An update on the ‘mystery illness’ in drc

_Get your daily dose of health and medicine every weekday with STAT’s free newsletter Morning Rounds. Sign up here._ Good morning! I’m not huge on gamification, except in three instances: my

Survivor fantasy league, Oscars predictions, and the STAT Madness competition. This week, I am getting to participate in all three. Voting is open for STAT’s annual bracket-style

competition in which readers choose the most impressive biomedical and health research published last year. Learn more about this year’s competitors and vote. WEEKEND UPDATES ON FEDERAL

HEALTH AGENCIES Here’s what’s been happening at HHS and NIH over the last few days: * On Saturday, renowned geneticist and former longtime NIH director Francis Collins announced that he has

retired, leaving an agency being upended by budget cuts and layoffs. He stepped down from the director role in 2021 to return to his research laboratory, but on Saturday gave no reason for

his abrupt departure from the NIH. Read more. * On Friday, HHS Secretary Robert F. Kennedy Jr. posted a document in the Federal Register proposing that the agency rescind its longtime

practice of giving members of the public a chance to comment on the agency’s plans. The move stands in contrast to Kennedy’s repeated promises to make HHS an agency with processes and data

so accessible that public records requests would not even be necessary. Read more from the eagle-eyed Isabella Cueto, who was the first reporter to spot the statement. PAUSED CDC PROGRAM

RATTLES MATERNAL, INFANT HEALTH RESEARCHERS Researchers have been distressed in recent weeks as they suddenly discovered they were locked out of a critical dataset, called PRAMS, which is

based on a unique annual survey to understand the state of infant and maternal health in the U.S. PRAMS includes more information about the life circumstances of newborns and their parents

than birth certificates, providing insight into the causes of the high rates of maternal mortality in the U.S.  “If we can’t see this information, we cannot develop public health strategies

to improve our maternal morbidity and mortality in the United States,” Marian Jarlenski, a professor of health policy, told STAT’s Anil Oza. The CDC told Anil on Friday that the interruption

is temporary, as they make the survey compliant with some of President Trump’s executive orders. Read more from Anil on the tenuous future of these data.  AN UPDATE ON THE ‘MYSTERY ILLNESS’

IN DRC What looks like a large and sometimes fatal outbreak in western Democratic Republic of the Congo is likely caused by a number of illnesses and in some cases, a suspected exposure to

a toxic substance, Mike Ryan, the head of the WHO’s health emergencies program, said Friday. Reports of a large number of unexplained illnesses and deaths in Equateur province have garnered

international attention, likely in part because this region of DRC has had several Ebola outbreaks in recent years. A report from WHO’s regional office for Africa that was released Friday

said there have been 943 cases with 52 deaths in the Basankusu health zone this month. Ryan said that in casting a wide net, investigators are believed to be detecting cases caused by a

variety of illnesses. Ebola and Marburg, its cousin virus, have been ruled out, but a high number of people tested for malaria have been positive. “This is a significant set of deaths and

disease caused by multiple agents in a vulnerable population,” Ryan said. Local authorities believe that some of the earliest cases and deaths may have been the result of a poisoning event,

where a toxin was present in water. The investigation continues. — _Helen Branswell _ HOW TO MAKE A VACCINE FOR A PANDEMIC THAT HASN’T HAPPENED YET Sixteen years ago, when the h2N1 “swine

flu” began spreading around the world, we had a few crucial lucky breaks. One was that, because multiple vaccines targeting previous h2N1 flu viruses were already licensed in the U.S., the

FDA could fast-track approval of pandemic vaccines, swapping out the old h2 virus and replacing it with the new version.  Emergency response planners in the federal government have long

hoped to use that strain change rule if the dangerous H5N1 bird flu virus ever triggers a pandemic. Makers of mRNA vaccines were able to move quickly to create vaccines during the Covid-19

pandemic, and they could move even faster on a future pandemic vaccine if they get a head start. In the final days of the Biden administration, HHS issued a nearly $600 million contract to

Moderna to develop vaccines protecting against five subtypes of influenza that could prompt pandemics, including H5N1. Now, RFK Jr.’s HHS is re-evaluating that contract. Read more from

STAT’s Helen Branswell on what it means. COMPARING A RACE-SPECIFIC AND RACE-NEUTRAL LUNG EQUATION An equation used to assess lung function without accounting for a patient’s race can

identify 2.5 to four times more Black children with asthma symptoms as compared to an earlier version that does adjust the results for race. That’s according to a study published Friday in

JAMA Network Open of more than 1,500 children that compared the Global Lung Initiative’s 2012 equation (which uses race) to the one from 2022 (which does not).  The results are in line with

previous research that shows using race in these equations tends to underestimate abnormal results among Black children. Still, some experts say that creating truly neutral tools is harder

than it may sound. “Because racial inequality affects health in complex ways, fairness through unawareness can sometimes cause additional harm,” reads a paper published in the latest issue

of the American Journal of Respiratory and Critical Care Medicine. If you’re interested in this topic, consider returning to last year’s Embedded Bias series from STAT’s Usha Lee McFarling

and Katie Palmer. You can learn a lot about the history of race-based clinical algorithms and what other factors clinicians are trying to incorporate into these equations instead.

Separately, Katie also has a Q&A publishing today on how AI can distort clinical decision-making to prioritize profits over patients. WHAT MEDICAID CUTS COULD MEAN FOR DISABLED PEOPLE

Rachel Litchman is one of at least 5.8 million disabled and elderly Americans who rely on long-term care services to survive. She was approved for Medicaid-funded Home and Community-Based

Services last year, five months after she applied as a new full-time wheelchair user. The workers paid through these services help her to get in and out of her (inaccessible) apartment, get

food, shower safely, and so much more.  But the Medicaid cuts that the Trump administration has proposed will decimate the care that people like Litchman receive, she argues in a new First

Opinion essay. “The shadow of the nursing home looms in the face of Medicaid cuts,” she writes. Read more on what’s at stake. WHAT WE’RE READING * Iowa has high cancer rates. Trump’s cuts to

CDC and NIH are already hitting the state, NPR * A study of mint plants. A device to stop bleeding. This is the scientific research Ted Cruz calls ‘woke,’ ProPublica * ‘Post-vaccination

syndrome’: a dubious diagnosis that could do harm, STAT  * Texas leaders quiet amid the biggest measles outbreak in decades, Texas Tribune * Medicare and Medicaid agency faces compromised

functions and disruption from Trump’s firings, STAT