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Scientists investigate bird flu outbreak in seals



Last summer, a highly contagious strain of avian influenza that was spreading among North American birds entered marine mammals, causing seal splash along the coast of Maine. In June and July, more than 150 dead or sick seals washed ashore.

Now the study provides a new insight into the outbreak. Scientists reported Wednesday in the journal Emerging Infectious Diseases that of 41 beached seals tested for the virus, nearly half were infected with it. The researchers concluded that it was likely that wild birds transmitted the virus to seals at least twice. In several seals, the virus had mutations associated with adaptation to mammals.

The risk to humans remains low and the seal outbreak has subsided rapidly, scientists said.

“As far as we can tell, it was a dead end,” said Caitlin Sawatsky, a research fellow at Tufts University’s Cummings School of Veterinary Medicine and author of the new paper. “The virus that entered these seals did not survive.”

But the report comes amid growing fears that the virus, which has already caused the largest avian flu outbreak in the country’s history, could adapt and spread more efficiently among mammals, potentially causing a new pandemic.

It remains unclear whether the seals transmitted the virus to each other or picked it up from birds in the first place. But the number of affected seals suggests that either the virus spreads easily among marine mammals or the barrier to bird-to-seal transmission is low.

“We really don’t know if it’s transmitted from bird to seal, bird to seal, bird to seal 100 times in a row, or if it’s passed on to a pair of seals and then spread,” said Wendy Puriar, a virologist at Tufts Veterinary School. and author of a new article. “Both are possible,” she added. “None of them are great.”

Either scenario calls for closer observation of the seals, said David Stalknecht, a wildlife disease and influenza expert at the University of Georgia who was not involved in the study.

“We just need to keep an eye on them,” he said. “The easiest way to find out if this persists in seals is to keep testing them.”

The current version of H5N1 has become unusually widespread in wild birds and has been repeatedly transmitted to mammals, including lynxes, raccoons and foxes. Scientists believe that most wild mammals contract the virus directly from birds.

But an outbreak of bird flu last fall on a Spanish mink farm showed that the virus can spread efficiently among some mammalian species. another mass death of sea lions in Peru raised concerns that marine mammals could also transmit the virus to each other.

Seals are known to be susceptible to avian flu, and other versions of the virus have previously caused outbreaks in animals.

The new study is the result of a collaboration between researchers from several academic institutions and wildlife organizations, including the Maine and New England Wildlife Centers, as well as federal scientists.

The researchers collected samples from 1,079 wild birds and 132 gray and harbor seals washed ashore in the North Atlantic from January 20 to July 31, 2022. “It gave us a really powerful opportunity to see what is happening with birds and seals. at the same time in the same region,” the doctor said. Purye said.

The researchers found that wild birds had two flu waves. The first, which peaked in March 2022, primarily affected birds of prey, while the second, which began in June, affected gulls and sea ducks known as eiders.

No seal tested positive for avian influenza during the first wave of avian infections. But during a summer stranding, 19 out of 41 seals tested positive.

The researchers found two slightly different versions of the virus in the seals. One matched what circulated in terns, and the other resembled what circulated in a wider range of birds, including gulls and eiders. The findings suggest that the virus has spread at least twice.

Since these seals do not normally eat birds, scientists suspect that the animals pick up the virus from the environment, possibly through contact with bird droppings.

Seal virus samples also had mutations that were rare or absent in birds. Mutations were found in three seal samples that have been shown to improve virus replication or increase virulence in mammals.

Such mutations are not unique. IN another recent studyA team of Canadian scientists found the same mutations in some virus samples taken from foxes infected with avian influenza. “When there is spread from birds to mammals, they seem to be acquired pretty quickly,” says the doctor. Savatsky said.

The presence of these mutations in itself is not a cause for alarm, the doctor notes. said the groom. But constant surveillance is needed not only to protect human health, but also to protect wild animals from a virus that has already proven its destructive power.

“These emerging diseases need to be considered on a larger scale than just ‘pandemic potential,'” he said, “because they affect so many other species around the globe.”

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Opioids: Chronic pain patients struggle to get prescription drugs




Jessica Layman estimates that over the past few years she has called more than 150 doctors looking for someone to prescribe opioids for her chronic pain.

“Many of them are outright offensive,” said the 40-year-old Dallas resident. “They say things like, ‘We don’t treat drug addicts.

Layman has tried many non-opioid therapies to relieve the intense daily pain caused by double scoliosis, spinal disc collapse, and facet joint arthritis. But she said nothing worked as well as methadone, an opioid she’s been taking since 2013.

The last phone calls came late last year, after her previous doctor closed his pain management practice, she said. She hopes her current doctor doesn’t do the same. “If something happens to him, I have nowhere to go,” she said.

A layperson is one of the millions in the United States living with chronic pain. Many have struggled to get opioid prescriptions written and filled since Guide 2016 from the Centers for Disease Control and Prevention inspired laws against the practices of doctors and pharmacies. The CDC recently updated these guidelines to try to ease their impact, but doctors, patients, researchers and advocates say the damage is already done.

“We had a serious problem with opioids that needed to be addressed,” said Antonio Ciaccia, President 3 axis advisors, a consulting firm that analyzes prescription drug prices. “But federal crackdowns and guidelines have created collateral damage: patients are left with nothing.”

Born out of efforts to combat the country’s overdose crisis, the guidelines have resulted in legal restrictions on doctors’ ability to prescribe painkillers. The recommendations have led many patients to face the mental and physical health consequences of rapidly reducing or abruptly discontinuing medications they have been taking for years, with the risk of withdrawal, depression, anxiety, and even suicide.

In November, the agency published new rulesencouraging physicians to focus on the individual needs of patients. While the guidelines continue to say that opioids should not be used for pain, they soften recommendations on dose limits that were widely seen as hard and fast rules in the 2016 CDC guidelines. The new standards also warn physicians of the risks associated with rapid dose changes after long-term use.

But some doctors fear it will take a long time to make meaningful changes to the new guidelines, and for some patients it may be too little or too late. Reasons include a lack of coordination from other federal agencies, fear of legal repercussions among service providers, the reluctance of state politicians to change laws, and widespread stigma associated with opioids.

A 2016 guide to prescribing opioids for people with chronic pain filled a vacuum for government officials seeking solutions to the overdose crisis, the report said. Dr. Pooja Lagisettiassistant professor of medicine at the University of Michigan School of Medicine.

V dozens of state laws Restricting how health care workers prescribe or distribute these drugs has had an effect, she said: the number of opioids prescribed has dropped, even as the number of overdoses has continued to rise.

The first recommendations from the Centers for Disease Control and Prevention (CDC) “warned everyone.” Dr. Bobby Mukkamala, Chairman of the Task Force on Substance Use and Pain Relief of the American Medical Association. Doctors have reduced the number of opioid pills they prescribe after surgeries, he said. The 2022 amendments are a “dramatic change,” he said.

The human cost of the opioid crisis cannot be overestimated. Death from opioid overdose growing steadily in the US in the last two decades, with spike at the beginning of the covid-19 pandemic. The CDC reports that illegal fentanyl has caused a recent spike in overdose deaths.

Taking into account the perspective of patients with chronic pain, the latest recommendations attempt to reduce some of the harm for people who have benefited from opioids but have been cut off from them. Dr. Jean-Marie Perronedirector of the Pennsylvania Medical Center for Addictions and Politics.

“I hope we just continue to be careful not to spread too many concerns about never using opioids,” said Perrone, who helped develop the latest CDC guidelines.

Christopher Jones, director of the CDC’s National Center for Injury Prevention and Control, said the updated guidelines are not a regulatory mandate, but merely a tool to help clinicians “make informed, person-centered pain management decisions.”

several studies the question is whether opioids are the most effective way to treat chronic pain in the long term. But lowering the dose of the drug is associated with overdose deaths and suicide, with the risk increasing the longer a person takes opioids, according to a study by Dr. Stefan Kertészprofessor of medicine at the University of Alabama-Birmingham.

He said the CDC’s new guidance reflects “an extraordinary amount of information” from chronic pain patients and their physicians, but doubts it will have much of an impact unless the FDA and the Drug Enforcement Administration change how they enforce federal laws.

The FDA approves new drugs and their new formulations, Kertész said, but the advice it makes on how to start or stop patients may encourage clinicians to do so with caution, Kertész said. The DEA, which is investigating doctors suspected of illegally prescribing opioids, declined to comment.

DEA harassment of doctors has put Warner Robins, Georgia’s Danny Elliott in a terrible predicament, his brother Jim said.

In 1991, Danny, a representative of a pharmaceutical company, was electrocuted. Jim said he took pain medication for years for a brain injury until his doctor faced federal charges for illegally dispensing prescription opioids.

Danny went to doctors out of state, first in Texas and then in California. But Danny’s last doctor had his license suspended by the DEA last year and he couldn’t find a new doctor to prescribe the drugs, Jim said.

Danny, 61, and his wife Gretchen, 59, committed suicide in November. “I am very frustrated and angry at pain patients being turned off,” Jim said.

Danny became a defender against forced cessation of drug use before death. Patients with chronic pain who spoke to KHN pointed to his plight, calling for more access to opioids.

Even for those with a prescription, it is not always easy to get the medicines they need.

Pharmacy chains another wholesale drug dealers settled billions of dollars in lawsuits over their alleged role in the opioid crisis. Some pharmacies have limited or stopped supplies of opioids, notes Chachcha of 3 Axis Advisors.

Reba Smith, 61, from Atlanta, said her pharmacy stopped filling prescriptions for Percocet and MS Contin in December. She said she took these opioids for years to cope with chronic pain after her iliac nerve was mistakenly severed during surgery.

Smith said she visited nearly two dozen pharmacies in early January but couldn’t find one that matched her prescriptions. She eventually found a local mail-order pharmacy that had a month’s supply of Percocet. But now this drug and RS Contin are out of stock, the pharmacy told her.

“It was a terrible three months. I was in terrible pain,” Smith said.

Many patients fear constant pain in the future. Layman thinks about the lengths she’s willing to go to get the cure.

“Would you agree to buy drugs on the street? Would you like to go to a drug treatment clinic and try to get painkillers there? What are you willing to do to stay alive?” She said. “That’s what it all comes down to.”

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Pharmaceutical giant Sanofi is the latest to cap insulin prices in the US



U.S. President Joe Biden, who has led calls for cost cuts on the drug, said Thursday in a statement: “This afternoon, all three of America’s top insulin makers agreed to substantially cut their prices following my calls to expand my $35 cap for seniors.” to all Americans.”

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Jennifer Lopez put her best foot forward in a cut-out abs-baring gown with a dramatic thigh slit



Jennifer Lopez loves the leg moment.

On March 18, the 53-year-old superstar and business mogul attended the launch party for her new shoe collection in collaboration with Revolve. Lopez arrived at the event with her best foot forward — literally posing with strappy platform lavender sandals thanks to the extremely high slit of her metallic-cut dress. She completed the look with a cropped gray coat with feathers, gold earrings and especially bright makeup.

“We’re Here” Lopez signed video from the event on Instagram. @jlojenniferlopez launch party for @revolve.

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In accordance with VVD, JLO Jennifer Lopez for Revolve is “a collection of 16 sculptural heels, ranging from chic metallic and crystal embellishments to animal prints.” The shoes are currently available on starting at $145 To $275.

Once at the party, Jennifer Lopez was photographed without a coat, showing off a sleek bodice design with a cut-out belly. She celebrated the launch with celebrity guests including Tiffany Haddish, Christina Milian and sisters Chloe and Halle Bailey. Before you start spreading rumors, Ben Affleck was in Austin, Texas to promote his new movie. airon SXSW.

Jennifer Lopez poses with Chloe and Halle Bailey at the presentation of JLo Jennifer Lopez for the Revolve collection.

Matt Winkelmeyer/Getty Images

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