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Lassa fever, eviction lawyers, ultra-processed foods, & poop transplants

October 29, 2024
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Morning Rounds Writer and Podcast Producer

Today's First Opinion on poop transplants taught me a new word: fulminant. According to Merriam-Webster, the adjective describes something that comes on "suddenly and with great severity." Scroll all the way down for context.

Oh, and of course you already know, but there's just one week to Election Day. Sign up for D.C. Diagnosis now, so you don't miss tomorrow's special edition.

infectious disease

A death from Lassa fever reported in Iowa

C. S. Goldsmith/CDC

Here's a virus you might not have heard of: Lassa fever is most often spread to humans from a rodent called the multimammate rat, and can cause Ebola-like illness in some patients. It's endemic to a number of countries in West Africa, where it causes hundreds of thousands of infections — and about 5,000 deaths — every year. On Monday, Iowa health officials announced that someone in the state who recently traveled to West Africa died after contracting the disease. 

The virus is rare in the U.S., with just eight known imported cases in the past 55 years, including this latest. One important note: While its symptoms are similar to an Ebola infection, Lassa fever does not trigger a large chain of human cases. STAT's Helen Branswell has everything you need to know about the virus and the case in Iowa.


public policy

How eviction lawyers could help fight preterm births

In 2017, New York City began rolling out a program that guaranteed lawyers to low-income tenants in certain ZIP codes. Evictions were reduced by half, and a study published yesterday in JAMA Pediatrics found the program was also associated with a 0.96% reduction in preterm births and infants born at low weights. That may sound minor but it's statistically significant, and translates to 600 fewer adverse birth outcomes each year.

Researchers used city vital records to analyze more than 260,000 Medicaid-insured births in the city between 2016 and 2020. More than 43,000 of those occurred in ZIP codes where eviction lawyers were available over the program's staggered implementation. Over four years, adverse birth outcomes continued to increase in the neighborhoods where tenants weren't offered lawyers, while rates leveled off in areas where they were.

"It's the same populations that are getting evicted that are at highest risk of poor birth outcomes to begin with," researcher Gracie Himmelstein told me in 2021 after authoring a study on the association between eviction and poor birth outcomes. Neither study proves causation, but the evidence suggests a right-to-counsel program could have real public health benefits, the recent study authors write. Some form of tenant right-to-counsel now exists in 17 cities, two counties and five states. 


election corner

'People had polio,' Trump tells Joe Rogan. 'It was like a disaster.' 

On Friday, former President Trump sat for a nearly three-hour interview with podcaster Joe Rogan, speaking carefully about vaccine safety. "They've come up with some amazing things," he said when Rogan asked about the pharmaceutical industry. "I know you're against certain vaccines, but like the polio vaccine, people had polio. It was like a disaster."

Later in the weekend, Trump told NYC rallygoers at Madison Square Garden that Robert F. Kennedy Jr. (who has a history of vaccine skepticism) would indeed have a role in a second administration. GOP officials and industry execs have expressed fear about what RFK Jr. might do in an official role. But Trump's comments on vaccines also indicate that he has not fully bought into RFK Jr.'s rhetoric.

Sign up for STAT's policy and politics newsletter, D.C. Diagnosis, for more analysis. There'll be a special bonus issue tomorrow morning. 



nutrition

Could some ultra-processed foods be good for you?

Jenny Kane/AP 

Not all ultra-processed foods are created equal. There's your chicken nuggets, but then there's your whole grain cereal and bread. The wide variety among such foods makes it tricky to determine the link between ultra-processed foods and any particular health outcome. Last month, physician and researcher JoAnn Manson analyzed three large long-running studies looking at ultra-processed foods and cardiovascular disease. 

STAT's Liz Cooney spoke to Manson about what she and her colleagues found. "We actually were surprised that there were several types of ultra-processed foods linked to lower risk of cardiovascular disease," Manson told Liz. "We did not expect as much diversity across types of ultra-processed foods." Read more from Liz.


hospitals

Quick stats: Alzheimer's at the ED

In 2022, Alzheimer's was the seventh leading cause of death in the U.S. Yesterday, the CDC's National Center for Health Statistics released a report on how people age 65 and older who have Alzheimer's disease interacted with emergency departments across the country between 2020 and 2022. Here's what the data shows:

  • About 36 out of every 1,000 people in this age group with Alzheimer's visited hospital emergency departments in the time span, and that rate increased with age.
  • Arriving by ambulance to the ED was almost twice as common for those older adults with Alzheimer's than those without the disease.
  • More than a third (37%) of ED visits from those with Alzheimer's ended with the patient admitted to the hospital, compared to about 28% of visits by those without the disease.

Keep up on the latest news about Alzheimer's with STAT's great coverage.


first opinion

Is 'poop as medicine' under threat? (Yes, you read that right.)

Physician Neil Stollman began performing "poop transplants" — incredulously — 20 years ago. He's kept doing it all this time because, as gross as it sounds, it actually works. For patients who have a specific, devastating bacterial infection in their colon called C. diff, a fecal transplant can repair damage to the organ's microbiome, weakening the bacteria.

But a looming FDA deadline has put the future of this care into question for the most vulnerable populations. The agency has approved two fecal transplant biotherapeutic products for C. diff patients, but neither is indicated for severe, fulminant, or pediatric patients. In a First Opinion essay, he argues that the FDA needs to ensure continued access to investigational fecal microbiota transplants for those who need them. Read more.


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What we're reading

  • Preparing for a new reality: Hurricanes threaten health, Boston Globe

  • Dreams of cancer vaccines are becoming more real. Here are 9 scientists making it happen, STAT
  • Pakistan begins another vaccination campaign after a worrying surge in polio cases, AP
  • I'm the director of the Center for Medicare. Here's how we executed the first round of drug price negotiation, STAT

Thanks for reading! More tomorrow,


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