KEY FACTS

• In the report published Thursday by Addiction, researchers analyzed the health of nearly 30,000 participants with cannabis use disorder (CUD) who were then paired with adults with no CUD exposure.

• The population-based group study involved five health databases in Alberta, Canada, with researchers noting that apparently healthy people are still at enhanced risk of cardiovascular disease if they have CUD.

• CUD—which impacts around 27% to 34% of people who use cannabis—is the continued use of weed despite significant negative effects on one's life and health.

• In the study, adults with CUD—notably, those who didn’t have simultaneous mental health disorders or other chronic conditions at the same time—were more at risk for cardiovascular disease if they were not on prescription medications and had not used healthcare services in the past six months.

• The results of the study should be considered exploratory, but the researchers note the potential value in using the disease as a marker—helping users take preventive action via increased testing and screening or surveillance for cardiovascular disease in these at-risk groups.

KEY BACKGROUND

Marijuana use has significantly risen over the past decade, with 55 million Americans saying they regularly use marijuana, as it has become the most commonly used federally illegal drug in the United States. Cannabis has already been linked to serious cardiovascular events, including heart disease, heart attacks, and strokes due to the stress that cannabis can put on the heart. Smoking cannabis can raise a person’s heart rate, dilate blood vessels and make the heart pump harder—immediately after use. The drug has also been linked to mental health risks in young adults, and people who use marijuana before the age of 18 have a greater risk of developing CUD, according to the Centers for Disease Control and Prevention.

Signs of CUD include using more marijuana than intended, attempting but failing to quit using the drug, giving up key family activities in favor of using marijuana, experiencing withdrawal symptoms and more. CUD is most common in the state of Washington, where cannabis is legal.

KEY QUOTE

“It's important to emphasize that these findings are observational, and they provide insights into patterns within our dataset. However, they do not establish a direct cause-and-effect relationship,” lead author Dr. Anees Bahji, at the University of Calgary's Cumming School of Medicine, told Forbes.

SURPRISING FACT

Americans spend more on legal marijuana than they do chocolate, spending $30 billion on the drug in 2022, compared to the $20 billion they reportedly spend on chocolate, according to MJBizDaily—a Colorado-based business news outlet that reports on the cannabis industry.

TANGENT

Marijuana remains illegal at the federal level, but many states have legalized it for recreational use, and the majority allow medical use. In late August, U.S. health officials recommended moving marijuana to a lower-risk drug classification, which would bring it to a “Schedule III” group—that is, once it goes through a substantial review process from the U.S. Drug Enforcement Administration. Schedule III drugs are classified as “substances with a low to moderate potential for physical and psychological dependence,” according to the DEA, and they are easier to study.

Marijuana has long been a Schedule I substance, implying “it has a high potential for abuse” and “no currently accepted medical use in treatment in the United States,” according to the DEA. President Joe Biden supports the legalization of marijuana for medical purposes. Though Biden has not stated whether he supports legalization for recreational use, he did say in 2021 that he supports states' rights to legalize it—should they choose to do so.

FURTHER READING

• Is marijuana as safe as we think? (The New Yorker)

• Marijuana linked to mental health risks in young adults, growing evidence shows (NBC)

• U.S. regulators might loosen restrictions on marijuana. Here’s what that would mean (PBS)

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Earlier this month, state police in Connecticut held a “DNA drive” in an effort to help identify human remains found in the state. Family members of missing people were invited to submit DNA samples to a government repository used to solve these types of cases, a commercial genetic database, or both, if they chose to.

Public agencies in other states have held similar donation drives, billed as a way to solve missing persons cases and get answers for families. But the drives also raise concerns about how donors’ genetic information could be used. Privacy and civil liberties experts warn that commercial DNA databases are used for purposes beyond identifying missing people, and that family members may not realize the risks of contributing to them. In fact, one drive planned in Massachusetts this summer was postponed because of concerns raised by the American Civil Liberties Union.

So far, most of these drives have been small. A half-dozen families showed up at the Connecticut event on September 16, which was sponsored by the University of New Haven, the Connecticut State Police, the Office of the Chief Medical Examiner, and another state agency. Close relatives of missing people—their parents, siblings, and children—were invited to provide a genetic sample to the Combined DNA Index System, or CODIS. A national database maintained by the Federal Bureau of Investigation, it contains DNA profiles of convicted offenders, evidence from presumed perpetrators, and missing persons. CODIS allows investigators to compare a relative’s DNA profile to one in the database to look for a familial match, a process called genetic genealogy.

Free consumer genetic kits from FamilyTreeDNA were also distributed at the Connecticut event. Similar to its competitors 23andMe and AncestryDNA, FamilyTreeDNA allows people to connect with long-lost relatives and explore their genealogy. It’s also used by police and nonprofit organizations to trace the family trees of missing people. That might yield connections to living relatives.

“This is a really powerful tool that can have a terrific impact and get closure for families and victims of homicides and sexual assaults,” says Claire Glynn, an associate professor of forensic science at the University of New Haven, who helped coordinate the event. She says genetic genealogy is useful in instances where a close family member hasn’t provided a sample to CODIS.

But genetic genealogy isn’t used by law enforcement only to identify missing persons and human remains. It is also widely used to identify suspects in investigations. Even if a suspect has not submitted their own genetic profile to a consumer site, investigators can infer biological relationships based on how much their DNA recovered at a crime scene matches that of other users. Police use that information, along with public records, to build out a suspect’s family tree and narrow down their identity.

This investigative use of genetic genealogy has exploded since police announced in 2018 that its use allowed them to identify Joseph James DeAngelo as the Golden State Killer. By one estimate, more than 600 criminal cases have been solved using genetic genealogy. The DNA Doe Project, a California-based nonprofit, says it has used the technique to identify more than 100 deceased people. In one controversial instance last summer, DNA from a newborn’s blood-screening test was used to connect his father with a crime years later.

That’s why Natalie Ram, a law professor at the University of Maryland, cautions that, although families of missing loved ones may be desperate to get answers, it matters which DNA database they choose. Strict state and national laws govern how CODIS data can be used. Family member reference samples collected for the purpose of identifying missing persons can’t be used in other types of criminal investigations.

On the other hand, save for in a few states, consumer DNA databases are largely unregulated and can change their terms of service at any time. Currently, FamilyTreeDNA and GEDmatch both allow law enforcement to upload DNA profiles. (AncestryDNA and 23andMe prohibit this practice.) FamilyTreeDNA automatically makes new users’ profiles available for these searches, although customers can later opt out. With GEDmatch, users must proactively opt in. They can choose whether to be included in all law enforcement searches or only those involving the identification of human remains.

Ram says agreeing to these searches means users are opting not only themselves in, but also their immediate family members, and even far-flung genetic relatives. Even people who have never committed a crime could be questioned because they share a portion of DNA with a suspect. People leave behind trace amounts of DNA all the time, and genetic information found at a crime scene may not necessarily come from a perpetrator.

“If I had a missing loved one, I would feel much more comfortable contributing to the missing-persons family reference sample component of CODIS, because it is so protected and so limited in its use,” Ram says.

There’s also a risk that by taking a consumer DNA test, users will find out information about their family that they might not otherwise want to know.

There may also be a danger in handing over a DNA sample intended for CODIS to the police. Albert Scherr, a law professor at the University of New Hampshire, says that law enforcement could use a person’s DNA for something other than solving missing persons cases. “Historically, when the police get a hold of someone’s DNA in some form, they don’t let go of it,” Scherr says.

Some state and local law enforcement have established “rogue” DNA databases that operate outside the purview of federal regulations. These databases sometimes contain the DNA profiles of people who were simply arrested or questioned, but never convicted, including minors and even victims. In one recent case, San Francisco law enforcement used a DNA sample provided by a rape survivor to later link her to a separate crime.

Michelle Clark, a death investigator for the Office of the Chief Medical Examiner in Connecticut, told WIRED that the DNA samples collected would be used only to help solve missing persons cases. At the event, Glynn and public officials also explained the risks of consumer databases and their different privacy settings. “We wanted to make sure every general member of the public that takes one of these kits has full control and full autonomy over their DNA, their data, and what they want or don’t want to do with it,” she says.

This year, DNA donation drives have also occurred in Georgia and North Carolina. At the Georgia event in DeKalb County, public officials sought DNA samples for both CODIS and genealogy databases in an effort to identify the remains of more than two dozen people, some of whom may have died under suspicious circumstances. At the North Carolina event, which was sponsored by the North Carolina State Bureau of Investigation and drew about 50 people, family members could submit DNA samples to CODIS. Officials also recommended taking a consumer DNA test but did not have kits on hand.

A DNA drive planned for June in Massachusetts was postponed in part because of privacy concerns raised by the state’s American Civil Liberties Union. The Middlesex County District Attorney’s Office, which was sponsoring the event, planned to ask volunteers for DNA samples in the form of cheek swabs. In return, people would get a free genetic ancestry analysis from FamilyTreeDNA.

Kade Crockford, director for the Massachussetts ACLU’s Technology for Liberty Program, says she worries about potential future uses of consumer DNA databases, such as investigating people who have had abortions. “Someone in Massachusetts who provides their sample to a database, thinking it’s going to be helpful to Massachusetts law enforcement, could be putting their cousin or niece in a different state at risk of law enforcement accessing that information to investigate an abortion crime,” she says. (In 2018, Georgia police tracked down the mother of fetal remains found in wastewater using DNA testing. A coroner determined that the fetus was from a miscarriage.)

Donia Slack, a forensic scientist at RTI International, a nonprofit that helped organize the North Carolina event, says family members may be willing to overlook the risks of consumer DNA databases. “A lot of times, family members just really want to find their loved ones. To them, that supersedes the possible issue with privacy.”

But DNA isn’t the only way missing people can be identified. Family members can also provide photos, medical and dental records, fingerprints, and other identification documents for their loved ones. Ultimately, people will have to decide for themselves how they want their DNA to be used, with the knowledge that their decision might spread to other branches of their family tree.

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The Japan Aerospace Exploration Agency (JAXA) Is making progress on its rover for a joint mission with India to the south pole of the moon.

JAXA and the Indian Space Research Organisation (ISRO) agreed to the cooperative project back in 2019. ISRO, which recently made India the fourth country to soft-land on the moon, will build the mission's lander, while JAXA will be responsible for the launch and a lunar rover.

The mission is slated to launch no earlier than 2025 on Japan's new H3 rocket, according to JAXA. The agency is meanwhile in the basic design phase of the rover with teams running tests in sand designed to simulate lunar regolith, the fine dust that covers the moon's surface. The tests will verify that the vehicle can perform its key science objectives on the moon.

The LUPEX project will investigate the quantity and quality of water on the moon. We hope to use this data as a basis for considering sustainable human activities on the moon in the future," Natsu Fujioka, who is part of the team developing the rover, said in a JAXA statement. 

The rover will be autonomous and will drive to seek out water with its science payloads. It will also be able to drill into the lunar surface to collect samples which will then be analyzed by the rover's instruments. Each of these capabilities is a feat in itself, but combining these and within weight constraints, presents a serious task.

"It is a challenging project to transport a rover weighing several hundred kilograms loaded with these instruments to the moon, move it around, and measure the collected samples in situ," Fujioka said.

Other agencies will also be sending science payloads on the mission. NASA's Neutron Spectrometer will seek out hydrogen up to 3.3 feet (1 meter) below the surface at the south pole, while the European Space Agency's (ESA) Exospheric Mass Spectrometer will assess gas pressure and chemical signatures at the surface.

"Analyses of various observational data over recent years suggest that water may be present in the lunar polar regions, the lunar polar regions being those areas around the moon's north and south poles," said Hiroka Inoue, who is involved in international cooperation and the selection of candidate landing site for LUPEX.

"If water can be found in these regions, it could be used as an energy source for future human activities on the moon. For this reason, countries are aggressively pursuing lunar exploration."

India launched the successful Chandrayaan-3 lunar landing mission this year, while Russia failed with its Luna-25 landing mission. Next year, NASA is tentatively scheduled to launch Artemis 2 in November 2024 to send astronauts around the moon. China meanwhile seeks to collect the first ever samples from the far side of the moon and bring them to Earth in 2024.

Other missions under NASA's Commercial Lunar Payload Services (CLPS) program and a Japanese commercial lander are also planned to shoot for the moon next year.

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Of those surveyed, 62 percent of individuals between the ages of 50 to 80 opposed using life expectancy as a factor in these decisions.

This goes against a growing trend in actual medical guidelines. These guidelines are crafted by national organizations based on solid medical evidence and are primarily designed to assist healthcare providers in determining when to suggest specific tests to patients. Moreover, these guidelines also influence insurance coverage decisions.

The introduction of life expectancy into these guidelines stems from the increased risks associated with certain screening tests as people age.

Additionally, research indicates that individuals need approximately 10 years to fully benefit from early cancer detection.

The poll highlighted that even among individuals categorized as “medical minimizers” — those who typically avoid medical interventions unless absolutely necessary — 57 percent did not support including life expectancy in cancer screening recommendations.

Furthermore, 70 percent of older adults surveyed expressed no issue if their peers underwent cancer screenings, even if guidelines did not advise it. The poll also touched on the 10-year life expectancy guideline, revealing that while 55 percent found it reasonable, 27 percent believed it was too brief.

“Personalizing cancer screening decisions to each patient’s health situation, rather than using one-size-fits-all age cutoffs, could benefit both very healthy and less healthy patients in different ways,” says Dr. Brian Zikmund-Fisher, a healthcare decision-making researcher and professor from the University of Michigan School of Public Health who worked on the poll, in a university release.

Dr. Zikmund-Fisher pointed out that this means talking about an individual’s projected lifespan and sometimes concluding that forgoing a screening could be the healthiest option.

These findings arrive at a crucial time, with an ongoing federal court case that might terminate the mandatory insurance coverage for cancer screenings based on national guidelines.

“Right now, insurance plans must cover the cost of cancer screenings for people in the groups covered by guidelines set by the U.S. Preventive Services Task Force,” explains poll director Dr. Jeffrey Kullgren, an associate professor of internal medicine at Michigan Medicine and physician and researcher at the VA Ann Arbor Healthcare System. “Depending on how the courts eventually rule, insurance coverage of some cancer screenings could end for some older adults, because insurers would be allowed to set their own standards for coverage and not have to abide by guidelines.”

Guidelines may evolve when new data emerges. An upcoming U.S. Preventative Services Task Force draft guideline might reduce the mammogram screening starting age to 40 but still not provide clear evidence for screening women over 75.

Additional insights from the poll include:

• 26% strongly disagreed with the idea of using life expectancy in screening guidelines.
• Strong disagreement was more pronounced among women (30%) than men (21%).
• Strong disagreement about ending screening based on life expectancy was also more common among Black respondents (37%) compared to White (24%) or Hispanic respondents (28%).
• 74% of White respondents were unconcerned if older adults had cancer screenings against their guidelines, whereas this figure was 61 percent for both Black and Hispanic respondents.

The poll included 2,563 adults between the ages of 50 and 80 in January 2023 and reflects the U.S. population.

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Tokyo-based ispace attempted its first lunar landing with the Hakuto-R Mission 1 spacecraft in April, which failed due to an altitude miscalculation.

The Financial Times had reported earlier this month that months of corporate turmoil preceded the mission's failure.

Speaking after the delay was announced, Chief Executive Takeshi Hakamada told a media briefing that the scientific equipment NASA has commissioned ispace to carry to the moon turned out to require a higher vibration absorption standard. He did not elaborate.

The U.S. unit of ispace, which has partnered with spacecraft software developer Draper to build lunar landers, has also encountered procurement delays for some parts, Hakamada said.

The company on Thursday also unveiled the design of its third lander named "APEX 1.0" which would be able to take a shorter trajectory to the moon, although its maximum load was reduced by 40% from a previous plan to 300kg.

Asked about the load reduction, Hakamada said it was due to "purely technological considerations".

There is no change to the launch schedule of ispace's second mission in 2024, but missions that will follow its delayed third mission may be postponed, the company added.

ispace halved its annual sales forecast for the fiscal year ending March 2024 to 3.1 billion yen ($20.8 million) due to the rescheduling, but its earnings forecast was upgraded to a net loss of 7.9 billion yen because of extraordinary insurance income.

Mitsui Sumitomo Insurance Group, a MS&AD (8725.T) unit, paid 3.7 billion yen last month to ispace for Hakuto-R Mission 1's failure.

In April, ispace shares made a blistering debut on the Tokyo Stock Exchange two weeks before the landing attempt, at one point rising to more than nine times its IPO price. The unsuccessful landing resulted in a steep sell-off, but the shares have since recovered, closing on Thursday at 1,401 yen.

($1 = 149.2900 yen)

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If you get an upset, gassy stomach while traveling on planes, you’re not alone.

The average person passes gas 12 to 25 times a day, but when you’re on a plane, you might feel like you’re constantly breaking wind. In addition to feeling gassy, some may experience an increase in other stomach issues during air travel. Though scientists have yet to directly measure digestive changes in people traveling on commercial passenger airlines, high-altitude research has revealed some clues to what’s happening in the gut when you’re in flight.

As you ascend to higher altitudes, atmospheric pressure decreases. This change in pressure makes the air feel thinner because there’s less oxygen.

Low air pressure and cold temperatures at these elevations cause the air to expand, spreading out molecules such as oxygen, nitrogen and argon, all necessary components of air. When the blood doesn’t carry sufficient oxygen to tissues, it causes hypoxia, says Harvey Hamilton Allen, Jr., a gastroenterologist at Digestive Disease Medicine of Central New York. A reduced oxygen level in the body slows down the activity of digestive enzymes, which may contribute to problems with digestion. Research on hypoxia has also indicated several other gastrointestinal (GI) changes, from an upset stomach to more severe issues, such as bleeding in the bowels, Allen says.

Fortunately, traveling in a plane isn’t the same as climbing to the top of Mount Everest, which stands at a lofty height of 29,029 feet. Though commercial airplanes soar a bit higher at an altitude between 31,000 and 42,000 feet, they contain cabin-pressure-control systems in which conditioned air simulates a pressure akin to that at 8,000 feet of altitude.

That change in cabin pressure can still make gas in your gut expand if you have food in your stomach. Think of how your ears pop when the plane quickly ascends or descends, says Rudolph Bedford, a gastroenterologist at Providence Saint John’s Health Center in California. Like the middle ear, the gut has air-filled cavities that widen to adjust to the sudden shift in pressure.

“Changes in cabin pressure and oxygen saturation, along with the vibration and motion of the plane, can inhibit gastric emptying,” Allen says. In other words, digested food can’t move to the small intestine, making it more difficult to do a number two. This can contribute to feeling bloated, gassy and nauseated.

The length of your flight matters as well. A one-hour flight won’t disrupt your gut as much as a 14-hour trip will. Spending most of your time sitting in a cramped seat can compress the abdomen and make it harder for food to pass through. Even if you maintain a good posture, sitting for long periods of time makes it harder for the expanded gas in the GI tract to escape. “Being less active slows down your intestinal motility, thereby exacerbating bloating and constipation,” says Sri Naveen Surapaneni, a gastroenterologist at Memorial Hermann Health System in Texas.

Additionally, if you have heavy foods in your stomach, this could be problematic if the plane runs into any turbulence. Surapaneni says a bumpy ride could lead to nausea and vomiting for people prone to motion sickness.

Stress might also be a culprit in a gassy airborne stomach. Research has shown that the gut has a close relationship with the brain: people with flight anxiety release the stress hormone cortisol, which reduces blood flow and oxygen to the digestive system. The decreased blood flow, in turn, slows down the digestive system. “For many people with anxiety, getting on a plane and flying for long periods stimulates symptoms of bloating, cramping in their abdomen and the butterflies-in-their-stomach feeling,” Bedford says.

If you’re someone with a preexisting GI condition, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), gastroenterologists warn that flying can worsen your symptoms. Bedford says people with Crohn’s disease, a type of IBD, may have episodes of diarrhea, while people with IBS, a noninflammatory condition that causes abdominal discomfort and altered bowel movements, report frequent bloating, diarrhea and constipation. The increase in symptoms, Bedford says, is not typically caused by the flight itself but by the anxiety of flying. Flight anxiety and underlying stress from delays or unexpected changes to travel plans may cause many people’s IBS to flare up, he says.

The good news is you can take steps to prevent tummy troubles on your next flight. Gut experts recommend drinking a lot of water. “When you’re traveling, you’re usually not drinking as much, so you’re becoming dehydrated,” Allen says. The dry air and low air pressure in long flights is dehydrating. “Dehydration due to low humidity levels in the cabin can slow down digestion and worsen constipation and preexisting IBS symptoms,” Surapaneni explains. Consider bringing a refillable water bottle with you on the plane.

If you are eating before your flight, opt for a light meal that’s gentle on the stomach. This includes lean proteins and foods rich in fiber and healthy fats, such as salmon and Greek yogurt with berries. “You don’t really want to have processed foods or salty foods before getting on a flight,” Bedford says. He also encourages people to not eat at least 30 minutes before the flight. Eating earlier can help your stomach digest the food before boarding.

Once on the plane, you’re better off skipping the wine, coffee or carbonated drinks, which might worsen an already upset stomach. Surapaneni also advises to stay mobile when it’s safe to do so, whether that’s by standing up to take a stretch or walking around the cabin.

If you have a GI condition or are nervous about an upcoming flight, it’s always a good idea to consult with your doctor before boarding in case there are other remedies they would recommend. Also, don’t fret if you continue feeling some digestive issues after landing. These symptoms are temporary and usually pass in 24 to 48 hours, Bedford says.

So the next time you’re on a plane, if you’re a little gassier than usual, Bedford says, it’s better to release it rather than attempt to hold it in for an entire flight. “Move around and let it rip—hopefully not sitting next to somebody, if you can avoid it,” he adds.

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As the climate crisis continues, the U.S. will see heat-related deaths multiply, according to research that scientists say is a sobering reminder of the importance of adapting to rising temperatures and reining in planet-warming pollution.

Across more than 100 U.S. cities, nearly 2,000 people died each year from exposure to extreme heat or cold between 1987 and 2000, the period over which data correlated to individual cities are available. By the 2010s the number of annual deaths was closer to 12,500. And when the global average temperature reaches three degrees Celsius above preindustrial averages—which scientists have said could occur around the end of the century, given current emissions reduction plans—the annual totals will be around 63,000 deaths related to extreme temperatures, according to research published last month in GeoHealth. Most of that growth comes from deaths in extreme heat.

The research is a direct response to a talking point by climate deniers that holds that because much of the U.S. has historically been more vulnerable to cold, a warming climate isn’t concerning, says study co-author Jangho Lee, an atmospheric scientist at the University of Illinois at Chicago. “Their argument was that since there are more cold-related deaths, compared to heat-related deaths, global warming will actually benefit human health,” he says. “We did not think that was true.”

That said, focusing on the balance between cold- and heat-related deaths might not be helpful because the latter are very likely undercounted, compared with cold-related mortality, says the University of Washington’s Kristie Ebi, an epidemiologist who specializes in climate change and wasn’t involved in the new research. For one thing, she says, many hypothermia deaths “have to do with water, alcohol and boats,” not the temperature alone. In addition, Ebi says, when evaluating temperature-related deaths, scientists consider a three-week period for cold days versus just a three-day lag for hot ones. And in the U.S., extreme heat is already more deadly than hurricanes, floods and tornadoes combined.

Lee and his colleague Andrew Dessler, a climate scientist at Texas A&M University, decided to run the numbers. They considered a trio of key factors that contribute to temperature-related deaths. First, the scientists noted that the U.S. population is expected to continue growing—so it’s no surprise that total temperature-related deaths will also grow. Additionally, they considered changing demographics, particularly the fact that the country’s population is aging, and both people with illnesses associated with aging, such as heart disease, and the elderly are at higher risk of dying from either cold or heat. Finally, the researchers considered adaptation by comparing cities’ current ability to manage extreme temperatures with what could happen if, for example, one that was more accustomed to helping people manage cold winters developed responses to better help them handle extreme heat.

Lee and Dessler’s findings suggest that, up through three degrees C of warming, increasing heat deaths and decreasing cold deaths will about balance out, with increases in total mortality driven by a growing and aging population. But with more than three degrees C of warming, they find, climate change will start pushing the number of deaths even higher.

Adaptation could reduce the rise by about a quarter, however. “We were surprised by how much adaptation factors control the future temperature-related deaths, even more than climate itself,” Lee says. “So it is very important for us to adapt.” In cases of extreme heat, adaptation reduced annual deaths by nearly 10,000.

But the findings shouldn’t make people complacent about the prospect of less than three degrees C of warming, says Elisaveta Petkova, an environmental epidemiologist at Drew University, who wasn’t involved in the new research. “I don’t think we should feel completely reassured by the fact that most of those effects in the paper are projected to happen above three degrees Celsius change,” she says. “When you have rising temperatures, the weather becomes really, really unpredictable,” making it potentially more dangerous.

That means the study is yet another reminder of the importance of dramatically cutting carbon pollution before the planet reaches such exacerbated levels of warming.

Moreover, Petkova says that the analysis’s emphasis on adaptation should inspire the U.S. to put more resolute focus on preparing for our climate future. “Adaptation is absolutely critical, and it requires consistent efforts,” she says. “The political climate in the United States has been a little unstable, and there hasn’t been a continuous vision about how adaptation should be approached.”

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Flossing incorrectly can even damage our gums – completely contrary to the outcome we're trying to achieve with flossing: better oral health.

"Sometimes we see patients traumatize the gumline with improper flossing technique, which can create clefts by cutting the gum and can lead to gum recession," warns Tufts University periodontologist Irina Dragan.

Led by periodontologist David Basali from Tufts University, Dragan and several colleagues put flossing to the test to find the way to reduce gum bleeding – a sign of inflammation.

The purpose of flossing is to help disrupt the biofilm cities oral microbes create to protect themselves. Like so many surfaces inside (and outside) of our bodies, our mouths contain both good and bad bacteria, which secure themselves on our teeth for easy access to our blood stream.

Our body's response to this invasion can lead to problematic inflammation elsewhere, including in our hearts and brains, and has even been associated with diseases like cancer and diabetes.

The researchers provided a group of volunteers in a randomized and single blinded clinical trial with a clear set of flossing instructions, while allowing a control group to do their usual thing.

The 36 participants who all had early signs of dental disease were assessed four times over the trial period of eight weeks. Over this time 88 percent of the trial group mastered the flossing technique and they experienced a 70 percent reduction in gum bleeding whereas the control group only saw a 30 percent reduction.

It is normal for gums to bleed when returning to flossing after some time, but this should improve gradually when flossing is done correctly, as the trial group demonstrated.

The test group was prescribed an adapted horizontal vertical flossing technique (or AHVFT), as follows:

1. Cut off approximately 32 cm (18 inches) of floss. With palms facing each other, as pictured above, wind each end around the ring finger (fourth finger) of each hand. There should still be about 12 cm (6 inches) of floss between both hands.
2. Fold hands towards the suspended floss, so palms now face down and pick up the floss between thumb and index finger in each hand.
3. Gently place the floss between two teeth, using the thumb/index finger to control the floss and avoid cutting into the gum. Push the floss up against the side of one tooth then move it back and forth in a sawing motion while also applying upward and downward pressure, "as if one were drying their back with a towel."

Repeat this technique on all your teeth.

The study participants were dental students and assistants, which probably explains why there was such a strong take-up of the technique in the trial group, the team note.

"This is the first study of which we are aware to prove that a person using floss with a specific technique will have less gum infection than a person who just does what they normally do," says periodontologist Paul Levi.

As someone who's always had a complicated relationship with flossing, I for one am keen to give this a shot!

This research was published in the Journal of Dental Hygiene.

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For a pathogen to make us sick, it must overcome a lot. First it has to enter the body, bypassing natural barriers such as skin, mucus, cilia and stomach acid. Then it needs to reproduce; some bacteria and parasites can do this virtually anywhere in the body, while viruses and some other pathogens can only do so from within a cell. And all the while, it must parry attacks from the body’s immune system.

So while we are constantly inundated by microbes, the number of microbes that enter our bodies is usually too low to get past our defenses. (A tiny enough dose may even serve to remind our immune system of a pathogen’s existence, boosting our antibody response to keep us protected against it.)

When enough pathogens do manage to breach our defenses and start to replicate, we get sick. Often this is just a numbers game. The more invaders you’re fighting off, the more likely you are to feel ill.

How many microbes need to enter the body before we start to feel sick?

This varies by pathogen and is known as a microbe’s “infectious dose.” Usually it takes quite a few, but some microbes require an incredibly small number of organisms to start an infection. Take norovirus for example, the stomach bug notorious for spreading whenever people are in close contact and touch the same surfaces, such as on cruise ships. Its infectious dose can be as small as 18 individual viruses, making it incredibly easy to transmit. It is also very hardy even outside the body, so an infected person who’s oozing the virus may leave a large amount of it behind — enough to easily infect others, even several days later.

What about the concept of “viral load”? Is that related?

They’re similar ideas, but while infectious dose refers to how many organisms will lead to an infection, viral load is an active measurement of infection: the number of organisms that are replicating within the host. The terminology was first introduced to the general public as part of our understanding of HIV/AIDS, and it increased in use after the start of the Covid pandemic.

How do researchers figure out a microbe’s infectious dose?

That’s still an inexact science. The gold-standard study, called a human challenge study, involves purposely giving people a dose of the pathogen.

Unfortunately, this approach is ethically difficult since it (obviously) carries a risk of serious illness and potential long-term complications.

So instead, researchers expose guinea pigs, rats, mice or ferrets, depending on the pathogen. But it can be difficult to directly extrapolate animal dosage to the human equivalent.

Additionally, the route of infection matters. Something that gets right into your bloodstream will likely require far fewer microbes to take hold than one that comes in through your mouth or lungs, for example, since the bloodstream allows the pathogen to bypass many host defenses. This is why, for example, the risk of HIV infection is much higher when it comes from a blood transfusion or needle stick versus a sexual route.

A third way of trying to figure out infectious dose is to use observational studies, where researchers deduce the number from seeing how long it takes for an exposed person (especially in families or other close-contact settings) to become sick. As you might suspect, this is often messy and inexact compared to the previous two methods.

Why are the infectious doses of some pathogens higher or lower than those of others?

We aren’t sure. It could be due to how an invader operates. Researchers have suggested that pathogens requiring direct contact with host cells tended to be more effective, so their infectious doses were fairly low. But if bacteria attack host cells indirectly (such as by secreting proteins that go on to harm host cells), then a larger dose of bacteria is necessary to infect the host, since the host-modifying secretions could be diluted by time and space. This idea was supported in a 2012 study that looked at viruses, fungi and parasites as well. But we still need additional confirmation for a wider variety of microbes.

What do we know about the infectious dose for the virus that causes Covid?

We’ve learned a lot in the nearly four years since it first appeared, but much of it comes from animal models of infection and human observational studies. Most animal models require a high dose of the virus — 10,000 to 1 million “plaque-forming units” (PFUs), where each unit is enough to infect a cell in tissue culture and kill it. Observational studies in humans, however, suggest that the infectious dose may be around 100 to 400 PFU on average, though again this method offers only a very rough guideline.

These studies suggest that one reason the virus is so easily transmissible is because it has a relatively low infectious dose, similar to other respiratory viruses such as RSV and “common cold” coronaviruses (and lower than the infectious dose of most strains of influenza virus).

And when we compare the infectious dose to the amount of virus exhaled by an infected individual, it’s not surprising that the virus spreads so quickly. A recent preprint shows that infected patients can exhale up to 800 viral RNA copies per minute for about eight days after their symptoms began. Even though we can’t directly translate RNA copies into the amount of live virus particles, if even half of those RNA copies are from a currently infectious virus, it’s theoretically possible to get a dose large enough to start an infection in just a minute of close contact.

Do vaccines raise the infectious dose?

When someone encounters a pathogen for the second time (whether because of a prior illness or vaccination), several host defenses spring into action. Antibodies generated from vaccination or prior infection will bind to the invading microbe. These will interfere with its ability to attach to a host cell, or single out the microbe for ingestion by cells called neutrophils. And if a virus does manage to invade a host cell, it will be targeted for destruction by memory T cells.

Due to this rapid response, fewer of the invading microbes survive compared to a naïve individual encountering the pathogen for the first time, which effectively raises infectious dose.

How can this knowledge help us avoid illnesses?

Exposure is a function of pathogen concentration and contact time, so if you can reduce either of those, you can better avoid infectious diseases.

This is why, from the start of the Covid pandemic, experts have recommended a “Swiss cheese” model of layered protection, with social distancing from other individuals playing a key role. The farther you are from an infectious person, the fewer of their viral particles you will be exposed to.

Adding a mask, especially a high-quality respirator such as an N95 with a snug fit, will further reduce the number of viruses you could inhale.

Ventilation also dilutes the number of viral particles in the air, hence why being outside or using an air filter indoors lessens your risk of infection.

Vaccination is another way to decrease your risk of Covid infection. Though the vaccines are imperfect, vaccination still reduces your risk of becoming infected in the first place, by increasing the infectious dose necessary to initiate an infection. It also reduces the chances of developing serious illness if you are infected. Several studies also suggest that vaccinated people are less likely to shed as many virus particles and that vaccination reduces viral load.

Masking, increased ventilation and distancing reduces the number of microbes you’re exposed to. Vaccination increases the infectious dose. These are the pillars of protection against infection from pretty much every pathogen. Transmission dynamics are complex, but the interventions we can take to protect ourselves are comparatively simple.

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Lava tubes are present all over the moon. These cave-like tunnels were caused by flowing lava on the moon’s surface. The top of the lava cave formed when the molten rock began to cool, creating an overhang. However, the lava beneath continued to drain, creating a tunnel through the moon’s surface.

We’ve also seen these lava tubes all over Earth, and they’re a common byproduct of lava flowing anywhere. So, how will these lava-made tunnels work for an underground Chinese moon base? Well, because they’re already creating a tunnel, the astronauts building the base could utilize natural resources as a roof, protecting them from the harsh radiation of space.

Image source: helen_f / Adobe

They’ll also prove very helpful for contending with the temperature swings the lunar surface experiences. Here on Earth, we have a much thicker atmosphere, which helps control the temperature and everything more. But, because the moon’s atmosphere is so thin, it lets in much more Sun radiation. As such, the moon is much warmer when lit up and colder when shrouded in darkness.

Astronauts will also have to contend with the possibility of debris impacts, which have helped give the moon its pockmarked look over the past several million years. If scientists are able to find more sloped lava tubes on the moon’s surface, then they could use them to create an underground moon base that is more protected from this debris.

Of course, the likelihood that China will create an underground base within the next several years is slim. The nation has shared plans to create a moon base by 2028 but doesn’t even have a manned mission set for the lunar surface until the 2030s. On the other hand, NASA’s Artemis III could take astronauts to the lunar surface in as little as the next three to four years.

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AMERICANS are outdoors less and less. A new Environmental Protection Agency study revealed that we spend 93 percent of our lives in a building or in a car. Yet physical and mental health may be waiting for us among the trees.

Forest bathing, aka “shinrin-yoku,” was first studied in 1983 by the Japanese Ministry of Agriculture, Forestry, and Fisheries as a potential way to address the country’s heart disease and depression rates. Their research found that spending as little as 10 minutes a day outside increased well-being. Other studies showed that being in a forested area lowers stress levels and blood pressure. Trees emit phytoncides, which are essentially airborne antibacterial oils. Breathing in forest air increases the level of infection-combating cells in our blood. Phytoncides also improve sleep and boost attention span and creativity.

Sometimes called forest therapy, the practice isn’t an exercise routine, and no, it doesn’t involve washing. At its most basic, it’s taking a walk in the woods.

“It’s slowing down so that our senses guide our experience. What we feel, see, smell, and hear keeps our focus on the now,” says Christy Knecht, an Association of Nature and Forest Therapy–certified forest bathing guide based in Huntington, Indiana. “At the end of a walk, I encourage the bathers to find a place to sit for 20 minutes. It’s opening our eyes, ears, and, eventually, our hearts to what the present moment has to offer.”

Jennifer Foley, owner of Balanced Soul in Broad Ripple, began offering guided forest bathing during the pandemic. “It was a safe way to rebuild human connection and to help establish a healing relationship with the natural world,” says Foley. Keep in mind, forest bathing isn’t one and done. Consistency is needed, but that’s true of any form of self-care, which is what Foley considers forest bathing to be. “It deepens mental relaxation and increases gratitude, selflessness, and wonder.”

Cleanse Your Mind

Ready to dip a toe into forest bathing? You needn’t go far. We have suggestions for three peaceful yet easily accessible locations in Indiana.

EAGLE CREEK PARK

Located on the far north side of Eagle Creek, Eagle’s Crest Nature Preserve trail is less traveled than others and a heavily wooded example of a primitive forest. 7201 Fishback Rd.

FORT HARRISON STATE PARK

Head down the Lawrence Creek Trail, a 4.2-mile loop that winds through upland woods and ravines. 6000 N. Post Rd.

PINE HILLS NATURE PRESERVE

Located within Shades State Park, this dedicated nature preserve was the first in Indiana and contains sandstone bluffs, hogback ridges, and species of pine rare to our state. 7751 S. 890 W, Waveland

GO DEEPER

The Nature Fix ($14.83) is a science-based guide to forest bathing.

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A deep dive into historical documents reveals that during the late medieval period in the 14th century CE, Oxford had a per capita murder rate four to five times higher than other high-population hubs like York and London.

And the reason? Bloody students.

Like, quite literally. Newly translated documents list 75 percent of the perpetrators of murders with known background as "clericus", a term most commonly used to describe students or members of the then-recently founded University of Oxford. And 72 percent of the victims were also classed as clericus.

This information has been compiled into a newly relaunched, interactive website by Cambridge University's Violence Research Centre. It's called the Medieval Murder Map, where you can explore the map to learn the details of violent historical crimes.

A Crononers' Roll recording the death of Hervey de Playford of London in 1315 or 16. (Medieval Murder Map)

"A medieval university city such as Oxford had a deadly mix of conditions," says criminologist Manuel Eisner, lead murder map investigator and Director of Cambridge's Institute of Criminology.

"Oxford students were all male and typically aged between fourteen and twenty-one, the peak for violence and risk-taking. These were young men freed from tight controls of family, parish or guild, and thrust into an environment full of weapons, with ample access to alehouses and sex workers."

Originally launched in 2018, the Medieval Murder Map has received a significant update. Eisner and his team have translated and studied coroners' rolls, records of investigations into violent crimes penned in Latin. These records included the who (perpetrator and victim, where known), the location, the weapon, and details of the crime.

The researchers then pinned these details to contemporaneous maps reconstructed by the Historic Towns Trust. The website now has the details of 354 murders across the three cities, with new details on accidents, sudden deaths, sanctuary church cases (in which the suspected felon would seek protection on consecrated ground to gain time for pleading their case with the coroner), and deaths in prison.

A late 13th century map of Britain. (British Library)

Murder cases in medieval England were treated in similar ways to how they are heard now.

"When a suspected murder victim was discovered in late medieval England the coroner would be sought, and the local bailiff would assemble a jury to investigate," explains Eisner.

"A typical jury consisted of local men of good repute. Their task was to establish the course of events by hearing witnesses, assessing any evidence, and then naming a suspect. These indictments were summarized by the coroner's scribe."

It wasn't guaranteed that the perpetrator would be brought to justice. But the crime rate in Oxford is certainly striking. Back then, the city had a population of around 7,000, with around 1,500 of those people students. Eisner and his colleague, historical criminologist Stephanie Brown of the University of Cambridge, worked out that the murder rate was around 60 to 75 people per 100,000 per year.

That's huge, compared to England's city murder rate today of less than 20 murders per million. The researchers say that the high crime rate is probably the result of a lot of young men gathered in one place (because women didn't go to university), and a lot of booze. And ready access to weapons, of course.

"Knives were omnipresent in medieval society," says Brown. "A thwytel was a small knife, often valued at one penny, and used as cutlery or for everyday tasks. Axes were commonplace in homes for cutting wood, and many men carried a staff."

Detail of a circa 12th to 13th century miniature of one man killing another with an axe. (British Library)

One murder recorded in Oxford took place after a gentleman took exception to another urinating on the street. The unfortunate victim was a servant unrelated to the disagreement. In another incident, a group of revelers took to the streets in the wee hours to sing and make merry; murder ensued when they refused to let a man they encountered join their party.

Sex workers could also be the victims of crimes, as with the case of one poor woman who, instead of being paid as requested, was violently killed.

"Circumstances that frequently led to violence will be familiar to us today, such as young men with group affiliations pursuing sex and alcohol during periods of leisure on the weekends. Weapons were never far away, and male honor had to be protected," Eisner says.

"Life in medieval urban centers could be rough, but it was by no means lawless. The community understood their rights and used the law when conflicts emerged. Each case provides a glimpse of the dynamics that created a burst of violence on a street in England some seven centuries ago."

You can peruse these cases in detail and at leisure on the Medieval Murder Map website.

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Rather, people with reflux disease who also had changes in their esophageal mucosa—known as erosive reflux disease and defined by esophageal inflammation—experienced about a 2.4-times higher risk of esophageal cancer than those with nonerosive reflux disease.

Additional endoscopic monitoring to keep track of mucosal anomalies that could progress to esophageal cancer might not be necessary for patients with endoscopy-confirmed nonerosive GERD, the researchers noted in The BMJ.

Article Information

Published Online: September 27, 2023. doi:10.1001/jama.2023.18744

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Anxiety is a tricky foe, mainly because it can be so challenging to identify. You may feel irritable, tired, restless, and simply out of balance, according to David Merrill, M.D., Ph.D., a psychiatrist at Providence Saint John’s Health Center in California.

To make things even more confusing, physical symptoms usually pop up in addition to emotional ones—and often, until you get a proper diagnosis, it may feel like you’re fighting a cold, flu, allergies, or even a hangover.

That’s because the brain-body connection is very strong, and what might seem like unrelated mental and physical conditions could actually be intricately linked in an ongoing cycle, Dr. Merrill says. For example, anxiety could cause digestive problems, and those effects could, in turn, worsen your anxiety.

That notches both problems up unless the issue is recognized and addressed. Here, some clues that your body is manifesting anxiety in physical ways—and what you can do to feel better, ASAP.

1. Rapid heart rate

Anxiety is part of the body’s built-in alarm system, alerting us to danger in the surrounding environment, according to Joseph Laino, Psy.D., senior psychologist and assistant director for clinical services for ambulatory behavioral health at the Family Health Centers at NYU Langone Health.

A part of the brain called the amygdala rings that alarm during a perceived threat and it causes a cascade of effects—such as a surge of the hormones cortisol and adrenaline—meant to prep us to flee or fight.

That can increase your heart rate and blood pressure, and even lead to heart palpitations, Dr. Laino says. 'That reaction is essential to our health and preservation, because a surge of anxiety can propel us to move quickly,' he explains. But when that alarm button seems stuck in the 'on' position, it can exacerbate these reactions, which are designed to be temporary.

2. Chills or sweating

As part of the fight-or-flight response, you may experience a sudden temperature change, Dr. Merrill says. That’s because another part of the brain involved in anxiety is the hypothalamus, which regulates body heat.

Because of that, you could have chills, feel drenched in sweat, or weirdly, both at the same time. That effect could also come from the way muscles fire up during an anxiety response, he adds, as one more way to get you ready to take on threats. That’s why you may have odd muscle aches in conjunction with the hot or cold flashes.

3. Shortness of breath

Your heart and lungs work in concert to keep you going strong, so when one is affected, the other is likely to be, too. If you’re experiencing a sudden rise in heart rate, that could lower your oxygen intake and your lungs see that as a tip-off to power up, so they start working harder, Dr. Merrill says.

'This is why, in extreme anxiety—like a panic attack—you’ll not only have a rapid heart rate, but also shortness of breath, and the advice with those is to try and implement deep breathing so that both can get corrected,' he says.

Of course, if you’re having chest pains, the symptoms don’t subside, or it feels worse after a few minutes, seek immediate medical attention.

4. Nausea or indigestion

In addition to the parts of the brain, and certain hormones, being associated with anxiety, the central nervous system plays a major role in the stress response as well, and Dr. Merrill notes that there are more nerve fibers in the gut than anywhere else in the body. That’s why, when you feel excited, you have those butterflies—it’s your nervous system responding to stimulus.

Another hormone, serotonin, steps in here as well, he adds. Most of your serotonin—the 'happy chemical' that send signals between nerve cells—is in your gut as well, and when emotional distress happens, it can throw off your nerve signaling and serotonin response. The result? Belly problems.

'Any kind of emotional imbalance like anxiety is likely to create stomach issues, such as nausea, indigestion, and upset stomach,' he says.

5. Constipation or diarrhoea

As the body prepares to respond to a threat, it shuttles resources like blood flow to what it considers necessary for short-term mobilization. What’s not needed when you’re in the middle of a fight or you’re sprinting away from danger? Digestion.

'As your blood flows toward muscles, vision, and hearing to react to threats, your motility can change,' says Dr. Merrill. That often results in constipation but can also swing in the other direction toward diarrhoea. In some cases, you may toggle between the two. Related effects can include bloating, excessive gas, abdominal pain, and cramping.

6. Tingling, sharp pains, and tightness

Because the central nervous system is connected to the peripheral nervous system, that means you’re wired from head to toe, Dr. Merrill says, and when there’s anxiety in the brain, it sends out signals all along those connections. Much like your muscles, heart, and lungs are prepped for a threat, your nerves fire up to ensure the rest of your body is ready to jump or punch, too.

'Because your nerves are activated, that can create an effect anywhere along those nerve systems,' says Dr. Merrill. 'You may have tingling fingers or toes, for example, or the hairs on your arms stand up like you’re scared.'

If a nerve fires suddenly, there could be sharp pain or tightness as well—especially in areas where the nerves are in tighter clusters, like your lower back, jaw, or neck.

How to deal with your anxiety symptoms

Right now, with stay-at-home orders and extreme economic uncertainty part of the 'new normal,' anxiety levels are very high, even for those who haven’t experienced much anxiety in the past, Dr. Merrill says.

Mindfulness-based practices can help, especially if they involve some type of physical movement that benefits both body and mind. He suggests yoga or tai chi, for example, because they incorporate breath-work in their practices.

In terms of treatment, Dr. Laino suggests talking with your healthcare provider about both your symptoms and anxiety as a possible cause to ensure you’re getting an accurate diagnosis from a trained professional. Even if you’re under a stay-at-home order, there are many telehealth options right now, he adds, which means you can have an appointment and even get a prescription without going into an office.

Most of all, take it seriously. 'Just because a symptom is linked to anxiety doesn’t mean it should be ignored,' he says 'There are various medications and talk therapies that can help people who suffer with acute, chronic, or post-traumatic anxieties.'

Best of all, as your anxiety knots get loosened, it’s likely many of your physical issues will start to ease as well.

Where to find help for your mental health

If you're struggling with your mental health and need help, try these resources:

• Call the Mind infoline, for signposting on where to seek help: 0300 123 3393

• Go to your GP, and explain your symptoms - they can offer you medical help

• You can refer yourself for an online NHS therapy programmes nhs.uk/service-search

• If you just want to talk to someone, call the Samaritans 116 123

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Our relationship with pets has changed drastically in recent decades. Pet ownership is at an all-time high, with a recent survey finding 69% of Australian households have at least one pet. We spend an estimated A$33 billion every year on caring for our fur babies.

While owning a pet is linked to numerous mental and physical health benefits, our pets can also harbour infectious diseases that can sometimes be passed on to us. For most people, the risk is low.

But some, such as pregnant people and those with weakened immune systems, are at greater risk of getting sick from animals. So, it’s important to know the risks and take necessary precautions to prevent infections.

What diseases can pets carry?

Infectious diseases that move from animals to humans are called zoonotic diseases or zoonoses. More than 70 pathogens of companion animals are known to be transmissible to people.

Sometimes, a pet that has a zoonotic pathogen may look sick. But often there may be no visible symptoms, making it easier for you to catch it, because you don’t suspect your pet of harbouring germs.

Zoonoses can be transmitted directly from pets to humans, such as through contact with saliva, bodily fluids and faeces, or indirectly, such as through contact with contaminated bedding, soil, food or water.

Studies suggest the prevalence of pet-associated zoonoses is low. However, the true number of infections is likely underestimated since many zoonoses are not “notifiable”, or may have multiple exposure pathways or generic symptoms.

Dogs and cats are major reservoirs of zoonotic infections (meaning the pathogens naturally live in their population) caused by viruses, bacteria, fungi and parasites. In endemic regions in Africa and Asia, dogs are the main source of rabies which is transmitted through saliva.

Dogs also commonly carry Capnocytophaga bacteria in their mouths and saliva, which can be transmitted to people through close contact or bites. The vast majority of people won’t get sick, but these bacteria can occasionally cause infections in people with weakened immune systems, resulting in severe illness and sometimes death. Just last week, such a death was reported in Western Australia.

Cat-associated zoonoses include a number of illnesses spread by the faecal-oral route, such as giardiasis, campylobacteriosis, salmonellosis and toxoplasmosis. This means it’s especially important to wash your hands or use gloves whenever handling your cat’s litter tray.

Cats can also sometimes transmit infections through bites and scratches, including the aptly named cat scratch disease, which is caused by the bacterium Bartonella henselae.

Both dogs and cats are also reservoirs for methicillin-resistant bacterium Staphylococcus aureus (MRSA), with close contact with pets identified as an important risk factor for zoonotic transmission.

Birds, turtles and fish can also transmit disease

But it’s not just dogs and cats that can spread diseases to humans. Pet birds can occasionally transmit psittacosis, a bacterial infection which causes pneumonia. Contact with pet turtles has been linked to Salmonella infections in humans, particularly in young children. Even pet fish have been linked to a range of bacterial infections in humans, including vibriosis, mycobacteriosis and salmonellosis.

Close contact with animals – and some behaviours in particular – increase the risk of zoonotic transmission. A study from the Netherlands found half of owners allowed pets to lick their faces, and 18% allowed dogs to share their bed. (Sharing a bed increases the duration of exposure to pathogens carried by pets.) The same study found 45% of cat owners allowed their cat to jump onto the kitchen sink.

Kissing pets has also been linked to occasional zoonotic infections in pet owners. In one case, a woman in Japan developed meningitis due to Pasteurella multicoda infection, after regularly kissing her dog’s face. These bacteria are often found in the oral cavities of dogs and cats.

Young children are also more likely to engage in behaviours which increase their risk of getting sick from animal-borne diseases – such as putting their hands in their mouth after touching pets. Children are also less likely to wash their hands properly after handling pets.

Although anybody who comes into contact with a zoonotic pathogen via their pet can become sick, certain people are more likely to suffer from serious illness. These people include the young, old, pregnant and immunosuppressed.

For example, while most people infected with the toxoplasmosis parasite will experience only mild illness, it can be life-threatening or cause birth defects in foetuses.

What should I do if I’m worried about catching a disease from my pet?

There are a number of good hygiene and pet husbandry practices that can reduce your risk of becoming sick. These include:

• washing your hands after playing with your pet and after handling their bedding, toys, or cleaning up faeces

• not allowing your pets to lick your face or open wounds

• supervising young children when they are playing with pets and when washing their hands after playing with pets

• wearing gloves when changing litter trays or cleaning aquariums

• wetting bird cage surfaces when cleaning to minimise aerosols

• keeping pets out of the kitchen (especially cats who can jump onto food preparation surfaces)

• keeping up to date with preventative veterinary care, including vaccinations and worm and tick treatments

• seeking veterinary care if you think your pet is unwell.

It is especially important for those who are at a higher risk of illness to take precautions to reduce their exposure to zoonotic pathogens. And if you’re thinking about getting a pet, ask your vet which type of animal would best suit your personal circumstances.

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Approximately 1 in every 4 American adults has indicated they definitely plan to obtain the updated COVID-19 vaccination, as per a new study from the nonprofit health policy organisation KFF.

While, another quarter of adults, on average, believe they'll likely get the shot.

These findings, published recently, are part of the ongoing Covid-19 Vaccine Monitoring poll, conducted by KFF between September 6 and 13, involving a nationally representative sample of 1,296 adults. 

The survey offers an early insight into the potential uptake of the new Covid-19 shots in the United States.

Dr William Schaffner, an infectious disease expert at Vanderbilt University, who was not part of the survey, commented on the results, stating that there's hope in the middle group - those who haven't firmly decided. 

About 40% of the population falls into this category, and they could be convinced to receive the vaccine with the right approach. However, they are also vulnerable to hurdles and inconveniences, such as issues with insurance and vaccine supply, which have hindered the vaccine rollout in the early stages.

The survey also revealed hesitancy regarding the new shots for children, with only about 40% of parents expressing intent to vaccinate their kids and teens.

These updated vaccines are designed to combat the latest variants of the virus, coinciding with a rise in infections, hospitalisations, and deaths. 

Yet, they have arrived during a period of COVID-19 fatigue, with only 17% of Americans having received their bivalent booster. This figure is lower than the initial vaccine uptake in 2020 but higher than the uptake of previous booster shots.

Demographics played a role in vaccine intent, with those aged 65 and older being more likely to express willingness to get the new shots. However, 37% of those who previously received a Covid-19 vaccine indicated they probably or definitely won't get the new version.

Dr Peter Hotez, a vaccine expert, pointed out that some people are not getting the new vaccines due to a lack of awareness regarding their necessity. 

There's confusion about why this booster differs from the previous one and why it's needed to target new variants. Additionally, the message that even previously vaccinated individuals are still at risk of hospitalisation without a booster hasn't reached everyone.

The initial challenges of the fall vaccination campaign have also contributed to the hesitancy, and efforts are being made to address these issues. 

However, there's concern about potentially alienating a significant portion of the most committed individuals in the process.

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“It is no secret that Apple is making more money on Bing existing than Bing does,’’ Mikhail Parakhin, Microsoft’s MSFT, +0.21% chief of advertising and web services, said in U.S. District Court in Washington. The comment drew a laugh from the courtroom. Parakhin was describing Microsoft’s years of futility trying to supplant Google on Apple devices.

Analysts estimate that Apple AAPL, -0.89% collects $15 billion to $20 billion a year in revenue-sharing payments from Google in return for giving its search engine the coveted default slot on Apple’s devices. The revenue is generated when users click on advertisements in search results.

The U.S. Department of Justice accuses Alphabet’s GOOG, +1.55% GOOGL, +1.54% Google of using similar agreements to lock out rival search engines such as Bing and Yahoo, stifling innovation. The trial began Sept. 12 and is expected to continue into November.

In questioning Parakhin, Google lawyer Ken Smurzynski sought to knock down one of the government’s key arguments: that Google’s existing market dominance allows it to collect massive amounts of user data to improve search results and widen its lead over competitors.

Google’s team counters that dramatic improvements in artificial intelligence mean search engines can improve results without relying on user data. Smurzynski introduced a document in court that included comments about that from Microsoft CEO Satya Nadella.

“AI will fundamentally change every software category, starting with the largest category of all – search,” Nadella said in February blog post for Microsoft.

But Parakhin compared AI to driverless cars: not quite ready for prime time. Asked by U.S. District Judge Amit Mehta whether a search engine could be built solely off machine learning, he replied: “We’ve seen companies try. We haven’t seen anybody succeed.”

Mehta likely won’t issue a ruling in the antitrust case until early next year. If he decides Google broke the law, another trial will determine how to curb its market power.

One option would be to bar the Mountain View, Calif.-based company from paying Apple and others to make Google the default search engine.

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Iranian Communication Minister Isa Zarepour said the Noor-3 satellite had been put in an orbit 450 kilometers (280 miles) above Earth's surface, the state-run IRNA news agency reported. It was not clear when the launch took place.

There was no immediate acknowledgment from Western officials of the launch or of the satellite being put into orbit. The U.S. military did not immediately respond to a request for comment. Iran has had a series of failed launches in recent years.

The most recent launch was carried out by Iran's paramilitary Revolutionary Guard, which has had more success. Gen. Hossein Salami, the top commander of the Guard, told state TV that the launch had been a "victory" and that the satellite will collect data and images.

Authorities released footage of a rocket taking off from a mobile launcher without saying where the launch occurred. Details in the video corresponded with a Guard base near Shahroud, some 330 kilometers (205 miles) northeast of the capital, Tehran. The base is in Semnan province, which hosts the Imam Khomeini Spaceport from which Iran's civilian space program operates.

The Guard operates its own space program and military infrastructure parallel to Iran's regular armed forces and answers only to Supreme Leader Ayatollah Ali Khamenei.

It launched its first satellite into space in April 2020. But the head of the U.S. Space Command later dismissed it as a "tumbling webcam in space" that would not provide vital intelligence. Western sanctions bar Iran from importing advanced spying technology.

The United States has alleged that Iran's satellite launches defy a U.N. Security Council resolution and has called on Tehran to undertake no activity related to ballistic missiles capable of delivering nuclear weapons.

The U.S. intelligence community's 2022 threat assessment claims the development of satellite launch vehicles "shortens the timeline" for Iran to develop an intercontinental ballistic missile because it uses similar technology.

Iran has always denied seeking nuclear weapons and says its space program, like its nuclear activities, is for purely civilian purposes. U.S.

intelligence agencies and the International Atomic Energy Agency, or IAEA, say Iran abandoned an organized military nuclear program in 2003.

Over the past decade, Iran has sent several short-lived satellites into orbit and in 2013 launched a monkey into space. The program has seen recent troubles, however. There have been five failed launches in a row for the Simorgh program, another satellite-carrying rocket.

A fire at the Imam Khomeini Spaceport in February 2019 killed three researchers, authorities said at the time. A launchpad rocket explosion later that year drew the attention of then-President Donald Trump, who taunted Iran with a tweet showing what appeared to be a U.S. surveillance photo of the site.

Tensions are already high with Western nations over Iran's nuclear program, which has steadily advanced since Trump five years ago withdrew the U.S. from the 2015 nuclear agreement with world powers and restored crippling sanctions on Iran.

Efforts to revive the agreement reached an impasse more than a year ago. Since then, the IAEA has said Iran has enough uranium enriched to near-weapons grade levels to build "several" nuclear weapons if it chooses to do so. Iran is also building a new underground nuclear facility that would likely be impervious to U.S. or Israeli airstrikes. Both countries have said they would take military action if necessary to prevent Iran from developing a nuclear weapon.

Iran has expressed willingness to return to the 2015 nuclear deal but says the U.S. should first ease the sanctions.

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You may know the feeling. After a strenuous run or workout, you think you deserve an extra long rest on the couch, or an elevator ride instead of taking the stairs.

You are far from alone. A wide range of studies show that as people increase their amount of structured exercise, like going to the gym or running on the track, they tend to "laze about" more when it comes to performing everyday physical activities that are not considered to be structured exercise.

"In 67% of the studies, we can see that people cut back on physical activities in their daily lives as compensation for more training. This includes walking less, cycling less and taking an elevator instead of the stairs," says Julie Marvel Mansfeldt, a graduate student at the University of Copenhagen's Department of Nutrition, Exercise and Sports (NEXS).

Mansfeldt is the lead author of a systematic review of 24 research studies, all of which describe people's levels of daily physical activities before and during interventions with various structured exercise programs. The study is published in the journal Current Nutrition Reports.

One's level of regular physical activity seems to play a significant role in whether or not a person successfully loses weight.

"Losing weight is about changing the balance between the amount of energy you consume and the amount you expend. You can either change your diet to eat less or increase your level of physical activity," says Julie Marvel Mansfeldt.

"In theory, an energy deficit resulting from exercising more should result in weight loss. But in practice, we see that the two things are seldom linked and that weight loss from exercise is often less than expected. This indicates that some kind of compensatory mechanism must exist. Surprisingly and contrary to what many people think, we do not typically increase the amount of food we eat upon starting exercise training. This then suggests that we must be decreasing non-exercise physical activity, which refers to all the physical activities we do in our daily lives aside from the structured exercise."

One of the studies concludes that this decline made subjects lose 22% less weight than expected from their exercise training program.

We think we deserve it

According to graduate student Julie Marvel Mansfeldt, our tendency to be less physically active outside of exercise time is probably a mixture of physiological and psychological mechanisms within us.

"The compensation can come from simply feeling more tired after a training session at the gym. But there is probably a psychological factor at play too, which is a kind of reward system that kicks in and makes us think we deserve to lie on the couch and skip the long walk with the dog, or take the car to the supermarket instead of cycling," Mansfeldt explains.

While many of us probably believe that we feel hungrier and eat more after engaging in structured sport or exercise activities, research in this area actually shows that this kind of compensation is not as common.

The studies also demonstrated that the compensatory reduction of non-exercise physical activities is a common response among both men and women, and both among people with a body weight within the healthy range and those with overweight.

The researchers hope that the new knowledge will be put into practice both by individuals and professionals:

"The number of overweight people is constantly growing. Therefore, it is important to look at what we can do to facilitate a net energy balance whereby the amount of energy a person consumes is no greater than the amount of energy they expend," says Mansfeldt.

"Currently, weight loss programs involving exercise always state that participants need to be careful not to eat more. But because this second mechanism also appears to play an important role, I hope that it will be mentioned to anyone who begins an exercise-based weight loss program in the future. That they should remember to be as active on a daily basis as usual, and be careful to not give up cycling to work, walking the dog, taking the stairs, and so on."

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Time is not to be trusted. This should come as news to no one.

Yet recent times have left people feeling betrayed that the reliable metronome laying down the beat of their lives has, in a word, gone bonkers. Time sulked and slipped away, or slogged to a stop, rushing ahead or hanging back unaccountably; it no longer came in tidy lumps clearly clustered in well-defined categories: past, present, future.

“Time doesn’t make sense anymore,” a redditor lately lamented. “It feels quicker. Days, weeks, months it’s going by at 2x speed.” Hundreds agreed—and blamed the pandemic.

I’m surprised anyone is surprised. No one understands time. Time is a notorious trickster, evading the best efforts of scientists to pin it down for thousands of years. Psychologists call it a quagmire. Physicists say it’s a mess, hopeless, the ultimate terrorist. A failure of imagination. There’s nothing new about time being nuts.

Intrigued by the pervasive sense of pandemic-induced time distortion, psychologists at first speculated that loss of temporal landmarks was at work: office, gym, pulling on of pants. Words such as “Blursday” crept into the vocabulary, along with “polycrisis” and “permacrisis,” referring to the plethora of perturbances creating instability, pushing time out of sync: war, climate, politics.

Yet for all the newish research involving linguistics, neuroscience, psychology, scientists have made no real progress. We still know pretty much what we’ve always known: Scary movies and skydiving make time seem eternal, as does waiting for rewards (that call from the Nobel committee) or being bored (are we there yet?). In contrast, being happily immersed in some task (“flow”), facing deadlines, running for a bus, getting old, can make time run fast.

Attempts to find a biological mechanism for time—a single stopwatch in the brain—have likewise gotten nowhere. Rather, the brain teems with timekeepers, tick-tocking at different rates, measuring milliseconds and decades, keeping track of breath, heartbeat, body movements, information from the senses, predictions for the future, memories.

“There are thousands of possible intricate answers, all depending on what exactly scientists are asking,” explained one neuroscientist, sounding much like a physicist—that realm of science that routinely slices time into slivers of seconds, describes the universe a trillionth of a trillionth of a second after its birth, yet still doesn’t have clue how to think about it.

Even the great late physicist John Wheeler, who coined the term black hole for a thing made only of spacetime, was stumped by time itself. He once admitted he couldn’t do better than quote a bit of graffiti he’d read on a men’s room wall: “Time is nature’s way to keep everything from happening at once.”

Philosophers have long told us that time is an illusion; modern physicists agree. That doesn’t add much insight. Illusions are stories the brain creates to make sense of confusing information, the chaos out there and within. This describes nearly everything we think we know. Without time, there’s no way of making a narrative; there’s no way of making a universe.

One major problem is: Time can’t begin unless there’s time, because without “before” and “after” there’s no causality, nothing can happen. (If you’re not already confused, you’re probably not paying attention.)

Once time starts ticking, it flies along like an arrow in a single direction. There’s no physical reason this should be so. An atom can swallow a particle of light and let it go, and if you run the film backward you can’t tell the difference. A video of a person eating sushi played backward, however, would strike us as weird (and vaguely disgusting). Whether it’s making closets messy, melting glaciers, or wearing down mountains, the arrow of time answers only to the second law of thermodynamics. Disorder itself is what gives time its order. The engine that powers it is probability: There are more ways for things to fall apart than come together. Entropy (almost) inevitably increases.

Initially a way to think about heat and the dissipation of energy that makes perpetual motion machines impossible, entropy has evolved to take a central place in information theory. That brilliant manuscript shredded by your dog may contain your original words yet be too scrambled and slobbery to read. That same manuscript dropped into a black hole may eventually evaporate back into the universe. Is the information lost? Physicists love to argue about this.

Entropy also means loss of opportunity: The water at the top of a dam can spin a turbine; at the bottom, that same energy has degraded, the potential to be useful irretrievable. Or in the words of the ever-wise Jack Handy: “If you ever drop your keys into a river of molten lava, let ’em go ... because, man, they’re gone!”

The real cause of crumbling time, I’d guess, is our uneasy (if understandable) discomfort with the evils of entropy.

A “senior” like me is your poster child for entropy. Long before we appear old, disintegration has begun. Joints lose elasticity, start to creak and snap; lenses cloud and rigidify, hearing falters, muscles weaken, arteries clog, memories fade, words fail … something else I can’t remember right now.

All that aside, we have freezers that unmelt water. Galaxies and life exist—islands of order in our entropy-saturated universe. A rose takes decayed matter in soil and refashions it into nicely nested petals. Conflicts can be solved, peace restored—if we put in work enough to make it happen. Sooner or later, the energy returns to the universe as generally useless random motion. A lot of senseless jiggling around of stuff is what heat is, which makes me wonder why no one connects global warming with the general wonkiness of our times. But that’s just me.

Photo-illustration: WIRED Staff; Getty Images

Not everyone buys this cosmic arrow-of-time idea. For one thing, if time is a one-way street into decomposition, then the universe had to begin in an oddly well-composed state; there’s no good reason that should be true either. Some physicists argue it’s just as logical that the Big Bang was simply an orderly phase the universe passed through in its otherwise convoluted history. Or that our universe is one of an infinite menagerie of universes—one that by accident emerged with unusual regularity.

For another thing: Why only one way? Why not two dimensions of time? Or more? It’s not ruled out, though few physicists dare to ask the question; they don’t quite know how. The scenario also raises the question: Which time are we in? (A question many of us pondered informally over the past few years.)

Time, in physics, is designated by “imaginary” numbers—like the square root of minus one—less exotic than it sounds. It goes off at right angles to the space dimensions. On a graph, time and space can look interchangeable. In imaginary time, the universe doesn’t need to have a beginning and an end, an idea incorporated into Stephen Hawking’s “no boundary” proposal. It would just be. Asking when time began would be like asking what’s north of the North Pole. At some point, imaginary time turns “real,” distinguishes itself from space, and races off on the road not yet taken.

Ever since Einstein, we’ve known that space and time are inseparable. If the speed of light is constant (and it must be), then when distance (space) changes, so must time, because speed is just distance divided by time—like miles per hour. Everything, including us, drifts through spacetime and at the speed of light, even though the space bit and the time bit are unevenly distributed. Generally, and especially during a pandemic, we sit on our butts, moving mostly through time. If we run around the block, we move more through space, less through time. Time slows. Run fast enough and time stops. Photons racing toward us from the sun at the speed of light never get old—they only travel through space.

The good news is, all time is “you time.” You can take it with you! Indeed, you must! It’s yours to save or waste or even kill. Even “now” is not the same for everyone. Contemplate “now” on a star—say, our very own sun. You’re seeing it roughly eight minutes ago, in the past. Present and past aren’t clearly defined. It doesn’t take physics to tell us that. According to the Stanford Encyclopedia of Philosophy, no less: “if pastness were something we could perceive, then we would perceive everything in this way, since every event is past by the time we perceive it.” (Confused yet?)

The bad news, for someone like me, anyway, is that time plus gravity brings old people down—literally. Gravity is, after all, the curvature of spacetime, and among the things it curves are spines. It also tugs on our skin, causing it to sag; our middles, making them round. It shrinks our bones. Thank goodness gravity also tugs on time, slowing it down.

“Everything likes to live where it will age the most slowly, and gravity pulls it there,” explains Kip Thorne, in his Science of Interstellar. If you want to live longer, forget the penthouse; you’re better off in the basement.

You could even, in theory, use gravity to turn time all the way around, creating a “closed time-like curve”—physicist talk for a time machine. Unfortunately, it appears that any attempt to create such a system would self-destruct as soon as you turn it on. Hawking also came up with the Chronology Protection Conjecture, to keep you from killing your grandfather, but also, he noted, to “keep the world safe for historians.”

One thing scientists know for sure about time as well as space is that under a sufficient pull of gravity and/or very short distances—say, in the heart of black holes or the beginning of time—spacetime “boils” into a state Wheeler first called “quantum foam.” Where the smooth landscape of spacetime meets the discrete, uncertain realm of the quanta, space and time get chopped up in a cosmic scale Cuisinart. Without “left and right,” or “up and down,” space becomes mangled beyond meaning. Without “before and after,” time evaporates.

Thorne reminds us that quantum foam is everywhere: “inside black holes, in interstellar space, in the room where you sit, in your brain.” That pervasive buzz in our heads, that “brain fog” affecting so many of late, may be imagined, if you please, and I do, as space and time frothing like bubbles in the bath.

In desperation, physicists continue to try any number of loopy schemes for time, including loopy time, stringy time, holographic time. Perhaps time crystalizes into its present shape out of shattered shards swimming around in the early universe. A new phase of matter known as a “time crystal” may have been created recently with the help of quantum computers. (“This is a subject in its infancy,” said physicist Frank Wilczek, who came up with the concept a dozen years ago.)

The physicist Carlo Rovelli, in his popular book The Order of Time, reminds us that reality is merely a complex web of events onto which we project ideas of past, present, and future. Nothing exists that isn’t connected to everything else in space and time, and space and time emerge from these connections. If that seems circular, it is. Curved spacetime tells matter how to move, as Wheeler put it. Matter tells spacetime how to curve. Recent work suggests that spacetime itself may be woven out of quantum entanglements—connections Einstein once dismissed as “spooky action at a distance” but are, in fact, quite real.

Which is all to say: Time and space are ever-evolving relationships, just like everything else. In the end, the mind scientists and the matter scientists landed on the same page.

For the rest of us, the Earth still turns, marking our hours and days. Striations in rocks tell geological time; radioactive decay dates ancient artifacts; DNA can clock evolution; the age of the elements can be read by nucleocosmochronology (one of my favorite terms in science). The National Institute of Standards and Technology keeps time with cesium fountain clocks, using lasers, vacuum chambers, clouds of ultracold atoms to nail the natural resonance frequency of the cesium—the basis for the standard second (9,192,631,770 Hz).

Scientists have theories about why time passes more quickly as we get older, but to me, it’s just math. If my denominator is 76, a year is 1/76th of my life, a much smaller slice than, say, 1/2—the percent of a lifetime a year marked when I was 2 years old. And yet, that 2-year-old is also me. I am the sum of all my histories. As Anne Lamott wrote: “I am every age I ever was and so are you.”

I like making time for myself—which I’d do anyway, whether I wanted to or not. I like taking my time, also thankfully not an option. I like knowing that moving fast—say, dancing—uses up space and grants me time. I’m glad I don’t live in a penthouse.

I am mindful that my ever-smaller slivers should be put to good use, so I’ve got a lot of half-finished books lying about. I’ll give a movie maybe 10 minutes. I’m trying to force myself not to miss things I really want to do for dumb reasons—reasons such as: I’m embarrassed, it’s raining, there’s always tomorrow. There isn’t always tomorrow.

In Tom Stoppard’s Arcadia, the almost-17-year-old Thomasina discovers the equations of nature—chaos, entropy, heat death—but doesn’t have room in the margins of her lesson book to finish the calculations (that will take computers); her brother Valentine, from another time entirely, centuries hence, explains the meaning of the math: “everything is mixing … all the time, irreversibly … till there’s no time left. That’s what time means.”

Thomasina answers: “Yes, we must hurry if we are going to dance.”

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Millions of students will stay home from tomorrow after Punjab, Pakistan's most populous province, announced blanket closures having recorded 357,000 conjunctivitis cases since the start of the year.

The fast-spreading eye infection causes redness, itchiness and discharge from the eyes and contamination can spread through hand contact, as well as coughing and sneezing.

"The closure has been announced as a proactive measure to give maximum protection to students against the infection," Punjab education department spokesman Zulfiqar Ali told AFP.

There are 127,000,000 residents in eastern Punjab province and 56,000 state schools, as well as thousands of independent schools also subject to the shutdown.

"We hope this will break the cycle of the infection in the province," Ali said.

Schools across Pakistan had already been due to shut on Friday owing to a public religious holiday, however many would usually open over the weekend to provide extra classes or stage exams.

Punjab authorities said students would be screened at school gates when they reopen Monday.

© 2023 AFP

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In September 2023, the Centers for Disease Control and Prevention issued a health advisory alerting doctors and public health officials of an increase in flesh-eating bacteria cases that can cause serious wound infections.

I'm a professor at the Indiana University School of Medicine, where my laboratory studies microbiology and infectious disease. Here's why the CDC is so concerned about this deadly infection – and ways to avoid contracting it.

What does 'flesh-eating' mean?

There are several types of bacteria that can infect open wounds and cause a rare condition called necrotizing fasciitis. These bacteria do not merely damage the surface of the skin – they release toxins that destroy the underlying tissue, including muscles, nerves and blood vessels. Once the bacteria reach the bloodstream, they gain ready access to additional tissues and organ systems. If left untreated, necrotizing fasciitis can be fatal, sometimes within 48 hours.

The bacterial species group A Streptococcus, or group A strep, is the most common culprit behind necrotizing fasciitis. But the CDC's latest warning points to an additional suspect, a type of bacteria called Vibrio vulnificus. There are only 150 to 200 cases of Vibrio vulnificus in the US each year, but the mortality rate is high, with 1 in 5 people succumbing to the infection.

How do you catch flesh-eating bacteria?

Vibrio vulnificus primarily lives in warm seawater but can also be found in brackish water – areas where the ocean mixes with freshwater. Most infections in the US occur in the warmer months, between May and October. People who swim, fish or wade in these bodies of water can contract the bacteria through an open wound or sore.

Vibrio vulnificus can also get into seafood harvested from these waters, especially shellfish like oysters. Eating such foods raw or undercooked can lead to food poisoning, and handling them while having an open wound can provide an entry point for the bacteria to cause necrotizing fasciitis. In the US, Vibrio vulnificus is a leading cause of seafood-associated fatality.

Why are flesh-eating bacteria infections rising?

Vibrio vulnificus is found in warm coastal waters around the world. In the US, this includes southern Gulf Coast states. But rising ocean temperatures due to global warming are creating new habitats for this type of bacteria, which can now be found along the East Coast as far north as New York and Connecticut. A recent study noted that Vibrio vulnificus wound infections increased eightfold between 1988 and 2018 in the eastern US.

Climate change is also fueling stronger hurricanes and storm surges, which have been associated with spikes in flesh-eating bacteria infection cases.

Aside from increasing water temperatures, the number of people who are most vulnerable to severe infection, including those with diabetes and those taking medications that suppress immunity, is on the rise.

What are symptoms of necrotizing fasciitis? How is it treated?

Early symptoms of an infected wound include fever, redness, intense pain or swelling at the site of injury. If you have these symptoms, seek medical attention without delay. Necrotizing fasciitis can progress quickly, producing ulcers, blisters, skin discoloration and pus.

Treating flesh-eating bacteria is a race against time. Clinicians administer antibiotics directly into the bloodstream to kill the bacteria. In many cases, damaged tissue needs to be surgically removed to stop the rapid spread of the infection. This sometimes results in amputation of affected limbs.

Researchers are concerned that an increasing number of cases are becoming impossible to treat because Vibrio vulnificus has evolved resistance to certain antibiotics.

How do I protect myself?

The CDC offers several recommendations to help prevent infection.

People who have a fresh cut, including a new piercing or tattoo, are advised to stay out of water that could be home to Vibrio vulnificus. Otherwise, the wound should be completely covered with a waterproof bandage.

People with an open wound should also avoid handling raw seafood or fish. Wounds that occur while fishing, preparing seafood or swimming should be washed immediately and thoroughly with soap and water.

Anyone can contract necrotizing fasciitis, but people with weakened immune systems are most susceptible to severe disease. This includes people taking immunosuppressive medications or those who have pre-existing conditions such as liver disease, cancer, HIV or diabetes.

It is important to bear in mind that necrotizing fasciitis presently remains very rare. But given its severity, it is beneficial to stay informed.

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