Five diagnosed with Legionnaires’ disease in New Hampshire, health officials say
(NEW YORK) — Authorities warned residents of Lincoln, New Hampshire, to monitor themselves for symptoms of Legionnaires’ disease after five people fell ill in June and July.
The New Hampshire Department of Health and Human Services on Monday linked the outbreak of the bacterial pneumonia — which is caused by inhaling water droplets contaminated with Legionella bacteria — to a cooling tower behind the RiverWalk Resort in downtown Lincoln.
“Anybody who has visited the area near the contaminated cooling tower should monitor themselves for symptoms,” Dr. Benjamin Chan, New Hampshire state epidemiologist, said in a DHHS statement.
“People who develop fever or other symptoms of pneumonia within 14 days after spending time in this area should talk to their healthcare provider about testing for Legionella infection,” he added.
The cooling tower has been sanitized and put back into operation after discussion with state officials, RiverWalk Vice President Renee Blood told ABC News affiliate WMUR-TV.
“Out of an abundance of caution, additional testing will be performed later this week,” Blood told WMUR.
The test results are expected next week.
DHHS said the cooling tower’s continued operation could mean further exposure risks, particularly for people within a half-mile of the facility.
“Anyone who is visiting the specified area should assess their health risk,” DHHS said. “Those who are older, are current or former smokers, have weakened immune systems, or have certain medical conditions like chronic lung disease and diabetes are at higher risk for developing Legionnaire’s disease.”
Symptoms usually begin between two and 14 days following exposure and can include fever, cough and shortness of breath. The bacteria can also cause serious pneumonia, the stage known as Legionnaires’ disease. The condition can be fatal if left untreated.
DHHS noted, however, that most healthy people exposed to Legionella bacteria do not fall ill.
(NEW YORK) — Children with long COVID-19 may show different symptoms depending on their age, a new study suggests.
The study, published Wednesday in the journal JAMA, is the first looking at how long COVID affects children and teens from the National Institute of Health (NIH)-funded RECOVER initiative, which seeks to better understand, diagnose, prevent and treat the condition.
Among younger children, between ages 6 and 11, headache was the primary symptom followed by trouble with memory, focus and sleep, as well as stomach pain.
Teens and pre-teens between ages 12 and 17 tended to report more fatigue-related symptoms, such as daytime sleepiness or low energy, body aches and pains, and neurological symptoms, including headaches and difficulty with memory and focus. This age group was also more likely to experience changes in taste or smell.
“We really wanted to understand how does long COVID look different across the ages?” Dr. Rachel Gross, lead study author and a general pediatrician and clinical researcher at NYU Langone Health, told ABC News.
Study participants were recruited from more than 60 U.S. health care and community settings between March 2022 and December 2023, with children between ages 6 and 17 with and without previous COVID-19 infection.
“We know that children are changing over time, we know that they’re growing over time, that they’re developing, that their immune system may be changing, that their hormones may be changing. So, we weren’t surprised that we were seeing differences across these different age groups,” Gross said. “But next steps, we really need to understand why this is happening so we can understand the underlying mechanisms that may be related to these differences.”
Gross said most of what researchers know about long COVID comes from studies of adults, and this is one of the first studies to characterize what prolonged symptoms children may be experiencing. She said much more long COVID research needs to focus on children.
“There have been many misperceptions about COVID and children, even since the beginning of the pandemic,” she said. “There was a common misperception that children didn’t get COVID infections, and we know that’s not true. And now there’s a common misperception that children don’t develop long COVID, and we know from studies like this and others that that is not true, and that long COVID in children is not a rare condition.”
‘I can’t figure out what’s wrong’
Gabrielle “Gabby” Jospa, from Plainview, New York, is one of many children who knows all too well that children can, and do, develop long COVID.
The now 15-year-old contracted COVID-19 in December 2021. At first, she thought it was just a cold or a less severe virus. However, she developed severe symptoms including a high fever, fast heart rate, nausea, body aches, stomachache and falling oxygen levels that required a visit to the emergency room, Gabby told ABC News.
Once the initial symptoms were gone, there were many lingering after-effects. Gabby’s pulse and oxygen levels improved but not to where they were pre-COVID, according to her mother, Amy Jospa, and they knew something was wrong.
Gabby started experiencing fatigue and brain fog, and developed swollen joints, unexplained rashes and even postural orthostatic tachycardia syndrome (POTS), a condition that causes the heart to beat faster than normal when transitioning from sitting or lying down to standing, Amy Jospa told ABC News.
Gabby also has a history of migraines, experiencing them about once a year, but they worsened after COVID-19 to once per week and then once per day. They visited several doctors, none of whom could figure out what was wrong.
“The doctors will just tell you like — and it’s not the doctor’s fault — ‘Oh, it’s just a cold’ or ‘Oh, I’ll just give you headache medicine’ but it doesn’t go away, and you’re starting to feel after a while, after seeing a million doctors, like ‘I can’t figure out what’s wrong with me. It’s hopeless,'” Gabby told ABC News.
In September 2023, with some help from Gabby’s cardiologist getting her the right series of tests, Gabby was diagnosed with long COVID. Gabby said she was “excited” more than upset to finally have a proper diagnosis.
Gabby and her mother tried to enroll in several long COVID studies at hospitals but she was rejected before she was accepted into the RECOVER study at NYU Langone, and had her first in-person visit in November 2023.
They say the RECOVER study has been helpful in terms of helping Gabby improve and better manage her long COVID symptoms.
“The RECOVER study also doesn’t include just medical testing,” Amy Jospa said. “They do cognitive testing on her, and it’s helped Gabby feel more normal and less stigmatized about the process, because she’s not the only one with brain fog. Like, ‘I have this; it stinks, but I’m not alone, and there are people who are working really hard to figure this out and get me to where I need to be.’ It’s like positive change, and I think that’s been the nicest part, seeing the shift mentally for her.”
Gabby and her mother say she’s still not 100% back to where she was before COVID. Before contracting COVID, Gabby, who swims competitively, used to be able to swim for 45 minutes straight. Now, she physically exhausts more easily so she needs breaks.
Amy Jospa said they made modifications to Gabby’s gym schedule at school and that Gabby has more time between classes because she can’t rush in the hallways between classes.
“I still manage, even though there are struggles,” Gabby said. “I managed to find a way to make it work so I can keep going mentally as well as physically.”
ABC News’ Dr. Kierstin Luber contributed to this report.
(LONDON) — A mass polio vaccination campaign is underway in Gaza to inoculate children after the first case in 25 years was recently detected in the strip.
Several organizations — including the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), the Hamas-run Gaza Ministry of Health and other partners — began the campaign on Sunday in central Gaza, where the case was confirmed.
The WHO has sent more than 1 million vaccine doses with the goal of vaccinating more than 640,000 children under age 10. The campaign will be rolled out in three-day phases each in central, southern and northern Gaza, according to Dr. Richard Peeperkorn, WHO representative for the Palestinian territory,
The UN estimates that in 2022, polio vaccination coverage, conducted through routine immunization, was at 99%.
However, since the outbreak of the war, this percentage has fallen. According to the latest WHO-UNICEF routine immunization (WUENIC) report, the number is estimated to be at 89% in 2023 due to the number of newborns not vaccinated.
Israel has agreed to limited pauses in the fighting, for about six hours a day, to facilitate the campaign, according to the WHO.
Children will receive two drops of novel oral polio vaccine type 2 (nOPV2), which has been used for outbreak response under the WHO’s Emergency Use Listing approval since March 2021.
“We are targeting 157,000 children under 10 [in central Gaza]. We will do it for three consecutive days and, if needed, we’ll add a day,” Peeperkorn said on Sunday.
The vaccination will target 138 different sites including hospitals, medical points, schools and community points — including water and food distribution points — according to the WHO.
Among those participating in the vaccination campaign is the medical nonprofit MedGlobal. Five of the organization’s medical treatment points in Gaza are ready to administer vaccines.
Dr. John Kahler, a pediatrician and co-founder of MedGlobal, who has been on multiple medical missions to Gaza, said temporary pauses are not enough to fix long-term systemic issues, but this proves they can happen for critical medical situations.
“First of all, it shows how collapsed the public health system is,” he told ABC News. “But it also shows that it is possible for both sides to come to some type of a temporary — but important — agreement to permit [vaccinations] to happen.”
UNICEF said during the first full day of the vaccination campaign, 72,600 children received a dose of polio vaccine.
Poliovirus was first detected in sewage samples from Deir al-Balah and Khan Younis — in central and southern Gaza, respectively — in mid-July, in tests conducted by the Ministry of Health in coordination with the United Nations.
“The presence of the virus that causes polio … represents a new health disaster,” the ministry said in a statement at the time. “There is severe overcrowding, a scarcity of available water and its contamination with sewage water, the accumulation of tons of garbage and the occupation’s prevention of the entry of hygiene materials, which creates a suitable environment for the spread of various epidemics.”
In mid-August, the Ministry of Health reported the first case of polio in 25 years in a 10-month-old child who had not been vaccinated. Doctors suspected polio after symptoms resembled the virus, which was confirmed in test conducted in Amman, the capital of Jordan.
Kahler said the true number of polio cases is likely much higher with many that have got undetected.
“If you really do have one case of paralytic polio, you have, by definition, hundreds or more,” he said. “Remember, 90% of polio is asymptomatic. So, this is why it spreads. It’s highly contagious…Given the breakdown in the infrastructure, there will be no way of knowing how many.”
Polio largely affects children under age 5 and can lead to paralysis or death. According to the Palestinian Central Bureau of Statistics, there are about 341,000 children under the age of five in Gaza.
(NEW YORK) — A new report by March of Dimes found that over 5.5 million women live in U.S. counties experiencing limited to no access to maternity care resources that include hospitals or birthing centers, obstetric care or obstetricians.
The report is the latest by the maternity care-centric nonprofit to highlight a worsening state of maternity care in the U.S., with a rise in closure of hospital obstetric units contributing to what the organization calls “a growing maternal and infant health crisis.”
March of Dimes estimated that more than 2.3 million women of reproductive age live in counties deemed to be maternity care deserts, with approximately 150,000 births in these counties. More than three million additional women live in counties with limited maternity care access.
“We’re going from bad to worse. We already have the worst maternal mortality rate of our industrial peer countries, and we know that access matters,” Dr. Amanda Williams, March of Dimes’ chief medical officer, told ABC News. “If we don’t have access, then we don’t even have a chance.”
Maternity care deserts have a significant impact on health outcomes for expecting women. Data shows that women in maternity care deserts have a 13% chance of experiencing preterm birth, and receive inadequate prenatal care at higher rates, according to the report. Low-income and women of color are disproportionately affected.
People in maternity care deserts have to travel approximately 2.6 times further to receive care than those who live in counties where care exists, and early data has found that ob-gyns are leaving states with strictest abortion bans, Williams said.
“As the report suggests, the Dobbs decision — the effects of which have yet to be fully realized — is likely playing a major role in the already shrinking ob-gyn workforce in many rural areas of the country,” Dr. Stella Dantas, president of the American College of Obstetricians and Gynecologists, said in a statement.
“As we continue to find ways to increase access, we must also vigorously combat legislative interference in the practice of medicine so that clinicians are free to practice without fear of criminalization and patients are able to get the care they need and deserve in the communities they live and raise their families in,” the statement continued.
Approximately 35% of all U.S. counties are now considered maternity care deserts, having no birthing facilities or obstetricians. North Dakota, South Dakota, Alaska, Oklahoma and Nebraska are the most impacted states, according to March of Dimes.
Since 2022, over 100 counties experienced a decline in maternity care access, totaling over 100 hospitals closing their obstetric units, resulting in delayed access to emergency care and forcing families to travel farther to receive critical care, according to the report.
Between 2015 and 2022, the prevalence of pre-pregnancy hypertension rose by over 80%, according to March of Dimes. Preeclampsia, a potentially fatal condition that causes a pregnant woman’s blood pressure to rise, can lead to preterm birth, stroke, seizure, and other complications for expecting women.
In maternity care deserts, the rates of pre-pregnancy hypertension was 1.3 times higher than counties with full access to care, according to the report.
Leveraging telehealth services, improving reimbursement policies for obstetric services at hospitals, and improving access to midwifery services are some of the policy solutions to improve care, Williams noted.
“Not only are there people, a lot of people who live in these maternity care deserts, there are beautiful things, just as in the natural desert, you might find a gorgeous flower or cactus,” Dr. Williams said. “There are churches, there are community centers, there are community based organizations. And so we need to figure out how in healthcare and in public health, we can partner with some of those organizations to be able to extend care to those who live in maternity care deserts.”