First Edition: April 18, 2019

Kaiser Health News: As Syphilis Invades Rural America, A Fraying Health Safety Net Is Failing To Stop It
When Karolyn Schrage first heard about the “dominoes gang” in the health clinic she runs in Joplin, Mo., she assumed it had to do with pizza. Turns out it was a group of men in their 60s and 70s who held a standing game night — which included sex with one another. They showed up at her clinic infected with syphilis. That has become Schrage’s new normal. Pregnant women, young men and teens are all part of the rapidly growing number of syphilis patients coming to the Choices Medical Services clinic in the rural southwestern corner of the state. She can barely keep the antibiotic treatment for syphilis, penicillin G benzathine, stocked on her shelves. (Weber, 4/18)

The Washington Post Fact Checker: Pence, Buttigieg And The Debate Over ‘Conversion Therapy’
It’s a Hoosier rumble! Democratic presidential hopeful Pete Buttigieg has been calling out Vice President Pence for what he views as animus against gay rights. Buttigieg came out as gay when Pence was still governor of Indiana, after the two had tangled over Pence’s signing of the Religious Freedom Restoration Act (RFRA). The law was signed in March 2015, and Buttigieg came out in June of that year. (Kessler, 4/18)

The Hill: Cummings Accuses Oversight Republicans Of Obstructing Drug Price Probe 
House Oversight and Reform Committee Chairman Elijah Cummings (D-Md.) on Wednesday accused ranking member Jim Jordan (R-Ohio) of deliberately trying to undermine the committee’s investigation into rising drug prices. In a letter sent Wednesday, Cummings condemned what he claimed were Jordan’s efforts to “actively obstruct” the committee’s investigation into prescription drug pricing. (Weixel, 4/17)

CNN: GOP Lawmakers Set Up Roadblocks To Voter-Approved Medicaid Expansion
Many residents in three deep-red states rejoiced last fall when voters approved Medicaid expansion, circumventing the objections of their elected representatives. But the victories in Utah, Idaho and Nebraska -- which would have extended coverage to tens of thousands of residents in each state under the Obamacare provision -- have proven short-lived. This week, Idaho's GOP lawmakers and governor joined their peers in Utah and Nebraska in slapping work requirements and other restrictions on access to Medicaid. Idaho legislators had considered bills with less stringent measures, but ultimately rejected those. (Luhby, 4/13)

Montana Public Radio: Montana Senate Passes Medicaid Expansion Reauthorization
The bill to continue Medicaid expansion in Montana passed out of the state Senate Tuesday after teetering on the edge of a deadline for end of session negations. The reauthorization of the health coverage program for low-income adults, packaged with new work and public service requirements for certain enrollees, passed 28-22 in its final Senate vote. Around 96,000 people are currently covered by expanded Medicaid in Montana. (Cates-Carney, 4/16)

MTN News: Medicaid Expansion Bill Passes Final Vote In Montana Senate
The bill would continue a program that provides government-funded medical coverage for about 96,000 lower-income adults in Montana. Medicaid expansion is set to expire in June unless the Legislature reauthorizes it. HB 658 would extend it several years and add new eligibility requirements. ... HB 658 will now go back to the House. If the House votes to approve the Senate’s amendments, the bill will go to Bullock for his signature. If they reject the amendments, a conference committee will have to reconcile the differences. (Ambarian, 4/16)

The New York Times: Doctors Accused Of Trading Opioid Prescriptions For Sex And Cash
Last summer, a woman in northern Alabama who law enforcement officials said was a prostitute typed a message to a doctor: “Can u get any Xanax.” The doctor replied: “What makes you think I know a Xanax source?” Just below, he added a smiley face, and then described his home as the “Fun House.” The doctor was one of the scores of medical professionals across seven states who were charged by federal prosecutors on Wednesday with schemes to illegally distribute millions of pain pills. Opioid prescriptions were exchanged for sex in some cases, and for cash with an added “concierge fee” in others. One doctor was accused of routinely prescribing opioids to friends on Facebook. (Robertson, 4/17)

The Associated Press: 60 People Charged In Illegal Prescription Opioid Crackdown
U.S. Attorney Benjamin Glassman of Cincinnati described the action, with 31 doctors facing charges, as the biggest known takedown yet of drug prescribers. Robert Duncan, U.S. attorney for eastern Kentucky, called the doctors involved "white-coated drug dealers." Authorities said the 60 includes 53 medical professionals tied to some 350,000 prescriptions and 32 million pills. The operation was conducted by the federal Appalachian Regional Prescription Opioid Strike Force, launched last year by the Trump administration. (Sewell, 4/17)

Reuters: Dozens Of Doctors In Appalachia Charged In Opioid Fraud Bust
“The opioid epidemic is the deadliest drug crisis in American history, and Appalachia has suffered the consequences more than perhaps any other region,” Attorney General William P. Barr said in a statement. (Borter, 4/17)

The Washington Post: Doctors In Seven States Charged With Prescribing Pain Killers For Cash, Sex
“That is the equivalent of one opioid dose for every man, woman and child” in the region, Brian Benczkowski, an assistant attorney general in charge of the Justice Department’s criminal division, said in an interview. “If these medical professionals behave like drug dealers, you can rest assured that the Justice Department is going to treat them like drug dealers.” (Horwitz and Higham, 4/17)

The Wall Street Journal: Dozens Of Medical Professionals Charged In Opioids Sting
The cases revealed in the indictment include a man in Tennessee who called himself the “Rock Doc” and allegedly prescribed hundreds of thousands of pills in exchange for sex; a doctor in Alabama who prosecutors say recruited prostitutes to become patients and let them use drugs at his house; another who wrote prescriptions on behalf of Facebook friends; and a dentist in Kentucky accused of needlessly pulling teeth to justify giving his patients addictive drugs. The charges against them include unlawful distribution of controlled substances and conspiracy to obtain controlled substances by fraud. (Gurman and Randazzo, 4/17)

The Associated Press: Doctor's Dosing Prompts A Look At More Hospital Regulation
How might Ohio better regulate hospitals following allegations that an intensive care doctor ordered excessive painkiller doses for dozens of patients who then died? That's the question facing officials in Ohio, the only state that doesn't license general hospitals. (4/17)

The New York Times: ‘Partly Alive’: Scientists Revive Cells In Brains From Dead Pigs
The brains did not regain anything resembling consciousness: There were no signs indicating coordinated electrical signaling, necessary for higher functions like awareness and intelligence. But in an experimental treatment, blood vessels in the pigs’ brains began functioning, flowing with a blood substitute, and certain brain cells regained metabolic activity, even responding to drugs. When the researchers tested slices of treated brain tissue, they discovered electrical activity in some neurons. (Kolata, 4/17)

The Associated Press: Scientists Spur Some Activity In Brains Of Slaughtered Pigs
Scientists restored some activity within the brains of pigs that had been slaughtered hours before, raising hopes for some medical advances and questions about the definition of death. The brains could not think or sense anything, researchers stressed. By medical standards "this is not a living brain," said Nenad Sestan of the Yale School of Medicine, one of the researchers reporting the results Wednesday in the journal Nature. But the work revealed a surprising degree of resilience among cells within a brain that has lost its supply of blood and oxygen, he said. (Ritter, 4/17)

Reuters: Yale Study Revives Cellular Activity In Pig Brains Hours After Death
The scientists emphasized that their work did not even come close to reawakening consciousness in the disembodied pig brains. In fact the experiment was specifically designed to avoid such an outcome, however improbable. Still, the study raises a host of bioethical issues, including questions about the very definition of brain death and potential consequences for protocols related to organ donation. (Gorman, 4/17)

The Wall Street Journal: Scientists Restore Some Brain Function After Death In Animal Experiments
The science is still a very long way from having applications in human brains, and the findings in no way suggest the brain was alive, the research team and other scientists stressed. “This is not a living brain, but it is a cellularly active brain,” said Yale neuroscientist Nenad Sestan, who led the study. Still, the results could open up new avenues of study into brain function and how drugs affect it, potentially improving drug development for conditions like dementia or stroke that have for decades stumped the pharmaceutical industry, brain experts said. It also could have future implications for organ donation, forcing the medical community to re-evaluate when it’s appropriate to take organs for transplants, experts said. (Hernandez, 4/17)

NPR: Pig Brains Partly Revived By Scientists Hours After Animals Died
The potential ethical questions raised by this research range from how to protect animal welfare to how it might affect organ donation from people declared brain-dead. "The science is so new that we all need to work together to think proactively about its ethical implications so that we can responsibly shape how this science moves forward," says Khara Ramos, director of the neuroethics program at the National Institute of Neurological Disorders and Stroke. (Greenfieldboyce, 4/17)

Reuters: Twenty Years After Columbine, Mass Shooting Survivors Help Others Heal
Almost two decades separate the traumatic experiences of Michelle Wheeler and Chad Williams, who both survived mass shootings. But as they shared their stories one evening last July, 20 years seemed to evaporate in the crisp Colorado air. The similarities were too many to count. The same gripping fear. The loss and devastation that followed. The lasting trauma and overwhelming grief. So many funerals and memorial services. (Millis, 4/17)

The Associated Press: 'We Don't Get Over It': Pain Of Mass Shootings Stretches On
Alex Rozenblat can still hear the cries of a wounded boy calling for help as she hid from the gunfire that killed 17 people at Marjory Stoneman Douglas High School last year. Talking to therapists at the school in Parkland, Florida, didn't help. Each session had a different counselor, and she found herself rehashing traumas she had already expressed. She would rather turn to her friends, who understand what she went through. "There is slight pressure to get better as quickly as you can, and since it's been a year, everyone thinks that you are better," the 16-year-old said. (Spencer, Kennedy and Slevin, 4/18)

The New York Times: ‘Infatuated’ With Columbine: Threats And Fear, 20 Years After A Massacre
The 20th anniversary of the attack at Columbine High School was supposed to be marked with prayers and memorials. Instead, millions of parents, students and educators across Colorado awoke on Wednesday to news that an armed 18-year-old woman with an infatuation with the massacre had flown across the country to Colorado and that hundreds of schools had closed as a precaution as the authorities frantically searched for her. By day’s end, the woman, a Florida high school student identified as Sol Pais, was discovered dead of an apparent self-inflicted gunshot wound in the mountains west of Denver. (Turkewitz and Healy, 4/17)

The Washington Post: Sol Pais: Infatuated With The Columbine Shooting, She Flew To Colorado And Bought A Gun
When she stepped into Colorado Gun Broker on Monday, Sol Pais knew exactly what she wanted to buy. A 12-gauge pump-action shotgun. The same gun one of the shooters used in the 1999 attack on Columbine High School. The 20th anniversary of that attack was just five days away — and the school was less than two miles down the road. For weeks, the 18-year-old had been planning this trip, a pilgrimage from her home in South Florida to the Denver suburb where the modern era of school shootings had begun. (Oldham, Contrera, Shapira and Thebault, 4/17)

The Associated Press: Supreme Court Asked To Void Louisiana Abortion Clinic Law 
A Louisiana abortion clinic is asking the Supreme Court to strike down regulations that could leave the state with just one clinic. A divided high court had previously agreed to block the law pending a full review of the case. An appeal being filed with the court Wednesday says the justices should now take the next step and declare the law an unconstitutional burden on the rights of women seeking an abortion. The Louisiana provision is similar to a Texas law the court struck down in 2016. (4/17)

The Hill: House Democrats Probe Trump Administration's Funding Of Anti-Abortion Group 
House Democrats are launching a probe of the Trump administration's decision to fund an anti-abortion group through a federal family planning program while cutting government support for Planned Parenthood.  The Trump administration announced last month that four Planned Parenthood affiliates would not be awarded Title X family planning grants this year, despite receiving them in the past. The administration also announced that, for the first time, it would fund Obria, a chain of anti-abortion clinics that don't provide contraception. (Hellmann, 4/17)

The Associated Press: Florida House OKs Bill Requiring Parental Abortion Consent
Legislation that would require consent from a parent or guardian before a girl under 18 could obtain an abortion passed the Florida House on Wednesday night after a lengthy debate and amid questions about its constitutionality. The Republican-led House voted 69-44 largely along party lines for the bill, which now moves to the Senate where a similar bill is pending. The measure sponsored by GOP Rep. Erin Grall of Vero Beach would require that a minor get written, notarized permission from a parent or a legal guardian to obtain an abortion. (4/17)

The Wall Street Journal: Health-Care Stock Rout Deepens Amid Political Pressure
Health-care stocks are trailing the broader market by a historic margin early in 2019, the latest example of how political shifts have buffeted certain sectors. With another slide Wednesday, the S&P 500 health-care sector is now down 0.9% for the year, compared with a 16% advance for the broader index. If that gap holds through the end of the month, it would mark just the second time since 2000 that an S&P 500 sector has lagged behind by a margin that big in the first four months of the year, according to Dow Jones Market Data. (Ramkumar, 4/17)

NPR: High-Deductible Insurance Linked To Delays In Cancer Diagnosis And Treatment
In 2017, Susan learned that she carries a genetic mutation that may elevate her lifetime risk of developing breast cancer to 72 percent. Her doctor explained that individuals who have this mutation in the BRCA2 gene have choices in treatment. Some people opt for a preventive double mastectomy. But Susan could instead choose to undergo increased cancer screenings, which, for her, would mean an annual mammogram and annual MRI scan. (Stallings, 4/18)

The Wall Street Journal: Measles Outbreak Upends Passover Traditions
The growing measles outbreak is colliding with Passover, one of the holiest Jewish celebrations and a time when families travel to be together. New York City health officials have warned that the holiday, with its large get-togethers and long, ritual meals, risks spreading measles, which is highly contagious and easily transmitted. City officials expect the number of measles cases to increase over the next several weeks partly because of gatherings over the holidays, said Herminia Palacio, the city’s deputy mayor for health and human services. The outbreak is worst in ultra-Orthodox communities in Brooklyn, N.Y., and nearby Rockland County. (West and King, 4/17)

The Hill: New York Extends Mandatory Measles Vaccination Order 
The New York City Board of Health unanimously voted Wednesday to extend to extend a public health emergency in parts of Brooklyn as the borough continues to struggle with a measles outbreak. The mandate, which was first implemented last week, orders that residents in the neighborhood of Williamsburg aged 6 months or older get vaccinated for the disease or face a fine of $1,000. The order was extended until officials declare the outbreak is over. (Axelrod, 4/17)

The Washington Post: Measles Outbreak: Israeli Flight Attendant In Serious Condition After Contracting Virus
Public health officials in Israel are urging crew members on national air carriers to ensure they have received the proper dosage of the measles vaccine after a flight attendant contracted the deadly disease, possibly in New York. Officials with Israel’s Ministry of Health said a 43-year-old flight attendant for the national airline El Al had flown back to Israel late last month from John F. Kennedy International Airport in New York. New York state has been a battleground for concurrent measles outbreaks in Brooklyn and Queens, as well as in Rockland County. However, because of the woman’s “impaired mental status,” officials said it could not be confirmed where or when she contracted the virus. (Bever, 4/17)

The Washington Post: Third Measles Patient Confirmed In Maryland, Unrelated To Earlier ‘Household Contact’ Cases
Maryland health officials confirmed Wednesday that a third person contracted measles in the Pikes­ville area of the state this month. The latest person to contract the disease is not connected to the previous two patients who had “household contact” with their cases, health officials said. Due to health privacy laws, officials did not release any information about the patients. (Williams, 4/17)

The Associated Press: Doctors Use HIV In Gene Therapy To Fix 'Bubble Boy' Disease
They were born without a working germ-fighting system, every infection a threat to their lives. Now eight babies with "bubble boy disease" have had it fixed by a gene therapy made from one of the immune system's worst enemies — HIV, the virus that causes AIDS. A study out Wednesday details how scientists turned this enemy virus into a savior, altering it so it couldn't cause disease and then using it to deliver a gene the boys lacked. (4/17)

The Washington Post: Gene Therapy Cures Infants With ‘Bubble Boy’ Immune Disease
“It’s a game changer,” said Jennifer Hemall, a pediatric immunologist at Children’s Hospital of Philadelphia, who was not involved in the study. “For immunologists following this disease, gene therapy has always been out there as the hope of the future. It’s exciting to see this wave of treatments actually becoming a reality.” (Wan, 4/17)

NPR: 'Bubble Boy' Disease Helped By Advances In Gene Therapy
Gene therapy has been used successfully over the past decade. Scientists at St. Jude Children's Research Hospital in Memphis, Tenn., modified the procedure for SCID by giving the infants a short course of chemotherapy before introducing the new gene. This helped the new cells take up permanent residence. The babies developed apparently healthy immune systems, according to the new study. "I am thrilled to see these outstanding results," says Ewelina Mamcarz, a transplant physician and first author on the new paper. (Harris, 4/17)

Stat: In A Mouse Study, CRISPR Edits Lung-Disease Gene In Utero
Companies that hope to treat severe inherited diseases via CRISPR genome editing are already testing the technique in adults, while push-the-envelope types are arguing for repairing defective genes much earlier — in IVF embryos so new they’re still in a lab dish (the “CRISPR babies” route). Now scientists in Philadelphia have taken preliminary steps toward a possible middle way: They injected CRISPR into the amniotic fluid of pregnant mice, editing a lung-disease-causing gene in a small number of mouse fetuses, they reported on Wednesday. (Begley, 4/17)

The New York Times: E.P.A. Moves To ‘Close The Door’ On Asbestos. Consumer Groups Say Loopholes Remain.
The Trump administration on Wednesday issued a regulation it said would impose new restrictions on asbestos, a deadly substance once commonly found in insulation materials. The final Environmental Protection Agency rule goes somewhat further than the initial version the agency had proposed, but public health advocates said it still fell short of the protections needed. Under the rule, the agency will require companies to obtain federal approval in order to domestically manufacture or import specific types of products using asbestos. (Friedman, 4/17)

The New York Times: How A Chicago Woman Fell Victim To Candida Auris, A Drug-Resistant Fungus
Gregory Spoor got the distressing news about his wife on the morning of Jan. 16 while standing outside her room in the intensive care unit at Northwestern Memorial Hospital in Chicago. The doctor explained that Stephanie Spoor, 64, had contracted a “rare, very rare, fungus.” The physician said the fungus was called Candida auris, and it appeared to have entered her bloodstream through a catheter or other intravenous line during her treatment. Mr. Spoor sent a text to the couple’s four children. (Richtel, 4/17)

The New York Times: Prostate Drugs May Raise Diabetes Risk
Two commonly used drugs for treating an enlarged prostate may increase the risk for Type 2 diabetes. Benign prostate hypertrophy, or B.P.H., may cause difficulty in urinating or increased frequency and urgency of urination. A study published in BMJ examined the use of two similar drugs often prescribed for the condition, finasteride (Proscar) and dutasteride (Avodart), in 39,000 men. As controls, the 11-year study used 16,000 men taking tamsulosin (Flomax), a different type of drug for B.P.H. (Bakalar, 4/18)

Stat: U.S. Team Ready To Start Pregnancies With 'Three-Parent' Embryos
Researchers at Columbia University in New York have created embryos containing genetic material from three people and are ready to use them to start pregnancies. But they’re at a legal impasse. At a public forum at Harvard Law School on Wednesday, Dietrich Egli, assistant professor of developmental cell biology at Columbia, said his team has used a controversial technique called mitochondrial replacement therapy to make embryos for four female patients. The women are all carriers of genetic disorders that are passed down through maternal mitochondria, the energy-generating organelles inside cells. (Mulling, 4/18)

The New York Times: A Giant Laid Low By Too Many Blows To The Head
Tall and imposing, indomitable even, 6-foot-8 with shoulders and a back broad enough to push a pickup truck. He was a star lineman on a state championship team in high school and for the University of Colorado Buffaloes, where he set a team record for starts and minutes played. He was an Associated Press third-team all-American and played three years in the N.F.L. Yet the word that jumps most quickly to mind when talking to Ryan Miller is “fragile.” (Powell, 4/17)

The New York Times: Stress Tied To Heart Disease, Especially In People Under 50
Stress may increase the risk for heart disease, especially in younger people. Researchers writing in BMJ used Swedish data on 136,637 people diagnosed with stress-related disorders, including post-traumatic stress disorder, acute stress reaction and others. They compared them with 171,314 unaffected siblings, and with 1,366,370 people in the general population without a stress disorder diagnosis. They tracked their health for up to 27 years. (Bakalar, 4/17)

The New York Times: The Right Way To Use A Public Bathroom (To Avoid Getting Sick)
There are a handful of things in this world I’m extremely thankful for, yet also quite grossed out by. Public bathrooms are one of them. (Also: colonoscopies.) My disgust peaks around this time of year, when everyone around me seems to be coughing or sneezing or both — sometimes in the next stall. What, if anything, can we do to minimize our exposure to germs when we have to relieve ourselves in public? I called a handful of experts — it’s fun to ask total strangers about toilet bacteria, believe me — and dug up some pretty nasty research to find out. You’re welcome. (Moyer, 4/17)

The Associated Press: Legionnaires' Disease Found In Adjacent California Prisons
Legionnaires' disease bacteria that killed one inmate and sickened another is more widespread than expected in a California state prison, officials said Wednesday, citing new test results. Preliminary results found the bacteria in the water supply at a prison medical facility in Stockton and at two neighboring youth correctional facilities, Corrections Department spokeswoman Vicky Waters said. (4/17)

The Washington Post: Tick, Tick, Tick: Alaska Braces For Invading Parasites
Health and wildlife officials are taking steps to prepare for potentially dangerous parasites that could gain a foothold because of Alaska’s warming climate. Non-native ticks represent a threat to wildlife and people because they can carry and transmit pathogens, said Micah Hahn, an assistant professor of environmental health with the Institute for Circumpolar Health Studies at the University of Alaska Anchorage. (Joling, 4/17)

The Associated Press: Police: Maryland Man Spread HIV To 4 Women He Met Online
Police say a Maryland man knowingly spread HIV to four women after meeting them on dating sites and apps. The Frederick News-Post reported Tuesday that 34-year-old Rudolph Jericho Smith has been charged with first-degree assault and reckless endangerment. He also faces counts of knowingly transferring or attempting to transfer HIV to another person. The charge is a misdemeanor under Maryland's general health law. (4/17)

The Associated Press: For-Profit Jail, Family Settle Arkansas Inmate Death Lawsuit
Lawyers reached an undisclosed settlement Tuesday in a federal lawsuit in which the family of an Arkansas man alleged employees of a for-profit jail left the man to die in his cell as his health deteriorated. Representatives for Michael Sabbie's family and LaSalle Corrections, which runs the Bi-State Justice Center in Texarkana, Texas, said they would not comment on the terms of the settlement stemming from Sabbie's 2015 death, according to the Texarkana Gazette. (4/17)