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Morning Rounds Shraddha Chakradhar

Good morning and welcome to the work week. Elizabeth Cooney filling in for Shraddha again. Let’s get to it.

WHO signals alarm over possible unreported Ebola cases in Tanzania

The WHO is on high alert about possible unreported Ebola cases in Tanzania. In an extraordinary statement issued Saturday, the agency pressed the country to deliver patient samples for testing at an outside laboratory. The statement pertains to a Tanzanian doctor who reportedly had Ebola-like symptoms and who died Sept. 8 after returning to her country from Uganda. Several of the woman’s contacts fell ill, but Tanzanian authorities maintain they tested negative for Ebola and have not yet shared the tests for independent verification. The alarm comes as the Ebola outbreak in neighboring Democratic Republic of the Congo reaches its 14th month, with 3,160 cases reported and 2,114 deaths to date.

E-cigarette makers will have to share marketing plans, safety studies under FDA proposal

As the death toll from vaping-related lung illnesses reached eight last week, the FDA unveiled a sweeping draft policy outlining the information e-cigarette makers must submit to the agency in order to sell their products. The companies would need to demonstrate that a product is “appropriate for the protection of the public health.” The FDA also said it would pay special attention to how these makers intend to prevent youth use of their products.

While the FDA’s policy is still pending, the nation’s largest retailer is acting immediately. Walmart says it will stop selling e-cigarettes at its namesake stores and Sam's Clubs in the U.S. following a rising number of illnesses and deaths related to vaping.

New editor says NEJM’s mission won’t change, but its execution will

In his first piece as editor-in-chief of the New England Journal of Medicine, Dr. Eric Rubin leads with a joke: An international search for a successor to Dr. Jeffrey Drazen found him 100 yards away. Rubin, a Harvard infectious disease doctor and researcher, said despite his familiarity — he’s been an associate editor since 2012 — change is coming.

What is your mission?

I think our mission isn’t just to publish a journal, it’s to be communicators. How communication can happen in the future, I don’t really know, but it’s less and less likely to be simply a print publication.

What prompted you to join the journal in 2012?

I showed up to one of the editorial meetings. It’s an incredibly learned, interesting, funny discussion about the merits that can be very far-ranging. There was no question after I went to that meeting that is something that I want to do.

STAT Plus subscribers can read my full Q&A with Rubin here.

Inside STAT: What to know about EEE, a mosquito-borne virus on the rise

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Mosquitoes in a Petri dish. (Darren McCollester/Getty Images)

If you don’t live in one of the six states that have reported 20 cases of EEE so far this year, you might not be familiar with Eastern equine encephalitis. Massachusetts — a historic hotspot for the virus — has recorded nine cases and Michigan reported seven. Other states that have seen cases in 2019 are New Jersey, North Carolina, Rhode Island, and Connecticut. Six of the infected people have died to date. The good news is that EEE is not common at all. But the bad news is that the infections can be severe. Have more questions? STAT’s Helen Branswell answers them here. As she says, if it hasn’t hit your radar yet, it likely will.

World leaders talk progress on universal health coverage

World leaders are gathering in New York City this week for the UN General Assembly — and today, universal health coverage is on the agenda. Officials will hold a high-level meeting today on accelerating progress toward universal health coverage, which UN countries are trying to achieve by 2030. Broadly speaking, universal health coverage means that everyone can receive the quality health care they need without financial hardship. But achieving that will take serious action, according to a new WHO report released ahead of the meeting. The report finds that countries need to start spending at least 1% more of their GDP on primary health care and expand care in underserved areas if they want to meet the 2030 goal.

Who’s using medical marijuana?

Combing through a large national survey from 2016-2017, researchers have gleaned that people with medical conditions — notably asthma, chronic obstructive pulmonary disease, arthritis, cancer, and depression — are more likely to say they use marijuana than people without such illnesses. Those numbers skew young: A quarter of people age 18 to 34 reported current marijuana use but that shrank to 2.4% for people 65 and older. "Clinicians should screen for marijuana use among patients, understand why and how patients are using marijuana, and work with patients to optimize outcomes and reduce marijuana-associated risks," the authors urge. They also caution that because the study was observational, they can’t establish cause and effect between medical conditions and marijuana use.

An investment in better care for early psychosis

The National Institute of Mental Health has awarded $40 million over five years of funding to improve treatment and care for early psychosis. Each year in the U.S., roughly 100,000 young people experience a first episode of psychosis, which can lead to a slew of problems if untreated. Research suggests that an approach called coordinated specialty care — which uses a team of specialists to come up with a recovery-oriented plan for each person — can improve outcomes. The idea has caught on: There are currently more than 260 CSC programs in 49 states. Now, the NIMH is hoping to build on those programs by funding scientific hubs that research how to keep improving care. The agency is also funding a national center tasked with pulling together data from CSC programs across the country.

Correction: While the FDA's Office of Criminal Investigations’ probe into cases of lung damage among people who use e-cigarettes was revealed yesterday, the office has been involved in the investigation all along, an official said. An item in Friday’s newsletter got the timing wrong.

What to read around the web today

  • Her face transplant is failing after 6 years. Now this patient awaits an uncertain future. Boston Globe
  • Want to reduce suicides? Follow the data — to medical offices, motels and even animal shelters. Kaiser Health News
  • Trial over weight-loss pill behind 'up to 2,000 deaths' to start in France. The Guardian
  • Inside Congress’s failure to act on fentanyl despite warnings, deaths. Washington Post
  • Communique from an exurban satellite clinic of a cancer pavilion named after a financier. Longreads

Thanks for reading! More tomorrow,

Shraddha

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Monday, September 23, 2019

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