Performing medicine can be difficult in any setting but perhaps no more challenging than during a humanitarian crisis.

Doctors, nurses, and other medical professionals are often performing under extreme duress with a limited number of tools compared to working in a traditional hospital setting.

There have been medical advances over the centuries when it comes to battlefield medicine both in the training and the equipment used, but more recent improvements in care may be helping save more lives in wars, such as the one in Ukraine and ongoing Israel-Hamas conflict, than were available a decade or two ago.

Experts told ABC News that some of the innovations are in the technology used -- such as portable laboratories -- to organizational changes, such as making sure civilians are also receiving basic health care on top of surgical care to prevent a separate public health crisis from emerging.

Social media helping doctors

In past humanitarian conflicts, when telegrams or landline calls were the standard form of communication, it was hard for doctors treating patients in conflict zones to ask for help or advice from their colleagues abroad.

In conflict zones, whether it's a local doctor or a doctor who has been deployed from another country, medical professionals are often treating patients with conditions they are not familiar with.

Dr. Tom Weiser, clinical professor of surgery in the field of trauma, critical care, and emergency general surgery at Stanford University School of Medicine, said the advent of social media and connectivity has been a major asset to doctors working in conflict zones.

"Being able to reach out to colleagues, and ask advice about, 'Hey, I have this thing that I've never seen before,'" he told ABC News. "I may be a plastic surgeon or a gynecologist and now I've been recruited into this conflict, [someone] who has surgical skills but is now suddenly operating or asked to operate beyond his or her normal scope of practice."

Weiser added, "I would say that probably the biggest change is the ability to receive advice or perspective from those who might have had an experience who is not necessarily sitting next to you or leaning over your shoulder, but can [be] just a phone call or WhatsApp or Telegram or a YouTube video away."

Portable laboratories

One of the recent innovations of Doctors Without Borders or Médecins Sans Frontières (MSF) is the "Mini-Lab," which is designed to be a transportable clinical laboratory that is easy to set up and is affordable when MSF workers are deployed.

According to MSF, it can be set up in areas where traditional laboratories are lacking, and even non-experts can use it after brief training.

"That's something that you can kind of deploy to a conflict zone within limits," Dr. Amber Alayyan, MSF's deputy program manager for Palestine, told ABC News.

"So, with that, it's a miniature microbiology lab and that's been quite revolutionary in the sense that we can deploy that quite quickly," Alayyan added.

Alayyan said this helped with longer-term surgical missions or "surgical programs that especially in the situation like in Gaza, or in other places that we've seen sort of more 'modern conflicts' whether it's we've not used it in the Ukraine, but that kind of setup or in Syria, where you have a lot of very severe injuries."

Alayyan explained that in conflicts with severe injuries and surgeries that don't have the best hygiene, there is a high potential for wounds to get infected.

"That's where something like the mini-lab would come into play," she said.

Staff can use the mini-lab to determine what kind of disease or infection someone has and from there, figure out how to treat it.

Advancements in amputations

Over the years, there have been a number of innovations in the field of amputation from the introduction of tools such as artery forceps in the 16th century to techniques to make the surgery more effective.

Although doctors often try to save a limb, Weiser said that over the past few decades, medical professionals have realized some limbs may be so badly damaged, especially in conflict, that amputation may be more beneficial.

"Fundamentally, a lot of people can spend a lot of time salvaging limbs that then are fairly useless to the person because they've just lost so much tissue that you might have a limb, say a foot, that's still there but the patient kind of drags it along and it's actually more of a hindrance, especially for somebody who's otherwise young and healthy than if you had done an amputation," he said. "I do think that we've learned not to try and overtreat limbs that really aren't going to be functional."

He added that it's also important to make this realization quickly to prevent a patient from going through multiple unnecessary surgeries.

"You can put somebody through many, many operations and then, at the end of the day, realize you've done all these operations, you got all these anesthetics, you've done all this reconstruction or attempted reconstruction, and you still don't have a functional extremity," Weiser said.

Access to basic primary care

Alayyan said there has been more of an emphasis in recent conflicts compared to past conflicts to provide basic primary care to those affected.

"I can't emphasize enough the need for people to look at primary care during a conflict and what I mean by that are vaccinations, making sure that the diseases that would be prone to epidemic levels are under control, that basic hygiene is under control, that basic health is being looked after," she said.

She said the term "lifesaving care" doesn't just mean treating the injuries experienced during war but also making sure basic health needs are met.

"In the past, lifesaving meant surgery, surgery, surgery. And I think that what we've seen…from day one of a conflict, sure you have many people who are injured, you have many surgical needs," Alayyan said.

"But the health system will surely collapse in many of these situations and then you run into -- the longer conflict goes on -- the longer children have gone without vaccines, the longer women have gone without prenatal care," she added.

Alayyan said when she was working on the Syria conflict in 2013, there was a big focus on surgery and injuries but not on primary care or chronic diseases.

"What you see is that after a few months, kids are born, they don't have their vaccinations," she said. "Children who were born in a period of time, like say six months, where they haven't had any vaccines, and those are the kids who are gonna grow up who are going to be more prone to getting measles, et cetera, versus the kids who already like one or two who have already gotten around to vaccines."

With adults in Syria, Alayyan said that due to a lack of focus on chronic diseases, and not getting patients their medications or treatments, many started to experience severe health issues.

"So, there has been more of a focus of bringing chronic diseases to the table in emergency operations and emergency humanitarian support," she said.

However, Alayyan said Gaza is a distinct situation because there are no safe zones or places to ago amid intense fighting from Israeli forces.

"The Israeli army has sent out flyers or texts saying 'Leave this area now and go to this [other] area' but then the population goes to that area, and then it's still being bombed," she said. "So there's not actually a safe place for them to go and it's very, very difficult for us as healthcare providers to provide any kind of care when there isn't a safe area where we can actually do that."

Both Alayyan and Weiser spoke about the importance of medical professionals needing to feel they are safe when they are treating patients in conflict zones.

"We can do a lot more when we know that we have access to our population, that we ourselves are protected, that the hospitals and the clinics where we're working are not under fire, and the current conflict, obviously in Gaza, is a case in point for that, but it's not the only one," Alayyan said.

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(NEW YORK) -- Respiratory illness activity is elevated or increasing across most areas of the United States, according to data from the Centers for Disease Control and Prevention (CDC).

In total, 15 states plus New York City are experiencing "high" or "very high" levels of respiratory illness activity, defined as people going to the doctor with symptoms from any respiratory disease including flu, COVID, RSV and the common cold.

COVID-19 and flu hospitalizations appear to be trending upward while RSV hospitalizations appear to be to be stable, the data shows.

Weekly COVID-19 hospitalizations have reached levels not seen since the end of February with 22,513 recorded the week ending Dec. 2. However, they remain lower than rates seen at the same time last year.

COVID-19 hospitalization rates are elevated for infants and young children and highest among senior citizens, meaning serious illness is mainly affecting the oldest and youngest Americans.

COVID-19 deaths are currently stable, but experts have previously warned that because deaths are a lagging indicator, the number of fatalities due to the virus could rise over the next few weeks.

The CDC is actively tracking a rising variant known as JN.1, a descendant of the BA.2.86 omicron subvariant, according to an update posted by the federal agency on Friday.

Currently, JN.1 makes up an estimated 21% of cases. While some scientists believe it may be more transmissible due to its continued growth, there is currently no evidence it is more severe than previous variants.

Meanwhile, flu activity continues to increase with the southeast and south-central areas of the U.S. reporting the highest levels of activity, according to the CDC. Modeling from the federal health agency estimates flu infections are growing or likely growing in 34 states, declining or likely decline in one state, and stable or uncertain in four states.

Flu hospitalizations are also increasing, yet the number of new admissions remains low at 5,753 admitted the week ending Dec. 2, an increase from 4,268 the previous week, data shows.

The CDC estimates that there have been at least 2.6 million illnesses, 26,000 hospitalizations, and 1,600 deaths from flu so far this season.

Meanwhile, RSV weekly hospitalization rates have very slightly declined to 2.4 per 100,000 for the week ending Dec. 2 from 2.5 per 100,000 the previous week. RSV hospitalizations remain elevated among young children under 4 and are increasing in older adults over 65.

It comes as the White House urged the makers of RSV immunizations this week that protect infants and toddlers to speed up production to increase access.

The monoclonal antibody shots, which are a bit different than a vaccine but still provide protection, have been in high demand and short supply.

Meanwhile, hospitals in some areas of the U.S., such as in Washington state, are reinstating masking.

At Northwest Healthcare Response Network in western Washington, officials said RSV cases hit a threshold required updating rules on masking throughout its partner hospitals, according to local ABC News affiliate KOMO News.

Additionally, Mary Bridge Children's Hospital in Tacoma reached the RSV threshold earlier this week and the flu threshold on Thursday, officials told KOMO News.

When it comes to vaccinations, data showed much higher uptake for the flu vaccine than for the COVID-19 or RSV vaccine.

As of Dec. 2, 40.8% of adults and 41.6% of children have received the annual flu shot, CDC data shows. Comparatively, 17.2% of adults and 7.7% of children have received the updated COVID-19 vaccine and just 15.9% of adults aged 60 and older have received the new RSV vaccine.

Dr. Philip Huang, director of Dallas County Health and Human Services, advised people to follow the same mitigation measures they have for previous seasons.

"Everything that we're hearing about it is not any new virus or new pathogen, it is the common things that we see every season that perhaps coming together," he said. "The preventive things are all the same, you know, stay home if you're sick, wash your hands, cough into your sleeve, don't rub your eyes, nose and mouth, get up to date on the vaccinations."

Huang said he might advise wearing a mask if you're around someone who is at a higher risk of severe illness or if you're in a crowded area with poor ventilation.

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(ATLANTA) -- For nearly a month, COVID-19 hospitalizations have been increasing following weeks of decline and relatively low levels throughout the summer, according to data from the Centers for Disease Control and Prevention (CDC).

As of Nov. 25, there were 19,444 weekly hospitalizations due to the virus compared to 15,006 four weeks earlier, data shows.

While this marks an increase of 29.6%, it is lower than the 150,650 weekly hospitalizations at the peak of the omicron wave during the 2021-22 season.

Rates of COVID hospitalizations remain elevated among senior citizens, middle-aged adults and children under age 4, meaning the virus is affecting both the oldest and youngest Americans.

"COVID has not disappeared, although it may have gone from many people's minds and the top of their attention," Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center, told ABC News. "I'm afraid the COVID virus is still very much with us."

He added, "These omicron variants and subvariants are highly contagious. They're causing lots of milder illness that does not require hospitalizations. However, there are substantial hospitalizations across the country."

Vaccine protection waning among seniors

Americans aged 65 and older have the highest rate of weekly hospitalizations of any age group in the U.S., as they have throughout the pandemic, at 13.5% per 100,000 for the week ending Dec. 2, CDC data shows.

Experts said there are multiple reasons for this age group to have high rates of hospitalizations, including age being a risk factor for severe disease and senior citizens having more chronic underlying medical conditions that raise the risk of severe disease.

Another reason is vaccine uptake and waning immunity. While 94.4% of adults aged 65 and older completed a primary series of the original vaccine, 33.3% of adults aged 65 and older have received the updated vaccine, according to CDC data.

"Many people, although they have been vaccinated in the past, have not taken advantage of this updated vaccine," Schaffner said. "And the protection afforded by the previous vaccinations is now slowly declining. And so, we have a highly vulnerable population whose protection is slowly waning."

Those aged 50 to 64 have the second-highest rate of weekly hospitalizations by age group at 2.7% per 100,000. Experts said, similarly, this is a group that is starting to see the emergence of chronic underlying conditions that raise the risk of severe illness from COVID.

Dr. Peter Chin-Hong, a professor of medicine and an infectious diseases expert at the University of California, San Francisco, said another reason middle-aged and older Americans have higher rates of hospitalization is that the most vulnerable among this group are not receiving treatments like Paxlovid. Reports have suggested that in some states, it's prescribed in less that 25% of cases.

"It represents a failure of our system to intervene and provide early therapy," Chin-Hong. "You can't really just blame vaccinations because there's a get out of jail card, which is Paxlovid and even remdesivir."

While only those at risk of severe illness are recommended to take Paxlovid, Chin-Hong said it's been a relatively underused treatment because some may feel they don't need the drug or doctors may feel hesitant to prescribe it due to concerns about how the medication interacts with other prescription drugs.

There's also some confusion about who pays for Paxlovid, Chin-Hong said. While it has been and will continue to be free through 2024 for people with Medicare or Medicaid, people with private insurance may have co-pays associated with the drug now that it will no longer be purchased and distributed by the government.

Young kids also at risk of severe illness

Infants and young children under age 4 have the third-highest rate of hospitalizations by age group at 1.6% per 100,000 for the week ending Dec. 2, CDC data shows.

Although children are less likely to fall severely ill and die from COVID compared to adults, they can get sick enough to be hospitalized.

Schaffner said it's a fallacy for a parent to think their child does not need to get vaccinated because they are relatively healthy because children can fall severely ill. What's more, studies have shown that COVID vaccines do decrease hospitalizations among kids.

"It has been very difficult for people to keep two apparently conflicting notions in their mind at the same time," Schaffner said. "First, everyone knows that children are less apt to be seriously affected by COVID infections than older adults. The alternate concept that is hard for parents to grasp is that nonetheless, young children account for the third most common age group with hospitalizations."

Chin-Hong said that parents are less hesitant to get their children vaccinated against influenza than against COVID-19. As of Nov. 18, 38.2% of children aged 6 months to 17 years have gotten a flu shot, CDC data shows. Comparatively, 6.9% of children have gotten an updated COVID vaccine as of Nov. 25.

"More than double are getting flu shots," he said. "So, it's not that everybody's saying, 'No' to vaccines. They're being selective."

While COVID has not followed a traditional seasonal trend like flu, experts say that for all age groups, increases in hospitalizations have occurred during the colder months when people begin to stay indoors, heat is turned up, windows are closed, and holiday gatherings people bring people together -- "ideal conditions for respiratory viruses to spread," said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children's Hospital and an ABC News contributor.

"As people gather for the holidays, it's crucial to remain vigilant about COVID-19, especially in protecting vulnerable populations like the elderly and infants," Brownstein continued. "Practicing good hygiene, such as regular hand washing, and staying home if feeling unwell are key. Additionally, ensuring proper ventilation in indoor spaces and considering wearing masks in crowded settings can significantly reduce the risk of transmission."

The experts also advised the importance of staying up to date on COVID-19 vaccinations and said it's not too late to get a shot.

"Seriously, make a plan and do it as quickly as possible," Schaffner said. "Getting yourself vaccinated and making sure your family members are vaccinated, that's without a doubt -- and I mean, this sincerely -- the best present, you can give yourself and give to them this holiday season, and you will help also make your neighborhood and your community safer."

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(NEW YORK ) -- Dangerous antimicrobial-resistant bacteria are spreading among patients in Ukraine amid the country's war with Russia, new federal data shows.

High rates of antimicrobial resistance (AMR) before Russia's invasion of Ukraine in February 2022, along with a rise in traumatic wounds and overwhelmed health care systems, has led to increased detection of multi-drug resistant infections in Ukraine and surrounding countries, according to a new report published Thursday by the Centers for Disease Control and Prevention (CDC).

Antimicrobials are medicines used to prevent and treat infectious diseases and include antibiotics, antivirals, antifungals and antiparasitics.

AMR occurs when bacteria, viruses, fungi and parasites stop responding to the drugs, causing the infections to become difficult, or even impossible, to treat.

AMR is considered one of the top global public health threats, according to the World Health Organization. Bacterial AMR causes more deaths around the world than HIV or malaria, according to several studies.

For the report published Thursday, the Center for Public Health of Ukraine (UPHC) and regional partners looked at infections in three regional hospitals in the Ternopi and Khmelnytskyi regions in western Ukraine and the Vinnytsia region in western-central Ukraine. The data was then reviewed by the CDC.

Between November and December 2022, of 353 patients surveyed, 50, or 14% of, patients on surveyed wards had health care-associated infections and, of that group, there were high rates of antimicrobial resistance, according to the report.

Of the AMR group, 60% had an infection with an organism resistant to carbapenems, a class of antibiotics. Among patients with Klebsiella pneumoniae, a common type of bacteria found in the intestines that can become dangerous if it spreads, all were resistant to carbapenems and third-generation cephalosporins, another class of antibiotics, the data showed.

In comparison with a European Union-wide survey from 2016 to 2017, just 5.5% of patients had health care-associated infections and, of those related to a family of bacteria that include Klebsiella, just 6.2% were resistant to carbapenems, according to the report.

The report also found gaps in infection prevention and control, as well as laboratory capacity, which raises the risk of delaying diagnosing and causing these organisms to spread.

The authors say more capacity is needed to prevent, detect and respond to antimicrobial resistance to "save lives within Ukraine and limit international spread."

Among the hospitals in the regions surveyed, the UPHC is working to improve this detection by creating routine surveillance, upgrading laboratory equipment, providing technical training for staff and increasing availability and use of hand-hygiene disinfectants, according to the report.

Partners are also working to help provide Ukraine with additional supplies due to increased demand during wartime and to help laboratories be capable of testing for bacterial susceptibility to newer-generation antibiotics.

"Antimicrobial resistance is an urgent global public health threat," the CDC said in a release. "During times of war, this threat can be intensified because of challenges conflicts pose for health care system infrastructure. Collaborative efforts are underway to strengthen health care capacity for infection prevention and control, laboratory detection of antimicrobial resistance, and clinical management of infected patients. These efforts need ongoing support to be scaled nationally."

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(NEW YORK) -- The number of patients in the U.S. traveling out of state to obtain abortion care has doubled since 2020. Nearly one in five patients in the first half of 2023 traveled to other states for abortion care, compared to one in 10 patients traveling out of state in 2020, according to new research from the Guttmacher Institute.

According to data gathered by Guttmacher, the number of people who traveled over state lines to access abortion care more than doubled in the first six months of 2023 -- 92,100 patients traveled across state lines for abortion care, compared with 40,600 people who traveled in the first half of 2020.

Those people are mainly traveling to states that border states where bans have ceased nearly all abortion services, according to Guttmacher.

The Guttmacher Institute says this surge in travel is largely driven by abortion bans going into effect since the U.S. Supreme Court overturned Roe v. Wade in 2022, overturning federal protections for abortion rights.

The state with the largest increase in the number of patients traveling from out of state for abortion care was Illinois, according to Guttmacher.

"Illinois is bordered by three states that ban abortion as well as the restrictive states of Iowa and Wisconsin — in 2020, 21% of the abortions that occurred in Illinois were to people coming from out of state, this increased to 42% in the first six months of 2023," Rachel Jones, a principal research scientist at Guttmacher, told ABC News.

Illinois borders Indiana, Kentucky and Missouri. It also borders Wisconsin, which had ceased nearly all abortion services until a court decision last month issued a ruling that an 1849 law did not apply to abortion, but only applied to the termination of a pregnancy without the mother's consent.

Two Planned Parenthood locations in Wisconsin have since resumed abortions.

At least 16 states have ceased nearly all abortion services since the U.S. Supreme Court overturned Roe v. Wade.

New Mexico also saw an increase in the number of patients who traveled across state lines for abortion care, with the state bordering Texas and Oklahoma, where nearly all abortions have ceased, according to the data.

Additionally, an estimated 8,230 patients from out of state received abortion care in New Mexico, data showed.

Despite an abortion ban being in place in Florida, the state still saw an uptick in the number of abortions that took place. According to data gathered by Guttmacher, an estimated 5,780 patients traveled to Florida for abortion care.

Florida has a 15-week abortion ban in place and a 6-week abortion ban that could go into effect if the 15-week ban is upheld by the state Supreme Court.

The data also showed the impact of bans going into effect.

"In South Carolina, the number of abortions provided in the formal health care system decreased by 79%—from 750 in August 2023 to 160 just one month later—after the state started enforcing a ban on abortions after six weeks gestation on August 23, 2023," a Guttmacher policy analysis said.

But what the study doesn't cover is what happened to patients who were unable to travel across state lines for care.

"We're documenting an increase in abortion in states bordering those where abortion is banned, which demonstrates that there are lots of people — tens of thousands of people — have been able to travel to another state to get care. We know that there are thousands of people, maybe tens of thousands of people, who aren't able to do that, who don't have the resources or the logistical support to do that," Jones said.

"And that's what this study doesn't tell us —who's not able to overcome these barriers," Jones said.

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(NEW YORK) -- Eligible adults can now receive free at-home rapid tests, telehealth sessions and at-home treatments for both COVID and influenza through a newly expanded federal government program.

Initially launched as a pilot program in select areas, the Home Test to Treat program from the National Institutes of Health is now available nationwide at test2treat.org.

Any adult with a current positive test for COVID or flu can enroll to receive free telehealth care and, if prescribed, medication delivered to their home. Follow-up care is also possible through the treatment process.

"If something comes up and [patients] want to have a follow up, they can return for a second telemedicine visit," said Andrew Weitz, Ph.D., NIH lead for the Home Test to Treat program.

"We actually haven't seen this happen at all yet," he added.

Those not currently positive for COVID or flu can have free tests delivered if they are uninsured or insured through select federal programs such as Medicare, Medicaid, the VA health care system, or Indian Health Services.

"I think that these [telehealth] delivery mechanisms are going to be absolutely crucial to unburden the in-person offices and the lines that we have and wait times," said Dr. Michael Mina, chief science officer at eMed, the company that helped implement the new Home Test to Treat program.

COVID tests can also be ordered through a separate program, covidtests.gov, which relaunched a few months ago allowing orders for an additional four tests per household, or eight tests for those who haven’t already placed an order yet this fall.

As the largest source of funding for medical research in the world, the NIH is also pursuing its research-oriented mission to explore how technology can be leveraged to improve health care access more broadly.

"We're doing this to both benefit public health, but at the same time, being the NIH, which is really a research organization, one of our aims through this program is to better understand how technologies like at-home tests and telemedicine can improve health care access for people across the country," Weitz said.

The program is set to expire in the spring of 2024, but it remains to be seen if the initiative will potentially transfer to the private sector.

"Whether or not a program like this could get enough interest from the public to be sustained by the commercial sector or is this something that needs sustained government investment... those are the types of research questions that we're looking to answer from this program," Weitz said.

The program will initially provide the Pfizer COVID-19 & Flu Home Test, the first FDA-authorized test that can detect both viruses in one swab at home.

Treatment for respiratory illnesses must typically begin within a short window of onset of symptoms or as soon as possible.

"By the time most people get to the doctor for [respiratory illnesses], they're already outside of the therapeutic window where treatment could have helped and so then they're kind of stuck, hoping that the body is going to clear the virus but some end up in the hospital," Mina said.

Medication from the program delivered to the home will be available at no cost regardless of insurance status. If picked up from a pharmacy, patients may be asked to pay out of pocket or provide their insurance, but can ask the pharmacy if they have government procured treatments available at no cost.

"For acute respiratory viruses like COVID and influenza, really starting treatment as soon as possible after infection will help you to limit the growth that the virus will make in the first place and therefore help to limit the damage that it does to the cells of the body," Mina said.

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(WASHINGTON) -- The Biden administration is putting off its plan to ban menthol cigarettes until next March after an aggressive lobbying push by civil rights groups -- some sponsored by Big Tobacco -- who argued a ban would unfairly target Black smokers.

The delay, acknowledged in an online posting Wednesday, is a major defeat for health advocates who have been pushing for years to limit access to menthol cigarettes, which are aggressively marketed in Black communities. According to the Centers for Disease Control and Prevention, menthol can enhance the addictive effects of cigarettes and make it harder to quit.

"We can't reduce tobacco use and associated disease and death without eliminating menthol as a flavor. That's really the next step," said Chrissie Juliano, executive director of the Big Cities Health Coalition, which represents city health departments across the country.

The Biden administration had seemed on board with restricting the sale of menthol cigarettes, with the Food and Drug Administration proposing the ban in April 2022. A final rule was supposed to be released in August. When a final rule was sent to the White House budget office this fall, advocates believed they were close to the finish line.

But in private phone calls, civil rights groups including the ACLU; the National Organization of Black Law Enforcement Executives, or NOBLE; and Rev. Al Sharpton's National Action Network warned the White House against the plan, with some officials suggesting that a regulatory crackdown could harm President Joe Biden's reelection chances with Black voters.

A senior administration official, who spoke on condition of anonymity because of the sensitivities involved, confirmed that the delay was the result of those conversations.

"It is a signal to the community that lobbied on this that we heard you and we need some more time to look at this," the official told ABC News.

The White House declined to comment.

Now anti-tobacco groups say they worry the rule won't happen at all, especially in an election year. They point to the fact that several of the groups involved in discussions with the White House and others running ads against the ban are sponsored by tobacco companies.

Yolonda Richardson, president of the Campaign for Tobacco-Free Kids, said more than 45,000 Black people die from smoking each year -- a figure the administration knows well.

“I don't know how Black Lives Matter if you're willing to put 45,000 lives at risk” by keeping menthol cigarettes on the market, she said.

NOBLE lists tobacco giant Altria among its sponsors. Another group, the National Association of Blacks in Criminal Justice, which ran ads against the proposed ban, is sponsored by Reynolds American.

NOBLE and NABCJ didn't immediately respond to a request for comment.

Tobacco-maker Reynolds American said it supports organizations that "contribute to the debate" on issues important to its consumers.

"Reynolds has been clear on where it stands on this topic - we strongly believe there are more effective ways to deliver tobacco harm reduction than banning products. Banning products often leads to unintended consequences such as the increase of illegal/unregulated products flooding the market," according to the company statement.

Altria did not immediately respond to requests for comment, but in a statement on menthol cigarettes in general said: "We believe prohibition does not work, and criminalizing menthol will lead to serious unintended consequences. We also believe the science and evidence does not support bans on menthol cigarettes and characterizing flavors in cigars."

Sharpton's National Action Network says it participated in phone calls with the White House because it believes the menthol ban would have unintended consequences. A spokesperson did not answer questions about whether tobacco companies sponsor the organization.

"National Action Network has taken the position that, unless there are real safeguards against criminal prosecution of Black and Brown communities, the proposed menthol ban will have unintended consequences," according to a statement shared with ABC News. "This position was taken after working with Gwen Carr, the mother of Eric Garner; attorney Ben Crump; and the ACLU. NAN is also not opposed to a ban on all cigarettes." (Eric Garner, a 43-year-old Black man, died in 2014 after being placed in a police chokehold while being arrested on Staten Island in a dispute over selling loose cigarettes.)

Juliano and Richardson said any suggestion that the rule could criminalize Black smokers doesn't make sense because the rule goes after manufacturing and distribution only.

"These regulations do not suggest in any way shape or form that individuals would bear the brunt of any enforcement," Juliano said.

Richardson said misinformation is a problem as much as the politics.

“I think it's very easy for the tobacco industry to stoke fears on an issue that clearly the Black and African American community feels very strongly about and it's very emotional issue for this community," she said.

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(NEW YORK) -- A Texas mother of two says she "desperately" wants a chance to try for a third child but is in jeopardy of losing her uterus due to Texas' abortion bans. She is currently carrying a pregnancy with virtually no chance the baby will survive to birth or long afterwards and said she has been denied the safest form of abortion care for her -- a dilation and evacuation procedure.

She is now asking a court to allow her to get abortion care in her home state. She is set to appear remotely in an emergency hearing on Thursday. Her attorneys expect a ruling during the hearing. Her lawsuit stands apart from another ongoing lawsuit filed by 20 women who say their lives were put in danger by the bans.

Days after the Center for Reproductive Rights' lawyers appeared before the Texas Supreme Court arguing for an injunction on the state's abortion bans, attorneys filed a second lawsuit that happened to hit back at one of the state's arguments against them -- that women filing the suit were not seeking appropriate emergency response from the state because they are not currently in emergencies that require abortion care.

Kate Cox, a Texas woman, filed an emergency lawsuit against the state of Texas seeking a temporary restraining order on Texas' abortion bans in her case, so she can be provided with the abortion care she seeks.

Cox "needs urgent abortion care due to a lethal fetal diagnosis and threats to her life, health, and fertility from continuing the pregnancy," according to a press release from the CRR.

A CRR attorney told ABC News that the new lawsuit was "not strategic" or in response to arguments made by the state last week.

"She called us after the Texas Supreme Court argument, because she got the amniocentesis results, and she's been having health conditions going on right now. Whereas the other plaintiffs were talking about things that happened to them throughout the last couple of years dealing with Texas abortion bans," Marc Hearron, senior counsel at CRR, told ABC News.

Texas has multiple abortion bans in place and is one of 16 states that have ceased nearly all abortion services since the U.S. Supreme Court issued a decision overturning Roe v. Wade, ending federal protections for abortion rights.

Texas' bans include exceptions that allow abortions in cases of medical emergencies and fatal fetal diagnoses, but doctors and patients claim, in another lawsuit filed in March, that they are unable to provide care or have been denied care, respectively, under the laws. Under Texas' bans, it is a second-degree felony to perform or attempt an abortion, punishable by up to life in prison and a fine of up to $10,000. The law also allows private citizens to sue anyone who "aids or abets" an abortion.

Plaintiffs allege that the laws are confusing and do not define the exception to bans -- which allow abortions to save the life of the mother or preserve bodily function -- and wager significant penalties against doctors, up to life in prison.

Suit alleges Cox's health is at risk

In a new lawsuit filed Tuesday, Cox said she has been unable to get an abortion due to Texas' multiple abortion bans. Cox's baby has received a diagnosis that her baby has full Trisomy 18, which is a condition with a very high likelihood of miscarriage or stillbirth and low survival rates, according to Cox's lawsuit.

According to Hearron, Cox has been told by physicians that they can provide her with an induction of labor if the baby's heart stops beating. Cox -- already a mother of a 3-year-old and a 1-year-old -- has had two cesarean deliveries, and was told that an "induction carries serious risk of uterine rupture," according to the lawsuit.

"I do not want to put my body through the risks of continuing this pregnancy. I do not want to continue until my baby dies in my belly or I have to deliver a stillborn baby or one where life will be measured in hours or days, full of medical tubes and machinery," Cox said in the lawsuit.

"Trisomy 18 babies that survive birth often suffer cardiac or respiratory failure. I do not want my baby to arrive in this world only to watch her suffer a heart attack of suffocation. I desperately want the change to try for another baby and want to access the medical care now that gives me the best chance at another baby," Cox said in the lawsuit.

The CRR also alleged that Cox's health is at risk and that she "risks debilitating health complications" if she continues her pregnancy, including potential loss of fertility.

"If Kate is not allowed to have an abortion in Texas, she will be forced to continue the pregnancy until she either miscarries or gives birth to a stillborn or to a baby that could live only minutes. Her only other option is to try to flee the state," the CRR said in a release.

"Kate's OB-GYNs have warned her of dire consequences to her health should she continue the pregnancy. The lawsuit asks the court to temporarily halt Texas' abortion bans as they apply to Kate and her husband Justin Cox, who fears liability under S.B. 8--Texas' vigilante abortion ban," the CRR said.

Cox's hearing in Texas court is scheduled for 10 a.m. ET, according to the CRR.

State argues 20 women don't have standing

In court, prosecutors argued that the 20 women filing a suit claiming Texas' abortion bans put their lives in danger do not have standing to ask a court for relief because they are asking for "generalized" relief.

"If the Court were to say what the trial court said, and then they had a patient with a new circumstance does this resolve that question? I'm not sure if it would or not," said Beth Klusmann, the prosecutor who made arguments on behalf of the state.

Klusmann was asked by a justice if the state's position is that they want a woman who is pregnant and has a health condition she believes meets the exceptions to the abortion bans to file a lawsuit in order for her suit to have standing the state, to which Klusmann responded that such a patient would have standing, although it may not be the only circumstance in which a woman would have standing.

"You would at least then know that the law is the problem and not the doctor refusing to perform an abortion that otherwise would normally fall within the law. I mean that's also part of the concern here is that some of these women appear to have fallen within the exception but their doctors still said no, that's not the fault of the law. That's that's a decision of the doctor," Klusmann said.

A prosecutor appearing on behalf of the state also argued that the state has sovereign immunity -- meaning that it cannot be sued unless the legislature permits such a suit.

The Texas Supreme Court has not yet issued a decision on whether it will allow the lawsuit filed by 20 women and two OB-GYNs will be allowed to continue, or if it will allow a preliminary injunction suspending implementation of the bans in cases of medical emergencies and fatal fetal anomalies. A decision is expected sometime before June 2024.

Hearron said that in the CRR's conversations with the state, they have not divulged what their stance is on whether Cox should be granted an abortion.

"We've done this in this one case, but this is not an option for most people -- to file a lawsuit while they're in the midst of a health crisis," Hearron said.

"Someone who has ruptured membranes doesn't have time. They need an abortion … even though we've done this in this one situation, this cannot be the answer -- that every single person who needs an abortion in the state of Texas files lawsuit," Hearron said.

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(NEW YORK) -- Tracking one of the deadliest living beings on Earth will be the key to saving thousands of lives each year, researchers at the University of South Florida say.

The pesky bite of a mosquito has the potential to bring more than just itchiness and inflammation. More than 1 million people worldwide die from mosquito-borne diseases every year, according to the American Mosquito Control Association.

As global temperatures warm, the risk of contracting a mosquito-borne illness becomes more prevalent, simply because a hotter climate creates optimal breeding conditions for the insect.

Now, researchers at the University of South Florida are using citizen science -- the practice in which the public voluntarily participates in scientific research -- to help create artificial intelligence algorithms to help identify and stop disease-carrying mosquitoes before they are able to infect humans and other large mammals.

The citizen science aspect in the identifying process is critical, Ryan Carney, an assistant professor at the University of South Florida's Department of Integrative Biology, told ABC News.

"As big of a problem that mosquitoes and mosquito-borne diseases are, we can all do our part to fight them," he said.

In a small outdoor fountain containing thousands of mosquitoes, researchers are able to extract individual mosquitoes and use a zoom lens attached to a phone to capture an image of the mosquito. The image can then be uploaded via free apps to the Global Mosquito Observations Dashboard, a user-friendly web interface funded by the National Science Foundation that monitors invasive and vector mosquitoes.

AI is then used to train several algorithms to detect -- in the larval or adult stage -- the species of mosquito, which allows mosquito-controlled district officials to locate the mosquitoes capable of transmitting disease and eliminate them.

The database is essentially a "one-stop shop" to view all the mosquito observations throughout the world, Carney said.

Some of the most severe diseases mosquitoes carry and spread among humans are malaria, West Nile virus, Eastern equine encephalitis, yellow fever, dengue and Zika, according to the Centers for Disease Control and Prevention.

Some mosquito-borne illnesses such as malaria, dengue and chikungunya virus are on the rise after decades of progress in prevention.

In 2023, malaria was transmitted on U.S. soil for the first time in 20 years, according to the CDC. A total of nine transmissions were reported in multiple states.

Seven of those transmissions occurred in Sarasota County, Florida, prompting state and county health officials to issue mosquito-borne illness alerts in the region over the summer, when mosquitoes are at their most active.

"When you ask people what's the most dangerous animal in the world, most people think of things like sharks," Carney said. "It's actually the mosquito that's the deadliest animal on the planet, responsible for about 700 million infections each year and nearly one million deaths."

Climate change could exacerbate the problem though, Carney said, describing the rise in global temperatures as a "perfect storm" for mosquito-borne diseases.

"It affects virtually every step of the transmission process, from the habitats to the mosquitoes to the pathogens to the human hosts," Carney said. "...Higher temperatures makes everything worse."

Worsening drought, one of the consequences of climate change, will likely cause people to store water, the containers of which can serve as a breeding habitat for mosquitoes, Carney said.

The resiliency of mosquitoes will allow them to thrive amid a warming climate. Even if the climate changes rapidly, mosquitoes are expected to adapt with it, as well as expand their ranges, Carney said. Research published in the past year alone has discovered "super" mosquitoes that have mutated to withstand insecticides as well as mosquitoes who have leaned how to avoid the pesticides used to kill them.

"Climate means that there's going to be more areas with more mosquitoes, that are going to be spreading more disease to more susceptible people," he said.

Humans will need to "remain vigilant" in monitoring mosquitoes and the diseases they carry in the upcoming years, Carney said.

Carney reminded the public to think of the "Three D's" of mosquito protection and prevention: Drain standing water near your home; dress appropriately with long sleeves, light colors and loose-fitting clothes; and defend with insect repellent.

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(NEW YORK) -- The Biden administration recently announced a proposal that would require all lead water service pipes to replaced in the United States within the next decade.

The proposal, led by the Environmental Protection Agency (EPA), is an attempt to protect Americans from lead exposure, which can cause severe health issues in children and adults, including developmental delays, kidney damage and pregnancy complications.

There are more than 9.2 million lead pipes throughout the country, but there are certain states that would particularly benefit from the proposal.

Four states -- Florida, Illinois, Ohio and Pennsylvania -- contain nearly 40% of all lead service lines in the U.S. at more than 3.63 million total, according to an April 2023 report from the EPA.

Dr. Aaron Packman, professor of civil and environmental engineering at Northwestern University and director of the Northwestern Center for Water Research, said there are two issues in Illinois: one being the government-owned city water infrastructure and the other being the lines people own individually on their properties.

"The issue with the city infrastructure, a lot of it is old ... and it's been under maintained over the last few decades because of decreasing federal funding available for water infrastructure," he told ABC News. "The bigger issue we have now is that lead was widely used to connect the water mains in the street to people's houses."

He continued, "And so there are enormous numbers of these lead service lines, as they're called, that are in people's front yards or coming into their apartment building or school, and it's harder for city governments typically to conduct work on private property."

Residents of Chicago, in particular, would be greatly impacted by the initiative because nearly 400,00 lead water pipes are located in the city -- the most of any city in the U.S. In the early 20th century, an agreement negotiated between plumbers' unions and the lead industry resulted in a requirement of using lead in pipes, "so they're just everywhere," Packman said.

Considering the monumental challenge of replacing so many lines, the EPA has made an exception and is allowing Chicago to take 40 to 50 years to replace its pipes, according to local media reports.

"This is long-term fallout from bad industrial governmental decisions 50-plus years ago," Packman said. "It's larger cities, older cities with older infrastructure and are more densely populated or more built up, all of those factors make this take longer, be more challenging."

Pennsylvania may also benefit from the proposal. In Philadelphia, similar agreements around the same time period also resulted in lead being required in the city's pipes.

Additionally, a February 2023 report from the nonprofit Environment America revealed that despite Pennsylvania law requiring schools to test some taps for lead every year, a loophole allows districts to avoid testing taps by holding a public meeting to discuss the issue.

As of 2018, Pennsylvania was one of the states with the highest blood levels reported among kids, Centers for Disease Control and Prevention (CDC) data shows.

According to the CDC, children under the age of 6 are at greatest risk for health problems due to lead exposure, which can affect growth and development.

"For children, we see developmental delays and behavior problems related to lead exposure, because it is a very potent neurotoxin," Dr. Ruth McDemott-Levy, professor & co-director of the Mid-Atlantic Center for Children's Health and the Environment, at Villanova University, told ABC News. "And so, if we don't catch it quickly enough ... we're talking about lifelong problems for the child and, that can affect the ability to perform well in school, to get a decent paying job."

But it's not just children. Adults can also suffer health consequences from lead exposure including high blood pressure, gastric discomfort and kidney issues, McDermott-Levy said.

Additionally, if a pregnant woman is exposed to lead over a long period or has prior high blood levels, the toxin can cross the placenta to the fetus and increase the risk of miscarriage, neurocognitive damage, premature birth or low-birth weight, according to the CDC.

She added that the proposed rule would really benefit low-income families of color, who are most impacted by lead exposure, including in water. For a city like Philadelphia, which is considered the nation's poorest large city by poverty rate, according to 2022 Census Bureau data, that would certainly be the case.

"For example, we filter our water; it's just a given that's what we do and we can do that," McDermott-Levy said. "But not everyone can afford that or can keep up with changing the filter and all of those sorts of things. So, I think it's going to have the greatest impact on low-income people of color."

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(NEW YORK) -- In the long-running debate on whether a meat-free or meat-filled diet promotes better health, a new study is giving weight to the benefits of a meat-free diet.

Researchers at Stanford University examined the health of 22 sets of identical twin adults to see how they fared when one twin ate a vegan, or animal product-free diet, while the other twin ate an omnivorous, or animal- and plant-filled diet over two months.

The study, published Nov. 30 in the journal JAMA Network Open, looked specifically at the twins' cardiovascular health, including cholesterol levels, sugar levels, insulin levels and body weight.

After eight weeks following their respective diets, the twin siblings who ate a vegan diet had lost more weight, reduced their LDL, or "bad" cholesterol, and experienced lower insulin levels, according to the study's findings.

"The findings from this trial suggest that a healthy plant-based diet offers a significant protective cardiometabolic advantage compared with a healthy omnivorous diet," the study's authors wrote.

The study's findings build on previous research showing that plant-based diets are better than non-plant-based diets when it comes to cardiovascular health.

A study published last year found that eating a plant-based diet can add years to your life. For that study, researchers in Norway used computer models to compare a typical Western diet -- heavy on animal-based proteins, dairy and sugar -- with a more ideal plant-based diet that's heavy on fruits, vegetables, beans and grains, and light on animal-based proteins.

According to the computer models, a 20-year-old who went all in on the plant-based diet could add 10 years to their life. An 80-year-old who started a plant-based diet could add three years to their life expectancy, according to the study, published in February 2022 in PLOS Medicine.

What makes the Stanford study different is its use of twins who have the same genetic makeup and contributing environmental factors, according to the study's authors.

"Because identical twins have nearly identical DNA and many shared experiences (eg, upbringing, geographic region growing up, and similar exposure to other variables), observed differences in health outcomes after adoption of different dietary patterns can largely be attributed to the diet itself," the authors wrote.

A plant-based diet is a way of eating that consists mostly or entirely of foods derived from plants, including vegetables, grains, nuts, seeds, legumes and fruits.

Plant-based diets typically consist of eating few to no animal foods and are different from vegan diets, which eliminate all animal foods and products, and vegetarian diets, which eliminate all meat, fish and poultry.

Plant-based diets also often emphasize whole foods.

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(NEW YORK) -- CVS is the latest pharmacy to change its drug pricing formula, a move it said would increase transparency and simplify costs.

The company will now base drug costs on the amount that it pays for a drug -- limiting the markup and service fee to customers.

"What CVS is doing -- at the pharmacy and at the PBM [pharmacy benefit managers] -- is rewiring or resetting how reimbursement happens in an industry that has become very complex and largely follows a model based on how things used to be a decade ago," a CVS Pharmacy spokesperson told ABC News. "Only we can take this kind of step forward, given our leadership on the PBM and pharmacy. It is a necessary foundational step to make this entire system more consumer-friendly, preserve choice for payers, and maintain a viable retail pharmacy industry."

Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital and an ABC News contributor, said the announcement by CVS aligns with the industry's decision to be more straightforward with drug prices.

"By basing drug costs on their actual acquisition price, CVS is taking a crucial foundational step to make healthcare more consumer-friendly and ensure the viability of retail pharmacies," he said.

Many consumers may not be impacted immediately by this change. The earliest consumer impact would be the first half of 2024 for those using cash pharmacy discount cards at a CVS Pharmacy.

In 2025, CVS Pharmacy said it will launch this model with pharmacy benefit managers. Savings will mostly be seen on the payer or plan sponsor side but will depend on exactly how the model is adopted, individual client use and how the plan is applied to an individual’s benefits.

Dr. Lucas Berenbrok, an associate professor of pharmacy and therapeutics at the University of Pittsburgh, said pharmacies and consumers alike will benefit from these new pricing models. Pharmacies will have a more predictable reimbursement rate and consumers may be less likely to overpay for generic drugs, he noted.

"I think it could give patients in the public even more trust that someone's looking out for them and that they're able to get medications at a fair price," Berenbrok told ABC News.

The CVS pricing model is similar to the cost-based pricing for prescription drugs at Express Scripts announced last month.

"It's encouraging to see major players like CVS and Express Scripts taking steps to eliminate the complexity in drug pricing, ultimately benefiting consumers and payors alike," Brownstein said.

Dr. Jade A. Cobern, MD, MPH, is a board-certified pediatrician specialized in preventive medicine and a member of the ABC News Medical Unit.

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(NEW YORK) -- Nearly one year ago, Christie Martin, a mom and realtor in Las Vegas, said she started taking Ozempic to help her lose weight.

Martin, 58, told ABC News' Good Morning America that within a matter of months of taking the medication, she had lost over 30 pounds.

But Martin, who said she had gotten into a routine of drinking nearly one bottle of wine per night after work, said she soon noticed a side effect of the drug: She lost her appetite for alcohol.

"I did not want to drink anymore," Martin said. "I went to the grocery store and I didn't even want to buy a bottle of wine. I would even go out with friends and other coworkers and clients and maybe I would try to order a glass of wine at dinner, and I couldn't even finish it. It just didn't sit well with me."

Martin said that before taking Ozempic, she was someone who would have wine at lunch and who "loved" having wine at dinner. At home, she said she saw drinking wine as a "reward" after a long day of working and being a single mom.

"I have no desire to drink wine anymore," she said of the effect of Ozempic. "And that's crazy to me because I couldn't stop before."

Martin's experience is one that is ringing true for researchers as well.

One small, recently published case study found that six people who screened positive for alcohol use disorder saw a clinically significant decrease in symptoms while using semaglutide, the active ingredient in Ozempic and another medication, Wegovy, for weight loss.

While this small case study doesn’t provide strong scientific evidence that these drugs can also be used to treat alcohol use disorder, experts say it does reinforce the need for larger, randomized clinical trials that are in early stages.

Alcohol use disorder is a medical condition that is characterized by "an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences," according to the National Institutes of Health's National Institute on Alcohol Abuse and Alcoholism. Nearly 30 million people over the age of 12 in the United States have alcohol use disorder, according to the U.S. Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration’s 2022 National Survey of Drug Use and Health, the most recent data available.

Martin, who was not part of the case study, said that she was never diagnosed with alcohol use disorder, but acknowledged that her drinking was "an issue" prior to taking Ozempic.

"The fact that I just have no desire for it is something I didn't expect and is just an amazing side benefit," she said. "I can't even tell you."

How semaglutide may help with alcohol use

Semaglutide, a GLP-1 receptor agonist medication, is the active ingredient in drugs like Ozempic and Wegovy that have skyrocketed in popularity over the past year due to their success in being used for weight loss.

The U.S. Food and Drug Administration has approved Ozempic as a treatment for Type 2 diabetes alongside diet and exercise if other medications cannot control blood sugar levels well enough.

Although Ozempic is not explicitly approved for chronic weight management, it can be prescribed off-label and used safely for people who are obese.

Wegovy is essentially the same injectable drug as Ozempic, prescribed at a higher dosage. The FDA has specifically approved Wegovy for patients with severe obesity, or who are overweight and have one or more weight-associated conditions like high blood pressure or high cholesterol.

Both drugs work by slowing down movement of food through the stomach and curbing appetite, thereby causing weight loss.

Experts have theorized that the way in which semaglutide interacts with the brain to stop overeating also helps with other addictive behaviors, including alcohol use.

"Theories are that it works in the brain and the rewards center," said ABC News chief medical correspondent Dr. Jennifer Ashton, a dual board-certified physician in OBGYN and obesity medicine who was not involved in the semaglutide study.

Ashton described the research showing drugs used for weight loss may help people curb alcohol use as a "potential major indication."

In addition to raising the risk of health complications including cancer, drinking alcohol is listed by the U.S. Department of Health and Human Services as a known human carcinogen.

Heavy drinking is typically defined as consuming eight drinks or more per week, according to the U.S. Centers for Disease Control and Prevention. One serving of alcohol is defined as five ounces for wine and just 1 1/2 ounces for hard alcohol, far less than what is typically served in bars, restaurants and people's homes.

Currently, treatments for alcohol use disorder include three FDA-approved medications, behavioral interventions, and tech-based or app-based therapies, according to Ashton.

"This isn't just about potentially choosing one [treatment]," Ashton said. "It's about, if you have an alcohol use disorder or a substance abuse disorder, filling the boat and getting as much treatment as you can to make a big change in your lifestyle."

Currently, the use of semaglutide medications for alcohol use disorder is considered off-label and therefore unlikely to be covered by insurance, making this option too costly for most to afford. Without insurance coverage, the cost of medications like Ozempic and Wegovy can run more than $1,000 a month.

Results from clinical trials that provide stronger scientific evidence are a year or more away and would still need to be approved through appropriate regulatory agencies before this indication could be approved.

For questions and concerns about alcohol use, SAMHSA, the Substance Abuse and Mental Health Services Administration, has a 24/7 free and confidential helpline available at 1-800-662-HELP (4357), and online at samhsa.gov/find-help/national-helpline.

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(NEW YORK) -- The Centers for Disease Control and Prevention is warning consumers about a multistate salmonella outbreak linked to some cantaloupes.

The CDC published another food safety alert on Friday, after multiple retailers and brands -- including Trufresh, Crown Jewels Produce, Vinyard Fruit and Vegetable Company, CF Dallas, ALDI and Pacific Trellis Fruit -- issued recalls for both whole and pre-cut cantaloupes.

The cantaloupes were sold by some retailers with labels or stickers that read "Malichita" or "Rudy," and by others in clear containers or cups, pre-cut or sliced into cubes. (More specific information is included below.)

The CDC also released investigation details citing epidemiologic and laboratory data that showed "cantaloupes are contaminated with Salmonella and are making people in this outbreak sick." Canada is also investigating the outbreak, the CDC said, and "has linked illness ... with the same Salmonella strain to cantaloupes."

As of time of publication, there have been 117 reported illnesses, 61 hospitalizations and two deaths across 34 U.S. states connected to the outbreak, according to the CDC.

The two deaths were reported in Minnesota.

The agency said the illnesses were reported between Oct. 17 and Nov. 10, however the CDC noted the number of people with illnesses connected to the outbreak is likely higher than current figures suggest.

"Recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak," the CDC stated. "The true number of sick people in this outbreak is also likely much higher than the number reported. This is because many people recover without medical care and are not tested for Salmonella."

Several brands and retailers have initiated outbreak-related cantaloupe recalls so far.

Whole cantaloupes

Last week, Trufresh, operating under parent company Sofia Produce LLC., expanded an earlier Nov. 8 recall to include all Malichita brand and Rudy brand whole cantaloupes sold between Oct. 10 and Nov. 3. The affected products were distributed directly to states including Arizona, California, Connecticut, Maryland, Missouri, Montana, Nevada, New Jersey, New York, Oregon, Pennsylvania, Tennessee, Utah, Illinois, Michigan, Wisconsin, Texas and Florida, as well as Canada.

On Nov. 22, Crown Jewels Produce also recalled Malichita brand whole cantaloupes that were distributed to retailers and wholesalers in Ohio and California and sold between Oct. 31 and Nov. 9 due to possible salmonella contamination, according to a company announcement on the FDA website.

Pacific Trellis Fruit issued a similar recall on Nov. 24. According to a company announcement on the FDA website, the recall involves "4,872 cases of Malichita brand whole cantaloupe" packed in corrugated cartons and distributed between Oct. 18-26 in California, Illinois, Oklahoma, Texas and Wisconsin, and sold in various retail supermarkets.

Whole cantaloupes included in the above recalls "might have a sticker that says 'Malichita' or 'Rudy,' with the number '4050,' and 'Product of Mexico/produit du Mexique,'" according to the CDC.

Sliced or pre-cut cantaloupe products

In coordination with Sofia Produce, CF Dallas voluntarily recalled pre-cut fruit products sold under the Freshness Guaranteed and RaceTrac brand names that may have contained the recalled cantaloupes. The affected products were packaged in clear square or round plastic containers with best-by dates between Nov. 7-12. The products were sold in Illinois, Indiana, Kentucky, Louisiana, Michigan, North Carolina, Ohio, Tennessee, Texas and Virginia.

In a statement on the FDA website, CF Dallas noted that the "fresh-cut fruit products associated with the recalled whole cantaloupe have expired, however consumers who have purchased these items and may have frozen them for later use are urged not to consume the products and to dispose of them immediately or return the items to their local store for a full refund."

Vinyard Fruit and Vegetable Company, located in Oklahoma City, issued a recall earlier this month on pre-cut cantaloupe, which included cantaloupe cubes, melon medleys and fruit medleys that were sold in Oklahoma stores between Oct. 30 and Nov. 10. A company statement on the FDA website notes that the recall was issued in relation to the earlier Sofia Produce whole cantaloupes recall.

On Nov. 14, ALDI issued a recall in association with Sofia Produce on both whole cantaloupe and pre-cut fruit products in clamshell packaging with best-by dates between Oct. 27-31 that were sold in ALDI stores in Illinois, Indiana, Iowa, Kentucky, Michigan and Wisconsin. Click here for full recall details.

"Investigators are working to identify any additional cantaloupe products that may be contaminated," the CDC said in its food safety alert on Friday.

If you can't tell if your cantaloupe was impacted by the current recalls and food safety alert, throw it away and do not consume it. The CDC has advised people to wash items and any surfaces that may have come into contact with the fruit "using hot soapy water or a dishwasher," and to "call your healthcare provider if you have any ... severe Salmonella symptoms."

Symptoms and treatment of salmonella sickness

Salmonella is a bacteria that can make people sick, and most types cause an illness called salmonellosis, according to the CDC.

Most people with salmonellosis experience symptoms such as diarrhea, fever and stomach cramps, which may occur hours to days after infection, the CDC states, though some do not develop symptoms for several weeks.

Infections are diagnosed through lab testing. Most people recover within four to seven days without antibiotics, according to the CDC. Antibiotic treatment is recommended for people with severe illness, those with weakened immune systems, adults 50 and older with medical issues like heart disease, as well as infants, and adults older than 65, the agency states.

An earlier version of this story was originally published on Nov. 27, 2023

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(MASON, Ohio) -- A county in Ohio has recorded 142 cases of pediatric pneumonia since August, caused by a mix of known infections, including common cold, strep and a bacterial infection called mycoplasma pneumonia, according to a press release from the Warren County Health District.

"We do not think this is a novel/new respiratory disease but rather a large uptick in the number of pneumonia cases normally seen at one time," the release stated.

Some European countries have reported an uptick in respiratory illness cases, including mycoplasma pneumoniae infections, in recent weeks, according to local health agencies.

Recently, China has also been dealing with a surge of respiratory illnesses among children, according to the World Health Organization (WHO). The uptick has been partly attributed to the removal of pandemic restrictions leading to a resurgence of known viruses and bacteria, health authorities have insisted.

"There is zero evidence that what we're seeing in Warren County has any connection to any respiratory activity in the state, in the country, or in the world," Dr. Clint Koenig, the medical director of Warren County Health District told ABC News.

Bacterial infections like mycoplasma pneumonia tend to flare up in cyclical patterns, rising every few years. Viruses like influenza, RSV, and the common cold follow similar trends on an annual basis with cases typically rising in colder months.

"Despite the headlines that we're seeing in China, there is no indication that there are any new viruses or bacteria spreading from country to country," said Dr. John Brownstein, chief innovation officer at Boston Children's Hospital and an ABC News Contributor.

"This is typical seasonal bacterial and viral activity that we see each year," he added.

"Based on our provisional assessment, we are seeing seasonal trends. Nothing is appearing out of the ordinary, but we are continuing to monitor," said a spokesperson from the Centers for Disease Control and Prevention.

Only a few of the 142 pneumonia cases have been confirmed as mycoplasma pneumonia, according to Koenig. He points out that providers typically don't test for every virus and bacterium, making it difficult to determine which pathogens are dominating.

So far, there have been some hospitalizations including patients with underlying conditions but no reported deaths, Koenig said.

"The vast, vast majority" are getting better and returning to school, he added.

A spokesperson from the CDC told ABC News that it's continuing to monitor respiratory illness activity across the country and remaining in touch with private labs regarding testing of bacterial illnesses.

"Based on our provisional assessment, we are, at this point, seeing activity that is typical for the season, but we are continuing to monitor," a spokesperson from the federal agency shared in part of a statement.

Health officials continue to recommend that everyone over the age of six months old get an updated COVID-19 vaccine and their annual flu shot.

Older adults over the age of 60 are also eligible for an RSV vaccine to protect against severe illness and death. An RSV vaccine is also available to pregnant women to protect newborns as well as a shot for infants under the age of 8 months.

Those with respiratory illness symptoms such as fever, cough or sore throat should stay at home, get tested, and seek treatment, according to the CDC.

"As we approach the holiday season when many of us will be gathering together with family and friends, please remember to take necessary precautions to protect your health: wash your hands, cover your cough, stay home when ill, and stay up to date on vaccines," the Warren County release stated.

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