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.

Q: The Centers for Disease Control and Prevention on Wednesday posted data showing nearly 68,000 drug overdose deaths were reported last year. The number may go up as more investigations are completed, but the agency expects the tally will end up below 69,000. Overdose deaths had been climbing each year since 1990, topping 70,000 in 2017. The numbers were celebrated by the U.S. secretary of health and human services. “Lives are being saved, and we’re beginning to win the fight against this crisis,” Alex Azar wrote in a tweet. But the overdose death rate is still about seven times higher than it was a generation ago. “We’re still in a pretty sad situation that we need to address,” said Rebecca Haffajee, a University of Michigan researcher. Researchers do not believe this is the start of a dramatic decline. Data from the first months of this year likely will show that the decrease is not gaining steam, said Farida Ahmad of the CDC’s National Center for Health Statistics. The improvement was driven by a drop in deaths from heroin and prescription painkillers. Those falls were offset somewhat by continuing growth in deaths involving a different opioid, fentanyl, as well as other drugs such cocaine and methamphetamines. Overdose deaths often involve more than one drug. The improvement is not uniform: Some states seem to be making dramatic progress, while deaths continue to rise in others. The preliminary CDC data suggested deaths last year were down by as many as 1,000 or more in Ohio and Pennsylvania — each seeing declines of about 20%. Meanwhile, deaths increased by about 17% in Missouri, which had more than 200 additional deaths. It can take months for authorities to complete toxicology tests and other elements of a death investigation involving drugs. And some states report faster than others. The CDC is expected to report more complete data later this year. The current overdose epidemic has killed more people than any other in U.S. history, and it had been on a soaring trajectory. From 2014 to 2017, overdose deaths jumped by 5,000 or more each year. Experts trace the epidemic’s origins to 1995 and the marketing of the prescription painkiller OxyContin. It was meant be safer and more effective than other prescription opioids, but some patients got hooked and found they could crush the tablets and snort or inject them to get high. Gradually, many turned to cheaper street drugs such as heroin and fentanyl. In 2015, heroin began causing more deaths than prescription painkillers or other drugs. In 2016, fentanyl and its close cousins became the biggest drug killer, and in 2018 they were involved in about 46% of the reported overdose deaths, according to the preliminary CDC data. Strategies to reduce drug overdose deaths have included tougher policing, treatment program expansions, policies to limit opioid painkiller prescriptions and wider distribution of the overdose-reversing drug naloxone. Haffajee and other researchers are trying to figure out what measures are most responsible for the slight improvement. “It’s complicated because there are so many policies going on, and as an evaluator it’s very hard to separate them out and determine which is working,” she said. Valerie Hardcastle, a Northern Kentucky University administrator who oversees research and other work on local health issues, has seen the overdose epidemic play out in her region, near Cincinnati. She believes a major factor is Narcan, a nasal spray version of naloxone, that has been widely distributed through the efforts of philanthropists and local, state, and federal officials. “It’s fantastic that we have fewer deaths, don’t get me wrong,” she said. “But I’m not sure it’s an indication that the opioid problem per se is diminishing. It’s just that we have greater availability of the drugs that will keep us alive.” ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. ___ This story has been corrected to show Ahmad’s first name is Farida, not Farid.

A: Number of US overdose deaths appears to be falling.
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Q: The nation’s disaster risk management office says 1,192 cases have been identified. More than two-thirds of cases are of the more virulent pneumonic form. The office says less than 30 percent of people who have had contact with plague patients can be traced, making it more difficult to control the spread of the disease. Plague is endemic in Madagascar. This year’s outbreak is unusual because it has reached the nation’s two largest cities, Antananarivo and Toamasina.

A: Madagascar’s plague deaths up to 124, island nation says.
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Q: In October 2019, we received multiple inquiries from readers about the accuracy of reports that claimed a 22-year-old woman had contracted the HIV virus during a manicure. During that month, social media users widely shared a 2015 article published on the Filipino website TheAsianParent, with the headline “22-Year-Old Woman May Have Contracted HIV During a Manicure.” The article reported that: According to New York Daily News, a 22-year-old Brazilian woman was diagnosed with HIV after getting a manicure using shared equipment. Doctors say the case, which was first reported in the journal AIDS Research and Human Retroviruses last year, highlights a “new form of transmission for the virus.” She had none of the usual risk factors…The journal article says that when the woman was first diagnosed, she was found to have advanced HIV. However, she didn’t have any of the normal risk factors associated with contracting the virus, such as having sex without a condom, or sharing infected needles. When medical professionals probed further, they discovered that the woman had shared “manicure instruments years before with a cousin who was later found to be HIV-positive.” Blood analysis also suggested that the woman had first got the virus around 10 years ago. The article was originally published on TheAsianParent’s sister website in Singapore, on Nov. 2, 2015. The case attracted widespread media attention in 2014, including articles by Fox News and the New York Daily News. It’s not clear why it began to trend once again online in October 2019. The report is based on a November 2014 paper entitled “An HIV-1 Transmission Case Possibly Associated With Manicure Care,” which was published in the journal Aids Research and Human Retroviruses. That paper can be read in full here. It was written by researchers from the Santo André Aids Program, the Adolfo Lutz Institute, and the University of São Paulo, all located in São Paulo, Brazil. As the U.S. Centers for Disease Control and Prevention (CDC) explains, HIV is typically transmitted through the exchange of certain bodily fluids during sexual contact or sharing syringes. Other modes of transmission exist, but they are less common. It is rare for HIV to be contracted through inanimate objects (an inanimate object that transmits an infectious disease is known as a “fomite”). However, the CDC notes: “It’s possible to get HIV from tattooing or body piercing if the equipment used for these procedures has someone else’s blood in it or if the ink is shared. The risk of getting HIV this way is very low …” The 2014 paper described a case involving a Brazilian woman suspected of having contracted HIV a decade earlier, when she was 12 years old, by using cuticle scissors and other manicure implements that had also been used by her cousin, a manicurist. The researchers came to the conclusion that this was probably (though not certainly) the way in which she contracted the disease, after performing what’s known as phylogenetic analysis of each woman’s strain of HIV. The following is a good explanation of how phylogenetic analysis works, from Harvard University’s T.H. Chan School of Public Health: “When a person becomes infected with HIV, their virus is similar to the virus of the person who infected them. Because HIV mutates quickly, each infected person’s virus evolves differently over time … HIV phylogenetics is the study of the evolutionary history and relationships among transmitted viruses. A phylogenetic tree is an illustration of those relationships and HIV transmission dynamics.” After conducting phylogenetic analysis, the São Paulo researchers were able to conclude that the 22-year-old woman probably contracted HIV from her older cousin about 10.81 years earlier. At that time, the older woman knew she had HIV, but her family did not, and she had stopped taking zidovudine and lamivudine, a combination of antiretroviral drugs that can lower the risk of transmitting HIV. The woman at the center of the case denied any sexual abuse by a third party (an account corroborated by her family), and based on interviews with both women, the only remaining plausible method of transmission was their shared use of manicure implements while the younger woman was around 12 years old. The researchers summarized their findings as follows: A recently diagnosed 22-year-old female with no history of transmission risk factors prompted a thorough investigation of possible alternative risk factors. As the patient had evidence of advanced disease and laboratory data compatible with long-standing infection, past events were reviewed. About 10 years ago the patient shared manicure utensils with an older cousin, later known to be HIV infected; this prompted the phylogenetic analysis of the HIV sequences of both patients. Phylogenetic analyses of partial HIV-1 polymerase and envelope sequences from both patients revealed highly related sequences, with an estimated common ancestor date (about 11 years ago) that coincided with the putative sharing of manicure instruments, during a time in which the cousin was not virally suppressed. Taken together, the information about the infection of this patient suggests the use of shared manicure instruments as an alternative route of fomite HIV-1 transmission. Although the woman and her cousin shared manicure implements, the woman did not exactly contract HIV “during a manicure,” a description used by TheAsianParent that has engendered a degree of fear or concern, among some social media users, about visiting nail salons. Those fears appear to be largely unwarranted. The Brazilian case was scientifically notable precisely because it appears to be the first ever documented case of HIV transmission via manicure implements, and the already very low risk of transmission will diminish even further if members of the public visit properly licensed nail salons whose staff thoroughly sanitize all implements. Although TheAsianParent rightly stated that the woman “may have” contracted HIV from the manicure implements, reflecting the probability (rather than certainty) asserted by the researchers, other websites omitted that nuance in their headlines, with Fox News, for example, writing “Woman Contracts HIV Through Shared Manicure Equipment.”

A:
A woman in Brazil contracted HIV during a manicure.
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