CDC is investigating 109 unusual hepatitis cases in children

The number of unusual hepatitis cases in previously healthy young children has risen to 109, the CDC said, including eight children who needed liver transplants and five who died. Half of the children had confirmed adenovirus infections, the leading suspected cause of these illnesses. But the CDC warned that the investigations are in an early stage and it is too soon to draw conclusions. And anticipating that parents may be spooked by news of severe hepatitis in young children, the CDC’s Jay Butler said the country isn’t seeing increased rates of pediatric hepatitis — although national data is not kept on unknown causes — but the agency is watching whether more children are being checked for jaundice, a sign of liver disorder. More than 300 pediatric hepatitis cases of unknown etiology or origin have been reported by more than two dozen countries. STAT's Helen Branswell has more.

An NIH advisory panel on improving efficiency hasn’t met in seven years

An oversight board tasked with making the NIH more efficient and more effective mysteriously stopped meeting seven years ago, according to a STAT review of agency records — and its members don’t know why. The de facto disappearance of the NIH’s Scientific Management Review Board, critics charge, is emblematic of the agency’s broader reluctance to accept criticism and to modernize. Some science policy experts have argued lately that the NIH operates too slowly, funds research too conservatively, and labors under a bureaucratic structure that is cumbersome and unwieldy. “I had the sense that we were asking questions in areas that they didn’t really want to get into,” Nancy Andrews, a board member and the former dean of the Duke University School of Medicine, told STAT’s Lev Facher. An NIH spokesperson did not respond to a request for comment. Read more.

State laws vary widely on adolescent consent and privacy in medical care

Confidentiality between an adolescent patient and a clinician is crucial to providing good health care, the American Academy of Pediatrics says. Reaching that goal is complicated as access to electronic health records improves while state laws for minors’ consent and privacy are inconsistent across the country. A study out in Pediatrics today, appearing as the national debate continues on whether the Supreme Court will overturn Roe v. Wade, looks at the wide variability among states on rules governing reproductive health, immunizations, substance use, and other issues. For example: All 50 states had some provisions for managing STIs, but there were differences based on age, whether that included HIV, and whether confidentiality is protected. “Inconsistency in privacy protection creates inequitable care and could result in breaches of privacy that place the patient in potentially unsafe situations,” the authors write.

Closer look: How lipid nanoparticles became the future of gene therapy

A model looking inside liposome nanoparticles for drug delivery. (adobe)

If you’ve heard of lipid nanoparticles lately, it’s probably for their role ferrying mRNA Covid vaccines where they need to go. But the dream of using a fatty sheath to shield and shepherd genomic therapies through the human body goes back decades, predating CRISPR gene-editing and mRNA as a medicine. In the ’80s and ’90s, as gene therapy was first taking off, precursors to LNPs were proposed as safer, cheaper, easier-to-manufacture alternatives to the viral vectors in vogue at the time. Millions of dollars of biotech investment poured in. But the road to developing safe, reliable, mass-producible lipid nanodelivery-bots that could shuttle genes into cells turned out to be rockier than anyone anticipated. STAT’s Megan Molteni takes you on that journey in a special report, with stops including a meringue-whipping hematologist, a messy legal melee, and forays into breaking the laws of biology.

Almost one-quarter of doctors report mistreatment from patients or visitors

Nearly 1 in 4 doctors experience mistreatment in the workplace, most often from patients and visitors, a new survey reports. Such episodes contribute to burnout, the study in JAMA Network Open said, but workplace systems to diminish offensive behavior or bystander actions eased physician distress. The survey of just over 1,500 Stanford physicians differs from other research looking at problems within health care organizations affecting trainees, such as this NEJM study reporting discrimination, abuse, harassment, and burnout in surgical residency. The new study of physicians found that women (31%) were more likely to report mistreatment than men (15%) and more likely to experience sexual harassment and verbal abuse. Multiracial and Black physicians were more likely than white and Asian physicians to cite at least one form of mistreatment. The authors urge organizations to create systems to ensure physicians are treated with respect and dignity.

Opinion: Strengthening Gavi can advance global vaccine equity

The Biden administration’s upcoming Covid-19 summit will spotlight the global failure to achieve vaccine equity: 80% of people in high-income countries are vaccinated vs. only 16% of people in low-income countries. Poor countries have been left behind because rich and vaccine-producing countries jumped the queue, the costs and challenges of vaccine delivery were vastly underestimated, and international coordination failed, Nina Schwalbe of the United Nations University International Institute for Global Health writes in a STAT First Opinion. “This is not the first time that a global effort to reach people equitably with vaccines has required a new way of doing business. A transformation that occurred more than 20 years ago gives hope that it can happen again.” Read her ideas for how Gavi, the Vaccine Alliance, which was created to solve stagnating childhood immunization coverage, can get global Covid vaccination back on track.

What to read around the web today

Hundreds of suicidal teens sleep in emergency rooms. Every night. New York Times
British scientist says U.S. anti-abortion lawyers misused his work to attack Roe v. Wade. The Guardian
How many abortions are actually performed in the U.S.? Rates have declined for decades. USA Today
Covid shots made Moderna biotech’s biggest star, but what now? Boston Globe
How climate scientists keep hope alive as damage worsens. Associated Press
Hospitals look to raise treatment costs as nurses’ salaries increase. Wall Street Journal