Health News

Polio discovered in New York City wastewater samples

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(NEW YORK) -- Health officials announced Friday that polio has been detected in wastewater samples in New York City.

It comes just a few weeks after a case of polio was detected in Rockland County, located north of the city.

Story developing...

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CDC no longer requires unvaccinated to quarantine after being exposed to COVID

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(ATLANTA) — The Centers for Disease Control and Prevention updated its COVID-19 guidance Thursday to ease recommendations for people who are unvaccinated and have been exposed to COVID-19.

Previously, the CDC advised that people who were unvaccinated or hadn't received their booster shots should quarantine for five days after exposure. If no symptoms appear, the quarantine can end.

The new guidance no longer recommends that unvaccinated people quarantine after exposure, instead suggesting they mask up for 10 days and get tested five days after they were exposed.

This is the same guidance that was previously given to vaccinated and boosted people who were exposed to COVID and essentially simplifies the CDC's quarantine recommendation. Americans who are exposed to the virus, regardless of vaccination status, no longer need to stay at home if they've had an exposure, per the CDC's latest guidelines.

"We're in a stronger place today as a nation, with more tools -- like vaccination, boosters, and treatments -- to protect ourselves, and our communities, from severe illness from COVID-19," Dr. Greta Massetti, chief of the field epidemiology and prevention branch at the CDC and one of the authors of the updated guidance, said in a statement.

"This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives," she said.

The CDC also included updated guidance on how people can use testing to end their isolation after getting sick with COVID-19, recommending two negative tests 48 hours apart before going out in public again without a mask.

The new guidance recommends people take their first test on day six of isolation if they're fever-free, with a second rapid test 48 hours later.

If both tests are negative, people can leave their homes and not use a mask around others. Massetti said the CDC decided to recommend two tests, two days apart, because of recent Food and Drug Administration studies showing the serial testing, or testing multiple times, improves efficacy of rapid tests.

"We want to ensure that when people are using an antigen test, that we're relying on the most accurate information, avoiding potentially making decisions based on false negative results," Massetti told reporters Thursday.

Waiting 48 hours before taking another test mitigates "some of those performance issues," she said.

But officials were clear that the CDC still considers testing optional and doesn't expect all Americans to have access to tests.

"We are still recommending that decisions for ending isolation should be based on symptoms and time," Massetti said.

The guidance Massetti referred to suggests that anyone who tests positive for COVID-19 should isolate for at least five days.

If the person remains fever-free for 24 hours without the use of medication by day 5, or never had symptoms, they can end isolation but are advised to wear a mask for a full 10 days.

The CDC also said it was no longer recommending schools use test-to-stay, which allowed students who were close contacts of those who test positive for COVID to continue to attend in-person classes as long as they remain asymptomatic and continue to test negative.

Massetti said because unvaccinated and vaccinated people no longer are advised to quarantine, test-to-stay was no longer necessary.

"Because we're no longer recommending quarantine, we're no longer including a section on test-to-stay because the practice of handling exposures would involve masking rather than a quarantine, and test-to-stay was an alternative to quarantine," she said.

The CDC also said it was removing its recommendation of testing asymptomatic people without known exposures in most community settings and deemphasizing six feet of social distancing, which has been recommended since the early days of the pandemic.

"Physical distance is just one component of how to protect yourself and others," the guidance reads. "It is important to consider the risk in a particular setting, including local COVID-19 Community Levels and the important role of ventilation, when assessing the need to maintain physical distance."

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Only half of eligible Americans have gotten their first COVID booster

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(NEW YORK) — As we approach the fall, there is a renewed push to get Americans vaccinated against COVID-19, particularly the elderly and the vulnerable, who continue to bear the brunt of the nation's COVID-19 crisis.

Although over 61 million people, over the age of 50, are eligible to receive their second COVID-19 booster shot, just a third have actually done so, according to data from the Centers for Disease Control and Prevention.

Similarly, less than half of Americans, over the age of 5, who are eligible to receive their first booster have received their supplemental shot.

"One of the key messages coming out of this moment is: If you are 50 or over and you have not gotten a shot this year ... it is absolutely critical that you go out and get one now," White House COVID-19 coordinator Dr. Ashish Jha said told ABC “This Week” co-anchor Martha Raddatz, last month.

Although the immunity provided by vaccines continues to wane with time, CDC data shows that COVID-19 booster doses are helping to significantly increase protection against severe forms of COVID-19 disease and death, particularly among older Americans.

Among people ages 50 years and older, the unvaccinated had a risk of dying from COVID-19 that was 29 times higher than their fully vaccinated and double-boosted peers.

In April, risk of death was 42 times higher among the unvaccinated. Despite the fact that there has been a decline in vaccine efficacy, data shows that the shots are still largely helping protect against severe disease.

Among people ages 50 years and older, vaccinated people with one booster dose had a risk of dying from COVID-19 that was 4 times higher than those fully vaccinated and double boosted.

Older Americans — particularly those over 70 — are being hospitalized at a significantly higher rate than all other age groups. Comparatively, people 70 and over, in the U.S., are entering the hospital 10.5 times more often than people ages 18 to 29.

On average, about 6,100 virus-positive Americans are now entering the hospital each day. There are currently about 43,000 virus-positive patients hospitalized across the country.

The overall number of patients hospitalized has also been at a plateau for several weeks. However, numbers remain significantly lower than at the nation's peak, when there were more than 160,000 patients hospitalized with the virus.

In addition, although death totals also remain much lower than during other parts of the pandemic, hundreds of Americans are still dying from COVID-19 every day.

On average, nearly 400 American deaths to COVID-19 are reported each day, and over the last seven days, the U.S. has reported more than 2,700 deaths, according to the CDC.

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Polio vaccine boosters offered to kids in London as virus linked to New York case detected

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(LONDON) — Children in London are being offered polio vaccine boosters after sewage samples with the virus were found in multiple areas across the city.

The U.K. Health Security Agency announced Wednesday that all children between ages 1 and 9 across the British capital will be eligible to receive an inactivated polio vaccine booster.

"This will ensure a high level of protection from paralysis and help reduce further spread of the virus," the agency said in a statement.

"While the majority of Londoners are protected from polio, the [National Health Service] will shortly be contacting parents of eligible children aged 1 to 9 years old to offer them a top-up dose to ensure they have maximum protection from the virus," Jane Clegg, chief nurse for the NHS in London, added.

There are more than 1 million children between those ages who live in London as of mid-2020, the latest year for which data is available, according to the U.K. Office of National Statistics.

Between February 8 and July 5 of this year, poliovirus has been detected in 19 sewage samples across nine boroughs including at Beckton Sewage Treatment Works in London, which is the largest sewage treatment plant in the U.K.

Recently, a report indicated a polio case in New York was genetically linked to the samples found in the U.K.

Polio vaccines are part of routine immunizations for children. In the U.S., vaccinated children are not recommended to get a booster shot at this time.

According to the UKHSA, the booster program will begin in the areas where the virus has been detected and where vaccination rates are lowest before being rolled out across the city.

"The NHS in London will contact parents when it's their child's turn to come forward for a booster or catch-up polio dose -- parents should take up the offer as soon as possible," the agency's statement read.

 

On July 21, health officials reported a case of polio was discovered in Rockland County in New York -- just north of New York City -- in a 20-year-old unvaccinated man.

The man contracted vaccine-derived polio, which means he was infected by someone who received the oral polio vaccine, which is no longer used in the U.S. or the U.K.

The oral vaccine uses a live weakened virus, which -- in rare cases -- can spread through fecal matter and infect unvaccinated individuals. Comparatively, the injectable polio vaccine, uses an inactivated virus.

As of Aug. 5, 11 samples were genetically linked to the Rockland County patient including six samples collected in June and July from Rockland County and five samples collected in July from nearby Orange County, health department data shows.

However, health officials have said the majority of the population is not at risk for polio because most were vaccinated as part of their regular childhood immunizations, but that it's important for those who are unvaccinated to get their shots.

The New York State Health Department told ABC News its focus would be on ensuring immunizations.

"Our current focus is to ensure unvaccinated New Yorkers and children get immunized against polio and that they are up to date with their polio immunization schedule," the department said.

The Centers for Disease Control and Prevention is the organization in the U.S. that makes vaccine recommendations, but has not suggested any such move to add a fifth dose of polio vaccine to the current vaccine schedule underway.

The CDC did not immediately respond to a request for comment from ABC News.

The agency recently told ABC News the U.S. health agency is deploying a team to New York to investigate the case in Rockland County. The team will also administer vaccines in the county.

"These efforts include ongoing testing of wastewater samples to monitor for poliovirus and deploying a small team to New York to assist on the ground with the investigation and vaccination efforts," the agency said in a statement.

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FDA's move to stretch monkeypox vaccine supplies could pay off, experts say

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(SILVER SPRING, Md.) -- The Food and Drug Administration announced an emergency use authorization to move forward with their plan to stretch out the current monkeypox vaccine supply with a new injection method that will try to stretch one dose into five. Vaccine experts say that the scientific rationale behind this decision is sound, but technical challenges with the rollout technique may still be ahead.

"In recent weeks, the monkeypox virus has continued to spread at a rate that has made it clear our current vaccine supply will not meet the current demand," FDA Commissioner Bob Califf said Tuesday during a press briefing.

But this swift decision has some asking if this way of giving a vaccine that is still experimental.

Dr. Demetre Daskalakis, deputy coordinator for the White House Monkeypox Response, sought to reassure gay, bisexual and men who have sex with men -- the group most affected by the outbreak right now -- that the new strategy is evidence-based.

"I think that the due diligence done by the FDA, looking into the data, should assure them that the vaccine is immunologically equivalent and safe," Daskalakis, a leading expert on LGBTQ health, said during a Tuesday briefing.

Experts say the scientific rationale is sound, but the data isn't robust

The data Daskalakis is referring to comes from a 2015 study that evaluated both ways of administering the vaccine, that found "a similar immune response," according to the FDA. Other data comes from smallpox and influenza vaccines.

"We look at the totality of the available scientific evidence and we bring that together to try to do the best by public health," Dr. Peter Marks, FDA's vaccine chief, said on Tuesday.

Vaccine scientists interviewed by ABC News agreed that the scientific rationale supporting the new injection technique is strong, but note prior studies have been small.

"The data supports this based on the original clinical trial data and their approval from FDA," Dr. Richard Kuhn, Krenicki Family Director of Inflammation, Immunology, and Infectious Disease at Purdue University, told ABC News.

Dr. Dan Barouch, Director, Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center says it's crucial to continue collecting data to better understand if the new injection technique will be equally effective in this outbreak.

"There is some data, but it's a small amount of data -- and it needs to be studied in larger numbers with more sophisticated assays that we have today with the actual vaccine that's being used right now," Barouch told ABC News.

The National Coalition of STD Directors, a nonprofit representing sexual health clinics that have been on the frontlines of the current outbreak - questioned the decision. Without clear data on efficacy, giving smaller, shallower injections could give people a false sense of security, they argued on Twitter.

Trickier injection method can be taught

Healthcare providers will need to be trained in how to give shots between layers of the skin, instead of the more typical deeper injections below the skin. The technique is not overly complex and has been done in the past with other vaccines. But because it is slightly more difficult, the shallower injection into the skin is not commonly used.

"There is a lot of history of getting vaccines by the intradermal route, but not recently," Barouch said. "Most people are not trained or experienced in administering vaccines by the intradermal route."

Despite challenges, vaccine scientists say dose sparing technique could still pay off

"Currently we have a larger demand for monkeypox vaccine than we have doses of the vaccine. I am confident this is why a dose sparing strategy was authorized," Dr. Robert Frenck, director of the Vaccine Research Center at Cincinnati Children's Hospital Medical Center, told ABC News.

Kuhn also agrees with FDA's decision to allow shallower injections to stretch limited vaccine supply.

"The guidance on the intradermal is supported by earlier trials and is meant to increase availability of the current vaccine stocks," Kuhn said, but warned that we need to be thinking about opening vaccine eligibility.

"I would prefer that we move now with this attenuated non-replicating vaccine," he continued. "This is not a gay disease, and my concern is that we should be open to larger segments of the population, independent of sexual orientation, for the application of diagnostics and therapeutics."

"Now is the time to try to get in front of this outbreak since we have a reasonable history of smallpox vaccination and some data on monkeypox," he added.

But no one can perfectly predict the future of this outbreak.

"Only time will tell if this was the right decision or not," Barouch said.

Dr. Jade A Cobern, board-eligible in pediatrics, is a member of the ABC News Medical Unit and a general preventive medicine resident at Johns Hopkins.

ABC News' Cheyenne Haslett and Sony Salzman contributed to this report.

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Think you have monkeypox? It might be another skin condition

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(NEW YORK) -- With the number of cases of monkeypox rising across the world, and descriptions of rashes from the virus varying from person-to-person, people are concerned that any new bumps might be monkeypox.

But with more than 10,300 cases in the U.S. so far, dermatologists interviewed by ABC News caution that a mysterious rash could easily be something else -- though any new rash should be taken seriously.

"Common things are common. Many other common skin conditions in the community that are more likely to be on your skin other than monkeypox," said Dr. Mark Abdelmalek, associate professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania and founder of Dermatology of Philadelphia / Mohs Surgery Center.

There are many skin bumps which can be totally normal which can appear like monkeypox, including zits, acne, skin reactions to heavy metals, ingrown hairs or even eczema or psoriasis.

Viruses such as molloscum, commonly seen in children, and varicella virus, known as chickenpox in children and shingles in adults, "can look like monkeypox due to vesicles -- which are fluid filled bumps, and cause discomfort such as itching or pain," said Dr. Michelle Henry, dermatologist and founder of Skin & Aesthetic Surgery of Manhattan.

Other sexually transmitted infections including syphilis, herpes and genital warts can present with red or raised bumps on the body.

Bacterial infections such as impetigo, which occur on areas of previous injury such as eczema or open wounds, can cause redness, inflammation and raised bumps.

There are even genetic conditions "such as neurofibromatosis which can cause longstanding skin growths, which can look like monkeypox to an untrained eye," Henry said.

How does the monkeypox rash develop?

Experts said anyone with a new rash should try to track the timeline of how it develops, taking pictures if possible. A monkeypox rash "can appear anywhere and is usually associated with systemic symptoms and generally feeling unwell," Abdelmalek said. The "rash starts typically with a prodrome, but you can just have lesions presenting without the prodromal in up to half of cases having skin lesions as the first sign" he said.

Once the rash develops, "it has an evolution," said Henry. "It starts out flat, and then develops bumps which become fluid or pus filled, and then scabs over and you are infectious until the rash is healed."

What should I do if I think someone else has monkeypox?

Dermatologists are warning against monkeypox vigilantism after a woman with a skin condition called neurofibromatosis 1 was surreptitiously filmed on the New York City subway in a Tiktok video that later went viral.

Do "not assume that a rash you see in public is monkeypox, because it is probably not going to be monkeypox," Abdelmalek said.

If you suspect someone else may have monkeypox, "practice good hand hygiene and maintain safe distance from them," Henry said.

What should I do if I think I have monkeypox?

According to the Centers for Disease Control and Prevention, if someone is concerned they have monkeypox they should call their health care provider who can perform further testing by taking a sample of the lesion which can determine if the person is truly infected or if it is another mimicker of the illness.

"It is important to have lesions looked at before direct skin-to-skin contact, if you have lesions you are unsure about they should be covered up until further evaluation," Abdelmalek said.

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CDC sends team to New York to investigate polio case

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(NEW YORK) -- The Centers for Disease Control and Prevention has deployed a federal team to New York to investigate the case of polio detected in Rockland County.

The team will also help administer vaccinations in the county.

It's unclear how long the CDC will remain in the county or if the findings will be released to the public.

"CDC continues to collaborate with the New York State Department of Health to investigate a recent case of paralytic polio in an unvaccinated individual from Rockland County," the federal health agency said in a statement to ABC News. "These efforts include ongoing testing of wastewater samples to monitor for poliovirus and deploying a small team to New York to assist on the ground with the investigation and vaccination efforts."

On July 21, the New York State Health Department announced a patient in Rockland County had contracted a case of vaccine-derived polio, the first case in the United States in nearly a decade.

This means the unvaccinated patient was infected by someone who received the oral polio vaccine, which is no longer used in the U.S.

Unlike the polio vaccine given by injection, which uses an inactive virus, the oral vaccine uses a live weakened virus.

In rare cases, the virus can be spread when an unvaccinated person is exposed to contaminated fecal matter. This is different from wild polio, which infects people by circulating naturally in the environment.

Since then, it's been revealed the patient was a previously healthy 20-year-old man who had traveled to Europe. He was diagnosed after he went to the hospital when he developed paralysis in his legs.

Last week, the state health commissioner said "hundreds" of people in New York could be infected after the virus was found in wastewater samples in multiple counties.

As of Aug. 5, 11 samples were genetically linked to the Rockland County patient including six samples collected in June and July from Rockland County and five samples collected in July from nearby Orange County, health department data shows.

"Although no additional cases have been identified at this time, these results indicate there is more than one person shedding the virus in their stool in these communities," the CDC's statement read. "These individuals might have no symptoms or only mild symptoms, such as a sore throat and fever, but they can unknowingly still spread polio to those who are not protected by vaccination."

New York State Health Commissioner Dr. Mary Bassett called on anybody who hasn't received the polio vaccine to do so.

The statewide rate of polio vaccination is 78.96% while the Rockland County rate sits at 60.34%, state data shows. In Orange County, the rate is even lower at 58.66%.

"Based on earlier polio outbreaks, New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected," Bassett said in a statement Thursday. "Coupled with the latest wastewater findings, the Department is treating the single case of polio as just the tip of the iceberg of much greater potential spread."

The statement continued, "We must meet this moment by ensuring that adults, including pregnant people, and young children by 2 months of age are up to date with their immunization -- the safe protection against this debilitating virus that every New Yorker needs."

Health officials say most Americans are protected from polio infection because they were vaccinated against the disease during routine childhood immunizations.

Editor's Note: This story has been updated to clarify how polio can be transmitted.

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Monkeypox: What public health experts want you to know

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(NEW YORK) -- Since the first case of monkeypox was detected in the United States in mid-May, the outbreak has led to more than 10,300 reported cases across the country as of Wednesday.

The evolving situation moved the Department of Health and Human Services to declare a public health emergency last week.

Many questions have emerged over the last two-and-a-half months including how the disease spreads, how it's treated and which vaccines can prevent infection.

Experts spoke to ABC News about the primary methods of transmission, why most patients won't need treatment and what people can do to protect themselves.

How monkeypox spreads

In the current outbreak, monkeypox has been mostly spreading via skin-to-skin contact with a person with monkeypox or through contact with a patient's rash, lesions, scabs or body fluids.

Although monkeypox can spread during intimate sexual contact, as many cases have during this outbreak, there is no evidence it is a sexually transmitted disease.

It can also spread through prolonged contact with objects or fabrics -- including clothes, bed sheets and towels -- touched or used by someone with monkeypox, but this brings a lower risk.

Dr. Gabriela Andujar Vazquez, an infectious disease physician and associate hospital epidemiologist at Tufts Medical Center in Boston, told ABC News a person is much less likely to contract monkeypox by brushing past a positive patient or by using shared public spaces such as a swimming pool, gyms, restrooms or public transit compared with skin-to-skin contact.

"We don't think shared bathrooms, locker rooms, things that are shared publicly -- or even within households -- are a major mode of transmission," she said. "It's really direct contact with a person who is infectious."

This is different from a previous monkeypox outbreak in 2003, linked to contact with pet prairie dogs, which were infected after being kept near small mammals from Ghana.

Dr. Jessica Justman, an associate professor of medicine in epidemiology at Columbia Mailman School of Public Health, emphasized this could change.

"I think we all learned with COVID that things can change, particularly in public health when we are dealing with an outbreak and we just need to all be prepared for the information to change and the public health messaging to change as we gain more information," Justman told ABC News. "And COVID was a brand new virus. At least with monkeypox, it's not a brand-new virus."

She added, "But the current outbreak has a number of features to it that are different from prior outbreaks."

Signs and symptoms

The incubation period from the time a person is exposed to when symptoms first appear can range from three days to 17 days, according to the Centers for Disease Control and Prevention.

The most common symptom is a rash that can appear on the arms, legs, chest or face or on or near the genitals, the health agency said.

Lesions start out as dark spots on the skin before progressing to bumps that fill with fluid and/or pus.

Finally, the lesions will scab over and eventually fall off. People may be left with scars or skin discoloration, but health officials say a person is no longer infectious once the scabs are gone and a fresh layer of skin has formed.

Other symptoms include fever, headache, fatigue, chills, muscle aches, backache and swollen lymph nodes.

What treatments are available

Most monkeypox patients recover within two to four weeks without specific treatments and receive "supportive care" such as Tylenol for fever or topical pain relievers for rashes.

However, some patients at high risk of severe illness, such as those with weakened immune systems, may benefit from treatment.

"We have an antiviral medication we can offer to patients if they need a little more help handling the rash," Andujar Vasquez said. "But that would be for a subset of patients. Not every patient needs to be on antiviral medication."

Tecovirimat, known under the brand name TPOXX, is a two-week course of pills approved by the U.S. Food and Drug Administration to treat smallpox.

However, TPOXX was made available to treat monkeypox under "compassionate use" by the CDC after animal studies showed it can lower the risk of death.

Vaccines that can protect against infection

There are two vaccines that can be used to prevent monkeypox.

The only one currently being used is JYNNEOS, which is a two-dose vaccine approved by the FDA to prevent smallpox and monkeypox.

"We would give the vaccine ideally by four days from your exposure, but we think it may be still beneficial to do it if it's been 14 days after you were exposed," Andujar Vasquez said.

Data from Africa has shown two doses of JYNNEOS are at least 85% effective in preventing monkeypox infection.

The other vaccine, ACAM2000 -- which the U.S. has in a stockpile -- is not being used because it has been shown to cause side effects in people with certain conditions, such as those who are immunocompromised.

To increase the number of JYNNEOS doses available, health officials announced Tuesday they would be implementing a new strategy to inject the vaccine intradermally, just below the first layer of skin, rather than subcutaneously, or under all the layers of skin.

This will allow one vial of vaccine to be given out as five separate doses rather than a single dose.

Prevention methods

The experts say for most Americans, the risk for monkeypox is still low. However, they recommend proper hand hygiene and following CDC guidelines for practicing safer sex.

"It's worth it to pay attention to what's happening with monkeypox, but I would not worry about shaking hands with people [without monkeypox] or opening doors or touching surfaces," Justman said.

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Formerly conjoined twins celebrate 21st birthday and 20th anniversary of separation

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(LOS ANGELES) -- Josie Hull and Teresa Cajas are celebrating a huge milestone many didn’t think would happen.

The twins, born in July 2001, just turned 21. They’re not only marking their big birthday but also the 20th anniversary of their physical separation.

Hull and Cajas were just girls when they traveled from a small village in Guatemala to undergo a high-risk separation surgery at UCLA in 2002, a journey ABC station KABC-TV in Los Angeles followed over the years.

They were joined at the head, a rare condition that affects only about one in every two-and-a-half million babies.

Dr. Mark Urata, an oral and plastic surgeon at Children's Hospital Los Angeles, was on the team that operated on Hull and Cajas.

“Josie and Teresa shared a blood supply because they were connected at the brain. The brain tissue had to be separated,” he explained to ABC News.

Following their 23-hour surgery, Hull and Cajas had setbacks, including brain infections that left Cajas with permanent brain damage and Hull with seizures and other complications.

But the girls pressed on and even though they now live separately with different families, they are still close. Hull and Cajas reunited for important moments like their 10th birthday, quinceañera and, just recently, their 21st birthday.

“To watch them grow independently and to thrive has been probably one of the greatest joys of both my personal and professional life,” Urata said.

Today, Hull runs a nonprofit called Once Upon a Room, which she started with a friend when they were 12. The group decorates hospital rooms and encourages pediatric patients in 20 hospitals across the U.S.

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Harvard doctor on study claiming climate change intensifies pathogens

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(NEW YORK) — In a new study published in the journal Nature Climate Change, researchers found that climate change is expected to aggravate 58% of the world’s infectious diseases.

“The societal disruption caused by pathogenic diseases, as clearly revealed by the COVID-19 pandemic,” the authors wrote in the study published Monday, “provides worrisome glimpses into the potential consequences of looming health crises driven by climate change.”

Dr. Aaron Bernstein, director of the Climate MD program at the Center for Climate, Health, and the Global Environment at Harvard University’s Chan School of Public Health, sat down with ABC News’ “Start Here” podcast to discuss the study’s findings, as well as its far-reaching implications.

START HERE: Dr. Bernstein can you just explain to me what this study found? How does climate change relate to something like COVID or monkeypox?

BERNSTEIN: Great question, Brad, and thanks so much for having me. Climate change matters to pretty much every infection you can imagine that we already know about. But it's also true that it matters to things that we have never yet seen, like COVID-19 prior to 2019. And that's because we know that diseases that are surprises like COVID, or HIV when it first appeared, because usually a virus moves from an animal into a person.

Well, how does that happen? Well, people obviously have to bump into animals, but also animals bumping into other animals. And what climate change does is it makes everything that can head for the hills or the poles get out of the heat. It's like a big game of bumper cars. So there's animals that have never touched each other, running into each other, trying to get out of the heat.

So there's really two issues here. One is how the more intense heat events, the changes in how rain happens with climate change, affect diseases we know. And then there's how this bumper car problem might affect new things appearing in ways that we don't really want to see and have been seeing an unfair share of lately.

START HERE: I'm trying to get a sense of what pathogens this would affect. The study says it will aggravate, I think they said, 58 percent [of the world's infectious diseases]. Are you saying that more than half of the viruses on Earth are basically going to get worse because of this in the coming years?

BERNSTEIN: They looked at all pathogens, it wasn't just viruses. I mentioned viruses because they're the ones that tend to be the ugly surprises, like COVID-19 or HIV. But they looked at bacteria, they looked at fungi. And again, what they wanted to answer was does climate change look like it's going to be overall worse for the infections we know about or overall better?

There are certainly some diseases, and malaria is a good [example]. Malaria has been in west Africa forever. It's been there so long that the human genome has evolved to cope with the parasites, in the form of sickle cell disease. Many people will know about sickle cell disease, it's a disease where your red blood cells, [in] a reaction, look like a sickle.

Well, if you have two copies of that gene that are defective, you get sickle cell disease. But if you have one copy, you're actually protected from malaria. That's how much malaria has been in the population of West Africa, it's been there that long. That's actually selected for, that gene to protect people from malaria. But it's going to get so warm in west Africa in this century, we expect that malaria is actually going to decrease in incidence because it's too hot for the mosquitoes.

So there are some diseases like that where we think that climate change is probably going to make them, at least in local situations, less likely. But on balance, what they found is that the majority of things we know are likely to get worse because it's going to get wetter. Heavy downpours of rain are a major risk for outbreaks of waterborne diseases, particularly for people who get water from wells, which is almost all of the rural U.S.

In a lot of the rest of the world, heat in particular isn't just an issue for animals bumping into each other and viruses going over, it affects where things like mosquitoes and ticks that transmit disease live. So here in New England, we have the most prevalent insect-transmitted disease in the country, which is Lyme disease. We've definitely seen that disease able to live in places it couldn't [before] because it's warm enough for the tick to survive.

START HERE: And there's a shorter winter to kill the thing.

BERNSTEIN: Exactly.

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Hundreds of Americans still dying of COVID each day despite signs the latest surge may be slowing

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(NEW YORK) — After several weeks of steady increases in coronavirus infections and hospitalizations, there are encouraging signs that the latest viral resurgence may be abating in the United States.

The rate of new infections appears to be dropping, with the U.S. now reporting 107,000 new cases each day — an average that has fallen by 12% in the last week, according to data collected by the Centers for Disease Control and Prevention (CDC).

The number of virus-positive Americans currently receiving care in hospitals across the country has plateaued at around 43,000 patients, according to data from the U.S. Department of Health and Human Services. Throughout the summer, hospital admission rates had been rising in many areas of the country, particularly in the South.

Hospitalizations, however, remain significantly lower now than during every other COVID-19 surge. There were more than 160,000 patients hospitalized with the virus during the surge last winter.

On average, nearly 400 American deaths to COVID-19 are reported each day, a daily total that has not seen any significant declines since the spring.

Over the last seven days alone, the U.S. has reported just under 2,700 COVID-19 deaths.

The latest viral surge has been largely driven by highly infectious variants, which continue to infect and reinfect Americans. It has been more than eight months since the original omicron variant emerged, and although the original strain is no longer circulating in the U.S., its subvariants continue to spread.

BA.5, a subvariant of omicron, is currently estimated to account for more than 87% of new COVID-19 cases in the U.S.

Omicron and its subvariants have been better at chipping away at vaccine efficacy, which has caused health experts to reignite their call for Americans to get vaccinated and boosted.

Last week, Dr. Anthony Fauci, the government's top infectious disease expert, warned that Americans who are not up to date on their COVID-19 vaccinations may be in "trouble" this fall, with immunity waning over time.

Although the burden of hospitalization and death continues to affect primarily individuals who are still unvaccinated, as well as those at highest risk, such as the elderly or the immunocompromised, other people who "don't fall into those categories" may also find themselves at-risk for severe disease, Fauci said during an interview with KNXAM.

More than 70 million Americans remain unvaccinated. Less than half of eligible Americans have received their first booster and only about one-third of people 50 years and older, who are eligible for a second booster, have received their supplemental shot.

Fauci stressed that in order to "get your arms around" the pandemic, more people must be vaccinated, domestically and globally, "so you don't give this virus such ample opportunity to freely circulate, and when you do that, the virus has more of an opportunity to mutate, and when you give it an opportunity to mutate, that's when you get new variants."

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Monkeypox patient speaks out about what it's like to have the disease

Courtesy Jeffrey Todd

(NEW YORK) -- When the first lesion appeared on Jeffrey Todd's right cheek in mid-July, the 43-year-old didn't pay too much attention to it.

"I noticed I had like a pimple or like a blemish on my cheek and it had this very odd-looking raised white circle around the outside of the blemish and it felt indented a little bit like a crater," Todd, who lives in Hollywood, California, told ABC News.

Being aware of the monkeypox outbreak spreading across the U.S., Todd said he did a Google search of what monkeypox rashes look like and "one of the images looked exactly like my blemish."

He thought, however, the blemish would disappear by morning.

Over the next two days, Todd developed a series of bumps on the back of his right arm and back and a lesion appeared on his neck. He was itchy and had backaches, fatigue and shooting pain down his legs -- all telltale signs of monkeypox.

Being diagnosed

Todd was first tested on July 13 but it took a while to get his results. He didn't know at the time that the first clinic he visited sent the sample to a lab. The sample though was spoiled by the time it got there so it couldn't be tested, he said.

As his condition continued to worsen, he went to the emergency room at Cedars-Sinai Medical Center, where staff performed an in-house test. The next day, Todd got his test results back and found out he was positive for monkeypox.

He is one of the more than 8,900 Americans who have tested positive for the disease across 48 states, the District of Columbia and Puerto Rico as of Tuesday, according to the Centers for Disease Control and Prevention.

Last week, the U.S. Department of Health and Human Services declared the outbreak a public health emergency, 78 days after the first case was detected in the country in mid-May.

The outbreak has mostly affected men who identify as gay, bisexual or other men who have sex with men, although the CDC has warned it is not a sexually transmitted disease and anyone is at risk of infection.

Todd, who identifies as gay, said he was contacted by the Los Angeles County Department of Public Health. The nurse assigned to his case believes he contracted monkeypox at an event during Pride weekend in Los Angeles in late June.

"I was at a dance party," he said. "It was enclosed. It was hot, sweaty. I was shirtless. It was really jam-packed -- a lot of physical touching and close proximity to people. So that seems very much like where it probably happened."

The CDC has said most cases in this outbreak have occurred from skin-to-skin contact or direct contact with a patient's rash, lesions or body fluids.

The disease can also spread from prolonged contact of objects or fabrics used by a monkeypox patient, but it is a lower risk form of transmission, according to the CDC.

'Traumatizing' lesions

There are no treatments specifically for monkeypox. The disease is a cousin of smallpox, so antiviral drugs developed to treat smallpox may be used.

Tecovirimat, known as TPOXX, which is a two-week course of pills, can be considered for people at high risk of severe illness, such as those with weakened immune systems.

Todd said he heard about this treatment from friends of his in New York but it was difficult for him to access it.

After being tested for monkeypox the first time, he asked his physician if he could get on the antiviral medication. He said his physician referred him to an infectious disease specialist.

"He called me immediately and was like, 'You know, I will try to get you on this medication but it's a lot of red tape. Only the county is able to prescribe it but I'll do the paperwork and get this going for you,'" Todd said.

After the county received his positive test from Cedars Sinai, Todd said he was approved for TPOXX two weeks after his symptoms first began.

Although his condition has improved since starting treatment, Todd said his lesions have caused him some pain. In late July, the lesion on his face scabbed over and fell off, leaving behind a small hole.

"My doctor said that the lesion was killing the tissue inside of my face," he said. "It literally was so traumatizing to me."

He continued, "I was expecting that to happen ... I was excited that the scab was falling off and then part of my face was coming out."

Todd said his doctor told him that hole will eventually heal but he will be left with a scar.

Raising awareness about monkeypox

Todd has made several videos showing the progress of his condition, including the "gruesome" nature of his lesions, which he has shared to social media platforms such as Instagram and TikTok.

While he says some of the messages have not been kind, he said the overwhelming majority have been positive. He's also encouraged some of his friends to get vaccinated.

Vaccines are recommended for those who have been exposed to monkeypox and for those who may be more likely to get it.

Data from Africa has shown two doses of vaccination with the smallpox vaccine, JYNNEOS, is at least 85% effective in preventing monkeypox infection.

Todd, who is officially ending his 28-day quarantine on Tuesday, said he wants to raise awareness of what it can be like to have a case of monkeypox.

"Please know that this can happen and I think that's the dialogue that needs to be out there," he said. "When I see people don't take it seriously, they think, 'Oh, it's like Chickenpox.' But no, it's horrible and now I have a hole in my face."

He went on, "I don't want anyone else to go through what I've been going through."

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Bug bites begone! Experts break down how to treat itchy skin and stings this summer

Joao Paulo Burini/Getty Images

(NEW YORK) -- It's time to say "bye-bye" to bug bites.

As summer is still in full effect, so are lots of bugs that are ready to bite or sting exposed skin. Whether you are headed on a nature walk or out for a pool dip, everything from mosquitos and ticks to bees and other insects are ready to pounce.

But there are ways to prevent and treat your skin against some of those pesky stings, itches, bumps or marks left behind.

ABC News' Good Morning America consulted with board-certified medical and cosmetic dermatologist Dr. DiAnne Davis, as well as board-certified pediatrician and expert on Bug Bite Thing's medical advisory board Dr. Mona Amin to find out how to prevent and treat bug bites this season.

Are there any key indicators that would let someone know that they have a bug bite versus other skin irritations? How are you able to tell the difference?

Amin: With bug bites, you will usually see a lump or bump of redness and surrounding irritation -- this is generally where the insect bit you and a telltale sign. Some people report seeing or feeling an insect bite them and then noticing the rash develop. Others have seen the rash begin as a hive, where the skin surrounding the bite looks red and puffy -- our bodies create a histamine response to the irritant, which is the saliva of the insect.

What's the first thing you should do when you have identified that you have a bug bite?

Davis: I know this is easier said than done, but the first thing you should try to do is not scratch the bug bite. For bites that itch, apply an ice pack or an over-the-counter anti-itch cream, such as hydrocortisone. Another option is to take an over-the-counter oral antihistamine.

To reduce swelling, apply an ice pack to the bite. If it's a painful bite, take an over-the-counter painkiller, such as acetaminophen or ibuprofen.

What's a top product you recommend when treating a bug bite and why?

Amin: I recommend using Bug Bite Thing immediately after you notice the bite as it will reduce the itching, stinging and swelling within seconds. The product only uses suction and is chemical-free, making it a safe option for people of all ages, including infants and toddlers.

How do you go about getting rid of the sting, itch or pain associated with any bug bites or stings?

Davis: Topical steroids, which also encompass over-the-counter anti-itch creams, can really help to ease the inflammation that occurs with bug bites and reduces the itching.

What are some best practices to help ease inflammation caused by bug bites?

Amin: The best thing is to minimize scratching as soon as you see the bite. When we scratch our skin, this leads to more inflammation. More inflammation leads to more scratching. It's what we call the "itch-scratch" cycle. Using a cool compress can also help ease inflammation after a bite.

Are most bug bites treatable at home? When is it necessary to seek professional help?

Davis: If you experience any serious symptoms after a bug bite, such as a rash, fever, body aches, difficulty breathing, chest pain, swollen lips, tongue, and/or face, dizziness, vomiting, or a headache, contact your doctor or a board-certified dermatologist immediately. Make sure you tell the doctor about your recent bite so that they can examine you for a transmitted disease.

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Vaccine for Lyme disease enters final stage of clinical trial

rbkomar/Getty Images

(NEW YORK) -- Researchers are one step closer to developing a vaccine for Lyme disease, which affects nearly half a million people each year in the United States, according to the U.S. Centers for Disease Control and Prevention.

Pfizer, the maker of a COVID-19 vaccine, announced Monday it is starting a phase 3 clinical trial on its Lyme disease vaccine, known as VLA15.

The study will include over 6,000 participants from 50 locations around the world, including the U.S. Children ages 5 and older will also be included in the study, according to Pfizer.

“With increasing global rates of Lyme disease, providing a new option for people to help protect themselves from the disease is more important than ever,” Annaliesa Anderson, Ph.D., senior vice president and head of vaccine research and development at Pfizer, said in a press release announcing the study. “We hope that the data generated from the Phase 3 study will further support the positive evidence for VLA15 to date, and we are looking forward to collaborating with the research sites across the U.S. and Europe on this important trial."

Lyme disease, the most common vector-borne disease in the U.S., is a tick-borne infectious disease that, if left untreated, can affect the joints, heart and nervous system, according to the CDC.

There has not been a vaccine for the disease for the past 20 years. The most recent vaccine for the disease, LYMErix, was discontinued in the U.S. in 2002.

"This one is protein-based vaccine technology," ABC News chief medical correspondent Dr. Jennifer Ashton said of the new Pfizer vaccine. "It’s important to prevent not only short-term signs and symptoms of Lyme disease but long term, so we’re talking about things like short-term fever, headache, fatigue, rash, and then if untreated, it can spread to the joints, heart and central nervous system."

The vaccine is administered through three shots given over a period of several months, followed by a booster dose 12 months later, according to Pfizer, who is developing the vaccine with Valneva, a French biotech firm.

If the trial moves forward as planned, Pfizer said it expects to submit an authorization request to the U.S. Food and Drug Administration in 2025.

Lyme disease, mainly caused by the bacterium Borrelia burgdorferi, is transmitted to humans via tick bites. In most cases, the tick must be attached to the skin for at least 36 hours before the bacterium can be transmitted.

Symptoms generally appear after one week, with approximately 70% to 80% of people experiencing a classic “bull's eye” rash which expands in size at the site of the bite.

Symptoms in the acute phase include fever, headache and fatigue. If left untreated, the infection can spread to joints, the heart and the nervous system. People also may experience lingering symptoms that last months or even years, such as muscle and joint pain, cognitive defects and sleep disturbances, according to the CDC.

Once confirmed with laboratory testing, most cases can be treated for a few weeks with antibiotics. According to the Mayo Clinic, Lyme disease should be treated immediately and may require intravenous antibiotics if the case is severe.

Lyme disease is most commonly found in the Northeast and upper Midwest, with 96% of all cases in 14 states -- Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin, according to the CDC.

The CDC recommends preventive measures to avoid ticks including avoiding "wooded and brushy areas with high grass and leaf litter" and walking in the center of trails.

When hiking or in wooded areas, you can also treat your clothes and gear with products containing 0.5% permethrin, according to the CDC. They also recommend always doing a "tick check" after being outside and wearing insect repellent with Deet.

Ticks can also come into the home through clothing and pets, so the CDC recommends checking pets for ticks and tumble drying clothes on high heat for 10 minutes after coming indoors to kill ticks.

If you are ever in a situation where you are bitten by a tick, the Cleveland Clinic recommends tugging gently but firmly near the head of the tick until it releases its hold on the skin.

People who are outdoors in areas that may have ticks should also conduct a full body check when they return, including checking under the arms, in and around the ears, inside the belly button, behind the knees, in and around the hair, between the legs and around the waist, the CDC recommends.

Copyright © 2022, ABC Audio. All rights reserved.


From patient to doctor: One woman's resilient fight after six brain surgeries, stroke

ABC News

(NEW YORK) -- A Texas doctor who survived six brain surgeries and a stroke is now treating people at the same hospital where she used to be a patient, bringing a unique perspective to her practice as a physical medicine and rehabilitation (PM&R) physician.

"You learn so many things in medical school but one of the things you don't learn is how to be a patient," Dr. Claudia Martinez told ABC News' Good Morning America. "What they're feeling, what they're thinking, what their families are thinking -- and we went through that for so many years, me and my mom, just navigating the medical system from the other side and seeing all the barriers we had to go over."

"I'm very thankful for that experience and getting to now share what I know with patients and better help them," she added.

Martinez, 31, is a third-year resident physician at TIRR Memorial Hermann hospital, a teaching hospital for Baylor College of Medicine and University of Texas Health Science Center at Houston. But just a few years ago, she was unable to walk or do many everyday tasks by herself. It was at TIRR where Martinez rebuilt her life and where her doctor, Dr. Lisa Wenzel, both treated her and supported her dream of pursuing medicine.

"[Wenzel] was in charge of my entire rehab stay. She's a spinal cord injury specialist. She's been my mentor along the way and my advocate, the one who has helped me get my accommodations for medical school and now residency, and just really given me that hope that I could still be a physician even though she saw me at my lowest point," Martinez said.

Martinez was diagnosed in 2011 with Chiari malformation, an abnormality where portions of the brain "[extend] through the natural opening at the base of the skull," creating pressure on the brain, according to the National Institute of Neurological Disorders and Stroke.

Often, surgery is the only option for patients.

"So my first brain surgery was for Chiari malformation and many of the subsequent [surgeries]," Martinez said of her experience. "The last two were for a complication that developed from my previous surgeries where my brain stem got tethered to the dura -- it's a pretty rare occurrence but it was causing a lot of issues in regards to my brainstem, and so the surgeon had to go in there and kind of de-tether that area."

Overall, Martinez had six brain surgeries in the span of five years with her first surgery in 2012 and her last on Feb. 6, 2017.

"The recoveries from each brain surgery got harder each time," Martinez recalled. "After my first one, it was pretty OK, but then after that second one, the third, the fourth and fifth, every time it was just more and more difficult to bounce back."

It was during her sixth brain surgery when Martinez said she suffered a stroke.

"It was a very risky surgery. Going in, the neurosurgeon told us there were many complications that could happen, [saying], 'Expect these things to happen because of the area that we're going to manipulate; your brain stem controls your breathing, your heart rate, a lot of your autonomic functions,'" Martinez recalled. "...I ended up with a stroke that left me unable to function from the neck down. And of all the things that really could have happened, it was a success in our eyes, but it definitely changed my life for sure."

After her stroke, Martinez said she couldn't walk and was "unable to function from the neck down." She was transferred to TIRR Memorial Hermann where she underwent intensive physical, speech, and occupational therapies for a year.

"There was a point when I was at TIRR that I was like, 'I didn't think that I would make it here.' But I was very persistent, and I wanted to prove not to other people, but just to myself that I could do this. I worked harder than my classmates because I never wanted my disability or my medical illness to define me or have other people let me kind of slide by with doing less, just because I had a disability or was in the hospital so long," Martinez said.

Despite her difficulties and the long odds, Martinez didn't give up. With the support of her family and medical team, she took a year off from medical school to focus on recovery. She then returned to finish her degree program and was matched with TIRR in the spring of 2020 for her residency. Martinez graduated from UTHealth Houston McGovern Medical School that May.

Martinez said her health experiences resulted in at least two unexpected outcomes. The first was the need to shift her initial goal of becoming a surgeon to specializing in PM&R.

"Of all the function I've regained, [the function in my] hands is the one that has been the biggest limiting factor, so I kind of see it as a blessing in disguise," Martinez said. "From there, I got redirected and had to look elsewhere. And when I got to TIRR and saw what they do and how they help after these big life-changing events, I just knew I was meant to be here all along."

The second unexpected outcome from her medical hurdles was meeting her husband Andrew, after local news outlets in Texas, including ABC affiliate KTRK-TV in Houston, shared her journey. The two bonded over their shared experiences undergoing brain surgeries; Andrew had undergone treatment for glioblastoma, a rare type of tumor that can affect the brain or spinal cord.

Today, Martinez wants others to know that "disabilities don't define the capability of a person."

"Never underestimate someone with a disability," she said. "There's so much that they can do and they have so much worth to bring to the world. Sometimes we just need to have a little compassion and patience and now that I'm here being a physician, there [are] so many things that I do differently than my colleagues just because I have a disability, but that doesn't mean that I can't do the things they do."

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