Health

(NEW YORK) — A Virginia girl will be able to celebrate the holidays this year with a bright smile on her face thanks to a life-changing surgery that she is believed to be the first pediatric patient to undergo.

Nicole Serna-Gonzalez, 11, was born with a condition called unilateral congenital facial paralysis, which left her unable to smile, blink or show emotion on the right side of her face. The condition happens in around 2 out of 1,000 births, according to the Children’s Hospital of Philadelphia.

Nicole’s parents, Sergio and Carolina Gonzalez, said doctors initially told them they believed the condition would either improve or go away completely.

When it didn’t as Nicole got older, she underwent further testing that showed part of a nerve had not developed while she was in utero, leading to her face paralysis, according to Carolina Gonzalez.

She said that when she and her husband learned Nicole’s facial paralysis would not go away on its own, they sought out treatments in hopes of making her life easier. She said they also worked to make sure Nicole knew she was beautiful the way she was born.

“I didn’t want to fix her because I think something is wrong. I love her smile before. It’s who she was,” Carolina Gonzalez told ABC News. “But I wanted for her to live a life where she doesn’t have to tell her story on a daily basis.”

Nicole’s condition is so rare that her parents said they had difficulty finding information about it online, particularly finding cases where the paralysis was successfully fixed.

In her research, Carolina Gonzalez said she discovered Dr. Patrick Byrne, who is now chair of the Head and Neck Institute at Cleveland Clinic in Ohio.

The Gonzalez family traveled to meet with Byrne, where they said they discovered he could treat Nicole’s facial paralysis with a first-of-its-kind, 12-hour surgery.

Sergio Gonzalez described learning about the surgery and then deciding to move forward with it for Nicole as a “big leap of faith.”

“It was scary and we were worried but also we didn’t’ want to let pass an opportunity for her,” he said. “For us as parents, it was really important to do the most that we could and not regret it and not deny her the opportunity, but it was a big leap of faith.”

The Gonzalezes, also the parents of a 7-year-old boy, said they were made aware that the process would be long, with Nicole not seeing full results for possibly as long as two to three years.

Byrne said he watched as Nicole and her family decided to move forward with the surgery, knowing how important it is to have the ability to smile.

“When people lose their ability to express their emotions on their face, it really has profound effects,” Byrne told ABC News. “It affects not only how you feel about yourself, but it has dramatic effects of how people respond to you. It’s a really difficult way to go through life because you don’t’ get the responses from people that most of us do in everyday situations.”

On June 8, 2021, Byrne led a team of five surgeons, an anesthesiologist and multiple nurses in performing a facial reanimation operation on Nicole, which involved removing a sensory nerve from her leg and implanting it in her face.

“We identify one facial nerve, a nerve in her good side, that drives her smile and her blink, and we sacrifice it and connect the nerve graft from her leg to that nerve, and then tunnel it all the way across from one side of the face to the other,” said Byrne. “Once that’s done, then we open up the paralyzed side of her face and we have to dissect out each one of the facial nerve branches.”

In order to give Nicole the most natural-looking smile possible, Byrne and his fellow surgeons performed a first-of-its-kind trivector gracilis free tissue transfer. They removed the gracilis muscle from Nicole’s leg and divided into three slips and then implanted the muscles under and around her eyes.

“We have to implant these muscles in a way that they’ll not only work but hopefully look beautiful and look natural, once they start working,” said Byrne. “Now when Nikki smiles spontaneously, when she smiles with her mouth, she’s also smiling with her eyes, like we do naturally.”

Byrne said that as Nicole continues to get further and further away from her surgery, she’ll end up with he calls a “nicely symmetric face.”

“She’s already beautiful and she’s special,” he said. “But we’re looking forward to even more improvement as she goes through her further development.”
PHOTO: Nicole Serna-Gonzalez, 11, is pictured with her parents and brother.
Annie Neill/Cleveland Clinic
Nicole Serna-Gonzalez, 11, is pictured with her parents and brother.

More than one year after undergoing surgery, Nicole describes her own smile as “magical.”

“I feel happy with my new smile and I think it’s really magical,” she told ABC News. “The side of my face, when I smile, it moves, and I’m really happy about that. I have a full smile now.”

The fifth-grader, who said she loves history and loves to craft, said she feels “happy” that she can share her story in hopes that, “Other people who have face paralysis can get help.”

Sergio and Carolina Gonzalez said that while the months before and after the surgery were difficult, they are happy to see Nicole doing so well.

They said they also want to share their family’s story to give hope to other families who, like they once were, may be searching for ways to help their child.

“I want more parents to be able to look up and find it and normalize the whole thing, including the surgery process,” said Carolina Gonzalez. “As parents, whatever the situation is for the child, I think it’s so important to always build your child, always make them feel secure, make them feel special, because they are. That’s how we raised Nicole.”

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(WASHINGTON) — The White House’s COVID-19 coordinator on Sunday said a sharp rise in cases and hospitalizations since Thanksgiving wasn’t “totally” surprising — and he reiterated that holiday gatherings would be safer if people received their updated vaccines.

“We’ve seen increases each of the last two winters and then what else is happening? In colder, drier air the virus spreads more efficiently. … The good news here is that we can prevent those infections from turning into serious illness if people go out and get that updated bivalent vaccine,” Dr. Ashish Jha told ABC “This Week” co-anchor Martha Raddatz of the 40%-plus jump in COVID-19 numbers.

“The updated vaccine is essential for keeping people out of the hospital. So we’re making the case that we’re at a point where it’s safe to gather, but you still have things to do,” said Jha, who for months has been telling the public that keeping current on their shots is the best way to return to normalcy while limiting illness.

The Biden administration has both acknowledged continuing strain from COVID-19 in parts of the country while saying the pandemic’s darkest period is in the past given the ready availability of treatments and vaccines.

On “This Week,” though, Raddatz noted statistics tell a slightly different story.

She cited one figure from Jha himself that less than half of nursing home residents had gotten their updated booster despite being in a high-risk group. “Why hasn’t this been happening?” she asked.

“A lot of people are confused about whether they need one or not,” Jha said. “We’re being very clear about this: If you’ve not gotten a vaccine in the last six months, it is essential to go out and get the new updated bivalent.”

Jha was also pressed by Raddatz on the low uptake of the new booster so far, as well as low mask use in many parts of the country. “How can you say that is really working?” she asked.

He said the testing, treatment and vaccine strategy needs to be implemented at many levels of society beyond the federal government — with help from governors and mayors, religious leaders and more — focusing on older people most at risk.

“If we’re going to get a country as big and diverse as ours through this difficult period, we’re all going to have to pull on this together,” he said.

But, Raddatz said, polling from the Kaiser Family Foundation found that many people were still unsure what the benefit would be of updating their vaccines.

While government data shows about 69% of the population completed their primary vaccine series, only 14% of people older than 5 have gotten the latest booster, which better protects against newer strains of the virus.

“From a benefit point of view, these are incredibly safe vaccines. They clearly work. They clearly reduce infections to some degree, hospitalizations and deaths to a very, very large degree,” Jha said. “The thing I remind people — people often say, ‘Well, I got my booster last year, do I really need it?’ And I say, ‘Well, I got my flu shot last year. I don’t expect that to protect me this winter. I go out and get my flu shot every winter,’ and that same way people have to go out and get their COVID shot.”

Separately, Raddatz asked Jha about anecdotal reports of shortages for children’s medicine like amoxicillin.

Jha said that while manufacturing and supply is “good,” the demand “is unprecedented” in some areas given circulating viruses — COVID-19 as well as the flu and respiratory syncytial virus (RSV).

That was causing “spot outages,” Jha said, but he said he was encouraged that decreasing cases of RSV would ease the problem.

“Our job is to make sure that supply continues, in fact ramps up further, and that we get it into stores,” he said. “That, I am confident, will continue to happen.”

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(NEW YORK) — Despite fears of a potential “tripledemic,” at least one of three viruses circulating in the United States seems to be trending downward.

Cases of respiratory syncytial virus, or RSV, appear to have peaked in mid-November and are now declining, according to data from the Centers for Disease Control and Prevention.

Because RSV appeared much earlier than usual in the season, filling up beds — particularly in pediatric hospitals — it seemed poised to continue.

But RSV is petering out while cases of the flu continue to increase, and COVID-19 infections rise after months of holding steady.

“What we have to remember is that, at some level, even if we have an earlier season, it doesn’t mean that it’s going to be a longer season,” said Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital and an ABC News contributor. “Virus will spread but, once it runs out of susceptible hosts, at some point transmission is going to die down as part of that surge.”

Brownstein says RSV cases rose rapidly due to children not being exposed to the virus over the last two years due to lockdowns and those who were born during the pandemic.

However, so many have been infected that the virus is running out of people to infect, he said.

“So, it’s not surprising that we’re seeing a sort of a downturn,” Brownstein said. “Now, whether that downturn is permanent or we’ll see another surge this winter is still, I think, yet to be seen.”

Although some of the major impact of RSV might be over with, the same can’t be said for either flu or COVID-19.

Over the last four weeks, weekly flu cases have risen from 16,081 to 35,704, according to CDC data. Meanwhile, over the same period, weekly COVID-19 infections have increased from 281,270 to 455,466, data shows.

Brownstein said neither of these is unexpected considering that cases have historically risen after Thanksgiving during the last two years of the pandemic, as people gather in crowded indoor spaces without mitigation measures.

“We absolutely recognized that Thanksgiving would be an accelerator, almost like a mass super-spreading event and that’s exactly what happened,” he said. “Now, we’re about to have a second mass super-spreading event as part of the holidays and so we’ll have to see how these virus cycles play out as a result of that.”

Brownstein also theorized another reason for the surge in flu and COVID-19 while RSV decrease is what is known as viral interference, which occurs when one virus either prevents or reduces infection from another virus.

This means that while RSV was widely circulated, it may have helped stave off infection from other viruses.

“Now, we don’t know it for sure, but there is a theory that our immune systems are already so revved up from RSV, that doesn’t allow room for other viruses,” he said. “That shift in RSV downward, potentially, is giving room for other viruses to make more headway, and here we’re seeing the rise of flu and COVID taking place now.”

However, no matter which viruses are circulating, Brownstein said the message is still the same: for people to get vaccinated and boosted against flu and COVID-19 if they haven’t already.

As of Thursday, only 14.1% of Americans aged 5 and older have received an updated bivalent booster.

“We are only nine days out from Christmas right now,” he said. “We’re at people entering the holiday season. There’s still time to get that protection and that’s the single biggest thing people can do right now.”

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(NEW YORK) — The new bivalent COVID booster this fall was relatively 80% effective at keeping older adults out of the hospital due to complications from the virus compared to seniors who were fully vaccinated with at least two shots but had let several months pass, according to a new study by the Centers for Disease Control and Prevention.

The new study is the latest in real-world assessments of the newly formulated shot and confirms what researchers have been saying for months: Immunity wanes with time. It also highlights the dire warning from doctors that people who were vaccinated early in the pandemic but opted to forgo boosters this fall are vulnerable this winter.

While the benefits are most dramatic with people 65 and older, there was a benefit for all adults in keeping them away from emergency rooms, according to the CDC.

“These studies show pretty unequivocally that the vaccines provide about 40 to 80% extra protection. So put another way that can cut an individual’s risk of hospitalization due to COVID-19 and about half,” said Dr. Ruth Link-Gelles, program lead on a CDC task force examining vaccine effectiveness.

Early in the pandemic, the CDC considered a person “fully vaccinated” if they got the first two shots in a series, although it later recommended getting a third shot, and then a bivalent booster to shore up a person’s immunity.

But despite public health officials pleading with Americans to get “up-to-date” on their shots, many people remain skeptical on the effectiveness while others haven’t given much thought to going beyond those first two shots.

According to the latest Kaiser Family Foundation COVD-19 Vaccine Monitor, only about four in 10 adults say they’ve gotten the new bivalent booster or will get it as soon as they can. Among people 65 and older who haven’t gotten the booster, about a third of respondents said that they don’t think they need it and another third said they didn’t think the benefit of the updated booster was worth it.

About a quarter said they have been too busy or have not had time to get the new booster yet.

Link-Gelles said it’s not uncommon for someone to get COVID or the flu after getting a shot for it. But the focus is on preventing hospitalization, not infection.

“What we’re really looking for is does that vaccine keep people out of the hospital,” she said. “And what we know from the (flu) vaccine as well as from these COVID vaccines is that you may get infected, but your symptoms are likely to be a lot less severe. You’re much less likely to need to go to the hospital if you got your updated booster.”

The CDC study released Friday confirms unvaccinated patients are most at risk of hospitalization. It also looked at people who were fully vaccinated with at least two shots but had let months go by without a booster.

The biggest impact was in seniors: The relative effectiveness of the bivalent was 78% at keeping people 65-plus out of the hospital compared to patients who had gotten their primary series six to 11 months earlier. If the patient was fully vaccinated a year ago, the relative effectiveness of the bivalent was 83%.

The impact on adults was less dramatic but still there: Adults who got the bivalent within two to four months of their last dose — a timeline on par with CDC recommendations — were a third less likely to wind up visiting emergency room or at urgent care.

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(ATLANTA) — About four in 10 adults say they’ve gotten the new bivalent booster or will get it as soon as they can, according to the latest Kaiser Family Foundation COVID-19 Vaccine Monitor.

In the survey, 22% of adults said they have gotten the shot, while around 16% said they will soon.

The data differs slightly from the numbers provided by the Center for Disease Control and Prevention, which shows that 15.5% of adults have gotten the bivalent booster dose so far.

The findings come as the Biden administration ramps up its push to get people boosted ahead of the holiday season and winter months. In late November, officials launched six-week campaign focused on reaching seniors and communities hit hardest by the virus and making it easier to get the shot.

For adults 65 and older, who are at highest risk of COVID-19, the KFF survey found uptake is slightly higher — around 39%. And again, another 16% say they intend to get the booster soon.

But this still leaves more than half of older adults without the shot, and without any intention of getting one.

People remain unconvinced about booster’s benefits

Among people who have already gotten the original COVID vaccine series but have not rolled up their sleeves for a booster, the most common response from adults (44%) was that they don’t think they need one.

More than a third, or 37%, said they didn’t think the benefits are worth it. Another third, or 36%, said they were too busy or hadn’t had time.

About a quarter said they didn’t want to deal with bad side effects, while 17% said they were waiting to see if there would be a surge in their area first.

Why some older people, despite their higher risk, say they aren’t getting boosters

Among people 65 and older who haven’t gotten the booster, about a third of respondents said that they don’t think they need it (36%) and another third said they don’t think the benefit of the updated booster is worth it.

About a quarter said they have been too busy or have not had time to get the new booster yet.

Pandemic has negatively changed views on routine vaccines

Another key point from the December KFF polling was a growing opposition to regular vaccinations for school children, as a requirement for attending public schools.

And while the poll found that people weren’t losing trust in the vaccines — that metric has largely stayed the same over time — they felt more strongly about whether vaccines should be required or not.

The new KFF Vaccine Monitor found that nearly three in 10 adults nationwide now say that parents should be able to choose whether to vaccine their kids for measles, mumps and rubella, rather than it be required — which is up more than 10% from a 2019 poll conducted before the pandemic by Pew Research.

Among parents, opposition to requiring those childhood vaccines now stands at 35%, up from 23% in 2019, KFF found.

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(NEW YORK) — Prince Harry and Meghan, the Duchess of Sussex, open up in the final episode of their Netflix docuseries about their pregnancy loss, which they say happened in July 2020, as they settled into their new home in California.

“I was pregnant,” Meghan says in the six-part series, titled “Harry & Meghan.” “I really wasn’t sleeping and the first morning that we woke up in our new home is when I miscarried.”

At the time of the miscarriage, Meghan and Harry were embroiled in a lawsuit against a U.K. tabloid publisher over the publication of a handwritten letter Meghan sent in 2018 to her estranged father, Thomas Markle.

Harry says in the docuseries that he believes the stress of the lawsuit contributed to Meghan’s miscarriage.

“I believe my wife suffered a miscarriage because of what the Mail did,” Harry said, referring to the U.K. tabloid that first published the letter. “I watched the whole thing.”

He continued, “Now, do we absolutely know that the miscarriage was caused by that? Of course we don’t. But bearing in mind the stress that that caused, the lack of sleep and the timing of the pregnancy, how many weeks in she was, I can say from what I saw, that miscarriage was created by what they were trying to do to her.”

Home footage aired in the episode shows Meghan writing on her laptop and poring over documents related to the case.

Harry and Meghan’s lawyer, Jenny Afia, identified onscreen as a partner at Schillings, a London-based law firm, says she also saw the stress Meghan was under.

“Meghan and I would be texting at 1 a.m. or 3 a.m., her time. She’d be awake, unable to sleep thinking about this case and the wider issues and the toll it was taking,” she said. “I knew the stress the latest development was having on Meghan, and that was that the Mail were going to argue that Meghan’s friends had already spoken about the letter to People magazine, and that Meghan had authorized that article, which she hadn’t.”

Meghan’s friend and former “Suits” co-star Abigail Spencer says she was coming to help Meghan unpack her new home when she saw her fall to the ground.

“I’m driving up just like, ‘Alright, we’re going to unpack. We’re going to get settled,’ and Meg is standing outside waiting for me and I can tell something is off,” Spencer said. “She’s like, ‘I’m having a lot of pain.’ She was holding Archie and she just fell to the ground.”

Meghan herself described the experience in a New York Times opinion piece about pregnancy loss, which was published in November 2020.

“I felt a sharp cramp. I dropped to the floor…I knew, as I clutched my firstborn child, that I was losing my second,” she wrote. “Hours later, I lay in a hospital bed, holding my husband’s hand. I felt the clamminess of his palm and kissed his knuckles, wet from both our tears. Staring at the cold white walls, my eyes glazed over. I tried to imagine how we’d heal.”

It is not known how many weeks Meghan was into her pregnancy when the loss occurred.

Meghan and Harry were the parents of a son, Archie, at the time of the miscarriage. They went onto have another child, a daughter they named Lili, in June 2021.

Later in the docuseries, Meghan describes the length of her court battle against the tabloid publisher, saying, “When all of this started, I had no children. And now I have birthed two and lost one and it’s still going on.”

A U.K. judge ruled in Meghan’s favor in the case last year.

What to know about early miscarriage and stress

Early pregnancy loss, or miscarriage, occurs during the first 13 weeks of pregnancy, known as the first trimester. Statistics can vary, but it happens in at least 10% of known pregnancies, according to the American College of Obstetricians and Gynecologists.

That number is likely considerably higher, as many women miscarry before they realize that they’re expecting. Additionally, one recent study indicated that 43% of women who had at least one successful birth reported having had one or more first trimester losses.

As many as half of early miscarriages happen when the embryo does not develop properly, often because it has an abnormal number of chromosomes, which is a result of an egg or sperm that fertilized with fewer chromosomes than normal, according to the American College of Obstetricians and Gynecologists.

The group says miscarriage is usually a “random event,” and not the result of external factors, such as stress.

“Working, exercising, stress, arguments, having sex, or having used birth control pills before getting pregnant do not cause miscarriage. Few medications can cause miscarriage,” the American College of Obstetricians and Gynecologists states on its website. “Morning sickness — the nausea and vomiting that is common in early pregnancy — also does not cause miscarriage.”

The group notes that “some women who have had a miscarriage believe that it was caused by a recent fall, blow, fright, or stress,” but “in most cases, this is not true. It may simply be that these things happened to occur around the same time and are fresh in the memory.”

One factor that can impact pregnancy loss is age, according to the American College of Obstetricians and Gynecologists. The frequency of early pregnancy loss doubles for women between 35 and 40 years old from 20% to 40%.

“Most end because of a chromosome abnormality,” the group states. “There also is some evidence that chromosome abnormalities in the embryo increase as men get older. But it is not clear at what age this begins for men.”

Meghan, now 41, was 37-years-old when she announced her pregnancy with Archie, and 39-years-old when she announced her pregnancy with Lili.

Other potential risk factors for miscarriages include having had two or more previous miscarriages, having problems with the uterus and cervix, including fibroids and scars, and infections like sexually transmitted infections, according to the March of Dimes.

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(NEW YORK) — Over the last few weeks, COVID-19 cases and hospitalizations have been steadily increasing in Los Angeles County.

Public health experts told ABC News that newer subvariants circulating plus low booster uptake has led to a surge and it may be time to mask up again.

Average daily infections currently sit at 3,028, a 129% increase from the 1,322 average cases recorded one month ago, according to an ABC News analysis of data from the county’s Department of Public Health.

What’s more, hospitalizations currently sit at 1,304, a jump from the 580 hospitalizations reported one month ago, the analysis found.

‘In a winter surge’

“What we’re seeing here in Los Angeles is what we’ll describe as a winter surge,” Dr. Armando Dorian, CEO of USC Verdugo Hills Hospital and an emergency medicine physician, told ABC News. “We were at a point where we had zero COVID patients in the hospital and over the last couple of weeks, there’s been a steady increase in the number of inpatients with COVID as either the diagnosis or part of their diagnosis.”

Dorian said the surge, both at his hospital and in the county as a whole, is not like previous surges that have occurred during the winter, which overwhelmed hospitals, but that the numbers are not insignificant.

“Currently, we’re sitting just under I think around 18% of the patients in the hospital are COVID-positive,” he said.

Dr. Soniya Gandhi, associate chief medical officer at Cedars-Sinai, told ABC News it’s a similar situation at her hospital.

However, this surge is different compared to previous surges because hospitals are also dealing with flu and RSV cases, in what’s been described as a “tripledemic.”

“We’re seeing now the other circulating viruses like flu and RSV, which we hadn’t experienced in prior surges,” Gandhi said. “So, we are starting to see a lot of COVID in the community. We’re starting and have been seeing a lot of flu as well in the community. Our flu positivity rate was as high as 30% last week, which is incredibly high compared to [past] years.”

However, in some good news, RSV cases appear to have peaked in early November and are now on the decline in California, data from the Centers for Disease Control and Prevention shows.

New variants and low booster update

Experts said there are a few reasons for the rising number of COVID-19 cases in the community, one of them being new variants.

“We have newer subvariants, namely BQ.1 and BQ.1.1 that are cousins of the prior omicron variant,” Gandhi said. “They’re more infectious, and they’re increasingly prevalent in the community.”

Data from the CDC shows that in Region 9, where Los Angeles is located, the two variants make up 67.8% of all new infections.

Additionally, more people are gathering in crowded indoor spaces due to the colder weather and the holiday season, which increases the risk of spread.

However, another factor is that vaccination and booster rates are lower than what doctors would like to see. Department of Public Health data shows only 13% of those aged 5 and older have received an updated booster dose.

“The true reason to get the booster or vaccinated is so that you potentially keep yourself from getting really ill from it and avoiding hospitalization,” Dorian said. “We do see a percentage of people that potentially could have definitely prevented themselves from getting admitted to the hospital, or even getting significantly ill because they did not get boosted or vaccinated.”

Are mask mandates coming back?

Meanwhile, the potential return of an indoor mask mandate hangs over the county.

Last week, Public Health Director Dr. Barbara Ferrer said during a press conference a mask mandate would not be implemented even as the county entered the “high” COVID-19 community transmission category, as defined by the CDC.

This was a reversal from a previous policy that moving into the high category would trigger a mandate. Instead, Ferrer said the mandate would be reinstated if certain hospital metrics were met such as 10% of county hospital beds filled with COVID patients.

Experts said right now the county is trending in the direction of a mask mandate.

“I think if we continue to trend in the direction, where we seem to be going, I think based on the previously outlined criteria, a mask mandate could certainly return and probably would need to be seriously considered,” Gandhi said. “That being said, I don’t think individuals should wait for a mask mandate to practice common sense.”

Dorian agreed, saying that implementing a mask mandate would be polarizing and that people should consider their own risk level and the level of those around them when considering masking.

“Do we really need somebody to tell us when to put a mask on is the question,” Dorian said. “I think if you’re not feeling well, or you’re potentially immunocompromised, or you’re going into a space where there’s a lot of people, you should just mask.”

He continued, “So, I think just continuously educating the community on why we’re asking and why there’s an increase and making sure we protect the vulnerable.”

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(NEW YORK) — A ruptured ascending aortic aneurysm — the reported cause of death of American soccer writer Grant Wahl — is a rare but deadly medical condition.

Wahl, 49, a prominent journalist in the U.S. soccer community, collapsed on Dec. 9 while covering the World Cup in Qatar and could not be revived. On Wednesday, his wife, Dr. Celine Gounder, revealed that Wahl’s unexpected death was due to the rupture of an undetected ascending aortic aneurysm with hemopericardium, following an autopsy performed by the New York City Medical Examiner’s Office.

“Grant died from the rupture of a slowly growing, undetected ascending aortic aneurysm with hemopericardium,” Gounder wrote in a post on Substack. “No amount of CPR or shocks would have saved him.”

When someone who is young and otherwise appears to be healthy dies suddenly, “we worry about the possibility of underlying health conditions,” Dr. Eric Isselbacher, the co-director of the Thoracic Aortic Center at Massachusetts General Hospital, told ABC News.

“There’s no good way to know, in a case like this, until the autopsy exactly what happened. But we do see things like this happening in young people and it’s a sobering reminder of aortic aneurysms, particularly when people don’t know about them, because it can cause rupture and death,” he said.

What is an aortic aneurysm?

The aorta is the main artery that carries blood away from the heart to the rest of the body and brain. An aortic aneurysm is a balloon-like bulge in the aorta. An aneurysm weakens that portion of the artery, allowing blood to dissect or separate its walls and can cause it to rupture. An ascending aortic aneurysm is one where there is bulging and weakening of a section of the aorta before it curves into the aortic arch.

Hemopericardium means that there was blood found in the tissue surrounding the heart that is most likely related to the aortic aneurysm. If enough blood gets in this tissue around the heart, it can prevent the heart from pumping properly.

Doctors say aortic aneurysms that develop slowly over time, like Wahl’s, may not have any related symptoms until it gets large, dissects or ruptures. If an aneurysm dissects or ruptures, someone may feel sharp chest pain, have trouble breathing, become confused or pass out.

It is reported that Wahl was recently experiencing some cold symptoms and was treated for bronchitis.

“The chest pressure he experienced shortly before his death may have represented the initial symptoms,” Gounder also wrote.

Doctors say it is possible that some symptoms of a growing aortic aneurysm could mimic symptoms of a respiratory infection like cough or chest discomfort, but it is not known if that is what happened in Wahl’s case.

It is also unlikely that an automated external defibrillator would have saved Wahl’s life during the medical emergency; only surgery can repair a ruptured aortic aneurysm.

Who is at risk?

This condition is rare. There is no routine screening test recommended for an ascending aortic aneurysm. While it is unclear exactly how many people have this condition, one recent study estimated the prevalence of thoracic aortic aneurysms, including the ascending type, is around 0.16% of the population.

Nearly 10,000 people died from aortic aneurysms or aortic dissections in 2019, reported the U.S. Centers for Disease Control and Prevention.

Abdominal aortic aneurysms, located in a lower section of the aorta, have “very clear risk factors” — tending to occur in people in their late 60s and 70s, in smokers and people with high blood pressure or high cholesterol, Isselbacher said. Aneurysms that are in the chest, such as an ascending aortic aneurysm, however, are generally not due to those typical risk factors and tend to be due to an abnormality of the aorta from birth or inherited conditions, he said.

“The problem with those is because they don’t have the typical risk factors, people don’t know if they might have them or not,” he said. “But there are a few clues that you’re at risk for them.”

For Isselbacher, it’s important for people to know their family history, including if there is a relative with heart rhythm issues or one who died at a young age from sudden death, and if you have a bicuspid aortic valve, as that could go along with an enlarged aorta, he said.

“Because if you can catch that, you can do something about it,” he said.

Though the “vast majority” of patients with aortic aneurysms detect them incidentally from an imaging study ordered for another reason, he said.

“They had a cough, so they got a chest X-ray. They were smokers, so they got a lung cancer screening CT scan. They had some palpitations, they got an echocardiogram. And then those studies, incidentally, show the enlarged aorta,” he said.

According to the CDC, ascending aortic aneurysms can also be associated with high blood pressure, sudden injury and inherited connective tissue disorders like Marfan syndrome or Ehlers-Danlos syndrome, though they can also happen in people with no known risk factors. It is not known if Wahl was diagnosed with any related genetic conditions.

People who are known to have a risk factor like Marfan syndrome or Ehlers-Danlos do often get routine imaging done to see if underlying problems like aneurysms are present. But there are others who don’t know they have an underlying risk factor or an aneurysm until they have a problem like this.

According to the American Heart Association, if an aortic aneurysm is found, the decision of when to repair it can depend on related symptoms, the size of the aneurysm, how fast it grows and the person’s underlying health conditions. The two main treatment options are medications and surgery.

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(NEW YORK) — In Carson City, Nevada, one family is choosing to spend more time indoors because they said smoke from wildfires and soaring temperatures caused by climate change are sometimes making it difficult for them to breathe outside.

Jennifer Cantley, who is a mother of three, told ABC News that she checks the air quality outside before she lets her children go out and play. Cantley said she and two of her children have asthma, which she said makes the conditions more dangerous for them.

“When the smoke comes in and we start seeing these beautiful Sierra mountains behind me disappearing, it’s first of all, it’s really hard because we’re having our beautiful view taken away from us,” she said. “But at the same time, now that means we’re going to be back indoors and we can’t leave for sometimes it’s a whole month.”

Cantley is part of “Moms Clean Air Force,” a nonprofit environmental advocacy organization made up of more than 1 million parents. Cantley helped push local legislators to install an air quality monitor in her community.

56% of U.S. adults between the ages of 18 and 45 say they are worried about the effects of climate change on children’s physical health, according to a new ABC News/Ipsos poll. In a separate question, 71% of parents with children under the age of 18 say they are concerned about the impact that climate change will have on their children. This number rises to 79% of parents living in the western U.S.

“As a result of climate change, children are suffering more heat related illness, more asthma attacks from breathing forest fire smoke,” Frederica Perera, a professor of environmental health sciences at Columbia University, told ABC News. Perera is also the author of the recent book “Children’s Health and the Peril of Climate Change.”

“They’re suffering more physical injury and psychological trauma from severe storms and floods,” she said. “Also, we’re seeing more infectious diseases that are carried by ticks and malaria that have moved to new areas due to climate change and also from air pollution.”

In one study published this year, Perera and her co-authors wrote fetuses, infants and children “can be vulnerable to exposure to air pollution and climate change.”

“We used to think the placenta was a perfect barrier and the baby was literally in a cocoon, protecting them from the factors that the mother might experience in her environment,” she said. “And that’s not true. Air pollution is capable of reversing, moving across the placenta into the fetus.”

“My number one goal is making sure now my children, but the future generations have clean air, clean water and public lands,” Cantley said.

This ABC News/Ipsos poll was conducted using Ipsos Public Affairs’ KnowledgePanel® November 14-16, 2022, in English and Spanish, among a random national sample of 1,328 adults ages 18-45. Results have a margin of sampling error of 3.0 points, including the design effect. See the poll’s topline results and details on the methodology here.

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(ALBUQUERQUE, N.M.) — A mother is speaking out about how dangerous respiratory syncytial virus, or RSV, can be as her 2-year-old battles the disease.

Jazlynmae Gonzalez just spent her birthday in the pediatric ICU at the University of New Mexico Hospital in Albuquerque and has been trying to fight off the virus for the last two weeks.

Her mother, Melissa, told ABC News that Jazlynmae was having such trouble breathing that she was intubated and had to spend eight days on a ventilator.

Now, her family and her doctors hope she’s slowly on the mend, though still on oxygen, working to breathe on her own.

“You could see like her ribs, like her skin sucking through like her ribs,” Melissa told Faith Abubey Wednesday afternoon. “She had a lot of shoulder breathing, nose flaring and just like if somebody was running a marathon and just breathing you know hard and fast.”

She called seeing her daughter get so sick the “scariest thing” she’s seen.

“Knowing I can’t do anything to make it better, and just do ‘mommy’s little quick fix,’ and just wake her up, and tell her, it’s okay,” Melissa said. “That’s been the hardest thing.”

Over the past several weeks, pediatric hospitals have been reporting they are at capacity or near capacity due to an early surge of RSV cases.

According to the Centers for Disease Control and Prevention, RSV is particularly dangerous among infants and young children, including those with weakened immune systems, have chronic lung or heart conditions or have neuromuscular disorders.

Every year, between 58,000 and 80,000 children younger than age 5 are hospitalized every year and between 100 and 500 children die from the condition.

Also complicating matters is an early flu season and COVID-19 cases ticking up after holding steady for months,

UNMH staff said the hospital has been struggling to deal with the “tripledemic” and is currently well over 100% capacity.

“It’s hard. Our ERs are full, our waiting rooms are full,” lead pediatrician Dr. Anna Duran told ABC News. “Our physicians are having to examine patients in the waiting room, you know, and we’ve run out of space.”

She continued, “We just have to continue seeing each and every patient, because they will continue to come.”

UNMH said it put up a tent outside of its emergency department on Friday to help relieve some of the strain.

The hospital is in its eighth straight week of the children’s hospital being above capacity — and in recent weeks, it has now seen the same exact thing happen on the adult side, spokesperson Chris Ramirez told ABC News.

However, data from the CDC shows RSV cases may be receding after peaking in mid-November.

Weekly cases have declined from 15,188 the week ending Nov. 26 to 12,571 the week ending Dec. 3, according to an ABC News analysis of the data.

Melissa said she hopes Jazlynmae is home by Christmas and that by sharing her daughter’s stories, other parents can watch for the signs of RSV before it progresses to a serious condition.

“I don’t want another mom, another dad, another sibling to go through what we went through,” Melissa said. “It’s the most heart-wrenching thing to watch your baby go through…and it’s not just a little cold. Because that little cold? I could have lost my baby.”

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