according to the public health agency.

"We have treatment that is available, things like Tamiflu. Not only do we have that in pharmacies, but we have it in stockpile, here in the country. And we have vaccine candidates that are matched to the current virus," Cohen said.

She maintained that the U.S. government is closely monitoring the situation. 

"The fact that it spread to one human case is certainly making us want to take this very seriously. But folks should know that right now, the risk to them is very low," Cohen said.

"These are the things that reassure me: 20 years of preparation, no genetic changes to this virus, no human-to-human spread and nothing in the virus in terms of adaptations that would make us think it is more adaptive to human spread," she added.

Recent analyses from the CDC indicate that the virus has not adapted to better infect humans.

"As we look more closely at the virus's genetics, it is very similar to the virus that we've seen spread in bird populations. And so, we're not seeing an important change in the virus that would increase our alarm," said Dr. John Brownstein, chief innovation officer at Boston Children's Hospital and an ABC News medical contributor.

Those who work with wild animals or livestock may be at higher risk of being exposed and infected with bird flu, according to the CDC.

People should avoid direct contact with wild birds and observe them from a distance, according to the CDC. It is also important to avoid contact with sick or dead animals, in general. Human infections can occur when the virus gets into a person's eyes, nose or mouth, or is inhaled, typically after prolonged contact.

"The risk really is concentrated in those that are working in close proximity to animals and birds," Brownstein said.

"And those are the people that we, of course, need to improve our surveillance and make sure that we identify any case as early as possible," he added.

Because milk products are pasteurized, there is no concern about the safety of the commercial milk supply, according to the USDA. Other federal agencies like the FDA and CDC warn against drinking raw milk or products made from it, due to the risk of viruses and bacteria, which may lead to infection or foodborne illnesses.

"So far, there is no concern for food in our supply chain. There is no risk to those that are consuming dairy and meat products," Brownstein said.

The USDA also remains confident that the meat supply is safe and reminds us that cooking to a safe internal temperature kills bacteria and viruses, including bird flu.

"We feel in a good place to be able to understand this, learn more, and be prepared. But we are taking it very seriously. And so, you are seeing a mobilization of all of the government levers that we have to make sure that we are prepared," Cohen said.

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Costco launches weight loss programs that could include Ozempic, Wegovy

A pharmacist holds a box of Novo Nordisk A/S Ozempic brand semaglutide medication at a pharmacy in Provo, Utah, Nov. 27, 2023. (George Frey/Bloomberg via Getty Images)

(NEW YORK) -- Costco members love the big box retailer for its wide selection of goods but now the warehouse club is wading into specialized health care and expanding its partnership with Sesame to offer exclusive pricing on weight loss programs.

Sesame said Tuesday in a press release that Costco will offer members a three-month subscription at the exclusive discount of $179 when they sign up for the weight loss program within the health care company's direct-to-patient marketplace.

The subscription includes a live video consultation appointment with a weight loss doctor of the patient's choice, guidance on nutrition and exercise and a medical history analysis for an individualized, clinically-appropriate treatment program. Based on that history, the doctor may prescribe the member a weight loss medicine like Ozempic or Wegovy.

"Individual patient eligibility for drug therapies available through Sesame are determined by the assessment of appropriateness of each therapy by the Sesame-listed provider, and are subject to availability," according to the company.

The cost of that medicine, however, is not included in the base price and without insurance, these drugs can cost upwards of $1,000 per month.

Another challenge could potentially be getting the prescription filled as pharmacies across the country have reported shortages amid increased consumer demand for these drugs. Earlier this year, Ozempic and Wegovy maker Novo Nordisk said it's working to increase supply, but the U.S. Food and Drug Administration still has semaglutide -- the main ingredient in both prescriptions -- on its list of drug shortages.

The move from Costco follows rivals Amazon and Weight Watchers, which both offer similar weight loss services to members.

Costco did not immediately respond to ABC News' request for comment.

Sesame said the program is about making high-quality specialty care like weight loss more accessible and affordable.

"We are witnessing important innovations in medically-supervised weight loss," Sesame co-founder and CEO David Goldhill said in the press release. "Sesame’s unique model allows us not only to make high-quality specialty care like weight loss much more accessible and affordable, but also to empower clinicians to create care plans that are specific to — and appropriate for — each individual patient."

Because Sesame doesn’t accept health insurance, Costco Members who prefer to pay cash for health care needs could do so.

Costco first announced its partnership with Sesame in September 2023 to deliver exclusive, low pricing from Sesame’s marketplace to members for core health care services such as virtual primary care, health checkups and virtual mental health therapy.

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EtO gas used to sterilize medical devices ignites fears over link to cancer

Activist Vera Holmes, whose family has lived in Memphis for generations, says she will keep pushing until the EtO facility is out of her community. (ABC News)

(NEW YORK) -- After years of holding community meetings and knocking on doors, community activists are now seeing action about an invisible risk raising concerns about cancer in their communities.

A recently announced rule from the Environmental Protection Agency would reduce an estimated 90% of ethylene oxide emissions from the facilities that use it. Ethylene oxide is a colorless and odorless gas that is considered essential for sterilizing medical devices but also has been linked to cancer risk for people breathing in significant amounts of it over time.

Around 20 billion medical devices used in the United States, including ventilators, syringes and catheters, are sterilized with ethylene oxide (EtO) every year.

“Ethylene oxide is the most widely used, safe and effective, scientifically proven modality for medical device sterilization not only in the United States, but worldwide,” said Dr. Suzanne Schwartz, director of the Office of Strategic Partnerships and Technology Innovation at the Center for Devices and Radiological Health at the U.S. Food and Drug Administration.

While there is no known risk to doctors and patients using the EtO-sterilized devices, the Environmental Protection Agency (EPA) announced in 2022 that long-term exposure to the gas emissions from facilities can increase the risk of cancers including lymphoma, leukemia, stomach and breast cancers.

There are 88 facilities that use EtO to sterilize medical equipment all around the country in 32 states and Puerto Rico. Some residents nearby fear that the emissions that escape these facilities could be threatening their health.

The new EPA rule comes after years of activism from residents in communities that were notified the amount of EtO they could be exposed to posed a risk of cancer that the EPA considered concerning.

In South Memphis, Tennessee, the Mallory Heights Community Development Corporation has been raising awareness of the potential hidden danger of EtO emissions in their neighborhood.

“So many people that I know within my family and live in this area have died of cancer or have cancer now,” Vera Holmes, president of the Mallory Heights CDC, told ABC News' Nightline.

While scientists say it is nearly impossible to link any one person’s cancer to EtO, local residents raise concerns about their cancer diagnoses being related. Ural Grant, who has lived in South Memphis for more than 35 years, was diagnosed with Stage 4 colon cancer in 2019. He says that many of his neighbors also have cancer.

“I thought this was my American dream right here to have a home, to have a house,” Grant said. “But then it kind of turned into an American nightmare.”

Grant says he cannot afford to move due to mounting medical bills. Similarly, many of those impacted by EtO emission live in working-class neighborhoods.

KeShaun Pearson, president of Memphis Community Against Pollution, believes that racial injustice is at play when toxic gas emission happens in predominantly Black neighborhoods.

“[Memphis] as a whole has an F in air pollutants and in air quality, and 98% of the particular matter that makes up the pollution is here in South Memphis,” Pearson said. “That is not coincidental. That is by design. It's been designed that this area specifically is a place where people's lives can be sacrificed.”

In Laredo, Texas, residents face a similar battle. The border town is home to a population of about 250,000 people, mostly working-class and Hispanic.

“This is one of the largest warehousing areas in the city,” said Victor Trevino Jr., a local attorney who has lived in this town all his life. “We have residential areas right next to this industrial area within a couple of miles.”

Among the industrial facilities nearby, Midwest Sterilization Corporation has been in operation since 2005. Up to 40% of all the nation's sterilization kits are sterilized in this location.

“Laredo has a 95% Hispanic population. We have one of the highest poverty rates in the state,” Trevino said. “This is really a crisis for us at this point.”

Victor’s father, Dr. Victor Trevino Sr., has worked as a physician in the community for around 40 years. He also served as the health authority before his current role as mayor of Laredo. He says it’s important to balance the need for employment with safety.

“It employs a significant amount of people, and employment is good for a community,” Dr. Trevino Sr. said to Nightline. “But we also have to say, ‘at what cost?’”

Despite the plant being built in 1976, many residents living just minutes from Midwest Sterilization say that they have no idea the plant was even there.

“We have always been in compliance with state and federal regulations and continue to be,” Midwest Sterilization Corporation said in a statement to ABC News. “Our top priority is ensuring that we can continue to keep communities safe while helping to save patients’ lives. We are firmly committed to doing everything possible to continue to reduce emissions and keep Laredoans safe.”

Now, changes are happening on a federal level.

For the first time in 50 years, the EPA released new rules for commercial sterilization that uses EtO, aiming to reduce emission by more than 90%. Under the new regulation, facilities will have to implement major changes including pollution control, ventilation systems, and increased monitoring and reporting.

EPA Administrator Michael Regan said in a statement that the agency listened to impacted communities in drafting a rule to protect their health.

“We’ve arrived at a historically strong rule that will protect the most exposed communities from toxic air pollution while also ensuring that there will be a process that safeguards our nation’s critical supply of sterilized medical equipment,” Regan said.

Scott Whitaker, the CEO of AdvaMed, a group that represents sterilization facilities, spoke about potential changes during a House of Representatives Energy and Commerce Committee hearing.

“We've made it clear that we welcome updated regulations. After all, our industry's commitment to saving and improving lives does not end where sterilization begins,” Whitaker said. “How regulators implement this updated rule is critical to ensuring that there is (1) no disruption to the medical supply chain and (2) no harm to patients, and that (3) the communities surrounding these facilities remain safe.”

While AdvaMed added in a statement that they have worked with the FDA and the EPA to ensure the final rule would “enhance and not hinder” their company’s "already-well-established commitment" to safe sterilization, the facilities could take two, three years or longer to comply with the new rule.

The FDA emphasizes the importance to balance reducing emissions while not jeopardizing the medical device supply chain.

“It is not a zero-sum game,” Schwartz said. “We have to be able to achieve these objectives in parallel and together.”

The company in Memphis, Sterilization Services of Tennessee, announced last year they would move to a new location outside of the community. In a letter to a member of Congress, they said they “have never been out of compliance with reference to federal, state, and local mandates.”

*To address legal’s note – this quote was all that was included in the broadcast.

ABC News has reached out to Sterilization Services of Tennessee and received no response.

Activists like Vera Holmes say she will keep pushing until the EtO facility is out of her community.

“People are tired,” said Holmes. “They're afraid to speak up or speak out. But that's up to us as leaders to step in and say, ‘hey, we hear you, and we can make some things happen.’ It just takes the right team to do the right thing.”

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