policy

FDA rules promise sweeping changes on food dyes, cigarettes

Adobe

The Food and Drug Administration published two rules Wednesday that could spark major changes for public health and consumers — curbing nicotine levels in cigarettes and banning red dye no.3 from food and drugs. 

The first proposal would significantly lower the legal nicotine limit per gram of tobacco for cigarettes, most cigars, and pipe tobacco compared to the levels in popular cigarette brands today. The ambitious change is a bid to make smoking less addictive and could prevent 8.5 million tobacco-related deaths by 2100, according to a 2018 Journal of the American Medical Association paper.

The second rule regarding dye is long overdue, arriving 30 years after the additive was found to cause cancer in rats. Advocates have routinely pushed the FDA to ban the substance, which the agency formerly included on a list of color additives “generally recognized as safe.” 

Read more about the public health implications from STAT’s Sarah Todd and Lizzy Lawrence.

infectious disease

H5N1 study suggests primates are susceptible to virus, but virulence remains uncertain

New data from a National Institutes of Health team has provided long-sought evidence that primates are also susceptible to H5N1 infection through consuming raw milk, although the fallout appears to be less deadly than some feared.

As H5N1 has spread through U.S. dairy herds, scientists have worried about what might happen to people who drink unpasteurized milk laced with the virus, as cats on farms with sick cows have died from drinking it. 

The study found that monkeys infected through the nose and windpipe with a strain of the H5N1 virus circulating in dairy cattle developed moderate to severe disease, including pneumonia. Animals exposed directly in the mouth and stomach, to mimic drinking, became infected but showed no signs of illness. However, even without symptoms they still developed antibodies and shed low levels of virus through their nose and mouths, indicating the potential to further spread the disease. 

The new research may shed some light on a handful of unexplained H5N1 bird flu cases in children discovered in California in recent weeks. To date, the CDC has confirmed 67 human cases of H5N1, the majority of them in dairy and poultry workers with exposure to infected animals, and the majority in California. But two pediatric cases—one identified in San Francisco County last week and one in Marin County in November—have not yet been linked to a known exposure. — Megan Molteni

First Opinion

The first step to addressing the physician shortage

The U.S. faces a dramatic physician shortage that can’t be solved without restructuring the country’s residency programs, write Nicole McCann, a public health researcher, and Rochelle Walensky, the former director for the Centers for Disease Control and Prevention. 

Medical residencies are concentrated in the Northeast where hospitals boast sub-specialty and super-specialty programs, depriving both rural and primary care programs. This concentration has consequences. Across the country, 76 million people live in primary care deserts and the supply of health care workers is lagging woefully behind the demand, in part caused by pressing health care needs of the aging U.S. population. 

To learn more about how incremental improvements in the number of rural and primary care graduate medical education slots will not match the intensifying shortage of doctors in the least healthy areas of the country, read this First Opinion essay.