Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
--------
Question: Paragraph: In 2004, a virulent form of canine influenza surfaced at greyhound racing parks in Florida. In that outbreak, it infected 24 greyhounds and killed 8 more. The contagion has since been confirmed in seven states, having killed greyhounds at tracks in Florida, Massachusetts, Arizona, West Virginia, Wisconsin, Texas and Iowa. It is highly contagious, spreading through shared items (like toys) or human contact (kennel workers have carried the virus home with them), in addition to dog-to-dog encounters. The virus that has been felling greyhounds is an H3N8 flu closely related to an equine flu strain. It is not related to typical human flus or to the H5N1 avian flu that killed about 100 people in Asia. Several states — including Florida, Minnesota, and Louisiana, among others — reported another rash of cases in late June 2017. According to the American Veterinary Medical Association (AVMA), the outbreaks in those states were caused by a strain known as canine H3N2 influenza, which was first reported in Chicago in 2015. An AVMA spokesperson, Sharon Granskog, told us in a phone interview that such outbreaks can be seasonal in nature: There’s a time of year when more dogs are in contact with one another, they’re at dog parks, it’s highly contagious. We suggest that you make sure if your dog is going to a dog park that it’s healthy and talk to a veterinarian about whether or not a vaccine would be right for your dog. The disease was first reported in the U.S. in 2004 after several racing greyhounds in Florida contracted it. The AVMA said that they believed that the dogs became infected by a strain of H3N8 influenza, which is particular to horses. Dr. Ruben Donis, chief of molecular genetics for the influenza branch of the Centers for Disease Control and Prevention, confirmed that the flu jumped from horses to dogs, “a very rare event of considerable scientific interest” and added “at this point, there is no reason to panic.” How that jump occurred is either not known at this point or is not being commented on, so the email’s assertion that the eating of raw meat was to blame should be regarded as speculation rather than as fact. While there is always the possibility the virus might again jump species, this time to humans, this strain of flu has been present in horses for more than 40 years without any documented cases of humans catching it or the related canine flu. But there are vaccines available for both the equine and canine flus. Many readers have been confused (and unnecessarily frightened) by the difference between the terms “morbidity rate” and “mortality rate.” The morbidity rate describes the percentage of animals that will contract the disease after being exposed to the virus, but, despite its name, the term has nothing to do with the death rate associated with the flu. (Nearly 80 percent of dogs exposed to the canine flu virus will contract only a mild form of the disease which mimics kennel cough, a type of canine bronchitis that is rarely serious.) The mortality rate, which describes the percentage of animals that will die after contracting the disease, is in the much lower range of 5 to 8 percent, according to Dr. Cynda Crawford, the veterinary immunologist who first isolated the canine flu virus: The mortality rate is around 5 to 8 percent, says veterinarian Cynda Crawford at the University of Florida’s College of Veterinary Medicine in Gainesville. “I want to stress that despite the rumors that are out on the Internet and other such sources, this disease is not as deadly as people want to make it,” Crawford said. She says she receives more than 30 calls a day from concerned veterinarians. Dr. Crawford describes the contagion as producing in dogs “a moist, productive cough that ends in a gagging response, that will persist for one to four weeks, despite treatment with antibiotics or cough suppressants. Some dogs develop a thick, yellow discharge from the nose. A very few dogs will spike a high fever, between 105 to 107 degrees Fahrenheit. They become lethargic and weak, with rapid, shallow breathing. This is likely to progress to pneumonia.” Other veterinary experts have estimated the potential death rate as between 1 and 10 percent, with the higher percentage applying to very young, very old, or infirm dogs. Presence of the virus in dogs can be confirmed only through blood tests performed at the Cornell University College of Veterinary Medicine. Results of such blood screens take as long as two weeks. Dr. Crawford recommends keeping dogs showing symptoms of respiratory disease at home and away from other dogs for up to two weeks. The CDC, which is tracking the disease, issued no official recommendations. Because the symptoms of this as yet unnamed virus somewhat mimic bordetella, a less virulent illness commonly known as kennel cough, it is hard to ascertain how widespread the flu has become. On the flipside of that confusion, vets in various parts of the country have been thrown into a panic when encountering run-of-the-mill kennel cough in any of their clients, fearing they are instead confronting cases of the new flu. The Animal Health Diagnostic Center at Cornell University inserted a caution against such hair-trigger diagnosis within a larger advisory about the potential for the flu to have spread to the state of New York: “One should not lose sight of the fact that all respiratory infections in dogs are not due to canine influenza virus. Adhering to the ‘band wagon’ approach could result in the failure to appropriately treat dogs with infections previously known to cause respiratory problems in dogs.” We found this good advice for vets and dog owners in our inbox one day: PLEASE DO NOT PANIC, and do NOT assume that every cough is Canine Influenza. Kennel Cough from parainfluenza and Bordetella is more common. However, the Animal Health Diagnostic Center at Cornell is interested in receiving samples from dogs that appear to have kennel cough. Clinical Signs: Since this is a new pathogen in dogs, there is currently no natural immunity present in the unexposed canine population. Almost all exposed dogs will become infected, and nearly 80% have clinical signs. In the mild form the dogs will have a cough that persists for 10 to 21 days. The cough may be soft and moist or dry. Many dogs will have a nasal discharge from a secondary bacterial infection and low grade fever. The nasal discharge responds to broad spectrum antibiotics. In the severe form with pneumonia there is a high fever (104-106 F) and respiratory difficulties. X-rays may show consolidation. These dogs often have secondary bacterial infections and have responded to broad-spectrum antibiotics and supportive care including intravenous hydration. The incubation period is two to five days and dogs may shed virus for seven to 10 days. The disease can spread rapidly throughout a boarding kennel. Dogs that are coughing SHOULD NOT BE BROUGHT TO SHOWS or Performance EVENTS. In a 1 June 2017 advisory to its members, the AVMA suggested that vaccines against the H3N2 virus strain “might be another prevention option” for dogs who were at least 8 weeks old and also recommended isolating dogs who could be infected, as well as not sharing toys between dogs and disinfecting shelter, veterinary, and boarding facilities. Claim: A virus deadly to dogs has been spreading in the canine population of the U.S.

Answer: Has a virus deadly to dogs been spreading in the canine population of the U.S.?


Question: Paragraph: This release makes no mention of the costs of the drugs compared in this study, even though the drugs have been in use for years and are widely available. Since the study is a comparison of various treatments for this form of cancer, it seems relevant to offer a cost comparison as well as a comparison of efficacy. It appears that the high dose methotrexate is given over a 24-hour period, presumably in the hospital, while the standard methotrexate is given as a single dose. Also, the high dose methotrexate is followed by leucovorin administration while the standard dose is not. According to the site GoodRx, the cost for methotrexate in low-dose (2.5 mg) pill form averages out to about $50 for a month’s supply. Newer, injectable variations of the drug cost upwards of $500 a month for the 25 mg dose. The release states that patients receiving high doses of the drug methotrexate “had a significantly better outcome, by 5 to 6 percent” than did patients receiving the current standard of care, which is gradually escalating doses of the drug. The release also explains that patients nine years old or younger who were also treated with a steroid called decadron (dexamethasone) for half as long as normal (14 versus 28 days) benefited from the treatment while patients 10 and older did not. We’re not sure of the meaning behind these results as portrayed in the release. Which outcome was better by 5 or 6 percent? The study has several. Does that mean the relapse rate was reduced or is it the event free survival that was better? It would be more meaningful to readers if the release had included the actual relapse and event free survival rates for each group analyzed in terms most people can understand. For example: “relapse rates were 5 percent lower in Group X compared to Group Y.” We’ll give this category a satisfactory rating largely due to the release including information that patients 10 and older receiving dexamethasone “were at much higher risk for a debilitating bone condition called osteonecrosis,” although we would have been happier if that greater risk would have been quantified. However, the published study explains that there were toxicity problems beyond that of dexamethasone and the release would have been stronger including that information as well. The release stated the study was randomized and controlled, and provides a broad overview of the study design, for which we give the release a borderline satisfactory under this criteria. However, these are the superficial results. On deeper delving into the study methodology, the statistical significances of the results were very close to not statistically significant. This is due to their planned interim stopping of the treatment and the fact that they were looking at multiple outcomes in multiple groups. This release doesn’t demonstrate disease-mongering. While the release does say that this clinical trial was run by the Children’s Oncology Group, which is funded by the National Cancer Institute and the National Institutes of Health, it makes no mention of possible conflicts of interest. Compounding that is the fact that the published study says, “Disclosures provided by the authors are available with this article at www.jco.org,” but that information is behind the journal’s paywall for most readers, so it’s unknown if there is, or is not, a conflict. It appears as though five of the authors (out of a total of about 20) have some conflicts of interest, mostly from several types of drug company payments. The release is comparing the efficacy of treatment regimens using different drugs so alternative treatments for B-acute lymphoblastic leukemia are noted. The release makes clear at the end that the treatment of this disease is improving thanks to refinement of the use of existing drug treatments, meaning that they are readily available for patient use. The release suggests the study findings could change the way childhood leukemia is treated. Modifying existing treatments to enhance a patient’s survival is certainly novel enough to warrant a release. There is no use of unjustifiable language in this release. However, the tone may be a bit overly optimistic given the study findings. Claim: Relapses of childhood leukemia improve with high doses of common chemo drug

Answer: This release reports the findings of a large clinical trial testing whether alternative dosing regimens of standard chemotherapeutic drugs can improve the treatment of B-acute lymphoblastic leukemia. The study showed that using high doses of the drug methotrexate, rather than the standard regimen of gradually increasing doses, improved the outcomes for patients with the disease. The study also showed that using the steroid dexamethasone increased a debilitating bone condition in patients 10 and older but not in patients nine or younger. While the study results are promising, they are by no means clear-cut in the release. The release needed some qualifiers in order to give a clear picture of the benefits. The release also neglected to discuss costs and potential conflicts of interest among the investigators. This form of cancer — B-acute lymphoblastic leukemia — is the most common cancer in children and a major cause of cancer death in patients under 40 years old. And while the majority of patients survive with appropriate treatment, anywhere from one-fifth to one-quarter of patients do not. This study showed that refining the dosing of standard cancer drugs may improve the outcome for some high-risk patients.


Question: Paragraph: So far, Somalia has reported only three cases. But if the disease is unleashed, it could spread like wildfire through camps housing malnourished families who huddle under makeshift domes built from sticks and rags. Many of the 2.4 million Somalis displaced by conflict and other disasters live in such camps. Out of a total population of 15 million, around six million Somalis may not have enough to eat this year, the United Nations says, weakening their immune systems and ability to survive the pandemic. Islamist al Shabaab insurgents also hold parts of southern Somalia, making it hard for health workers to visit and impossible to do testing there. “I have witnessed wars, cholera, dysentery,” Ahmed, tall and bespectacled, told Reuters. “A doctor who fears for his life cannot save people. I have learned to forget worrying and instead help rescue people.”  A decade ago, al Shabaab seized him as he was trying to stem a cholera epidemic in territory they held. They had seen a cross inside his ambulance and - wrongly assuming it meant he was a foreign spy - arrested him and his team. A phone call from a high-level contact saved their lives, he said. Right now, Somalia only has about 25 intensive care beds, 110 quarantine beds and 100 treatment beds available, Ahmed said. More are being built. In the capital, patients at the old Italian-built maternity Martini Hospital have been moved out to make way for a new coronavirus ward. The sound of hammering echoes through its wide, tree-lined compound as construction workers rush to finish repairs. The health ministry and prime minister’s office have allocated about $11 million for coronavirus preparation, Ahmed said. Expenses are high - all medical equipment is imported and coronavirus tests are sent to Kenya for processing. The World Health Organisation (WHO) has trained 500 health workers in Somalia since January, said Dr. Mamunur Rahman Malik, the organization’s country representative. The WHO also brought in personal protective equipment to handle the first 300 or 400 cases, Malik added. Ahmed’s biggest worry is that the disease may spread very fast. Somalia has a tradition of physical greetings, and even wealthy people are reluctant to quarantine away from family. Many, like Faduma Abdikadir, simply have nowhere to isolate themselves. The 38-year-old mother is sleeping under a tree in a makeshift camp in the capital Mogadishu with her eight children, having fled fighting in the countryside. “Most of the time we use ashes and sand to wash hands. We are hungry. We beg people to buy water to drink and wash our hands,” she said. Claim: Somali doctor, veteran of many battles, girds for war with coronavirus.

Answer:
Somali doctor Abdirizak Yusuf Ahmed has escaped an execution, battled deadly diseases and treated war victims. Now - at 35 years old - he’s been tapped to lead his nation’s response to the coronavirus.