TASK DEFINITION: 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.
PROBLEM: Paragraph: The 2017 case is the first case of pediatric tetanus in Oregon in more than 30 years and alarmed infectious disease experts who said tetanus is almost unheard of in the U.S. since widespread immunization began in the 1940s. The child received an emergency dose of the tetanus vaccine in the hospital, but his parents declined to give him a second dose — or any other childhood shots — after he recovered, the paper said. “When I read that, my jaw dropped. I could not believe it. That’s a tragedy and a misunderstanding, and I’m just flabbergasted,” said Dr. William Schaffner, an expert in infectious diseases and chair at the Department of Preventive Medicine at the Vanderbilt University School of Medicine in Nashville, Tennessee. “This is an awful disease, but ... we have had a mechanism to completely prevent it, and the reason that we have virtually no cases anymore in the United States is because we vaccinate, literally, everyone.” Doctors in Portland, Oregon, who treated the child declined to provide any further information about the family at a news conference Friday, citing medical privacy laws. It was the first time that Dr. Judith Guzman-Cottrill, the pediatric infectious disease expert who treated the child, had ever seen tetanus because of widespread vaccination against it in the U.S. When the boy arrived at the emergency department, his muscle spasms were so severe he could not talk, could not open his mouth and was struggling to breathe, she said. “We had a hard time taking care of this child — watching him suffer — and it is a preventable disease,” Guzman-Cottrill said. News about the tetanus case comes as lawmakers in Oregon and Washington are considering bills that would end non-medical exemptions for routine childhood vaccines as the Pacific Northwest weathers its third month of a measles outbreak. Seventy people in southwest Washington, most of them unvaccinated children, have been diagnosed with the highly contagious viral illness since Jan. 1, as well as a handful of people in Portland, Oregon. Unlike measles, which is a virus, someone who has survived a case of tetanus is not immune and can get the illness again if they remain unvaccinated. Tetanus also isn’t transmitted person-to-person by sneezing or coughing like the measles, but instead comes from bacterial spores that are found in the environment. Tetanus spores exist everywhere in the soil. When an unvaccinated person gets a deep, penetrating wound, those spores can invade the cut and begin producing the bacteria that causes the illness. The tetanus bacterium secretes a toxin that gets into the bloodstream and latches onto the nervous system. Anywhere from three to 21 days after infection, symptoms appear: muscle spasms, lockjaw, difficulty swallowing and breathing and seizures. The disease can cause death or severe disability in those who survive, Schaffner said. About 30 people contract tetanus each year nationwide, according to the CDC, and 16 people died of it between 2009 and 2015. It’s rare among children; those over 65 are the most vulnerable. In the case in Oregon, the boy cut himself on the forehead while playing, and his family stitched up the wound themselves. Six days later, he began clenching his jaw, arching his neck and back and had uncontrollable muscle spasms. When he began to have trouble breathing, his parents called paramedics and he was transported by air to Oregon Health & Science University’s Doernbecher Children’s Hospital in Portland. When he arrived, he asked for water but could not open his mouth. The child was sedated, put on a ventilator and cared for in a darkened room while wearing ear plugs because any stimulation made his pain and muscle spasms worse. His fever spiked to almost 105 degrees (40.5 Celsius), and he developed high blood pressure and a racing heartbeat. Forty-four days after he was hospitalized, the boy was able to sip clear liquids. Six days later, he was able to walk a short distance with help. After another three weeks of inpatient rehabilitation and a month at home, he could ride a bike and run — a remarkable recovery, experts said. The child’s care — not including the air ambulance and inpatient rehabilitation — cost nearly $1 million, about 72 times the mean for a pediatric hospitalization in the U.S., the paper noted. “The way to treat tetanus is you have to outlast it. You have to support the patient because this poison links on chemically and then it has to be slowly metabolized,” Schaffner said. Cases of tetanus have dropped by 95 percent in the U.S. since widespread childhood vaccination and adult booster shots became routine nearly 80 years ago; deaths have dropped 99 percent. The CDC recommends a five-dose series of tetanus shots for children between the ages of 2 months and 6 years and a booster shot every 10 years for adults. ____ Follow Gillian Flaccus on Twitter at http://www.twitter.com/gflaccus Claim: CDC: Unvaccinated Oregon boy almost dies of tetanus.

SOLUTION: An unvaccinated 6-year-old Oregon boy was hospitalized for two months for tetanus and almost died of the bacterial illness after getting a deep cut while playing on a farm, according to a case study published Friday by the U.S. Centers for Disease Control and Prevention.

PROBLEM: Paragraph: The Department of Health Services reported Friday that Wisconsin has seen 459 hospitalizations and 11 deaths due to flu complications this season. The number of hospitalizations is three times higher than last year at this time. The Centers for Disease Control and Prevention has elevated Wisconsin to its high flu category. South-central and southwestern Wisconsin have been hardest hit. And physicians said it could get worse before it gets better. “The best thought is that we are still going to be seeing it rise before we see it fall. Generally, the flu season lasts anywhere between four and 12 weeks, with eight kind of being the average,” said Dr. Joseph McBride, an infectious disease specialist at UW Health in Madison. “I would imagine we are going to remain pretty high throughout January, but we’ll see.”   In Milwaukee: 131 people have been hospitalized with the flu compared with 17 at this time last season. “We know that it’s hitting some families pretty hard,” Aurora Health Care pediatrician Dr. Kevin Dahlman said. State Health Officer Jeanne Ayers urged anyone who has not had an annual flu shot to get one. Claim: Flu hospitalizations spike across Wisconsin with 11 deaths .

SOLUTION: Wisconsin health officials are urging people to protect themselves as flu numbers spike across the state.

PROBLEM: Paragraph: The story devotes its second paragraph to cost, including how that cost may differ depending on whether patients have insurance. Well done. This is a really close one. The story does a lot of things well here. It notes that, in one trial, there was no difference in the benefits between Xofluza and existing flu treatment drug oseltamivir (better known as Tamiflu). However, it does not actually quantify the benefits associated with Xofluza. Instead, the story states that it “may alleviate some symptoms and shorten the time patients feel sick.” We approve of the cautious language used throughout the story, but we like to see quantified benefits in instances where the information is available. In this case, an article published in the New England Journal of Medicine in September reported that Xofluza reduced the “time to alleviation of symptoms” by a mean of 25-38 hours, compared to placebo (the difference depended on the age group of the patient). Ergo, a not satisfactory rating here. The story addresses this issue head on, earning it a solid satisfactory rating from us. One point that would have made it even stronger would have been to note that the company selling Xofluza warns that pregnant women and nursing mothers may want to avoid the drug, as it is not known whether the drug may harm the fetus or if it would pass into breastmilk for nursing mothers. The story does a good job of describing the supporting evidence clearly and concisely. No disease mongering here. In fact, the story provides good context on the risks posed by influenza. The story incorporates input from two sources at the FDA, but the information appears to stem from an FDA statement. Information from pharmaceutical companies is clearly marked, but we really look for news stories to incorporate input from independent sources — beyond what may be available in a news release. The story addresses the similarities (and differences) to other drugs that address flu symptoms, particularly oseltamivir (Tamiflu). The story notes that Xofluza has received FDA approval. As noted above, the drugs similarities and differences to existing pharmaceutical treatment options was laid out clearly. The news peg here was FDA’s approval of the drug, which is also made clear. The work goes well beyond what you would find in any news release. We particularly applaud the story’s discussion of viruses developing resistance to antiviral drugs. Claim: F.D.A. Approves New Drug for Flu

SOLUTION:
This story is one of two we are reviewing that focuses on FDA’s approval of a drug designed to speed patient recovery from flu symptoms (the second story is from ABC News). The drug is baloxavir marboxil, marketed under the trade name Xofluza. This New York Times story hits most of the points that we want to see in a story about a new drug. The criteria that we use at HealthNewsReview.org to review health-related news stories were not developed in a vacuum. Rather, these are the criteria we feel are essential to allow patients and health care providers to make informed decisions about diagnosis and treatment options. While we do ding it on a couple things, the story does not exaggerate the findings, and provides people with the fundamental details they need to be informed patients. We were especially pleased that this story did not perpetuate misinformation that’s developed around this drug — that is, that it could help reduce transmission of the virus. To date, there is no evidence to show that as a benefit.