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2001 Anthrax Attacks Fast Facts | CNN

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CNN
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Here’s a look at the 2001 anthrax attacks, also referred to as Amerithrax.

There are four types of anthrax infection: cutaneous (through the skin), inhalation (through the lungs; the most deadly), gastrointestinal (through digestion) and injection anthrax. Injection anthrax is common in heroin-injecting users in northern Europe. This has never been reported in the United States.

Anthrax can be contracted by handling products from infected animals or by breathing in anthrax spores and by eating undercooked meat from infected animals.

It has been blamed for several plagues over the ages that killed both humans and livestock. It emerged in World War I as a biological weapon.

The Centers for Disease Control and Prevention categorizes anthrax as a Category A agent: one that poses the greatest possible threat for a negative impact on public health; one that may spread across a large area or need public awareness and requires planning to protect the public’s health.

Five people died and 17 people were sickened during anthrax attacks in the fall of 2001; outbreak is often referred to as Amerithrax.

Anthrax was sent via anonymous letters to news agencies in Florida and New York and a congressional office building in Washington, DC.

Of the five victims who died of inhalation anthrax, two were postal workers. The other three victims were an elderly woman from rural Connecticut, a Manhattan hospital worker from the Bronx and an employee at a Florida tabloid magazine who may have contracted anthrax through cross-contamination.

The letters were sent to NBC anchor Tom Brokaw, Sen. Majority Leader Tom Daschle, Sen. Patrick Leahy, and the New York Post offices. The letters were postmarked Trenton, New Jersey.

No arrests were made in the attacks.

The FBI has interviewed more than 10,000 people and issued more than 6,000 subpoenas in the case.

4.8 million masks and 88 million gloves were purchased by the Postal Service for its employees, and 300 postal facilities were tested for anthrax.

Over 32,000 people took antibiotics after possible exposure to anthrax.

Stevens, Bob – photo editor at American Media Inc, died of inhalation anthrax, October 5, 2001

Morris, Thomas Jr. – DC postal worker, died of inhalation anthrax, October 21, 2001

Curseen, Joseph Jr. – DC area postal worker, died of inhalation anthrax, October 22, 2001

Nguyen, Kathy – employee at Manhattan hospital, died of inhalation anthrax, October 31, 2001

Lundgren, Ottilie – Connecticut woman, died of inhalation anthrax, November 22, 2001

October 5, 2001 – Sun photo editor Stevens dies of inhalation anthrax.

October 12, 2001 – NBC News announces that an employee has contracted anthrax.

October 15, 2001 – A letter postmarked Trenton, New Jersey, opened by an employee of Senate Majority Leader Daschle contains white powdery substance later found to be “weapons grade” strain of anthrax spores. More than two dozen people in Daschle’s office test positive for anthrax after the envelope is discovered.

October 19, 2001 – An unopened letter tainted with anthrax is found in the offices of the New York Post. One Post employee is confirmed to have a cutaneous infection and a second shows symptoms of the same infection.

October 21, 2001 – DC postal worker Morris Jr. dies of inhalation anthrax.

October 22, 2001 – DC postal worker Curseen dies of inhalation anthrax.

October 31, 2001 – Nguyen, a stockroom worker for the Manhattan Eye, Ear and Throat Hospital, dies of inhalation anthrax.

November 9, 2001 – The FBI releases a behavioral profile of the suspect, who is probably a male loner and might work in a laboratory.

November 16, 2001 – A letter sent to Senator Leahy is found to contain anthrax. The letter is among those at the Capitol that has been quarantined. The letter contains at least 23,000 anthrax spores and is postmarked October 9, in Trenton, New Jersey.

November 22, 2001 – Lundgren, a 94-year-old Connecticut woman, dies of inhalation anthrax.

January 2002 – FBI agents interview former US Army bioweapons scientist Steven Hatfill as part of the anthrax investigation.

June 2002 – Bioweapons researcher Hatfill is named a “person of interest” by the FBI.

June 25, 2002 – The FBI searches Hatfill’s Maryland apartment and Florida storage locker with his consent.

June 27, 2002 – The FBI says it is focusing on 30 biological weapons experts in its probe.

August 1, 2002 – The FBI uses a criminal search warrant to search Hatfill’s Maryland apartment and Florida storage locker a second time; anthrax swab tests come back negative.

August 6, 2002 – Attorney General John Ashcroft refers to Hatfill as a “person of interest.”

August 11, 2002 – Hatfill holds a press conference declaring his innocence. He holds a second one on August 25, 2002.

September 11, 2002 – The FBI searches Hatfill’s former apartment in Maryland for the third time.

August 26, 2003 – Hatfill files a civil lawsuit against Attorney General John Ashcroft, the Justice Department and the FBI claiming his constitutional rights have been violated. The suit alleges violations of Hatfill’s Fifth Amendment rights by preventing him from earning a living, violations of his Fifth Amendment rights by retaliating against him after he sought to have his name cleared in the anthrax probe and the disclosure of information from his FBI file. The suit also seeks an undetermined amount of monetary damages.

July 11, 2004 – The former headquarters of American Media, Inc. in Boca Raton, Florida, where Stevens contracted the anthrax is pumped full of chlorine dioxide gas for decontamination. This was the last building exposed to anthrax in the fall of 2001.

June 27, 2008 – The Justice Department reaches a settlement with Hatfill. The settlement requires the Justice Department to pay Hatfill a one-time payment of $2.825 million and to buy a $3 million annuity that will pay Hatfill $150,000 a year for 20 years. In return, Hatfill drops his lawsuit, and the government admits no wrongdoing.

July 29, 2008 – Bruce Ivins, a former researcher at the Army’s bioweapons laboratory at Fort Detrick, Maryland, dies after overdosing during a suicide attempt on July 27.

August 6, 2008 – Judge unseals and releases hundreds of documents in the 2001 FBI Anthrax investigation that detail Ivins’ role in the attacks.

August 8, 2008 – The Justice Department formally exonerates Hatfill.

September 25, 2008 – The court releases more documents including emails that Ivins sent to himself.

February 19, 2010 – The Justice Department, FBI and US Postal Inspection Service announce its investigation into the 2001 anthrax mailings is at an end.

March 23, 2011 – A report, entitled The Amerithrax Case, is released through the Research Strategies Network, a non-profit think tank based in Virginia. According to the report, old mental health records suggest Ivins should have been prevented from holding a job at a US Army research facility in Maryland. The report was requested by the US Department of Justice.

October 9, 2011 – The New York Times reports indicate there are scientists questioning the FBI assertions regarding Ivins. Possibly Ivins, if he was involved, worked with a partner. Also, the scientists say the presence of tin in the dried anthrax warrants that the investigation be reopened.

November 23, 2011 – The Justice Department settles for $2.5 million with Stevens’ family. The family originally sued for $50 million in 2003, arguing that the military laboratory should have had tighter security.

December 19, 2014 – The Government Accountability Office releases a 77-page report reviewing the genetic testing used by the FBI during the investigation into the anthrax attacks.

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The benefits of ‘body doubling’ when you have ADHD, according to experts | CNN

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CNN
—

Once a week, ADHD coach Robin Nordmeyer joins a Zoom meeting with other coaches while she writes blogs, does administrative tasks or works on content for presentations she has been putting off.

Nordmeyer, who has ADHD, isn’t necessarily using the meeting to collaborate with others — she just needs their presence as a motivator to help her get things done.

“I run a business, and I have to balance lots of different areas of the business,” said Nordmeyer, cofounder and managing director of the Center for Living Well with ADHD-Minnesota, an ADHD coaching group near Minneapolis serving all ages.

“Some of those things come very easy — like, they’re in my wheelhouse, they energize me, I can’t wait to get to them,” Nordmeyer said. “And some of those things are a little more tedious, or I have some resistance around them.”

What Nordmeyer does to get through those tougher tasks is sometimes known as “body doubling,” a productivity and self-help strategy that involves working with another person around to help improve motivation and focus. It has been popular for some time among people with ADHD — attention-deficit/hyperactivity disorder — especially during the pandemic.

“The idea is that the presence of another is essentially a gentle reminder to stay on task,” said Billy Roberts, clinical director of Focused Mind ADHD Counseling in Columbus, Ohio. “For folks (with) ADHD whose minds tend to wander and get off task, the body double somehow works as an external motivator to stay on task.”

Body doubling isn’t just for people with ADHD, but like many “coping strategies, something that can be helpful for anybody is more central and important for folks with ADHD,” said J. Russell Ramsay, professor of clinical psychiatry at the University of Pennsylvania’s Perelman School of Medicine and codirector of the university’s ADHD Treatment and Research Program.

A neurodevelopmental disorder commonly diagnosed in childhood but lasting into adulthood, ADHD stems from underdeveloped or impaired executive function and self-regulation skills, according to Harvard University’s Center on the Developing Child. Those skills help us to plan, focus attention, remember instructions and multitask. Symptoms of ADHD include inattention, hyperactivity and impulsivity — so people with this disorder might have trouble concentrating, staying organized, managing their time or controlling their impulses, which can affect both their work and personal lives, Roberts said.

If people with ADHD have no intrinsic interest in a task, Roberts said, they typically struggle with a lack of internal motivation to complete it or even to get started. Body doubling provides that motivation, experts said.

“It also draws on our social selves,” Ramsay said. “A lot of people with ADHD will say, ‘I have a hard time getting started on this if I’m doing it for myself, but if I know somebody else is relying on me, if somebody else is waiting outside for me to show up to go for our walk, I’m more likely to go and be there because I don’t want to let them down.’”

There doesn’t appear to be extensive research on body doubling for productivity, according to Roberts and other experts. “But I do know that the idea of externalizing motivation is a long-standing, evidence-based mechanism for managing ADHD,” Roberts said.

In theory, the method is pretty straightforward, but there a few factors to keep in mind to make the most of it.

Body doubling can help with pretty much any task you’re having a hard time getting done — whether that’s work, chores, exercise, schoolwork or paperwork. The other person doesn’t have to be doing the same thing as you, unless the activity you need body doubling for — such as exercising — requires that assistance.

Be choosy about whom you ask to be your body double. The person should be as committed to you completing your work as you are, Roberts said — not distracting you with conversation or anything else. Choose someone who usually makes you feel comfortable and safe, and who can encourage you when necessary.

“It’s important to keep a body double session focused on its purpose,” Nordmeyer said. If conversations do come up, table them for later, perhaps during a break or dinner.

Asking someone to be your body double might feel awkward, but Roberts said the best approach is often a straightforward one. You could say, “It’s something I heard can help with productivity. Would you mind just being around me while I work on this? Maybe you have something you could work on, too.”

You could also barter with them, in a sense, by making an offer such as, “You help me organize my garage on Saturday; I’ll help you organize your home office on Sunday,” Ramsay said.

Those small first steps of seeking a partner and setting up the session get you started and keep you going, he added.

Scheduling regular body doubling sessions is one option, Nordmeyer said, or just ask whenever the need arises. How transparent you are about why you need a body double is up to you, as is whether you have more than one body double.

“It depends on the individual,” Roberts said. “If it turns into a distraction more than mindfulness, accountability or behavioral support, then you just want to rework things. You can kind of tinker with things until you find what works.”

If you don’t have a friend or colleague to be your body double, you aren’t out of luck.

Some TikTok users, such as Allie K. Campbell, regularly go live while they’re working so others can use them as a virtual body double. There are also body doubling or coworking platforms or apps such as Flown, Focusmate or Flow Club.

In virtual sessions, “most body doubles ask you to share your camera, and a lot of people are real nervous about being visible,” Nordmeyer said. “The purpose of that is to make sure you’re still in your chair working. … But there might be other ways you can create that accountability through a chat feature.”

The benefits of body doubling are likely why some people like working on things in coffee shops, libraries or coworking spaces — which can be sources of passive body doubling if you don’t have someone to ask, Roberts said.

“Some people work better with community support and just the awareness of other people around them,” he added. “You saw that a lot with the pandemic, like people learning more about the kinds of structure they needed.

“We all think and work differently, and there’s nothing wrong with that,” Roberts said.

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What is stiff person syndrome, the condition Celine Dion is battling? | CNN

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Complications from stiff person syndrome, a rare neurological condition that causes spasms and muscle rigidity, have caused singer Celine Dion to cancel her “Courage World Tour” dates through 2024, according to a statement posted Friday on the star’s social media account.

Dion postponed several performances in December after learning the reason for her muscle pain and difficulties with mobility. “While we’re still learning about this rare condition, we now know this is what’s been causing all of the spasms that I’ve been having,” Dion said at the time.

Despite undergoing daily physical therapy, “she is in a lot of pain,” a source close to Dion told CNN.

In the Instagram announcement of the tour’s cancellation, Dion is quoted as saying: “I’m so sorry to disappoint all of you once again. I’m working really hard to build back my strength, but touring can be very difficult even when you’re 100%.

“It’s not fair to you to keep postponing the shows, and even though it breaks my heart, it’s best that we cancel everything now until I’m really ready to be back on stage again. I want you all to know, I’m not giving up… and I can’t wait to see you again!”

Stiff person syndrome is characterized by muscle rigidity and spasms, heightened sensitivity to stimuli such as sound and lights, and emotional distress that can cause muscle spasms, according to the National Institute of Neurological Disorders and Stroke. Over time people with the condition can develop “hunched over postures,” the NINDS said.

The condition typically begins with muscle stiffness in the middle part of the body, the trunk and abdomen, before advancing to stiffness and spasms in the legs and other muscles, according to the Cleveland Clinic.

The muscle spasms can be “quite severe. These can cause falls, severe pain and significant disability,” said Dr. Emile Sami Moukheiber of the Stiff Person Syndrome Center at Johns Hopkins Medicine. “Falls from severe spasms are very common. These spasms can be precipitated by startle, severe emotions, cold weather.”

These spasms can be strong enough to fracture bone, and any fall can lead to severe injury.

Dion said in her December Instagram video that spasms affect “every aspect” of her daily life, “sometimes causing difficulties when I walk and not allowing me to use my vocal cords to sing the way I’m used to. It hurts me to tell you this today.”

The syndrome can also cause anxiety.

“Many patients, if not all, have an anxiety that is intrinsic to the disease and that anxiety actually feeds on the physical ailments of the disease that people can have,” Dr. Scott Newsome, director of the Stiff Person Syndrome Center, said in a video on the organization’s website.

At times, people with stiff person syndrome may be afraid to leave their homes because “street noises, such as the sound of a car horn, can trigger spasms and falls,” the NINDS noted.

Stiff person syndrome is very rare. About 1 out of every 1 million people have the syndrome, and most general neurologists will see only one or two cases in their lifetimes, Moukheiber said.

The first case of stiff person syndrome was reported in the 1950s, according to Newsome, and the disease was historically referred to as “stiff man syndrome.”

Since then, it has been found to affect twice as many women as men, and the name was changed to stiff person syndrome to avoid confusion.

The condition can develop at any age, but symptoms most often begin in a person’s 30s or 40s, according to the Cleveland Clinic.

Stiff person syndrome is thought to have features of an autoimmune disease, according to the National Institute of Neurological Disorders and Stroke: “It is frequently associated with other autoimmune diseases such as type-I diabetes, thyroiditis, vitiligo, and pernicious anemia.”

Although the exact cause isn’t clear, according to the institute, research shows it may be due to an autoimmune response “gone awry” in the brain and spinal cord.

“People with SPS have elevated levels of GAD, an antibody that works against an enzyme involved in the synthesis of an important neurotransmitter in the brain,” the institute noted on its website. “A definitive diagnosis can be made with a blood test that measures the level of glutamic acid decarboxylase (GAD) antibodies.”

Other tests include an electromyography (EMG), which measures electrical activity in the muscles, and a lumbar puncture, commonly called a spinal tap.

Because of the rarity of the disease and the ambiguity of its symptoms, people will often seek care for chronic pain before they get neurological care. The condition can be misdiagnosed as anxiety, fibromyalgia, multiple sclerosis, Parkinson’s disease, psychosomatic illness or even a phobia, the NINDS noted.

On average, it takes about seven years for someone to receive a diagnosis of stiff person syndrome, Newsome says.

“Sometimes, [patients] get labeled crazy,” he said, “because on exam early on, there aren’t the hallmark features of stiff person syndrome.”

There is no known cure for stiff person syndrome, but medications can ease the symptoms. Immunoglobulin medications can help lower sensitivity to light or sound triggers, potentially helping head off falls or spasms.

Pain relievers, anti-anxiety medications and muscle relaxers can be a part of treatment for this disease. The Stiff Person Syndrome Center also uses botulinum toxin injections.

Additional benefits may come from the use of acupuncture, physical therapy, heat and water therapy, the Cleveland Clinic noted.

“If left untreated, the disease can cause severe impairment of daily living,” Moukheiber said.

Dion, who previously said she has struggled with her health for a while, said she has a great team of medical professionals and her children’s support.

“I’m working hard with my sports medicine therapist every day to build back my strength and my ability to perform again,” she said. “But I have to admit it’s been a struggle.”

For a performer like Dion, loud noises and bright lights could act as triggers of muscle spasms.

“This is a very challenging illness that might take a toll on her if it is not treated aggressively, timely and appropriately,” Moukheiber said.

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HIV/AIDS Fast Facts | CNN

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CNN
—

Here’s a look at the origins, treatments and global response to HIV and AIDS.

HIV stands for human immunodeficiency virus.

AIDS stands for acquired immunodeficiency syndrome.

HIV/AIDS is spread through sexual contact with an infected person, sharing needles with an infected person, through transfusions of infected blood or through an infected mother.

People infected with HIV go through three stages of infection:

Acute infection, or acute retroviral syndrome, which can produce flu-like symptoms in the first month after infection.
Clinical latency, or asymptomatic HIV infection, in which HIV reproduces at lower levels.
AIDS, in which the amount of CD4 cells fall below 200 cells per cubic millimeter of blood (as opposed to the normal level of 500-1,500).

HIV-1 and HIV-2 can both cause AIDS. HIV-1 is the most common human immunodeficiency virus; HIV-2 is found mostly in western Africa.

Antiretroviral therapy (ART) involves taking a cocktail of HIV medications used to treat the virus. In 1987, Azidothymidine (AZT) became the first FDA-approved drug used to attempt to treat HIV/AIDS.

from UNAIDS:

38.4 million – Number of people living with HIV/AIDS worldwide in 2021.

5.9 million – Approximate number of people living with HIV globally that are unaware of their HIV-positive status in 2021.

160,000 – Newly infected children worldwide in 2021.

1.5 million – New infections worldwide in 2021.

650,000 – Approximate number of AIDS-related deaths worldwide in 2021.

Of the 4,500 new infections each day in 2019, 59% are in sub-Saharan Africa.

40.1 million – Approximate number of AIDS-related deaths worldwide since the start of the epidemic.

Sub-Saharan Africa is comprised of the following countries: Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Democratic Republic of the Congo, Ivory Coast, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Republic of the Congo, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, Sudan, South Sudan, Swaziland, Tanzania, Togo, Uganda, Zambia and Zimbabwe.

1981 – The Centers for Disease Control and Prevention (CDC) publish the first reports of men in Los Angeles, New York and San Francisco who were previously healthy and are suffering from rare forms of cancer and pneumonia, accompanied by “opportunistic infections.”

1982 – The CDC refer to the disease as AIDS for the first time.

1983 – French and American researchers determine that AIDS is caused by HIV.

1985 – Blood tests to detect HIV are developed.

December 1, 1988 – First World AIDS Day.

1999 – Researchers in the United States find evidence that HIV-1 most likely originated in a population of chimpanzees in West Africa. The virus appears to have been transmitted to people who hunted, butchered and consumed the chimpanzees for food.

January 29, 2003 – In his State of the Union speech, US President George W. Bush promises to dramatically increase funding to fight HIV/AIDS in Africa.

May 27, 2003 – Bush signs H.R. 1298, the US Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, also known as PEPFAR (US President’s Emergency Plan for AIDS Relief), that provides $15 billion over the next five years to fight HIV/AIDS, tuberculosis and malaria abroad, particularly in Africa.

July 30, 2008 – H.R. 5501, The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, becomes law and authorizes up to $48 billion to combat global HIV/AIDS, tuberculosis and malaria. Through 2013, PEPFAR plans to work in partnership with host nations to support treatment for at least four million people, prevention of 12 million new infections and care for 12 million people.

October 2011 – In his book, “The Origins of AIDS,” Dr. Jacques Pepin traces the emergence and subsequent development of HIV/AIDS to suggest that initial AIDS outbreaks began earlier than previously believed.

July 24, 2012 – Doctors announce during the 19th International AIDS Conference that Timothy Ray Brown, known as the “Berlin patient,” has been clinically “cured” of HIV. Brown, diagnosed with leukemia, underwent a bone marrow transplant in 2007 using marrow from a donor with an HIV-resistant mutation. He no longer has detectable HIV.

March 3, 2013 – Researchers announce that a baby born infected with HIV has been “functionally cured.” The child, born in Mississippi, was given high doses of antiretroviral drugs within 30 hours of being born. A year later, the child now has detectable levels of the virus in her blood, 27 months after being taken off antiretroviral drugs, according to scientists involved with her case.

June 18, 2013 – Marking the 10th anniversary of PEPFAR, Secretary of State John Kerry announces that the millionth child has been born HIV-free due to prevention of mother-to-child transmission programs (PMTCT).

March 14, 2014 – The CDC reports on a case of likely female-to-female HIV transmission. Unlike previous announcements of other cases involving female-to-female transmission, this case excludes additional risk factors for HIV transmission.

July 24, 2017 – A 9-year-old child from South Africa is reported to have been in remission for over eight years without treatment, according to Dr. Avy Violari, who spoke at the 9th International AIDS Society Conference on HIV Science in Paris.

November 2018 – According to PEPFAR’s website, they have “supported life-saving antiretroviral treatment (ART) for more than 14.6 million men, women and children” since 2003.

March 5, 2019 – According to a case study published in the journal Nature, a second person has sustained remission from HIV-1. The “London patient” was treated with stem cell transplants from donors with an HIV-resistant mutation. The London patient has been in remission for 18 months since he stopped taking antiretroviral drugs. The study also includes a possible third remission after stem cell transplantation, this person is referred to as the “Düsseldorf patient.”

May 2, 2019 – A study of nearly 1,000 gay male couples, where one partner with HIV took antiretroviral therapy (ART), found no new cases of transmission to the HIV-negative partner during sex without a condom. The landmark, eight-year study, published in the Lancet medical journal shows that the risk of passing on the HIV virus is eliminated with effective drugs treatment.

October 7, 2019 – Governor Gavin Newsom signs a bill making HIV prevention drugs available without a prescription in California starting on January 1, 2020. The medications covered by the new legislation are pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), which both help prevent HIV infections. California becomes the first state in the country to allow pharmacists to provide the drugs without a physician’s prescription.

November 6, 2019 – According to a study published in the Journal of Acquired Immune Deficiency Syndromes, a team of scientists has detected a new strain of HIV. The strain is a part of the Group M version of HIV-1, the same family of virus subtypes to blame for the global HIV pandemic, according to Abbott Laboratories, which conducted the research along with the University of Missouri, Kansas City.

June 15, 2020 – A study is published in the journal JAMA Network Open showing that the life expectancy of people with HIV approaches that of people without the virus, when antiviral therapy is started early in infection. However, disparities still remain in the number of chronic health problems that people with HIV endure.

July 7, 2020 – Scientists presenting at the 23rd International AIDS Conference announce a new study that found an injection of the investigational drug cabotegravir every eight weeks was more effective at preventing HIV than daily oral pills. It is also announced that a Brazilian man might be the first person to experience long-term HIV remission after being treated with only an antiviral drug regimen – not stem cell transplantation.

November 16, 2021 – A new study finds a second patient whose body has seemingly rid itself of HIV. The international team of scientists reports in the Annals of Internal Medicine that the patient, originally from the city of Esperanza, Argentina, showed no evidence of intact HIV in large numbers of her cells, suggesting that she may have naturally achieved what they describe as a “sterilizing cure” of HIV infection. The 30-year-old woman in the new study is only the second patient who has been described as achieving this sterilizing cure without help from stem cell transplantation or other treatment.

December 20, 2021 – The US Food and Drug Administration announces that it has approved the first injectable medication for pre-exposure prophylaxis (PrEP) to lower the risk of getting HIV through sex.

February 15, 2022 – A US woman becomes the third known person to go into HIV remission, and the first mixed-race woman, thanks to a transplant of stem cells from umbilical cord blood, according to research presented at a conference on Retroviruses and Opportunistic Infections.

December 1, 2022 – An experimental HIV vaccine, called eOD-GT8 60mer, has been found to induce broadly neutralizing antibody precursors among a small group of volunteers in a Phase 1 study. The clinical trial results, published in the journal Science, suggest that a two-dose regimen of the vaccine, given eight weeks apart, can elicit immune responses against the human immunodeficiency virus.

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Zika Virus Infection Fast Facts | CNN

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CNN
—

Here’s a look at Zika virus, an illness spread through mosquito bites that can cause birth defects and other neurological defects.

Sources: Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and CNN

Zika virus is a flavivirus, part of the same family as yellow fever, West Nile, chikungunya and dengue fever.

Zika is primarily transmitted through the bite of an infected female Aedes aegypti mosquito. It becomes infected from biting an infected human and then transmits the virus to another person. The Aedes aegypti mosquito is an aggressive species, active day and night and usually bites when it is light out. The virus can be transmitted from a pregnant woman to her fetus, through sexual contact, blood transfusion or by needle.

The FDA approved the first human trial of a Zika vaccine in June 2016. As of May 2022, there is still no available vaccine or medication.

Cases including confirmed, probable or suspected cases of Zika in US states and territories updated by the CDC.

Most people infected with Zika virus won’t have symptoms. If there are symptoms, they will last for a few days to a week.

Fever, rash, joint pain and conjunctivitis (red eyes) are the most common symptoms. Some patients may also experience muscle pain or headaches.

Zika virus infection during pregnancy can cause microcephaly, a neurological disorder that results in babies being born with abnormally small heads. Microcephaly can cause severe developmental issues and sometimes death. A Zika infection may cause other birth defects, including eye problems, hearing loss and impaired growth. Miscarriage can also occur.

An August 2018 report published by the CDC estimates that nearly one in seven babies born to women infected with the Zika virus while pregnant had one or more health problems possibly caused by the virus, including microcephaly.

According to the CDC, there is no evidence that previous infection will affect future pregnancies.

(Sources: WHO, CDC and CNN)

1947 – The Zika virus is first discovered in a monkey by scientists studying yellow fever in Uganda’s Zika forest.

1948 – The virus is isolated from Aedes africanus mosquito samples in the Zika forest.

1964 – First active case of Zika virus found in humans. While researchers had found antibodies in the blood of people in both Uganda and in Tanzania as far back as 1952, this is the first known case of the active virus in humans. The infected man developed a pinkish rash over most of his body but reported the illness as “mild,” with none of the pain associated with dengue and chikungunya.

1960s-1980s – A small number of countries in West Africa and Asia find Zika in mosquitoes, and isolated, rare cases are reported in humans.

April-July 2007 – The first major outbreak in humans occurs on Yap Island, Federated States of Micronesia. Of the suspected 185 cases reported, 49 are confirmed, and 59 are considered probable. There are an additional 77 suspected cases. No deaths are reported.

2008 – Two American researchers studying in Senegal become ill with the Zika virus after returning to the United States. Subsequently, one of the researchers transmits the virus to his wife.

2013-2014 – A large outbreak of Zika occurs in French Polynesia, with about 32,000 suspected cases. There are also outbreaks in the Pacific Islands during this time. An uptick in cases of Guillain-Barré Syndrome during the same period suggests a possible link between the Zika virus and the rare neurological syndrome. However, it was not proven because the islands were also experiencing an outbreak of dengue fever at the time.

March 2015 – Brazil alerts the WHO to an illness with skin rash that is present in the northeastern region of the country. From February 2015 to April 29, 2015, nearly 7,000 cases of illness with a skin rash are reported. Later in the month, Brazil provides additional information to WHO on the illnesses.

April 29, 2015 – A state laboratory in Brazil informs the WHO that preliminary samples have tested positive for the Zika virus.

May 7, 2015 – The outbreak of the Zika virus in Brazil prompts the WHO and the Pan American Health Organization (PAHO) to issue an epidemiological alert.

October 30, 2015 – Brazil reports an increase in the cases of microcephaly, babies born with abnormally small heads: 54 cases between August and October 30.

November 11, 2015 – Brazil declares a national public health emergency as the number of newborns with microcephaly continues to rise.

November 27, 2015 – Brazil reports it is examining 739 cases of microcephaly.

November 28, 2015 – Brazil reports three deaths from Zika infection: two adults and one newborn.

January 15 and 22, 2016 – The CDC advises all pregnant women or those trying to become pregnant to postpone travel or consult their physicians prior to traveling to any of the countries where Zika is active.

February 2016 – The CDC reports Zika virus in brain tissue samples from two Brazilian babies who died within a day of birth, as well as in fetal tissue from two miscarriages providing the first proof of a potential connection between Zika and the rising number of birth defects, stillbirths and miscarriages in mothers infected with the virus.

February 1, 2016 – The WHO declares Zika a Public Health Emergency of International Concern due to the increase of neurological disorders, such as microcephaly, in areas of French Polynesia and Brazil.

February 8, 2016 – The CDC elevates its Emergency Operations Center for Zika to Level 1, the highest level of response at the CDC.

February 26, 2016 – Amid indications that the mosquito-borne Zika virus is causing microcephaly in newborns, the CDC advises pregnant women to “consider not going” to the Olympics in Rio de Janeiro. The CDC later strengthens the advisory, telling pregnant women, “Do not go to the Olympics.”

March 4, 2016 – The US Olympic Committee announces the formation of an infectious disease advisory group to help the USOC establish “best practices regarding the mitigation, assessment and management of infectious disease, paying particular attention to how issues may affect athletes and staff participating in the upcoming Olympic and Paralympic Games.”

April 13, 2016 – During a press briefing, CDC Director Thomas Frieden said, “It is now clear the CDC has concluded that Zika does cause microcephaly. This confirmation is based on a thorough review of the best scientific evidence conducted by CDC and other experts in maternal and fetal health and mosquito-borne diseases.”

May 27, 2016 – More than 100 prominent doctors and scientists sign an open letter to WHO Director General Margaret Chan, calling for the summer Olympic Games in Rio de Janeiro to be postponed or moved “in the name of public health” due to the widening Zika outbreak in Brazil.

July 8, 2016 – Health officials in Utah report the first Zika-related death in the continental United States.

August 1, 2016 – Pregnant women and their partners are advised by the CDC not to visit the Miami neighborhood of Wynwood as four cases of the disease have been reported in the small community and local mosquitoes are believed to be spreading the infection.

September 19, 2016 – The CDC announces that it has successfully reduced the population of Zika-carrying mosquitoes in Wynwood and lifts its advisory against travel to the community.

November 18, 2016 – The WHO declares that the Zika virus outbreak is no longer a public health emergency, shifting the focus to long-term plans to research the disease and birth defects linked to the virus.

November 28, 2016 – Health officials announce Texas has become the second state in the continental United States to confirm a locally transmitted case of Zika virus.

September 29, 2017 – The CDC deactivates its emergency response for Zika virus, which was activated in January 2016.

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Avian Flu Fast Facts | CNN

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CNN
—

Here’s a look at avian flu.

Avian influenza, also called avian flu or bird flu, is an illness that usually affects only birds.

There are many different strains of avian flu: 16 H subtypes and 9 N subtypes. Only those labeled H5, H7 and H10 have caused deaths in humans.

The most commonly seen and most deadly form of the virus is called “Influenza A (H5N1),” or the “H5N1 virus.”

Most cases of human bird flu infections are due to contact with infected poultry or surfaces that are contaminated with infected bird excretions: saliva, nasal secretions or feces.

Symptoms of avian flu include fever, cough, sore throat and sometimes severe respiratory diseases and pneumonia.

The CDC recommends oral oseltamivir (brand name: Tamiflu), inhaled zanamivir (brand name: Relenza) and intravenous permavir (brand name: Rapivab) for the treatment of human illness associated with avian flu.

The mortality rate is close to 60% for infected humans.

Early 1900s –The avian flu is first identified in Italy.

1961 – The H5N1 strain is isolated in birds in South Africa.

December 1983 – Chickens in Pennsylvania and Virginia are exposed to the avian flu and more than five million birds are killed to stop the disease from spreading.

1997 – Eighteen people are infected by the H5N1 strain in Hong Kong, six die. These are the first documented cases of human infection. Hong Kong destroys its entire poultry population, 1.5 million birds.

1999 – Two children in Hong Kong are infected by the H9N2 strain.

February 2003 – Eighty-four people in the Netherlands are affected by the H7N7 strain of the virus, one dies.

February 7, 2004 – Twelve thousand chickens are killed in Kent County, Delaware, after they are found to be infected with the H7 virus.

October 7, 2005 – The avian flu reaches Europe. Romanian officials quarantine a village of about 30 people after three dead ducks there test positive for bird flu.

November 12, 2005 – A one-year-old boy in Thailand tests positive for the H5N1 strain of avian influenza.

November 16, 2005 – The World Health Organization confirms two human cases of bird flu in China, including a female poultry worker who died from the H5N1 strain.

November 17, 2005 – Two deaths are confirmed in Indonesia from the H5N1 strain of avian influenza.

January 1, 2006 – A Turkish teenager dies of the H5N1 strain of avian influenza in Istanbul, and later that week, two of his sisters die.

January 17, 2006 – A 15-year-old girl from northern Iraq dies after contracting bird flu.

February 20, 2006 – Vietnam becomes the first country to successfully contain the disease. A country is considered disease-free when no new cases are reported in 21 days.

March 12, 2006 – Officials in Cameroon confirm cases of the H5N1 strain. The avian flu has now reached four African countries.

March 13, 2006 – The avian flu is confirmed by officials in Myanmar.

May 11, 2006 – Djibouti announces its first cases of H5N1 – several birds and one human.

December 20, 2011 – The US Department of Health and Human Services releases a statement saying that the government is urging scientific journals to omit details from research they intend to publish on the transfer of H5N1 among mammals. There is concern that the information could be misused by terrorists.

July 31, 2012 – Scientists announce that H3N8, a new strain of avian flu, caused the death of more than 160 baby seals in New England in 2011.

March 31, 2013 – Chinese authorities report the first human cases of infection of avian flu H7N9 to the World Health Organization. H7N9 has not previously been detected in humans.

December 6, 2013 – A 73-year-old woman infected with H10N8 dies in China, the first human fatality from this strain.

January 8, 2014 – Canadian health officials confirm that a resident from Alberta has died from H5N1 avian flu, the first case of the virus in North America. It is also the first case of H5N1 infection ever imported by a traveler into a country where the virus is not present in poultry.

April 20, 2015 – Officials say more than five million hens will be euthanized after bird flu was detected at a commercial laying facility in northwest Iowa. According to the US Department of Agriculture, close to eight million cases of bird flu have been detected in 13 states since December. Health officials say there is little to no risk for transmission to humans with respect to H5N2. No human infections with the virus have ever been detected.

January 15, 2016 – The US Department of Agriculture confirms that a commercial turkey farm in Dubois County, Indiana, has tested positive for the H7N8 strain of avian influenza.

January 24, 2017 – Britain’s Department for Environment, Food & Rural Affairs releases a statement confirming that a case of H5N8 avian flu has been detected in a flock of farmed breeding pheasants in Preston, UK. The flock is estimated to contain around 10,000 birds. The statement adds that a number of those birds have died, and the remaining live birds at the premises are being “humanely” killed because of the disease.

February 12, 2017 – A number of provinces in China have shut down their live poultry markets to prevent the spread of avian flu after a surge in the number of infections from the H7N9 strain. At least six provinces have reported human cases of H7N9 influenza this year, according to Chinese state media, Xinhua.

March 5-7, 2017 – The USDA confirms that a commercial chicken farm in Tennessee has tested positive for the H7N9 strain of avian flu, but says it is genetically different from the H7N9 lineage out of China. The 73,500-bird flock in Lincoln County will be euthanized, according to Tyson Foods.

February 14, 2018 – Hong Kong’s Centre for Health Protection announces that a 68-year-old woman has been treated for the H7N4 strain. This is the first case of this strain in a human.

June 5, 2019 – Since 2013 there have been 1,568 confirmed human cases and 616 deaths worldwide from the H7N9 strain of avian flu, according to the Food and Agriculture Organization of the United Nations.

December 2019 – The United Kingdom Department for Environment, Food & Rural Affairs confirms that a case of H5N1 avian flu has been detected at a poultry farm in Suffolk. 27,000 birds are humanely killed because of the disease.

April 9, 2020 – The USDA confirms that a commercial turkey flock in Chesterfield County, South Carolina has tested positive for the H7N3 strain of avian flu.

January 2021 – India culls tens of thousands of poultry birds after avian influenza is detected in ducks, crows and wild geese in at least a dozen locations across the country.

February 18, 2021 – Russian authorities notify WHO that they have detected H5N8 in humans. “If confirmed, this would be the first time H5N8 has infected people,” a WHO Europe spokesperson says in a statement.

June 1, 2021 – China’s National Health Commission announces the first human case of H10N3.

February 2022 – The USDA confirms that wild birds and domestic poultry in the United States have tested positive for the H5N1 strain of avian flu. By May 17, 2023, the CDC reports there are 47 states with poultry outbreaks.

April 26, 2022 – China’s National Health Commission announces the first human case of H3N8.

April 28, 2022 – The CDC announces a case of H5 bird flu has been confirmed in a man in Colorado.

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Autism Fast Facts | CNN

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CNN
—

Here is a look at autism.

Autism or autism spectrum disorder (ASD) incorporates a group of neurodevelopmental disorders causing impaired communication skills and social skills. ASD generally starts before three years of age and lasts a lifetime, but early intervention plays a role in treatment and progress.

ASD is about four times more common among boys than girls, according to the Centers for Disease Control and Prevention (CDC).

ASD can be found among all races, ethnicities and socioeconomic groups.

The prevalence of ASD in the United States is about one in 36 8-year-olds, according to a 2023 CDC report.

Health care costs for children with autism are four to six times greater than medical costs for children without autism, according to research published in the Journal of Autism and Developmental Disorders.

April 2 is World Autism Day.

There is no definitive medical test to diagnose autism. Instead, the disorder is diagnosed by observing a child’s development.

According to the CDC, signs of autism may include deficits in social communication and interaction in a variety of contexts, difficulty engaging in back-and-forth conversation and an absence of interest in forming friendships with peers.

The debate over whether autism spectrum disorders are caused by vaccines started in 1998 when the medical journal The Lancet published a now-retracted study by researcher Andrew Wakefield linking the MMR vaccine to autism.

Most of Wakefield’s co-authors withdrew their names from the study when they learned he had been compensated by a law firm intending to sue manufacturers of the vaccine in question. In 2010, Wakefield lost his medical license. In 2011, the Lancet retracted the study after an investigation found Wakefield altered or misrepresented information on the 12 children who were the basis for the conclusion of the study.

Other researchers have not been able to replicate Wakefield’s findings. Several subsequent studies trying to reproduce the results have found no link between vaccines and autism, including several reviews by the Institute of Medicine.

Early 1900s – Autistic characteristics are studied as symptoms of schizophrenia.

1938 – Donald Gray Triplett of Mississippi is first examined by child psychiatrist Leo Kanner of Johns Hopkins Hospital and later becomes the first person diagnosed with autism symptoms.

1943 – Triplett is identified as “Donald T.” in the paper “Autistic Disturbances of Affective Contact” by Kanner. The paper elaborates on the idea that autism is related to lack of parental warmth; this is later dubbed the “refrigerator mother” theory.

1944 – Hans Asperger, an Austrian physician, publishes a paper about autistic syndrome. The paper gains wider recognition when it is translated into English in the early 1990s.

1964 – Bernard Rimland, a research psychologist, publishes “Infantile Autism: The Syndrome and Its Implications for a Neural Theory of Behavior,” which contradicts the “refrigerator mother” hypothesis. Kanner is the author of the foreword.

1965 – Rimland founds the National Society for Autistic Children (now the Autism Society). He later establishes the Autism Research Institute.

1980 – Autism is classified separately from schizophrenia in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).

December 18, 2007 – The United Nations adopts a resolution declaring April 2 World Autism Awareness Day.

October 29, 2014 – The medical journal Nature reports that scientists have identified 60 genes with a greater than 90% chance of increasing a child’s autism risk.

December 17, 2015 – Scientists at Harvard and MIT announce they have found, for the first time, a link between autistic behavior and reduced activity of a key neurotransmitter, a type of brain chemical that enables the transmission of signals across neurons, allowing the brain to communicate with other organs.

April 21, 2016 – The Simons Foundation announces that it is launching an autism research project called SPARK. The study, which involves scientists at 21 hospitals and university clinics, will focus on the possible connection between genetics and autism. Parents of children with autism are invited to sign up online and participate in the study. The group also works with Autism Speaks and the Autism Science Foundation to run the Autism BrainNet network, which is an autism brain bank that collects postmortem donations.

February 2017 – Researchers find that monitoring MRI brain scans of infants may help predict whether they will develop autism, according to a study published in the journal, Nature. The researchers found a possible link between brain enlargement during the first year of life and an autism diagnosis at age 2. This builds on previous similar research.

March 19, 2017 – CBS News’ “60 Minutes” profiles “Sesame Street’s” newest Muppet character, a girl named Julia who has autism.

April 11, 2017 – A study published in the American Journal of Public Health finds that people with autism are three times more likely than the general population to die because of preventable injuries, and children and young teens with autism are 40 times more likely to die from preventable injury than the general child population. Suffocation, asphyxiation and drowning are the leading causes of fatal injuries among people with autism.

March 26, 2018 – According to a study published in JAMA Pediatrics, children with autism spectrum disorder and their younger siblings are less likely to be fully vaccinated than children unaffected by autism.

March 4, 2019 – A study of over 650,000 children published in the journal Annals of Internal Medicine shows that the measles, mumps, and rubella vaccine does not increase the risk of autism and does not trigger autism in children who are at risk.

April 29, 2019 – A study published in JAMA Pediatrics suggests that children can be screened for autism spectrum disorder at 14 months of age with high accuracy (instead of 18 to 24 months of age, as is currently recommended).

January 23, 2020 – A study in the journal Cell identifies 102 genes that are associated with an autism risk. Previously, researchers were only aware of 65.

May 10, 2020 – In a report published in the Journal of Autism and Developmental Disorders, the CDC estimates that 2.2% of Americans adults have autism spectrum disorder. The report, which is the first US study of autism in adults, indicates that up to 5.4 million people age 18 and older, or about 1 in 45 people, have an autism spectrum condition.

February 14, 2022 – A meta-analysis published in JAMA Pediatrics finds that early mortality, due to natural or unnatural causes, is more than two times more likely for people with autism spectrum disorder than the general population.

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Vaccines Fast Facts | CNN

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CNN
—

Here’s a look at information and statistics concerning vaccines in the United States. For vaccines related to coronavirus, see Coronavirus Outbreak Timeline Fast Facts.

The Centers for Disease Control and Prevention (CDC) provides vaccine recommendations by age, as well as by disease.

For more than 100 years, there has been public discord regarding vaccines based on issues like individual rights, religious freedoms, distrust of government and the effects that vaccines may have on the health of children.

Exemptions to vaccines fall into three general categories: medical, religious and philosophical.

As of May 25, 2022, 44 states and the District of Columbia have enacted legislation allowing religious exemptions from vaccines, and 15 states allow philosophical (non-spiritual) exemptions.

1796 – Edward Jenner develops the smallpox vaccine, the world’s first successful vaccine.

1855 – Massachusetts mandates that school children are to be vaccinated (only the smallpox vaccine is available at the time).

February 20, 1905 – In Jacobson v. Massachusetts, the US Supreme Court upholds the State’s right to compel immunizing against smallpox.

November 13, 1922 – The US Supreme Court denies any constitutional violation in Zucht v. King in which Rosalyn Zucht believes that requiring vaccines violates her right to liberty without due process. The High Court opines that city ordinances that require vaccinations for children to attend school are a “discretion required for the protection of the public health.”

1952 – Dr. Jonas Salk and his team develop a vaccine for polio. A nationwide trial leads to the vaccine being declared in 1955 to be safe and effective.

1963 – The first measles vaccine is released. In 2000, the CDC declares the US has achieved measles elimination, defined as “the absence of continuous disease transmission for 12 months or more in a specific geographic area.” While the US has maintained measles elimination since, there are occasional outbreaks.

1986 – Congress passes the National Childhood Vaccine Injury Act. This coordinates vaccine activities across several government agencies to monitor vaccine safety, requires vaccine information statements are provided to those receiving vaccines, and creates the National Vaccine Injury Compensation Program to compensate those injured by vaccines on a “no fault” basis.

March 19, 1992 – Rolling Stone publishes an article by Tom Curtis, “The Origin of AIDS,” which presents a theory that ties HIV/AIDS to polio vaccines. Curtis writes that in the late 1950s, during a vaccination campaign in Africa, at least 325,000 people were immunized with a contaminated polio vaccine. The article alleges that the vaccine may have been contaminated with a monkey virus and is the cause of the human immunodeficiency virus, later known as HIV/AIDS.

August 10, 1993 – Congress passes the Omnibus Budget Reconciliation Act which creates the Vaccines for Children Program, providing qualified children free vaccines.

December 9, 1993 – Rolling Stone publishes an update to the Curtis article, clarifying that his theory was not fact, and Rolling Stone did not mean to suggest there was any scientific proof to support it, and the magazine regrets any damage caused by the article.

1998 – British researcher Andrew Wakefield and 12 other authors publish a paper stating they had evidence that linked the vaccination for Measles, Mumps and Rubella (MMR) to autism. They claim they discovered the measles virus in the digestive systems of autistic children who were given the measles, mumps and rubella (MMR) vaccine. The publication leads to a widespread increase in the number of parents choosing not to vaccinate their children for fear of its link to autism.

2004 – Co-authors of the Wakefield study begin removing their names from the article when they discover Wakefield had been paid by lawyers representing parents who planned to sue vaccine manufacturers.

May 14, 2004 – The Institute of Medicine releases a report “rejecting a causal relationship between the MMR vaccine and autism.”

February 2010 – The Lancet, the British medical journal that published Wakefield’s study, officially retracts the article. Britain also revokes Wakefield’s medical license.

2011 – Investigative reporter Brian Deer writes a series of articles in the BMJ exposing Wakefield’s fraud. The articles state that he used distorted data and falsified medical histories of children that may have led to an unfounded relationship between vaccines and the development of autism.

2011 – The US Public Health Service finds that 63% of parents who refuse and delay vaccines do so for fear their children could have serious side effects.

June 17, 2014 – After analyzing 10 studies, all of which looked at whether there was a link between vaccines and autism and involved a total of over one million children, the University of Sydney publishes a report saying there is no correlation between vaccinations and the development of autism.

February 2015 – Advocacy group Autism Speaks releases a statement, “Over the last two decades, extensive research has asked whether there is any link between childhood vaccinations and autism. The results of this research are clear: Vaccines do not cause autism. We urge that all children be fully vaccinated.

August 23, 2018 – A study published in the American Journal of Public Health finds that Twitter accounts run by automated bots and Russian trolls masqueraded as legitimate users engaging in online vaccine debates. The bots and trolls posted a variety of anti-, pro- and neutral tweets and directly confronted vaccine skeptics, which “legitimize” the vaccine debate, according to the researchers.

October 11, 2018 – Two reports published by the CDC find that vaccine exemption rates and the percentage of unvaccinated children are on the rise.

January 2019 – The World Health Organization names vaccine hesitancy as one of 10 threats to global health in 2019.

September 4, 2019 – Facebook announces that educational pop-up windows will appear on the social media platforms when a user searches for vaccine-related content, visits vaccine-related Facebook groups and pages, or taps a vaccine-related hashtag on Instagram

December 19, 2019 – The US Food and Drug administration announces the approval of a vaccine for the prevention of the Ebola virus for the first time in the United States. The vaccine, Ervebo, was developed by Merck and protects against Ebola virus disease caused by Zaire ebolavirus in people 18 and older.

December 27, 2019 – A study published in the medical journal JAMA Network Open finds that a single dose of the human papillomavirus (HPV) vaccine may be just as effective as two or three doses at preventing cancer-causing HPV infection.

February 3, 2020 – The National Institute of Allergy and Infectious Diseases (NIAID) announces that a clinical trial for an HIV vaccine has been discontinued since the vaccine was not found to prevent infections of human immunodeficiency virus, the virus that causes AIDS.

May 3, 2023 – The US FDA approves, Arexvy, the first vaccine to protect against respiratory syncytial virus or RSV. It is a single shot for adults 60 or older.

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Sleep apnea raises risk of long Covid by up to 75% for some, study says | CNN

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CNN
—

Adults who have obstructive sleep apnea have up to an 75% increased risk, on average, of developing long Covid after a SARS-CoV-2 infection compared with people without sleep apnea, a new study found.

Women with obstructive sleep apnea had up to an 89% increased risk, while men had a 59% higher risk, according to the analysis of electronic health data on nearly 1.8 million people.

Obstructive sleep apnea is a potentially dangerous disorder in which breathing stops for about 10 seconds multiple times during the night due to a blockage of the airways by heavy or relaxed soft tissues in the mouth and throat.

A second analysis of medical records of a smaller group of 330,000 adults found the risk to be only 12%, according to the study, which is part of RECOVER, or Researching Covid to Enhance Recovery. RECOVER is a National Institutes of Health initiative dedicated to understanding why some people develop long Covid and how best to detect, treat, and prevent the condition.

Why the huge difference in numbers? People in the larger study had additional health concerns, or comorbidities, such as obesity, diabetes, high blood pressure and heart disease, said senior study author Lorna Thorpe, co-lead of the RECOVER Clinical Science Core at NYU Langone Health.

“The range of 12% to 75% is likely due to a combination of different study populations and different levels of comorbidities, but also different definitions of long Covid,” she said. “We didn’t even have a diagnostic code for long Covid until October 2021.

“I believe the risk is likely to be in the middle, but we will need additional studies to tease that out,” added Thorpe, a professor and director of the division of epidemiology at NYU Grossman School of Medicine.

A third analysis of medical records of 102,000 children with sleep apnea found no correlation between sleep apnea and long Covid after the various confounding health conditions were factored out, “which, of course, is great news,” Thorpe said.

“By using three very large networks of electronic health records, we were able to do this study three times, which is one of the strengths of the research,” she added. “This study is the first collaboration of this focus and scale to find that adults with sleep apnea are at greater risk for long Covid.”

This is an “important study” on long Covid, said Dr. Sairam Parthasarathy, a principal investigator of the University of Arizona Health Sciences RECOVER Adult Study and professor of medicine.

“Research needs to be done in a prospective study to verify this association, and if found to be true these findings have implications for treatment of long Covid,” said Parthasarathy, who was not involved in the study.

“It is important to note that some of the symptoms of long Covid such as fatigue may be related to obstructive sleep apnea, and that the treatment of obstructive sleep apnea may improve such long Covid-related symptoms,” he added.

The study, published Thursday in the journal Sleep, is one of a several studies released since Congress allocated $1.15 billion to NIH in January 2021, to study the long-term effects of Covid over a four-year period. To date, the agency says it has used about $811 million to fund research.

Researchers wanted to investigate the role of sleep apnea in long Covid due to the well-known association between the condition and poorer outcomes after a Covid infection.

“People with sleep apnea are at higher risk for a more severe case of Covid-19, admission to intensive care at the hospital and for mortality,” Thorpe said.

“Obstructive sleep apnea can result in increased inflammation, potentially disrupted sleep leading to an increased propensity to develop infections and reduced immunity,” said Dr. Bhanu Prakash Kolla, a sleep medicine specialist in the Center for Sleep Medicine at the Mayo Clinic in Rochester, Minnesota.

“This could potentially explain the pathway by which obstructive sleep apnea leads to an increased risk of having Covid and also … (long Covid),” said Kolla, who was not involved in the study.

Sleep apnea is an underdiagnosed condition regardless of gender, said the University of Arizona’s Parthasarathy.

“It is conservatively estimated that 80% of patients with obstructive sleep apnea (OSA) are not diagnosed,” he said. In addition, “an assumption with these analyses is that patients with OSA are likely to be treated. However, nearly half of them are not using the treatment.”

Why would women have up to an 89% higher risk compared with 59% in men? The study did not address that issue.

However, “one can postulate this difference may be based on what we know about sex differences in sleep and immune responses,” said Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine in Chicago.

Zee, who was not involved with the new research, coauthored one of the first published studies on the link between sleep apnea and serious Covid infection.

“Women typically have stronger immune responses to viral infections, and thus also vulnerability for post-infection inflammation,” Zee said. “Women in general have more insomnia and with long Covid tend to present with fatigue and insomnia symptoms, which are also common symptoms of long Covid.”

Another reason could be that sleep apnea has historically been considered a male disease, Thorpe said, which could mean that by the time a woman is diagnosed her apnea is more advanced.

“It could be that the women who are documented in electronic health records have more severe sleep apnea because physicians more often look for sleep apnea among men,” she said.

As scientists continue to learn more about long Covid, further information will become available, Thorpe said. In the meantime, people who have sleep apnea — or who snore, snort and stop breathing at night, which are all signs of the condition — should be exceedingly careful when they contact Covid.

“People with sleep apnea who get infected with Covid should seek early treatment and consider getting Paxlovid, the oral medication prescribed to reduce risk of severe outcomes,” Thorpe said. “They should also keep up with their vaccinations to lower the risk of infection in the first place.”

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What happens if you wake up before your alarm? Tips from sleep experts | CNN

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Sign up for CNN’s Sleep, But Better newsletter series. Our seven-part guide has helpful hints to achieve better sleep.

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—

Many people dread the blaring sound of an alarm clock, signaling the start of a busy workday. Others wish they weren’t already awake and that the sound had actually woken them up.

Waking up many minutes or even hours before the alarm is not a new phenomenon, sleep experts tell CNN, but it can cause people discomfort.

More than a third of Americans get fewer hours of sleep a night than the minimum recommendation of seven hours, according to the US Centers for Disease Control and Prevention. According to the National Institutes of Health, studies across the globe show anywhere from 10% to 30% of the population struggles with insomnia, defined as the consistent difficulty falling asleep and the inability to return to sleep after going to bed.

Those experiencing insomnia can have a combination of “nocturnal awakenings” and what’s categorized as “early morning awakenings,” according to a 2009 study from the Stanford Sleep Epidemiology Research Center and other universities. The study finds that some people may experience early awakenings without other insomnia symptoms such as “difficulty initiating sleep,” “nocturnal awakenings” and “non-restorative sleep,” meaning sleep that isn’t substantial even with the recommended hours.

While insomnia treatments include cognitive behavioral therapy and medication, other daily tips can have an impact on early morning awakenings. An acute sleep disorder could be at play for someone not experiencing chronic insomnia but waking up early.

The constant waking up before that daily sound is coupled with an immense frustration about not falling back asleep. The stress can feel isolating and all-consuming, taking more precedence than the initial sleep problem.

“You start ruminating about it, and then you start doing things that make insomnia worse,” said Dr. Rajkumar Dasgupta, associate professor of clinical medicine at the University of Southern California Keck School of Medicine in Los Angeles.

“Don’t start telling yourself … ‘I’m going to make myself stay in bed until I fall asleep,’ ” he said.

So, what can you do about it?

If you wake up suddenly — in what feels like the early morning hours — resist checking the clock. Finding out it’s 3 a.m. when you set the alarm for 7 a.m. can cause increased worry about the hours of sleep you hoped to attain.

“The anxiety and the frustration build,” said sleep specialist Wendy Troxel, a senior behavioral scientist at Rand Corp. “Clock watching becomes habitual, and that habitual response of frustration and anxiety also causes a stress response in the body.”

When anxiety and worry take precedence, cortisol levels increase, and the body becomes alert. This process is counterproductive for maintaining drowsiness, as the brain becomes hyper-engaged.

“You look at the clock. It’s 3 o’clock in the morning like clockwork, and immediately might grit your teeth. You think of all the demands … how awful it is going to be when you’re sleep-deprived,” Troxel said. “All of this mental processing and agitation is antithetical to the sleep state. It’s making you more alert and aroused … versus sending the signal to the brain that it’s OK to drift.”

If your alarm is on the phone, checking the clock can pose an even more significant trigger. Consider getting an alarm that isn’t attached to your phone.

“Our phone is our strongest signal to our waking lives,” Troxel said. “You’re getting the light exposure from your phone, which can directly stimulate your circadian signal for alertness. The content of what we are consuming on our phones can be very activating, whether it’s scrolling through social media or reading the news. These can all stimulate emotional states that are more activating rather than relaxing.”

Paradoxically, experts say to get out of bed. Yes, even at 3 a.m.

“Abandon the idea of getting back to sleep,” Troxel said. “When you do that, when you let the pressure go that sleep isn’t so effortful, sleep is more likely to come back.”

In a stimulus control technique, you can distract your brain with a mundane task to help bring back drowsiness faster than staying frustrated in bed.

Mentally assigning the bed with sleeping helps people associate positive sleep thoughts with their space. Leaving the room when agitation sets in can separate the frustration from the bed.

Anything from reading a book to knitting or listening to soft music (but not using a phone) can positively distract the brain. Once drowsiness sets in again, head back to bed.

Dasgupta recommends keeping track not only of when you went to bed and woke up on a given night, but also the calming techniques, environmental factors — and even nutrition and exercise routines that seemed to help you sleep that day.

“Perfect sleep is like having a puzzle, and you need all the right pieces,” Dasgupta said. “People who have insomnia, they’re missing one of those sleep hygiene pieces. When you make your recommendation, like a muscle relaxation, maybe that’s not the thing that they were missing. Maybe sound wasn’t the key part. Maybe you need more of that weighted blanket.”

It also depends on our given circadian rhythm, or the 24-hour solar cycle the body runs on that alerts us when sleepiness sets at night. If any environmental factors change — such as travel, work schedule or lighting — the body’s circadian rhythm may be thrown off, signaling an uncomfortable early wake-up before the alarm, Dasgupta said. In this case, changing the lighting in a given room or getting alternative lighting could help.

Progressive muscle relaxation may work — start at the toes, clench the given muscles for three seconds and release. Breathe through this process. The 4-7-8 breathing exercise coupled with muscle relaxation can be successful, Dasgupta said. Breathe in for 4 seconds, hold it for 7 seconds and breathe out for 8 seconds.

Relaxing breath

Follow along as Dr. Ellen Vora guides you through the 4-7-8 breathing technique.

Source: Courtesy Dr. Ellen Vora

Others may find that yoga, meditation or reading can help when they wake up before their alarm. The same techniques don’t work for everyone, but practicing various strategies that may affect sleep is critical, ultimately building a well-followed routine.

If the problem continues beyond three times a week for three months, experts recommend talking to a sleep specialist. It may require more than a simple habit change.

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