California confirms first US case of more severe mpox strain — but risk to public remains low
Jun Li/Getty Images/STOCK
(SAN MATEO COUNTY, Calif.) — Health officials in California have confirmed the first domestic case of a more severe strain of mpox in a traveler from Eastern Africa, according to the U.S. Centers for Disease Control and Prevention.
The risk to the public remains low, according to the agency. Health officials are working to identify any people who may have been exposed to the person who recently traveled from Eastern Africa and was treated shortly after returning to the U.S. at a local medical facility, the CDC said.
Casual contact — including during travel — is unlikely to pose significant risks for transmission, the agency noted.
This is the first confirmed case in the U.S. of a strain, or clade, of the virus called clade 1b.
Another strain, clade 2b, was primarily responsible for the global outbreak in 2022. During the outbreak, mpox primarily spread through close sexual contact — and a strong vaccination effort was credited with helping slow the surge of cases. This less severe version continues to circulate in the U.S at low levels. The CDC does not currently recommend booster shots for those who are considered high-risk and already fully vaccinated.
Clade 1b was recently found in September in the Congo, likely responsible for a growing outbreak in Africa that led the World Health Organization to declare a global health emergency. Early data shows that this clade is more severe and may be spreading through other contact routes in households and often to children.
People with mpox, which was formerly known as monkeypox, often get a rash that can be located on hands, feet, chest, face, mouth or near the genitals, the CDC said.
(WASHINGTON) — President-elect Donald Trump is nominating a critic of COVID-19 lockdown policies to serve as the head of the National Institutes of Health.
In a statement, Trump said he has picked Dr. Jay Bhattacharya to serve as NIH director to work in cooperation with Robert F. Kennedy Jr. — whom Trump named as his pick for secretary of the Department of Health and Human Services — to direct the nation’s medical research.
“Together, Jay and RFK Jr. will restore the NIH to a Gold Standard of Medical Research as they examine the underlying causes of, and solutions to, America’s biggest Health challenges, including our Crisis of Chronic Illness and Disease,” Trump said in the statement. “Together, they will work hard to Make America Healthy Again!
Bhattacharya is a professor of health policy at Stanford University who gained notoriety for openly opposing COVID-19 lockdown restrictions.
In addition to a medical degree, he has a doctorate in economics.
Trump also nominated Jim O’Neil to serve as the deputy secretary of the Department of Health and Human Services to “oversee all operations and improve Management, Transparency, and Accountability,” according to a statement.
(NEW YORK) — Nicole Hallingstad credits her cat, Rudy, with finding her breast cancer.
Despite an unremarkable mammogram screening just seven months earlier, the 42-year-old knew something was wrong when Rudy kept pawing at something on the right side of her chest.
Hallingstad had another mammogram, which this time found a golf-ball-sized tumor in her breast that she said was from a fast-growing form of breast cancer.
After surgery, she needed both radiation and chemotherapy – but neither were available where she lived.
Hallingstad faced a difficult decision. Her options were to travel more than 1,000 miles once a month for chemotherapy and then relocate for six weeks of radiation treatment, or move to another state where she could get chemotherapy and radiation in one place. Hallingstad chose the latter.
“I was very fortunate that I was able to take the option to move and continue working and receive the care I needed,” Hallingstad told ABC News. “But that is a choice that is unsustainable for far too many Native women, and frankly, uncertain.”
Why was cancer care so inaccessible for Hallingstad? Because she lived in Alaska.
Hallingstad, a member of the Tlingit and Haida Native Indian Tribes of Alaska, faced profound barriers to breast cancer care that are shared by many American Indian and Alaska Native (AI/AN) women. These barriers have contributed to growing disparities over the last three decades.
“It’s often really difficult to get to a qualified health care center that is close to the rural areas where so many of our people live,” Hallingstad said. “And transportation is not readily available for many people to get the trip to the center, to get their screening to even have access to the kind of machinery that is needed for this important treatment work.”
A recent report by the American Cancer Society (ACS) showed that the rate of breast cancer deaths among U.S. women has decreased by 44% from 1989 to 2022. But that progress has not held true for all women, including AI/AN women, whose death rates have remained unchanged during that same time.
While AI/AN women have a 10% lower incidence of breast cancer than white women, they have a 6% higher mortality rate, according to the ACS.
The ACS also found that only about half of AI/AN women over 40 years old surveyed for the report said they’d had a mammogram in the last two years, compared to 68% of white women. That lack of timely screenings increased the risk of discovering cancer in more advanced stages, which in turn could result in higher death rates.
“This is a population for which we are very concerned,” Karen Knudsen, CEO of the American Cancer Society, told ABC News. “Given the mammography rates [of AI/AN women] that we’re actually seeing, which are well behind other women across the country.
Knudsen emphasized the need to “create that additional awareness about the importance of getting screened for breast cancer early because of the link to improved outcomes,” especially in Indigenous communities.
There are also cultural barriers to cancer care and awareness. “Culturally, we don’t often speak about very deep illness, because we don’t want to give it life,” Hallingstad said.
That fear, not necessarily shared by all Indigenous communities, is a common reason people from any background may choose not to discuss cancer risk, or to seek help if they think they have a serious health problem.
Melissa Buffalo, an enrolled member of the Meskwaki Nation of Iowa, is the CEO of the American Indian Cancer Foundation, where she works alongside Hallingstad. Her organization recently received a grant to study the knowledge and beliefs surrounding cancer and clinical trials among Indigenous people in Minnesota. Buffalo said she hopes to “create resources and tools that are culturally relevant, culturally tailored, so that we can help to build trust within these healthcare systems.”
Advocates like Buffalo and organizations like the ACS are also creating toolkits to help existing systems increase their outreach to AI/AN women. However, “there is not a ‘one size fits all’ approach to everything,” Dr. Melissa Simon, an OB/GYN at Northwestern University and founder of the Chicago Cancer Health Equity Collaborative, told ABC News.
“We have to also acknowledge that the patient has some variation too, just like the cancer itself. To treat it has some variation,” Simon said.
“We have to talk about it,” Hallingstad said about breast cancer in the Indigenous community. “We need to understand treatment options. We need to bring care facilities closer and we need to make sure our populations are being screened and are following treatment.”
Jade A. Cobern, MD, MPH is a physician board-certified in pediatrics and preventive medicine and a medical fellow of the ABC News Medical Unit.
Sejal Parekh, M.D., is a board-certified, practicing pediatrician and a member of the ABC News Medical Unit.
LW, who asked not to show her face, is a 16-year-old transgender teenager challenging Tennessee’s ban on gender-affirming medical treatments that have improved her quality of life. (ABC News)
(WASHINGTON) — Medical treatments for transgender children, endorsed by major American medical associations and safely used for decades, hang in the balance at the U.S. Supreme Court on Wednesday as the Biden administration and three families with transgender teenagers ask the justices to strike down a state law banning some gender-affirming care for kids.
The landmark case — U.S. v. Skrmetti — comes from Tennessee, which is among 26 states that have moved to prohibit administration of puberty-blocking medication and hormone therapy to minors who seek to identify with, or live as, a gender identity inconsistent with his or her sex at birth.
Oral arguments mark the first time the nation’s highest court has openly considered a state law targeting transgender people. It is also the first time an openly transgender litigator, ACLU attorney Chase Strangio, will argue a case in the Supreme Court chamber.
The historic hearing thrusts the justices to the forefront of a cultural debate that has sharply divided the country and tested the limits of science and parental rights.
The outcome of the case could determine access to health care for hundreds of thousands of trans teens and more broadly influence how communities treat transgender people in hospitals, schools and on sports fields.
The government argues that Tennessee’s SB1, which was enacted in March 2023, violates the Constitution’s Equal Protection clause because it discriminates on the basis of sex to decide who can receive otherwise legal medical treatments available to youth.
“Put simply, an adolescent assigned female at birth cannot receive puberty blockers or testosterone to live as a male, but an adolescent assigned male at birth can,” the administration wrote in its brief to the court.
The Tennessee law expressly allows minors who are not transgender to receive gender-affirming treatments to address a “congenital defect, precocious puberty, disease, or physical injury.”
Denying discrimination, the state argues its law is a reasonable regulation of medical treatment based on its purpose, meant to protect children from potential long-term health risks and possible irreversible changes to the body.
The law’s Republican sponsors claim that contradictory scientific evidence and documented regret among some young people who have transitioned both warrant caution in developing standards of care.
The law also cites a “compelling interest in encouraging minors to appreciate their sex, particularly as they undergo puberty” and preventing them from becoming “disdainful of their sex.” The government says the text proves an intent to enforce gender conformity.
Hundreds of Tennessee transgender children were receiving treatments before SB1 was enacted, legislators concluded. It is not known how many suffered alleged harm.
The plaintiffs in the case include 16-year-old LW and her parents Brian and Samantha Williams of Nashville. After several years of successful hormone therapy, LW now has to travel out of state to continue treatments she says have dramatically improved her quality of life.
“I feel normal now,” LW said in an exclusive interview with ABC News last month.
“Our state legislature had made such a big deal out of parents rights during COVID, about masks and vaccines — that that’s for parents to decide these medical decisions for their children,” noted Samantha Williams. “And then, they made this medical decision for our child.”
Nationwide, an estimated 300,000 Americans ages 13 to 17 identify as transgender, according to the Williams Institute at UCLA School of Law. Of those, nearly 100,000 live in states that have banned access to gender-affirming medical treatments for minors.
“It’s a case of enormous significance that presents fundamental questions about the scope of state power to regulate medical care for minors, of the rights of parents to make medical decisions for their children… and the level of scrutiny that courts should apply to laws that discriminate against transgender people in general,” said Deepak Gutpa, a veteran Supreme Court litigator. “This is a major, major constitutional civil rights issue.”
More than 60% of Americans say they oppose law banning certain types of gender-affirming medical treatment for minors, according to Gallup.
Major American medical associations have endorsed the treatments for more than a decade as part of “individually tailored interventions” to support trans kids and affirm their sense of self. Not all transgender children seek medical care to facilitate transition to another sex.
“It needs to be part of a very deliberate process that involves medical specialists, who are expert at doing this, and, again, are following the science,” said Dr. Ben Hoffman, a pediatrician and president of the American Academy of Pediatrics. “It all begins and ends with science. This is not about any sort of agenda.”
Clinical practice guidelines from the American Endocrine Society, based on more than 260 research studies, recommend the use of puberty-delaying medications and waiting until a child reaches adulthood to consider gender-affirming surgery.
The American Academy of Pediatrics says the effects of puberty blockers are not permanent if treatment is discontinued. Many effects of hormone therapy can also be reversed. Long-term risks may include fertility challenges and possible harm to bone density, but the group says those risks require further study.
In contrast to the U.S. medical establishment, several European countries, including the United Kingdom, have reversed course on the use of gender-affirming treatments as a standard-of-care for transgender children, citing insufficient scientific evidence of long-term benefits.
“When you look at the totality of the medical research, to me there is more than enough uncertainty and evidence of bad outcomes for kids who’ve gone through these treatments when they reach the later stages in life,” said Tennessee Senate GOP Leader Jack Johnson.
A federal district court sided with the plaintiffs, temporarily halting enforcement of SB1, but the Sixth Circuit U.S. Court of Appeals reversed. The panel of judges concluded Tennessee had a rational basis for enacting the law.
“Kind of the whole ballgame in the case is the debate about whether there actually is discrimination on the basis of sex,” said Erin Murphy, a Supreme Court litigator and former clerk to Chief Justice John Roberts.
“It’s really not,” Murphy argued. “To say providing testosterone to a biological boy and biological girl is the same thing because testosterone is involved — it’s a different treatment that has different risks.”
David Cole, former legal director of the American Civil Liberties Union, which is representing the Williams family, says the court’s conservative majority will have to confront the legacy of its decision.
“I think there’s no question in 25 years that the court will have recognized that treating people differently because their gender identity is sex discrimination,” Cole said.
“The question is whether the court wants to write a decision will be overturned, you know, in the course of the next 10 years or 15 years,” he said, “or whether it wants to recognize what is going on, which is sex discrimination.”
A decision in the case is expected by the end of June 2025.
