The first Cyclospora deaths, autism policy and a breakthrough in emergency medicine

Welcome back to Health(y) Discourse. 

Last week, we explored why scientists are excited — but not ready to celebrate — over a new autism study, why doctors are sounding the alarm about e-bike injuries, what you should know about the growing measles outbreak and whether flossing really could help you live longer. 

This week, we’re separating concern from context. Has the Cyclospora outbreak become more dangerous? Will new autism guidance affect families? Who gets access to experimental medicines before they’re approved? And why are trauma surgeons excited about powdered plasma? 

Other stories that caught my eye this week:

• A more than 15-year collaboration between Baylor College of Medicine and Houston Zoo led to a breakthrough in the fight against one of the deadliest diseases in young Asian elephants.
  
• Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to the president in 2021 and 2022, invoked his Fifth Amendment right against self-incrimination over 100 times during a Senate hearing in late July, prompting Louisiana, Florida and Alabama to open state-level inquiries into him.
  
• Smartwatches and other wearable devices are getting more advanced and more accurate. Now researchers say the next frontier is figuring out how to turn the flood of information into meaningful insights for users, and perhaps, even for their doctors. 

Peer Review

Rehashing the week’s health headlines

💨 Public Health Watch

The first Cyclospora deaths: Has the outbreak changed?

For weeks, the Cyclospora outbreak has largely been a story about food recalls and a miserable gastrointestinal illness. This week, Michigan health officials reported the first two deaths linked to the outbreak, raising understandable concerns about whether the parasite has become more dangerous. 

Investigators continue to trace the outbreak to shredded iceberg lettuce served at some Taco Bell restaurants in multiple states, though state and federal investigations are ongoing. Public health experts say the deaths occurred in people with several underlying medical conditions, and Cyclospora rarely causes life-threatening illness in otherwise healthy people. 

Bottom line: The outbreak is serious, but not because Cyclospora has suddenly become deadlier. The biggest takeaway is to stay informed about recalls and seek medical care if prolonged diarrhea leads to dehydration or doesn’t improve.

👀 Worth Watching

Will new autism therapy guidelines change care?

The Trump administration this week released new guidance aimed at increasing oversight of autism therapy providers that bill Medicaid, saying the changes are intended to improve accountability and ensure children receive evidence-based care. Supporters argue the guidance could improve quality and reduce fraud, while some clinicians and advocacy groups worry additional administrative requirements could make it harder for families to access services if providers leave Medicaid. The practical impact will depend on how individual states implement the new rules and whether they affect provider participation. 

Bottom line: Most families won’t notice immediate changes, but if your child receives Medicaid-funded autism services, it’s worth paying attention as states roll out the new requirements.

🚩 Reality Check

Who should get early access to experimental drugs?

Earlier this summer, STAT revealed that a 79-year-old patient (widely rumored to be U.S. President Donald Trump) received special access to Eli Lilly’s experimental obesity drug retatrutide — a medication still awaiting FDA approval.

This week, after physicians across the country began asking why their own patients couldn’t receive the same opportunity, the pharmaceutical company announced it would allow a limited number of additional patients to apply through its expanded access program. To qualify, patients must have severe obesity that hasn’t responded to approved treatments, at least two serious obesity-related complications and be unable to enroll in a clinical trial. 

Bottom line: This story isn’t really about one weight-loss drug. Expanded access — sometimes called compassionate use — exists to give seriously ill patients access to promising experimental therapies when no satisfactory alternatives exist. These programs raise difficult questions about fairness, transparency and who gets access first when demand far exceeds supply. Bioethicists have long argued that manufacturers should clearly explain how these decisions are made so physicians and patients understand who qualifies, and who doesn’t.

🧪 New Development

A new blood product could save lives — but probably not in your local ER

The FDA approved the nation’s first freeze-dried plasma, a blood product that can be stored for years without refrigeration and mixed with sterile water when needed. Unlike traditional plasma, which must be frozen and thawed before use, the powdered version can be carried into combat zones, helicopters and ambulances, allowing trauma teams to treat severe bleeding much sooner. Trauma surgeons and military physicians have pushed for the product for years because minutes matter after catastrophic blood loss.

Bottom line: This probably won’t change your next hospital visit, but it could dramatically improve survival for people injured in rural areas, disasters or military combat — where getting blood to a patient quickly can mean the difference between life and death. 

Have your say

Last week, we asked if the recent measles outbreaks changed your views on vaccines. A majority of you, about 57%, said you were more supportive. Nearly 30% said you were more skeptical of vaccines, and almost 15% said no, your views hadn’t changed.

What else I’m Covering

• How the neurodiversity movement has left some autism families behind
• Could GLP-1 drugs become the first longevity medications? Scientists think it’s possible
• Terry Wahls: The doctor who claims functional medicine reversed her MS
• Smartwatches are getting smarter. Is healthcare ready?

Get in Touch

That’s all for this week. If you have questions about a health-related story or study you saw in the wild, send me an email at jcraig@san.com or share them below.
— Jess