Bird flu is now in a pig (not good)

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Happy Halloween! Tonight I am going to a wedding rehearsal dressed as Jo March from “Little Women.” The bride and groom are dressing up as Buttercup and Westley from “The Princess Bride,” which is maybe the most precious thing I have ever heard.

(To get into the spooky spirit, check out this STAT 1.0 era story on five haunted hospitals in the U.S.)

Bird flu was found in a pig for the first time. This is not good

H5N1 bird flu virus has been found in a pig on a farm in Oregon, USDA reported yesterday. The pig did not display signs of illness. There were five pigs on the farm, all of which have been euthanized to allow for testing. A second pig may also have been infected, Oregon authorities later revealed. Two others have tested negative.

Why is this a big deal? As STAT’s Helen Branswell explains, pigs are sometimes called a “mixing vessel” for flu viruses because they can be infected with both bird flu and human flu viruses. If a pig is infected with both at the same time, the viruses can swap genes, potentially creating a hybrid virus that is better able to spread to and among people than regular bird flu viruses. This is called “reassortment.”

Oregon’s state veterinarian Ryan Scholz said this version of H5N1 was from wild birds — it’s not associated with the strain that has been spreading among U.S. dairy cows since the spring. Read more from Helen on what we know.

Just how good are Apple’s new Airpod hearing features?

Many people who deal with hearing loss never get treatment. So there was a lot of immediate excitement among audiologists about Apple’s new AirPods Pro features, which, for the $249 price tag, allow users to test their hearing and use the popular earbuds as hearing aids. 

Apple says the earbuds are “clinical grade” — but what does that mean, exactly, and do they live up to expectations? STAT’s Mario Aguilar spoke with Apple executives and hearing experts about the limitations of the new technology and the benefits it can deliver. Read more.

The health policies some voters are literally gambling on this election

Everyone has an opinion on who should, or will, win the presidential election next week. But some people are actually betting money on it. More than $100 million has been wagered on the presidential election on Kalshi, an online betting company, according to a story from NPR yesterday

When I looked at the company’s election prediction forecast yesterday, it showed a 63% chance of Trump winning. What would that mean for health care? It’s hard to predict exactly. He’d probably keep the ACA. He’s pledged to take on chronic illness, in light of a growing “Make America Healthy Again” movement. He’s held strong on divisive policies against immigrants and transgender people, while softening his stance on a national abortion ban.

But if Harris wins? The foundation of her health care platform lies in the ACA and Inflation Reduction Act — two laws passed by Democrats. She’s long advocated for reproductive health services, and recently proposed canceling medical debt and expanding Medicare price negotiation.

We’ll know the outcome soon enough. But if you’re tired of election news, might I recommend a story by STAT’s Lev Facher about how some addiction professionals want the field to focus more on gambling as a public health issue?

Study finds police have unfettered access to prescription drug info

As more and more states pass bans on gender-affirming hormones for youth, researchers became interested in how easy it is for police to access records of who’s taking drugs like testosterone. A study published yesterday in JAMA found that testosterone prescription data was accessible to law enforcement without safeguards like a warrant or subpoena in nearly half of U.S. states.

That’s possible because, for controlled substances like testosterone, each state has a prescription drug monitoring program that tracks its dispensation. Some of these programs also track medical codes, potentially allowing law enforcement to infer from the data whether a person is receiving a drug like testosterone because they’re cisgender with hypogonadism, or because they’re a trans man.

Only 11 states require law enforcement to obtain a warrant before accessing prescription data, while 14 require a subpoena. (At the federal level, drug enforcement can always access this data without a warrant.) More research is needed to better understand the consequences of this access, the authors write — in particular, whether the data is being used to enforce bans on gender-affirming care.

The latest news on GLP-1s

There were two important updates yesterday regarding the blockbuster weight loss drugs Ozempic (the diabetes version of semaglutide) and Wegovy (the weight loss version). Here’s what you need to know:

• On the regulatory side: All doses of Ozempic and Wegovy are listed as available on the FDA’s drug shortage list as of yesterday, STAT’s Elaine Chen reported. This raises the possibility that the medications could soon be taken off the list entirely, which could pose challenges to patients who rely on compounded versions of the drugs (which are only legally available because of the shortage). Read more.
• On the science: In a 68-week trial, Wegovy reduced arthritic knee pain for people with high BMIs. Participants who took the drug lost almost 14% of their body weight on average — changes that were accompanied by reductions in pain. Read more from STAT’s Isa Cueto on the research and what it could mean for patients.

Autism diagnoses increased in women, racial minorities through the 2010s

Men and boys are more likely to be diagnosed with autism spectrum disorder than women and girls. But an analysis of electronic health records between 2011 and 2022, published yesterday in JAMA Network Open, found that diagnosis rates among girls and women increased significantly over the decade, narrowing the gap from a four-to-one to a three-to-one male-female ratio. Similar longstanding diagnostic disparities between white patients and racial/ethnic minorities also narrowed over time.

Kids ages 5 to 8 were diagnosed at the highest rate, seeing an increase from 2.3 per 1,000 kids in 2011 to 6.3 in 2022, the data showed. But the greatest increase was actually among 26-to-34-year-olds, a group that had 450% more annual diagnoses by the end of the time period.

It should be noted: None of these changes are necessarily caused by a sudden change in how many people have autism. Rather, the study authors point to changes in screening practices, diagnostic definitions, and policies, as well as increased advocacy and education including on social media.

What we’re reading

• Can John Green make you care about tuberculosis? New York Times

• More men are getting vasectomies since Roe was overturned, Scientific American

• What Trump and RFK Jr.’s ‘Make America Healthy Again’ gets right — and very wrong, STAT
• The screen you really don’t want to see in a classroom, Atlantic
• I’m a geriatric physician. Here’s what I think is going on with Trump’s executive function, STAT