A recent estimate by researchers at the University of Miami suggests that 100 million sharks are killed every year. That overfishing is putting many species at risk of extinction. But it is also having some unintended consequences for other fish that sharks prey on. VOA’s Kevin Enochs reports.
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China’s crackdown on imports of plastic trash should be a signal for rich nations to increase recycling and cut down on non-essential products such as plastic drinking straws, the head of the U.N. Environment Program said on Monday.

Erik Solheim, a former Norwegian environment minister, urged developed nations to re-think their use of plastics and not simply seek alternative foreign dumping grounds after China’s restrictions took effect this month.

“We should see the Chinese decision I heard some complaints from Europeans as a great service to the people of China and a wake-up call to the rest of the world,” he said in a telephone interview from Nairobi. “And there are lots of products we simply don’t need.”

Prime examples, he said, were microbeads – tiny pieces of plastic often used in cosmetics which have been found to pollute the world’s oceans, rivers and lakes – and drinking straws.

“The average American uses 600 straws a year,” he said, generating vast amounts of plastic waste. “Everyone can drink straight from the bottle or the cup.”

He suggested restaurants and bars could put up signs along the lines of: “If you desperately need a straw we will provide it.” 

Some companies have already cut back on straws.

He praised bans on microbeads, sometimes used as abrasives in facial scrubs or toothpaste. The United States passed a law in 2015 to ban microbeads and a ban in Britain took effect this month.

Piles of waste have built up in some western ports after China, the main destination for more than half of plastic waste exported by western nations, banned “foreign garbage” including some grades of plastics and paper.

Solheim said companies including Coca-Cola, Nestle and Danone were taking steps to raise plastic recycling or to shift to biodegradable packaging. Kenya has banned plastic bags.

“But the problem is so huge that a lot more needs to be done” by governments and businesses, Solheim said.

“It’s a much better idea if nations overall take care of their own waste,” rather than seek new dumping grounds, he said, adding that: “It’s not obvious that well-run nations like India and Vietnam want to be taking over this waste,” after China’s ban.

Last week, the European Commission outlined a new policy push to promote recycling of plastic. It said it was mulling a tax, curbs on throwaway items such as plastic bags and new quality standards.

In December, almost 200 nations signed a U.N. resolution to eliminate plastic pollution in the oceans, with the U.N. Environment Agency projecting that there could be more plastic in the sea than fish by 2050.
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U.S. Democratic senators have blocked a bill that would have banned abortions after 20 weeks, ensuring that the procedure stays legal through the later terms of a woman’s pregnancy.

Republican leaders in the Senate knew the bill had little chance to pass, but wanted to pressure Democrats to take a stance on abortion, particularly vulnerable Democrats facing re-election and from states that voted for President Donald Trump.

The bill fell short by a 51 to 46 vote. It needed 60 votes to end a filibuster and proceed to a vote.

The vote largely fell along party lines, with only two Republicans voting against it — Susan Collins from Maine and Lisa Murkowski from Alaska. Three Democrats voted for the measure. All three — Joe Manchin of West Virginia, Joe Donnelly of Indiana, and Bob Casey of Pennsylvania — are from states that voted for Trump in the 2016 election.

More than half of the Senate’s Democrats and independents are up for re-election this year, and 10 of them are in states Trump won.

“This afternoon, every one of us will go on record on the issue,” Senate Majority Leader Mitch McConnell said on the Senate floor Monday ahead of the vote.

The legislation passed the House in October largely along party lines. The bill calls for a ban on abortions after five months, and would also threaten doctors who perform abortions after that time to five years in jail. The bill exempts women who need an abortion to save their lives, as well as rape and incest survivors.

Democrats criticized the Republican leadership on Monday for prioritizing an abortion ban less than a week after a government shutdown and before issues on spending and immigration are resolved.

“While the country is waiting for us to come together and solve problems, Republicans are wasting precious time with a politically motivated, partisan bill engineered to drive us apart — and hurt women,” said Democratic Sen. Patty Murray, ahead of the vote.
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Scientists have assembled the most complete human genome to be mapped with a single technology using a new pocket-size portable DNA sequencer, which they say could one day make genome mapping quick and simple enough to do at home.

Using a device about the size of a mobile phone and called a MinION, made by Oxford Nanopore Technologies, researchers from Britain, the United States and Canada said they were able to sequence much longer strands of DNA than previously, making the process cheaper and swifter.

“If you imagine the process of assembling a genome … is like piecing together a jigsaw puzzle, the ability to produce extremely long sequencing reads is like finding very large pieces of the puzzle, which makes the process far less complex,” said Nick Loman, a professor at the University of Birmingham’s Institute of Microbiology and Infection who co-led the work.

Understanding and interpreting the human genome is a cornerstone of modern medicine, offering a wealth of information about a person’s inherited genetics risks, the antibodies they have, or how their diseases — such as cancer — have developed.

The first mapping of the human genome — essentially a person’s genetic recipe — was completed in 2003. It cost government-funded scientists $3 billion and 13 years of work.

‘Landmark for genomics’

Loman said the mini-sequencer may soon allow genome mapping to become a routine part of medical care.

“At the moment, sequencing is quite laborious and occurs in expensively equipped laboratories,” he said. “But in future, we can imagine sequencing using pocket-size devices in [doctors’] surgeries, in clinics and even in people’s own homes.”

The MinION works by detecting the change in current flow as single molecules of DNA pass through a nanopore — or tiny hole — in a membrane. Mapping a human genome with this device costs around $1,000.

“This is a landmark for genomics,” said Matt Loose of the University of Nottingham, who worked with Loman. “The long reads that are possible with nanopore sequencing will provide us with a much clearer picture of the overall structure and organization of the genome than ever before.”

The research was published Monday in the journal Nature Biotechnology.
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Women who are deficient in iodine and trying to get pregnant may have half the chance of conceiving compared to women with healthy iodine levels, according to a recent U.S. study.

Researchers followed more than 500 women trying to conceive over about five years and found that, overall, those with moderate to severe iodine deficiency had 46 percent lower odds, per cycle, of becoming pregnant.

“Our finding that moderate deficiency is associated with difficulty conceiving has important public health implications,” said lead study author Dr. James Mills of the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland.

“We were surprised that moderate to severe deficiency was so common and that it reduced the chance of a woman becoming pregnant by almost 50 percent in each menstrual cycle,” he told Reuters Health by email.

Iodine plays a vital role in brain development during pregnancy, but past research finds that about 30 percent of women of childbearing age have iodine blood levels below the target of 100 micrograms per liter, the authors note in Human Reproduction.

Current U.S. guidelines suggest that pregnant and breastfeeding women take a supplement containing 150 micrograms of iodine, but these recommendations don’t address what women should do before they become pregnant.

Mills and his colleagues analyzed data from 2005 to 2009 on 501 women who, when they enrolled in the study, had recently discontinued contraception to become pregnant. At the outset, researchers collected urine samples for iodine analysis. Women also reported on risk factors related to infertility during interviews and then over the next 12 months kept daily journals and used fertility monitors to time sexual intercourse and ovulation. They also used digital pregnancy tests at home to identify pregnancies and menstruation cycles.

The research team found that 44 percent of the urine samples were in the deficient range for iodine. Almost a quarter of all samples were in the moderate to severe deficiency range, with less than half of the recommended level.

At 12 months after enrollment, 332 women (71 percent) had become pregnant, 42 (10 percent) did not, and the rest dropped out of the study for various reasons.

Future studies will also examine the relationship between iodine status and other aspects of reproduction, such as thyroid problems and fetus development.

“Although it is challenging to find women who are about to try to become pregnant and monitor them, it is important to replicate these findings,” Mills said.

No easy answers

It’s tough to give advice to women regarding iodine levels, testing and supplements, said Sarah Bath of the University of Surrey in the U.K.

“Unfortunately, there is no method of assessing iodine status in individuals, so people cannot get tested to know whether they have an adequate amount,” she told Reuters Health by email. “The test used in this study can only be applied to large groups.”

The study also didn’t look at the effect of iodine supplements on conception, only the comparison between a group of women with inadequate iodine versus a group with adequate iodine, she added.

“This study doesn’t provide evidence that iodine supplementation is beneficial in those trying to conceive,” she said. “If people do consider an iodine supplement, however, they should not take a kelp or seaweed supplement, as this can lead to excessive iodine intake.”

Choosing a diet with an adequate amount of iodine is key, both Mills and Bath advised. Iodine levels in food can vary by country and type of food, and high levels of iodine can also be an issue, so “more is better” isn’t necessarily true either, they added. Good sources of iodine can be found in fish, especially white fish, seafood, milk and dairy products. Some salts contain iodine, but women shouldn’t consume more salt just to get more iodine.

“This issue has not yet been addressed for women trying to conceive,” Mills added. “Therefore, choosing the right diet is prudent … and many experts believe that taking prenatal vitamins that contain iodine is a good idea.”
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After three decades and 15 billion dollars, just three countries still harbor polio. Those three countries, Pakistan, Afghanistan and Nigeria, all suffer from violent insurgencies. A new study is one of the first to document how a lack of security sets back efforts to eradicate the paralyzing disease. VOA’s Steve Baragona has a report.
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Polio cases in Pakistan rose by 73 percent during the most intense periods of civil conflict there in recent years, according to a new study.

The report, in the journal Proceedings of the National Academy of Sciences,  is one of the first to provide concrete evidence of the impacts insecurity has on efforts to eradicate the paralyzing disease.

Over the past three decades, polio has gone from infecting more than 1,000 children per day to just a handful of cases per year. But experts say as long as the disease circulates anywhere, it remains a threat to unvaccinated children everywhere. 

WATCH: The fight against polio continues

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Pakistan, Afghanistan and Nigeria are the last three countries on Earth that have not stopped the disease from spreading. 

All three suffer from violent militant attacks. 

The polio eradication campaign has overcome violence before. Vaccinators have brokered cease-fires in El Salvador, Lebanon, Sri Lanka, the Democratic Republic of the Congo and elsewhere, all of which are now polio-free. 

“The question is, is the effect (of insecurity in Pakistan) big enough to really be a barrier to polio eradication?” asked lead author Amol Verma at the University of Toronto. 

“Our study suggests that yes, it is,” Verma said.

While polio vaccination teams have been singled out for attacks, including a mother and daughter in Quetta earlier this month, Verma and colleagues looked at violence more generally. They studied casualty figures from terrorist attacks, suicide bombings, drone strikes and gun battles tallied from news reports at pakistanbodycount.org and other sites.

They compared these data to monthly, district-by-district statistics on new polio cases, and data from polio campaigns on the numbers of children reached. 

Although conflicts sometimes forced the cancellation of a campaign, the violence had an impact even when vaccinators continued their work. 

“Even when vaccination campaigns were carried out in times of high insecurity, the vaccination coverage was about 5 percent lower than in times of low insecurity,” Verma said. 

Health workers have been “rather heroic in trying to reach people in these very difficult-to-reach regions,” he added, explaining that vaccinators would reach everywhere they could, but knew some areas were too dangerous.

Those unreachable areas added up to more than a quarter-million children not getting vaccinated, and a 73 percent increase in newly paralyzed children.

“Even though it’s only a 5 percent reduction in vaccination rates, that is enough to allow the virus to continue to be circulated and transmitted,” he said.

The study authors acknowledge that campaign officials sometimes falsify records, and population data in Pakistan are limited. 

“Despite data collection issues and the inherent difficulty of accurately quantifying levels of insecurity and its impact, the authors have statistically shown that a causal relationship between insecurity and polio incidence exists,” said Richard Sullivan, co-director of the Conflict and Health Research Group at King’s College London, who was not involved with this study.
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The moon is providing a rare triple treat this week.

On Wednesday, much of the world will get to see not only a blue moon and a supermoon, but also a total lunar eclipse, all rolled into one. There hasn’t been a triple lineup like this since 1982 and the next won’t occur until 2037.

The eclipse will be visible best in the western half of the U.S. and Canada before the moon sets early Wednesday morning, and across the Pacific into Asia as the moon rises Wednesday night into Thursday.

The U.S. East Coast will be out of luck; the moon will be setting just as the eclipse gets started. Europe and most of Africa and South America also will pretty much miss the show.

A blue moon is the second full moon in a month. A supermoon is a particularly close full or new moon, appearing somewhat brighter and bigger. A total lunar eclipse — or blood moon for its reddish tinge — has the moon completely bathed in Earth’s shadow.

“I’m calling it the Super Bowl of moons,” lunar scientist Noah Petro said Monday from NASA’s Goddard Space Flight Center in Greenbelt, Maryland.

Others prefer “super blue blood moon.”

Either way, it’s guaranteed to impress, provided the skies are clear.

The moon will actually be closest to Earth on Tuesday — just over 223,000 miles (359,000 kilometers). That’s about 1,500 miles (2,400 kilometers) farther than the supermoon on Jan. 1. Midway through Wednesday’s eclipse, the moon will be even farther away — 223,820 miles (360,200 kilometers) — but still within unofficial supermoon guidelines.

While a supermoon is considered less serious and scientific than an eclipse, it represents a chance to encourage people to start looking at the moon, according to Petro.

“I’m a lunar scientist. I love the moon. I want to advocate for the moon,” he said.

Throw in a blue moon, and “that’s too good of an opportunity to pass,” according to Petro.

As the sun lines up perfectly with the Earth and then moon for the eclipse, scientists will make observations from a telescope in Hawaii, while also collecting data from NASA’s moon-circling Lunar Reconnaissance Orbiter, launched in 2009.

Just like the total solar eclipse in the U.S. last August cooled the Earth’s surface, a lunar eclipse cools the moon’s surface. It’s this abrupt cooling — from the heat of direct sunlight to essentially a deep freeze — that researchers will be studying.

Totality will last more than an hour.

“The moon is one of the most amazing objects in our solar system,” Petro said. “It really is the key to understanding the solar system, through interpreting the geology and surface of the moon.”

NASA plans to provide a live stream of the moon from telescopes in California and Arizona, beginning at 5:30 a.m. EST.
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New data from 22 high- and low-income countries show antibiotic resistance to a number of serious bacterial infections is growing at an alarming rate. The World Health Organization surveyed one-half million people with suspected bacterial infections between March 2016 and July 2017.

The survey, the first of its kind, is vital in improving and understanding the extent of antimicrobial resistance in the world. World Health Organization Spokesman Christian Lindmeier, tells VOA the findings raise many red flags.

“The data that these countries provided show us that in some of the most common bacteria, the most commonly reported resistant bacteria, we find the resistance of sometimes up to 65 even up to 82 percent, depending on the bacteria. And… these are really alarming data,” he said.

The most commonly reported resistant bacteria include e-coli bacterial infection, staph infections, pneumonia and salmonella. The World Health Organization is encouraging all countries to set up good surveillance systems for detecting drug resistance. This, it says, will provide needed information to tackle what it calls one of the biggest threats to global public health.

If drug resistance is not successfully tackled, Lindmeier warns the world could return to the dangerous days before penicillin was invented.

“A simple infection, a cut, minor surgery suddenly can turn into a potentially most dangerous, life-threatening situation because infections would then prove drug resistant,” he said. “A cancer treatment for example would become a huge challenge on top of the cancer because the already low immune system could not be boosted any more with antibiotics. Any infection would pose an additional risk.”

Lindmeier says some countries are taking these warnings to heart. For example, he notes Kenya is enhancing its national antimicrobial resistance system, Tunisia is now collecting national drug-resistant data, and Korea is strengthening its surveillance system.

 
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To mark World Leprosy Day, the World Health Organization is calling for the eradication of this ancient disfiguring disease by combating the stigma and discrimination that discourages people from seeking the help they need.

Leprosy, a hideously disfiguring disease that has blighted the lives of countless millions since Biblical days, is curable. And yet, the World Health Organization reports more than 200,000 people, most in Southeast Asia, are affected with the disease and new cases continue to arise every year.

Leprosy is a chronic bacterial disease with a slow incubation period of about five years. In some cases, symptoms may occur within one year, but can take as long as 20 years to appear.

Leprosy was eliminated globally as a public health problem in 2000, but the disease persists in individuals and communities. WHO spokesman, Tarik Jasarevic, tells VOA this is unacceptable, as an effective treatment exists that can fully cure people of leprosy.

“Since ’95, WHO has provided this multi-drug therapy free of cost to all leprosy patients in the world,” he said. “In 2016, WHO launched global leprosy strategy, 2016-2020, accelerating toward a leprosy-free world. This is basically to revamp the efforts for leprosy control. The strategy focuses on avoiding disabilities, especially among children.”

This year’s World Leprosy Day focuses on preventing disabilities in children. WHO reports children account for nearly nine percent of all new cases of leprosy, including almost seven percent of those with visible deformities.

The U.N. health agency notes early diagnosis and early treatment can prevent disability. It says disabilities do not occur overnight, but happen after a prolonged period of undiagnosed and untreated disease.

Unfortunately, it notes many people do not seek help until it is too late and deformities already have appeared. This is because of the stigma and discrimination associated with leprosy.

WHO is calling for laws discriminating against people with leprosy to be abolished and replaced with policies promoting inclusion of such people within society.
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A common ingredient of toothpaste could be developed to fight drug-resistant strains of malaria. Scientists at Britain’s Cambridge University found that triclosan has the potential to interrupt the infection at two critical stages — in the liver and the blood. Faith Lapidus reports.
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President Donald Trump’s description of the climate on planet Earth doesn’t quite match what data show and scientists say.

In an interview with Piers Morgan airing Sunday on Britain’s ITV News, the president said the world was cooling and warming at the same time and that claims of melting ice caps haven’t come true.

TRUMP: “There is a cooling, and there’s a heating. I mean, look, it used to not be climate change, it used to be global warming. That wasn’t working too well because it was getting too cold all over the place.”

Ten different climate scientists contacted by The Associated Press said the president was not accurate about climate change. Rutgers University climate scientist Jennifer Francis responded in an email: “Clearly President Trump is relying on alternative facts to inform his views on climate change. Ice on the ocean and on land are both disappearing rapidly, and we know why: increasing greenhouse gases from burning fossil fuels that trap more heat and melt the ice.”

THE FACTS: The world hasn’t had a cooler-than-average year since 1976 and hasn’t had a cooler-than-normal month since the end of 1985, according to more than 135 years of temperature records kept by NASA and the National Oceanic and Atmospheric Administration.

The last four years have been the four hottest years on record globally, with 2010 the fifth hottest year, according to NOAA. Every year in the 21st century has been at least three quarters of a degree (0.4 degrees Celsius) warmer than the 20th century average and in the top 25 hottest years on record, NOAA records show.

And while a good chunk of the United States had a frigid snap recently, most of the rest of the world was far warmer than normal, according to temperature records.

Zeke Hausfather of the Berkeley Earth temperature monitoring program, initially funded by nonscientists who doubt that the world is warming, said in an email: “The world has been warming steadily over the past 50 years, with 17 of the past 18 years being the warmest since records began in the 1850s. It is not accurate to say that the climate has been ‘cooling as well as warming.’”

TRUMP: “The ice caps were going to melt, they were going to be gone by now, but now they’re setting records. They’re at a record level.”

THE FACTS: It is a bit more nuanced, but not quite right.

While a small number of experts a decade ago had predicted that Arctic would be free of summer sea ice by now, most mainstream scientists and the United Nations’ Intergovernmental Panel on Climate Change did not, instead they said Arctic sea ice would shrink, which it has, said Pennsylvania State University ice scientist Richard Alley. Most scientists, including the director of the National Snow and Ice Data Center, are predicting that the Arctic will be free of summer sea ice sometime around the 2040s.

The Arctic set a record for the lowest amount of sea ice in the winter, when sea ice usually grows to its maximum levels, in March 2017. In 2012, the Arctic set a record for lowest sea ice levels. 

Sea ice recovered slightly from that record and in 2017 in September, the annual low was only the eighth lowest on record, according to the National Snow and Ice Data Center. But the 10 lowest years of sea ice have been all in the last 11 years. Arctic sea ice is declining at a rate of 13.2 percent per decade, according to NASA.

Princeton University climate scientist Michael Oppenheimer said the Antarctic sea ice pack, less directly influenced by global climate change, varies from year to year. Antarctica hit a record low for sea ice in March 2017, the same month the Arctic hit a record winter low. Antarctic sea ice also reached a record high in 2014.

“Both of the large ice sheets of Greenland and Antarctica are losing hundreds of billions of tons of ice per year. Sea ice continues to decline significantly in the Arctic decade by decade, and the thickness of Arctic ice is now less than 50 percent of what it was 40 years ago,” National Snow and Ice Data Center scientist Ted Scambos said in an email.
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The world has another ally in the war against microplastics. Just before Christmas, the Italian government voted to ban the tiny beads that show up primarily in beauty products by 2020. Italy joins a growing list of countries, the United States included, that have banned microplastic products. VOA’s Kevin Enochs reports.
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All coral reefs go through bleaching episodes, and these episodes of drought or extreme heat can hurt even the healthiest of reefs. But climate change means more heat, more often, and new research is showing the world’s reefs do not have time to recover. VOA’s Kevin Enochs reports.
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U.S. health officials say the flu outbreak this winter is on track to be one of the most severe in the past 15 years.

In their latest weekly report Friday, the Centers for Disease Control and Prevention (CDC) said the flu is now widespread in every U.S. state except for Hawaii. The CDC said at this rate of infection, by the end of the flu season, around 34 million people will have come down with the flu.

Officials say last week, 1 in 15 doctor visits across the country was for symptoms of flu.

Past outbreaks 

Health officials say more people are seeking care for flulike illness than at any other time since the 2009 swine flu pandemic that swept the country. Apart from that outbreak, the last time the country experienced such high levels of seasonal flu was in 2003-04. 

The CDC said the virus this winter has caused nearly 12,000 people to be hospitalized and killed 37 children. Officials say the death toll of children is likely to rise as pediatric deaths must first be reported to a medical examiner and can take longer to be documented. 

Differences this year

The flu typically affects children and the elderly the most. However, hospitalization rates for people 50 to 64 — those who mostly fall under the baby boomer demographic — has been unusually high this season. Officials say the rate of hospitalization for baby boomers is 44.2 per 100,000 people, which is nearly triple what it was last season.

The CDC does not track adult flu deaths directly.

This year’s flu strain, mostly the H3N2 flu virus, is the same main bug from last winter, which did not have as severe an outbreak. Experts say that they are not sure why the pandemic is so bad this year and that flu seasons are notoriously hard to predict. 

Dr. Dan Jernigan, director of the influenza division at the CDC, told reporters on a conference call Friday that one notable difference in this year’s flu outbreak is that the pandemic hit almost all states in the country at the same time. “We often see different parts of the country light up at different times, but there is lots of flu all at the same time” this year, he said.

Jernigan said a surge of cases in January could have been caused by children returning to school after the Christmas break and spreading the virus. 

Flu peak

The flu season usually peaks in February. Influenza activity has already begun to taper off in some parts of the United States, particularly in California, which has been one of the hardest-hit states. Officials say this flu season also began early and so could end earlier.

Flu is a contagious respiratory illness that causes such symptoms as fever, cough, muscle aches, headaches and fatigue. Most people who get the flu get better within a week or two. However, some people develop serious complications caused by viral infection of the nasal passages and throat and lungs. 

The CDC recommends a flu vaccine for everyone older than 6 months. However, officials say this year’s vaccine is only about 30 percent effective in preventing infection.
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One in four children and teens who get their blood pressure screened at routine checkups may appear to have hypertension, but that result often doesn’t hold up in repeat tests, a U.S. study suggests.

Researchers examined data from electronic medical records for almost 755,795 children and adolescents treated at Kaiser Permanente facilities in Southern California, including 186,732 patients diagnosed with high blood pressure.

About 18 percent of kids diagnosed with mild hypertension and 51 percent of youth with more severe high blood pressure got repeat tests at the same visit when their condition was initially detected.

When the tests were repeated during the same visit, 52 percent of kids diagnosed with high blood pressure in the first assessment no longer had hypertension based on the average result from two screenings.

This means a lot of kids got falsely diagnosed with high blood pressure, said lead study author Corinna Koebnick of Kaiser Permanente Southern California.

“Repeating high blood pressure readings will avoid unnecessary follow-up visits but also to prevent the possibility that true hypertension is overlooked,” Koebnick said by email.

Among kids initially diagnosed with high blood pressure, the diagnosis was confirmed at a follow-up checkup for 2.3 percent of patients with mild hypertension and 11.3 percent of youth with more severe cases, the study also found.

One limitation of the study is that different clinicians or methods for measuring blood pressure might impact which patients were diagnosed with hypertension, the authors note. Because most clinicians didn’t follow recommendations to repeat blood pressure screenings during initial visits and schedule follow-up appointments, it’s also possible that this influenced the proportion of kids with misdiagnosed hypertension, they add.

Don’t rush

Still, the results suggest that pediatricians should repeat blood pressure tests during the same visit to verify the results and make sure children get the appropriate follow-up care if needed, the study team concludes in The Journal of Clinical Hypertension.

“If the first blood pressure reading is normal, it does not need to be repeated at that visit,” said Dr. Joyce Samuel, a researcher at the McGovern Medical School at the University of Texas Health Science Center at Houston. “However, if the first reading is high, taking a few minutes to repeat it may save considerable time, anxiety and cost in the long-run by avoiding unnecessary referrals to blood pressure specialists,” Samuel, who wasn’t involved in the study, said by email.

Initial blood pressure readings may falsely suggest hypertension if the tests are done too quickly, especially if screening happens right at the start of the visit before children have a chance to sit and relax for a few minutes, noted Dr. David Kaelber, a researcher at Case Western Reserve University and chief medical informatics officer of the MetroHealth System in Cleveland, Ohio.

If children appear to have hypertension with the first assessment using an automated blood pressure machine, doctors might get a different result when they repeat the test manually, Kaelber, who wasn’t involved in the study, said by email.

“Automated machines are known to typically generate at least slightly higher blood pressure measures than manually taken blood pressure,” Kaelber said.

Doctors should check blood pressure at each annual physical, according to recommendations from the American Academy of Pediatrics (AAP). Children who have high blood pressure should try to lower it with lifestyle changes like improving diet and exercise habits before trying medication, the AAP advises.

“I think the most important message for parents is that they should be asking about their child’s blood pressure just like they ask about their child’s height and weight,” said Dr. Joseph Flynn, a researcher at the University of Washington and Seattle Children’s Hospital who was lead author of the AAP blood pressure guidelines.

“I’m sure that many parents request their child be re-measured if they don’t believe the height or weight for some reason,” Flynn, who wasn’t involved in the study, said by email. “Similarly, if the child’s blood pressure is high, they should ask that it be repeated at the same visit if that hasn’t already happened.”

 
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The mosquito-born Zika virus may be responsible for an increase in birth defects in U.S. states and territories even in women who had no lab evidence of Zika exposure during pregnancy, U.S. health officials said on Thursday.

Areas in which the mosquito-borne virus has been circulating, including Puerto Rico, southern Florida and part of south Texas, saw a 21 percent rise in birth defects strongly linked with Zika in the last half of 2016 compared with the first half of that year, the U.S. Centers for Disease Control and Prevention said in its weekly report on death and disease.

Researchers said it was not clear if the increase was due to local transmission of Zika alone or if there were other contributing factors.

The Zika outbreak was first detected in Brazil in 2015 and spread through the Americas. It has been linked to thousands of suspected cases of microcephaly, a rare birth defect marked by unusually small head size, eye abnormalities and nerve damage resulting in joint problems and deafness.

For the report, the CDC examined existing birth defect reporting systems in 14 U.S. states and Puerto Rico to look for birth defects possibly associated with Zika.

They divided these areas into three groups: places with local Zika transmission, places with higher levels of travel-associated Zika, and places with lower rates of travel-related Zika.

Overall, they found three cases of birth defects potentially related to Zika per 1,000 live births out of 1 million births in 2016, about the same as the prior reporting period in 2013-2014.

When they looked specifically in areas with local Zika transmission and looked only at birth defects most strongly linked with Zika, they saw an increase.

“We saw this significant 21 percent increase in the birth defects most strongly linked to Zika in parts of the U.S. that had local transmission of Zika,” Peggy Honein, an epidemiologist and chief of the CDC’s Birth Defects Branch, said in a telephone interview. “The only area where we saw this increase was in the jurisdictions that had local transmission.”

CDC researchers anticipate another increase in possible Zika-related birth defects when 2017 data are analyzed because many pregnant women exposed to Zika in late 2016 gave birth in 2017.
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Two of the largest mass vaccination campaigns against yellow fever ever seen in the world have begun in Nigeria and Brazil. Both campaigns, which are supported by the World Health Organization, aim to prevent the spread of the disease.

Nigeria plans to vaccinate more than 25 million people throughout the coming year, making this the largest yellow fever campaign in the country’s history. In preparation, the World Health Organization has trained thousands of health care workers on how to administer the vaccine.

The WHO says nearly 3,000 vaccination teams are being deployed across the states of Kogi, Kwara, Zamfara and Borno. In the case of Borno State, it says the campaign will focus on camps for internally displaced people and host communities.

WHO spokesman Tarik Jasarevic says the goal of the campaign is to reduce yellow fever transmission by achieving 90 percent coverage in those states.

“It is a part of an initiative to eliminate yellow fever epidemics,” he said. “As you know, we cannot … eradicate the yellow fever virus because it is being transmitted by mosquitoes. But, with the effective vaccine that exists for a number of years now, it can be prevented. So, mass vaccination is the best way to prevent outbreaks of yellow fever.”

The WHO reports the mass immunization campaign launched in Brazil will deliver so-called fractional doses of yellow fever to nearly 24 million people in Rio de Janeiro and Sao Paulo. Fractional dosing is a way of extending vaccine supplies so more people are protected from the spread of the disease.

A full dose of vaccine provides life-long protection against yellow fever. One-fifth of the regular dose confers immunity against the disease for at least 12 months and possibly longer. That is considered an effective short-term strategy in places where the vaccine is in short supply.
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Since late last year, Ugandan medical facilities have been grappling with a severe blood shortage. The crisis underscores a longer term struggle to get Ugandans to give blood. Halima Athumani reports for VOA from Kampala.
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The United States Food and Drug Administration will be talking about alternatives to cigarette smoking as it deliberates whether to approve a new product offered by tobacco companies that delivers nicotine to the user without burning tobacco. The American Lung Association reports that cigarette smoking rates in the U.S. are at historically low levels. A little over 15 percent of Americans smoke.
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The American Lung Association says fewer Americans smoke cigarettes now than before tobacco control policies were put in place. 

In its annual report, the ALA says smoking rates among adults and teens are at historic lows. On average, just over 15.5 percent of American adults and eight percent of high school students smoke cigarettes.

The association gets its data from the Centers for Disease Control and Prevention which show the smoking rate declined from 20.9 percent in 2005 to 15.5 percent in 2016. Still, CDC data shows that nearly 38 million American adults continue to smoke. 

“The good news is that these data are consistent with the declines in adult cigarette smoking that we’ve seen for several decades. These findings also show that more people are quitting, and those who continue to smoke are smoking less,” according to Corinne Graffunder, director of the CDC’s Office on Smoking and Health quoted in a news release from the CDC. 

Yet, the American Lung Association finds that certain groups and regions in the United States are disproportionately impacted by tobacco use and exposure to second-hand smoke. Thomas Carr, the ALA’s Director of National Policy who wrote the 2018 report “The State of Tobacco Control,” said poorer Americans, those who are less educated, Native Americans and some ethnic groups have smoking rates that are close to 30 percent or higher. 

“The tobacco industry advertises more to some of these groups and more heavily than others, and you will find in low-income areas, there are sometimes a bigger concentration of tobacco stores and that kind of thing.”

There’s also peer pressure, and when friends or parents smoke, teens tend to take up the habit. Studies show that most people who smoke start before they are 18. Some start as young as age 11 according to The Campaign for Tobacco-Free Kids. Carr calls it a pediatric disease. “It starts in your teens and then once you’re hooked, you can’t get off of it.”

The lung association is pushing states to raise the age where young people can legally purchase cigarettes to 21, the minimum age in the United States for purchasing alcohol. The thought is that if middle and high school students can’t get cigarettes, they are less likely to start smoking. “It cuts off access to people 15 to 17 years old. A lot of times they’ll go to their friends who are 18 (and still) in high school, but they’re not as likely to hang around with people who are 19 or 20 or 21.” So far five states — California, Oregon, Maine, Hawaii and New Jersey have raised the age to 21. 

The lung association issues an annual report to help promote state and federal regulations to make it easier for people who smoke to quit and to help those who don’t smoke not to start. 
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Sao Paulo closed its zoo and botanical gardens Tuesday as a yellow fever outbreak that has led to 70 deaths is picking up steam.

The big Inhotim art park, which attracts visitors from all over the world, also announced that all visitors would have to show proof of vaccination to be allowed in. The park said the measure was preventative and no case of yellow fever had been found there.

Cases of yellow fever have been rising in Brazil during the southern hemisphere summer rainy season, and health officials are planning to vaccinate millions of people in the coming weeks in the hopes of containing the outbreak.

Authorities did not say when the Sao Paulo zoo or nearby botanical gardens would reopen. The zoo said in a statement that a wild monkey was found dead last week in the park that contains the zoo and tests Monday confirmed it was positive for yellow fever.

According to figures put out by each state, 148 cases have been confirmed in the southeastern states of Minas Gerais, Sao Paulo and Rio de Janeiro. Of those, 69 people have died. A week ago, the Health Ministry had confirmed 34 cases and 19 deaths in those states; it also confirmed one case in the capital district that ended in death.

Sao Paulo has registered the most cases, with 81, and the World Health Organization recommended last week that foreigners planning to travel anywhere in the state be vaccinated for the mosquito-borne disease. Brazil’s own recommendations include only parts of the state.

Much of Brazil is considered at risk for the yellow fever, but last year it saw its largest outbreak of the disease in decades, including in areas not previously thought to be at risk. More than 770 people were infected, and more than 250 died. Minas Gerais was at the epicenter of that outbreak, and it declared a state of emergency last week.

Yellow fever typically causes fever, muscle pain and nausea; some patients also experience the jaundice from which the disease gets its name.
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U.S. mayors increasingly view climate change as a pressing urban issue, so much so that many advocate policies that could inconvenience residents or even hurt their cities financially.

The annual survey of big-city executives, released Tuesday by the Boston University Initiative on Cities, also reflected the nation’s sharp political divide. Ninety-five percent of Democratic mayors who responded believed climate change was caused by human activities, a view shared by only half of Republican mayors. 

A clear majority of mayors were prepared to confront President Donald Trump’s administration over climate change and felt their cities could be influential in counteracting the policies of the Republican president, who at times has called global warming a hoax and last year withdrew the U.S. from the Paris climate accord.

“A striking 68 percent of mayors agree that cities should play a strong role in reducing the effects of climate change, even if it means sacrificing revenues or increasing expenditures,” a report accompanying the survey stated.

Boston mayor started survey

In all, 115 mayors of cities with at least 75,000 residents answered the fourth annual survey named for Thomas Menino, a longtime Democratic mayor of Boston who founded the university program before his death in 2014. The survey was sponsored in part by The Rockefeller Foundation and Citigroup.

Organizers of the survey declined to release a list of the 115 mayors who responded, citing confidentially agreements. According to the report, nearly two-thirds of the mayors were Democrats and the cities had an average population of 233,000.

The survey cited the availability and affordability of housing as the single most pressing concern of mayors, followed closely by climate change and municipal budget pressures caused in part by federal and state cuts. 

A foreword to the report, signed by Democratic Los Angeles Mayor Eric Garcetti and Betsy Price, the Republican mayor of Fort Worth, Texas, argued that cities can exert formidable influence over U.S. and global policies. 

“At a time when the national conversation is divisive, cities offer a sense of hope and shared identity,” the mayors said. 

Democrats support changes

Sixty-eight percent of mayors said they would be willing to expend additional resources or sacrifice revenue to combat climate change. 

Democrats were more than twice as likely as Republicans to promote environmental policies that might inconvenience motorists in their cities, and almost three times as likely to support entering into regional climate pacts or networks. Yet only 26 percent of Democrats and 5 percent of Republican mayors were eager to slap any costly new regulations on the private sector. 

The survey found that attitudes about climate change differed geographically as well as politically. For example, 90 percent of all Eastern mayors and 97 percent from the Midwest blamed human activities for climate change, compared to 70 percent from Southern cities.

 
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Drugmakers’ response to the threat posed by “superbugs” remains patchy even after years of warnings, according to the first analysis of individual companies’ efforts to tackle the antibiotic resistance crisis.

The rise of drug-resistant bacteria is a growing threat to modern medicine with the emergence of infections resistant to even last-resort antibiotics — a situation made worse in recent years by overuse of antibiotics and cutbacks in drug research.

New analysis by the nonprofit Access to Medicine Foundation (AMF), published Tuesday, found that GlaxoSmithKline and Johnson & Johnson were doing more than most among large research-based pharmaceutical companies to tackle the problem, while Mylan led the way among generic drugmakers and Entasis was top among biotechs.

Overall, GSK led the field with 55 antimicrobial pipeline projects, including 13 vaccines.

But action taken by such companies is only the start of what could be done to address the problem, which former Goldman Sachs chief economist Jim O’Neill in 2014 estimated could cause 10 million deaths a year worldwide by 2050.

“The whole of modern medicine depends on being able to control and treat infections,” said Jeremy Farrar, director of the Wellcome Trust charity. “Perhaps the most exciting area of medicine at the moment, immunotherapies for cancer, is impossible unless you can control infection.”

‘Definitely more’ should be done

While more experimental antibiotics are now moving through development than a few years ago, the number is still down from what it was during the 1980s and 1990s. And a lot more work needs to be done to ensure appropriate use of medicines — both new ones and the thousands of metric tons of older pills churned out each year by generic companies.

“There’s definitely more that all companies can do,” said Jayasree Iyer, executive director of AMF, which published the analysis at the World Economic Forum annual meeting in Davos, Switzerland. “We need to strengthen the research and development pipeline, and when new products reach the market, we need to ensure that they are used in a conservative way so that misuse and overuse is limited.”

There are now 28 experimental antibiotics in late-stage development against critical pathogens, but only two of these are supported by plans to ensure they can be both made accessible and used wisely if they reach the market.

The AMF said four companies — GSK, Shionogi, Pfizer and Novartis — had taken steps to separate sales representatives’ bonuses from the volume of antibiotics sold, but that much more needed to be done across the industry to counter overuse.

Another under-recognized problem is the pollution caused by mass production of antibiotics, due to lax oversight of wastewater runoff.

In India’s Hyderabad region, for example, the presence of hundreds of drug factories and inadequate water treatment has left lakes and rivers laced with antibiotics, making the area a giant petri dish for anti-microbial resistance.

The AMF urged multinational drugmakers to do more to ensure that their suppliers of bulk antibiotic ingredients were complying with rigorous wastewater standards.
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