Category: 8. Health

Just steps from the operating theaters at Melbourne’s Footscray Hospital, a storeroom holds a quiet rebellion against medical waste. Stacked neatly on wire racks are bundles of surgical gowns and drapes — some wrapped in pale blue disposable plastic, others in washable fabric that’s made to last.

The difference seems small, but to critical-care doctor and anesthesiologist Forbes McGain, the latter pile signals a hospital daring to push back against the tide of single-use items pervasive in healthcare.

Today’s beach outing is not the same as your grandparents’ beach outing: With intense summer heat waves now the norm due to climate change, and with the ozone layer still not fully healed, people need more and better sun protection when outdoors.

Sunscreen offers proven protection from sunburn and skin cancer — but it’s also often comprised of a cocktail of ingredients including chemicals that scientists warn are a growing source of environmental pollution.

Much of this concern focuses on a variety of ingredients known as ultraviolet (UV) filters. Sunscreens typically come in two forms: organic (using chemicals to absorb solar radiation), or inorganic (using zinc oxide and titanium oxide to reflect away solar radiation).

An estimated 6,000 to 14,000 metric tons of UV filtering chemicals are released annually into coastal regions with coral reefs. And in recent years, scientific evidence of sunscreen chemicals harming sensitive marine ecosystems has accumulated, resulting in a series of local, regional and national bans of some chemical ingredients to protect living reefs.

Experts now underline that these concerns go far beyond coral reefs.

In a 2025 paper, researchers at Plymouth Marine Laboratory in the UK outlined how some sunscreen chemicals impact a host of marine organisms at a molecular, cellular, individual or community level. Studies show that UV filters are linked to effects on enzyme growth, endocrine disruption, reproductive issues and more. UV filters can affect not only coral, but species of seagrass, fish and other marine life.

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There are multiple axes of toxicities associated with the petrochemical sunscreens, ranging from reproductive development toxicities to neurotoxicity to increased risk for mutagenicity and carcinogenicity and then endocrine disruption.

Craig Downs, executive director, Haereticus Environmental Laboratory

The researchers are calling for an “urgent investigation” of the wider impacts on marine life. “If there’s a risk that these chemicals can harm coral and other marine life, if there’s less harmful compounds out there that we can use instead, then we need to establish what they are,” says Anneliese Hodge, a Ph.D. student at Plymouth Marine Laboratory and lead author of the 2025 paper. “We need to research that … and figure out the alternatives.”

Experts emphasise that sunscreen ingredients number among the many thousands of other synthetic pollutants that leak into the environment annually, most of which haven’t been tested for safety. Scientists have already assessed that humanity has crossed a “safe operating space” for chemical pollution and release of these “novel entities.”

In addition, there are preliminary findings that some chemicals used in some sunscreens may also impact human health — though those findings are still cloaked in uncertainty due to a lack of long-term ecotoxicological testing. These early findings have given rise to an “anti-sunscreen” movement in the media that experts say must be addressed with caution to avoid misinformation.

Sunscreen’s environmental toll

UV filters are known as a “pseudo-persistent pollutant.” Over time, they will degrade, though some may break down into more toxic forms. However, the speed of degradation is being outpaced by the rapid and consistent rate at which they’re flowing into the environment.

Sunscreen chemicals wash off beachgoers’ or sunbathers’ bodies or enter the environment via wastewater. Many treatment facilities can’t remove them, meaning that potentially vast quantities of wastewater effluent contain UV filters. This pollution load reaches environmentally concerning levels during the Northern Hemisphere’s peak summer holiday season.

It’s not only sunscreens that are responsible; UV filters are present in an array of cosmetics and also released by various industries, says Lenka McGachy, professor of environmental chemistry at the University of Chemistry and Technology, Prague.

This ubiquity makes them a common pollutant in waters across the world, even in far-flung locales like Antarctica.

Numerous studies have outlined the ways in which corals, seagrass, fish and other marine organisms are susceptible to sunscreen chemical ingredients. Studies show they can prompt coral bleaching, impact zooplankton hatching or development rates, and cause impairments to the structure of sea urchin sperm. Other research has found UV filters in species like rainbow trout, threatened loggerhead turtles and dolphins.

But knowledge gaps remain, say experts. A 2025 paper notes “significant or complete data gaps for acute and chronic exposure data” of organic UV filters for freshwater “amphibians, sediment organisms, aquatic fungi and other rarely tested organisms.”

Craig Downs, an ecotoxicologist and executive director of the Haereticus Environmental Laboratory in the US, emphasises that these contaminants are found not only in coastal waters but also in freshwater lakes and streams. “There are multiple axes of toxicities associated with the petrochemical sunscreens,” he says. “Ranging from reproductive development toxicities to neurotoxicity to increased risk for mutagenicity and carcinogenicity and then endocrine disruption.”

A troubling, largely unanalyzed brew

Sunscreen pollution poses a big problem for researchers: It isn’t happening in a vacuum. It exists in the environment alongside a host of other contaminants, and how they all interact remains unknown. “When you have a complex mixture of chemicals, like what you might have at a wastewater effluent site, it can potentially increase the overall impact on the organism,” Hodge says. Sorting out interaction impacts is challenging.

For example, one troublingly recent study found that sunscreen chemicals, including ethylhexyl methoxycinnamate (EHMC), can bind to plastics in the environment and slow their degradation.

“It’s as if [EHMC] acts like a ‘biofilm stabiliser,’ shielding the plastic and its microbial inhabitants from natural degradation processes,” study co-author Sabine Matallana-Surget, a professor of environmental molecular microbiology at the University of Stirling, UK, wrote in an email. “Plastic already takes up to a century to degrade in the ocean; if it’s covered by stabilising biofilms triggered by co-pollutants like EHMC, its persistence could be even longer.”

Equally worrying is that this comingling can create a “co-pollution scenario” with the microbial communities that cling to plastic-UV filter surfaces, posing a risk to marine ecosystems and human health. If marine organisms ingest these plastics, they not only face harm from the physical plastic, but also from the chemicals coated and absorbed by it.

There’s still another concern, says Awadhesh Jha, a professor of genetic toxicology and ecotoxicology at University of Plymouth: The bioaccumulation of UV filters and other chemicals in marine species may end up being consumed by people.

An estimated “4.3 billion people are reliant on fish for 15 per cent of their protein intake,” he says. “Safeguarding production of healthy seafood in the changing environment is crucial for the sustainability of aquaculture industries.”

Coral- and reef-safe, or not?

Experts are urging stricter regulation of sunscreen marketing, noting that while some readily available sunscreens branded as “reef-safe” or “coral-safe” don’t contain chemical UV filters, these brands often don’t come with actual evidence of meeting safety goals.

These labels, in some instances, amount to little more than greenwashing, according to experts. Studies suggest that a number of sunscreens branded reef- or coral-safe are “a bit less toxic than the not environmentally friendly sunscreens,” but are still toxic, says Pedro Echeveste De Miguel, a marine microbial ecologist at the University of the Balearic Islands, Spain.

For many products, these claims are made without adequate toxicity testing or proof to validate them. “That’s really concerning. It misleads consumers into thinking that they’re doing the right thing,” Hodge says.

There’s also a need to challenge assumptions and claims that inorganic mineral-based sunscreens are always better for the environment than formulas using organic UV filters. A recent paper found that “coral-friendly” sunscreens containing zinc oxide (a mineral formulation) caused severe impacts to soft and hard corals, as compared to “reef-safe” formulas containing organic UV filters that caused mild or no effects.

“This shows why credible, standardised testing is urgently needed,” says Johanna Leonhardt, director of operations at Soneva Conservation & Sustainability in the Maldives, who was part of the study. She also emphasises that ecotoxicology testing must not only include individual ingredients, but also full formulation testing, and that companies should fully disclose active filter ingredients.

A sensitive topic

While sunscreens can have real environmental impacts, misinformation is also rife. Social media has recently given rise to an avid anti-sunscreen movement spreading unsubstantiated claims that these products cause a range of diseases, including cancer.

That being said, there are concerns among experts regarding studies finding that chemicals used in sunscreens (such as avobenzone, oxybenzone, octocrylene and ecamsule), when applied to the skin, can enter the bloodstream. Similarly, research suggests inorganic sunscreens containing nanoparticles can get into the blood. But still other studies suggest these chemicals may have no impact and are safe, though more research is needed.

A major health concern for both people and marine life is the potential for endocrine disruption linked to some chemicals. As with the environmental concerns, much of the human health focus has coalesced around two ingredients: oxybenzone and octinoxate.

“This isn’t just about damaging coral. These compounds have the potential to damage health, to cause problems with human health,” says Greg Kearns, associate dean for research at Texas Christian University’s Burnett School of Medicine in the US

“No studies been done to say this amount of this sunscreen and this chemical causes this injury or illness,” Kearns cautions. “But we know the potential exists. And if the potential exists, that begs the question in science, do we need to know more about this? I think the answer is, yes.”

Studies suggest that a range of chemicals — including oxybenzone, ethylhexyl methoxycinnamate (octinoxate) and 4-methylbenzylidene camphor — should be avoided during pregnancy due to their endocrine-disrupting potential. Research published last year found that sunscreen ingredients like phenols and parabens could also increase the risk of hypertension during pregnancy.

In 2021, the US Food and Drug Administration assessed that only zinc oxide and titanium oxide are “generally recognised as safe and effective,” noting that 12 other ingredients didn’t meet FDA criteria due to lack of data. Elsewhere, the EU has placed limits on the use of oxybenzone and homosolate. Recently, the Australian government flagged the same chemicals for restrictions due to health concerns.

All these data put users worried about environmental and potential health effects in a tricky spot, especially given that specific ingredients and concentrations are often not listed on product bottles or squeeze tubes.

David Andrews, acting chief science officer at the Environmental Working Group, a research and advocacy nonprofit, says that ultimately it’s not “an all-or-nothing type equation” for sunscreen users. “We know getting sunburned is bad and sunscreen is one of those tools against that,” he says.

His organisation suggests using mineral-based sunscreens first as the safest option — both from a health and environmental perspective — but also stresses that, ultimately, decisions on use should be based on what works best for each person.

Others such as Hodge agree that although several studies suggest mineral UV filters may be less acutely harmful than some organic filters, but uncertainties about particle behaviour and sub-lethal effects mean further research is required.

“Sometimes the narrative when we discuss sunscreens and its impact on marine life, it quickly … steers towards people thinking that we’re telling them that they can’t wear sunscreen, and that they think it needs to be a choice between harming marine life or getting skin cancer,” she says. “I think it’s important that consumers do know that we’re not telling them to not wear sunscreen.”

Screening your sunscreen

Experts Mongabay spoke to agree that changes are needed in the way sunscreens are made and regulated to better protect people and Earth. Industry and manufacturers also must do much more to ensure and prove the safety of their products.

“We support much needed efforts to do a more comprehensive review of health and environmental concerns,” Andrews says. “That includes substantiating the safety and toxicity of these sunscreens during long-term usage.”

He underlines that this is not a call for people to abandon sunscreen use, but for consumers to educate themselves and scrutinise ingredients, and make use of traditional techniques to manage exposure to the sun. “You don’t want to overly rely on sunscreen,” he notes, stating that appropriate clothing, sun hats and seeking shade are important in sun protection.

Downs, from the Haereticus lab, says more urgent innovation is needed to formulate safe sunscreen. “If you want to make sunscreen safe, then you need an active ingredient that can be [used] at high doses, doesn’t absorb systemically into the skin and doesn’t cause toxicity,” he says. “Some of the mineral sunscreens, if they’re made correctly, could meet that demand.”

Others emphasise the use of “green chemistry” principles to ensure ingredients don’t persist or cause harm. New formulations, some using natural ingredients, hold promise.

But in Downs’ view, real change won’t happen without prompting from governments and regulatory bodies. “If you were to say in four years or five years, we’re going to ban petrochemical sunscreen chemicals, like they’ve done in Palau [a Western Pacific island nation], you would get a serious investment and activity in true green chemistry innovation to find a hopefully toxicologically safer ingredient and one that doesn’t persist in the environment.”

An industry move is currently underway to add sun protection factor (SPF) boosters to products to reduce the volume of UV filters used. While this would cut the UV filter pollution load, shifting from one chemical to another without testing for impacts is potentially problematic. “We don’t really know the full extent that some of these compounds can also have on the marine environment,” Hodge says.

“We really need more evidence and more research to fully know exactly what we need to be switching to,” she says. “And we need to find that healthy balance between providing sufficient sun protection whilst also ensuring that our sunscreen ingredients are environmentally conscious.”

This story was published with permission from Mongabay.com.

A full night of deep sleep is not a luxury – it might be a shield. New research suggests that the right kind of sleep can help ward off memory trouble in people whose brains already show signs of Alzheimer’s disease.

Scientists studied older adults with no diagnosed dementia and found something striking. When these adults spent more time in the deepest stage of sleep, their memory held up better even if amyloid deposits were present.

Understanding amyloid plaque

Linked with Alzheimer’s disease, amyloid plaques are clumps of protein fragments, called amyloid-beta, that build up between nerve cells in the brain.

Normally, your body produces and clears these protein fragments without a problem. But in Alzheimer’s, the cleanup process doesn’t keep up.

The fragments start sticking together, first in small clusters that may be toxic, and eventually in larger, sticky deposits known as plaques.

These plaques interfere with how neurons communicate, almost like static on a phone line, and they can also trigger the brain’s immune cells to overreact, causing damaging inflammation.

Scientists study amyloid because it seems to play a central role in the chain of events that leads to memory loss and cognitive decline.

But here’s the tricky part: we still don’t know if amyloid plaques are the main cause of the disease or more like a byproduct of deeper problems

Sleep, brain waves, and Alzheimer’s

The study tracked 62 cognitively healthy older adults and measured sleep and memory on the same timeline.

Researchers used positron emission tomography (PET) to measure amyloid in the brain and monitored sleep with electroencephalography to capture brain waves overnight.

Deep sleep here means NREM slow-wave sleep, a stage marked by large, slow oscillations that help the brain reset. The team then gave participants a face-name memory task the next day and compared performance.

This work comes from Matthew Walker and colleagues at the University of California, Berkeley. The project also examined whether sleep helped beyond other known cognitive reserve factors like education and physical activity.

Deep sleep resets the brain

Deep sleep helps the brain tune synapses and prepare for new learning the next day. It also supports the transfer of fragile short-term memories into more stable long-term storage.

There is another piece that matters for Alzheimer’s biology.

During sleep, the brain’s glymphatic system ramps up clearance of waste proteins, including amyloid and tau, by moving cerebrospinal fluid through tiny channels that flush neural tissue.

Findings from older adult brains

Among people with similarly high amyloid levels, more deep sleep lined up with stronger next-day memory.

That link was specific to the deep, slow-wave part of non-rapid-eye-movement (NREM) sleep, not lighter sleep or REM.

“Think of deep sleep almost like a life raft that keeps memory afloat, rather than memory being dragged down by the weight of Alzheimer’s disease pathology,” said Walker.

The benefit appeared where it was needed most – in those carrying a higher amyloid burden. It also remained even after accounting for age, sex, body mass index, gray matter atrophy, education, and physical activity.

Poor sleep, higher Alzheimer’s risk

Short sleep in older adults is linked to more amyloid and lower cognitive scores.

A large analysis of more than 4,000 adults found a higher amyloid burden among those reporting six hours or fewer per night, along with worse memory.

Researchers see a two-way pattern. Poor sleep can go hand in hand with rising amyloid, and rising amyloid can disrupt sleep quality.

These feedback loops make sleep a practical target. It is a daily behavior with clear, measurable features and plenty of room for improvement.

Pills don’t replace deep sleep

Not all sleep is equal, and some sedatives change the structure of sleep in unhelpful ways.

A 2023 review reported that benzodiazepines tend to reduce the time spent in the deepest NREM stages while expanding lighter stage 2 sleep.

There is also interest in a newer class of sleep medicines that act on the orexin system.

In a small randomized trial, the insomnia drug suvorexant reduced cerebrospinal fluid levels of amyloid beta and phosphorylated tau over several hours in healthy middle-aged adults.

These findings do not mean a pill will protect memory or that anyone should change treatment without medical guidance. However, they do suggest that the type and depth of sleep matter at least as much as the number of hours.

Better sleep, lower Alzheimer’s risk

Simple habits can tilt sleep toward deeper stages. Avoiding caffeine – especially later in the day – helps the brain reach consolidated slow-wave sleep.

Regular movement, a cool and dark bedroom, fewer screens at night, and even a warm shower an hour before bed can all make it easier to fall asleep.

Scientists still need long-term studies to determine whether training deep sleep over months or years can slow cognitive decline in people with rising amyloid.

Teams are also exploring safe ways to amplify slow waves during sleep, using sound cues or gentle electrical stimulation.

The ultimate goal is simple: help the brain keep learning day after day, even in the face of early disease markers.

The study is published in BMC Medicine.

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The death rate from hypertensive kidney disease in the US has increased by 48% since 1999, according to findings from a recent analysis of US Centers for Disease Control and Prevention – Wide-Ranging Online Data for Epidemiology Research (CDC WONDER) data.¹

In addition to the stark increase in high blood pressure-related renal disease mortality over the past 25 years, study findings highlight disproportionate impacts on African American and Hispanic males, underscoring the need for equitable interventions and efforts to address structural barriers in order to reduce disparities and improve outcomes.¹

“This is the first study to examine 25 years of national data on hypertensive kidney disease deaths across all U.S. states and major demographic groups,” Joiven Nyongbella, MD, an internal medicine resident at Wayne State University/Henry Ford Rochester Hospital, said in a statement.² “Despite national efforts to reduce health inequalities, Black individuals still had over three times the death rate compared to other groups of people.”

Hypertension is a major risk factor for end-organ damage, including kidney damage. According to the National Kidney Foundation, it is the second leading cause of end-stage renal disease after diabetes and contributes significantly to both morbidity and mortality.³

“High blood pressure isn’t just about strokes or heart attacks – it’s also a major cause of kidney disease and death, especially in Black and Hispanic communities,” said Nyongbella.² “The message is simple: check your blood pressure, treat it early and don’t ignore it, because it can quietly lead to life-threatening kidney problems.”

To better understand mortality trends and disparities in hypertensive renal disease, he and a team of investigators analyzed death data from the CDC WONDER database from 1999 to 2023 using ICD-10 codes for hypertensive renal disease with and without renal failure. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated and stratified by year, sex, race, ethnicity, and region.¹

Results showed that from 1999 to 2023, hypertensive renal disease caused 274,667 deaths among individuals ≥ 15 years of age, with AAMR increasing from 3.3 to 4.91 (average annual percent change [AAPC], 1.51%; 95% CI, 0.53–2.50; P = .0023).¹

Upon analysis, men had a greater mean AAMR than women (4.48 vs 3.69; P <.001), with a 22% increased mortality in cases with renal failure (P <.0001) but no significant sex differences observed in cases without renal failure (P = .36).¹

Investigators called attention to significant differences across racial groups, with Black individuals having the highest mean AAMR (10.37) versus 3.33-3.90 in other groups. Of note, this disparity remained consistent regardless of renal failure status. Additionally, Hispanic individuals had a 15% higher AAMR when compared to non-Hispanic individuals (4.55 vs 3.97; P <.001).¹

Regionally, the West had the greatest overall AAMR (4.59), but the 3 states with the highest rates were in the South: Washington DC (7.6), Tennessee (5.9), and Mississippi (5.83).¹

“This study provides important observational data indicating a concerning rise (48%) in age-adjusted deaths due to high blood pressure-related kidney disease over the last 25 years, especially among men, and Black and Hispanic individuals,” said Sidney Smith Jr, MD, a cardiologist and professor of medicine at the University of North Carolina’s School of Medicine.² “These findings are in line with the recently released 2025 AHA/ACC High Blood Pressure Guideline and AHA’s Presidential Advisory on Cardiovascular Kidney Metabolic (CKM) Health. Both papers emphasize the importance of early treatment for high blood pressure, its direct link to kidney disease, as well as the impact of social factors among high-risk populations.”

References

1. Nyongbella J, Pineiro De Jesus P, Lavu V, et al. Hypertensive Renal Disease Mortality in the United States (1999–2023): A 25- Year Analysis of Trends and Sociodemographic Disparities. Hypertension.
2. American Heart Association. Deaths from high blood pressure-related kidney disease up nearly 50% in the past 25 years. EurekAlert! September 4, 2025. Accessed September 4, 2025. https://www.eurekalert.org/news-releases/1096246?
3. National Kidney Foundation. High Blood Pressure and Chronic Kidney Disease. Accessed September 4, 2025. https://www.kidney.org/high-blood-pressure-and-chronic-kidney-disease

New research has found that beta-blockers — medications commonly prescribed to lower heart rate and blood pressure — did not offer clear benefits for certain heart attack patients.

Participants were assigned to either take a beta-blocker or not, within two weeks of leaving the hospital. Researchers found that over the course of almost four years, there was not a significant difference in all-cause death rates, repeat heart attacks, or heart failure hospitalizations between the two groups — suggesting that beta-blockers didn’t offer a notable benefit when taken following a heart attack.

Lead study author Borja Ibáñez, MD, PhD, says that while the results weren’t necessarily surprising — the clear lack of benefit was.

• The investigational topical drug CGB-500 outperformed efficacy benchmarks while meeting safety endpoints
• 59% of patients achieved IGA treatment success
• 71% of patients experienced ≥4-point improvement in worst itch

SAN CARLOS, Calif., Sept. 4, 2025 /PRNewswire/ — CAGE Bio, a biotechnology company advancing ionic liquid–based therapies for immune-mediated skin diseases, today announced positive topline results from its double-blinded, Phase 2b dose-ranging trial of CGB-500 in patients with atopic dermatitis (AD). Globally, AD affects over 200 million people of which ~92% have <10% affected body surface area¹, of which ~40% suffer from moderate to severe disease. In the US alone, 6.6 million people suffer from moderate to severe atopic dermatitis² and an overwhelming number of these have <10% affected body surface area (BSA) with limited effective treatment options. 

The Phase 2b study enrolled 180 patients ≥12 years of age at 16 sites across the United States. A large majority of patients (~85%) had moderate AD, while 9% had mild and 6% had severe AD, all with affected body surface area <10%.

The trial met primary and secondary endpoints, demonstrating best-in-class treatment success, rapid itch reduction, and a favorable safety profile.

• 59% of patients achieved Investigator’s Global Assessment (IGA) treatment success (Clear or Almost Clear with ≥2-grade improvement)—higher than reported by other topical therapies in AD.
• 71% of patients experienced ≥4-point improvement in worst itch (PP-NRS)
• 35% achieved complete itch resolution (“0” itch score).

Efficacy results were statistically significant vs. vehicle, setting a new benchmark for treatment success for topical therapies in AD.

“This is a highly significant advancement. There are limited topical options for patients with moderate-to-severe atopic dermatitis (AD) with low body surface area involvement, and physicians often prescribe systemic medications. CGB-500 may offer a much-needed alternative for localized skin-directed treatment for these patients. The rapid and sustained itch relief reported by patients and high rate of disease improvement as adjudicated by the study dermatologists makes this an attractive proposition” said Justin Ko, MD MBA, Board-Certified Dermatologist and Scientific Advisory Board chair for CAGE Bio.

CGB-500 was well tolerated with no new or unexpected safety signals, underscoring its potential as a safe and effective option for long-term management of AD.

“Ionic liquid technology enables local delivery of medicine at efficacy levels comparable to systemic drugs, but with a safety profile similar to topicals. It is exciting to see this technological advantage translated into benefit for patients,” said Dr. Samir Mitragotri, inventor of the ionic liquid platform.

“These results mark an important milestone for CAGE Bio and, most importantly, for patients living with this burdensome disease. These data further strengthen our belief in our mission to provide high efficacy targeted and localized treatment of immunological skin diseases. We are excited to rapidly advance CGB-500 into Phase 3 trials and towards potential registration,” said Dr. Nitin Joshi, CEO of CAGE Bio.

CAGE Bio looks forward to sharing the full data at an upcoming scientific congress. 

About CAGE Bio

CAGE Bio Inc. is a biotechnology company dedicated to developing innovative therapies for immune-mediated diseases using its proprietary ionic liquid technology platform. The company’s pipeline includes clinical and preclinical assets targeting high-incidence dermatological conditions.

¹Silverberg, J. I., et al., https://doi.org/10.1089/derm.2022.29015.jsi

²https://allergyasthmanetwork.org/what-is-eczema/eczema-statistics/

SOURCE CAGE Bio Inc.

Millions of years ago, humans’ ancestors lost the function of a specific gene — but switching that gene back on could help protect people from gout, a new experimental study suggests.

Gout is a type of arthritis that causes sudden, severe pain and swelling in the joints. It happens when there is too much uric acid in the blood, which can form sharp crystals in the joints, triggering painful inflammation. The painful attacks can come on quickly and may last for days or weeks.

The Food and Drug Administration (FDA) has confirmed H5N1 highly pathogenic avian influenza (HPAI) contamination in specific lots of RAWR Raw Cat Food Chicken Eats following the death of a cat that consumed the product. Whole genome sequencing indicates the virus strains detected in the animal and the contaminated pet food originated from a common source.

The San Francisco Department of Public Health notified federal authorities after a cat became ill with H5N1 and was subsequently euthanized. The animal had consumed product from Lot CCS 25 093 with a sell-by date of October 3, 2026. Initial PCR testing of the open product sample collected from the pet owner detected H5N1, which was later confirmed through additional testing by USDA National Veterinary Services Laboratories.

FDA collected and tested two retail samples of the same product from a different lot (CCS 25 077, sell-by date September 18, 2026). Both samples tested positive for Influenza A Virus, with one sample confirmed positive for H5N1 through whole genome sequencing.

The contaminated products are sold frozen in 2.5-pound resealable plastic bags containing 40 one-ounce sliders. The yellow and white bags with black lettering are distributed in retail stores nationwide and online. Lot CCS 25 077 is printed on the center back of affected bags.

“FDA is concerned about the lots of RAWR Raw Cat Food Chicken Eats described above because whole genome sequencing suggests the H5N1 detected in the now-deceased cat and in Lots CCS 25 093 and CCS 25 077 of the Chicken Eats product originated from a common source of contamination,” the agency stated in its release.

Laboratory analysis identified the virus as genotype B3.13, which has previously been found in other raw poultry-based pet food brands associated with feline illness or death. The sequencing results showed H5N1 from all three samples were within the same cluster, indicating relatedness to a virus lineage detected from November to December 2024 that is no longer circulating.

H5N1 can cause illness and death in birds, poultry and mammals including domestic cats and large felids such as panthers, bobcats and mountain lions. While dogs can contract the virus, they typically exhibit mild clinical signs and lower mortality rates compared to cats. No cases have been detected in dogs within the U.S., though fatal cases have occurred in other countries.

The FDA reports no known human cases of HPAI contracted through exposure to contaminated pet food. The agency continues its investigation and will provide updates as new information becomes available.

MADRID, Spain—Leaning on the support of community health workers (CHWs) and the ability of nurses to prescribe medications helped bring blood pressure under control among adults with hypertension in rural South Africa, according to the results of the IMPACT-BP trial.

The effort, with or without the automated transfer of data from home BP monitors to primary care clinics, provided a greater reduction in mean systolic readings by 6 months compared with standard care—by 8 to 9 mm Hg, Thomas Gaziano, MD (Mass General Brigham, Boston, MA), reported earlier this week at the European Society of Cardiology Congress 2025.

By 1 year, the reduction had risen to about 10 mm Hg. Rates of hypertension control—to below 140/90 mm Hg—increased dramatically as well.

“In rural South Africa in a very impoverished community, we were able to reduce blood pressure up to 10 mm Hg, persistent through 12 months of the study, and increase control of blood pressure by 20 to 30%,” Gaziano said.

The findings were published simultaneously in the New England Journal of Medicine.

The IMPACT-BP Trial

Globally, Gaziano noted, only 56% of individuals with hypertension are aware they have high BP, 31% are receiving treatment for it, and 18% have it under control, with even worse numbers in certain parts of the world where there are greater challenges accessing healthcare.

In South Africa, for example, the waiting time to see a provider within the public healthcare system is up to 3.5 hours, with individuals having to deal both with travel costs and time lost at work, he said.

“The staff are overworked,” said Gaziano. “Most of the clinics and primary care clinics in South Africa in rural areas are not serviced by physicians, but by nurses only. They’re extremely overworked with the burden of chronic disease as well as infectious disease, and people living with HIV in particular.”

The South African government has been interested in lessening the crowding of clinics and moving care into the communities, he said. That has been done for antiretroviral therapy for HIV, and Gaziano’s team wanted to test whether it was achievable for hypertension management.

IMPACT-BP was conducted in the uMkhanyakude district of the KwaZulu-Natal province of South Africa, with investigators recruiting 774 adults with hypertension (BP > 140/90 mm Hg on two measurements separated by more than 6 months) from primary care clinics. The mean age of the participants was 62 years, and 76% were women. At baseline, mean systolic BP was 147 mm Hg, with 20.2% of patients having a reading of at least 160 mm Hg. Nearly half (46.5%) were HIV-positive and only a minority had running water in their home (14.5%) or were employed (11.2%).

The patients were randomized to three arms:

• Standard of care: Participants would go to the clinic, where a nurse would measure BP and prescribe medications, if necessary. Patients would go to the pharmacy to pick up the antihypertensive drugs.
• CHW-led care: Participants would get a home-based BP monitor and a trained CHW would ensure that it was working and record measurements off the device. Those readings would be entered into a clinical decision support tool. Nurses would examine the data and prescribe antihypertensives. The CHW would then take the medications to patients’ homes.
• CHW-plus care: This was similar to the CHW-led model, but with a home BP monitor equipped with a cuff designed to automatically transfer data to the nurse at the clinic. CHWs would still visit patients to deliver medications and assess adherence.

The primary outcome was the change in systolic BP at 6 months, and that favored both CHW arms of the trial. At that time, average systolic BP was 145.8 mm Hg with standard care, 137.5 mm Hg with CHW-led care, and 136.5 mm Hg with CHW-plus care (P < 0.001 for both CHW arms versus standard of care). Those figures were 144.8, 134.1, and 134.0 mm Hg, respectively, at 1 year.

The rate of BP control to a goal of less than 140/90 mm Hg at 6 months was 57.6% with standard care, 76.9% with CHW-led care, and 82.8% with CHW-plus care. The proportions in the two intervention arms increased—to 82.8% and 85.7%—by 1 year.

There were no adverse events deemed to be related to the study.

‘Robust Proof-of-Concept’

The discussant for the study, Tazeen Jafar, MD (Duke-NUS Medical School, Singapore, and Duke Global Health Institute, Durham, NC), said an important finding is that the added electronic element—automated data transfers from the BP cuff—did not enhance the BP reductions obtained with CHW-led care.

“The overall message from this [is] that interaction of humans with the patients was key to improving blood pressure control” in the trial, she said.

Similar multicomponent, CHW-led interventions in other low- and middle-income countries—like the one studied in COBRA-BPS, which Jafar led, for instance—have provided generally consistent results, with some variation in the magnitude of the BP impact, she added.

The mean reduction in systolic BP was about 5 mm Hg with the intervention tested in COBRA-BPS, and the smaller effect compared with IMPACT-BP could be related to how care was delivered, Jafar suggested. In COBRA-BPS, the intervention was delivered by CHWs who worked for the public health sector, whereas in IMPACT-BP, the CHWs were hired specifically for the trial and were not performing other tasks. In addition, medications were not delivered for free in COBRA-BPS.

“I think when IMPACT-BP is scaled up and integrated into the health sector, one would expect to see attenuation of the benefit that we are seeing in the standalone program,” Jafar said.

Another challenge for wider applicability of the approach studied in IMPACT-BP is that nurses were responsible for prescribing medications, something that is not available in many countries. And it will be important moving forward to move recruitment of patients beyond the clinics, where participants were enrolled for IMPACT-BP, Jafar said, noting that many people with hypertension are not seeking care at healthcare facilities.

These issues aside, IMPACT-BP was an excellent study that “fills a large knowledge gap by providing robust proof-of-concept evidence regarding the success of this community health worker-led intervention in the region,” she said. “Community health workers are a readily available resource in many low- and middle-income countries, and they can be leveraged upon to scale up the intervention.”

She added that this type of intervention could have relevance, too, for underserved populations in higher-income countries.

The US Food and Drug Administration (FDA) yesterday warned pet owners after tests found a link between H5N1 avian influenza samples from a sick cat in San Francisco County and a brand of raw cat food containing chicken.

Cat illnesses and deaths from H5N1 have been linked before to raw food and raw milk consumption, which prompted earlier recalls from different companies.

In a statement, the FDA said the San Francisco County Department of Health learned that a cat became ill with H5N1 after eating Rawr Raw Cat Food Chicken Eats and was euthanized. County officials tested a sample from an open container of the product collected by the cat owner, revealing H5N1.

The product is sold in 2.5-pound resealable plastic bags in retail and online stores nationwide. The two lots have sell-by dates of September 18, 2026, and the brand’s 40-count 1-ounce slider product expires October 3, 2026. The company has a production facility based in Grass Valley, Calif. 

Samples from cat and food related, from B3.13 genotype

Whole-genome sequencing on samples from the cat and the food was performed by the US Department of Agriculture (USDA) National Veterinary Services Laboratory (NVSL). Earlier this week, the USDA posted a notification of a detection of H5N1 in a domestic cat from San Francico County with a collection date of July 13 and a detection date of August 29.

FDA testing on samples from the same company but a different lot number were positive for influenza A, and sequencing on one of the samples was positive for H5N1.

The FDA said it was concerned because testing of products from two different lots and the sample from the cat originated from a common contamination source and are related. Sequencing from all three samples were within the same cluster and involve a lineage detected in November and December 2024 that is no longer circulating.

NVSL testing of all three samples found that they belong to the B3.13 H5N1 genotype that circulated in dairy cows, then spread to commercial poultry farms across several states. The same genotype has been detected in raw cat food before and was implicated in cat illnesses and deaths.

So far, no human illnesses have been linked to exposure to H5N1-tainted cat food, the FDA said.

Company removed products but questions FDA communications

The company today posted a safety alert, saying it was deeply saddened by the illness and death of any cat, but claimed that the FDA waited weeks before providing information to help the company understand the investigations. 

It said it uses only USDA-inspected human food-grade chicken and that the H5N1 finding should be addressed at the USDA level. Rawr said the sample from the sick cat’s home was tested 6 weeks after the product was opened, raising the possibility that it might have been contaminated in the home environment. It added that products from the other lot were produced from a different poultry source. 

Out of an abundance of caution, the FDA said it removed products from both lots from the market weeks ago, well before the FDA’s announcement.

More detections in US turkeys, wild birds

In other H5N1 developments, the North Dakota Department of Agriculture reported an outbreak at a commercial turkey farm in Dickey County, with the detection confirmed on August 30. The outbreak follows a USDA notification earlier this week regarding an outbreak at a South Dakota turkey farm.

Also, the USDA Animal and Plant Health Inspection Service (APHIS) today reported a detection in a backyard poultry flock from Henry County, Georgia. The location has 50 birds.

APHIS also added a few more detections in wild birds with August sample collection states, which include mallards from Idaho and Vermont, a black vulture from North Carolina, and a bald eagle from New York.