health

boar’s-head-to-reopen-plant-as-mold-and-funky-meat-problems-pop-up-elsewhere

Boar’s Head to reopen plant as mold and funky meat problems pop up elsewhere

Boar’s Head plans to reopen the Jarratt, Virginia, facility at the center of a deadly Listeria outbreak last year despite federal inspections continuing to find sanitation violations at three of the food company’s other facilities, according to federal records obtained by The Associated Press.

The AP obtained 35 pages of inspection reports via a Freedom of Information Act Request. Those reports cover inspections between January 1 and July 23 at three other Boar’s Head facilities: Forrest City, Arkansas; New Castle, Indiana; and Petersburg, Virginia. Overall, the reports reveal a suite of violations, including mold, condensation dripping over food areas, overflowing trash, meat and fat residue built up on walls and equipment, drains blocked with meat scraps, and pooling meat juice. The reports also recorded staff who didn’t wear the proper protective hairnets and aprons—and didn’t wash their hands.

In one violation, reported in the Petersburg facility, inspectors found meat waste collecting under equipment, including “5-6 hams, 4 large pieces of meat and a large quantity of pooling meat juice.”

The problems echo the sanitation violations recorded at the Jarratt plant before contamination with Listeria—particularly linked to the company’s liverwurst—caused an outbreak that led officials to shut it down. That outbreak spanned July to November of last year and sickened 61 people across 19 states, hospitalizing 60 and killing 10. Inspection reports revealed problems with mold, water leaks, dirty equipment and rooms, meat debris stuck on walls and equipment, various bugs, and, at one point, puddles of blood on the floor.

Amid the outbreak response, Boar’s Head vowed to make big changes to improve its food safety systems. Those included setting up a panel of food safety advisers, which included Frank Yiannas, a former Food and Drug Administration official, and Mindy Brashears, who served as the US Department of Agriculture undersecretary for food safety during Trump’s first term and has been nominated for the position again in Trump’s second.

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texas-prepares-for-war-as-invasion-of-flesh-eating-flies-appears-imminent

Texas prepares for war as invasion of flesh-eating flies appears imminent

Past success

As the flies’ host and geographic range expand, pressure is intensifying to control the flies—something many countries have managed to do in the past.

Decades ago, screwworms were endemic throughout Central America and the southern US. However, governments across the regions used intensive, coordinated control efforts to push the flies southward. Screwworms were eliminated from the US around 1966, and were pushed downward through Mexico in the 1970s and 1980s. They were eventually declared eliminated from Panama in 2006, with the population held at bay by a biological barrier at the Darién Gap, at the border of Panama and Colombia. However, in 2022, the barrier was breached, and the flies began advancing northward, primarily through unmonitored livestock movements. The latest surveillance suggests the flies are now about 370 miles south of Texas.

The main method to wipe out screwworms is the sterile insect technique (SIT), which exploits a weakness in the fly’s life cycle since they tend to only mate once. In the 1950s, researchers at the US Department of Agriculture figured out they could use gamma radiation to sterilize male flies without affecting their ability to find mates. They then bred massive amounts of male flies, sterilized them, and carpet-bombed infested areas with aerial releases, which tanked the population.

Panama, in partnership with the US, maintained the biological barrier at the Colombian border with continual sterile-fly bombings for years. But as the flies approached this year, the USDA shifted its aerial deliveries to Mexico. In June, the USDA announced plans to set up a new sterile fly facility in Texas for aerial deliveries to northern Mexico. And last month, the USDA halted livestock trade from southern entry points.

Miller said in the announcement today that SIT is no longer enough, and Texas is taking its own steps. Those include the new bait, insecticides, and new feed for livestock and deer laced with the anti-parasitic drug ivermectin. Miller also said that the state aims to develop a vaccine for cattle that could kill larvae, but such a shot is still in development.

Texas prepares for war as invasion of flesh-eating flies appears imminent Read More »

after-using-chatgpt,-man-swaps-his-salt-for-sodium-bromide—and-suffers-psychosis

After using ChatGPT, man swaps his salt for sodium bromide—and suffers psychosis

After seeking advice on health topics from ChatGPT, a 60-year-old man who had a “history of studying nutrition in college” decided to try a health experiment: He would eliminate all chlorine from his diet, which for him meant eliminating even table salt (sodium chloride). His ChatGPT conversations led him to believe that he could replace his sodium chloride with sodium bromide, which he obtained over the Internet.

Three months later, the man showed up at his local emergency room. His neighbor, he said, was trying to poison him. Though extremely thirsty, the man was paranoid about accepting the water that the hospital offered him, telling doctors that he had begun distilling his own water at home and that he was on an extremely restrictive vegetarian diet. He did not mention the sodium bromide or the ChatGPT discussions.

His distress, coupled with the odd behavior, led the doctors to run a broad set of lab tests, revealing multiple micronutrient deficiencies, especially in key vitamins. But the bigger problem was that the man appeared to be suffering from a serious case of “bromism.” That is, an excess amount of the element bromine had built up in his body.

A century ago, somewhere around 8–10 percent of all psychiatric admissions in the US were caused by bromism. That’s because, then as now, people wanted sedatives to calm their anxieties, to blot out a cruel world, or simply to get a good night’s sleep. Bromine-containing salts—things like potassium bromide—were once drugs of choice for this sort of thing.

Unfortunately, bromide can easily build up in the human body, where too much of it impairs nerve function. This causes a wide variety of problems, including grotesque skin rashes (warning: the link is exactly what it sounds like) and significant mental problems, which are all grouped under the name of “bromism.”

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rfk-jr.-defends-$500m-cut-for-mrna-vaccines-with-pseudoscience-gobbledygook

RFK Jr. defends $500M cut for mRNA vaccines with pseudoscience gobbledygook


He clearly has no idea what antigenic shift means.

US Secretary of Health and Human Services Robert F. Kennedy Jr. testifies before the Senate Committee on Health, Education, Labor, and Pensions on Capitol Hill on May 20, 2025 in Washington, DC. Credit: Getty | Tasos Katopodis

If anyone needed a reminder that US health secretary and fervent anti-vaccine advocate Robert F. Kennedy Jr. has no background in science or medicine, look no further than the video he posted on social media Tuesday evening.

In the two-and-a-half-minute clip, Kennedy announced that he is cancelling nearly $500 million in funding for the development of mRNA-based vaccines against diseases that pose pandemic threats. The funding will be clawed back from 22 now-defunct contracts awarded through the federal agency tasked with developing medical countermeasures to public health threats. The agency is the Biomedical Advanced Research and Development Authority (BARDA).

Kennedy is generally opposed to vaccines, but he is particularly hostile to mRNA-based vaccines. Since the remarkably successful debut of mRNA COVID-19 vaccines during the COVID-19 pandemic—which were developed and mass-produced with unprecedented speed—Kennedy has continually disparaged and spread misinformation about them.

In the video on Tuesday, Kennedy continued that trend, erroneously saying that, “as the pandemic showed us, mRNA vaccines don’t perform well against viruses that infect the upper respiratory tract.” In reality, COVID-19 vaccines are estimated to have saved more than 3 million lives in the US in just the first two years of the pandemic and additionally prevented more than 18 million hospitalizations in the US in that time. Nearly all COVID-19 vaccines used in the US are mRNA-based.

However, Kennedy’s video only went more off the rails from there. He continued on with this nonsensical explanation:

Here’s the problem: mRNA only codes for a small part of viral proteins usually a single antigen. One mutation, and the vaccine becomes ineffective. This dynamic drives a phenomenon called antigenic shift meaning that the vaccine paradoxically encourages new mutations and can actually prolong pandemics as the virus constantly mutates to escape the protective effects of the vaccine.

Fact-check

To unpack this nonsense, let’s start with how mRNA-based vaccines work. These vaccines deliver a snippet of genetic code—in the form of messenger RNA (mRNA)—to cells. Our cells then translate that mRNA code into a protein that the immune system can, essentially, use for target practice, producing antibodies and cell-based responses against it. After that, if the immune system ever encounters that snippet on an actual invading virus or other germ, it will then recognize it and mount a protective response. Such snippets of germs or other harmful things that can prompt an immune response are generally called antigens.

In the case of COVID-19 vaccines, the mRNA snippet codes for a portion of the SARS-CoV-2 virus’s spike protein, which is a critical external protein that the virus uses to attach to and infect cells. That portion of the spike protein is considered an antigen.

SARS-CoV-2, including its spike protein, is continually evolving, regardless of whether people are vaccinated or not, let alone what type of vaccine they’ve received. The virus racks up mutations as it continuously replicates. Some of these mutations help a virus evade immune responses, whether they’re from vaccination or previous infection. These immune-evading mutations can accumulate and give rise to new variants or strains, making it part of a process called antigenic drift (not shift). Antigenic drift does reduce the efficacy of vaccines over time. It’s why, for example, people can get influenza repeatedly in their lifetimes, and why flu shots are updated annually. However, it does not mean that vaccines are immediately rendered ineffective upon single mutations, as Kennedy says.

For example, the current leading SARS-CoV-2 variant in the US is NB.1.8.1, which has six notable mutations in its spike protein compared to the previous leading variant, LP.8.1. Further, NB.1.8.1 has seven notable spike mutations compared to the JN.1 variant, an ancestor for this line of variants. Yet, studies suggest that current mRNA COVID-19 vaccines targeting JN.1 are still effective against NB.1.8.1. In fact, the Food and Drug Administration, in line with its expert advisors, left open the possibility that vaccine makers could carry over the same JN.1-targeting seasonal COVID-19 vaccine formula from last season for use in this season.

Drift vs. shift

While antigenic drift is an accumulation of small, immune-evading mutations over time, Kennedy mentioned antigenic shift, which is something different. Antigenic shift is much more dramatic, infrequent, and is typically discussed in the context of influenza viruses, which have segmented genomes. Antigenic shift is often defined as “the reassortment of viral gene segments between various influenza viruses of human or zoological origin, which leads to the emergence of new strains.” The Centers for Disease Control and Prevention gives an example of such a shift in 2009. That’s when a new influenza virus with a collection of genome segments from influenza viruses found in North American swine, Eurasian swine, humans, and birds emerged to cause the H1N1 pandemic.

In the video, Kennedy went on to muddle these concepts of drifts and shifts, saying:

Millions of people maybe even you or someone you know caught the omicron variant despite being vaccinated, that’s because a single mutation can make mRNA vaccines ineffective.

Among the COVID-19 variants that have risen to dominance only to be quickly usurped, there’s usually a small handful of mutations—like the examples above with six or seven mutations in the spike protein. But omicron was a different story. Omicron emerged carrying an extremely large suite of mutations—there were 37 mutations in its spike protein compared to its predecessors. Kennedy’s suggestion that it rose to prominence because of a single mutation is egregiously false.

However, due to the extreme number of mutations, some researchers have suggested that omicron does represent an antigenic shift for SARS-CoV-2. Although the pandemic virus—which is a coronavirus—does not have a segmented genome, the “magnitude of Omicron-mediated immune evasion” fits with an antigenic shift, the researchers said.

“Highly vulnerable”

While long-term drifts and rare shifts can reduce the effectiveness of vaccines, creating the need for updated shots, the point only bolsters the case for using mRNA vaccines in the event of another health emergency. Currently, no other vaccine platform beats the development and production speeds of mRNA vaccines. Kennedy said that instead of mRNA vaccines, he’ll shift to developing vaccines using strategies like whole-virus vaccines. But this decades-old strategy requires growing up large supplies of virus in eggs or cell culture, which takes months longer than mRNA vaccines. Further, using whole, inactivated viruses can often produce more side effects than other types of vaccines because they include more antigens.

Overall, experts were aghast that Kennedy has abandoned mRNA vaccines for pandemic preparedness programs. One expert, who asked not to be named for fear of reprisal, told Stat News: “It’s self-evident that this is the single best technology we have now to rapidly produce a vaccine for the largest number of people,” the expert said. “And you are throwing away a technology which was exceedingly valuable in saving lives during the most recent pandemic.”

Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, told the outlet that the move “leaves us highly vulnerable. Highly vulnerable.”

Photo of Beth Mole

Beth is Ars Technica’s Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes.

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In trial, people lost twice as much weight by ditching ultraprocessed food

In a small randomized controlled trial, people lost twice as much weight when their diet was limited to minimally processed food compared to when they switched to a diet that included ultraprocessed versions of foods but was otherwise nutritionally matched.

The trial, published in Nature Medicine by researchers at University College London, adds to a growing body of evidence that food processing, in addition to simple nutrition content, influences our weight and health. Ultraprocessed foods have already been vilified for their link to obesity—largely through weaker observational studies—but researchers have struggled to shore up the connection with high-quality studies and understand their impact on health.

The ultraprocessed foods researchers provided in the new trial were relatively healthy ones—as ultraprocessed foods go. They included things like multigrain breakfast cereal, packaged granola bars, flavored yogurt cups, fruit snacks, commercially premade chicken sandwiches, instant noodles, and ready-made lasagna. But, in the minimally processed trial diet, participants received meals from a caterer rather than ones from a grocery store aisle. The diet included overnight oats with fresh fruit, plain yogurt with toasted oats and fruit, handmade fruit and nut bars, freshly made chicken salad, and from-scratch stir fry and spaghetti Bolognese.

While the level of processing differed between the diets, the large-scale nutrition content—fat, protein, carbohydrates, fiber—were similar, as was the proportions of fruits, vegetables, dairy, and starchy food. Overall, both diets adhered to the dietary guidance from the UK government, called the Eatwell Guide (EWG).

Diet processing

The trial had a crossover design, meaning that participants were randomly split to start out on either the ultraprocessed food (UPF) diet or the minimally processed food (MPF) diet. They stayed on their starter diet for eight weeks, then took a break, and switched to the other diet. For both diets, food was delivered directly to the participants’ homes. Participants ate what they wanted and, mostly, didn’t seem to cheat by sneaking other food, based on food diaries and reported adherence.

Fifty participants completed at least one diet, while 43 completed both diets. The participants were mostly women, with a mean age of 43, and all had a body mass index categorized as overweight or obesity. At the start of the trial, ultraprocessed foods made up, on average, nearly 70 percent of the participants’ standard diets, and they were not adhering to the EWG recommendations.

In trial, people lost twice as much weight by ditching ultraprocessed food Read More »

“red-meat-allergy”-from-tick-bites-is-spreading-both-in-us-and-globally

“Red meat allergy” from tick bites is spreading both in US and globally


Remember to check for ticks after your next stroll through the woods or long grasses.

Hours after savoring that perfectly grilled steak on a beautiful summer evening, your body turns traitor, declaring war on the very meal you just enjoyed. You begin to feel excruciating itchiness, pain, or even swelling that can escalate to the point of requiring emergency care.

The culprit isn’t food poisoning—it’s the fallout from a tick bite you may have gotten months earlier and didn’t even notice.

This delayed allergic reaction is called alpha-gal syndrome. While it’s commonly called the “red meat allergy,” that nickname is misleading, because alpha-gal syndrome can cause strong reactions to many products, beyond just red meat.

The syndrome is also rapidly spreading in the US and around the globe. The Centers for Disease Control and Prevention estimates as many as 450,000 people in the US may have it. And it’s carried by many more tick species than most people realize.

Map showing alpha-gal syndrome prevalence.

Cases of suspected alpha-gal syndrome based on confirmed laboratory evidence.

Credit: CDC

Cases of suspected alpha-gal syndrome based on confirmed laboratory evidence. Credit: CDC

What is alpha-gal syndrome?

Alpha-gal syndrome is actually an allergy to a sugar molecule with a tongue-twisting name: galactose-alpha-1,3-galactose, shortened to alpha-gal.

The alpha-gal sugar molecule exists in the tissues of most mammals, including cows, pigs, deer, and rabbits. But it’s absent in humans. When a big dose of alpha-gal gets into your bloodstream through a tick bite, it can send your immune system into overdrive to generate antibodies against alpha-gal. In later exposure to foods containing alpha-gal, your immune system might then launch an inappropriate allergic response.

Picture of lone star tick

A lone star tick (Amblyomma americanum). The tick can cause alpha-gal syndrome as well as carry other diseases, including ehrlichiosis, tularemia, and Southern tick-associated rash illness.

A lone star tick (Amblyomma americanum). The tick can cause alpha-gal syndrome as well as carry other diseases, including ehrlichiosis, tularemia, and Southern tick-associated rash illness. Credit: wildpixel/Getty

Often this allergy is triggered by eating red meat. But the allergy also can be set off by exposure to a range of other animal-based products, including dairy products, gelatin (think Jell-O or gummy bears), medications, and even some personal care items. The drug heparin, used to prevent blood clotting during surgery, is extracted from pig intestines, and its use has triggered a dangerous reaction in some people with alpha-gal syndrome.

Once you have alpha-gal syndrome, it’s possible to get over the allergy if you can modify your diet enough to avoid triggering another reaction for a few years and also avoid more tick bites. But that takes time and careful attention to the less obvious triggers that you might be exposed to.

Why more people are being diagnosed

As an entomologist who studies bugs and the diseases they transmit, what I find alarming is how rapidly this allergy is spreading around the globe.

Several years ago, experts thought alpha-gal syndrome was primarily limited to the Southeastern US because it was largely associated with the geographical range of the lone star tick.

photo of tick feeding on human

How a tick feeds.

However, both local and global reports have now identified many different tick species across six continents that are capable of causing alpha-gal syndrome, including the prolific black-legged tick, or deer tick, which also transmits Lyme disease.

These ticks lurk in yards and urban parks, as well as forests where they can stealthily grab onto hikers when they touch tick-infested vegetation. As tick populations boom with growing deer and human populations, the number of people with alpha-gal syndrome is escalating.

Why ticks are blamed for alpha-gal syndrome

There are a few theories on how a tick bite triggers alpha-gal syndrome and why only a small proportion of people bitten develop the allergy. To understand the theories, it helps to understand what happens as a tick starts feeding on you.

When a tick finds you, it typically looks for a warm, dark area to hide and attach itself to your body. Then its serrated teeth chew through your skin with rapid sawing motions.

As it excavates deeper into your skin, the tick deploys a barbed feeding tube, like a miniature drilling rig, and it secretes a biological cement that anchors its head into its new tunnel.

A tick’s mouth is barbed so it can stay embedded in your skin as it draws blood over hours and sometimes days.

Credit: National Institute of Allergy and Infectious Diseases

A tick’s mouth is barbed so it can stay embedded in your skin as it draws blood over hours and sometimes days. Credit: National Institute of Allergy and Infectious Diseases

Once secure, the tick activates its pumping station, injecting copious amounts of saliva containing anesthetics, blood thinners, and, sometimes, alpha-gal sugars into the wound so it can feed undetected, sometimes for days.

One theory about how a tick bite causes alpha-gal syndrome is linked to the enormous quantity of tick saliva released during feeding, which activates the body’s strong immune response. Another suggests how the skin is damaged as the tick feeds and the possible effect of the tick’s regurgitated stomach contents into the bite site are to blame. Or it may be a combination of these and other triggers. Scientists are still investigating the causes.

What an allergic reaction feels like

The allergy doesn’t begin right away. Typically, one to three months after the sensitizing tick bite, a person with alpha-gal syndrome has their first disturbing reaction.

Alpha-gal syndrome produces symptoms that range from hives or swelling to crushing abdominal pain, violent nausea, or even life-threatening anaphylactic shock. The symptoms usually start two to six hours after a person has ingested a meat product containing alpha-gal.

Due to a general lack of awareness about the allergy, however, doctors can easily miss the diagnosis. A study in 2022 found that 42 percent of US health care practitioners had never heard of alpha-gal syndrome. A decade ago, people with alpha-gal syndrome might go years before the cause of their symptoms was accurately diagnosed. Today, the diagnosis is faster in areas where doctors are familiar with the syndrome, but in many parts of the country it can still take time and multiple doctor visits.

Unfortunately, with every additional tick bite or exposure to food or products containing alpha-gal, the allergy can increase in severity.

Chart showing tick relative sizes

The lone star tick isn’t the only one that can cause alpha-gal syndrome. Black-legged ticks have also been connected to cases.

Credit: US Army

The lone star tick isn’t the only one that can cause alpha-gal syndrome. Black-legged ticks have also been connected to cases. Credit: US Army

If you think you have alpha-gal syndrome

If you suspect you may have alpha-gal syndrome, the first step is to discuss the possibility with your doctor and ask them to order a simple blood test to measure whether your immune system is reacting to alpha-gal.

If you test positive, the main strategy for managing the allergy is to avoid eating any food product from a mammal, including milk and cheese, as well as other potential triggers, such as more tick bites.

Read labels carefully. Some products contain additives such as carrageenan, which is derived from red algae and contains alpha-gal.

In extreme cases, people with alpha-gal syndrome may need to carry an EpiPen to prevent anaphylactic shock. Reputable websites, such as the CDC and alphagalinformation.org, can provide more information and advice.

Mysteries remain as alpha-gal syndrome spreads

Since alpha-gal syndrome was first formally documented in the early 2000s, scientists have made progress in understanding this puzzling condition. Researchers have connected the allergy to specific tick bites and found that people with the allergy can have a higher risk of heart disease, even without allergy symptoms.

But important mysteries remain.

Scientists are still figuring out exactly how the tick bite tricks the human immune system and why tick saliva is a trigger for only some people. With growing public interest in alpha-gal syndrome, the next decade could bring breakthroughs in preventing, diagnosing, and treating this condition.

For now, the next time you are strolling in the woods or in long grasses, remember to check for ticks on your body, wear long sleeves, long pants, and tick repellent to protect yourself from these bloodthirsty hitchhikers. If you do get bitten by a tick, watch out for odd allergic symptoms to appear a few hours after your next steak or handful of gummy bears.

Lee Rafuse Haines is associate research professor of molecular parasitology and medical entomology at University of Notre Dame.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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The Conversation is an independent source of news and views, sourced from the academic and research community. Our team of editors work with these experts to share their knowledge with the wider public. Our aim is to allow for better understanding of current affairs and complex issues, and hopefully improve the quality of public discourse on them.

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four-radioactive-wasp-nests-found-on-south-carolina-nuclear-facility

Four radioactive wasp nests found on South Carolina nuclear facility

According to the DOE, the site produced 165 million gallons of radioactive liquid waste, which has been evaporated to 34 million gallons. The site has 51 waste tanks, eight of which have been operationally closed, with the remaining 43 in various states of the closure process.

Outside experts have been quick to point out critical information missing from the DOE’s nest report, including the absolute level of radioactivity found in the nest, the specific isotopes that were found, and the type of wasps that built the nest. Some wasps build their nests from mud, while others might use chewed-up pulp from wood.

Timothy Mousseau, a biologist at the University of South Carolina who studies organisms and ecosystems in radioactive regions, told the Times that the DOE’s explanation that the wasps gathered legacy contamination for their homes is not unreasonable. “There’s some legacy radioactive contamination sitting around in the mud in the bottom of the lakes, or, you know, here and there,” he said.

“The main concern relates to whether or not there are large areas of significant contamination that have escaped surveillance in the past,” Mousseau said. “Alternatively, this could indicate that there is some new or old radioactive contamination that is coming to the surface that was unexpected.”

The DOE report of the first wasp nest said that the nest was sprayed to kill wasps, then bagged as radioactive waste. The ground and area around where the nest had been did not have any further contamination.

In a statement to the Aiken Standard, officials working at the DOE site noted that the wasps themselves pose little risk to the community—they likely have lower contamination on them and generally don’t stray more than a few hundred yards from their nests.

However, the Times pointed out a report from 2017, when officials at SRS found radioactive bird droppings on the roof of a building at the site. Birds can carry radioactive material long distances, Mousseau said.

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Idaho has become the wild frontier of vaccination policy and public health


Idaho charts a new path as trust in public health craters.

Some 280,000 people live in the five northernmost counties of Idaho. One of the key public officials responsible for their health is Thomas Fletcher, a retired radiologist who lives on a 160-acre farm near Sandpoint.

Fletcher grew up in Texas and moved to Idaho in 2016, looking for a place where he could live a rural life alongside likeminded conservatives. In 2022, he joined the seven-member board of health of the Panhandle Health District, the regional public health authority, and he was appointed chairman last summer.

PHD handles everything from cancer screenings to restaurant hygiene inspections, and the business of the board is often mundane, almost invisible. Then, this February, Fletcher issued a short announcement online. Parents, he wrote, should be informed of the potential harms of common childhood vaccines. It was time for the board to discuss how best to communicate those risks, rather than “withholding information contra the CDC narrative.” Fletcher invited everyone who believes in “full disclosure and transparency when providing informed consent on childhood vaccines” to attend the next monthly meeting of the board, on a Thursday afternoon.

PHD board meetings tend to be sparsely attended. This one was standing-room only—the start of a monthslong debate over vaccine safety and the question of what, exactly, it means to provide informed consent.

Versions of that debate are playing out across the United States in the aftermath of the COVID-19 pandemic, which many Americans believe was badly mismanaged. The backlash has upended longstanding norms in public health: The nation’s top health official, Robert F. Kennedy Jr., publicly questions the value of common vaccines. Prominent vaccine skeptics now sit on a key advisory committee that shapes immunization practices nationwide. Polls suggest that trust in health authorities is politically polarized — and perhaps historically low. Immunization rates are dropping across the country. And many advocates are promoting a vision of public health that’s less dependent on mandates and appeals to authority, and more deferent to individuals’ beliefs.

Much of that energy has been reflected in Kennedy’s Make American Healthy Again, or MAHA, movement. The coalition is diverse — and has sometimes fractured over vaccination issues—but often channels a long-running argument that Americans should have more freedom to choose or reject vaccines and other health measures.

The backlash against traditional health authorities, said Columbia University medical historian James Colgrove, is unprecedented in recent US history. “It’s been a very, very long time since we’ve been in a place like this,” he said.

Perhaps more than anywhere else in the country, Idaho has experienced these shifts—an ongoing experiment that shows what it looks like to put a vision of individual health freedom into practice. And places like the Panhandle Health District have become testing grounds for big questions: What happens when communities move away from widespread and mandated vaccination? And what does it mean to turn MAHA principles into local public health policy?

During a recent visit to Idaho, Kennedy described the state as “the home of medical freedom.” In April, Gov. Brad Little signed the Idaho Medical Freedom Act, which bans schools, businesses, and government agencies from requiring people to participate in medical interventions, such as mask-wearing or vaccination, in order to receive services. It’s the first legislation of its kind in the country. The bill has a carveout that keeps school vaccine requirements in place, but those requirements are already mostly symbolic: The state’s exemption policy is so broad that, as one Idaho pediatrician told Undark, “you can write on a napkin, ‘I don’t want my kids to get shots because of philosophical reasons,’ and they can go to kindergarten.” Overall, reported vaccination rates for kindergarteners in Idaho are now lower than in any other state that reported data to the federal government—especially in the Panhandle Health District, where fewer than two-thirds arrive with records showing that they are up-to-date on common shots.

“It’s really kind of like watching a car accident in slow motion,” said Ted Epperly, a physician and the CEO of Full Circle Health, which operates a network of clinics in the Boise area.

Photo of Idaho countryside

A view of Sandpoint, Idaho, which sits on the shores of Lake Pend Oreille. The city, a part of Bonner County, is served by the Panhandle Health District.

Credit: Kirk Fisher/iStock/Getty Images Plus

A view of Sandpoint, Idaho, which sits on the shores of Lake Pend Oreille. The city, a part of Bonner County, is served by the Panhandle Health District. Credit: Kirk Fisher/iStock/Getty Images Plus

Public health leaders often ascribe the low vaccination rates to the work of bad-faith actors who profit from falsehoods, to the spread of misinformation, or to failures of communication: If only leaders could better explain the benefits of vaccination, this thinking goes, more people would get shots.

In interviews and public statements, health freedom advocates in Idaho describe a far deeper rift: They do not believe that public health institutions are competent or trustworthy. And restoring that trust, they argue, will require radical changes.

Fletcher, for his part, describes himself as an admirer of RFK Jr. and the Make America Healthy Again movement. With the recent appointment of a new member, he said, MAHA supporters now hold a majority on the board, where they are poised to reimagine public health work in the district.

Local public health

In the US, public health is mostly local. Agencies like the Centers for Disease Control and Prevention conduct research and issue influential recommendations. But much of the actual power rests with the country’s thousands of state, local, and tribal public health authorities—with institutions, in other words, like the Panhandle Health District, and with leaders like Fletcher and his fellow PHD board of health member Duke Johnson.

Johnson says he grew up in Coeur d’Alene, Idaho, in the 1960s, the descendant of homesteaders who arrived in the 19th century. He attended medical school at the University of California, Los Angeles and eventually returned to Idaho, where he runs a family medical practice and dietary supplement business in the town of Hayden.

In Idaho, health boards are appointed by elected county commissioners. The commissioners of Kootenai County gave Johnson the nod in July 2023. Johnson took the role, he said, in order to restore trust in a medical system that he characterized as beholden to rigid dogmas and protocols rather than independent thinking.

In interviews and public statements, health freedom advocates in Idaho describe a far deeper rift: They do not believe that public health institutions are competent or trustworthy.

Last winter, Johnson took a tour of one of the PHD clinics. Among other services, it provides routine childhood immunizations, especially for families with limited access to health care. As is standard in pediatrics practices, the clinic hands out flyers from the CDC that review the potential side effects of common vaccines, including “a very remote chance” of severe outcomes. Johnson was unimpressed with the CDC writeup. “I thought: This isn’t completely covering all of the risk-benefit ratio,” Johnson said. He felt families could be better informed about what he sees as the substantial risks of common shots.

Johnson is an outlier among physicians. The overwhelming majority of laboratory scientists, epidemiologists, and pediatricians who have devoted their lives to the study of childhood disease say that routine immunizations are beneficial, and that serious side effects are rare. Large-scale studies have repeatedly failed to find purported links between the measles-mumps-rubella, or MMR, vaccine and autism, or to identify high rates of severe side effects for other routine childhood immunizations. The introduction of mass vaccinations in the US in the 1950s and 1960s was followed by dramatic declines in the rates of childhood diseases like polio and measles that once killed hundreds of American children each year, and sent tens of thousands more to the hospital. Similar declines have been recorded around the world.

Children can suffer side effects from common shots like the MMR vaccine, ranging from mild symptoms like a rash or fever to rare fatal complications. Public health agencies and vaccine manufacturers study and track those side effects. But today, many Americans simply do not trust that those institutions are being transparent about the risks of vaccination.

Johnson shares some of those concerns. The website for his clinic, Heart of Hope Health, describes offering services for “injection-injured” patients, encouraging them to receive a $449 heart scan, and advertises “no forced masks or vaccinations.” (During a PHD board meeting, Johnson said that one of his own children suffered an apparent bad reaction to a vaccine many years ago.) “The lack of trust in established medicine is probably 10 times bigger than the people at Harvard Medical School realize,” Johnson told Undark during an evening phone call, after a long day seeing patients. Top medical institutions have brilliant scientists on staff, he continued. But, he suggested, those experts have lost touch with how they’re seen by much of the public: “I think sometimes you can spend so much time talking to the same people who agree with you that you’re not reaching the people on the street who are the ones who need the care. And I’m in the trenches.”

Many public health experts agree that restoring trust is an urgent priority, and they are convinced that it will come through better communication, a reduction in the circulation of misinformation, and a re-building of relationships. Johnson and others in the health freedom movement frequently adopt the language of restoring trust, too. But for them, the process tends to mean something different: an overhaul of public health institutions and a frank accounting of their perceived failures.

At the board meeting in February, Johnson laid out the proposal for a change in policy: What if the board wrote up its own document for parents, explaining the evidence behind specific vaccines, and laying out the risks and benefits of the shots? The goal, he told Undark, was “to make sure that the people that we’re responsible for in our in our district can make an informed decision.”

Fletcher was also hoping to change the way PHD communicated about vaccines. Why did a push for informed consent appeal to him? “I can summarize the answer to that question with one word,” Fletcher said. “COVID.”

Nobody’s telling me what to do

Idaho is ideologically diverse, with blue pockets in cities like Boise, and texture to its overwhelming Republican majority. (Latter-Day Saint conservatives in East Idaho, for example, may not always be aligned with government-skeptical activists clustered in the north.) Parts of the state have a reputation for libertarian politics—and for resistance to perceived excesses of government authority.

People came West because “they wanted to get out to a place where nobody would tell them what to do,” said Epperly, the Boise-area physician and administrator. That libertarian ethos, he said, can sometimes translate into a skepticism of things like school vaccination requirements, even as plenty of Idahoans, including Epperly, embrace them.

Like all US states, Idaho technically requires vaccination for children to attend school. But it is relatively easy to opt out of the requirement. In 2021, Idaho lawmakers went further, instructing schools to be proactive and notify parents they had the option to claim an exemption.

“Idaho has some of the strongest languages in the US when it comes to parental rights and vaccine exemptions,” the vaccine-skeptical advocacy group Health Freedom Idaho wrote in 2021. In the 2024–2025 school year, more than 15 percent of kindergarten parents in the state claimed a non-medical exemption, the highest percentage, by far, of the states that reported data.

The pandemic, Epperly and other Idaho health care practitioners said, accelerated many of these trends. In his view, much of that backlash was about authority and control. “The pandemic acted as a catalyst to increase this sense of governmental overreach, if you will,” he said. The thinking, he added, was: “‘How dare the federal government mandate that we wear masks, that we socially distance, that we hand-wash?’”

Recently, advocates have pushed to remove medical mandates in the state altogether through the Idaho Medical Freedom Act, which curtails the ability of local governments, businesses, and schools to impose things like mask mandates or vaccine requirements.

The author of the original bill is Leslie Manookian, an Idaho activist who has campaigned against what she describes as the pervasive dangers of some vaccines, and who leads a national nonprofit, the Health Freedom Defense Fund. In testimony to an Idaho state Senate committee this February, she described feeling shocked by mitigation measures during the COVID-19 pandemic. “Growing up, I could have never, ever imagined that Idaho would become a place that locked its people down, forced citizens to cover their faces, stand on floor markers 6 feet apart, or produce proof of vaccination in order to enter a venue or a business,” Manookian told the senators.

“Idaho has some of the strongest languages in the US when it comes to parental rights and vaccine exemptions.”

Where some public health officials saw vital interventions for the public’s well-being, Manookian saw a form of government overreach, based on scant evidence. Her home state, she argued, could be a leader in building a post-COVID vision of public health. “Idaho wants to be the shining light on the Hill, that leads the way for the rest of the nation in understanding that we and we alone are sovereign over our bodies, and that our God-given rights belong to us and to no one else,” Manookian said during the hearing. A modified version of the bill passed both houses with large majorities, and became law in April.

Epperly, like many physicians and public health workers in the state, has watched these changes with concern. The family medicine specialist grew up in Idaho. During the pandemic, he was a prominent local figure advocating for masking and COVID-19 vaccinations. When the pandemic began, he had been serving on the board of the Boise-area Central District Health department for more than a decade. Then, in 2021, Ada County commissioners declined to renew his appointment, selecting a physician and vocal opponent of COVID-19 vaccines instead.

A transformative experience

For Thomas Fletcher, the Panhandle Health District board of health chair, the experience of the pandemic was transformative. Fletcher has strong political views; he moved away from Texas, in part, over concerns that the culture there was growing too liberal, and out of a desire to live in a place that was, as he put it, “more representative of America circa 1950.” But before the pandemic, he said, although he was a practicing physician, he rarely thought about public health.

Then COVID-19 arrived, and it felt to him that official messaging was disconnected from reality. In early 2020, the World Health Organization said that COVID-19 was not an airborne virus. (There’s a scientific consensus today that it actually is.) Prominent scientists argued that it was a conspiracy theory to say that COVID-19 emerged from a lab. (The issue is still hotly debated, but many scientists now acknowledge that a lab leak is a real possibility.) The World Health Organization appeared to indicate that the fatality rate of COVID-19 was upwards of 3 percent. (It’s far lower.)

Many people today understand these reversals as the results of miscommunications, evolving evidence, or good-faith scientific error. Fletcher came to believe that Anthony Fauci—a member of the White House Coronavirus Task Force during the pandemic—and other public health leaders were intentionally, maliciously misleading the public. Fletcher reads widely on the platform Substack, particularly writers who push against the medical establishment, and he concluded that COVID-19 vaccines were dangerous, too—a toxic substance pushed by pharma, and backed knowingly by the medical elite. “They lied to us,” he said.

That shift ultimately led the retired physician to question foundational ideas in his field. “Once you realize they’re lying to us, then you ask the question, ‘Well, where else are they lying?’” Fletcher said during one of several lengthy phone conversations with Undark. “I was a card-carrying allopathic physician,” he said. “I believed in the gospel.” But he soon began to question the evidence behind cholesterol medication, and then antidepressants, and then the childhood vaccination schedule.

In 2022, lawmakers in Bonner County appointed Fletcher to the board of health. Last year, he took the helm of the board, which oversees an approximately 90-person agency with a $12 million budget.

“As Chairman of Panhandle Health, I feel a certain urge to restore the trust—public trust in public health—because that trust has been violated,” he said.

The informed consent measure seemed like one way to get there.

Conversations around informed consent

On a February afternoon, in a conference room at the health district office in Hayden, a few dozen attendees and board members gathered to discuss vaccination policy and informed consent in the district.

During the lengthy public comment periods, members of the public spoke about their experiences with vaccination. One woman described witnessing the harms of diseases that have been suppressed by vaccination, noting that her mother has experienced weakness in her limbs as the result of a childhood polio infection. Several attendees reported firsthand encounters with what they understood to be vaccine side effects; one cited rising autism rates. They wanted parents to hear more about those possibilities before getting shots.

In response, some local pediatrics providers insisted they already facilitated informed consent, through detailed conversations with caregivers. They also stressed the importance of routine shots; one brought up the measles outbreak emerging in Texas, which would go on to be implicated in the deaths of two unvaccinated children.

“Once you realize they’re lying to us, then you ask the question, ‘Well, where else are they lying?’”

Johnson, defending the measure, proposed a document that listed both pros and cons for vaccination. The PHD Board, he argued, “would have a much better chance of providing good information than the average person on the Internet.”

The conversation soon bogged down over what, exactly, the document should look like. “If the vote is yay or nay for informed consent, I’m all in with two hands,” said board member Jessica Jameson, an anesthesiologist who ultimately voted against the measure. “But my concern is that we have to be very careful about the information we present and the way that it’s presented.” The board members, she added, were neither “the subject matter experts nor the stakeholders,” and studies that seemed strong on first-glance could be subject to critique.

Marty Williams, a nurse practitioner in Coeur d’Alene who works in pediatrics, had heard about the meeting that morning, as materials about the measure circulated online.

Williams is a former wildland firefighter, a father of five, and a Christian; he snowboards and bowhunts in his free time, and speaks with the laid-back affect of someone who has spent years coaching anxious parents through childhood scrapes and illnesses. A document associated with the proposal looked to him less like an attempt at informed consent, and more like a bid to talk parents out of giving their children immunizations. “If you read this, you would be like, ‘Well, I would never vaccinate my child,’” he recalled. “It was beyond informed consent. It seemed to be full of bias.”

He and his practice partner, Jeanna Padilla, canceled appointments in order to attend the meeting and speak during a public comment period. “The thought of it coming from our public health department made me sick,” Williams said. “We’re in the business of trying to prevent disease, and I had a strong feeling that this was going to bring more fear onto an already anxiety-provoking subject.” The issue felt high-stakes to him: That winter, he had seen more cases of pertussis, a vaccine-preventable illness, than at any point in his 18-year career.

Williams has always encountered some parents who are hesitant about vaccination. But those numbers began to rise during the COVID-19 pandemic. Trust in public health was dropping, and recommendations to vaccinate children against COVID-19, in particular, worried him. “Is this going to push people over the edge, where they just withdraw completely from vaccines?” he wondered at the time. Something did shift, he said: “We have families that historically have vaccinated their children, and now they have a new baby, and they’re like, ‘Nope, we’re not doing it. Nope, nope, nope.’”

In his practice, Williams described a change in how he’s approached parents. “I don’t say, ‘Well, you know, it’s time for Junior’s two months shots. Here’s what we’re going to do.’ I don’t approach it that way anymore, because greater than 40 or 50 percent of people are going to say, ‘Well, no, I’m not doing vaccines. And they get defensive right away,’” he said. Instead, he now opens up a conversation, asking families whether they’ve thought about vaccination, answering their questions, providing resources, talking about his personal experiences treating illness—even inviting them to consider the vaccine schedules used in Denmark or Sweden, which recommend shots for fewer diseases, if they are adamant about not following CDC guidelines.

The approach can be effective, he said, but also time-consuming and draining. “It’s emotional for me too, because there’s a piece of this that being questioned every single day in regards to the standard of care, as if you’re harming children,” he said.

“If you read this, you would be like, ‘Well, I would never vaccinate my child.’ It was beyond informed consent. It seemed to be full of bias.”

Williams doubts his comments at the February meeting achieved much. “I was shocked by what I was hearing, because it was so one-sided,” he said. What seemed to be missing, he said, was an honest account of the alternatives: “There was no discussion of, OK, then, if we don’t vaccinate children, what is our option? How else are we going to protect them from diseases that our grandparents dealt with that we don’t have to deal with in this country?”

The board punted: They’d discuss the issue again down the road.

This isn’t new

Versions of this debate have played out across Idaho—and across the country — since the end of COVID-19’s emergency phase. In an apparent national first, one Idaho health district banned COVID-19 vaccines altogether. In Louisiana, Surgeon General Ralph Abraham told public health departments to stop recommending specific vaccines. “Government should admit the limitations of its role in people’s lives and pull back its tentacles from the practice of medicine,” Abraham and his deputy wrote in a statement explaining the decision. “The path to regaining public trust lies in acknowledging past missteps, refocusing on unbiased data collection, and providing transparent, balanced information for people to make their own health decisions.”

In several states, Republican lawmakers have moved to make it easier for people to opt out of vaccines. Not all those efforts have been successful: In West Virginia this past March, for example, the Republican-dominated legislature rejected a bill that would have made it easier to obtain exemptions. Keith Marple, a Republican lawmaker who voted against the measure, cited his personal experiences with people who had been left disabled by polio. “West Virginia needs to look after its children,” he said, according to the news site West Virginia Watch.

In an apparent national first, one Idaho health district banned COVID-19 vaccines altogether.

In Idaho, like many states, vaccination rates have dropped. In the 2023-2024 school year, a bit more than 65 percent of kindergarten families in the Panhandle Health District furnished records showing they’ve received the MMR vaccine and five other common immunizations, down from just over 69 percent in the 2019-2020 school year. (State officials note that some children may have received shots, but their parents did not submit the paperwork to prove it.) Such figures, infectious disease modelers say, leave the area vulnerable to outbreaks of measles and other illnesses.

During an interview with Undark earlier this year, Sarah Leeds, who directs the immunization program for the Idaho Department of Health and Welfare, noted her colleagues across the country are reporting resistance to their work. “Sometimes it’s hard when you might be feeling like people think we’re the villain,” she said. “But I know our team and our leadership knows we do good work, and it’s based on sound science, and it’s important work for the community. And we just keep that at the front of our minds.”

When the board reconvened in early March, more advocates for the informed consent policy came out to back it. Among them was Rick Kirschner, a retired naturopathic doctor, author, and speaker. (His best-known book is titled “Dealing With People You Can’t Stand.”) Kirschner lived for decades in Ashland, Oregon. Early in 2020, he began to diverge from his neighbors over COVID-19 policies. He and his wife visited north Idaho that summer, and bought a home there weeks later. Compared to pandemic-conscious Oregon, it felt like a different reality. That Thanksgiving, he said during a recent Zoom interview, they attended a celebration “with 10 families and all their kids running around. It just was, ‘Oh, we’re Americans again.’ And it was just terrific.”

At the meeting in March, several people said that it was necessary to restore trust in public health institutions. But what, exactly, did that mean? Kirschner argued that it required more information, including more detailed accountings of all the ways public health interventions like vaccination could cause harm, and more detail on where the scientific literature falls short. “Denying information risks backfiring when risks that were hidden become known and trust in authorities craters,” he said during the hearing.

“I find that people are smarter than these public health people give them credit for,” he said during his call with Undark. There was a tendency in public health, he felt, to treat people like cattle. “The mindset of public health is, ‘They’re dummies, and we need to direct them and to what we think is in their interest,’” he said.

Others at the meeting pushed back against suggestions that public health workers and clinicians were not already providing detailed information to patients. “It’s not like Panhandle Health is against informed consent, or does not have that as part of the process” said Peggy Cuvala, a member of the board. Cuvala has personal experience with the issue: She spent more than three decades as a public health nurse and nurse practitioner with the Panhandle Health District. “I would never force anyone into vaccination,” she said in a phone interview.

Cuvala is well aware that vaccine side effects happen—one of her own children, she said, suffered an adverse reaction to a shot—but she’s also seen transformative benefits. For years, she had to fill out reports on cases of Haemophilus influenzae that had caused meningitis in young children, including one case in which an infant died. Then a vaccine arrived. “Within a year of that vaccine coming out, I didn’t have to do those reports anymore,” she told Undark.

Cuvala describes herself as feeling perplexed by the recent direction of the board. “I think protecting and promoting the health and well being of the residents in North Idaho is critical,” she wrote in an email. “This work should be directed by the board collectively without political bias.”

During the meeting, legal questions came up, too: What were the liability implications of drawing up a custom PHD vaccine safety document?

In a previous meeting, Fletcher had pushed for a document that just gave basic details on the duration and scope of the randomized controlled trials that common vaccines had been subjected to. Such information, he argued, would demonstrate how poorly vetted the shots were—and show how they could be dangerous, even fatal. After that, he said in an interview, it was the parent’s choice. “If some mom wants her kid to get it, fine, give it to him,” Fletcher said. The ultimate arbiter of who was correct would be the brutal process of natural selection: “Let Darwin figure it out.”

In the March meeting, the board voted against creating a subcommittee to explore how to draft the document. “It’s dead,” said Fletcher during a phone call in early May.

A matter of trust

The discussion around the informed consent measure, though, was not entirely gone. On a Saturday morning in early May, the board held a lengthy public planning session at a government building in Coeur d’Alene. During a visioning session, attendees put stickers on pieces of paper next to words describing opportunities for the district. At the bottom of the page, someone wrote, in large, all-caps: “TRUST.”

Kirschner spoke again at the meeting, urging the board to revive the measure. So did a handful of other attendees, including Ron Korn, a county commissioner.

In a short interview at the meeting, PHD spokesperson Katherine Hoyer expressed some uncertainty about what substantive differences, precisely, the measure would offer over what’s already taking place in clinics. “What they’re proposing is that we provide patients with information on medical practices and vaccines,” she said. “That is happening.”

Fletcher sees opportunities ahead. In July, the board unanimously reelected him as chair. And, he said, he has a new ally in the push for an informed consent policy. Jessica Jameson, one of the board members who opposed the measure, recently resigned. Fletcher described her successor, a naturopathic doctor who was appointed to the board last month, as aligned with the MAHA movement. That brings the total MAHA-aligned members, by his count, to four — securing a majority on the seven-member board. “My plan is unfolding just as I wanted,” he said during a call in late July.

During an earlier conversation, Fletcher had reflected on the strange position of RFK Jr., who is perched atop the Department of Health and Human Services, which is staffed by many of the people he spent his career opposing. “He has hundreds of thousands of employees; 99.99 percent of them think he’s full of shit,” Fletcher said. Fletcher, in some ways, has his own miniature version of that problem: An antagonist of institutional public health, overseeing a public health organization.

The precise informed consent measure, he acknowledged, may not come to pass. But the debate itself has merit, he said: “Even if we lose, whatever lose means, even if we don’t make any positive forward motion — you never know. Every time you talk about this, you maybe change someone’s sentiment. You maybe move things forward a little bit. Which is why I do it.”

Fletcher’s role is small. But, he suggested, added together, the cumulative efforts of local politicking could amount to a revolution. “Robert Kennedy needs as many people putting their oar in the water and stroking in the same direction,” Fletcher said. “He can’t do it alone. So if there are 10,000 Thomas Fletchers out there, all going in the same direction, then maybe we can have hope.”

Rajah Bose contributed reporting from Idaho.

This article was originally published on Undark. Read the original article.

Idaho has become the wild frontier of vaccination policy and public health Read More »

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Five children see HIV viral loads vanish after taking antiretroviral drugs


The first widespread success in curing HIV may come from children, not adults.

An ARV tablet being held in Kisumu, Kenya, on April 24, 2025 Credit: Michel Lunaga/Getty

For years, Philip Goulder has been obsessed with a particularly captivating idea: In the hunt for an HIV cure, could children hold the answers?

Starting in the mid-2010s, the University of Oxford pediatrician and immunologist began working with scientists in the South African province of KwaZulu-Natal, with the aim of tracking several hundred children who had acquired HIV from their mothers, either during pregnancy, childbirth, or breastfeeding.

After putting the children on antiretroviral drugs early in their lives to control the virus, Goulder and his colleagues were keen to monitor their progress and adherence to standard antiretroviral treatment, which stops HIV from replicating. But over the following decade, something unusual happened. Five of the children stopped coming to the clinic to collect their drugs, and when the team eventually tracked them down many months later, they appeared to be in perfect health.

“Instead of their viral loads being through the roof, they were undetectable,” says Goulder. “And normally HIV rebounds within two or three weeks.”

In a study published last year, Goulder described how all five remained in remission, despite having not received regular antiretroviral medication for some time, and in one case, up to 17 months. In the decadeslong search for an HIV cure, this offered a tantalizing insight: that the first widespread success in curing HIV might not come in adults, but in children.

At the recent International AIDS Society conference held in Kigali, Rwanda, in mid-July, Alfredo Tagarro, a pediatrician at the Infanta Sofia University Hospital in Madrid, presented a new study showing that around 5 percent of HIV-infected children who receive antiretrovirals within the first six months of life ultimately suppress the HIV viral reservoir—the number of cells harboring the virus’s genetic material—to negligible levels. “Children have special immunological features which makes it more likely that we will develop an HIV cure for them before other populations,” says Tagarro.

His thoughts were echoed by another doctor, Mark Cotton, who directs the children’s infectious diseases clinical research unit at the University of Stellenbosch, Cape Town.

“Kids have a much more dynamic immune system,” says Cotton. “They also don’t have any additional issues like high blood pressure or kidney problems. It makes them a better target, initially, for a cure.”

According to Tagarro, children with HIV have long been “left behind” in the race to find a treatment that can put HIV-positive individuals permanently into remission. Since 2007, 10 adults are thought to have been cured, having received stem cell transplants to treat life-threatening blood cancer, a procedure which ended up eliminating the virus. Yet with such procedures being both complex and highly risky—other patients have died in the aftermath of similar attempts—it is not considered a viable strategy for specifically targeting HIV.

Instead, like Goulder, pediatricians have increasingly noticed that after starting antiretroviral treatment early in life, a small subpopulation of children then seem able to suppress HIV for months, years, and perhaps even permanently with their immune system alone. This realization initially began with certain isolated case studies: the “Mississippi baby” who controlled the virus for more than two years without medication, and a South African child who was considered potentially cured having kept the virus in remission for more than a decade. Cotton says he suspects that between 10 and 20 percent of all HIV-infected children would be capable of controlling the virus for a significant period of time, beyond the typical two to three weeks, after stopping antiretrovirals.

Goulder is now launching a new study to try and examine this phenomenon in more detail, taking 19 children in South Africa who have suppressed HIV to negligible levels on antiretrovirals, stopping the drugs, and seeing how many can prevent the virus from rebounding, with the aim of understanding why. To date, he says that six of them have been able to control the virus without any drugs for more than 18 months. Based on what he’s seen so far, he has a number of ideas about what could be happening. In particular, it appears that boys are more likely to better control the virus due to a quirk of gender biology to do with the innate immune system, the body’s first-line defense against pathogens.

“The female innate immune system both in utero and in childhood is much more aggressive than the male equivalent when it encounters and senses viruses like HIV,” says Goulder. “Usually that’s a good thing, but because HIV infects activated immune cells, it actually seems to make girls more vulnerable to being infected.”

In addition, Goulder notes that because female fetuses share the same innate immune system as their mothers, the virus transmitted to them is an HIV strain that has become resistant to the female innate immune response.

There could also be other explanations for the long-lasting suppression seen in some children. In some cases, Goulder has observed that the transmitted strain of HIV has been weakened through needing to undergo changes to circumvent the mother’s adaptive immune response, the part of the immune system which learns to target specific viruses and other pathogens. He has also noted that male infants experience particularly large surges of testosterone in the first six months of life—a period known as “mini-puberty”—which can enhance their immune system in various ways that help them fight the virus.

Such revelations are particularly tantalizing as HIV researchers are starting to get access to a far more potent toolbox of therapeutics. Leading the way are so-called bNAbs, or broadly neutralizing antibodies, which have the ability to recognize and fight many different strains of HIV, as well as stimulating the immune system to destroy cells where HIV is hiding. There are also a growing number of therapeutic vaccines in development that can train the immune system’s T cells to target and destroy HIV reservoirs. Children tend to respond to various vaccines better than adults, and Goulder says that if some children are already proving relatively adept at controlling the virus on the back of standard antiretrovirals, these additional therapeutics could give them the additional assistance they need to eradicate HIV altogether.

In the coming years, this is set to be tested in several clinical trials. Cotton is leading the most ambitious attempt, which will see HIV-infected children receive a combination of antiretroviral therapy, three bNAbs, and a vaccine developed by the University of Oxford, while in a separate trial, Goulder is examining the potential of a different bNAb together with antiretrovirals to see whether it can help more children achieve long-term remission.

“We think that adding the effects of these broadly neutralizing antibodies to antiretrovirals will help us chip away at what is needed to achieve a cure,” says Goulder. “It’s a little bit like with leukemia, where treatments have steadily improved, and now the outlook for most children affected is incredibly good. Realistically in most cases, curing HIV probably requires a few hits from different angles, impacting the way that the virus can grow, and tackling it with different immune responses at the same time to essentially force it into a cul-de-sac that it can’t escape from.”

Children are also being viewed as the ideal target population for an even more ambitious experimental treatment, a one-time gene therapy that delivers instructions directing the body’s own muscle cells to produce a continuous stream of bNAbs, without the need for repeated infusions. Maurico Martins, an associate professor at the University of Florida, who is pioneering this new approach, feels that it could represent a particularly practical strategy for low-income countries where HIV transmission to children is particularly rife, and mothers often struggle to keep their children on repeated medication.

“In regions like Uganda or parts of South Africa where this is very prevalent, you could also give this therapy to a baby right after birth as a preventative measure, protecting the newborn child against acquisition of HIV through breastfeeding and maybe even through sexual intercourse later in life,” says Martins.

While Martins also hopes that gene therapy could benefit HIV-infected adults in future, he feels it has more of a chance of initially succeeding in children because their nascent immune systems are less likely to launch what he calls an anti-drug response that can destroy the therapeutic bNAbs.

“It’s very difficult for most antibodies to recognize the HIV envelope protein because it’s buried deep within a sugar coat,” says Martins. “To overcome that, these bNAbs carry a lot of mutations and extensions to their arms which allow them to penetrate that sugar coat. But the problem then is that they’re often viewed by your own immune system as foreign, and it starts making these anti-bNAb antibodies.”

But when Martins tested the therapy in newborn rhesus macaques, it was far more effective. “We found that the first few days or two weeks after birth comprised a sort of sweet spot for this gene therapy,” he says. “And that’s why this could really work very well in treating and preventing pediatric HIV infections.”

Like many HIV scientists, Martins has run into recent funding challenges, with a previous commitment from the National Institutes of Health to support a clinical trial of the novel therapy in HIV-infected children being withdrawn. However, he is hoping that the trial will still go ahead. “We’re now talking with the Gates Foundation to see whether they can sponsor it,” he says.

While children still comprise the minority of overall HIV infections, being able to cure them may yield further insights that help with the wider goal of an overall curative therapy.

“We can learn a lot from them because they are different,” says Goulder. “I think we can learn how to achieve a cure in kids if we continue along this pathway, and from there, that will have applications in adults as well.”

This story originally appeared on wired.com.

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Under RFK Jr, CDC skips study on vaccination rates, quietly posts data on drop

Vaccination rates among the country’s kindergartners have fallen once again, with coverage of the measles, mumps, and rubella (MMR) vaccination dropping from 92.7 percent in the 2023–2024 school year to 92.5 percent in 2024–2025. The percentage changes are small across the board, but they represent thousands of children and an ongoing downward trend that makes the country more vulnerable to outbreaks.

In the latest school year, an estimated 286,000 young children were not fully protected against measles. At the same time, the country has seen numerous explosive measles outbreaks, with case counts in 2025 already higher than any other year since the highly infectious disease was declared eliminated in 2000. In fact, the case count is at a 33-year high.

The latest small decline is one in a series that is eroding the nation’s ability to keep bygone infectious diseases at bay. In the 2019–2020 school year, 95 percent of kindergartners were protected against measles and other serious childhood diseases, such as polio. That 95 percent coverage is the target that health experts say prevents an infectious disease from spreading in a community. But amid the pandemic, vaccination rates fell, dropping to 93.9 percent MMR coverage in the 2020–2021 year, and have kept creeping downward.

Anti-vaccine era

At the height of the pandemic, some slippage in immunization coverage could be blamed on disrupted access. But anti-vaccine sentiments and misinformation are clearly playing a large role as vaccination continues to decline and access has largely resumed. For the 2024–2025 school year, nonmedical exemptions for childhood vaccinations once again hit a new high. These are exemptions driven by ideology and have risen with the influence of anti-vaccine voices, including current health secretary and fervent anti-vaccine advocate Robert F. Kennedy Jr.

Under RFK Jr, CDC skips study on vaccination rates, quietly posts data on drop Read More »

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Senate confirms CDC director as top FDA official resigns under political pressure

As of yesterday, Susan Monarez is in and Vinay Prasad is out among top federal health officials.

In a 51–47 vote along party lines, the Senate confirmed Monarez as the director of the Centers for Disease Control and Prevention. She is the first nominee for CDC director to be required to get Senate confirmation, following a 2022 law requiring it. She is also the first person to serve in the role without a medical degree since 1953.

Monarez has a PhD in microbiology and immunology and previously served as the deputy director for the Advanced Research Projects Agency for Health (ARPA-H) under the Biden administration. Monarez quietly helmed the CDC as acting director from January to March of this year but stepped down as required when Donald Trump nominated her for the permanent role. Before that, Trump had nominated Dave Weldon, but the nomination was abandoned over concerns that his anti-vaccine views would torpedo his Senate confirmation.

In contrast, Monarez aligns with the evidence-based public health community and has support from health experts. Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health, told NPR that she has known Monarez professionally for more than a decade. “She’s a loyal, hardworking civil servant who leads with evidence and pragmatism and has been dedicated to improving the health of Americans for the entirety of her career,” Nuzzo said of Monarez.

Similarly, Georges Benjamin, executive director of the American Public Health Association, told the outlet that Monarez “values science, is a solid researcher, and has a history of being a good manager. We’re looking forward to working with her.”

It remains to be seen how Monarez will balance evidence-based public health guidance with the ideologically driven choices of health secretary and fervent anti-vaccine advocate Robert F. Kennedy Jr.

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“it’s-shocking”:-massive-raw-milk-outbreak-from-2023-finally-reported

“It’s shocking”: Massive raw milk outbreak from 2023 finally reported


The outbreak occurred in 2023–2024, but little information had been shared about it.

On October 20, 2023, health officials in the County of San Diego, California, put out a press release warning of a Salmonella outbreak linked to raw (unpasteurized) milk. Such an outbreak is not particularly surprising; the reason the vast majority of milk is pasteurized (heated briefly to kill germs) is because milk can easily pick up nasty pathogens in the farmyard that can cause severe illnesses, particularly in children. It’s the reason public health officials have long and strongly warned against consuming raw milk.

At the time of the press release, officials in San Diego County had identified nine residents who had been sickened in the outbreak. Of those nine, three were children, and all three children had been hospitalized.

On October 25, the county put out a second press release, reporting that the local case count had risen to 12, and the suspected culprit—raw milk and raw cream from Raw Farm LLC—had been recalled. The same day, Orange County’s health department put out its own press release, reporting seven cases among its residents, including one in a 1-year-old infant.

Both counties noted that the California Department of Public Health (CDPH), which had posted the recall notice, was working on the outbreak, too. But it doesn’t appear that CDPH ever followed up with its own press release about the outbreak. The CDPH did write social media posts related to the outbreak: One on October 26, 2023, announced the recall; a second on November 30, 2023, noted “a recent outbreak” of Salmonella cases from raw milk but linked to general information about the risks of raw milk; and a third on December 7, 2023, linked to general information again with no mention of the outbreak.

But that seems to be the extent of the information at the time. For anyone paying attention, it might have seemed like the end of the story. But according to the final outbreak investigation report—produced by CDPH and local health officials—the outbreak actually ran from September 2023 to March 2024, spanned five states, and sickened at least 171 people. That report was released last week, on July 24, 2025.

Shocking outbreak

The report was published in the Morbidity and Mortality Weekly Report, a journal run by the Centers for Disease Control and Prevention. The report describes the outbreak as “one of the largest foodborne outbreaks linked to raw milk in recent US history.” It also said that the state and local health department had issued “extensive public messaging regarding this outbreak.”

According to the final data, of the 171 people, 120 (70 percent) were children and teens, including 67 (39 percent) who were under the age of 5. At least 22 people were hospitalized, nearly all of them (82 percent) were children and teens. Fortunately, there were no deaths.

“I was just candidly shocked that there was an outbreak of 170 plus people because it had not been reported—at all,” Bill Marler, a personal injury lawyer specializing in food poisoning outbreaks, told Ars Technica in an interview. With the large number of cases, the high percentage of kids, and cases in multiple states, “it’s shocking that they never publicized it,” he said. “I mean, what’s the point?”

Ars Technica reached out to CDPH seeking answers about why there wasn’t more messaging and information about the outbreak during and soon after the investigation. At the time this story was published, several business days had passed and the department had told Ars in a follow-up email that it was still working on a response. Shortly after publication, CDPH provided a written statement, but it did not answer any specific questions, including why CDPH did not release its own press release about the state-wide outbreak or make case counts public during the investigation.

“CDPH takes its charge to protect public health seriously and works closely with all partners when a foodborne illness outbreak is identified,” the statement reads. It then referenced only the social media posts and the press releases from San Diego County and Orange County mentioned previously in this story as examples of its public messaging.

“This is pissing me off”

Marler, who represents around two dozen of the 171 people sickened in the outbreak, was one of the first people to get the full picture of the outbreak from California officials. In July of 2024, he obtained an interim report of the investigation from state health officials. At that point, they had documented at least 165 of the cases. And in December 2024, he got access to a preliminary report of the full investigation dated October 15, 2024, which identified the final 171 cases and appears to contain much of the data published in the MMWR, which has had its publication rate slowed amid the second Trump administration.

Getting that information from California officials was not easy, Marler told Ars. “There was one point in time where they wouldn’t give it to me. And I sent them a copy of a subpoena and I said, ‘you know, I’ve been working with public health for 32 years. I’m a big supporter of public health. I believe in your mission, but,’ I said, ‘this is pissing me off.'”

At that point, Marler knew that it was a multi-county outbreak and the CDPH and the state’s Department of Food and Agriculture were involved. He knew there was data. But it took threatening a subpoena to get it. “I’m like ‘OK, you don’t give it to me. I’m going to freaking drop a subpoena on you, and the court’s going to force you to give it.’ And they’re like, ‘OK, we’ll give it to you.'”

The October 15 state report he finally got a hold of provides a breakdown of the California cases. It reports that San Diego had a total of 25 cases (not just the 12 initially reported in the press releases), and Orange County had 19 (not just the seven). Most of the other 171 cases were spread widely across California, spanning 35 local health departments. Only four of the 171 cases were outside of California—one each in New Mexico, Pennsylvania, Texas, and Washington. It’s unclear how people in these states were exposed, given that it’s against federal law to sell raw milk for human consumption across state lines. But two of the four people sickened outside of California specifically reported that they consumed dairy from Raw Farm without going to California.

Of the 171 cases, 159 were confirmed cases, which were defined as being confirmed using whole genome sequencing that linked the Salmonella strain causing a person’s infection to the outbreak strain also found in raw milk samples and a raw milk cheese sample from Raw Farm. The remaining 12 probable cases were people who had laboratory-confirmed Salmonella infections and also reported consuming Raw Farm products within seven days prior to falling ill.

“We own it”

In an interview with Ars Technica, the owner and founder of Raw Farm, Mark McAfee, disputed much of the information in the MMWR study and the October 2024 state report. He claimed that there were not 171 cases—only 19 people got sick, he said, presumably referring to the 19 cases collectively reported in the San Diego and Orange County press releases in October 2023.

“We own it. It’s ours. We’ve got these 19 people,” he told Ars.

But he said he did not believe that the genomic data was accurate and that the other 140 cases confirmed with genetic sequencing were not truly connected to his farm’s products. He also doubted that the outbreak spanned many months and into early 2024. McAfee says that a single cow that had been purchased close to the start of the outbreak had been the source of the Salmonella. Once that animal had been removed from the herd by the end of October 23, subsequent testing was negative. He also outright did not accept that testing identified the Salmonella outbreak strain in the farm’s raw cheese, which was reported in the MMWR and the state report.

Overall, McAfee downplayed the outbreak and claimed that raw milk has significant health benefits, such as being a cure for asthma—a common myth among raw milk advocates that has been debunked. He rejects the substantial number of scientific studies that have refuted the variety of unproven health claims made by raw-milk advocates. (You can read a thorough run-down of raw milk myths and the data refuting them in this post by the Food and Drug Administration.) McAfee claims that he and his company are “pioneers” and that public health experts who warn of the demonstrable health risks are simply stuck in the past.

Outbreak record

McAfee is a relatively high-profile raw milk advocate in California. For example, health secretary and anti-vaccine advocate Robert F. Kennedy Jr. is reportedly a customer. Amid an outbreak of H5N1 on his farm last year, McAfee sent Ars press material claiming that McAfee “has been asked by the RFK transition team to apply for the position of ‘FDA advisor on Raw Milk Policy and Standards Development.'” But McAfee’s opinion of Kennedy has soured since then. In an interview with Ars last week, he said Kennedy “doesn’t have the guts” to loosen federal regulations on raw milk.

On his blog, Marler has a running tally of at least 11 outbreaks linked to the farm’s products.

In this outbreak, illnesses were caused by Salmonella Typhimurium, which generally causes diarrhea, fever, vomiting, and abdominal pain. In some severe cases, the infection can spread outside the gastrointestinal tract and into the blood, brain, bones, and joints, according to the CDC.

Marler noted that, for kids, infections can be severe. “Some of these kids who got sick were hospitalized for extended periods of time,” he said of the some of the cases he is representing in litigation. And those hospitalizations can lead to hundreds of thousands of dollars in medical expenses, he said. “It’s not just tummy aches.”

This post has been updated to include the response from CDPH.

Photo of Beth Mole

Beth is Ars Technica’s Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes.

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