Health Desk

The mayor of Hawaii County has declared a state of emergency on Hawaii's Big Island over an outbreak of mosquito-borne dengue fever.

The island has seen nearly 250 confirmed cases of the mosquito-borne virus since September 2015. State health officials first reported two cases that originated there in late October 2015, Mayor Billy Kenoi says in his declaration.

Before Zika swept across most of Latin America and the Caribbean, the largest outbreak ever recorded had been in French Polynesia. Between 2013 and early 2014, researchers estimate nearly 20,000 people on the cluster of islands in the South Pacific were infected with the virus.

French Polynesia's brush with Zika underscores fears that the mosquito-borne virus could cause devastating neurological problems but it also offers insights into the disease — and hope that Zika can be contained.

Law enforcement officials would love to have a clear way to tell when a driver is too drugged to drive. But the decades of experience the country has in setting limits for alcohol have turned out to be rather useless so far because the mind-altering compound in cannabis, THC, dissolves in fat, whereas alcohol dissolves in water.

If you're a government official, you don't want to get a call from Cees Klumper's office.

Because there's a good chance what you'll hear is basically this: "Either you send us back the money that was misused in the past, or we'll deduct double the amount from your future grants. It's your choice."

There's never a shortage of questions about the twists and turns of health coverage. Here are answers to recent questions from readers about premium tax credit repayments for marketplace plans, out-of-network emergency care and nursing home bills.

Farm Contractors Balk At Obamacare Requirements

Feb 9, 2016

Obamacare is putting the agricultural industry in a tizzy.

Many contractors who provide farm labor and must now offer workers health insurance are complaining loudly about the cost in their already low-margin business.

Some are also concerned that the forms they must file with the federal government under the Affordable Care Act will bring immigration problems to the fore. About half of the farm labor workforce in the U.S. is undocumented.

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Anne Bowers wanted her boyfriend to buy her a used ring. Second-hand engagement rings are hundreds or even thousands of dollars less expensive than new ones.

But when it came time for him to propose, her husband went for a new ring. He said he just couldn't buy a second-hand ring. Why?

Second-hand rings have a history. They may have been worn by someone in an unhappy relationship.

The sighs we notice usually accompany emotions like relief or discontent. But our brains are programmed to make us heave an unconscious sigh every five minutes or so — no matter how we feel.

"Sighing is vital to maintain lung function," says Jack Feldman, a brain scientist at UCLA. These periodic deep breaths reinflate tiny air sacs in the lungs that have gone flat. But the brain circuitry behind those reflexive sighs has been a mystery.

Until very recently it was thought that just one bacterium was to blame for causing Lyme disease in humans. But it turns out that a second, related bug can cause it too.

In 2013, during routine testing of bacterial DNA floating around in the blood samples of people suspected of having Lyme disease, researchers at the Mayo Clinic in Rochester, Minn., realized they were looking at something different.

Do you know any global health stories that should be getting coverage — but are overlooked by the media?

The problems with high lead levels in Flint, Mich.'s water started in April 2014, when the city switched water sources and began drawing its supply from the Flint River. The new water was harder, and government officials allowed it to corrode the city's pipes, leaching lead and other toxins into the tap water.

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KELLY MCEVERS, HOST:

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ARI SHAPIRO, HOST:

Forget about the conventional wisdom that female genital mutilation, or FGM, rarely takes place outside of Africa and the Middle East. Recalibrate that to 30 countries on several continents, according to a new statistical analysis by UNICEF that calculates that at least 200 million females today have undergone some form of the procedure.

At 46 years old, Oliver Bogler's reaction to a suspicious lump in his chest might seem typical for a man. He ignored it for three to four months, maybe longer. "I couldn't really imagine I would have this disease," Bogler says. But when he finally "grew up" and went to the doctor, he was pretty quickly diagnosed with invasive breast cancer.

If you've been following the news about the spread of the Zika virus throughout Latin America, you've probably gotten lost in the jargon once or twice. What's a vector? A reservoir? What's local transmission — the opposite of express transmission?

So we went to the experts to help us wade through all this murky language. And they were helpful — sort of. Because it turns out that even the experts don't agree 100 percent on the definitions.

Nearly six years after its enactment, the Affordable Care Act remains a hot issue in the presidential race — in both parties.

"Our health care is a horror show," said GOP candidate Donald Trump at the Republican debate in South Carolina in December. Texas Sen. Ted Cruz, winner of the Iowa caucuses, said at the debate in Des Moines that the health law has been "a disaster," adding it's "the biggest job-killer in our country."

After Ebola, Surf's Up Again In Liberia

Feb 6, 2016

"Wait for the next one!" a teenager yells, perched on a shaded rock with a group of his friends.

"That's it, that's it!" cries another, gesturing toward a swelling wave that's gathering speed as it heads toward a surfer about 25 yards offshore. When he lets the wave pass him by, bobbing over its crest on a scuffed board, the group laughs. "Look at him, he's scared."

You wouldn't think of calling a mosquito "man's best friend." But that's the nickname that biologist Denise Valle uses for Aedes aegypti, the species that's been spreading the Zika virus in Brazil and many other countries in Latin America.

I think "man's best enemy" might be better.

The thing is, this mosquito likes to live near humans.

A major natural gas storage well in Southern California is still leaking, though less so than back in late October, when the giant gas leak was first reported. More than 5,000 families and two schools have been relocated since then, and the local utility that operates the facility is now facing several legal actions.

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KELLY MCEVERS, HOST:

With all the recent controversy around the cost of prescription drugs, we got to wondering how exactly do companies decide how much they should charge for a drug? So we asked NPR health policy correspondent Alison Kodjak to look into it.

Take a look at this question: How do modern novels represent the characteristics of humanity?

If you were tasked with answering it, what would your first step be? Would you scribble down your thoughts — or would you Google it?

Terry Heick, a former English teacher in Kentucky, had a surprising revelation when his eighth- and ninth-grade students quickly turned to Google.

"What they would do is they would start Googling the question, 'How does a novel represent humanity?' " Heick says. "That was a real eye-opener to me."

U.S. health experts cautioned Friday that the apparent discovery of the Zika virus in saliva and urine from people in Brazil does not necessarily mean the virus can be spread by more casual contact with infected people, such as through kissing.

"I think we need to be careful that don't we jump to any conclusions about transmissibility," Anthony Fauci, who leads the National Institute of Allergy and Infectious Diseases, said during an interview on NPR's Morning Edition.

The cystic fibrosis drug Orkambi can help people with specific genetic mutations breathe better, but treatment with the pill comes with a hefty sticker price — $259,000 a year.

Orkambi, which was approved by the Food and Drug Administration last July, is expected to take almost $36 million from California's general fund this fiscal year and next. That cost estimate doesn't include any discounts the state may receive from drug manufacturers.

The Zika virus has gone from an obscure disease to an international public health emergency.

Genetics researchers often discover certain snips and pieces of the human genome that are important for health and development, such as the genetic mutations that cause cystic fibrosis or sickle cell anemia. And scientists noticed that genetic variants are more common in some races, which makes it seem like race is important in genetics research.

U.S. officials say there's no need for alarm over reports from Brazil out Friday that active Zika virus has been found in saliva and urine samples. Mosquitoes remain the primary source of Zika, and there's no proof that saliva and urine can transmit the virus, even if it is present there. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, talks with Mary Louise Kelly about how the Zika virus may spread.

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