A PERSON in the UK was diagnosed with a never before seen strain of swine flu, dubbed H1N2.

It's the first human case of the virus found in the UK, the UK Health Security Agency (UKHSA) said.

The UKHSA has said H1N2 causes mild illness and respiratory symptoms


The UKHSA has said H1N2 causes mild illness and respiratory symptomsCredit: Getty

The Brit only suffered mild symptoms and has since recovered from the illness, while all their contacts are now being traced by the health watchdog.

The UKHSA has said it's now working to "assess the risk to human health" and "reduce potential spread".

From how it spreads, to the symptoms it causes and whether we could see more cases of it - here's everything you need to know about the new swine flu strain H1N2.

What is the virus?

The virus is called influenza A(H1N2)v.

According to the UKHSA, it's similar to flu viruses currently circulating in pigs in the UK.

But this is the first time this flu strain has been spotted in a human in the UK.

How was the case spotted?

The case was picked up during routine national flu surveillance carried out by the UKHSA and the Royal College of General Practitioners (RCGP), after a person based in North Yorkshire visited their GP with breathing problems.

The influenza A(H1N2)v virus was detected using a PCR test and genome sequencing - a laboratory procedure that identifies the unique DNA fingerprint of organisms.

Because it was spotted during routine flu surveillance, it's unlikely that this is the only case in the UK.

How did the patient get the virus?

It's not clear how the individual - who experienced a mild illness and has now fully recovered - got the virus in the first place.

They aren't thought to have had close contact with pigs.

As the UKHSA put it: "The source of their infection has not yet been ascertained and remains under investigation."

Is this the first time this strain has been seen?

H1N1, H1N2 and H3N2 are major subtypes of swine flu A viruses in pigs and occasionally infect humans.

This is the first time H1N2 has been reported in a human in the UK, but it has been seen in other parts of the world.

A total of 50 human cases of H1N2 have been reported globally since 2005.

However, none of these 50 cases are genetically related to the strain seen in the UK.

Paul Hunter, Professor in Medicine at the University of East Anglia, said H1N2 "has been reported sporadically over recent decades from several different countries but has yet to cause a major outbreak in humans.

“In 2022, seven cases of human infection with influenza A(H1N2) were reported globally, with one case in Europe, in the Netherlands.

While one of these seven cases was hospitalised, Professor Hunter said the others only experienced mild illness and respiratory symptoms.

How does swine flu spread?

Swine can be passed from diseased pigs to humans.

Professor Dan Horton, Professor of Veterinary Virology and Associate Dean of Research and Innovation at the University of Surrey, said "the detection of a virus normally found in pigs in a human is not a complete surprise", as "we already know that some viruses that infect pigs can also infect humans, and vice-versa". 

According to Professor Hunter: “Some, but not all, cases of influenza H1N2 had a history of contact with pigs."

But he added that "person to person transmission does not appear to be very efficient and sustained person to person transmission has not been reported so far".

Chief Veterinary Officer, Christine Middlemiss, said: "We know that some diseases of animals can be transferred to humans – which is why high standards of animal health, welfare and biosecurity are so important."

What measures have been put in place?

Meera Chand, Incident Director at UKHSA, said the agency is "working rapidly to trace close contacts and reduce any potential spread".

She added: "In accordance with established protocols, investigations are underway to learn how the individual acquired the infection and to assess whether there are any further associated cases."

Christine said "specialist veterinary and scientific knowledge" was being provided to support the UKHSA investigation.

"Pig keepers must also report any suspicion of swine flu in their herds to their local vet immediately," she went on.

Professor Horton said: “The next stage is the most important, to determine whether the patient did acquire the infection from pigs, and whether it has spread to other people.

"There is no evidence of human to human spread currently."

Will there be more cases?

Professor Ian Jones, Professor of Virology at the University of Reading, said that not every new strain detected will be a "threat".

"It's very unlikely the single case of H1N2 swine flu represents anything more than has been seen in the past," he explained.

"We should remember that surveillance programmes can discover infections that might never have been noticed based on case numbers or severity, so a level of reasoned tolerance has to be applied. 

"Not every new agent is a threat.”

What does is have to do with the 2009 swine flu pandemic?

In 2009, there was a pandemic in humans caused by the virus strain H1N1, commonly referred to as ‘swine flu’.

"That virus contained genetic material from viruses that were circulating in pigs, birds and humans in the 1990s and 2000s," according to the UKHSA.

This strain is different from the viruses currently circulating in pigs, the agency added.

The H1N1 strain was first detected in April of that year in North America but quickly spread across the US and worldwide.

By the time the WHO declared it a pandemic in June 2009, it had spread to 74 countries and territories.

It killed 457 people in the UK. But the UKHSA said it now circulates in circulates in humans seasonally, is included in the flu jab, and is not referred to as 'swine flu'.

The WHO declared the pandemic was over in August 2010.

What symptoms does H1N2 cause?

So far, it seems the H1N2 strain causes mild illness and respiratory symptoms.

The UKHSA outlined symptoms caused by common respiratory infections. They include:

  1. a continuous cough
  2. a high temperature, fever or chills
  3. a loss of, or change in, your normal sense of taste or smell
  4. shortness of breath
  5. unexplained tiredness, lack of energy
  6. muscle aches or pains that are not due to exercise
  7. not wanting to eat or not feeling hungry
  8. a headache that is unusual or longer lasting than usual
  9. a sore throat, stuffy or runny nose
  10. diarrhoea, feeling sick or being sick

Meanwhile, the Great Ormond Street Hospital for Children said swine flu causes the following symptoms:

  • a cough
  • sore throat
  • aching body
  • headache
  • feel chilly
  • feel very tired

It added that children with the flu might also get diarrhoea and vomiting.

What should I do if I have symptoms?

Guidance for people with respiratory infection symptoms currently states that they should get plenty of rest and and drink water to keep hydrated.

Painkillers such as paracetamol can also help ease your symptoms.

But antibiotics won't do anything to relieve symptoms from viral respiratory infections or speed up your recovery.

You won't be able to tell if you have swine flu unless you have a PCR test.

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ROME – Just hours after a Vatican news conference confirming Pope Francis’s trip to Dubai this weekend for a United Nations climate summit, the Vatican announced Tuesday that it has been cancelled upon medical advice due to an ongoing infection causing lung inflammation.

A Vatican spokesman announced, however, that Pope Francis will lead his Wednesday General Audience, though it wasn’t immediately clear whether he would do so from St. Peter’s Square as usual or via livestream from indoors as he conducted last Sunday’s Angelus address.

In a Nov. 28 statement, Vatican spokesman Matteo Bruni said that “even though the general clinical framework of the Holy Father in relation to the state of influenza and inflammation of the respiratory tract has improved, doctors have asked the Pope not to make the trip planned for the coming days to Dubai.”

Bruni, who hours earlier had briefed reporters on the papal trip and confirmed the pope’s plans to travel to Dubai, said Pope Francis accepted the doctor’s advice “with great regret, and the trip is therefore cancelled.”

“As the pope and the Holy See remain willing to be part of the discussions taking place in the coming days, the ways in which this can be implemented will be defined as soon as possible,” Bruni said, without offering further specifics.

Concern over the pontiff’s health arose Saturday when the Vatican issued a brief statement saying Francis had cancelled all of the day’s audiences due to a “mild flu.”

A second statement published later Saturday said Francis had gone to Rome’s Gemelli Hospital for a CAT-scan to rule out “pulmonary complications,” and that the scan “was negative.”

In a statement Monday, Bruni confirmed that the pope’s CT scan Saturday “ruled out pneumonia but showed pulmonary inflammation that caused some breathing difficulties.”

“For a greater effectiveness of the therapy, a cannula needle was positioned for an infusion of intravenous antibiotic therapy,” he said, saying the pope’s conditions are currently “good and stable, he does not have a fever, and his respiratory situation is clearly improving.”

In order to help facilitate the pope’s recovery, Bruni said some “important commitments” in coming days have been postponed so that Francis “can dedicate the desired time and energy to them.”

Other commitments “of an institutional character or which are easier to support given his current health conditions,” are still on the schedule, however, it remains unclear whether Pope Francis will preside over his Wednesday general audience this week as expected.

Concern over any form of respiratory disease for Pope Francis, who is missing part of one lung, spiked earlier this year when he was hospitalized with bronchitis, saying afterwards that it had been a close call.

In late March he was rushed to the Gemelli Hospital following his weekly general audience when he experienced breathing difficulties. He was diagnosed with bronchitis and was administered intravenous antibiotics before being released three days later.

Respiratory diseases are particularly alarming for Francis, as he had part of one lung removed as a young Jesuit due to a serious bout of pneumonia.

Following April’s hospital stay, the pope was admitted to the Gemelli Hospital again in June for surgery on an abdominal hernia and he continues to suffer from other milder maladies, such as ongoing sciatica and knee troubles.

This is not the first time Pope Francis has cancelled a scheduled trip. He postponed a July 2022 trip to the Democratic Republic of Congo and South Sudan, which was later rescheduled for January of this year.

Follow Elise Ann Allen on X: @eliseannallen

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By Philip Pullella

VATICAN CITY (Reuters) - Pope Francis has cancelled his planned trip to the COP28 climate meeting in Dubai because of the effects of influenza and lung inflammation, the Vatican said on Tuesday, adding to concerns about his health.

The pope, who is 86, was due to begin a three-day visit to Dubai on Friday and the Vatican had said earlier on Tuesday that he was going ahead with the trip.

"Although the Holy Father's general clinical condition has improved with regard to the flu and inflammation of the respiratory tract, doctors have asked the pope not to make the trip planned for the coming days to Dubai," the Vatican said.

The pope had agreed not to travel "with great regret," it added, saying that it would look into ways that the leader of the world's Roman Catholics could contribute to the discussions remotely.

In a briefing earlier on Tuesday, Vatican spokesperson Matteo Bruni had said Francis would deliver one of the keynote speeches in Dubai on Saturday and have bilateral meetings the same day with about 30 people, including about 20 heads of state.

The pope had also met with Spanish bishops visiting the Vatican on Tuesday.


The pope has made protection of the environment one of the cornerstones of his pontificate.

In a document issued in October, Francis had appealed to climate change deniers and foot-dragging politicians to have a change of heart, saying they cannot gloss over its human causes or deride scientific facts while the planet "may be nearing the breaking point".

Francis also said the transition to clean, renewable energy and the abandonment of fossil fuels was not going fast enough.

The Vatican had announced on Monday the pope would limit his activities this week in order to conserve his strength after contracting the flu.

A CT scan done at a Rome hospital on Saturday excluded pneumonia but detected inflammation in the pope's lungs that caused breathing difficulties. He was receiving antibiotics intravenously, the Vatican said on Monday.

As a young man in his native Argentina, Francis had part of a lung removed.

(Reporting by Philip Pullella and Alvise Armellini; additional reporting by Gavin Jones and Keith Weir; Editing by Bernadette Baum, Chris Reese and Lisa Shumaker)

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November 28, 2023, New Delhi: Both short and long-term exposure to air pollution can lead to a wide range of diseases, including stroke, chronic obstructive pulmonary disease, trachea, bronchus and lung cancers, aggravated asthma and lower respiratory infections. According to a World Bank report “Catalysing Clean Air in India” released in August 2021, the air pollution levels in India are among the highest in the world, posing a heavy threat to the country's health and economy. All of India’s 1.4 billion people are exposed to unhealthy levels of ambient PM 2.5 – the most harmful pollutant - emanating from multiple sources. These small particulates with a diameter of less than 2.5 microns, is about one-thirtieth the width of a human hair. Exposure to PM 2.5 can cause such deadly illnesses as lung cancer, stroke, and heart disease. Ambient and indoor air pollution is estimated to have caused 1.7 million premature deaths in India in 2019.

Latest estimates by the European Environment Agency (EEA) show that fine particulate matter (PM2.5) continues to cause the most substantial health impact. In a report released in October 2023, EEA states that air pollution is the single largest environmental health risk in Europe and a major cause of premature death and disease. Children and adolescents are particularly vulnerable because their bodies, organs and immune systems are still developing. Air pollution damages health during childhood and increases the risk of diseases later in life, yet children can do little to protect themselves or influence air quality policies.

In India, Delhi and NCR cities continue to suffer from the highest levels of air pollution during the months of October and November. The AQI levels rose to 450 in late October and touched 1000 day after Diwali and have continued to be in the 300-600 range last week. With thousand plus posts and comments received from residents of Delhi and NCR on the subject of toxic air in the last 30 days especially around the health impact felt, LocalCircles through a new survey has strived to find out how residents of Delhi NCR are coping and what are the various health issue they are experiencing. The survey received over 9,000 responses from residents of Delhi, Noida, Ghaziabad, Gurugram & Faridabad. 67% respondents were men while 33% respondents were women.

100% of Delhi NCR families surveyed indicated that they have had one or more members suffer due to air pollution

The air quality was expected to improve post Diwali but in several parts of Delhi NCR it is still in the AQI 300-600 range, including in several upmarket areas where vehicular traffic is heavy. The survey asked “Have you or members of your family in Delhi-NCR experienced/ are experiencing any ailment over the last 30 days due to air pollution?” Alarmingly, 100% of the 9740 Delhi NCR families who responded to the query indicated that they have had one or more members suffer due to pollution.

100% of Delhi NCR families surveyed indicated that they have had one or more members suffer due to air pollution

89% of Delhi NCR families surveyed either had or have someone suffering from sore throat and cough; 78% have someone who has suffered or is suffering from breathing difficulties

The survey next asked “What are all the ailments you or members of your family in Delhi NCR have experienced / are experiencing over the last 30 days due to air pollution?” Some among the 9,740 families surveyed indicated more than one ailment with 89% stating “sore throat and/ or cough”; 78% indicating “breathing difficulty/ asthma”; 67% indicated “runny nose and/or congestion”; 67% indicated “burning eyes”; 56% of respondents indicated “anxiety and/ or difficulty in concentrating”; 44% indicated “headache”; and 22% admitted to “difficulty in sleeping”. To sum up, 89% of Delhi NCR families surveyed either had or have someone suffering from sore throat and cough; 78% have someone who has suffered or is suffering from breathing difficulties.

89% of Delhi NCR families surveyed either had or have someone suffering from sore throat and cough; 78% have someone who has suffered or is suffering from breathing difficulties

Comparison of new survey results that concluded on November 23rd with that on October 31st shows that in 3 weeks, the percentage of Delhi NCR families with one or more individuals suffering from sore throat and/or cough has risen from 75% to 89% due to continuing high air pollution.

In 3 weeks percentage of Delhi NCR families with one or more individuals suffering from sore throat and/or cough has risen from 75% to 89%

Similarly, in the case of Delhi NCR families with one or more individuals suffering from congestion and/ or runny nose the percentage has risen from 38% to 67% in just three weeks.

In 3 weeks percentage of Delhi NCR families with one or more individuals suffering from congestion and/ or runny nose has risen from 38% to 67%

In the case of Delhi NCR families with one or more individuals suffering from breathing difficulty and/ or asthma, the percentage has more than doubled from 38% to 78% in three weeks, indicating that breathing problems are set to increase unless the air quality improves.

In 3 weeks percentage of Delhi NCR families with one or more individuals suffering from breathing difficulty and/ or asthma has risen from 38% to 78%

In summary, 100% of the families surveyed in Delhi NCR have indicated that one or more individuals in their household was either unwell earlier or is now due to the impact of air pollution, which remains at severe levels. The latest survey shows that 89% of the families surveyed have stated that one or more individuals in their family are unwell with “sore throat and/ or cough”; 78% indicated “breathing difficulty/ asthma”; 67% indicated “runny nose and/or congestion”; 67% indicated “burning eyes”; 56% of respondents indicated “anxiety and/ or difficulty in concentrating”; 44% indicated “headache”; and 22% admitted to “difficulty in sleeping”. In fact, the percentage of those unwell has risen sharply whether breathing difficulty/ asthma, or sore throat/ cough, or runny nose/ congestion. If the air pollution levels don’t come down sharply more people in these families are likely to fall sick and those suffering through the last 3 weeks may further experience deterioration in their health conditions. While people continue to experience short, medium and long term impact on their health due to toxic air, stubble burning in neighbouring states continues and so does manual road cleaning and garbage burning in Delhi and NCR cities with many wondering if those in administration are still on the job and addressing root causes.

Survey Demographics

The survey received over 9,000 responses from residents of Delhi, Noida, Ghaziabad, Gurugram & Faridabad. 67% respondents were men while 33% respondents were women. The survey was conducted via LocalCircles platform and all participants were validated citizens who had to be registered with LocalCircles to participate in this survey.

About LocalCircles

LocalCircles, India’s leading Community Social Media platform enables citizens and small businesses to escalate issues for policy and enforcement interventions and enables Government to make policies that are citizen and small business centric. LocalCircles is also India’s # 1 pollster on issues of governance, public and consumer interest. More about LocalCircles can be found on www.localcircles.com

All content in this report is a copyright of LocalCircles. Any reproduction or redistribution of the graphics or the data therein requires the LocalCircles logo to be carried along with it. In case any violation is observed LocalCircles reserves the right to take legal action.

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New cases don't respond to standard treatments and some can progress to pneumonia.


Veterinarians, including those in Florida, are reporting an increased number of dogs suffering from a potentially deadly and contagious respiratory illness.

The infections are not responding to commonly prescribed antibiotics, according to the University of Florida's College of Veterinary Medicine.

What isn't clear so far is whether the disease is caused by something new or from Canine Infectious Respiratory Disease Complex, known commonly as “kennel cough.” 

The mysterious illness began in Oregon during the summer and now has been reported in 14 states, according to the American Veterinary Medical Association.

What states have seen cases of the mysterious respiratory dog disease?

As of Monday, the illness had been reported in the following states:

  • California
  • Colorado
  • Florida
  • Georgia
  • Idaho
  • Illinois
  • Indiana
  • Maryland
  • Massachusetts
  • New Hampshire
  • Oregon
  • Rhode Island
  • Vermont
  • Washington

No central reporting system exists to confirm spike in respiratory cases

"The lack of a centralized reporting system means it’s not even possible to confirm that there is a spike in CIRDC — Canine Infectious Respiratory Disease Complex — incidence or severity," UF reported.

"The intense media coverage of a 'mystery disease' may be raising awareness and discussion about CIRDC cases that would otherwise be managed as usual. It’s also possible that localized clusters are occurring due to one or more known pathogens due to some predisposing factor, such as an asymptomatically infected dog visiting a dog park, day care, dog show, or boarding kennel, etc."

Kennel cough in dogs is a highly contagious respiratory disease in dogs, according to the American Kennel Club.

Is this a new pathogen that's affecting dogs?

Researchers are looking into the possibility of emerging or increasingly virulent pathogens, UF said.

Many of the cases suspected to have “atypical CIRDC” have not been confirmed with diagnostic testing.

While some dogs were tested, that was done weeks later, which is "too late to detect some of the most likely culprits, such as influenza virus, pneumovirus, and respiratory coronavirus."

Adding to the difficulties in detecting the culprit, many tests were done at a large diagnostic lab that does not include pneumovirus, UF said.

Dogs 101: How much food should I feed my dog? Here's what to know from puppy to adulthood.

Symptoms of mystery respiratory dog disease:

According to the University of Florida's College of Veterinary Medicine, symptoms of the mystery respiratory illness in dogs include:

  • Acute cough, sneezing, nasal discharge, eye discharge, fever, anorexia, lethargy.
  • Severe cases can progress to life-threatening pneumonia requiring oxygen and ventilator support.
  • Cough may persist for weeks to months.

The American Association of Veterinary Medicine added these symptoms:

  • Chronic mild to moderate inflammation of the trachea lasting six to eight weeks or longer, which is minimally or not responsive to antibiotics.
  • Chronic pneumonia that is minimally or not responsive to antibiotics.
  • Acute pneumonia that rapidly becomes severe and often leads to poor outcomes in as little as 24 to 36 hours
  • Difficulty or rapid breathing, wheezing, dehydration, fever, nasal or eye discharge, weight loss, loss of appetite and lethargy.

Understanding your dog: Why does my dog tilt its head? Trying to understand your pet's nonverbal communication.

The disease is highly contagious and spreads rapidly among dogs in contact with other dogs.

  • Dogs that visit with other dogs, such as boarding, day care, dog shows, dog parks
  • So far, animal shelters seem to be less frequently affected by unknown pathogens, although historic levels of crowding present risks for outbreaks
  • People and other species have not been reported to be at risk

Treatments of mysterious dog illness

Unlike more common infections associated with kennel cough, new cases do not respond to "standard medical therapy and can have a prolonged illness that can progress to pneumonia," according to the University of Illinois School of Veterinary Medicine.

Currently the treatment that dogs receive is symptomatic and supportiveDr. Marta Vidal-Abarca, with Petkeen.com told USA TODAY.

"This means that, since the agent causing the infection has not been identified, the treatment is not aimed at killing any pathogen in particular," Vidal-Abarca said.

"Instead, the treatment is aimed at mitigating clinical signs and facilitating the dog’s recovery."

Dog illness spreading across US: Mysterious and fatal dog respiratory illness now reported in 14 states

Treatment, Vidal-Abarca said, includes:

  • Oxygen therapy.
  • Use of a nebulizer to get medicine into the dog's lungs.
  • Antibiotics to treat secondary infection.
  • Measures to ensure the dog has "adequate nutrition" and hydration, including IVs.

How can you best protect your dog from the mystery respiratory illness?

Although researchers are not yet sure what causes the illness, here are tips from the AVMA and others to help keep your pet as safe as possible:

  • Make sure your dog has been fully vaccinated, especially for kennel cough.
  • Avoid dog parks, pet stores and grooming facilities.
  • Be mindful of boarding, unless absolutely necessary.
  • If your dog shows any signs of respiratory issues, contact your vet and keep your pet isolated.

Canine influenza virus affecting dogs in Florida

H3N2 is circulating along the eastern and western coasts as documented in show dogs and shelters, UF said.

H3N2 is an influenza A virus that is specific for dogs. The virus is currently circulating in dogs in different communities in the country, including Florida and Georgia. Most dogs have no immunity to this virus and will be infected upon exposure. The virus can also infect cats. There is no evidence it infects people.

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Researchers at Kanazawa University report in the Journal of Physical Chemistry Letters high-speed atomic force microscopy studies that shed light on the possible role of the open reading frame 6 (ORF6) protein COVID19 symptoms.


While many countries across the world are experiencing a reprieve from the intense spread of SARS-CoV-2 infections that led to tragic levels of sickness and multiple national lockdowns at the start of the decade, cases of infection persist. A better understanding of the mechanisms that sustain the virus in the body could help find more effective treatments against sickness caused by the disease, as well as arming against future outbreaks of similar infections. With this in mind there has been a lot of interest in the accessory proteins that the virus produces to help it thrive in the body.

"Similar to other viruses, SARS-CoV-2 expresses an array of accessory proteins to re-program the host environment to favor its replication and survival," explain Richard Wong at Kanazawa University and Noritaka Nishida at Chiba University and their colleagues in this latest report. Among those accessory proteins is ORF6. Previous studies have suggested that ORF6 potently interferes with the function of interferon 1 (IFN-I), a particular type of small protein used in the immune system, which may explain the instances of asymptomatic infection with SARS-CoV2. There is also evidence that ORF6 causes the retention of certain proteins in the cytoplasm while disrupting mRNA transport from the cell, which may be means for inhibiting IFN-I signalling. However, the mechanism for this protein retention and transport disruption was not clear.

To shed light on these mechanisms the researchers first looked into what clues various software programs might give as to the structure of ORF6. These indicated the likely presence of several intrinsically disordered regions. Nuclear magnetic resonance measurements also confirmed the presence of a very flexible disordered segment. Although the machine learning algorithm AlphaFold2 has proved very useful for determining how proteins fold, the presence of these intrinsically disordered regions limits its use for establishing the structure of ORF6 so the researchers used high-speed atomic force microscopy (HS-AFM), which is able to identify structures by "feeling" the topography of samples like a record player needle feels the grooves in vinyl.

Using HS-AFM the researchers established that ORF 6 is primarily in the form of ellipsoidal filaments of oligomers - strings of repeating molecular units but shorter than polymers. The length and circumference of these filaments was greatest at 37 °C and least at 4 °C, so the presence of fever could be beneficial for producing larger filaments. Substrates made of lipids - fatty compounds – also encouraged the formation of larger oligomers. Because HS-AFM captures images so quickly it was possible to grasp not just the structures but also some of the dynamics of the ORF6 behavior, including circular motion, protein assembly and flipping. In addition, further computer analysis also revealed that the filaments were prone to aggregate into amyloids as found in some neurodegenerative diseases, and which can lead to complications in COVID19 symptoms. As the researchers point out this aggregation works "to effectively sequester a vast numbers of host proteins, particularly transcription factors involved in IFN-I signaling."

Since these filaments break up in the presence of certain alcohols, urea, or sodium dodecyl sulfate Wong, Nishida and their colleagues conclude that the protein is largely held together by hydrophobic interactions. "Potential druggable candidates that dissociate ORF6 aggregates by disrupting hydrophobic interactions should be considered and tested in the near future to evaluate their therapeutic value in COVID19 management and treatment."

Figure: Observation of aggregation dynamics by COVID-19 severity factor ORF6 protein.

©Nishide, et al., 2023 Journal of Physical Chemistry Letters


High-speed atomic force microscopy

Atomic force microscopy (AFM) "feels" the topography of surfaces by the increase and decrease of surface forces tugging on a nanoscale tip as changes in surface height change the distance between the tip and the surface. The tip is mounted on a cantilever so that the tiny changes in the force can be read out by the resulting deflection in the cantilever.

AFM can resolve structures with subnanometre scale resolution. It has particular advantages for biological studies because it does not require conducting substrates or a current, which are requirements for other primary microscopes with comparable resolutions, such as the scanning tunnelling microscope.

For a long time AFM was limited by the time it takes to capture an image of the surface, but this changed when Toshio Ando at Kanazawa University revealed how the tool could be upgraded to high-speed AFM using various modifications to the scanning, deflection detection and other electronic devices, as well as specifications for the cantilever. With high-speed AFM it became possible to capture dynamics at the nanoscale for the first time.


Authors: Goro Nishide, Keesiang Lim, Maiki Tamura, Akiko Kobayashi, Qingci Zhao, Masaharu Hazawa, Toshio Ando, Noritaka Nishida, Richard W. Wong.

Title: Nanoscopic Elucidation of Spontaneous Self-Assembly of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Open Reading Frame 6 (ORF6) Protein

Journal: Journal of Physical Chemistry Letters

Published on Sep. 14,2023

DOI: 10.1021/acs.jpclett.3c01440

URL: pubs.acs.org/doi/10.1021/acs.jpclett.3c01440

/Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full here.

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The government has ramped up preparedness to tackle any unusual spike in respiratory diseases following reports about a recent outbreak of childhood respiratory illnesses and pneumonia in northern China.

A press release from the Directorate of Health and Family Welfare Services said the Union Health Ministry was closely monitoring the respiratory diseases situation after the World Health Organisation (WHO) recently released a report on the matter.

On reviewing the situation and assessing preparedness in Puducherry region, the Directorate of Health said that available data suggested that there was no abnormal increase in respiratory diseases, accounting for the low incidence of seasonal flu as of now.

As a precautionary measure though, the directorate has made all the facilities to treat those who come with such symptoms in the district hospitals and all the Primary Health Centres. Adequate beds have been allocated to admit and treat such patients at the Government General Hospital, TB Sanatorium (designated Respiratory Care Hospital) in Gorimedu and Indira Gandhi Government Medical College Hospital and Research Institute (IGMCRI).

Testing is underway at the IGMCRI as part of measures to handle seasonal respiratory infections.

The Health Directorate pointed out that seasonal influenza was a mild respiratory illness, usually with or without fever. People with chronic diseases are advised to approach the nearest health facility if they suffer from symptoms such as fever, runny nose, cough and difficulty breathing. Everyone is advised to strictly follow the practice of wearing a face mask as there is a habit of sneezing and coughing in crowded places. Avoiding crowded places can help prevent the flu. Proper hand washing and personal hygiene will help prevent infection, the advisory said.

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A long line of parents and their children at a hospital reception.

Parents with children who are suffering from respiratory diseases are lining up at a children's hospital in Chongqing, China, on November 23, 2023.Getty Images

  • Parts of northern China have seen a surge in children with respiratory illnesses.

  • The WHO requested more information from Chinese health officials, who said common bugs are the cause.

  • Experts do not believe this is the start of a new pandemic.

Cases of respiratory illness among children in northern China have surged in recent weeks, but it's unlikely this is the start of a new pandemic, according to the World Health Organization.

The WHO has been monitoring an increase in respiratory illness among children in northern China since mid-October. At a press conference on November 13, Chinese health authorities pinned a nationwide rise in respiratory disease, mostly in children, to the lifting of COVID-19 restrictions — which mostly ended in December 2022 — and the circulation of known pathogens such as flu, mycoplasma pneumoniae, respiratory syncytial virus (RSV), and SARS-CoV-2. The WHO said on Wednesday it's unclear if these are separate events.

Fears that this could be a new pandemic were sparked on November 21, when ProMED, an infectious disease alert system, flagged up "reported clusters of undiagnosed pneumonia in children" in parts of China and hospitals becoming overwhelmed.

However, after requesting detailed information from Chinese authorities, the WHO said that no unusual or novel pathogens had been detected.

Maria Van Kerkhove, acting director of the WHO's department of epidemic and pandemic preparedness and prevention, told STAT in an interview on Friday that the spike reflects an increased wave of cases, not discrete clusters that would be more indicative of a new virus.

"You hear 'undiagnosed.' People think, well, that means they must have ruled everything else out, and therefore it's probably new. You hear 'clusters,' which means there's some people linked in space and time. 'Children' — which is always alarming — 'with pneumonia,' which indicates a level of severity. And you hear 'China.' So I think a lot of people were immediately drawn back to the beginning of the Covid pandemic and thought: Oh God. Not again."

She gave two reasons why this outbreak is not the new COVID.

1) China is likely experiencing an immunity gap

In a conference call with the WHO on Thursday, Chinese health officials presented evidence suggesting the outbreak is partly caused by what's known as an immunity gap, STAT reported.

An immunity gap is the idea that lockdowns to prevent the spread of COVID also dramatically reduced the transmission of other common viruses and bacteria, such as flu and RSV. During this time, kids who had never been exposed to these bugs developed few immunological defenses against them, so when things went back to normal, and they were able to circulate again, more children were at risk of getting sick.

Van Kerkhove told the outlet that she backs this theory. "This is expected. This is what most countries dealt with a year or two ago," she said.

François Balloux, director of the UCL Genetics Institute, expressed the same view. "China is likely experiencing a major wave of childhood respiratory infections now as this is the first winter after their lengthy lockdown, which must have drastically reduced the circulation of respiratory bugs, and hence decreased immunity to endemic bugs," he said.

Insider health correspondent Hilary Brueck reported last year amid a spike in US children getting sick with viruses that the immunity gap or "debt" does not mean children's immune systems were damaged by lockdowns and other measures to prevent the spread of COVID, as some claimed.

2) The illnesses are not caused by a new virus

Chinese health officials said that the outbreak of respiratory illness is caused by known pathogens.

Van Kerkhove said that they provided the WHO with percentages of how many cases have been caused by influenza, rhinovirus, adenovirus, and mycoplasma pneumoniae, respectively.

She said that they had not seen patients who were not diagnosable, nor a clustering of undiagnosed pneumonias.

The health authorities also told the WHO that they had not detected any new variants or subtypes of the known pathogens. "This is not an indication of a novel pathogen," she said.

Her view is shared by other public health experts too. A group of biosecurity experts from UNSW Sydney, Australia, wrote in The Conversation on Monday: "There is no indication that the current situation in China is a new pandemic, but we should always identify and pay attention to undiagnosed pneumonia clusters. Early warning systems give us the best chance of preventing the next pandemic."

Read the original article on Business Insider

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Pope Francis has canceled his planned trip to the COP28 climate meeting in Dubai because of the effects of influenza and lung inflammation, the Vatican said Tuesday.

The pope, who is 86, was due to begin a three-day visit to Dubai on Friday and the Vatican had said earlier on Tuesday that he was going ahead with the trip.

"Although the Holy Father's general clinical condition has improved with regard to the flu and inflammation of the respiratory tract, doctors have asked the pope not to make the trip planned for the coming days to Dubai," the Vatican said.

The pope had agreed not to travel "with great regret," it added.

Francis, as a young man in his native Argentina, had part of a lung removed.

The Vatican announced on Monday the pope would limit his activities this week in order to conserve his strength.

A CT scan done at a Rome hospital on Saturday excluded pneumonia but detected inflammation in the pope's lungs that caused breathing difficulties. He was receiving antibiotics intravenously, the Vatican said on Monday.

The pope met with Spanish bishops visiting the Vatican on Tuesday.

© 2023 Thomson/Reuters. All rights reserved.

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Since mid-October 2023, the World Health Organization (WHO) has been monitoring data from Chinese surveillance systems that have been showing an increase in respiratory illness in children in northern China.

Chinese authorities attributed this increase to lifting of COVID-19 restrictions and the arrival of the cold season, and due to circulating known pathogens such as influenza, Mycoplasma pneumoniae, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mycoplasma pneumonia and RSV are known to affect children more than adults.


Pneumonia is a form of acute respiratory infection that is most commonly caused by viruses or bacteria. It can cause mild to life-threatening illness in people of all ages; however, it is the single largest infectious cause of death in children worldwide.

Pneumonia killed more than 808 000 children under the age of 5 in 2017, accounting for 15% of all deaths of children under 5 years. People at-risk for pneumonia also include adults over the age of 65 and people with preexisting health problems.

When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake. These infections are generally spread by direct contact with infected people. Vaccines can help prevent pneumonia.


Influenza (Flu) is a common cause of pneumonia, especially among younger children, the elderly, pregnant women, or those with certain chronic health conditions or who live in a nursing home.

Influenza is a highly contagious viral infection that is one of the most severe illnesses of the winter season. Influenza is spread easily from person to person, usually when an infected person coughs or sneezes.

Pneumonia is a serious infection or inflammation of the lungs. The air sacs fill with pus and other liquid, blocking oxygen from reaching the bloodstream. If there is too little oxygen in the blood, the body's cells cannot work properly, which can lead to death.

As flu strains change each year, it is necessary to get a flu vaccination each season to make sure you are protected against the most current strains. Pneumonia vaccinations are usually only necessary once, although a booster vaccination may be recommended for some individuals.

Walking Pneumonia

In recent days, there has been a surge in cases of infection by the bacterium mycoplasma pneumoniae Mycoplasma pneumonia reported in multiple hospitals across China, with children being the most affected. This year, the infection has occurred earlier than usual and has shown a trend toward affecting younger children, leading pediatricians to warn that this year could see a widespread outbreak of Mycoplasma pneumonia.

The Mycoplasma pneumoniae bacterium is one of the most recognized of all human pathogens, and there are different known species. These bacteria can cause many symptoms, including dry cough, fever, and mild shortness of breath on exertion. Mycoplasma pneumonia can spread easily among children.

Most people with respiratory infections caused by Mycoplasma pneumoniae don’t develop pneumonia. For this reason, Mycoplasma pneumonia is known as atypical pneumonia and is sometimes called walking pneumonia.

Mycoplasma pneumonia spreads quickly through contact with respiratory fluids in crowded areas, like schools, college campuses, and nursing homes. When someone coughs or sneezes, moisture containing the bacteria is released into the air, and others around them can easily breathe the bacteria in.

About 7 to 20 percent of cases of community-acquired (outside of a hospital) pneumonia happen as a result of infection by atypical bacterial microorganisms. Of these, Mycoplasma pneumoniae causes the most infections, though only about 10% of people infected will actually develop pneumonia.

Mycoplasma pneumonia symptoms are different from those of typical pneumonia caused by common bacteria, like Streptococcus and Haemophilus. Patients usually do not have severe shortness of breath, high fever, and a productive cough with Mycoplasma pneumonia. Instead, they have a low-grade fever, dry cough, mild shortness of breath, and fatigue.

Mycoplasma pneumonia may mimic an upper respiratory infection or common cold rather than a lower respiratory infection or pneumonia. A dry cough is the most common sign of infection.

In some cases, Mycoplasma pneumonia infection can become dangerous. If you have asthma, Mycoplasma pneumonia can make your symptoms worse. Mycoplasma pneumonia can also develop into a more severe case of pneumonia. In rare cases, untreated Mycoplasma pneumonia can be fatal.

Respiratory Syncytial Virus

Respiratory syncytial virus (RSV) causes mild illness in most children and adults. However, pneumonia can be serious, requiring treatment and sometimes hospitalization. Rarely, for people at high risk, pneumonia can be fatal.

For some infants, older adults, and people with certain health conditions, an RSV infection can become severe and lead to other health conditions, like bronchiolitis and pneumonia.

RSV typically stays confined to the upper airways. In certain situations, though, it can move into the lungs. While rare, this is when RSV-related pneumonia may develop. RSV is the leading cause of pneumonia in children under age 1.

Symptoms of RSV may be as mild as a runny nose and sore throat. When pneumonia develops, you may notice symptoms that happen slowly or suddenly. Symptoms may include cough with yellow, green, or bloody sputum, fever, chills, shallow or rapid breathing patterns, rapid pulse rate, chest pain with deep breaths or coughing, fatigue, and low appetite.

Don't Press Pandemic Panic Button

Scientists have cautioned against concerns of a potential new pandemic following the World Health Organization's request for more information from China regarding an increase in respiratory illnesses and pneumonia clusters among children.

While some worry that this surge might signal the emergence of another dangerous pathogen capable of triggering a pandemic, scientists believe, based on current information, it's more likely an increase in common respiratory infections like the flu. Similar rises in respiratory infections were observed globally after COVID-19 lockdowns were lifted, potentially including a resurgence of COVID itself.

Prevention Tips

Based on the available information, WHO recommends that people in China follow measures to reduce the risk of respiratory illness, which include recommended vaccines against influenza, COVID-19 and other respiratory pathogens as appropriate; keeping distance from people who are ill; staying home when ill; getting tested and medical care as needed; wearing masks as appropriate; ensuring good ventilation; and practicing regular handwashing.

WHO does not recommend any specific measures for travellers to China. In general, persons should avoid travel while experiencing symptoms suggestive of respiratory illness, if possible; in case of symptoms during or after travel, travellers are encouraged to seek medical attention and share travel history with their health care provider.

WHO advises against the application of any travel or trade restrictions based on the current information available on this event.

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KLANG: Covid-19 has never left and is still lurking around.

"It's just that cases are not as many or serious as they used to be," said Selangor Health Department deputy director (public health) Dr Wan Noraini Wan Mohamed Noor.

On the recent increase in Covid-19 cases in the state and country, Dr Wan Noraini said the small spike was in tandem with global trends.

"This is due to winter in the northern hemisphere, which is seeing an increase not only in Covid-19 cases, but in all other respiratory-related conditions as well," she said when contacted.

As for the current increase in the number of cases here, Dr Wan Noraini said it was probably due to unrestricted movement given that geographical borders have long been open.

"There have also hardly been reports of any serious cases and infections are just coming and going like the common flu," she added.

Hospital Tengku Ampuan Rahimah (HTAR) Klang director Dr Zulkarnain Mohd Rawi said although there was a spike in cases, the situation was not serious.

"There has been an increase in cases the past month, but we are not frightened of Covid-19 anymore.

"Everyone has been vaccinated and some people have become immune to the virus.

"And we also now have the required antiviral drugs to fight the infection," he said.

According to Dr Zulkarnain there were currently 16 patients admitted for Covid-19 at HTAR with three of them under Category 5, the most severe.

“Out of the three, one is being ventilated whilst another is on a high-flow oxygen mask.

"Usually cases like these come with comorbidities," he added.

He said out of the 13 remaining Covid-19 patients at HTAR, two were under Category 1 (the mildest), six under Category 2, one under Category 3 and four under Category 4.

When contacted, a private clinic in Subang Jaya said it has been receiving about three to four Covid-19 cases weekly.

Another clinic in Petaling Jaya said it was receiving at least two patients with Covid-19 daily.

Pharmacist Cynthia Lee, who manages Lee Pharmacy in Klang, said there was an increase in the sale of Covid-19 test kits from early this month.

"People who come to buy the kits seem to also be coughing very badly," she added. Malaysian Society of Infectious Diseases and Chemotherapy president Prof Dr Zamberi Sekawi said the small resurgence of Covid-19 infections was a common trend.

"It's a common pattern for small outbreaks of diseases such as Covid-19, and even the common flu, to take place here and there from time to time," he said.

Dr Zamberi added what was required now was for the relevant parties to observe, identify the locations, and mitigate the situation.

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Islanders died of chronic conditions and covid-19 in 2022 at numbers that surpassed even Hurricane Maria’s toll

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A previous version of this article incorrectly said that 110 Puerto Ricans died per 1,000 residents last year. The data shows that 110 Puerto Ricans died per 10,000 residents last year. The article has been corrected.

AGUAS BUENAS, Puerto Rico — In a purple house along a narrow road in Puerto Rico’s Central Mountain Range, Margarita Gómez Falcón’s breathing suddenly grew labored one March evening. She called an ambulance and began a grim two-hour wait for paramedics to arrive.

Health services across this self-governing island have been deteriorating for years, contributing to a surge in deaths that reached historic proportions in 2022, an investigation by The Washington Post and Puerto Rico’s Center for Investigative Journalism has found.

The case of Gómez Falcón, 67, underscores the many ways a faltering medical system has contributed to elevated death rates. She had struggled with kidney disease, covid-19, and breathing problems requiring the use of oxygen. But access to dialysis and other specialized medical care had dwindled, especially since Hurricane Maria devastated the island in 2017.

Aguas Buenas, a small, working-class town in the central highlands, had one working ambulance for its 25,000 people when Gómez Falcón called for help, so dispatchers sent a private one that had trouble finding her home in the town’s winding back roads. As her breathing slowed, her family members said, they gathered around her and prayed for paramedics to arrive in time. When they finally pulled up, she was already dead.

“At one point, she just leaned back, closed her eyes and she was gone,” said her sister, Carmen Gómez, 62.

Carmen Gómez, 62, and her mother, Margarita Negrón Falcón, 88, at their home in the barrio Juan Asencio of Aguas Buenas in Puerto Rico. In March 2022, Carmen Gómez's sister Margarita Gómez Falcón, 67, died in her home while waiting for an ambulance to arrive.
A photo of Margarita Gómez Falcón, who died last year, in the home of her daughter in Aguas Buenas.

Puerto Rico, with a population of 3.3 million people, experienced more than 35,400 deaths last year. That’s nearly 3,300 more than researchers would ordinarily expect based on historic patterns, according to a statistical analysis by The Post and Puerto Rico’s Center for Investigative Journalism (CPI).

This “excess mortality” — a term scientists use to describe unusually high death counts from natural disasters, disease outbreaks or other factors — resulted in part from a covid spike early last year that killed more than 2,300 people, health data shows.

A chart showing the excess deaths in Puerto Rico over the past year, and what number of those are associated with COVID-19.

But elevated death rates continued in the months after covid subsided, indicating a broader breakdown as the island lost medical staff and services and younger Puerto Ricans moved away, leaving behind a population that is increasingly elderly and facing age-related health complications.

The recent jump in mortality is the latest warning sign that years of natural disasters and financial crises have taken a deadly toll. Last year’s spike was concentrated among Puerto Ricans over age 65, with other age groups dying at more typical rates, the analysis found. If Puerto Rico had a more typical population of younger people, the death rate in 2022 would have been the same or potentially even lower than in the rest of the United States, the statistical analysis showed.

“These types of events, both hurricanes and earthquakes, as well as pandemics, have made evident the vulnerability of many older adults who live alone, many of whom live below the poverty line, who do not have the most basic resources to face that type of adversity,” said José Carrión-Baralt, a professor in the gerontology program at the Recinto de Ciencias Médicas Graduate School of Public Health in San Juan, Puerto Rico’s capital and biggest city.

Last year, 110 Puerto Ricans died per 10,000 residents, a rate that is nearly 11 percent higher than in the United States overall. That marks a reversal from years past, when the island had lower or similar death rates compared with the United States as a whole. Even the wealthiest Puerto Ricans experienced death rates last year similar to those long suffered by poorer communities.

A map showing how nearly half of Puerto Rico's municipalities have no hospitals, and have seen higher death rates.

Puerto Rico’s death rate in 2022 surpassed that of any other year in the past two decades, including 2017, when Hurricane Maria devastated large swaths of the island, according to the analysis. The increase in deaths appears to have continued into 2023, with preliminary data for the first quarter showing that the death rate remained elevated.

“It’s been nearly six years since Maria, and nothing has been resolved,” said Nereida Meléndez‚ a community activist in Aguas Buenas. “Here there are bridges that no one has done anything for. There are damaged highways no one has done anything to fix. Here one says, ‘What about that money they sent us? Where is it? What are they doing with it?’”

Puerto Rico’s Health Department has acknowledged that the island’s mortality rate rose to unusual heights in 2022, although its statistics are slightly different from the ones found in this analysis because researchers used different estimates for each municipality’s population. Officials have said they believe covid played a role in the surge of deaths, as did the shortage of doctors on the island, but health officials did not investigate the causes in their analysis.

“Right now, the conversation has focused on the cause of greatest impact, covid-19, which triggered the highest number of hospitalizations and deaths,” said Melissa Marzán Rodríguez, chief epidemiologist for Puerto Rico’s Health Department.

The analysis by The Post and the Center for Investigative Journalism, which is the first to comprehensively examine the reasons for the surge in mortality, confirms the role of covid and the shortage of doctors, but also points to other problems.

Puerto Rico’s leading killers last year were covid, cardiovascular disease, Alzheimer’s disease, drug overdoses, kidney disease and dementia — most of which are potentially less lethal with routine medical care.

Health data shows that in 2022, compared with the historical average from 2015 to 2021, deaths from Alzheimer’s increased by 26 percent, heart disease by 11 percent and mental health causes by 53 percent, with most of those deaths from substance abuse or dementia. Alcoholism also was listed as a leading cause of death.

Reversing Puerto Rico’s surge in death rates, experts said, would require addressing social, economic and political problems that have undermined medical services for those who need them most.

The death rate in Aguas Buenas increased by nearly 50 percent in 2022 compared with the town’s historical average — the largest increase of any community in Puerto Rico.

Gómez Falcón’s death certificate said that she died of a heart attack and that she also suffered from respiratory and kidney failure. But her family is haunted by the thought that she might have survived.

The state agency that dispatched the private ambulance said the problem was poor communication, not a systemic decline of medical systems. “The delay was not due to a lack of resources,” said Javier Rodríguez, commissioner of the state Emergency Medical Corps, in a statement. “Paramedics tried but failed to reach the caller for directions or a point of reference to get to the right location.”

The family of Gómez Falcón, however, sees a cascading series of failures, with the delayed ambulance just one problem among many undermining the health of Puerto Ricans — especially older ones.

“I know my sister wasn’t the only person who experienced this,” Carmen Gómez said.

As Puerto Ricans strove to rebuild in the months after Maria struck, an estimated 120,000 people — most of them of working age — moved away, according to the U.S. census. Accelerated migration continued through the end of the decade, and birthrates also fell. Puerto Rico’s overall population fell by nearly 12 percent from 2010 to 2020.

Sicker and older adults were left behind, making Puerto Rico one of the most rapidly aging societies on the planet. More than 1 in 5 residents are now over 65, which is higher than the U.S. average, according to an analysis by Hunter College’s Center for Puerto Rican Studies.

The population of Aguas Buenas, a city founded in the 19th century and named in honor of the crystal-clear water that flowed through its springs, shrank by nearly 4,500 residents after Maria, a drop of nearly 16 percent from a decade earlier.

But the population of those over 65 grew by about 9 percent, a shift that by itself can increase death rates because elderly people are more likely to die in any given year than younger ones.

A view of downtown Aguas Buenas in August.

On the streets of Aguas Buenas, the graying of its residents is as vivid as the ruby blossoms of its flamboyán trees. Elders stroll through the plaza clutching word-puzzle books while matriarchs sit perched on balconies watching comings and goings. The waiting rooms of local clinics run three rows deep with seniors. And the neighborhood bakeries are havens for old friends comparing notes on blood pressure medications.

It’s not just Puerto Rico’s young who have left. Doctors, including some who saw their clinics damaged by hurricanes and earthquakes, increasingly are in short supply, with about half of the town’s 15 physicians having moved away, people here said.

“Aguas Buenas has been a ghost town,” said Mayor Karina Nieves Serrano, who won a special election for a vacated seat last year. “We are trying to find ways to reawaken its self-image.”

In Puerto Rico overall, government data shows there are more than 400 fewer doctors than in 2019. Less than a third of the island’s municipalities have hospitals with accessible beds, with some Puerto Ricans living up to 20 miles away from the nearest facility, according to data from Puerto Rico’s Heath Department. In 2022, municipalities with no hospitals saw greater death rates than their historical averages.

Aguas Buenas itself has only ever had one small emergency room, leaving residents to rely on a few small clinics. Mariemma Jiménez works for one of the newer ones, NeoMed, helping to identify and eliminate barriers to care. She roams the remote barrios, setting up preventive-health fairs, arranging transportation for patients and educating poor farmworkers.

She estimated that most of the clinic’s patients are over age 60 and managing serious chronic disease. Bus service also has been cut, making it harder for those without cars to seek care amid a general deterioration of public services and political turmoil.

“It’s a demoralized population with many transportation needs living in far-flung barrios. These are people who are used to going to the doctor only when they are sick or in pain,” Jiménez said. “That’s where I see the breakdown.”

Natividad Flores Velázquez, 64, cares for her 88-year-old mother who has Alzheimer's, Luisa Velázquez Reyes, at her home in Aguas Buenas.

Puerto Rico’s public health system was once the envy of the Caribbean. Then-Gov. Pedro Rosselló privatized it in the 1990s, in what became known as “La Reforma.” Most government-owned hospitals were sold in an effort to control costs and streamline operations. But the opposite took place: By 2006, Puerto Rico’s economy tanked and public debt ballooned — in part, because of government borrowing to cover skyrocketing health costs.

The massive flight of doctors began then. In 2010, there were approximately 19,000 physicians on the island. As of 2022, there were 10,846, of whom 3,000 have active medical licenses but also practice in the mainland United States, according to data from the Colegio de Médicos Cirujanos of Puerto Rico.

Heart disease is a leading cause of death in Puerto Rico, with rates increasing 11 percent in 2022. But there are only 95 cardiologists — or one for every 17,500 adults between ages 18 and 64 — to treat them. It’s the lowest ratio among all U.S. jurisdictions, according to the American College of Cardiology. The national average is one per every 7,000 adults.

Table showing the top five increased causes of death since 2015-2021

Many of Puerto Rico’s cardiologists are themselves older than 65 but continue practicing because there are no younger physicians to take over their growing patient loads. Medical professionals leave the island largely because of low pay and poor working conditions, physicians and experts said.

It can take six to eight months, residents and physicians said, for patients to be seen. Urgent cases are managed as they come but interventions are sometimes too late, after more serious problems develop.

“All of that pressure weighs on you,” said cardiologist Luis Rosado Carrillo, who has 17,000 patients on his roster. He sees about half of them on a regular basis. “We are overwhelmed.”

During the pandemic, the terror of contracting covid kept geriatric patients away from the practice of family physician Belinda Rodríguez, who is based in Bayamón, a suburb of San Juan. Many opted for telehealth as their primary means of care, but when they returned for in-person visits as the pandemic waned, there was a “total decline” in their overall health, she said.

Their underlying conditions had worsened and many had developed insomnia, depression and anxiety, she said.

“It accumulates,” said cardiologist Luis Molinary Fernández. “And then you have a catastrophe.”

Patient advocates said the hardships of staying healthy in Puerto Rico push many to resign themselves to declining health.

“We all have to die of something,” said Wilfredo Ramos, 61, a stroke survivor who lives deep in the remote peaks of the Central Mountain Range, one of the most challenging topographies on the island.

In 2020, Ramos fell unconscious, and three days passed before someone found him bleeding near his bed after a massive brain hemorrhage inside his rural home, where he lived alone. He lost the use of one side of his body, can’t drive and has frequent fainting spells.

Karina Quiñones, who works with a community clinic, asked Ramos during a recent visit, “When was the last time you saw a doctor?” as she rummaged through a tub of seven prescription bottles.

“Maybe more than 18 months,” he replied. “Who’s going to take me?”

Quiñones, also a nurse, swallowed hard: “These scripts tell me you have high cholesterol.”

“And a heart condition,” Ramos added.

He said he was lonely and ashamed of his inability to fix anything in his life. His old house leaked after earthquakes left cracks in the kitchen. He had trouble being understood well enough on the phone with his insurer to schedule appointments. So he stopped trying to remedy his own health, apart from taking pills and some exercises to regain leg movement. Instead, he tinkered with what he could manage, repairing broken speakers and radios with his collection of old electronic parts.

“Sometimes I just sit in bed waiting for the hours to go by,” he confessed.

Some Puerto Ricans fashion workarounds and call in favors to coordinate health care, score lifesaving pills or get elusive cardiologist referrals. Families pay out of pocket for private ambulances or taxis because there are few public means to transport incapacitated loved ones to medical facilities. Some put fragile relatives into the back seat of whatever car is available for journeys to other cities for care.

“If we don’t do it, it doesn’t happen. It’s one problem after another that complicates health,” said Roberto Colón, 56, who lives in a city near Aguas Buenas and recently paid a private ambulance driver to bring his elderly mother home from surgery. “The Puerto Rican who loves this place will stay, but it will come with sacrifice.”

The public Aguas Buenas Municipal Cemetery 1 is at capacity.

At the Cementerio Municipal 1 in Aguas Buenas, workers installed a new aboveground tomb on a recent afternoon.

The graveyard, like most in Puerto Rico, is at capacity, in part because of poor planning and limited resources, but also because too many people are dying. A patch of dirt the length of about two parking spaces is all that’s left for the municipality to construct additional plots.

Across the street from the cemetery is the Monte Santo funeral home, one of two in Aguas Buenas. The local Facebook page, “What’s happening in Aguas Buenas,” is maintained by the other funeral home director, Carlitos Román, who posts a seemingly endless stream of funeral notices.

A worker rests beside one of the newer graves built at the Aguas Buenas Municipal Cemetery 1.

“We normally do about 140 to 150 services a year,” said Monte Santo director Héctor Montañez, looking at his 2022 records. “We are at 201. That’s the highest number in the 40-year history of this business.”

Meléndez, the community activist, said she grows depressed thinking about how her mostly elderly neighbors and relatives fight to stay healthy amid mounting pressures.

“Everything here is just hard,” Meléndez, 66, said while wiping sweat from her forehead. “Don’t tell me that I need to go to the United States because here I don’t have what I need. We deserve better services and a higher quality of life here.”

The road where Gómez Falcón’s family lives and where she died last year.

Gómez Falcón once presided over a large extended family living on a sloping mountainside with panoramic views. As health services deteriorated, she battled an inherited kidney disease that required regular dialysis, with the catheter often getting misplaced or stuck. Bacteria sometimes found its way inside the artificial blood vessel under her skin. It was a lot to manage, family members said, but Gómez Falcón did it alone so as not to burden anyone else.

The strain grew far more severe when Hurricane Maria swept her wooden home off the face of the mountain in 2017. The Category 4 storm with winds of up to 175 mph flattened 1 in every 10 homes in Aguas Buenas, according to local estimates.

Gómez Falcón was hospitalized in the nearby town of Cayey, where she underwent dialysis — with generators powering her treatment — three times a week. She came home to nothing but debris.

The Federal Emergency Management Agency helped Gómez Falcón rebuild the family home. But she caught covid and was hospitalized with breathing difficulties during a trip to Ohio the following year to visit three of her children for Christmas. She was never the same after that, reliant on oxygen 24 hours a day, family members said.

By February 2022, she suffered a new setback when her oxygen levels dipped dangerously low. Gómez Falcón survived because she reached the hospital in time.

She was not as lucky the next time she called for the ambulance, just three weeks later.

Gómez Falcón was cremated. Her family said she was ready to be reunited with her late husband of nearly 50 years.

Her daughter Catherine Meléndez spent her grieving months rearranging her mother’s house and discarded the chair where she took her last breath. One day her grandmother — Gómez Falcón’s 88-year-old mother — handed Meléndez her mother’s wedding ring.

Meléndez slid it through a silver necklace, where it sits close to her heart.

About this story

This report is the result of a joint investigation by The Washington Post and the Center for Investigative Journalism, a nonprofit news organization in Puerto Rico.


The Post used National Center for Health Statistics (NCHS) weekly counts of death by jurisdiction and age when calculating and comparing rates of death in Puerto Rico with the United States overall. For all other analyses, the Centro de Periodismo Investigativo (Center for Investigative Journalism) and The Post acquired, cleaned and standardized mortality records data from the Puerto Rico Health Department’s Demographic Registry in conjunction with Census Population Estimates since 2015. The Post used historical data on all deaths from five years before the covid-19 pandemic to estimate expected weekly deaths for different age groups for all of Puerto Rico using a robust regression model. Using a robust regression ensures that outliers like deaths following natural disasters do not heavily influence estimates. When analyzing specific causes of death and municipalities, The Post compared 2022 figures with historical averages and rates between 2015 and 2021. For the investigation, data was analyzed based on standard groupings in the Centers for Disease Control and Prevention’s 113 major causes of death. Historical counts of doctors and current hospital counts per municipality were provided by Puerto Rico’s Health Department.


Video editing by Angela Hill. Photo editing by Natalia Jiménez. Design and development by Rekha Tenjarla. Design editing by Betty Chavarria. Copy editing by Vanessa Larson. Editing by Christine Armario, Renae Merle and Craig Timberg. Data editing by Anu Narayanswamy.

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CHICAGO -- Chest CT images reveal that cigarette and marijuana smokers are at higher risk of developing emphysema, according to research presented November 28 at the RSNA annual meeting.

In her presentation, Jessie Kang, MD, from Dalhousie University in Halifax, Nova Scotia, Canada, showed findings suggesting that people who combine marijuana and cigarettes are 12 times more likely to develop centrilobular emphysema than non-smokers.

“With our study, we show that there are physical effects of marijuana smoking on the lungs and that cigarette smoking and marijuana smoking may have a combined damaging effect on the lungs,” Kang said in a statement.

While there is clear evidence that cigarette smoking causes harm to the lungs, little is known about smoking marijuana’s effects, as well as the combined effects of smoking both.

Kang also noted that marijuana is the most widely used illicit psychoactive substance in the world. Canada legalized nonmedical marijuana in 2018.

Kang and colleagues investigated the effects of marijuana smoking on the lungs and chest wall by evaluating CT chest images in regular marijuana smokers.

The team included people who have at least a two-year history of marijuana use, including use four times a month, and who have had a chest CT. The group excluded people who use marijuana as edibles or oral drops.

CT images show airway changes in a 66-year-old male marijuana and tobacco smoker with cylindrical bronchiectasis and bronchial wall thickening (arrowheads) in multiple lung lobes in a background of paraseptal and centrilobular emphysema. Image and caption courtesy of the RSNA.CT images show airway changes in a 66-year-old male marijuana and tobacco smoker with cylindrical bronchiectasis and bronchial wall thickening (arrowheads) in multiple lung lobes in a background of paraseptal and centrilobular emphysema. Image and caption courtesy of the RSNA.

The researchers found that the proportion of patients with paraseptal emphysema is higher in the cigarette smoker and combined smoker groups. They also found that marijuana smoking was tied to a five- to seven-times higher risk of developing paraseptal emphysema than nonsmokers.

Additionally, the researchers found that the combined smoking group was 12 times more likely to have centrilobular emphysema than nonsmokers. This is a type of pulmonary emphysema where the air sacs within the lungs are damaged, leading to breathing difficulties and other serious respiratory symptoms.

Finally, the team reported that the combined smoker group had a four times higher risk of developing bronchial wall thickening than nonsmokers. However, it also found no significant association between marijuana smokers and gynecomastia.

Kang said this study addressed misconceptions about smoking marijuana’s health effects on the lungs. However, she also called for more research to study the long-term effects, so that the public can make an informed decision on recreational usage of marijuana.

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Toronto emergency room doctors say the winter surge of COVID-19, flu and respiratory syncytial virus (RSV) infections is underway, with hospitals seeing a wave of visits across the GTA.

In the last week, nearly 250 Ontarians have been admitted to hospital, and Public Health Ontario (PHO) reports the COVID-19 wastewater signal is at its highest level in more than a year.

Toronto ER physician Dr. Kashif Pirzada took to social media this week to share he and his colleagues are doing far more resuscitations, crash intubations and seeing far more patients in cramped and packed emergency rooms.

“We are admitting adults again on the ward even younger people in their 30s and 40s,’ said Dr. Pirzada. “It means we have to do life-saving maneuvers so we have to put people on ventilators and we have to put people on machines to help them breathe …that’s very serious. That’s when [the] mortality rate is very high as well.”

“I had a healthy woman with no medical problems in her 40s, who was just fighting a cold for a few weeks and then developed severe pneumonia and had to end up in our ICU. So we saw that before COVID but now it’s much more common now.”

With the virus season revving up a little sooner than normal, these Toronto doctors say hospitals are not yet in crisis mode like they were last year when emergency departments were completely overwhelmed and children were sometimes waiting days for an ICU bed.

Dr. Pirzada said staffing levels are still not great.

“We’re just lucky that it’s not as overwhelming as last year but if it does get stressed and I’m worried about the holiday season, especially with the early inkling that we’re getting now that we won’t be able to handle it the way things are going. I’m really worried about what’s going to happen in the next month or so.”

When someone should be heading to an ER

“If you cross the line where you have a fever of more than five days, that makes us worried. If you have severe chest pain or trouble breathing, that’s a bad thing, you need to get checked out,” said Dr. Pirzada.

“[If] you are not eating or drinking anything, that’s also a bad sign, if you are so tired you can’t get up and do anything also a bad sign, especially in a kid, that’s also a sign to get checked.”

Doctors say now is the time to protect yourself, and if you’re sick, stay home and wear a mask.

“I went into a packed subway car the other day and I wear a mask in there because I was face to face with people. I think use your common sense like you don’t want to get more sick than you need to be. So in super crowded areas, I think it’s a good idea to wear [masks]. They’re annoying, they’re inconvenient, but I think they might save you a lot of grief this holiday season.”

Dr. Pirzada adds getting a COVID-19 booster would also help. The advice comes as just 24 per cent of the population has completed a primary COVID-19 vaccine series and two or more booster doses.

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CINCINNATI (WKRC) - Respiratory illnesses have been on the rise in the Tri-State.

Just as they predicted, infectious disease specialists said the case numbers for COVID-19, flu and RSV have jumped in the last few weeks.

Flu case numbers are only reported when a person is positive during a hospital stay or during outpatient services.

“So, two weeks ago we were seeing maybe 10 to 15 cases a day. Now, we are up to 25 to 30 cases a day in our outpatient clinics,” said Dr. Stephen Blatt, TriHealth’s medical director of infectious diseases.

Symptoms such as coughing, sneezing, fever and shortness of breath overlap quite a bit among the illnesses. So, how can people know what they have in order to get the correct treatment, especially if they were traveling recently?

Here’s Dr. Blatt’s recommendation:

“I think if you recently traveled for Thanksgiving and you suddenly have fever, cough or shortness of breath, you need to get tested, because there are treatments for both flu and COVID that can keep you from getting worse,” he said.

Those treatments include antiviral medications, such as Tamiflu or Paxlovid. People do need a prescription for those medications and they need to be taken as soon as a person is symptomatic to get the best benefits.

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November 28, 2023

4 min read

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Key takeaways:

  • Allergists should ask patients about the regularity, quantity and quality of their sleep.
  • STOP-BANG assesses eight risk factors that predict obstructive sleep apnea.

ANAHEIM, Calif. — Allergists can screen patients for obstructive sleep apnea, according to a presentation at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

“A really terrible question to ask a patient is, ‘How are you sleeping?’” Brian D. Robertson, MD, FACAAI, chief medical officer at NightWare, said during his presentation.


About 50% of people who snore also have obstructive sleep apnea. Image: Adobe Stock

Instead, he continued, physicians should ask patients if they wake up and go to sleep at the same time every day, how many hours of sleep they get each night, and if they still feel sleepy when they wake up.

Brian D. Robertson

“Ask about the regularity of their sleep, the quantity of their sleep, and the quality of their sleep,” said Robertson, who also is the incoming chair of the ACAAI respiratory sleep-related disorders committee. “If they’re answering, ‘Well, my sleep’s all over the place,’ that’s a problem, and they need to go see a sleep doctor.”

Excessive daytime sleepiness or fatigue is among the most common symptoms of obstructive sleep apnea, Robertson said, and it increases the risks for motor vehicle accidents by a factor of two to seven.

“I was in the military,” Robertson said. “I’ve had patients tell me they’ve fallen asleep flying planes, flying helicopters and, very scary, falling asleep while riding a motorcycle.”

Drowsy driving is a major contributor to risks for these patients and for the people around them, Robertson said.

“Nobody dies of anything in sleep medicine except behind the wheel of a vehicle,” he said.

Fragmented sleep or awakenings, snoring and witnessed apneas also are common symptoms.

Sleep-related choking and gasping are common too, which a lot of people believe is GERD, Robertson continued.

“But reflux is associated with apnea, and we take that seriously too,” he said.

OSA symptoms also include decreased vigilance, loss of cognitive or memory function and impaired concentration, morning dry mouth, mood disorders, morning headaches, GERD, nocturia/enuresis, and impotence or decreased libido.

“If they say, ‘I get, like, less than 6 hours a night’ — adults especially — they need to go see a sleep doctor, too,” Robertson said.

Multiple comorbidities are associated with OSA as well, Robertson continued, including drug-resistant hypertension (83%), congestive heart failure (76%), dysrhythmias (58%), pulmonary hypertension (77%), type 2 diabetes (70%), morbid obesity (males: 90%; females: 50%), and GERD (60%).

Atrial fibrillation (49%), stroke (90%) and trisomy 21 are associated with OSA as well, Robertson continued, all of which indicate the need for polysomnography.

“A good night’s sleep is taken for granted in this country,” Robertson said. “It’s partly electronics, and the fact that we can keep the day going through electricity instead of just when it gets dark, we fall asleep.”

Allergists with concerns about their patients’ sleep can screen for STOP-BANG, which is an acronym of eight risk factors, to determine if they should be referred to a sleep doctor.

The first factor is snoring.

“Do you snore? It’s about 50-50 for sleep apnea,” Robertson said.

Next is tiredness.

“Do you feel tired during the day?” he asked.

Third is observed, as in whether someone has observed the patient stop breathing while they were sleeping.

The fourth factor is high blood pressure, and the fifth is a BMI greater than 35 kg/m2. Sixth is age 50 years or older.

The seventh factor is neck circumference of greater than 43 cm for men and 41 cm for women.

“Men almost always know their neck size because that’s how shirts are sized. Women may not know that so much,” Robertson said.

The final factor is male gender.

“Three or more positive responses here indicates a high risk for sleep apnea,” Robertson said. “If you have a man who snores and sometimes is tired and falls asleep watching TV, that guy needs a sleep study.”

Robertson acknowledged that these criteria are very common, adding that almost every patient who came into his sleep clinic when he was practicing at Walter Reed National Military Center qualified for some kind of sleep study.

“It doesn’t take much,” he said.

Part of this is because it is impossible for patients to judge the quality of their sleep while they are sleeping, Robertson said.

“They don’t give you good histories. They don’t know what’s going on because they’re asleep,” he said. “You really have to put them in a lab to figure things out.”

Allergists can screen children too, Robertson said, with some differences between them and adults.

“Children don’t get really sleepy, like you’d guess. What they get is hyperactive, and they get inattentive,” Robertson said.

Robertson also associated ADHD and allergic rhinitis with OSA.

“You’ve seen these patients in your clinic because kids with allergic rhinitis get diagnosed with ADHD a lot more than kids without allergic rhinitis,” he said. “Especially if they have obesity too.”

Children who have enlarged tonsils may have OSA as well, Robertson said.

“Sleep apnea is fundamentally a mechanical problem. It’s a not enough space problem. There’s not enough space to breathe in the airway,” he said.

When patients fall asleep, their airway relaxes and collapses. But in patients with OSA, Robertson explained, the airway collapses completely, and patients will not be able to breathe unless they wake up.

“The patient wakes up so they can open up their airway and breathe. They fall asleep again, it collapses again, they wake up to breathe,” he said. “You’ll see these chains of events.”

Finally, snoring is another sign of OSA in children.

“Every once in a while, if they have a cold, don’t worry about it,” Robertson said. “But if it’s a chronic problem, that’s something to pay attention to.”

Robertson noted the pressing need caused by the prevalence of OSA, particularly among men, postmenopausal women, and certain populations of children, and why specialists such as allergists should become more involved in its diagnosis.

“There are not enough sleep doctors, frankly, in the world to take care of all of the people who have this particular issue, and we need the help from other clinicians,” he said.




Robertson BD. Sleep apnea and the allergist. Presented at: ACAAI Annual Scientific Meeting; Nov. 9-13, 2023; Anaheim, California.

Robertson reports employment as chief medical officer of NightWare.

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CHICAGO , Nov. 28, 2023 /PRNewswire/ -- Smoking marijuana in combination with cigarettes may lead to increased damage of the lung's air sacs, according to research being presented today at the annual meeting of the Radiological Society of North America (RSNA).

It is commonly believed that smoking marijuana is not harmful to the lungs. There is an abundance of established research that identifies the harms of cigarette smoking. In contrast, very little is known about the effects of marijuana smoking, and even less research has been done on the combined effects of smoking marijuana and cigarettes.

"Marijuana is the most widely used illicit psychoactive substance in the world, and its use has increased in Canada since the legalization of non-medical marijuana in 2018," said study co-author Jessie Kang, M.D., cardiothoracic radiologist and assistant professor in the Department of Diagnostic Radiology at Dalhousie University in Halifax, Nova Scotia, Canada. "Currently, not much research exists on the effects of marijuana smoking on the lungs."

To determine the effects of marijuana and cigarette smoking, researchers for the multicenter prospective study examined the chest CT images of four patient groups: non-smokers, cigarette smokers, marijuana smokers, and combined marijuana and cigarette smokers. Marijuana smokers included in the study had smoked marijuana at least four times a month for two years. Patients who ingested marijuana via edibles or oral drops were excluded from the study.

The researchers found that people who combined marijuana and cigarettes were 12 times more likely to have centrilobular emphysema than non-smokers. Centrilobular emphysema is a type of pulmonary emphysema where the air sacs within the lungs are damaged. This can lead to breathing difficulties and other serious respiratory symptoms.

"The mean number of marijuana smoking years was less than compared to cigarette smokers and combined marijuana and cigarette smokers," Dr. Kang said. "However, marijuana that is smoked is often unfiltered, which can potentially lead to more damaging particles entering the airways and lungs."

Combined marijuana and cigarette smokers were three to four times more likely to have airway wall thickening, which can lead to infections, scarring and further airway damage. Association with marijuana only and smoking only with bronchial wall thickening was not as significant. Similar results were seen with centrilobular and paraseptal emphysema, suggesting that the combination of cigarette and marijuana smoking may have a synergistic role on the lungs and airways.

"With our study, we show that there are physical effects of marijuana smoking on the lungs and that cigarette smoking and marijuana smoking may have a combined damaging effect on the lungs," Dr. Kang said.

According to Dr. Kang, further research is needed to identify the long-term effects of smoking marijuana.

"There is a common public misconception that marijuana smoking is not harmful," Dr. Kang said. "More research needs to be done in this area, so the public can make an informed decision on their recreational usage of marijuana."

Co-authors are Sebastian Karpinski, B.Sc., Paul Sathiadoss, M.B.B.S., Eric Lam, M.Sc., Eric Hutfluss, M.D., O. Osorio, M.D., D. A. Hashem, M.D., Matthew D. F. McInnes, M.D., and Giselle Y. Revah, M.D.

Note: Copies of RSNA 2023 news releases and electronic images will be available online at RSNA.org/press23.

RSNA is an association of radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Illinois. (RSNA.org)

Editor's note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-791-6610.

For patient-friendly information on chest CT, visit RadiologyInfo.org.

SOURCE Radiological Society of North America (RSNA)

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By Dr. Greg Zerovnik

Contributing Writer

11/28/2023 at 12:49 PM

SAN BERNARDINO, CALIF. – A new monoclonal antibody and new anti-viral vaccines are coming for the first time to provide protection against RSV, Respiratory Syncytial (sin-SISH-uhl) Virus. LaSalle Medical Associates clinics will be providing these breakthroughs to patients this fall.

“RSV is a cold-like virus that is usually mild but can put some people in the hospital,” says Dr. Cheryl Emoto, Medical Director of LaSalle Medical Associates. “For the first time this fall, young infants and seniors (those with the highest risk for severe disease) now have a way to prevent it.”

The Centers for Disease Control and Prevention notes that “Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization. Vaccines are available to protect older adults from severe RSV. Monoclonal antibodies are available to protect infants.”

The CDC goes on to note that RSV is “one of the most common causes of childhood illness and is the most common cause of hospitalization among infants [emphasis ours].” It usually starts in the fall and peaks in the winter, but this can vary.

Monoclonal antibodies and vaccines may now prevent RSV. A monoclonal antibody is a clone of a unique white blood cell (white blood cells are the body’s own infection fighters) given to augment and reinforce the body’s natural defenses. It’s the option available for infants who are entering their first RSV season. They are not used when someone already has RSV.

Up until now, almost all children have contracted RSV by the time they reach 24 months, so the new prevention regimen has the potential to prevent illness and potential complications such as bronchitis and pneumonia, making life easier for both infants and their parents or caretakers.

For older adults, the CDC estimates that between 60 to 100 thousand are hospitalized every year. resulting in 6,000 to 10,000 deaths. The most at-risk cohorts are older adults, adults with chronic heart or lung disease, those with weakened immune systems or certain underlying medical conditions and residents in nursing homes or long-term care facilities.

Complications may include asthma, chronic obstructive pulmonary disease (COPD, a chronic disease of the lungs that makes it hard to breathe), and congestive heart failure—when the heart can’t pump enough blood and oxygen through the body.

Additionally, this year, there is now a regimen for pregnant women that keeps the developing fetus safe from infection. Now is the time to contact your healthcare provider to schedule an appointment for preventive care, especially if you are pregnant, have an infant under 8 months of age or are 60 years of age or older.

LaSalle Medical Associates serves more than 350,000 patients in their clinics and statewide Independent Physicians Association Group (IPA) who are covered by Medi-Cal, Medicare, and Covered California, as well as those covered by Blue Cross, Blue Shield, Brand New Day, Molina, Care 1st, Health Net and Inland Empire Health Plan (IEHP).

LaSalle staff also help people who come into a clinic without any insurance to become enrolled for a variety of state and federal health coverage.

For more information call (909) 890-0407 or go online to LaSalleMedical.com.

Tags: (IEHP)and clinicsand Covered Californiaas well as those covered by Blue CrossasthmaBlue ShieldBrand New DayCare 1stCDCchronic obstructive pulmonary diseaseCOPDdelivering high-quality patient caredoctorsFresnoHealth NethospitalsInland Empire Health PlanKingsLos AngelesMaderamedi-calmedicareMolinaRespiratory Syncytial VirusriversideRSVSan BernardinoSan Bernardino and Tulare counties.

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pulmonary rehabilitation

For people living with chronic obstructive pulmonary disease (COPD), doing everything it takes to breathe properly is a priority. While you’ll have a medication protocol to follow, your doctor might also suggest undergoing pulmonary rehabilitation. This is a form of treatment that can be essential to living a full life with COPD. 

What’s Pulmonary Rehabilitation?

Pulmonary rehabilitation is a medically supervised program that helps people with lung diseases live more fulfilling lives. This program generally includes learning about breathing exercises, maintaining fitness, adjusting your daily behavior, and improving your overall nutrition.

When enrolled in the program, you may work with doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dietitians. It also encourages taking part in group activities so you’ll get support and advice from those who are dealing with similar situations. 

Who Qualifies For This Treatment

Usually, anyone who has had COPD for more than a year can qualify for pulmonary rehabilitation. All that’s required is for your doctor to refer you to a program of your choice. Of course, your doctor might have their own criteria for giving you a referral. These criteria can include having worsening symptoms and not responding to medication as well as you used to. 

RELATED: Improving Lung Function: 10 Things to Know About Pulmonary Rehab

How Rehabilitation Can Help You

Pulmonary rehabilitation is designed to be a well-rounded program that can help you regain your strength, carry out your daily activities, work, and remain social. It does this by combining exercises, breathing techniques, a nutrition program, support, education about your medication regimen, and stress management. 

Some of the exercises that you can expect include leg exercises like walking or climbing stairs, upper body exercises like turning cranks, and strength training like weight lifting.

Breathing techniques are also used to steadily increase your lung capacity, help you remove mucus from your lungs, and improve your lung function. These alone can help you carry out your job and other everyday activities more easily with COPD. 

For some people, managing their weight will be essential to maintaining proper lung function so having a personalized nutrition plan can help with that. Given that studies show how having COPD can negatively affect your mental health, having the support of therapists and your peers can have a positive impact as well. In fact, people who have that kind of support are less likely to suffer from the anxiety and depression that are associated with COPD. 

It’s important to note that working out with a physical therapist or another medical professional can still have its risks. Sometimes, the suggested exercises can put a strain on your muscles and bones. In that case, the team will stop the routine to

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A device to detect breast cancer in urine for young women, an affordable eco-friendly sanitary pads using plantain fibres and smart badge to protect you in the dark are among the university innovations being displayed at Prototypes of Humanity, an annual programme that trawls the world for the most innovative academic projects addressing problems affecting women.     

Prototypes for Humanity Programme

Prototypes for Humanity Programme

The three women’s health submissions are:

·       Smart badge enhancing nighttime security (eNOugh: University College London, United Kingdom) Designed for easy use during late hours, the badge integrates night vision, GPS, movement detection, an alarm, and AI support.

·       Affordable, eco-friendly sanitary pads using plantain fibres (Plad: Kwame Nkrumah University of Science and Technology, Ghana)

·       Device-enabled AIto detects breast cancer in urine for young women (The Blue Box: University of California, Irvine, United States)

These are some of the 100 projects featured at the Prototypes for Humanity programme which engaged with thousands of students and professors across 710 universities in 108 countries and within 200 different research fields this year. The resulting 100 shortlisted projects were developed by graduates from universities including: Yale, Stanford, Oxford, Princeton, Berkeley, MIT, Harvard, Cambridge and UCL will be present at the exhibition in Dubai, alongside supervising professors, and team members. $100,000 in prizes will be presented at The 2023 Prototypes for Humanity Awards Ceremony to projects across 5 categories that reflect key priority areas from the COP28 agenda.

Women’s Health has expectedly emerged as one of the key focus areas for graduates, across a wide range of disciplines, from data sciences to pharmacology, through to bioengineering and industrial design, tackling issues that include: injury rehabilitation, cardiac surgery, speech-language therapy, wound healing, neurological conditions, respiratory physiotherapy, and HIV Bio-screening.

Tadeu Baldani Caravieri, Director, Prototype for Humanity comments: “As we gather at the 2023 edition of Prototypes of Humanity, where ingenuity knows no bounds, we bring to the forefront an impressive array of academic projects by students in global academic institutions, alongside leading universities in developing countries. Among the many complementing faces of social impact, women’s health (including safety and emergency response) emerges unsurprisingly as a key area of concern – and one where technology, science and creativity is being channeled by academic talent from around the world. Through our participant’s research, we often encounter problems that are still not sufficiently voiced, and the solutions that offer a glimpse into the future of healthcare.”

The event is open to the public, at Emirates Towers (The Boulevard), Dubai prior to COP28 on Wednesday 29 November and Thursday 30 November 2023. This year, the assessment of submission relied also on AI, used to establish connections, and assess the relevance of the projects compared to large databases of published research in their respective fields. The 2023 Prototypes for Humanity Awards Ceremony will be held at COP28 on 2 December

The breadth of the solutions on display also reflects Prototypes for Humanity’s growing reach and community is at the heart of Dubai’s future-looking ecosystem, thanks to a new milestone partnership with the Dubai Future Foundation. The projects carry many of the underlying technologies necessary to achieve the ambitious goals that will be discussed by global leaders a few days later at COP28 in Dubai.  

The Prototypes for Humanity programme also seeks to help solutions go to market, by bringing together three key components, under a novel model: (i) academic IP (ii) venture studios and (iii) industry partnerships.

During the 2023 programme in Dubai, participating graduates will take part in workshops, round tables and discussions with startup and industry experts, as a first step towards entering Prototypes for Humanity structured venture-building programme – a new initiative that aims to directly support selected projects to create a viable business model and go to market.  

About Prototypes for Humanity

Prototypes for Humanity is the most comprehensive assembly of academic innovations that has the power to change the world.  We promote and support solutions creating real-world impact for the environment and society, by mobilizing academia, private and public sector

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