Morning Rounds: Getting healthier in the checkout aisle and the alcohol aisle

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It’s Brittany subbing for Theresa this fine Monday. Thank you for all of the excellent song recommendations over the weekend. If you want to check out my road trip playlist, you can find it here.

In today’s newsletter, we introduce you to neffy, the nasal spray alternative to the EpiPen. In my mind, it looks kind of like Microsoft’s Clippy, but for allergies.

Meet neffy, the nasal spray version of the EpiPen

CDC ups bird flu alarm — but only slightly

From STAT’s Helen Branswell: The CDC issued a new risk assessment of the H5N1 bird flu virus circulating in dairy cows Friday, increasing slightly its estimate of the chance the virus poses of triggering a pandemic. But the new assessment, developed using the agency’s influenza risk assessment tool or IRAT, still gauges the risk in the lower half of the moderate rate. Previous assessments of some swine influenza viruses and of the H7N9 bird flu virus have scored higher using the IRAT risk assessment.

Vivien Dugan, director of the CDC’s influenza division, told STAT this tool was designed to help the federal government prioritize its pandemic preparedness efforts, and isn’t meant to forecast whether a given flu virus will go on to cause a pandemic. The virus analyzed in the new assessment was taken from the first human H5N1 case in the U.S. this year, a farmworker in Texas whose infection was reported at the beginning of April. The previous H5N1 risk assessment was based on a 2023 outbreak of H5N1 in mink in Spain. Read more from Helen here, and keep up with STAT’s H5N1 coverage here.

Decreasing the amount of candy in the checkout aisle

What’s your favorite candy to eye in the checkout aisle? Or are you more tempted by chips? In March 2021, Berkeley, Calif., became the first town in the world to implement a “healthy checkout policy,” which set standards for what items are allowed to be displayed in that high-engagement-time area within three feet of a checkout register.

The policy allows only beverages without sweeteners (whether calorie-free or not) and foods with five or fewer grams of added sugars and 200 or fewer milligrams of sodium per serving in the following categories: sugar-free gum and mints, fruit, vegetables, nuts, seeds, legumes, yogurt or cheese, and whole grains.

A recent study in JAMA Network Open showed that after one year, the increase in healthy food and beverage displays compared to cities without the policy went from 29% to 62%, suggesting that similar policies would be effective in increasing the healthfulness of store checkout areas.

Don’t miss a STAT First Opinion on this topic by Anne Thorndike, a Mass Gen primary care physician not involved in the study.

The fight for better alcohol risk labels

You might be surprised to learn that most alcohol products are not regulated by a health-related agency like the FDA. Instead, the Alcohol and Tobacco Tax and Trade Bureau — a section of the Department of the Treasury — is in charge of labels on alcohol. But it doesn’t have a public health charge, such as warning consumers about health risks of alcohol or mandating nutrition facts. Its main function is as a tax collection agency.

As such, the TTB hasn’t taken a huge interest in changing the fine-print warnings on alcohol bottles to something like the colorful “Alcohol can cause cancer” labels that a Canadian study showed were effective in changing consumers’ alcohol buying habits. But that may be changing soon.

STAT’s Isa Cueto takes us on a journey through consumer and public interest groups’ two-decade-long fight to get stronger warning labels on alcohol, the science supporting alcohol warning labels, and how the alcohol industry is fighting back. Read the story here.

Happy summer — watch out for rabies

Another from STAT’s Helen Branswell: Campers waking up with bats in their tents. Cattle in Minnesota succumbing to rabies, likely transmitted by skunks. A local health department warning of a rabies-infected raccoon. Seeing these kinds of stories at this time of year isn’t a surprise; the risk of being exposed to rabies increases in the summer, Ryan Wallace, rabies program lead at the CDC, told STAT. That risk extends both to people and pets, which underscores the importance of vaccinating dogs and cats. Of more than 7,000 rabid dogs and cats detected in the U.S. over the past 20 years, 99% were unvaccinated, Wallace said.

Some parts of the country are seeing an increase in rabies detections this year — skunks in Minnesota and Iowa, and gray foxes in Arizona, New Mexico, and California. Wallace said that every year about 60,000 people in the U.S. are deemed to need post-exposure rabies vaccination. The country’s effort to reduce rabies risk is massive and expensive, but has real impact. There hasn’t been a detected human case of rabies in the past 2.5 years, Wallace said. “I’m knocking on wood.”

Helping stem cells come out of their bone homes

For anyone donating stem cells for a bone marrow transplant (or becoming their own donor, as recipients of the new gene therapies for sickle cell disease and beta thalassemia do), it’s necessary to undergo stem cell collection.

However, convincing enough stem cells to exit their niches in the bone marrow and enter the bloodstream, where they can be collected, is difficult. New research in Science looking at mouse and human cells explains one way blood cells resist entering the bloodstream. The study found that cells with certain macrophage markers on their surface were better at staying in the bone marrow and that cells could use a process called trogocytosis to attach these sticky markers to themselves. However, drugs used to push stem cells out of the bone marrow help turn off trogocytosis, and this new understanding gives a new target for future drugs that might improve stem cell collection efficiency.

What we’re reading

• Three MDMA therapy papers are retracted over data integrity concerns  — on the heels of the FDA’s rejection of the psychedelic treatment for PTSD, STAT
• Judge orders CDC to stop deleting emails of departing staff, calling it ‘likely unlawful’, Politico
• This athlete’s favorite part of the Olympics? Free health care, The 19th
• Why Trump’s mifepristone comments were a gift to the Harris campaign, STAT
• In South Africa, long Covid is an afterthought to tuberculosis, The Sick Times
• Is COVID endemic yet? Yep, says the CDC. Here’s what that means, NPR