Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

Input: Consider Input: 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.

Output: A virus deadly to dogs has been spreading in the canine population of the U.S.


Input: Consider Input: On 5 December 2018, the Seattle Times published an article whose terrifying headline ensured its own virality: “Rare brain-eating amoebas killed Seattle woman who rinsed her sinuses with tap water. Doctor warns this could happen again.” Sadly for those who visited this page hoping to find that the reporting was exaggerated or made-up, this really happened. Though her anonymity was maintained, the story of a 69-year-old Seattle woman who used tap water in her Neti pot for over a year and then died from a Balamuthia mandrillaris brain infection was documented in a 20 September 2018 case study published in the International Journal of Infectious Diseases: We report the case of a 69-year-old female who presented with a chronic nasal skin rash, new onset focal seizure, and a cerebral ring-enhancing lesion after a year of improper nasal irrigation. Despite aggressive and novel anti-amoebic treatment, she died as a result of a Balamuthia mandrillaris brain infection. One year before developing the brain infection, the authors reported, the woman developed a chronic sinus infection whose symptoms were not relieved by medication. She turned to using a Neti pot to rinse her sinuses, but instead of using sterile or saline water as directed, she used tap water filtered with a Brita system. After a month of this practice, and without any relief of her sinus symptoms, “she developed a quarter-sized, red raised rash on the right side of the bridge of her nose and raw red skin at the nasal opening.” Though several misdiagnoses followed, no doctor correctly recognized the rash as a symptom of an amoebic infection. The report stated that a year after that initial rash developed, the woman developed a seizure that required hospitalization. At that time, the doctors identified a lesion on the right side of the brain which they decided to biopsy. Some 19 days later, after a continued decline in the patient’s health, scientists from Johns Hopkins University suggested the possibility that the cause of her malady was an amoebic infection, and the Centers for Disease Control rushed a novel drug for her treatment. Unfortunately, they were unable to halt the progression of the disease, and the patient’s family made the decision to remove her from life support. An autopsy determined the cause of death to be Granulomatous Amebic Encephalitis (GAE), which the CDC defines as “a serious infection of the brain and spinal cord that typically occurs in persons with a compromised immune system.” In this case, the causative agent was an extremely rare amoeba named Balamuthia mandrillaris, one of three forms of amoeba known to be capable of infecting and consuming the human brain. Amoebas are a broad group of taxonomically mixed unicellular organisms that consume surrounding cellular material through absorption, and that express an ability to take on a variety of shapes. Several different species are associated with disease, most notably Naegleria fowleri, commonly known as the “brain-eating amoeba” that can cause a different kind of brain infection called primary amebic meningoencephalitis (PAM). Balamuthia mandrillaris was discovered in 1986 in the brain of a mandrill monkey during an autopsy at the San Diego Zoo and is now recognized to be a cause of GAE in both humans, several primates, and other animals, with an estimated 200 cases of human infection ever documented. The amoebae are ubiquitous in soil and groundwater although their presence is not expected in city-treated water, according to Liz Coleman, a spokeswoman for the Environmental Public Health division of Washington State’s Department of Health, quoted in the Seattle Times’ reporting. Merely ingesting the thing will not lead to health problems, but in rare cases (usually instances involving people with weakened immune systems, or those who are young or old), the organisms can infect a host through skin breakage or via the respiratory system. If they infect the central nervous system, they “ingest bits and pieces of host tissue [and produce] enzymes that degrade the tissue.” Nasal irrigation involves rinsing one’s sinus cavity with distilled or sterile water (or water that has been filtered to remove potentially infectious organisms), and one such method of water delivery is a Neti pot. The need for sterility is explicitly stated due to the (extremely small) risk posed by another amoeba, Naegleria fowleri, and it is the reason the FDA requires (in the absence of sterile water) a specific kind of filter capable of removing the amoeba and similarly-sized organisms from water before it is pushed through fragile sinus tissue. While the authors of this case report could not state with absolute certainty that the Neti pot was to blame, it is far and away the most likely explanation given the fact that the patient had been rinsing her sinuses with tap water regularly for an extended period of time: While it is recommended that only sterile water or saline be used … the patient used tap water that was filtered with a Brita Water Purifier … Improper nasal irrigation has been reported as a method of infection for the comparably insidious amoeba, N. fowleri. This precedent led us to suspect the same route of entry for the Balamuthia amoeba in our case. Although this hypothesis is consistent with the patient’s history and ultimate diagnosis, the water supply to the patient’s home was not tested, hence our ability to definitively trace the patient’s infection to improper nasal lavage is limited. Other routes of exposure are possible, according to a 2013 review of amoebic infections: Epidemiology of Balamuthia GAE is not well understood. However, based on several case reports it can be hypothesized that gardening, playing with dirt, or exposure to dust while motorcycling may play significant roles in the acquisition of Balamuthia infection. It has been shown that Balamuthia is found in the soil and dust in air and the route of infection is probably via inhalation of Balamuthia either present in soil or carried by the wind or the amebae entering the body through a cut or puncture. Once it gains entry into the body it is likely to spread hematogenously to the brain. Additionally, there is some indication that water may serve as a vehicle for acquiring the infection. Although the water used in the Neti pot likely caused this infection, Dr. Cynthia Maree, a co-author of the report and a member of the team that treated the woman in question, told the Seattle Times that “the risk of infection to the brain is extremely low,” adding that “people who use neti pots or other nasal-irrigation devices can nearly eliminate [that risk] by following directions printed on the devices, including using only saline or sterilized water.”

Output: A woman who rinsed her nasal passages using a neti pot filled with tap water contracted a fatal “brain-eating” amoeba infection.


Input: Consider Input: "The story tells readers the scans cost about $200-$400 and are generally not covered by insurance. The benefits in this case are estimates of 10-year survival in those found to have lung cancer through screening, which is provided. Since there is no control group, there would be no way to provide an absolute risk reduction. But, the story does provide a 5-year chance of death estimate for those diagnosed conventionally, e.g. as a result of symptoms. This provides some relative comparison of what screening MIGHT offer, although it's not known for sure and readers are cautioned that direct comparisons are not possible. The story mentions potential harms from screening, namely ""serious health risks from examining and treating tumors that may not be harmful."" The story could have been clearer about what some of these risks are (like undergoing unnecessary surgery with all of its risks and anxiety to the patient), but it appropriately mentions that screening may have harms, which is often overlooked. The story tells readers that the latest study is uncontrolled, meaning direct comparisons cannot be made between groups of people who were screened and groups of people who were not screened. The article does describe this limitation to the study. The story could have been clearer that this is an observational study vs. a randomized controlled trial–which is the gold standard in research. Direct comparisons between groups will be difficult to make in the absence of a future randomized controlled trial. The story tells readers that lung cancer is the leading cause of death from cancer in the U.S. The story does also describes the burden of lung cancer, providing estimates of 5-year survival without screening (estimates from the general population who were diagnosed as a result of symptoms). No obvious embellishments or overstatements. The story obtains information from physicians not associated with the research who can provide a range of perspectives on what screening may or may not offer to provide balance. The story provides some historical alternatives to CT screening for lung cancer (serial x-rays in the 1970s) and does indirectly describe the de facto alternative, that is, finding lung cancer as a result of symptoms. It does this by telling readers that lung cancer is rarely found curable in the absence of screening and providing estimates of chance of death within 5 years when diagnosed this way. The story indirectly states that lung cancer screening is not widely available (e.g. ""would widespread screening reduce cancer deaths?""). The story tells readers that interest in this technology increased in the late 1990s as a result of early work with lung cancer screening, providing some historical information about when lung cancer screening came onto the scene. The story also indirectly states that this is not widely available, implying that widespread lung cancer screening would be new, although a CT scan, the technology used for lung cancer screening, is not new. The story is well-researched and uses input from many experts, which would not normally be contained within a press release."


Output: Early screening for lung cancer gets mixed reviews