Health

(NEW YORK) — A panel of independent advisers for the U.S. Food and Drug Administration voted against recommending approval of psychedelic treatment — along with therapy — to treat post-traumatic stress disorder (PTSD) during a meeting on Tuesday.

The treatment, developed by Lykos Therapeutics, is a pharmaceutical version of midomafetamine, better known as MDMA and sometimes referred to as ecstasy.

The Psychopharmacologic Drugs Advisory Committee appeared to have serious doubts about the safety and efficacy of the treatment.

On the question of whether the available data shows that the drug is effective in patients with PTSD, nine of the advisers voted no and two voted yes. On the question of whether the benefits of MDMA outweigh the risks for the treatment of patients with PTSD, 10 advisers voted no and just one voted yes.

The FDA is expected to make a decision by Aug. 11, according to Lykos Therapeutics. The FDA usually follows the recommendations of the advisory panel, although the recommendations are not binding.

PTSD is a disorder that develops in some people after experiencing or witnessing a traumatic event, according to the National Institute of Mental Health.

People can experience a range of symptoms including nightmares, unwanted memories, anxiety, depression or heightened reactions, and the conditions can last for months or years.

A multitude of studies have suggested that psychoactive drugs, including cannabis, ketamine magic mushrooms and MDMA, may help treat PTSD and other mental health disorders.

Some psychiatrists began using MDMA for treatment in the late 1970s and early 1980s with claims that it helped promote trust and improved communication between doctors and patients, according to the National Institute on Drug Abuse.

MDMA was classified as a Schedule I drug, meaning it has “no currently accepted medical use and a high potential for abuse,” by the Drug Enforcement Administration in 1985.

In the 1990s, the FDA approved the first human trial examining use of MDMA to relieve pain in terminally ill patients as well as being used in combination with psychotherapy.

The company said it conducted two late-stage randomized placebo-controlled trials to evaluate the safety and efficacy of MDMA when used in combination with psychological intervention, such as talk therapy.

“This will be the first MDMA-assisted therapy and psychedelic-assisted therapy to be reviewed by the Psychopharmacologic Drugs Advisory Committee, a significant milestone in the field of psychedelic medicine, resulting from decades of clinical research and advocacy,” Amy Emerson, CEO of Lykos Therapeutics, said in a press release.

“We look forward to the opportunity to discuss the comprehensive data package of investigational MDMA and how, if approved, it may be used as a prescription treatment in combination with psychological intervention in adults with PTSD,” the statement continued

In briefing documents released on Friday, the FDA said that based on the clinical trial data submitted by Lykos Therapeutics, “participants appear to experience rapid, clinically meaningful, durable improvement in their PTSD symptoms.”

However, the federal health agency also noted concerns that the drug has the risk of causing “patient impairment” and the potential for “serious harm” as a result of impairment.

In the documents, the FDA said that if the drug is approved, there must be safeguards in place to monitor patients such as seen during the clinical trial, in which participants were monitored by two therapists for eight hours in a controlled setting and had to agree to not drive until the following day.

The FDA proposed further precautions, including enrolling patients in a registry to track side effects and progress.

Additionally, the FDA raised concerns about how the studies were conducted. Although designed to be double-blind — meaning neither the participants nor the researchers know who is receiving MDMA and who is not — the drug produces such “profound alterations” that the vast majority of participants were able to guess whether they received MDMA or a placebo, the agency wrote.

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(NEW YORK) — Plenty of travelers, whether visiting a new city or returning somewhere familiar, can relate to the surprise and delight of seeing your step count after a day of strolling the sights. And beyond the well-documented health benefits of walking, finding a pedestrian-friendly destination can make it all the easier to get around.

Now, new analysis has revealed which cities across the globe will help you reach your step-count goals — and in which you might fall short.

A recent study published in the journal Environment International by researchers Rafael Prieto-Curiel and Juan Pablo Ospina gathered data from nearly 800 cities across 61 countries to determine and model their various modes of transport: active mobility — walking or biking — public transport and cars.

The data was collected from nearly 850 million people in remote and urban regions alike to get a snapshot of where and why people ditch public transit or cars in favor of their own two feet for more active forms of travel.

An analysis of that data from The Economist has since revealed the most and least-walkable cities across the globe.

Most and least-walkable cities in the U.S.

For anyone looking to avoid a car, North America may not be the best spot to do so, as the study found. According to the study’s findings, nearly 92% of respondents in the U.S. and Canada regularly journey by car. Less than 4% of respondents in the U.S. and Canada said they walk or bike, and just under 5% take public transit.

The 100 least active walkable cities were all found in North America, which as The Economist noted may be the result of pro-car policies and government subsidies over decades.

Cities in the U.S. including New York, Boston and Houston were all clustered in the bottom left quadrant of The Economist’s plot chart depicting populations that mostly took journeys by car instead of active mobility, like walking or biking.

Unsurprisingly, larger, sprawled out cities tend to be less active than their smaller, densely populated counterparts, where people more frequently journey places by foot or on a bike.

There was not a single U.S. city in the top 10 list of most active walkable cities, and many showed up far down The Economist’s list: Corvallis, Oregon, for example, ranked 415. Flagstaff, Arizona, came in at 427, Boulder, Colorado, came in at 429 and Manhattan, New York, was ranked 434.

Most active, walkable cities around the world

The most active walkable city, according to The Economist’s analysis, is Quelimane, a small seaport town in Mozambique.

The other cities that rounded out the top 10 are in Europe, including four in Spain.

Peja, Kosovo, ranked No. 2 on the list, and the tree-lined canal streets of Utrecht in the Netherlands scored the No. 3 spot.

The Spanish port city Bilbao, which is known for the Frank Gehry-designed Guggenheim Museum, landed at No. 8 on the list, and León in northwest Spain, full of Roman ruins and Gothic cathedrals, was situated at No. 9.

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(NEW YORK) — Physicians are calling for primary care doctors to ask patients about loneliness and social isolation at routine health checks and when managing chronic diseases as emerging research suggests it could be just as important as checking blood pressure, heart health and lifestyle factors for health outcomes.

Published in the Annals of Family Medicine, the new guidance highlights several areas to better address social isolation and loneliness in the healthcare system through screening, chronic disease management, policies and partnerships with community resources in an effort to recognize this as a medical issue.

Last year, the U.S. Surgeon General, Dr. Vivek Murthy declared loneliness and isolation an epidemic and its health impacts have been compared to smoking up to 15 cigarettes a day.

Loneliness and social isolation can lead to a number of negative mental and physical health problems, according to research, and doctors say it’s important to discuss this topic in routine health visits and when managing chronic diseases.

“I think loneliness should be incorporated into healthcare and into primary care, because of how much it affects health,” Dr. Sebastian Tong, family physician at the University of Washington and corresponding author of the new guidance, told ABC News. “We’re seeing the prevalence is much higher than many chronic diseases.”

Research studies show that loneliness is common among young people and adults and estimates show about half of all U.S. adults experience loneliness, higher than the percentage of American adults who have chronic health conditions like type 2 diabetes or obesity, according to the U.S. Surgeon General.

“Patients should know that this is a common lived experience and may contribute to their emotional and physical health and health outcomes,” Dr. Mylynda Massart, family medicine physician, founder and director, UPMC Primary Care Precision Medicine Center and chair of Family Medicine at UPMC Magee Women’s Hospital, told ABC News.

Loneliness has been linked with higher rates of depression, anxiety and suicide, according to the Centers for Disease Control and Prevention. 

“If we can prevent or intervene early in loneliness, we may see a really nice downstream effect in terms of people’s overall mental health,” Dr. Jen Brull, president-elect of the American Academy of Family Physicians, told ABC News.

Social isolation has been associated with an increased risk of early death from any cause, a 50% increased risk of dementia, 29% increased risk of heart disease and 32% increased risk of stroke in older adults, according to the CDC.

“From my clinical experience, people come in with, for example, uncontrolled diabetes, and when I get down to the root of it, they’re living alone, they’re spending most of their time alone, and they aren’t able to motivate themselves people exercise or get healthy food,” Tong said.

Doctors say people can do their own self-assessment by asking questions like, “how often do you speak to someone outside of the home, are those meaningful conversations, do you feel fulfilled by your social interactions or do you think there is a gap in your social interactions and do these interactions impact your satisfaction with your current life situation,” Massart said.

But recognition is just the start as doctors say finding solutions that meet individual needs is necessary but challenging.

“Recognizing, understanding and diagnosing [social isolation and loneliness] is only half of the equation; we need system-wide treatments to find the right match for each patient based on their individual needs, environment, and preferences,” Massart said.

Community resources that involve group activities, therapy, or aid in transportation may already be in place in many areas that can mitigate social isolation and loneliness but these tools may miss some resources in more rural areas and doctors say this is where local health clinics may help the most.

“In smaller rural places, primary care docs have partnered and are aware of church organizations, community organizations, places that are in smaller pockets,” Brull said.

Massart said ultimately addressing social isolation and loneliness takes a village. 

“It always comes down to caring for each other and supporting each other through a network of more than one individual,” she said.

If you or a loved one are in crisis, free, confidential help is available 24/7 by texting or calling The Lifeline at 9-8-8.

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(NEW YORK) — Cases of whooping cough are on the rise across the United States, data from the Centers for Disease Control and Prevention shows.

There have been at least 4,864 whooping cough cases reported this year. This is nearly three times higher than the 1,746 cases reported at the same time last year.

The number of cases for 2024 is similar to those seen in 2018-2019, before the COVID-19 pandemic.

The national trends mirror those seen in many U.S. states. The Oregon Health Authority said Thursday that 178 cases have been reported as of May 29, a 770% increase from the 20 cases reported by at the same time in 2023, according to local ABC News affiliate KATU-TV.

Additionally, local reports indicate that schools in Pittsburgh, Pennsylvania, and Minnetonka, Minnesota, are seeing outbreaks of whooping cough.

Dr. Felicia Scaggs Huang, an assistant professor of pediatrics in the division of infectious diseases and medical director of infection prevention and control at Cincinnati Children’s Hospital Medical Center, said whooping cough cases are on the rise globally but that the number of cases in 2024 is similar to those before the COVID-19 pandemic.

“Although these numbers are up significantly from last year, these numbers are more similar to what we saw before the COVID-19 pandemic and, historically, we do see increases in cases on a cycle of every three to five years,” she told ABC News.

Whooping cough, or pertussis, is a very contagious respiratory illness caused by a type of bacteria called Bordetella pertussis.

These bacteria attach to the cilia — the tiny, hair-like structures found on the surface of cells – of the upper respiratory system and release toxins. The toxins damage the cilia and cause the upper airways to swell, according to the CDC.

Whooping cough is spread from person-to-person through coughing and sneezing. Infected people can be contagious for weeks without knowing they have whooping cough.

Early symptoms often resemble a common cold — runny nose, cough and low-grade fever — and typically last for one to two weeks. Symptoms, however, can progress to rapid, violent cough coughing fits that can last up to 12 weeks.

Infants under age one, pregnant women and immunocompromised people are at highest risk but, according to Dr. Syra Madad, an infectious disease epidemiologist and chief biopreparedness officer for New York City Health and Hospitals, “the truth is everybody is at risk.”

Babies who contract whooping cough may have a cold-like illness, struggle to breathe or have apnea, which is life-threading pauses in breathing, the CDC said.

Scaggs Huang said some people can fracture their ribs because of coughing episodes or developing pneumonia.

“Elderly adults or infants less than 6 months may have more complications, like pneumonia and low oxygen levels that require hospitalization,” she said.

Whooping cough can be treated with antibiotics and receiving treatment early can reduce the severity of the infection. Most whooping cough symptoms can be managed at home, according to the CDC.

A vaccine for whooping cough was introduced in the late 1940s and the number of cases each year has since dropped dramatically, decreasing more than 90% compared to the pre-vaccine era.

Before the vaccine, there were an estimated 200,000 cases annually among children and up to 9,000 children died, according to the CDC.

There are two types of vaccines used today to protect against whooping cough: diphtheria, tetanus, and pertussis (DTaP) vaccine for babies and children younger than 7 and tetanus, diphtheria, and pertussis (Tdap) vaccines for children aged 7 and older, adults and pregnant women.

“People often think ‘Well once you get vaccinated you have lifelong immunity,’ and that’s actually not the case. You certainly need to get those booster doses,” Madad said.

Scaggs Huang said people should apply lessons learned from COVID-19 to other infectious diseases.

“I think a lot of the lessons we’ve learned from the COVID-19 pandemic apply to a lot of other respiratory infections,” Scaggs Huang said. “If you see someone who is sick, ask them to keep your distance, especially if you have a young infant or an elderly or immunocompromised person in your home. If you’re sick, stay at home, and, if you’re ever traveling or you’re in an area where there are a lot of pertussis cases, it’s OK to wear a mask in public on an airplane or at the hospital.”

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(NEW YORK) — Ahead of Pride Month, a new report has highlighted increased cancer risk for those who identify as LGBTQ+ as researchers say that LBGTQ+ people may be more likely to smoke, drink alcohol or be living with obesity — all linked to cancer — and that they also may be more likely to avoid going to the doctor for fear of discrimination, which could cause delays in cancer diagnosis.

In an interview with ABC News, the chief scientific officer for the American Cancer Society Dr. William Dahut, also an experienced clinician-researcher in the field of prostate cancer, said that “we are very aware particularly in this population of a hesitancy about receiving healthcare. Because of biases, because of the lack of [physician] familiarity… we were concerned outcomes could be worse.”

The comprehensive analysis was released Friday by the American Cancer Society, a nonprofit organization focused on ending cancer for all people, and it is the first to provide national data on behavioral risk factors, cancer diagnoses and screening in this population.

Preventative cancer screening and vaccination rates in LGBTQ+ individuals were similar to heterosexual peers, except for lower cervical and colorectal cancer screening among transgender men.

“That was a little bit of positive news,” Dahut commented.

However, more than 1 million LGBTQ+ people are estimated to be living with cancer, although the research so far has been limited. The new report summarizes data collected from three major national surveys — the National Health Interview Survey, Behavioral Risk Factor Surveillance System and National Youth Tobacco Survey — to estimate risk factors and cancer incidence among those who identify as LGBTQ+.

The authors highlight policies in nine states where it is legal for medical professionals to refuse care to LGBTQ+ patients, covering an estimated 20% of the LGBTQ+ population.

Researchers said that doctors and nurses should be educated specifically on how to provide loving and inclusive care to LGBTQ+ people.

Sarah Danziger, M.D. is an Internal Medicine Resident at Dartmouth and a member of the ABC News Medical Unit.

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(CHICAGO) — The Chicago Department of Public Health (CDPH) declared the city’s recent outbreak of measles over on Thursday.

CDPH said 42 days have passed — two full incubation periods for measles — without any new cases confirmed.

On March 7, 2024, Chicago health officials confirmed the city’s first measles case in five years. Additional cases were confirmed in children and adults at a new arrivals shelter in Pilsen, on the lower west side of the city.

Over the course of the outbreak, 64 people in Chicago tested positive for measles, including 57 associated with Chicago shelters.

The CDPH said it collaborated with federal and local health care and community partners and “mobilized a rapid response of symptom screenings for shelter residents, detailed contact tracing, and isolation of people with suspected or confirmed measles,” according to its announcement.

Since the beginning of the outbreak, more than 30,000 doses of the measles, mumps and rubella (MMR) vaccine have been administered to Chicago residents, according to CDPH.

The Centers for Disease Control and Prevention (CDC) currently recommends two doses of the MMR vaccine, with the first dose given between ages 12 to 15 months and the second dose administered between ages 4 and 6. Adults are eligible to receive one dose of the vaccine if they are not immune.

One dose of the measles vaccine is 93% effective at preventing infection if exposed to the virus. Two doses are 97% effective, according to the CDC.

“The MMR vaccine is safe and by far the most effective way to protect yourself and others from future measles outbreaks, especially as tourism and travel ramp up over the summer months,” CDPH Commissioner Dr. Olusimbo Ige said in a statement. “Our goal is the elimination of measles in Chicago and everywhere, and with proper vaccination coverage, we know that zero is possible.”

Measles was considered eliminated in 2000 because most Americans were vaccinated against the disease or had some level of immunity. Over the last several years, however, vaccination rates have dipped and pockets of unvaccinated and undervaccinated communities have led to sporadic outbreaks across the U.S.

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(NEW YORK) — Popular weight loss drugs like Wegovy and Ozempic have changed the way many Americans are eating and as people taking these medications reassess their relationship with food, diet experts are offering helpful nutritional tips to add to your wellness plate.

Registered Dietitian Maya Feller spoke with ABC News’ Good Morning America about the intricacies of a proper diet and what to consider when taking a semaglutide, the active ingredient in those GLP-1 receptor agonist medications.

“People on this medication should think about the nutrient density of their foods,” she explained. “With a decreased intake, the nutritional value of a food becomes very important. Creating a balanced plate that includes protein, veggies and a starch helps give the body what it needs. Food should be consumed based on current health, and individual likes and dislikes.”

Nestle recently announced a new line of frozen meals that have been specifically designed to meet nutritional needs of those on GLP-1 weight loss drugs.

For Feller though, there are practical steps people can take without opting for specialty items, such as implementing a baseline of ingredients packed with the nutrition dieters may need.

“The weight loss drugs produce rapid and significant weight loss for some, along with decreased hunger and early satiety,” she said of people who lose their appetite or feel full sooner. “The rapid and significant weight loss can also induce unification loss of lean body mass.”

What foods to eat on GLP-1 weight loss medications

“People should be sure to eat sufficient amounts of high quality protein to support the rapid weight loss and loss of lean body mass,” she suggested. “In addition, fiber coming from vegetables, fruits, beans, root vegetables and ancient grains like fonio, millet, quinoa, as well as being mindful of hydration.”

As with any shift in diet and lifestyle, be sure to consult a primary care physician before making any drastic changes.

“A multivitamin may be indicated to bridge the nutrient gap that results from eating less,” Feller added.

How portion sizes may fluctuate while on weight loss medications

“Portion size will vary by person,” Feller said. “Some people may be able to tolerate half an apple with nut butter as a snack, while others will experience early satiety from [a glass of] water.”

As a result, Feller said people should take this as “an opportunity to listen to your body.”

“The medications work faster than behavior change, so people might be surprised by the change in what and how much they can eat,” she said.

Emphasis on specific nutrients

The Brooklyn-based nutritionist and Eating from Our Roots cookbook author explained that there may be indications for some of a “limited ability to eat protein fortified foods.”

So where she said “I would regularly recommend a plate that has three to four ounces of protein, plus six ounces of a non starchy vegetable and three ounces of starch,” that while “on these medications, many are unable to consume a balanced plate.”

“The recommendation may change to a vitamin and mineral enriched protein smoothie, plus a scrambled egg with one ounce of veggies,” Feller said.

Concerns with popular weight loss drugs and impact on diet

Feller’s concern with these medications is that she’s seen “people taking them without proper medical oversight.” And as a result, when someone on these medications, “they are not being taken care of by a RD, so are likely missing key nutrients that can be harmful in the long run.”

“What we eat is hugely important, and in the case of this class of medications, the stakes are even higher,” she said. “The nutrient density of meals inform of gut health, head health, bone health, brain health and more.”

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(NEW YORK) — A new study is shedding more light on the importance of exposing kids to peanut products at a young age to help reduce the risk of an allergy later in life.

The study, led by the National Institutes of Health’s National Institute of Allergy and Infectious Diseases and published Tuesday, found feeding kids peanut products, like thinned peanut butter, regularly from infancy to the age of 5, was associated with a 71% decrease in the rate of peanut allergy among adolescents.

According to the study, a child exposed to peanut products by six months of age has a 75% reduced risk of having a peanut allergy by age 5, and by age 12, that child is four times less likely to develop a peanut allergy.

In addition, the reduced risk from early exposure is maintained even if a child stops eating peanut products regularly after the age of 5, according to the study.

The findings build on existing research showing that early introduction of potential food allergens reduces the risk of developing an allergy later in life, contrary to what doctors recommended in the 1990s and early 2000s. At that time, the recommendation was to wait until children were older to introduce peanuts and other allergens.

Large studies have since shown that waiting actually increases the risk a child would develop allergic reactions.

Dr. Jeanne Marrazzo, director of the NIH institute that led the study, said the new findings show that early exposure to peanut products provide “lasting protection” for kids.

“If widely implemented, this safe, simple strategy could prevent tens of thousands of cases of peanut allergy among the 3.6 million children born in the United States each year,” Marrazzo said in a statement announcing the study’s findings.

Peanut allergies are one of the most common food allergies, affecting nearly 2% of adults and kids in the United States, according to the American Academy of Allergy Asthma & Immunology. Allergic reactions to peanuts can be life-threatening.

Here are three things for parents and caregivers to know about introducing peanut products to kids at a young age:

1. Some kids can be fed peanut products starting at 4 months old

Parents and caregivers should consult with their child’s pediatrician before exposing them to peanut-containing foods.

Guidelines from the NIAID say that a child with no eczema or food allergies can have age-appropriate peanut-containing foods freely introduced into their diet at home starting around 6 months of age.

If a child has severe eczema or an egg allergy, they should be fed peanut-containing foods only after consulting closely with a healthcare provider. The child’s doctor may choose to recommend allergy testing by a specialist before introducing peanut-containing foods to the child in a safe, controlled manner.

Peanut allergy testing is not required for a child with mild to moderate eczema.

They can have age-appropriate peanut-containing foods added to their diet around 6 months of age, according to the NIAID.

2. Make sure to thin out peanut products for kids

Dr. Wendy Sue Swanson, a Seattle-based pediatrician, told ABC News previously that parents and caregivers should make sure to thin out peanut products when first introducing them to infants.

“You want to just make sure that you’re creating a texture and a consistency that’s easy and safe for your baby,” Swanson said. “Making sure that if you’re using things like nuts or nut butters, that you’re just thinning those nut butters to a way that they’re not a choking risk.”

Parents could also mix a small amount — a quarter teaspoon — of peanut powder into purees like applesauce.

Kids under the age of 4 should not eat whole peanuts or peanut pieces as they are a choking hazard.

3. Look for symptoms of an allergic reaction in kids

Infants who have an allergic reaction to peanuts will likely show two different symptoms, either hives or vomiting, or both, according to Swanson. Other symptoms of an allergic reaction parents should also look out for include facial swelling, difficulty breathing, wheezing, diarrhea or passing out.

Symptoms will most likely present within minutes to two hours after a child consumes a peanut product.

Parents and caregivers should contact their child’s pediatrician if a mild allergic reaction such as a rash develops. If parents and caregivers observe any other symptoms beyond rash, they should dial 911 for immediate medical assistance.

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(NEW YORK) — Nearly two decades after the launch of the first HPV vaccine, mounting evidence shows that people who got vaccinated are dramatically less likely to develop HPV-related cancers in adulthood.

HPV is a common viral infection that causes an estimated 690,000 cases of cancer every year across the globe, according to researchers from the World Health Organization. The virus infects specific tissues, predisposing patients to develop cancers – including cervical, anal, and head and neck cancer.

First approved in 2006, the HPV vaccine was initially marketed to young women as prevention for cervical cancer. It has since been updated to protect against additional HPV strains and is now recommended for boys as well, to reduce the risk of anal and head and neck cancers. The vaccine is currently recommended for children aged 11 or 12, unvaccinated adults until age 26 and can be recommended by clinicians up to age 45.

Now, experts are seeing early signs of the benefits of cancer prevention.

In early 2024, Scotland found zero cases of cervical cancer for patients who were vaccinated at age 12 or 13. The report was one of the first population-level studies looking at hundreds of thousands of patients vaccinated for HPV through a routine vaccination program for children with a high uptake of 80%.

The benefits extend beyond cervical cancer. For high-income countries like the United States, the incidence of head and neck cancer has since surpassed cervical cancer as the main HPV-related cancer.

In May, at the 2024 American Society of Clinical Oncology (ASCO) conference, preliminary reports showed a 56% reduction in the risk of developing HPV-associated head and neck cancer in vaccinated men.

“The ASCO study results are exciting in that it begins to suggest what we all have long expected, which is that HPV-vaccination will have a marked impact on reducing the incidence of HPV-associated head and neck cancer,” said Dr. Michelle Chen, a head and neck cancer surgeon and Assistant Professor at Stanford University who has studied HPV vaccination rates.

Based on data, it’s likely that the full benefits of the HPV vaccine will be realized in decades to come, said Dr. Erich Sturgis, a professor at the Baylor Department of Otolaryngology-Head & Neck Surgery who works as a surgical oncologist and epidemiologist focusing on HPV-positive oropharyngeal cancers.

“It’s probably going to be a couple more decades before we really see the impact because overwhelmingly it’s those in their 50s, 60s and 70s who are getting these cancers,” said Sturgis.

Doctors said another encouraging sign is that people are signing up to get vaccinated. “These vaccines are safe, effective, and long-lasting,” Sturgis said.

A preliminary study from the 2024 ASCO conference showed that uptake of the HPV vaccine in the United States has gradually improved from 23.3% in 2011 to 43% in 2020.

“Overall, we are generally headed in the right direction with increasing rates of HPV vaccination, especially among males who have always lagged behind females,” said Chen.

However, doctors are still pushing every eligible person to get vaccinated. The percent of teens up-to-date on their HPV vaccination stagnated around 63% as of 2022 according to the Centers for Disease Control and Prevention.

“As a whole, we are far behind the Healthy People 2030 goal of 80% rate of HPV vaccination,” Chen said.

Adolescent boys are a key group that continue to lag behind, she told ABC News. Opportunities to close the gap include “targeted community vaccination campaigns, offering the HPV vaccination at the time of the flu shot, and elimination of any cost barriers.”

There are several barriers to pre-teens receiving the HPV vaccine. According to doctors, many parents are unaware of the benefits or cite safety concerns. Other parents feel like the vaccine is inappropriate for their children based on perceptions or beliefs about sexual activity.

“We have an incredible opportunity to prevent cancer in the next generation by the simple process of getting two vaccines in childhood,” Sturgis said. “To miss out on this opportunity is a real tragedy.”

Arifeen Rahman, MD is a resident in Otolaryngology-Head and Neck Surgery and a member of the ABC News Medical Unit.

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(PORT MORESBY, PAPUA NEW GUINEA) — Outbreaks of disease could emerge following the devastating landslide that occurred in Papua New Guinea, according to experts.

A mountainside collapse early Friday buried villages in the Enga province, located in the northern region, under rock, soil and rubble — wiping out homes, schools and businesses, local authorities said.

About 670 people are confirmed dead while the country’s National Disaster Center believes the true death toll could be as high as 2,000 with hundreds of bodies trapped under debris.

Population health and infectious disease experts told ABC News that, after a landslide, standing water, lack of access to medical care and improper sanitation can lead to disease outbreaks. Additionally, mental health can be severely impacted with symptoms lasting for several years after the event.

Infectious diseases are easily spread

“In the aftermath of a disaster … usually in the first couple of days, you’re really dealing with injuries, the trauma of getting hit by the debris, and those types of injuries,” Jeffrey Schlegelmilch, director of the National Center for Disaster Preparedness at Columbia Climate School at Columbia University, told ABC News. “So, it’s more of a trauma-focused response. Then, days and weeks out, comes the emergence of the infectious disease.”

Landslides often lead to large areas of pooling, standing water and disrupt an area’s infrastructure, resulting in a lack of a clean water supply or proper sanitation.

People may be drinking untreated drinking water or sewage-contaminated water, causing gastrointestinal illnesses, such as cholera. Meanwhile, standing water can attract mosquitoes and lead to mosquito-borne illnesses, such as malaria.

Dr. Nathaniel Hupert, an associate professor of population health sciences and of medicine at Weill Cornell Medicine in New York City, said the risk of malaria is important because Papua New Guinea has had a resurgence in malaria over the last 10 to 15 years for reasons that are not quite well understood.

In 2020, Papua New Guinea had more than 750,000 reported cases of malaria, the most of any country in the Asia-Pacific region.

“It turns out that, unlike earthquakes, which typically are not associated directly with increases in malaria, landslides that occur in countries that have high malaria rates seem to be associated with big outbreaks of malaria,” he told ABC News. “And this seems to be due to both the fact that the landslides clear away forests and also create spaces for pooling of water, which the mosquitoes that carry the malaria just love. … So, one of the things that we can probably predict in the aftermath of this really large landslide is that malaria rates are going to go up.”

Additionally, respiratory diseases — such as the common cold, the flu and even COVID — can also emerge as people take shelter in congregated settings, where such infections are easily spread.

Dr. Amesh Adalja, an infectious disease physician and senior scholar at Johns Hopkins Center for Health Security in Baltimore, Maryland, told ABC News because Papua New Guinea is in the southern hemisphere, it is currently entering its flu season, so medical workers will need to be on the lookout for rising cases.

“Some of the key things are going to be making sure people are vaccinated, are getting vaccinations,” he said. “But in many cases, vaccinations are going to take some time to kick in. So, it’s really going to be about hygiene, so that might mean wearing masks in congregated indoor settings, increasing ventilation in those types of indoor settings — if they’re able to, for example, open windows, keeping the air circulating.”

Indirect effects on those with chronic diseases

While many people will likely fall severely ill from illnesses related directly to the landslide, experts say there may be indirect consequences as well.

Patients suffering from underlying conditions, such as heart disease, diabetes or high blood pressure, may not have access to their doctor or a health care provider — or hospitals may be offline — due to the landslide.

Additionally, patients may not be able to access their medications, which could result in a worsening of their conditions.

Studies have shown that various natural disasters can worsen chronic conditions and fail to meet pharmaceutical needs. A study of evacuees relocated to San Antonio, Texas, after Hurricane Katrina in 2005 found medical relief pharmacy supplies did not meet the demands of evacuees.

“Anytime there is a severe disruption in the infrastructure of a country, such as what happens during a landslide, there’s going to be disruptions in the general medical care in a given area,” Adalja said. “The whole healthcare system can get disrupted anytime there’s a major impact like this and that’s going to be something that exacerbates all the other medical conditions that are not directly related to the landslide but are what’s present in the population to begin with.”

He said it will be important for aid workers and medical staff to try to fill in the gaps in medical care left by the landslide so people can keep track of their chronic conditions and that undiagnosed chronic conditions may be detected.

During a major event, such as a landslide, “people think about the acute things, but the chronic things can add up and can present a severe burden to the health care system in a place like Papua New Guinea,” Adalja said.

Mental health impacts

While the physical health impacts of a landslide can be devastating, the mental health impacts can also be severe and long-lasting.

A 2001 study looking at the impacts of the 1998 landslide in the Sarno area of southern Italy found that survivors were 20 times more likely to have post-traumatic stress disorder (PTSD) than members of a control group.

One year after the disaster, 90% of survivors in the study had criterion B symptoms of PTSD, which are characterized by unwanted, upsetting memories; nightmares; flashbacks; and emotional or physical reactions after experiencing traumatic reminders.

A 2022 study looking at survivors of the 2010 landslide in Bududa, in eastern Uganda, found that nearly half of participants had PTSD symptoms.

“With this landslide, it’s not just going to be the immediate loss of life or the displacement, but the recovery,” Hupert said. “So, emergency mental health is really critically important, but establishing and integrating into existing primary care the type of mental health support that may be needed is really going to be the thing that — is difficult to achieve — but would be most important in terms of long-term funding and planning. And those effects greatly outlive, in many cases, the immediate infectious disease impacts.”

Schlegelmilch explained that the mental health of landslide survivors often progresses a non-linear fashion and isn’t always a steady progression up or a regression down.

He added that, in addition to providing mental health counseling or medication when needed, providing help for survivors to balance their daily routines can be beneficial.

Schlegelmilch said he visited a shelter during one of his many trips to natural disaster areas in the U.S. where mental health workers told him the creation of a child-friendly space can boost the mental health of both children and adults.

“I think that we can’t underestimate the ability to sort of have a sense of normalcy and create a sense of normalcy for folks,” he added.

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