Health News

Cantaloupes linked to deadly salmonella outbreak in 34 states, CDC reports new hospitalizations

Kinga Krzeminska/Getty Images

(NEW YORK) -- The Centers for Disease Control and Prevention is warning consumers about a multistate salmonella outbreak linked to some cantaloupes.

The CDC published another food safety alert on Friday, after multiple retailers and brands -- including Trufresh, Crown Jewels Produce, Vinyard Fruit and Vegetable Company, CF Dallas, ALDI and Pacific Trellis Fruit -- issued recalls for both whole and pre-cut cantaloupes.

The cantaloupes were sold by some retailers with labels or stickers that read "Malichita" or "Rudy," and by others in clear containers or cups, pre-cut or sliced into cubes. (More specific information is included below.)

The CDC also released investigation details citing epidemiologic and laboratory data that showed "cantaloupes are contaminated with Salmonella and are making people in this outbreak sick." Canada is also investigating the outbreak, the CDC said, and "has linked illness ... with the same Salmonella strain to cantaloupes."

As of time of publication, there have been 117 reported illnesses, 61 hospitalizations and two deaths across 34 U.S. states connected to the outbreak, according to the CDC.

The two deaths were reported in Minnesota.

The agency said the illnesses were reported between Oct. 17 and Nov. 10, however the CDC noted the number of people with illnesses connected to the outbreak is likely higher than current figures suggest.

"Recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak," the CDC stated. "The true number of sick people in this outbreak is also likely much higher than the number reported. This is because many people recover without medical care and are not tested for Salmonella."

Several brands and retailers have initiated outbreak-related cantaloupe recalls so far.

Whole cantaloupes

Last week, Trufresh, operating under parent company Sofia Produce LLC., expanded an earlier Nov. 8 recall to include all Malichita brand and Rudy brand whole cantaloupes sold between Oct. 10 and Nov. 3. The affected products were distributed directly to states including Arizona, California, Connecticut, Maryland, Missouri, Montana, Nevada, New Jersey, New York, Oregon, Pennsylvania, Tennessee, Utah, Illinois, Michigan, Wisconsin, Texas and Florida, as well as Canada.

On Nov. 22, Crown Jewels Produce also recalled Malichita brand whole cantaloupes that were distributed to retailers and wholesalers in Ohio and California and sold between Oct. 31 and Nov. 9 due to possible salmonella contamination, according to a company announcement on the FDA website.

Pacific Trellis Fruit issued a similar recall on Nov. 24. According to a company announcement on the FDA website, the recall involves "4,872 cases of Malichita brand whole cantaloupe" packed in corrugated cartons and distributed between Oct. 18-26 in California, Illinois, Oklahoma, Texas and Wisconsin, and sold in various retail supermarkets.

Whole cantaloupes included in the above recalls "might have a sticker that says 'Malichita' or 'Rudy,' with the number '4050,' and 'Product of Mexico/produit du Mexique,'" according to the CDC.

Sliced or pre-cut cantaloupe products

In coordination with Sofia Produce, CF Dallas voluntarily recalled pre-cut fruit products sold under the Freshness Guaranteed and RaceTrac brand names that may have contained the recalled cantaloupes. The affected products were packaged in clear square or round plastic containers with best-by dates between Nov. 7-12. The products were sold in Illinois, Indiana, Kentucky, Louisiana, Michigan, North Carolina, Ohio, Tennessee, Texas and Virginia.

In a statement on the FDA website, CF Dallas noted that the "fresh-cut fruit products associated with the recalled whole cantaloupe have expired, however consumers who have purchased these items and may have frozen them for later use are urged not to consume the products and to dispose of them immediately or return the items to their local store for a full refund."

Vinyard Fruit and Vegetable Company, located in Oklahoma City, issued a recall earlier this month on pre-cut cantaloupe, which included cantaloupe cubes, melon medleys and fruit medleys that were sold in Oklahoma stores between Oct. 30 and Nov. 10. A company statement on the FDA website notes that the recall was issued in relation to the earlier Sofia Produce whole cantaloupes recall.

On Nov. 14, ALDI issued a recall in association with Sofia Produce on both whole cantaloupe and pre-cut fruit products in clamshell packaging with best-by dates between Oct. 27-31 that were sold in ALDI stores in Illinois, Indiana, Iowa, Kentucky, Michigan and Wisconsin. Click here for full recall details.

"Investigators are working to identify any additional cantaloupe products that may be contaminated," the CDC said in its food safety alert on Friday.

If you can't tell if your cantaloupe was impacted by the current recalls and food safety alert, throw it away and do not consume it. The CDC has advised people to wash items and any surfaces that may have come into contact with the fruit "using hot soapy water or a dishwasher," and to "call your healthcare provider if you have any ... severe Salmonella symptoms."

Symptoms and treatment of salmonella sickness

Salmonella is a bacteria that can make people sick, and most types cause an illness called salmonellosis, according to the CDC.

Most people with salmonellosis experience symptoms such as diarrhea, fever and stomach cramps, which may occur hours to days after infection, the CDC states, though some do not develop symptoms for several weeks.

Infections are diagnosed through lab testing. Most people recover within four to seven days without antibiotics, according to the CDC. Antibiotic treatment is recommended for people with severe illness, those with weakened immune systems, adults 50 and older with medical issues like heart disease, as well as infants, and adults older than 65, the agency states.

An earlier version of this story was originally published on Nov. 27, 2023

 

Copyright © 2023, ABC Audio. All rights reserved.


No link to foreign country with pneumonia outbreak in Ohio county: Medical director

ATU Images/Getty Images

(MASON, Ohio) -- A county in Ohio has recorded 142 cases of pediatric pneumonia since August, caused by a mix of known infections, including common cold, strep and a bacterial infection called mycoplasma pneumonia, according to a press release from the Warren County Health District.

"We do not think this is a novel/new respiratory disease but rather a large uptick in the number of pneumonia cases normally seen at one time," the release stated.

Some European countries have reported an uptick in respiratory illness cases, including mycoplasma pneumoniae infections, in recent weeks, according to local health agencies.

Recently, China has also been dealing with a surge of respiratory illnesses among children, according to the World Health Organization (WHO). The uptick has been partly attributed to the removal of pandemic restrictions leading to a resurgence of known viruses and bacteria, health authorities have insisted.

"There is zero evidence that what we're seeing in Warren County has any connection to any respiratory activity in the state, in the country, or in the world," Dr. Clint Koenig, the medical director of Warren County Health District told ABC News.

Bacterial infections like mycoplasma pneumonia tend to flare up in cyclical patterns, rising every few years. Viruses like influenza, RSV, and the common cold follow similar trends on an annual basis with cases typically rising in colder months.

"Despite the headlines that we're seeing in China, there is no indication that there are any new viruses or bacteria spreading from country to country," said Dr. John Brownstein, chief innovation officer at Boston Children's Hospital and an ABC News Contributor.

"This is typical seasonal bacterial and viral activity that we see each year," he added.

"Based on our provisional assessment, we are seeing seasonal trends. Nothing is appearing out of the ordinary, but we are continuing to monitor," said a spokesperson from the Centers for Disease Control and Prevention.

Only a few of the 142 pneumonia cases have been confirmed as mycoplasma pneumonia, according to Koenig. He points out that providers typically don't test for every virus and bacterium, making it difficult to determine which pathogens are dominating.

So far, there have been some hospitalizations including patients with underlying conditions but no reported deaths, Koenig said.

"The vast, vast majority" are getting better and returning to school, he added.

A spokesperson from the CDC told ABC News that it's continuing to monitor respiratory illness activity across the country and remaining in touch with private labs regarding testing of bacterial illnesses.

"Based on our provisional assessment, we are, at this point, seeing activity that is typical for the season, but we are continuing to monitor," a spokesperson from the federal agency shared in part of a statement.

Health officials continue to recommend that everyone over the age of six months old get an updated COVID-19 vaccine and their annual flu shot.

Older adults over the age of 60 are also eligible for an RSV vaccine to protect against severe illness and death. An RSV vaccine is also available to pregnant women to protect newborns as well as a shot for infants under the age of 8 months.

Those with respiratory illness symptoms such as fever, cough or sore throat should stay at home, get tested, and seek treatment, according to the CDC.

"As we approach the holiday season when many of us will be gathering together with family and friends, please remember to take necessary precautions to protect your health: wash your hands, cover your cough, stay home when ill, and stay up to date on vaccines," the Warren County release stated.

Copyright © 2023, ABC Audio. All rights reserved.


Suicides by firearm reach all-time high, rising 11% since 2019: CDC

Mats Silvan/Getty Images

(NEW YORK) -- Suicides by firearm have reached an all-time high, increasing 11% between 2019 and 2022, according to a new report from the Centers for Disease Control and Prevention (CDC), published Thursday.

An estimated 27,024 Americans died of suicide by firearm in 2022, compared to 23,941 people in 2019.

All race/ethnicity groups saw firearm suicide rates increase from 2019 to 2022, with American Indian and Alaska Native people experiencing the highest rate increase, at 66%.

The highest firearm suicide rates in 2022 were observed among white people, followed by American Indian and Alaska Native people. All other race/ethnicity groups, including Asian or Pacific Islanders, Black and Hispanic people, all had rates in 2022 half or less the rate of those top two groups. The report did not include breakdowns by sex or age.

Researchers suggest promoting secure firearm storage, as well as providing counseling and social services, as ways to potentially help reduce firearm suicides. In general, strategies to reduce suicide risk also include "fostering positive social connections, identifying and supporting persons at risk, and addressing underlying inequities in economic security and housing," according to the CDC report's authors.

The new CDC report follows a similar one released earlier this week by the federal agency showing that the total number of suicides reached a new record high of 49,449 in 2022, a 3% increase from the 48,183 seen in 2021.

In the past two decades, overall rates of suicide have increased by about one-third, over half of which were firearm suicides.

The proportion of suicides being carried out by firearm has been increasing since 2006, according to previous research. About 90% of suicides are carried out via firearm, suffocation, and overdose or poisoning.

Experts believe that the pandemic may have exacerbated known risk factors for depression and suicide such as social isolation and relationship stressors, as well as substance abuse.

An estimated 12.3 million adults have seriously contemplated suicide, with 3.5 million having made a plan and 1.7 million attempting suicide, according to CDC data from 2021. Suicide remains a leading cause of death in the United States, with one death every 11 minutes.

If you or someone you care about is struggling with thoughts of suicide, text or call the Suicide and Crisis Lifeline at 988. Free help is available 24/7.

Copyright © 2023, ABC Audio. All rights reserved.


Gen Z, millennial women face historic headwinds when it comes to their health: Report

The Good Brigade/Getty Images

(NEW YORK) -- Progress in women's health since the 1960s is backsliding, with millennial and Gen Z women facing heightened risks to their physical well-being and safety compared to their moms or grandmothers, according to a report released on Thursday by the Population Reference Bureau.

The analysis, which looked at how women in their 20s and early 30s fared across generations, found that women born after 1981 are more likely to be at risk of suicide, death in childbirth and being murdered than young women in previous generations.

The findings come even as younger generations of women are also more likely to have access to better educational opportunities and higher pay than their parents, according to the report.

“Young women today are obtaining college degrees and entering the workforce in record numbers to achieve their generation’s version of the American Dream. But structural barriers to health and safety are preventing many of them from reaching their full potential,” said Diana Elliott, vice president for U.S. programs at the Population Reference Bureau.

As reasons for why millennial and Gen Z women are struggling more, the organization cited the rise of harmful social media content, the lingering impacts of the COVID-19 pandemic, increased political divisions and rising inflation. It also blamed restrictions on reproductive health access for young women, including state abortion restrictions.

The report defines millennials as born between 1981 and 1999; Gen Z are born 2000 and later.

“Increased rates of suicide and homicide, and a lack of access to health care services like safe abortion, have the combined effect of reversing the health and safety gains women of previous generations experienced, especially women of color," said Elliott.

The Population Reference Bureau, a nonprofit research organization that partners with the U.S. Census Bureau to examine issues of gender and poverty, is funded by several philanthropies like the Bill & Melinda Gates Foundation and MacArthur Foundation.

Among the most startling findings in the new report is the jump in suicide rates compared to past generations. When baby boomers were teens back in the 1960s and 1970s, for example, the suicide rate was 3 girls per 100,000. Now, Gen Z female teens experience an unprecedented rate of 5 per 100,000, according to the report.

Deaths in childbirth have also soared, the analysis found. Maternal mortality among millennial women is some 30 deaths per 100,000, compared to 19 maternal deaths per 100,000 just a decade ago.

On the upside, women are significantly more likely to get a college degree, according to the report -- nearly 44% of millennial women compared to 28% of Generation X women. Incarceration rates are also declining for the first time in 50 years among women.

Copyright © 2023, ABC Audio. All rights reserved.


Biden administration to send free COVID tests to schools nationwide this winter

SONGPHOL THESAKIT/Getty Images

(NEW YORK) -- In another effort to get Americans to test for COVID-19 this winter, the Biden administration announced it would begin distributing tests for free to all school districts nationwide.

Schools will be able to place orders for the tests starting in early December, for delivery within about two weeks of ordering.

In a letter to schools Wednesday, the Department of Education urged schools to use the tests to try to contain the spread of COVID in the winter months.

"While the COVID-19 virus can be found year-round in the United States, infection rates are typically higher during the fall and winter months," wrote Roberto J. Rodríguez, assistant secretary at the Department of Education.

"These self-tests are easy to use and can play an important role in preventing the spread of COVID-19," he said.

The department encouraged schools to use the tests to "stock school nurses' offices and main offices with tests; to send test kits home with students or parents; or to distribute by other means to put these valuable safeguards in the hands of students, parents, and staff who need them."

The announcement comes just over a week after the administration opened up the free COVID test website for another round of ordering to all American households. The tests are all coming from the government stockpile.

The test ordering site now offers an additional four tests per household -- or eight tests per household for anyone who hasn't placed an order yet this fall.

 

Copyright © 2023, ABC Audio. All rights reserved.


Number of suicides in the US in 2022 reaches record level: CDC

xijian/Getty Images

(NEW YORK) -- The number of suicides in the United States has hit a record high, new provisional federal data shows.

In 2022, an estimated 49,449 people died by suicide, which is 3% higher than the 48,183 people who died in 2021, according to a report published early Wednesday by the Centers for Disease Control and Prevention's National Center for Health Statistics.

The suicide rate increased by 1% in 2022 to 14.3 deaths per 100,000 from 14.1 per 100,000 in 2021, marking this as the highest rate seen since 1941, according to the report.

The authors said when the final data for 2022 is collected, they expect the number of suicides to likely be higher as additional death certificates with pending causes of death are ruled as deaths by suicide.

"Reporting of suicides in particular can be delayed due to investigations regarding the cause and circumstances surrounding the death," the authors wrote.

For the report, the NCHS looked at 2022 death records received and processed as of Aug. 6, 2023, and compared it with 2021 final data.

When broken down by sex, the suicide rate for males was 1% higher in 2022 than 2021 at 23.1 per 100,000 compared with 22.8 and 4% higher for females at 5.9 per 100,000 compared with 5.7.

Among males, suicide rates declined for those ages 34 and younger and increased for those 35 and older. The report found that for females, rates fell for those ages 24 and younger and rose for those 25 and older.

Although the percentage increase was greater for females, the provisional number of suicides for males in 2022 was 39,255, nearly four times that of females at 10,194.

By age, rates for those under age 34 fell between 2021 and 2022 and increased for those aged 35 and older. The report found that the rate was highest for those aged 75 and older and lowest for those aged 10 to 14.

There were also disparities when it came to race/ethnicity. American Indians/Alaska Natives had the highest rate at 26.7 deaths per 100,000. However, the rate was 5% lower in 2022 compared with 2021 and was the only group to experience a decline in rates, although this decrease was not deemed statistically significant, according to the report.

All other race/ethnic groups experienced a 1% to 3% increase in suicide rates, but according to the report, none of these changes were deemed statistically significant either.

Suicides have been steadily increasing during the 21st century, leading to U.S. Surgeon General Vivek Murthy issuing a call to action in 2021 on a national strategy for suicide prevention as well as a youth mental health advisory.

Last year, the federal government launched the 988 Suicide & Crisis Lifeline for people to call or text if they or someone they know is experiencing a crisis.

If you are struggling with thoughts of suicide or worried about a friend or loved one, call or text the Suicide & Crisis Lifeline at 988 for free, confidential emotional support 24 hours a day, seven days a week.

Copyright © 2023, ABC Audio. All rights reserved.


US life expectancy rose in 2022 due to fewer deaths linked to COVID-19: CDC

National Center for Health Statistics, National Vital Statistics System

(NEW YORK) -- After two consecutive years of declines, life expectancy in the United States increased between 2021 and 2022, new provisional federal data shows.

Life expectancy, defined as the average number of years a person is expected to live from the time they are born, rose in the U.S. from 76.4 in 2021 to 77.5 in 2022, a report published early Wednesday by the Centers for Disease Control and Prevention's National Center for Health Statistics found.

While the increase is notable, it does not fully compensate for the loss of 2.4 years of life expectancy seen from 2019 to 2021, which was mainly due to increases in excess deaths as a result of the COVID-19 pandemic.

Prior to this increase, life expectancy had fallen to the lowest levels seen in 26 years, the data showed.

For the annual report, the NCHS looked at 2022 provisional mortality data and compared it to final 2021 data from the National Vital Statistics System.

The report found that life expectancy differed between sexes, although both saw increases between 2021 and 2022.

Males had a life expectancy of 74.8, an increase of 1.3 years, and females had a life expectancy of 80.2, an increase of 0.9 years. There was still a gap between the sexes, but it decreased to 5.4 years from 5.8.

The authors noted that between 2000 and 2010, the life expectancy between the sexes had narrowed to 4.8, "but then increased in 2020 and 2021 to levels not seen since 1996, when the difference was 6.0 years."

Life expectancy increased for every racial/ethnic group including 2.3 years for American Indians/Alaska Natives, 2.2 years for Hispanics, 1.6 years for the Black population, 1.0 years for Asians and 0.8 years for the white population.

Despite the increases, American Indians/Alaska Natives had the lowest life expectancy at 67.9 years while Asians had the highest life expectancy at 84.5 years.

Additionally, while life expectancy for Black Americans has been steadily lower than that of white Americans, the gap has been narrowing for nearly three decades, according to the report.

The report also looked at reasons for the increases in life expectancy. For the total population, more than 84% of the increase was credited due to decreases in COVID-19 mortality.

In 2021, there were approximately 460,000 COVID-19 deaths compared to approximately 244,000 COVID-19 deaths in 2022, according to CDC data.

Additionally, decreases in deaths from heart disease, unintentional injuries and cancer as well as homicides helped increase life expectancy.

The authors noted that life expectancy would have been even greater if not for increases in deaths due to influenza and pneumonia; perinatal conditions; kidney disease; nutritional deficiencies; and congenital malformations.

Copyright © 2023, ABC Audio. All rights reserved.


Cannabis use does not reduce long-term heroin use, study finds

Oksana Smith / EyeEm/Getty Images

(NEW YORK) -- People with heroin dependency don't use less of that drug if they start also using cannabis, according to a new study.

The findings cast some doubt on the idea that cannabis might help people reduce their dependence on opioids, experts say.

"Cannabis is becoming increasingly recognized as a therapeutic product," says study author Dr. Jack Wilson, a researcher at The Matilda Centre for Research in Mental Health and Substance Use at the University of Sydney.

But it may not be therapeutic in this specific case.

"Despite suggestions that cannabis may be used as a method for reducing opioid use, we found no evidence to suggest a relationship between the use of these [substances]," said Wilson.

The opioid epidemic in the United States is worsening, with the Centers for Disease Control and Prevention reporting over 80,000 deaths in 2021. In response to this crisis, states like New York and Illinois have amended their medical marijuana laws in recent years, now permitting the use of cannabis as an alternative to prescription opioids.

This legislative shift is the result of growing discussions about the potential role of cannabis in reducing opioid dependency, but research over the years has yielded mixed results.

"Increasing the availability of cannabis is unlikely to have an impact one way or the other on the opioid crisis and overdose death rate," said Dr. Andrew Saxon, a professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, and a member of the American Psychiatric Association's council on addiction psychiatry.

In this new study, researchers studied over 600 patients with heroin dependency, including those who both were and were not in treatment. Further, they inquired about the subjects' use of heroin and other drugs, including prescription opioids.

Unlike earlier studies that only looked at the short-term effects of both cannabis and opioid use, this study interviewed participants over a 20-year period.

The study found that cannabis use was very common among those who were dependent on heroin. However, there wasn't a consistent relationship between the patterns of use of the two drugs, and no evidence to suggest that cannabis use reduced long-term opioid use.

Doctors are still trying to understand how cannabis use impacts opioid use, and vice versa, says Dr. Stephanie Widmer, a medical toxicologist and emergency medicine physician practicing in New York.

"Much more research needs to be done," she says.

The intersection of cannabis and opioid use disorders presents a complex challenge for policymakers and healthcare providers, experts say.

"Opioid use disorders are such a persistent and complex condition," says study author Wilson, in part because everyone has a unique set of psychical and psychological needs that affect their treatment plan.

"Rather than implementing policies that allow people to substitute their opioids for cannabis, it may be more impactful to design a policy that ensures that all people with opioid use disorder are accessing effective treatments early and often," Wilson says.

Copyright © 2023, ABC Audio. All rights reserved.


Women who have reported mistreatment while giving birth say CDC report validates their trauma

Cavan Images/Getty Images

(BIRMINGHAM, Ala.) -- She delivered a healthy child, but left the maternity ward traumatized and ashamed.

"The most happy moment in my life is at the same time the most terrible moment in my life because of what they did to me," said a California mother who alleges hospital staff physically restrained her against her will and coerced her into accepting interventions to expedite her delivery at a hospital last year.

"I said, 'No, I don't want to. I'm full of energy,'" said the woman, who spoke to ABC News only on condition of anonymity to protect her family's privacy. "I said, 'No.' Nobody cared."

This patient is one of a growing number of women who advocates say are challenging a culture of silence and stigma around mistreatment during pregnancy and birth. The Centers for Disease Control and Prevention says the experiences are not uncommon and may contribute to the nation's maternal mortality rate -- one of the highest among the richest countries in the world.

Earlier this year, the agency launched an awareness campaign with a notice to American health systems to be more respectful in providing maternity care. ABC News spoke with a number of women across the country who said the guidance was overdue.

"If the CDC has to tell you to respect patients' rights and to respect the medical ethics of autonomy, I think we've really gone off the rails," said Julie Cantor, a women's rights advocate and attorney who is representing Doe.

The CDC analysis of a recent survey of 2,400 new mothers includes reported cases of ignored requests for help; being shouted at or scolded; violations of physical privacy; and threats to withhold treatment, or made to accept unwanted treatment.

"This mistreatment is very troubling," said CDC Chief Medical Officer Dr. Debra Houry in an interview. "This is why we need hospital systems, providers and communities to really be aware of this, because there's many things we can do."

Houry says cases of mistreatment are especially concerning at a time when maternal deaths in the U.S. are on the rise, especially among Black and Hispanic women. In 2021, the latest year for which data is available, 1,205 women died of maternal causes in the U.S. with a rate of 32.9 deaths per 100,000 live births -- up from a rate of 23.8 in 2020 and 20.1 in 2019, according to CDC data. Black and Hispanic women had higher rates in 2021, at 69.9 per 100,000 and 28 per 100,000, respectively. That's compared to 26.6 per 100,000 for white women.

"Potentially, in a stressful moment, there can be unconscious bias that comes out," Houry said. "This is why we need to be more cognizant of it and make sure that women feel empowered to come forward as well when they're experiencing this."

Mistreatment in maternity care, while not a new phenomenon, has historically been underreported and unaddressed, advocates for pregnant persons say. Some women say they are reluctant to raise concerns with providers, especially after an otherwise successful pregnancy.

"Cases are generally very hard to litigate and they're expensive, and so one of the issues that is a cultural phenomenon is, 'Well, if the mom's harmed, but the baby's fine, why is that worth any money?'" said Cantor. "It's a system that's built around moving money, not just fixing problems."

In 2016, the case of Caroline Malatesta of Birmingham, Alabama, helped put mistreatment of birthing persons in the national spotlight.

A jury delivered Malatesta a landmark $16 million judgment in her favor after claims of medical negligence and reckless fraud against Brookwood Baptist Medical Center, where she delivered her fourth child.

After devising a natural birth plan with her doctor that emphasized autonomy and freedom of movement, Malatesta said she was subjected to physical restraint.

"They pulled me to my back, flipped me over, and I remember the pressure on my back being so intense that I lifted my right leg and even pushed against the nurse's [hair net], just trying to fight to get back over," she said in an interview.

"The hard part came after, when everything's quiet, everyone goes away, and there's a sense of betrayal," Malatesta said. "I know that sounds unusual, but you have put your trust in these doctors, into this -- these people who are supposed to be looking out for your care."

In the months that followed, Malatesta says numbness turned into debilitating pelvic nerve pain and PTSD. All of it taking a toll on her ability to parent and on her relationship with her husband.

"One of the biggest roadblocks is that women feel like, 'Well, if I talk about what happened to me, it shows I'm just selfish because I wanted my birth to be a certain way when really I should have been thinking about the safety of the baby,'" said Malatesta. "Women have these birth plans because they care about the safety of their babies."

The jury's decision in Malatesta's case might have been rare, but instances of birth trauma are not, public health experts and pregnancy advocates told ABC News.

"I've heard thousands of those stories," said Cristen Pascucci, a birth advocate in Kentucky who supported Malatesta through the trial and whose site, Birth Monopoly, archives stories of mistreatment nationwide.

"There's a lot of gaslighting that goes on when anybody has anything to say about their birth other than 'it was beautiful,' 'it was wonderful,' 'it was great,'" Pascucci said. "But the bottom line is mistreatment is not necessary for safety."

Kimberly Turbin of Los Angeles, whose traumatic 2014 hospital delivery of her son has more than a million views on YouTube, said each woman's experience is unique.

"A lot of obstetric violence can be very kind. You don't even know you're being done a disservice because obstetric violence doesn't always look like my horrific birth video," said Turbin.

As her own mother recorded the scene with a cellphone, Turbin is heard questioning the need for an episiotomy, a cut made to the vaginal area to ease delivery, which she says her doctor then performed against her will.

"He doesn't tell me what my options are. He never mentions that the baby or I am in distress," Turbin said. "I'm getting a contraction. He comes near me with the scissors and starts slicing up my vagina 12 times."

After speaking with more than 80 attorneys who declined to take her case, Kimberly filed a lawsuit against her doctor on her own; she settled her case in 2017 and now helps other women seek justice.

The American College of Obstetricians and Gynecologists (ACOG) says a pregnant patient's autonomy should be a doctor's top priority, saying "it is never acceptable" for a provider to use "duress, manipulation, coercion, physical force or threats" to compel a recommended treatment for a patient or unborn child.

While life-or-death emergencies often require urgent medical intervention, ACOG says "it is imperative that pregnant and postpartum patients feel comfortable communicating" their wishes.

"Listen to your patients when they tell you they have questions. Listen to them when they have concerns about what's going on. And, listen to them when they say 'no.' You cannot force care on people," Cantor said.

The CDC says women should feel empowered to speak up about concerns with their experience in the maternity ward and that providers should be more sensitive to them.

"Certainly training helps to understand what are some of those biases that we all have," Houry said.

Training medical professionals is something Pascucci, the CDC, and women's health advocates are working to expand, but many say there also needs to be a fundamental shift in how society thinks about birthing persons at their most vulnerable moment.

"We can't keep saying, 'Well, this is just, you know, this must just be how it has to be.' It doesn't have to be this way. It does not have to be this way," Pascucci said. "It's just a matter of making the decision to change what we do."

Copyright © 2023, ABC Audio. All rights reserved.


What to know about the respiratory illnesses surging in some parts of China

ATU Images/Getty Images

(NEW YORK) -- A surge of respiratory illnesses related to flu, respiratory syncytial virus (RSV) and other infections has been sweeping across some parts of China and mainly infecting children, as the country experiences its first full winter since easing COVID-19 restrictions.

Amid media reports of "undiagnosed pneumonia" cases overwhelming hospitals over the past few weeks, health authorities have insisted that the uptick is linked to common illnesses.

Since May, China has been experiencing an increased number of children sick with mycoplasma pneumoniae – bacteria that causes mild infections of the respiratory system – as well as pediatric cases of RSV, adenovirus, influenza and COVID-19 since the fall, according to the World Health Organization (WHO).

Last week, the WHO submitted an official request to China for information on "an increase in respiratory illnesses and reported clusters of pneumonia in children."

No new viruses or unusual conditions have been identified, according to Mi Feng, spokesman for China's National Health Commission, who spoke at a press conference on Sunday.

"According to the analysis, acute respiratory diseases in China have continued to rise recently, which is related to the superposition of multiple respiratory pathogens," he said.

Mi Feng said that with the coming of winter and the increased number of respiratory illnesses, China's National Health Commission and the National Administration of Disease Control and Prevention are continuing to monitor these diseases, promote vaccination, dispatch medical resources, and make sure people receive treatment.

Following a meeting with local health authorities, the WHO noted that while the increase was earlier in the season than unusual, it was "not unexpected given the lifting of COVID-19 restrictions, as similarly experienced in other countries."

Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children's Hospital and an ABC News contributor, agreed with the WHO assessment that the surge is likely due to the lifting of COVID-19 restrictions. "These known pathogens are causing a rise in cases, particularly among children, but there have been no reports of unusual or novel viruses, and hospital capacities remain manageable," he said.

When COVID-19 began spreading across the world in January 2020, China initiated some of the harshest restrictions anywhere in an attempt to prevent outbreaks. Known as the "zero COVID" policies, they included lockdowns and mass testing. The country officially lifted its zero COVID policies in January 2023, and ended the last of its primary pandemic-era measures this past summer.

Brownstein said a seasonal increase in respiratory illnesses occurring as COVID-19 restrictions are being lifted is not exclusive to China, but is something seen globally. When the U.S. lifted many restrictions last year it experienced a very similar pattern, with most states reporting high levels of flu-like activity.

"The co-circulation of respiratory viruses and bacteria during the colder months often places additional burden on healthcare facilities, making it crucial for public health measures, including vaccination and enhanced surveillance, to be in place to manage these expected spikes in respiratory cases," Brownstein said.

Photos and videos have shown overcrowded areas at hospitals in China, including Beijing Children's Hospital. Reported cases among children are especially high in northern areas like Beijing and Liaoning province, where hospitals are warning of long waits to be seen.

Mi Feng said hospitals in densely populated areas with long wait times can lead to a risk of cross-infection, and urged parents to instead take their children, if they have mild symptoms, to grassroots medical and health institutions or general hospitals for pediatric care.

He also advised people to follow known and proven mitigation measures, including wearing masks, increased ventilation, and frequent hand washing.

On Sunday, China's health ministry also urged local authorities to increase the number of fever clinics.

ABC News' Karson Yiu contributed to this report.

 

Copyright © 2023, ABC Audio. All rights reserved.


Protecting babies from RSV this holiday season: What parents need to know

Jose Luis Pelaez Inc/Getty Images

(NEW YORK) -- A record number of people are expected to travel during the upcoming holiday season, starting with Thanksgiving -- just as respiratory illnesses are rising around most of the United States.

Currently, kids under 5 years old are being hospitalized with respiratory illnesses at a higher rate than any other age group, according to the Centers for Disease Control and Prevention. One of the most common types of respiratory viruses that circulates this time of year is called respiratory syncytial virus, or RSV.

"RSV is a very common virus. Most children in the United States get infected by the time they're 2 years of age," Dr. Jeffrey Kahn, chief of infectious diseases at Children's Health, Dallas, and professor of pediatrics at the University of Texas Southwestern Medical Center, told ABC News.

Even though exposure to RSV may be inevitable in a child's early life, families can take steps to minimize its effects this holiday season. Experts say avoiding people who are sick, good handwashing, getting preventive shots and breastfeeding all minimize the risk of severe complications from RSV for babies.

Here's what you need to know to help protect your child from RSV this season:

Thousands of kids a year are hospitalized with RSV

RSV is the most common cause of bronchiolitis, a breathing problem that affects young children. It's caused by inflammation in the smallest airways of the lungs that leads to mucous buildup, making it hard for babies to breathe, according to the CDC. In severe cases, infants may need to be hospitalized for breathing support or they may not be able to eat properly, leading to dehydration. Each year, RSV is responsible for 58,000-80,000 hospitalizations and between 100 and 300 deaths in children less than 5, the CDC says.

Among all age groups, babies less than 6 months old are at the highest risk of being hospitalized with RSV, especially those under 3 months old, according to the CDC. Babies who were born prematurely, or those with underlying heart, lung or neuromuscular problems, are also at high risk.

Doctors say that people visiting babies should consider wearing a mask during or after traveling, should wash their hands before holding a baby and, if someone is sick, they should stay away while having symptoms.

New preventive RSV shots are available

"For the first time in decades, really, maybe since the virus was discovered, we have some very useful tools now to prevent RSV infection," Kahn said.

There are three new preventative RSV products this season, giving doctors four total options against the disease. Doctors say they hope these shots can help turn the tide against severe RSV cases.

There are two protective shots available for babies, and both contain antibodies against the virus. Nirsevimab is new this season, while palivizumab has been on the market for nearly two decades.

Nirsevimab is a single seasonal shot for all babies less than 8 months old and some other high-risk kids up to 19 months old. Palivizumab is a monthly injection given in October through March to children less than 2 years old who have certain high-risk health problems and meet specific criteria.

There is currently a supply shortage of nirsevimab, so the CDC is encouraging that it only be given to babies less than 6 months old and some other high-risk kids who don't qualify for palivizumab this season.

There are also two RSV vaccines available for adults 60 and older. Additionally, Pfizer's RSV vaccine is also recommended for pregnant people in the third trimester to protect babies. When this shot is given at least two weeks before birth, it passes on about six months of protection to the newborn.

"If you're an older person, or pregnant, you need to remember that vaccinating yourself could go a long way to protecting our youngest, most at risk," Dr. Julia Arana, medical director of the hospitalists team and chief of staff at East Tennessee Children's Hospital, told ABC News.

Breastfeeding has a protective effect against severe RSV

Breastfeeding isn't an option for all parents, as some may choose not to breastfeed or cannot breastfeed for a variety of reasons. But for those who do, a number of research studies have shown that breastfed babies are less likely to have complications of RSV. Experts believe this may be because components in breast milk help boost a baby's immune system for added RSV protection.

"Breastfeeding clearly decreases the baby's chance of having to have an outpatient visit or go to the hospital or worse, go to the intensive care unit," Dr. Paul Offit, director of the vaccine education center and pediatrician in the division of infectious diseases at Children's Hospital of Philadelphia, told ABC News.

Some babies may still need to seek care

Despite best efforts, some babies may still need medical care.

Doctors say any baby who is struggling to breathe, has difficulty waking up, or has blue discoloration of the face or lips needs to be evaluated by a medical professional right away. Parents should also get medical help if their baby isn't feeding well or has signs of dehydration, such as dry lips or few wet diapers, according to the CDC.

Fever in some babies can also be a medical emergency, even if they appear to be well, so parents should talk to their pediatrician about when to seek care for a fever based on an infant's age.

While there's no specific treatment for RSV, hospitals can support babies through the illness with things like oxygen and IV fluids.

Dr. Jade A. Cobern, M.D., M.P.H., is a pediatrician, specialized in preventive medicine, and a member of the ABC News Medical Unit.

 

Copyright © 2023, ABC Audio. All rights reserved.


Abortion rates in US increased by 5% in 2021, the final year it remained a constitutional right under Roe: CDC

Stephen M. Dowell/Orlando Sentinel/Tribune News Service via Getty Images

(NEW YORK) -- Abortion rates increased by 5% in the United States in 2021, the final year the procedure remained a constitutional right under Roe v. Wade, according to new federal data.

In 2021, there were 625,978 abortions reported, according to an annual report published Wednesday by the Centers for Disease Control and Prevention (CDC). This is a rate of 11.6 abortions per 1,000 women between ages 15 and 44.

This is a decrease from a decade earlier when there were 669,202 abortions reported in 2012 with a rate of 13.1 per 1,000 women. However, it is up from the 620,327 abortions reported in 2020 with a rate of 11.1 per 1,000 women.

The report also looked at some demographics of who is receiving abortions in the U.S. In 2021, women in their 20s accounted for more than half of abortions at 57%.

Comparatively, adolescents under age 15 and adults aged 40 and older made up the lowest percentages of abortions at 0.2% and 3.6%, respectively.

The authors also noted the percentage changes may show the continuing decrease in adolescent pregnancies in the United States.

"From 2012 to 2021, national birth data indicate that the birth rate for adolescents aged 15–19 years decreased 53%, and the data in this report indicate that the abortion rate for the same age group decreased 41%," they wrote. "These findings highlight that decreases in adolescent births in the United States have been accompanied by large decreases in adolescent abortions."

There were also significant racial/ethnic disparities in abortion rates. Black women were the most likely group to obtain an abortion at 41.5%. White women were the second most likely group at 30.2% and Hispanic women were the third most likely at 21.8%.

In other terms, white women had the lowest abortion rate at 6.4 abortions per 1,000 women and Black women had the highest abortion rate at 28.6 abortions per 1,000 women.

The report also found that most patients getting an abortion have already had children.

When looking at what stage of pregnancy abortions were occurring in, the report found that an overwhelming majority occurred before 13 weeks' gestation, which is around the beginning of the second trimester.

Data showed 80.8% occurred at 9 weeks' gestation or earlier and 93.5% occurred before 13 weeks' gestation.

Additionally, 53% of those first-trimester abortions relied on medications. Medication abortions are a non-surgical form of abortion in which someone usually takes two pills to end a pregnancy.

Experts have previously stated that few abortions happen in the second and third trimesters and the data showed just that. Just 5.7% of abortions occurred between 14 and 20 weeks' gestation and 0.9% occurred at or after 21 weeks' gestation.

The CDC did not include data in the report about why patients opt for abortions at various stages of pregnancy.

However, the federal health agency said there are many reasons that determine the incidence of abortions including "access to health care services and contraception; the availability of abortion providers and clinics; state regulations, such as mandatory waiting periods, parental involvement laws, and legal restrictions on abortion providers and clinics; and changes in the economy and the resulting impact on family planning decisions and contraceptive use."

Copyright © 2023, ABC Audio. All rights reserved.


How to stay safe over Thanksgiving as respiratory virus activity ticks up in parts of the US

Thana Prasongsin/Getty Images

(NEW YORK) -- Millions of people are getting ready to gather with their family and friends for Thanksgiving, celebrating the holiday in a way that most closely resembles pre-pandemic ways for the first time in more than three years.

However, respiratory illness activity -- defined as people going to the doctor with symptoms of any respiratory illness such as fever, cough or sore throat -- is increasing across some areas of the United States, according to the latest data, updated Friday by the Centers for Disease Control and Prevention (CDC).

Additionally, emergency department visits due to flu, COVID and RSV are increasing. Hospitalizations for flu and COVID are increasing, but remain lower than the same time last year. RSV hospitalizations are increasing in areas tracking new admissions.

Experts said there are a few well-known mitigation measures you can follow to keep yourself and your loved ones safe during the holidays.

"There are safe and effective ways to prevent the bad outcomes of these diseases and it relies very much on the ABCs, staying up to date with vaccinations, testing yourself, staying home if you're sick, contacting your primary health care provider if you test positive to know if you're eligible for getting treatments, and then doing the everyday things to protect your loved ones," Dr. Albert Ko, a professor of public health, epidemiology and medicine at Yale School of Public Health, told ABC News.

Exercise caution when traveling

While most people will be traveling by car, AAA projects 4.7 million travelers will fly over Thanksgiving, which would be the highest number since 2005.

There will also likely be millions of people traveling by train or by bus to holiday gatherings.

Although it is not required by any transportation companies, experts said people may consider wearing well-fitting masks, that cover their noses and mouths, if they are in crowded or poorly ventilated areas.

This is coupled with good hand hygiene, including washing hands with warm water and soap for at least 20 seconds, or using hand sanitizer when hand washing isn't available.

However, the most important thing someone can do is stay home when sick, said Dr. Perry Halkitis, dean and professor of biostatistics and urban-global public health at Rutgers School of Public Health.

"The number one responsibility that we all have is that if we're feeling ill or slightly feeling ill or even beginning to feel ill, that we question whether or not we should travel," he told ABC News. "The number one thing that I would encourage people to do, if you're feeling ill, if you are potentially infectious, try not to go into large crowds, into situations where you can infect people."

Be up to date on vaccinations

Experts say one of the best ways that people can best protect themselves is to stay up to date on vaccinations.

For COVID-19, there is an updated vaccine formulated to target variants currently circulating that are related to XBB, an offshoot of the omicron variant, for those aged 6 months and older.

Halkitis said he often has conversations with people who ask why they should get the updated vaccine when they already got the primary series. He replies that it's similar to the flu vaccine, which is updated every year to target circulation.

For the majority of those aged 6 months and older, the CDC recommends receiving the standard quadrivalent flu vaccine, which protects against four different strains of the virus. High doses are available for those aged 65 and older.

For adults over age 60, two vaccines are available. For babies under 8 months old, and some babies between 8 months and 24 months, there are two monoclonal antibody shots available. The right one depends on a child’s age and underlying health conditions. People can also get an RSV vaccine during pregnancy that protects their infant after birth.

"As we're going into this winter season, we're actually getting back to normal," Ko said. "So, getting back to normal means that we're going to be having, during the winter season, increases in many of the respiratory diseases that we had in the past, and we have ways to immunize people against many of these threats that we're going to face in the winter."

Consider taking a rapid test

Currently, rapid at-home tests are available for COVID-19. Tests for flu and RSV require visiting a health care provider.

Experts told ABC News that people should take a rapid test before attending a gathering if they are experiencing symptoms. If it's positive, stay home and follow CDC isolation guidelines. If it's negative, you should not necessarily assume you don't have COVID and should consider taking another test 48 hours later.

Ko said that people can also consider taking a test if they will be gathering with people at high risk for severe complications from COVID-19, including those who are elderly, having underlying conditions or who are immunocompromised.

Open windows or doors for ventilation

Experts said that, if it's possible and not too cold, to host Thanksgiving outdoors. If that's not possible, they suggest opening windows and doors for ventilation.

The CDC says that improving ventilation can reduce virus particles in the home to keep respiratory diseases, such as COVID-19, from spreading.

"Ventilation is an important way that we can control infections," Ko said. "Not all infectious diseases are the same. They're not all transmitted in the same way … Ventilation is particularly important in those types of diseases where we have a lot of aerosol transmission and COVID is one good example."

Another option is buying air filters, particularly high efficiency particulate (HEPA) air filters. HEPA filters can remove at least 99.97% of airborne particles, according to the Environmental Protection Agency.

Importance of staying vigilant

Halkitis said over the last year or so, he has seen, from many people, a tendency to want to go back to the way things were prior to COVID-19.

"That's okay because there are vaccines available for several of these respiratory viruses," he said. "The problem, of course, is that the uptake of [some of] these vaccines is dismal at best and, as a result, going back to normal, when you've added COVID-19 to the mix and RSV to the mix, above flu and the common cold, creates a condition where a lot more people are going to get sick."

CDC data currently shows that hospital bed occupancy and capacity remain stable, but the more people that get sick and need medical care, the more a burden is placed on the health care system, Halkitis said. He said it's important to stay vigilant when it comes to preventing the spread of illnesses.

"If you look at the numbers, all of the numbers are moving in the wrong direction. There's increases in RSV, there's increases in flu, there's increases in COVID," he said. "So, keep your eyes on what's happening with the trends and make your decisions about where to go and what to do based on what you're seeing. Let the science direct your behavior."

Copyright © 2023, ABC Audio. All rights reserved.


How drugs like Ozempic, Mounjaro could transform holiday dinners like Thanksgiving

GMVozd/Getty Images

(NEW YORK) -- When Tara Rothenhoefer sits down at the Thanksgiving table this year, she said she envisions being able to enjoy herself rather than feel stressed about the food on the table.

Rothenhoefer said she attributes that change to Mounjaro, a medication that she said has helped her lose more than 200 pounds.

Prior to taking Mounjaro, Rothenhoefer said at a holiday like Thanksgiving, centered around a big meal, she would be worried about being able to "make good choices" when it comes to food.

"You're just really focused on the food as a whole rather than the holiday," Rothenhoefer told ABC News' Good Morning America, adding of the change she's seen since starting the medication, "I've been able to turn that fear and anxiety into more enjoyment and making sure that you know, I'm still eating the foods that I enjoy. I'm just making sure that I'm not eating as much."

Likewise, Joe Sapone, who has lost more than 100 pounds on Mounjaro, told GMA that for him, gathering at holidays like Thanksgiving is now more about the company he's around than the food.

"My enjoyment has not really decreased," he said. "Because it's as much about being with family and friends as it is about eating food."

Mounjaro and other drugs used for weight loss like Ozempic and Wegovy have skyrocketed in popularity over the past year as they have proven successful in changing some people's eating habits and helping people who are overweight and obese lose weight.

Clinical studies show users of the medications can lose between 5% and 20% of their body weight on the medications over time.

The active ingredient in Mounjaro, tirzepatide, works by activating two naturally produced hormones in the body: glucagon-like peptide-1, known as GLP-1, and glucose-dependent insulinotropic polypeptide, or GIP. The combination is said to slow the emptying of the stomach, making people feel full longer, and suppress appetite by slowing hunger signals in the brain.

Mounjaro -- made by Eli Lilly and Co. -- is approved by the U.S. Food and Drug Administration to treat Type 2 diabetes. Earlier this month, the FDA approved the drug Zepbound to treat obesity, which contains the same active ingredient, tirzepatide, as Mounjaro.

The drug is similar to semaglutide, the active ingredient in the medications Ozempic and Wegovy -- both made by Novo Nordisk -- but works slightly differently because it targets two hormones involved in blood sugar control rather than just one.

Ozempic is currently approved by the FDA as a treatment for Type 2 diabetes alongside diet and exercise if other medications cannot control blood sugar levels well enough.

Wegovy is essentially the same injectable drug as Ozempic prescribed at a higher dosage. The FDA has specifically approved Wegovy for patients with severe obesity, or who are overweight and have one or more weight-associated conditions like high blood pressure or high cholesterol.

Possible side effects of all three medications -- Mounjaro, Ozempic and Wegovy -- include nausea and stomach pain.

Dr. Katherine Saunders, clinical assistant professor of medicine at Weill Cornell Medicine in New York City, said people who are taking medications used for weight loss should be prepared to manage their expectations when it comes to big holiday meals, like Thanksgiving.

"It doesn't completely remove the pleasure that comes from food," Saunders told GMA. "It enables people to have a couple of bites and then say, 'I don't need to eat a large portion of this. That was enough.'"

Saunders noted too that it can take time for people to adjust to eating different amounts and different varieties of foods when on medications like Ozempic and Mounjaro.

"It can definitely take some time for people to get used to eating differently and selecting food differently when they're on these medications," she said. "So, if you don't change your eating behavior, or the content of your diet at all when you take these medications, that's when people can get into trouble."

Copyright © 2023, ABC Audio. All rights reserved.


Dozens of premature infants were evacuated from Gaza. Here's the care doctors say they will need

Isabel Pavia/Getty Images

(NEW YORK) -- More than two dozen premature, low-birthweight babies have been evacuated from Gaza to Egypt to receive specialized care amid the ongoing Israel-Hamas war.

But that is only the beginning of their precarious journey back to health as they escape the conflict zone.

A joint mission between the United Nations and the Palestine Red Crescent Society, led by the World Health Organization, evacuated 31 babies from the embattled Al-Shifa Hospital in northern Gaza to Al-Helal Al-Emarati Maternity Hospital in southern Gaza over the weekend. On Monday morning, 28 arrived in Egypt, while three others who were in stable condition continued to receive care in Gaza, WHO officials said.

In total, 39 babies were removed from incubators when Al-Shifa ran out of fuel on Nov. 11. Gaza has been under siege since the Oct. 7 terror attack by Hamas in Israel, and hospitals in Gaza have run out of fuel and been bombed.

As of Monday, at least five of the 39 babies have died, including three when the power to the incubators was cut off and two prior to evacuation, according to hospital staff and the WHO. The condition of three of the premature babies who remained at Al-Shifa because they didn't need emergency care remains unclear.

Many of the surviving babies were suffering from life-threatening health conditions including dehydration, vomiting, hypothermia and sepsis because they didn't receive any medication, and had not been in "suitable conditions for them to stay alive," Mohamed Zaqout, director of Gaza hospitals, said in a statement Sunday. Hypothermia can be a problem for premature babies who cannot regulate their own body temperature and can be a sign of several types of infections. The risk of hypothermia and sepsis can increase when premature babies are removed too soon from incubators and don't have adequate access to treatment.

This is the care doctors say they will need in order to survive.

Dr. Erin Schofield, a neonatologist at the University of Maryland Children's Hospital and an assistant professor at the University of Maryland School of Medicine, told ABC News that premature infants are the most vulnerable group of people in any hospital.

"They're the most technology-dependent, they are the most resource-dependent, and even in the United States, where we have every means to take care of them, they're still the biggest utilizers of medical technology," she said. "Premature babies are a lot more fragile than people think, and keeping them warm is not just an issue of holding them or bundling them in blankets."

Premature infants need the final months and weeks in the womb to adequately develop their organs including the brain, lungs and liver, according to the Centers for Disease Control and Prevention. Doctors said premature infants have unique health needs and their lives can be at risk without the right specialized care.

When babies are born several weeks early, they often need medical equipment to "support really every organ system, and that at its basis, at its core requires electricity. It requires heat, and if they don't have those, they [can] very quickly die," Schofield said.

This care requires more than wrapping them up in a warm blanket.

"Premature babies often rely on intensive monitoring and interventions performed under constant clinical supervision given how fragile they are, particularly those born at earlier gestational ages," Dr. Nicholas Cuneo, a hospitalist in the department of pediatrics at Johns Hopkins School of Medicine, told ABC News. "Without this type of intensive care, coupled with the appropriate resources, they can be at risk of serious and disabling complications or in some cases death."

All suffering 'serious infections'

Eleven or 12 of the evacuated babies are critically ill while the others are seriously ill, according to Dr. Rick Brennan, regional emergency director of the WHO Mediterranean region. Babies who are seriously ill typically require medical treatment and hospitalization but are not yet suffering life-threatening conditions, while those with critical illness are suffering from life-threatening conditions.

"Each of them has serious infections and quite a few of them have low body temperature, so they really do need detailed specialist care," Brennan said Monday. "Overnight, they received antibiotics, supportive therapy, oxygen. We are hoping that this will help stabilize all of them." Premature babies are at increased risk of getting infections, even in ideal conditions. Incubators that provide temperature regulation help stabilize babies in a number of ways, helping reduce the risk of infections among premature babies, while early removal can have cascading effects that increase the risk of infections, including sepsis, experts said.

"These tiny, delicate humans are sensitive and any lack of medications, consistent nutrition, temperature control, or even the slightest uncontrolled infection [could] be the difference between life or death," Dr. Alok Patel, a pediatrician at Stanford Children's Health and an ABC News medical contributor, said.

"Adequate care for these patients involves a multidisciplinary health care team including neonatologists, nurses, technicians, respiratory therapists, pharmacists, social workers and more," Patel added.

A team of 10 neonatal specialists took custody of the 28 premature babies at the Rafah border crossing on Monday and moved them to hospitals in Al-Arish, the largest city on the Sinai Peninsula in Egypt, according to Brennan. One group of babies is being taken to hospitals in Cairo.

"They are all, again, seriously ill. They have a long road to go," Brennan said. "It will take a long time for many of them to recover given their current condition, but we do understand that they are getting very good care at this time."

WHO officials said the remaining three babies were in stable condition and didn't need to be transferred from Gaza for further treatment in Egypt. It's unclear if they were suffering from serious infections, as well.

'They didn't ask for this'

Even transporting the premature babies to a safer area can exacerbate some of the health conditions they are facing, Schofield said.

"Transport is not a benign event, and we don't want to have to transfer a fragile premature baby unless we absolutely have to, unless the benefit outweighs the risk," she said. "In this case, getting fragile premature babies out of the conflict zone, it certainly outweighs the risks."

Schofield said once the babies are in a stable environment, staff will need to check for electrolyte imbalances from dehydration, signs of continued infection and internal bleeding.

They should be placed in incubators with temperature probes to control their body temperature, Schofield said. Additionally, they may require feeding tubes if they can't eat by mouth yet, as well as regular feedings of breast milk or specifically made infant formula they may not have had access to for days.

"Premature babies ... they didn't ask for this," Schofield said. "They didn't ask to be born in a conflict zone, and I think we really owe it to them to do our best to give them the best chance at survival.

She added, "It's heartbreaking to see these babies who, if they had not been born into conflict zones, really wouldn't face many challenges, and now being born in a conflict zone adds just heaps and heaps upon them, all of these challenges that really no child should have to face, so as much as we can, limit that in their exposure to this."

Dr. Jade A Cobern, M.D., M.P.H., is a pediatrician in a neonatal intensive care unit and a member of the ABC News Medical Unit.

ABC News' Will Gretsky contributed to this report.

 

Copyright © 2023, ABC Audio. All rights reserved.