Warning signs before current monkeypox outbreak were ignored, experts say

It didn't exactly come out of nowhere. Monkeypox seems to have exploded in May, spreading across Europe, the Americas, and other regions. But warning signs from Nigeria appear to have gone unheeded. After decades without cases, Nigeria experienced a large monkeypox outbreak starting in 2017 that continues today. Prior to this year, that outbreak spread beyond its borders eight times. Chikwe Ihekweazu, former director general of the Nigerian Center for Disease Control, said his country sought help to try to decipher what was going on, but the requests didn’t get much traction. “There wasn’t a lot of interest to support that work until now — sadly,” Ihekweazu, now head of WHO’s new Berlin hub for pandemic and epidemic intelligence, told STAT’s Helen Branswell. “It never really received the interest it needed to answer some of these questions.” Read more.

In animals, an off-the-shelf cancer vaccine staves off cancer spread

For all their promise, experimental cancer vaccines must be personalized, training individual patients’ immune systems to respond specifically to their tumor cells. Scientists seeking off-the-shelf solutions reported encouraging results yesterday in Nature built on an antibody that better arms the immune system. When tested in mice, the approach — which also recruits a broader immune response in other ways — was not only active against tumor cells resistant to other immunotherapies, but could also reduce metastases. If all goes as planned, the vaccine will be tested in human volunteers next year. “It’s a completely intriguing and new way to think about how to use a vaccine,” Padmanee Sharma of the University of Texas MD Anderson Cancer Center, who wasn’t involved in the study, told STAT’s Eric Boodman. Read more.

A child’s autopsy from 2008 helps medical detectives study polio-like illness

In 2008, a 5-year-old boy went within days from having cold symptoms to being unable to walk. It looked like polio to Peter Wright, a pediatric infectious diseases physician, but that wasn’t possible in the U.S. After the New Hampshire boy died, Wright asked his parents for permission to do an autopsy to understand why. While that didn’t solve the mystery, he found evidence of a common respiratory pathogen called enterovirus D68 in the fluid that bathes the spinal cord. Ten years later, when a syndrome called acute flaccid myelitis was puzzling doctors, researcher Matthew Vogt reached out to Wright to ask for autopsy samples. In a paper published yesterday in NEJM, Vogt and Wright describe how a new analysis of the samples further corroborates that EV-D68 is driving cases of AFM — and highlights the value of autopsies. STAT's Andrew Joseph explains.

Closer look: Despite shaky benefits and finances, proton cancer centers proliferate

Even as some proton therapy centers falter, some big-name hospitals are setting up the facilities to attract cancer patients. (adobe)

Proton therapy cancer centers, where large machines zap cancerous tumors in a more targeted way than traditional radiation, are multiplying. There’s an ongoing arms race, despite the treatment’s high price tag, spotty insurance coverage, and unclear benefits. “There has been a proliferation,” Steven Ullmann of the University of Miami said. “So to be able to pay off this thing, you have to do a lot of procedures.” That means a lot of money, Tara Bannow and Bob Herman report. A Medicare patient with prostate cancer would bring in nearly $53,000 in payments, even though other, cheaper forms of radiation are just as good for that cancer. Providers going all-in on proton therapy share the belief they’ll be vindicated by future research showing improved outcomes. But results from many NIH clinical trials are several years away. Read more in STAT+.

Long Covid poses risks to vaccinated people, too

Vaccination may reduce the risk of long Covid after a breakthrough infection, but it doesn’t eliminate the symptoms that dog people six months later, a large new study in Nature Medicine concludes. The researchers compared more than 33,900 vaccinated U.S. veterans six months after they caught Covid after getting their shots to people who had never tested positive for the virus. The risk of death and pulmonary and cardiovascular disorders was higher among the infected people, and rose with hospital or ICU admission. Those risks were lower after breakthrough infection than in unvaccinated people with Covid, but they were higher than in a comparison group of people with flu. “Vaccination only partially reduces the risk of death and post-acute sequelae,” the authors write. “The burden of death and disease experienced by people with [breakthrough infection] is not trivial.”

How grocery stores handle food recalls can vary

Federal agencies issue recalls of foods such as onions linked to salmonella or lettuce connected to listeria an average of 325 times per year. A half-dozen recalls about undeclared allergens are also made every week. A new report from U.S. PIRG that calls for better, more timely warnings of foodborne illnesses points out there are only two rules covering how recalls are communicated: The FDA must post the recall on its website and the company issuing the recall has to issue a news release. Under 2011 guidelines that aren’t final or enforced, the advocacy group's report says, stores with 15 or more locations selling these products can choose how they notify customers. In PIRG’s survey of 50 chains, including Albertsons, Publix, and Whole Foods, half notify customers by phone, text, or email within one business day but one-third ask customers to check the store’s website or social media for recalls.

What to read around the web today

Two years after Floyd murder, racial trauma permeates U.S. Associated Press
Whistleblower report on baby formula didn’t reach top FDA food safety official. Washington Post
Key Senate panel wants to axe in-person requirement for virtual mental health services. STAT
‘We have to test’: A Google AI leader on why it’s imperative to move slow in health tech. STAT+
Covid derailed learning for 1.6 billion students. Here’s how schools can help them catch up. Nature
There may be a backdoor way for hospitals to get paid for uninsured Covid-19 care. STAT+