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: 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 Council of State ruled that doctors had the right to end the medical support that has kept Vincent Lambert, brain-damaged and in vegetative state, artificially alive since a motorbike accident on the way to work plunged him into a coma in September 2008. The verdict follows a heart-rending battle between Lambert’s  wife Rachel, seeking to let the former psychiatric nurse die, and his parents, who took legal action last year to halt plans by his doctors to do that. Apart from places such as Belgium, the Netherlands and Switzerland, few countries in the world explicitly permit euthanasia or assisted suicide - sometimes known as mercy killings. But France, where President Francois Hollande promised prior to his 2012 election to introduce new right-to-die legislation, has left grey areas regarding more passive forms of euthanasia in a 2005 law on patient rights and care for the terminally ill. The so-called Leonetti law does not legalize euthanasia but also states, according to government information services, that patient treatment should not involve “excessive obstination”. Lambert’s parents, devoutly religious Catholics, said even  before the Council of State’s Tuesday ruling that they had asked the European Court of Human Rights to issue an emergency ruling on the case should the French judges go against their will to keep their son, now in his late 30s, as he is. The international rights court, based in the eastern French city of Strasbourg, said in a statement it would respond “as soon as possible”. While Hollande has yet to deliver on his promise of legislation by the end of the year on the rights of the incurably ill, the legal battles over Lambert’s fate and other cases has thrust the euthanasia debate firmly back onto the radar screen. As many as 25,000 people die a year in France after removal of medical support, according to Remi Keller, a member of the Council of State. In a separate case, a hospital doctor in southwest France is on trial on charges that he used lethal injections to hasten the deaths of seven old-aged people in 2010-2011. His lawyers say they intend to turn that trial into a debate about the wider issue of the boundaries of euthanasia.

Output: France reopens euthanasia debate with right-to-die ruling.


Input: Consider Input: Public Health Commissioner Monica Bharel said Wednesday any suspected cases of unexplained e-cigarette or vaping-associated pulmonary disease must be immediately reported to the Department of Public Health for the next 12 months. Last month, the agency sent an alert to 25,000 Massachusetts health care providers asking them to voluntarily report pulmonary-related disease associated with vaping. “Today’s action establishes the legal framework for health care providers to report cases and suspected cases so that we can get a better sense of the overall burden of disease in Massachusetts,” Bharel said in a written statement. She said the reporting will also help the state provide case counts to the US Centers for Disease Control and Prevention as they to try to understand the nationwide impact of vaping. U.S. health officials are investigating what might be causing hundreds of serious breathing illnesses in people who use e-cigarettes and vaping devices. They have identified about 450 possible cases in 33 states, including six deaths. Massachusetts is actively investigating several suspected vaping-associated pulmonary cases. There have been no confirmed Massachusetts cases. The last time the state health commissioner issued a similar mandate was two years ago. That mandate required providers to report cases of amnesia associated with intravenous drug use. The new mandate was sent to all clinicians — including internal medicine, family practice, general practice, emergency medicine, and clinical care — in Massachusetts as well as pediatricians, pulmonologists, and nurse practitioners. It asks providers to report any case of a person experiencing otherwise unexplained progressive symptoms of shortness of breath, fatigue, chest pain, cough, or weight loss, of any severity, and an abnormal chest imaging study associated with vaping. In the cases reported to the CDC, patients experienced coughing, shortness of breath, and fatigue. Symptoms worsened days or weeks before they were admitted to a hospital. Other symptoms reported by some patients included fever, anorexia, pleuritic chest pain, nausea, and diarrhea. All the patients had reported vaping in the weeks and months before going to the hospital. No specific product has been identified in all cases, nor has any product been conclusively linked to the clinical syndrome. According to the state health department, 41% of Massachusetts high school students have tried e-cigarettes at least once. About 20% of them reported using e-cigarettes in the past 30 days — a rate six times higher than adults. Nearly 10% of middle school students say they have tried e-cigarettes. A 2018 law signed by Gov. Charlie Baker includes e-cigarettes into the definition of tobacco, making it illegal to vape where it is illegal to smoke. The law also raised the minimum legal sale of tobacco products — including e-cigarettes — to 21.


Output: Massachusetts collecting data on possible vaping illnesses.