The science behind the zombie fungus from ‘The Last of Us’

Kevin Schafer/Getty Images

(NEW YORK) — The hit HBO series “The Last Of Us” describes a post-pandemic world devastated by a mass outbreak of a “zombie fungus” that infects and takes over the mind of its hosts. Originally a video game, the popular show was recently renewed for a second season.

Although its premise is science fiction, the fungus in the show is actually based in scientific reality.

Is the ‘zombie’ fungus real?

Cordyceps – the so-called “zombie fungus” – is a real fungus and is sometimes used in treatments and therapeutics in Chinese herbal medicine.

Although cordyceps does not infect humans, it does infect a wide range of insects.

In ants, cordyceps slowly infects its victims by mind-controlling the host to migrate to a humid climate where the conditions are perfect for its growth. Once a suitable environment has been found, the ant will dig its jaws into a plant and await death.

The fungus will then slowly consume the ant while eventually sending out its own spores – a sort of antenna to enthrall and trap future victims.

Could the ‘zombie fungus’ threaten human health?

There are thousands of species of cordyceps each designed to infect a particular species – luckily, humans aren’t one of them. The human body’s immune system is more advanced than that of an ant and has a higher internal temperature, which would protect it from cordyceps infection.

However, other fungi have made their presence known throughout human history. Ergot poisoning, also dubbed “St. Anthony’s Fire,” is caused by the contamination of grain and has been attributed to mass hysteria events such as the Salem Witch trials in the 17th century, Matthew Fisher, Ph.D., a professor of fungal disease epidemiology at the Imperial College School of Public Health, said.

While some fungi have been known to cause hallucinations on very rare occasions, “a human manipulating cordyceps is vanishingly unlikely,” Fisher said.

Scientists said that while there are approximately 150,000 species of fungi – with a few million yet to be discovered – only about 200 are known to infect humans.

How do fungi currently affect human health?

Fungal infections are responsible for over 150 million severe cases and an estimated 1.7 million deaths per year worldwide, according to one study.

Researchers estimate that nearly a billion people have skin, nail and hair fungal infections annually. More serious fungal infections usually appear in people with other underlying health problems such as asthma, AIDS, cancer, organ transplant recipients and those on corticosteroid therapies.

In a detailed report, the World Health Organization warned in October, 2022, of 19 fungal pathogens representing the greatest threat to public health.

Yet, fungal infections receive less than 1.5% of infectious disease funding while killing more people than tuberculosis – a leading infectious disease killer worldwide.

“It’s really shocking that research on fungal pathogens is so underfunded. Biohazardous threats are much broader than just bacteria and viruses,” Jessica Malaty Rivera, infectious disease epidemiologist and research fellow at Boston Children’s Hospital and The Johns Hopkins Center for Health Security, told ABC News.

Will there be a pandemic caused by fungal infections?

While some fungi can be transmitted from person to person, they generally do not spread as easily or quickly as viruses. Additionally, the human body’s immune response and the availability of antifungal medications make it less likely that a fungus would be able to cause a global outbreak.

It is unlikely that a single fungus would cause a global pandemic on the same scale that we’ve seen with COVID-19. Viruses typically spread through respiratory droplets whereas fungal infections spread through direct skin-to-skin contact or from sharing items.

Despite a low possibility of spurring a worldwide pandemic, the global burden of fungal infections remains high. “Many of these infections can be incredibly difficult to treat and have high mortality rates,” Rivera said.

Is climate change making things worse?

While it is highly unlikely climate change would lead to a zombie-like apocalypse according to experts, the warming of the globe continues to pose a threat to global health.

Research has shown that global pandemics from infectious diseases may become more common as habitats continue to bleed into one another and animals are exposed to species they have never interacted with before, while the space between humans and the natural world shrinks.

A new study also found that when scientists increased the temperature of a particular fungus was exposed to, the pathogen could adapt with certain genetic changes.

“These mobile elements are likely to contribute to adaptation in the environment and during an infection,” postdoctoral researcher Asiya Gusa Ph.D. of Molecular Genetics and Microbiology in the Duke School of Medicine said in a press release accompanied with the study. The research may suggest that pathogenic fungi can adapt to the planet’s warmer temperatures as well – highlighting the danger of global warming.

“It is clear that in a warmer wetter world, we are going to be exposed to more [fungi] than ever before – signs of this were seen during Hurricane Katrina – and this is going to pose an increased public health stress,” Fisher said.

“If we are going to really tackle climate change, we have to get more specific about the impact it has on public health,” Rivera said.

Copyright © 2023, ABC Audio. All rights reserved.

Eye drops recalled after 55 reports of bacterial infection, one death in 12 states

EzriCare

(NEW YORK) — Two types of artificial tears eye drops have been voluntarily recalled following 55 reports of adverse use effects, including eye infections, vision loss and even a bloodstream infection that led to one death, according to federal officials.

The affected eye drops were distributed by Aru Pharma, EzriCare and Delsam Pharma under Global Pharma Healthcare.

According to a health alert released by the Centers for Disease Control and Prevention Wednesday, federal, state and local health agencies have identified at least 55 individuals — some in health care facilities — across 12 states who had been infected with a strain of Pseudomonas aeruginosa that expresses bacterial enzymes, making it highly resistant to many antibiotics.

Those impacted were in California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah, Washington and Wisconsin.

Artificial tears are often used to relieve burning and irritation due to dryness of the eyes and provide lubrication while preventing further eye irritation.

“Use of contaminated artificial tears can result in the risk of eye infections that could result in blindness,” Global Pharma Healthcare said in a recall statement posted on the U.S. Food and Drug Administration website Thursday.

“Global Pharma Healthcare is notifying the distributors of this product, Aru Pharma Inc. and Delsam Pharma and is requesting that wholesalers, retailers and customers who have the recalled product should stop use,” the statement continued. “…Consumers should contact their physician or healthcare provider if they have experienced any problems that may be related to using these over-the-counter drug products.”

The CDC issues similar guidance, stating that anyone who may have used EzriCare’s artificial tears and suspects they have an eye infection should seek medical care. Signs of an eye infection may include discharge from the eyes, pain or discomfort, redness of the eye or eyelid, blurry vision, increased light sensitivity, a feeling of something in the eye, according to the CDC.

The CDC also recommended people reach out to their health care providers if they were using the eye drops under the care of a doctor.

EzriCare, one of the distributors of the impacted eye drops, has set up a website with information for consumers.

“We immediately took action to stop any further distribution or sale of EzriCare Artificial Tears. To the greatest extent possible, we have been contacting customers to advise them against continued use of the product. We also immediately reached out to both CDC and FDA and indicated our willingness to cooperate with any requests they may have of us,” the company said in a statement.

The artificial tears were available over-the-counter online. The CDC, FDA and EzriCare are advising consumers to discontinue using any recalled eyedrops.

When reached by phone, Delsam Pharma president Kuppusamy Arumugam told “Good Morning America” the eyedrops Delsam distributed were recalled after the company was notified of a problem with Ezricare’s eyedrops. Arumugam said any recalled eyedrops from Delsam can be sent back to the company for a refund.

According to the FDA, the recalled eye drops were packaged in bottles with safety seals and small cartons, with Ezricare drops having the NDC number 79503-0101-15 and UPC number 3 79503 10115 7, and Delsam Pharma drops labeled with the NDC number 72570-121-15 and UPC number of 72570-0121-15.

Consumers can direct questions to the distributors via email or phone. Aru Pharma and Ezricare can be reached at arupharmainc@yahoo.com or at@ezricare-info.com or at 1-518-738-7602 while Delsam Pharma is available at delsampharma@yahoo.com or 1-866-826-1306.

The FDA is also encouraging anyone impacted to file a report with the agency’s MedWatch Adverse Event Reporting program.

GMA has reached out to Aru Pharma for comment on the recall.

Copyright © 2023, ABC Audio. All rights reserved.

As US reels from Tyre Nichols video, what makes people act violently as a group?

Douglas Sacha/Getty Images

(NEW YORK) — Many were stunned when videos were released of Tyre Nichols, a 29-year-old Black man, being beaten to death by five Memphis police officers during a traffic stop.

Officers pulled Nichols from his car on Jan. 7, pepper sprayed him and used a taser, the footage shows. He managed to flee, but the officers caught up with him and held him on the ground as they punched and kicked him in the head and hit him with a baton, according to the video that was released last week.

Seven Memphis police officers have been relieved of duty, with the five involved in the beating charged with murder. Additionally, three Memphis Fire Department personnel were fired.

While it’s unclear what motivated the officers to act in that way, psychologists and other social experts told ABC News some people act differently in groups than when they are alone and may participate in group-based violence because of it.

Police may misperceive someone as a threat

George Smith, director of outpatient group therapy at McLean Hospital — a psychiatric hospital in Belmont, Massachusetts — said police group violence might be different from other forms of group violence because they may act when they view someone as a threat.

“I was just thinking about the five police officers, and they may have believed that there was an actual threat, either to the community or to themselves,” he told ABC News. “Thinking this person is a menace to the community, and we need to do something to protect humanity from this genuine threat, or it may be that they believe that this person was a threat to one of them.”

“And when that happens, your good judgment can go completely out the window,” he added.

Smith said the person police officers might think to be a threat could be completely innocent, but the violence can still occur anyway.

“Even in a more benign situation, when a traffic cop pulls somebody over, it may be a completely innocent person whose taillight was out,” he said. “But they don’t know if this person has a weapon in their glove compartment so there’s this unnatural tendency for them to get adrenalized and to approach the situation in a more belligerent way than was warranted.”

Wanting to feel part of a group

Experts told ABC News wanting to belong to a group is nothing new and extends from wild animals running in a pack to humans wanting to affiliate.

While joining a group may have been necessary for survival in prehistoric times, it is now for developing a sense of camaraderie and belonging, experts said.

“As people are part of a group, they start to feel identified with this group, they feel like it’s an important part of who they are, they might even come to define themselves in terms of being a member of a group,” Dr. Rebecca Littman, an assistant professor in the department of psychology at the University of Illinois Chicago, told ABC News.

“There’s different kinds of groups, some that are based on the premise of violence and others that are not,” she continued. “So, you feel like you’re very identified with this group, you want to be a good group member, you want to get along with everyone else. And that can lead kind of ordinary people who generally in their individual lives would never end up participating in violence.”

Those same people, even though they know violence is wrong, may still participate because they’ll feel shunned by the group if they don’t.

“People are afraid of losing a social status, particularly when it’s a group that they really care about,” said Littman, who has studied why people participate in group-based violence. “They don’t want to be ostracized or, even just in a less extreme form, they don’t want to be seen as the odd person out.”

Dr. Vivian Zayas, a professor in the department of psychology at Cornell University in New York, said if a person starts to go against what the group thinks, they might be seen as undermining the group.

“Strategically, there are consequences to people who don’t work well in a group,” Zayas told ABC News. “They can be left out of the group, they can be left out of decision-making, they can be marginalized, they could lose power and status. Those sorts of social punishments can be used to silence differing opinions.”

Groups can normalize violent behavior

Research has shown that people’s thoughts and actions are often influenced by how those around them think and act.

If a group normalizes a behavior, even if that behavior is bad — such as violence — then we might believe that behavior is acceptable.

“What can happen is that this group is creating this new set of social norms. Maybe in this group, we’re often in situations where we feel a lot of threat and we have to protect ourselves, and the way we protect ourselves is violence,” Littman said.

“So, you can kind of see how that violence in particular groups can become normalized in a lot of different ways and make people either themselves genuinely feel like it’s okay or at least feel like this is what is normal in my group,” she added.

Leaders can influence behavior

The experts told ABC News that because we are influenced by leaders — and leaders set examples for the group — if the leader believes in bad behavior, the group may follow.

“If that person has status in that group and if they’re saying that the behavior is appropriate for group members — even if initially, someone thought that the behavior is problematic — they might feel that or come to think that it’s more appropriate,” said Zayas.

Zayas added that someone in the group might also see that the leader was elevated by engaging in problematic behaviors and wasn’t punished or reprimanded so they think they can also engage in the behavior without getting in trouble.

Reports have emerged that Memphis Police Chief Cerelyn Davis adopted a “tough on crime” strategy when she took on the role.

Part of that included launching the SCORPION unit, which stands for Street Crimes Operation to Restore Peace in Our Neighborhood, of which the five officers were members. Activists and residents have said members of the unit used excessive force. The unit has since been disbanded.

“The process of listening intently to the family of Tyre Nichols, community leaders, and the uninvolved officers who have done quality work in their assignments, it is in the best interest of all to permanently deactivate the SCORPION Unit,” a statement from the department read.

This doesn’t mean that Davis advocated the use of violence nor that she encouraged her officers to be violent, but the officers may have felt they were fulfilling her mission, experts said.

“So, it became part of a shared mission and when you get that mission, and there’s buy-in, because you’re part of a group that believes this mission,” Smith said. “One’s ability to discern whether it actually is a perceived threat can get totally overshadowed by this belief that we together are saving the community from these threats that are out there.”

In a video posted on Jan. 26, Chief Davis condemned the officers’ actions and called the circumstances surrounding Nichols’ death “horrific.”

“I am not wavering in my commitment to you to have a police force that is here to serve and protect you,” she said. “Those five officers and others failed our community and they failed the Nichols family and that is beyond regrettable.”

Copyright © 2023, ABC Audio. All rights reserved.

How long eggs stay fresh, tips to store them and how to check if eggs are still safe to eat

d3sign/Getty Images

(NEW YORK) — Shoppers have seen significant price spikes on eggs as of late and since everyone wants to make the most of their hard-earned money, there are a few simple rules and tricks you should know to prevent prematurely tossing or wasting the staple protein.

Most egg cartons sold in stores get stamped with a “best if used by” or “best before” date for stores to control and rotate inventory. The U.S. Department of Agriculture explains that the printed “expiration date” is there so consumers know how long the eggs will be at their highest quality and best taste when stored in ideal conditions.

“Use by” dates show shoppers how long they have to consume the eggs before their overall quality diminishes. According to the USDA, the “use by” date “may not exceed 45 days including the day the eggs were packed into the carton.”

However, in many cases eggs can still be safely consumed beyond that date if they aren’t spoiled.

Eggs can last up to five weeks after they were packed, when stored in proper refrigerator conditions, according to The American Egg Board.

Here are some Grade A tips from the USDA to keep in mind when you need to know if you still have a good egg:

How to properly store store-bought eggs

Eggs purchased at the store should be brought straight home and refrigerated immediately at 40 degrees or colder, the USDA advises: “Keep them in their carton and place them in the coldest part of the refrigerator, not in the door.”

Typically, the coldest part of the fridge is lower shelves and towards the back of the unit.

Due to risk of bacteria growth and salmonella, don’t leave store-bought eggs out of the refrigerator for more than 2 hours. Any bacteria present in an egg can multiply quickly at room temperature, according to the USDA. When a cold egg sweats at room temperature, it can cause bacteria to move into the egg and spread more easily.

How long are eggs good once cracked?

Because bacteria can enter eggs through cracks in the shell, the USDA says to never purchase an egg that’s cracked.

“If eggs crack on the way home from the store, break them into a clean container, cover it tightly, keep refrigerated, and use within two days,” the agency states. “If eggs crack during hard cooking, they are safe. Remember that all eggs should be thoroughly cooked.”

How to use water to test if eggs are still fresh

Despite a “best by” or “packed on” date — or if you have a couple extra eggs out of their carton in the fridge and don’t remember when they got there — this sink or float test is a good baseline to determine if an egg is still fresh.

First, fill a bowl with enough cold water to cover the egg, and gently lower the egg in.

If it sinks to the bottom and stays on its side, the egg is very fresh, according to The Spruce Eats, which regularly tests common kitchen and cooking tricks like this one.

An egg that sinks to the bottom but floats on an angle or upright is slightly older but still safe to eat.

Eggs that float completely should be discarded as they’re too old to safely consume, The Spruce Eats notes.

As eggs age, the shell becomes more porous so more air is able to flow through and can create a larger air pocket between the egg membrane and shell. That small sack of air, once large enough, is what makes the egg float.

How long do you have to safely eat eggs once cooked?

Cooked eggs and dishes made with eggs should be eaten immediately after cooking. They can also be stored in a shallow container for quick cooling and then refrigerated for later use within three to four days.

When it comes to hard boiled eggs, the USDA states that the shell’s protective coating, or “bloom,” which is produced by a hen when it lays an egg, gets washed away “leaving bare the pores in the shell for bacteria to enter and contaminate it.”

For that reason, the USDA recommends hard-cooked eggs be refrigerated within two hours of cooking and used within a week.

How long do farmers market eggs stay fresh?

Because farm stands and farmers aren’t bound by the same USDA requirements to be washed, these eggs are often sold unrefrigerated and protected by their bloom.

According to The Happy Chicken Coop — an online publication and “group of chicken enthusiasts from around the world who have been raising chickens in their backyards for decades” — farm fresh eggs can be left unrefrigerated for up to a month, though after that, should be stored in a refrigerator, where they can be kept for up to six months.

Freeze raw eggs to use later

Yes, you can freeze eggs, just not in their shell because they will expand and break. So if you know you won’t finish an entire carton before the expiration, this is a great way to cut down on food waste.

According to The American Egg Board, there is a simple way to freeze eggs.

Crack the eggs into a bowl, gently whisk until whites and yolks are combined (not so much that air is introduced), and pour the eggs into an ice cube tray to freeze in individual servings. One cube is approximately half an egg. Once the cubes are frozen solid, transfer from the tray into a freezer-friendly, air-tight plastic bag.

Chef Jürgen David, director of pastry R&D at the Institute of Culinary Education, told ABC News’ Good Morning America that he suggests separating the whites from the yolks first “because many pastry applications call for just yolks or an unequal amount of yolks and whites.”

Gently beat the yolks until it forms a liquid and freeze and store as explained in the first method. One cube equals two egg yolks.

For the whites, pour directly into an ice cube tray, then freeze and store accordingly.

Frozen eggs keep best for two to three months, but can last up to a year in the freezer.

When ready to use the frozen eggs, thaw them in the refrigerator overnight or under running cold water and use them as intended.

Copyright © 2023, ABC Audio. All rights reserved.

A public health success story: How the Mpox crisis was controlled within 6 months

Vincent D. Johnson/Xinhua via Getty Images

(NEW YORK) — When the highly infectious Mpox virus, formerly called Monkeypox, was declared a public health emergency in August of last year, more than 450 people were testing positive every day. With more than 30,000 cases and 28 deaths, many feared Mpox could become the next pandemic.

The virus — characterized by a painful rash and deep lesion — was primarily spreading via skin-to-skin contact among sexual networks.

Now, roughly six months later, the emergency is over, with the nation averaging fewer than three cases per day. According to doctors and public health experts interviewed by ABC News, the virus didn’t disappear on its own. Instead, the virus was controlled through an aggressive, highly coordinated public health response.

“Mpox is a success story of conquering an outbreak,” said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco.

The successful control of Mpox was due largely to the rapid deployment of vaccines and treatments paired with an aggressive public awareness campaign that leveraged trusted voices in the LGBTQ community, which was hit first by the outbreak.

“Of course there have been criticisms,” said Dr. Vincent Hsu, an infectious disease specialist and AdventHealth’s infection control officer. “But the fact remains that in a relatively short period of time, we have been able to get the number of cases down to where there’s just very few.”

Key to that success was public outreach and education.

“Health departments and community advocates got the message out about Mpox — how the disease presented, how it was spread, how it could be treated and how it could be prevented, including vaccination,” said Dr. Roy M. Gulick, chief of the Infectious Diseases Division at Weill Medical College of Cornell University. “The sharp decrease in cases directly resulted from these efforts.”

Public health experts credited a strong, unified response from leaders in the LGBTQ community. In fact, the rapid response in the LGBTQ community did not allow the virus to spread even further, Hsu said.

“The LGBTQ community has a strong record of community advocacy and successful interactions with the public health system from the time of the HIV epidemic,” said Gulick. “Education led to behavior changes in the community, including limiting the number of sexual partners, as well as the enthusiastic uptake of the vaccine.”

“Some of the secret sauce came around communication,” added Chin-Hong, including “using trusted messengers from the community” to deliver the message. Chin-Hong pointed to Reggie Aqui, an ABC anchor in San Francisco and an openly gay man, as an example. Aqui was nominated for a GLAAD award for his work and community discussions about Mpox.

Another smart move was appointing Dr. Robert Fenton and Dr. Demetre Daskalakis to head the federal government’s MPox response, Chin-Hong said. Fenton and Daskalakis deployed evidence-based guidelines which helped doctors like him feel comfortable trusting their advice, he said.

Beyond education, an equally crucial factor in controlling the outbreak was the rapid deployment of existing vaccines and treatments that had been stockpiled for smallpox, a closely related virus.

“The prior availability of therapeutics meant we weren’t flying the plane as we were building it,” said John Brownstein, an ABC News contributor and chief innovation officer at Boston’s Children’s Hospital.

In August — with limited supplies of the only FDA-approved mpox vaccine — government public health officials made a controversial choice to break up a single vaccine into multiple doses, tweaking the route of administration to maximize the body’s immune response.

Thankfully, this new vaccine strategy worked — as did existing treatments, according to doctors and public health experts.

Still, experts warn the virus hasn’t been fully eradicated and could return. Although “the emergency is largely over,” Hsu said, “we need to continue to be vigilant.”

“The Mpox response is now a model by which to prepare for future infectious disease threats,” Brownstein said.

Added Chin-Hong: “I think Mpox generally provides a great playbook of how to deal with an outbreak: the alignment of science and politics needed, a national a local strategy that was implemented and having strong and unified consistent messaging that is empathic and specific.”

Copyright © 2023, ABC Audio. All rights reserved.

FDA issues warning letters to companies selling unproven mpox treatments

Jackyenjoyphotography/Getty Images

(NEW YORK) — A new warning from the Food and Drug Administration urges consumers to beware of marketers attempting to sell illegal and unproven mpox “medication” and “cures” in order to swindle scared, vulnerable people and bilk them out of their money.

The agency also shared a series of pictures of the alleged illegal products for sale.

These products, often sold online, have not been reviewed by FDA, the agency says, and are not proven safe or effective to treat mpox and other health conditions that they claim to address.

Several warning letters have been sent by FDA to the companies allegedly peddling these products.

One company’s website falsely claims that an “herbal natural remedy” for mpox comes from the carnivorous purple pitcher plant, Sarracenia Purpuria, the agency said.

“For decades, research has shown the effectiveness of Sarracenia Purpurea (Pitcher Plant) against past outbreaks of small pox [sic] in the 19th Century, found to halt viral replication in viral, derived from the Variola Virus also associated with Monkey Pox,” the company’s site says, according to FDA’s warning letter.

FDA notes that site also uses additional metatags and social media posts with key terms like “Monkey Pox,” “Herbal Natural Remedy” and “remedy coming soon!” to bring consumers to their site for purchases.

Another company’s site, which appears to target young parents, allegedly falsely claims that colloidal silver can help fight viral infections — not only mpox, but also COVID-19, RSV and other upper respiratory tract infections.

The FDA quotes this company as saying on its website, “What Can Colloidal Silver Treat? … As an antiviral, silver can kill the virus that causes COVID-19 and may be an effective adjunctive treatment. There is also evidence that it may be effective against other viruses of interest including monkeypox, herpes, RSV, and viruses that cause upper respiratory tract infections (like influenza).”

Claims like these are particularly concerning in light of their appeared marketing toward infants and children, the agency says — with marketers allegedly preying on parents’ scrambling to take care of their kids after a difficult fall and winter when pediatric patients were slammed hard with the tripledemic of RSV, Covid, flu and other viruses — amid notable shortages of the cold, fever and cough medications which are actually approved to help their symptoms.

The FDA said it’s “particularly concerned” that the second company marketed their colloidal silver product “for use in infants and children,” the letter says. The agency singled out a blog post for parents that advertised the product as tasting “like water and is easy to give to even the pickiest kids.”

“The use of untested drugs can have unpredictable and unintended consequences, especially in vulnerable populations such as children and infants who may be at greater risk for adverse reactions,” the FDA said, since their bodies absorb and metabolize drugs differently.

Health experts say the best way to get medical care for mpox — or any other malady — is to speak with your healthcare provider. Wellness products aren’t rigorously tested and don’t have great oversight, especially on the internet — something which marketers know they can take advantage of, according to experts.

Copyright © 2023, ABC Audio. All rights reserved.

Is Ozempic safe to take during pregnancy or while trying to conceive? Experts weigh in

Peter Dazeley/Getty Images

(NEW YORK) — The growing popularity of drugs like Ozempic, Mounjaro and Wegovy, designed to help people with Type 2 diabetes and obesity, has raised new questions about what those drugs could mean for pregnancy and fertility.

The medications, all brand names for a compound called semaglutide, have grown in popularity thanks to reported use by celebrities and posts from everyday people on social media about successful weight loss, many from women of childbearing age.

Given as a daily oral medication or weekly injection, drugs like Ozempic, Mounjaro and Wegovy, called GLP-1 RAs, help people produce insulin and lower the amount of sugar in the blood.

They also work by slowing down movement of food through the stomach and curbing appetite, thereby causing weight loss.

Side effects of the drugs can include severe nausea and constipation.

Because semaglutides are relatively new on the market — approved by the Food and Drug Administration within the last five years to treat Type 2 diabetes and obesity — there is still research to be done on exactly how they impact women of childbearing age, experts say. In addition, people who don’t have diabetes or obesity can still be prescribed the drugs “off-label,” which may have different impacts.

ABC News’ Good Morning America spoke with two experts who shared the latest on semaglutides and pregnancy.

Are Ozempic and other semaglutide medications safe to take during pregnancy?

No, according to Dr. Amanda Velazquez, director of obesity medicine in the Department of Surgery at Cedars-Sinai Medical Center in Los Angeles.

“This class of medications are not recommended for women who are pregnant,” Velazquez told GMA. “There have not been any studies that have been conducted to test these drugs in women who are currently pregnant, so they’re not at this time recommended.”

The FDA also says in its safety profiles of Ozempic, Wegovy and Mounjaro that they should not be taken during pregnancy, noting there is “insufficient data” available.

The FDA also explains that the drugs could cause weight loss, and that “weight loss offers no benefit to a pregnant patient and may cause fetal harm.”

Velazquez noted that in addition to there not being enough human research to show GLP-1 RAs are safe during pregnancy, animal studies have shown complications.

“For a human, what’s the effect on baby or mom? We don’t know,” she said. “However, from animal studies we know that animals that were on these medications and pregnant, it reduced the embryo size and it can cause abnormalities, developmental abnormalities, for the developing fetus.”

How long do you have to be off a semaglutide medication before getting pregnant?

The FDA recommends that people discontinue semaglutide treatment at least two months before they plan to become pregnant.

Dr. Sarah Lassey, a board-certified OB-GYN and co-director of the diabetes in pregnancy program at Boston’s Brigham and Women’s Hospital, said that window of time allows the medication to leave the body.

“We know that these medications can kind of be in your body for a longer period of time,” Lassey told GMA. “So we recommend transitioning off of this class of medication essentially two to three months prior to when you plan to start getting pregnant.”

Going off of the medications should be done under the supervision of a medical provider, just as when you start the medications, according to both Lassey and Velazquez.

Is the risk of semaglutides and pregnancy atypical?

No, according to Velazquez.

“This is a very standard risk,” she said. “These drugs are like drugs in other medical classes that we use in the sense that you shouldn’t be looking at these as unique.”

Velazquez said the medications for Type 2 diabetes and obesity should not be looked at differently than other drugs that a person would take for heart disease or high blood pressure, for example.

“It’s not the drugs, it’s that we see them as an option versus something that’s medically necessary,” she said, “when really this is medically necessary for many patients who find it difficult to lose weight, and that’s 70% of the population who are overweight or obese right now.”

Why would a person who wants to become pregnant take a semaglutide medication?

Drugs like Ozempic, Mounjaro and Wegovy can be very effective in helping people lower their blood sugar levels and get to a healthy weight, which can be critical for a healthy pregnancy, according to Lassey.

“We know that poorly controlled diabetes during pregnancy is associated with both maternal and fetal outcomes in a pregnancy,” she said, noting those risks can include miscarriage, birth defect, stillbirth and preeclampsia. “Our way to prevent any of these adverse outcomes is to control blood glucose levels and hemoglobin A1c in the time prior to conceiving as well as throughout the pregnancy.”

Lassey said that while the medications aren’t recommended generally for people who want to become pregnant in a short amount of time, for others, they can be lifesaving.

“If you’re a 20 to 30-year-old with diabetes and obesity, potentially, I think these classes of medications have really significant benefit for improving your blood sugar values and improving your overall cardiovascular profile,” she said. “So we’d recommend those medications knowing that down the line, if and when you were to conceive, we would have to change those medications.”

Do semaglutide medications impact fertility?

Lassey said there is not enough long-term research at this point to know how the medications may impact fertility.

“We just don’t know,” she said, adding, “However, we know that when people have better blood sugar control and things like that, they have lower rates of miscarriage and improvement in their fertility, typically.”

What to do if you get pregnant while taking a semaglutide medication

A person who becomes pregnant unexpectedly while taking a semaglutide should contact their healthcare provider, who can help them transition off the medication and make sure they are receiving proper maternal care.

The FDA also says on its website that there will be a “pregnancy exposure registry” that monitors outcomes in women “exposed to semaglutide during pregnancy,” and says pregnant women who are impacted and healthcare providers should contact the drug’s manufacturer.

Can you take a semaglutide medication while breastfeeding?

No, the medications have not been proven to be safe while breastfeeding, according to both Lassey and Velazquez.

“The data about breastfeeding, even about the availability of whether or not you can find these drugs in the breast milk, is very limited,” Lassey said. “It just hasn’t been studied yet, so we wait to initiate these medications until patients report that they have stopped breastfeeding.”

Both doctors also said that knowing that the medications will need to be stopped during pregnancy and breastfeeding should not prevent a person from considering them.

“This shouldn’t be a barrier to one trying out these drugs if they qualify and if they think this would be a good adjunct to their treatment plan from their healthcare provider,” said Velazquez. “What we do is we start the drug, in conjunction with a healthy lifestyle plan, we help them lose weight, improve their weight-related medical conditions and optimize their health for a healthier pregnancy and a healthier overall being … and then you [can] resume the medication once you’re done breastfeeding.”

Copyright © 2023, ABC Audio. All rights reserved.

If fentanyl is so deadly, why do drug dealers use it to lace illicit drugs?

Icy Macload/Getty Images

(NEW YORK) — With the nation still in the grips of an opioid epidemic that began decades ago, the crisis has deepened in recent years with the introduction of fentanyl, a synthetic opioid that is up to 100 times more potent than morphine.

The driving force behind a record-breaking 100,000 overdose deaths per year, fentanyl is now being laced in traditional opioids like oxycodone and heroin, and increasingly, in non-opioids like cocaine and various counterfeit pills.

But with its high death rate, why would drug dealers lace drugs with fentanyl, effectively killing off their potential customers?

According to experts, there are many reasons fentanyl has become such a widely used illicit drug, despite its high overdose potential.

Fentanyl is not always a death sentence

Fentanyl isn’t just a street drug. It is also a legal painkiller than can be given safely under the right circumstances.

When it comes to why some people overdose after taking fentanyl and some do not, it’s really “the fluctuation in purity that makes it unpredictable and deadly,” according to Nabarun Dasgupta, PhD, epidemiologist at the University of North Carolina at Chapel Hill studying opioids.

According to law enforcement officers and former drug dealers interviewed by ABC News, drug dealers often think they can mitigate the risk for their clients by measuring the fentanyl carefully.

Done correctly, lacing illicit drugs with fentanyl often creates a return stream of customers because fentanyl is considered highly addictive. This is why fentanyl is often found in drugs like cocaine, counterfeit Xanax, counterfeit Adderall, or other drugs not classified as opioids.

“Fentanyl is good for business if you layer addiction into it,” Dasgupta said.

Fentanyl is a cheap alternative to other opioids

A fraction of fentanyl could mimic the highs of other opioids, like heroin or prescription painkillers. Dealers will often use simple binding agents and a small amount of fentanyl when making counterfeit opioid pills or what they say is heroin, according to law enforcement.

Because a smaller dose has a similar effect relative to other opioids, it is also easier to smuggle.

Eric Falkowski, an incarcerated former fentanyl dealer interviewed by ABC News, claimed he could make over ten times the amount of counterfeit opioid pills with a kilo of fentanyl rather than with a kilo of traditional components.

Fentanyl production does not have tight quality control

Legal pharmaceutical products are manufactured with safeguards in place to ensure quality control. Drug dealers may not have professional chemistry skills and may not have quality control tests, which means that small mistakes when mixing the drug can be fatal.

“Street drugs have gotten a lot more variable since the start of the pandemic. Now you have mom and pop shops making street drugs – that creates disincentives for stability and control,” Dasgupta said.

In a phone interview with ABC News from prison last year, Falkowski spelled out his process and blamed the death in Tennessee on faulty equipment/mismanagement.

“I felt like I could mitigate some of the dangerousness by using better manufacturing techniques […] and that worked for a long time.” He said, adding that the Tennessee overdose outbreak caused by his counterfeit pills “really came from some inadequate procedures and equipment.”

Falkowski was ultimately convicted and sentenced to up to 25 years in prison in 2018 for intentionally adding fentanyl to counterfeit pills that resulted in someone’s death and over a dozen near-fatal overdoses in Murfreesboro, Tennessee.

Overdose deaths usually lead to investigation by law enforcement, which is bad for business and can often result in the dealer’s arrest. However, the drug is so profitable that it’s worth the risk. Falkowski told ABC he was able to have “a pretty long run” selling drugs laced with fentanyl before his pills killed someone.

Copyright © 2023, ABC Audio. All rights reserved.

Ten-year-old Uvalde shooting survivor healing from trauma with EMDR therapy

Gladys Gonzales and her 10-year-old daughter Caitlyne Gonzales. – Courtesy of Gonzales family

(UVALDE, Texas) — Gladys Gonzales says she felt the urgent need within hours to find mental health services for her 10-year-old daughter, Caitlyne Gonzales, who survived the massacre at Robb Elementary School in Uvalde, Texas.

“I came home to the realization of what had transpired, and it hit me that they had undergone a terrible, terrible thing, and so I knew right then and there that she was going to need in-depth therapy,” the mother told ABC News.

Nineteen children and two of their teachers were shot to death by an 18-year-old shooter, a former student, who attacked the school on May 24, 2022. Caitlyne’s best friend, 9-year-old Jackie Cazares, was one of the children killed.

Caitlyne has been outspoken since the shooting and has advocated for gun reform. She traveled to Washington, D.C, in December and called for an assault weapons ban to be passed on Capitol Hill.

“I decided to be a voice for my friends who can’t use their voice no more,” Caitlyne said at the time.

Gonzales said her daughter went through several traditional cognitive behavior therapists for post-traumatic stress disorder, but Caitlyne had a difficult time making progress and instead began “regressing.” Gonzales says she even brought her daughter to the Uvalde Together Resiliency Center, a site for long-term mental health services offered by Uvalde County officials and Texas Gov. Greg Abbott, however, Gonzales said the services weren’t effective for Caitlyne.

Gonzales said that as Caitlyne began to regress, she lost interest in her favorite activities, became more isolated, and more paranoid about the thought of losing her mother.

It was last summer that Gonzales says she took Caitlyne to a grief camp in San Antonio and met a counselor who suggested Caitlyne try a form of therapy called eye movement desensitization and reprocessing, or EMDR.

The American Psychological Association describes EMDR as an eight-phase treatment in which patients “briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation.” The bilateral stimulation is typically done with side-to-side eye movements or other rhythmic stimulations like taps or tones. This treatment causes a reduction in the “vividness and emotion associated with the trauma memories.”

According to a spokesperson for the APA, EMDR is “conditionally recommended” in their 2017 Clinical Practice Guideline for the treatment of PTSD and “evidence that indicates that they can lead to good treatment outcomes.”

In an email to ABC News, a spokesperson for the World Health Organization said that EMDR can be an effective treatment for children and is a recommended option for PTSD in the WHO guidelines.

Danielle Brown, an associate professor of social work at the University of Southern California and a licensed clinical social worker and psychotherapist who uses EMDR in her private practice, said that in simpler terms, EMDR “re-files” traumatic memories and allows the brain to make new connections around them.

“We’re not wiping out memories, but we’re reprocessing and reintegrating them with more positive—more kind of clear-eyed associations—so that it’s something that you’ll remember but it won’t trigger the same emotional or physiological response that we see in PTSD,” Brown said in an interview with ABC News.

Gonzales says Caitlyne’s struggles with talk therapy caused some of those emotional and physiological triggers, but in addition to this, Gonzales recalled one specific example in which she says a cognitive behavioral therapist dismissed her concerns.

“That therapist—after one session—told me, ‘There’s nothing wrong with her,’ those were her words and I was just shocked,” Gonzales said.

But Gonzales knew better since Caitlyne opened up to her about how she was feeling, and she says she also began experiencing night terror, which left Caitlyne unable to sleep alone because of excruciating fear. Gonzales also attributed her current graduate studies in counseling at Sul Ross Rio Grande College, and her previous work as a mental health caseworker for children who had severe emotional disturbance.

Caitlyne was officially diagnosed with PTSD in December, Gonzales said.

Gonzales said she had never heard of EMDR prior to the grief camp’s recommendation, and after an arduous approval process and waitlist, Caitlyne finally started EMDR therapy in San Antonio in January.

“I made a promise [the day of the shooting] that I would help my daughter the best to my ability, and if it’s driving an hour and a half to two hours to get her the appropriate health services, then so be it,” she said.

The 10-year-old survivor immediately expressed her satisfaction after the first session and her mom said she is finding success so far with EMDR.

Brown, who does not treat Caitlyne, said she is not surprised to hear about the trajectory of Caitlyne’s therapy.

“A lot of CBT approaches have you retell or recount the story start to finish, which is problematic in a couple of ways,” Brown said. “If you don’t have the language for the experience—which often happens in trauma because our language centers can turn off during a trauma—you’ll hear victims sometimes say, ‘I don’t have the words,’ or ‘I can’t articulate it,’ because literally the language isn’t there, so there’s not a cohesive narrative to describe.”

“The other problem is that sometimes recounting the details, that in itself is re-traumatizing,” she said. “So with EMDR, we approach it from a different way. You don’t have to have all the words and you don’t have to have all the memories for it and you don’t have to retell the story and relive it as we’re reprocessing the events or the memory.”

Gonzales said she now aspires to become an EMDR therapist and hopes that spreading awareness about her daughter’s experience will help inform other families dealing with PTSD.

“If a therapist doesn’t work for your child, don’t stay there, move on to the next one until you do find the correct therapist for your child,” she said. “For kids going through PTSD and trauma, it’s so important because they already have these risk factors in the future, and I would hate for them to fall into the cracks just because they didn’t receive appropriate treatment.”

Even though CBT did not work for Caitlyne, it still remains one of the recommended interventions for PTSD, according to the APA.

Copyright © 2023, ABC Audio. All rights reserved.

How a different therapy is being used to treat 10-year-old Uvalde shooting survivor

Gladys Gonzales and her 10-year-old daughter Caitlyne Gonzales. – Courtesy of Gonzales family

(UVALDE, Texas) — Gladys Gonzales says she felt the urgent need within hours to find mental health services for her 10-year-old daughter, Caitlyne Gonzales, who survived the massacre at Robb Elementary School in Uvalde, Texas.

“I came home to the realization of what had transpired, and it hit me that they had undergone a terrible, terrible thing, and so I knew right then and there that she was going to need in-depth therapy,” the mother told ABC News.

Nineteen children and two of their teachers were shot to death by an 18-year-old shooter, a former student, who attacked the school on May 24, 2022. Caitlyne’s best friend, 9-year-old Jackie Cazares, was one of the children killed.

Caitlyne has been outspoken since the shooting and has advocated for gun reform. She traveled to Washington, D.C, in December and called for an assault weapons ban to be passed on Capitol Hill.

“I decided to be a voice for my friends who can’t use their voice no more,” Caitlyne said at the time.

Gonzales said her daughter went through several traditional cognitive behavior therapists for post-traumatic stress disorder, but Caitlyne had a difficult time making progress and instead began “regressing.” Gonzales says she even brought her daughter to the Uvalde Together Resiliency Center, a site for long-term mental health services offered by Uvalde County officials and Texas Gov. Greg Abbott, however, Gonzales said the services weren’t effective for Caitlyne.

Gonzales said that as Caitlyne began to regress, she lost interest in her favorite activities, became more isolated, and more paranoid about the thought of losing her mother.

It was last summer that Gonzales says she took Caitlyne to a grief camp in San Antonio and met a counselor who suggested Caitlyne try a form of therapy called eye movement desensitization and reprocessing, or EMDR.

The American Psychological Association describes EMDR as an eight-phase treatment in which patients “briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation.” The bilateral stimulation is typically done with side-to-side eye movements or other rhythmic stimulations like taps or tones. This treatment causes a reduction in the “vividness and emotion associated with the trauma memories.”

According to a spokesperson for the APA, EMDR is “conditionally recommended” in their 2017 Clinical Practice Guideline for the treatment of PTSD and “evidence that indicates that they can lead to good treatment outcomes.”

In an email to ABC News, a spokesperson for the World Health Organization said that EMDR can be an effective treatment for children and is a recommended option for PTSD in the WHO guidelines.

Danielle Brown, an associate professor of social work at the University of Southern California and a licensed clinical social worker and psychotherapist who uses EMDR in her private practice, said that in simpler terms, EMDR “re-files” traumatic memories and allows the brain to make new connections around them.

“We’re not wiping out memories, but we’re reprocessing and reintegrating them with more positive—more kind of clear-eyed associations—so that it’s something that you’ll remember but it won’t trigger the same emotional or physiological response that we see in PTSD,” Brown said in an interview with ABC News.

Gonzales says Caitlyne’s struggles with talk therapy caused some of those emotional and physiological triggers, but in addition to this, Gonzales recalled one specific example in which she says a cognitive behavioral therapist dismissed her concerns.

“That therapist—after one session—told me, ‘There’s nothing wrong with her,’ those were her words and I was just shocked,” Gonzales said.

But Gonzales knew better since Caitlyne opened up to her about how she was feeling, and she says she also began experiencing night terror, which left Caitlyne unable to sleep alone because of excruciating fear. Gonzales also attributed her current graduate studies in counseling at Sul Ross Rio Grande College, and her previous work as a mental health caseworker for children who had severe emotional disturbance.

Caitlyne was officially diagnosed with PTSD in December, Gonzales said.

Gonzales said she had never heard of EMDR prior to the grief camp’s recommendation, and after an arduous approval process and waitlist, Caitlyne finally started EMDR therapy in San Antonio in January.

“I made a promise [the day of the shooting] that I would help my daughter the best to my ability, and if it’s driving an hour and a half to two hours to get her the appropriate health services, then so be it,” she said.

The 10-year-old survivor immediately expressed her satisfaction after the first session and her mom said she is finding success so far with EMDR.

Brown, who does not treat Caitlyne, said she is not surprised to hear about the trajectory of Caitlyne’s therapy.

“A lot of CBT approaches have you retell or recount the story start to finish, which is problematic in a couple of ways,” Brown said. “If you don’t have the language for the experience—which often happens in trauma because our language centers can turn off during a trauma—you’ll hear victims sometimes say, ‘I don’t have the words,’ or ‘I can’t articulate it,’ because literally the language isn’t there, so there’s not a cohesive narrative to describe.”

“The other problem is that sometimes recounting the details, that in itself is re-traumatizing,” she said. “So with EMDR, we approach it from a different way. You don’t have to have all the words and you don’t have to have all the memories for it and you don’t have to retell the story and relive it as we’re reprocessing the events or the memory.”

Gonzales said she now aspires to become an EMDR therapist and hopes that spreading awareness about her daughter’s experience will help inform other families dealing with PTSD.

“If a therapist doesn’t work for your child, don’t stay there, move on to the next one until you do find the correct therapist for your child,” she said. “For kids going through PTSD and trauma, it’s so important because they already have these risk factors in the future, and I would hate for them to fall into the cracks just because they didn’t receive appropriate treatment.”

Even though CBT did not work for Caitlyne, it still remains one of the recommended interventions for PTSD, according to the APA.

Copyright © 2023, ABC Audio. All rights reserved.