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 Alabama Department of Public Health said Friday that here has been a pneumococcal disease outbreak at the Ventress Correctional Facility in Barbour County. Three inmates were hospitalized and one inmate died after developing meningitis. Health officials said the Streptococcus pneumoniae bacteria can cause illnesses ranging from ear and sinus infections to pneumonia and meningitis. The Alabama Department of Corrections is giving antibiotics to inmates and staff who have had close contact with inmates who have been ill. The health department has ordered vaccine doses from the Centers for Disease Control and Prevention.
[A]: Illness outbreak reported at state prison, 1 inmate dead.


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


[Q]: "It’s the question-du-jour about the new health care law: Are people going to be able to keep their health insurance if they like it? President Barack Obama has several times said yes. But cancellation notices coming in the mail to policyholders tell another story. The contrast between Obama’s promises and what’s playing out in America has led to a fierce political war of words about who lied, who knew what and when, and how Americans will have to deal with the ramifications. Former Obama campaign strategist David Axelrod and Oklahoma Republican Sen. Tom Coburn debated the issue Monday on MSNBC’s Morning Joe. Coburn: ""You're no longer eligible to buy your own plan, which was the No. 1 promise that the president made to the American people. You cannot get what you had."" Axelrod: ""Most people are going to keep their own plans, senator, and you know that."" Coburn: ""That’s not true."" Moments later, Axelrod made his point again: ""The majority of people in this country, the vast majority of people in this country, are keeping their plan. People who are uninsured are going to have choices they never had before."" In this fact-check, we wanted to dig into what’s happening to the American health insurance system to see what policies are being canceled, how many, why and how you might be affected. A good starting point is to see how Americans get their insurance right now. Using census data, the Kaiser Family Foundation finds that in 2012, a little less than 50 percent of the public got their coverage through an employer-based plan. That is, a business negotiates a contract with an insurance company and offers health coverage to its workers. The second largest group, about 30 percent, gets insurance through either Medicare, Medicaid or both. A third group of people with insurance, about 6 percent, buy policies directly from insurance companies. This is called the individual market. (The remainder of Americans, around 16 percent, are currently uninsured.) The health care law that was passed in 2010 made changes to all three legs of the health insurance stool, but the biggest changes came in the individual market. Before the health care law was passed, the individual market was widely considered a mess. Insurers could turn you down for pre-existing conditions, and none of the insurance was standardized, so if you bought a policy, it wasn’t always crystal clear what you were getting. The law’s goal always had been to get these people into standardized plans that cover a defined list of benefits. As a result, some existing policies did not meet standards set by the new health care law. This is why people in this group may be seeing cancellation notices. Kaiser estimates that 15 million people are in the individual market. They are likely to have a very different experience from the ""vast majority"" cited by Axelrod. In New Jersey and Florida, hundreds of thousands of people have received cancellation notices and more are popping up across the country. It’s unclear how many people in the individual market will be forced to change their plan. And what happens to people who are will vary. People can buy another plan from the same company or shop around. Some of them will be eligible for government subsidies and some will not. This group is where the disruptions are most likely. Another group of people -- about 90 million -- are covered through through Medicare or Medicaid. While the Affordable Care Act does make changes, most notably in something called the Medicare Advantage program, they are not being moved into new coverage plans. That leaves the nearly 150 million people who get their insurance through the plans their employer offer. Those plans could change. But it’s tough to say how substantially, and how much as a result of the health care law. Part of that is because plans change every year. Still, some companies are making changes to bring costs down. For example, UPS is telling their employees that if their spouse can receive health insurance through a different employer, UPS will no longer offer them coverage. That certainly could mean people are not keeping their health care plan. How much of the blame should be shouldered by the health care law is a different matter. We asked a variety of experts to comment on the literal accuracy of Axelrod’s statement. For the most part, regardless of their opinion of the new health care law, they gave Axelrod the benefit of the doubt. ""It’s probably true -- at least for next year,"" said Gail Wilensky, the former head of Medicare and Medicaid under President George H. W. Bush. ""Most employers aren’t going to do anything about the insurance they are offering for 2014 because of the Affordable Care Act."" ""He is absolutely right,"" said Bob Laszewski, a health insurance consultant and head of Health Policy and Strategy Associates. But Laszweski also said Axelrod was intentionally diverting attention from the real problems taking place in the individual market. Gerard Anderson, director of the Center for Hospital Finance and Management at the Johns Hopkins Bloomberg School of Public Health, said, ""I would make the same comment that David Axelrod makes but without any real facts. The people with large employers are not really being impacted by the (health care law) and neither are the Medicare and Medicaid recipients."" Sabrina Corlette, program director at at Georgetown University’s Center on Health Insurance Reforms, echoed Anderson’s point. For Ted Marmor, a professor of health policy at Yale University, rejected Axelrod’s claim, largely because no one has the hard evidence to back it up or refute it. ""No one has the data to be sure,"" Marmor said. ""Axelrod has no authority for his claim. It is a hope."" But Marmor is among the minority of the experts we consulted. ""It's simply true,"" said Dan Mendelson, CEO of Avalere Health, a Washington health consulting group. ""Most of the lives are in the large corporate customer base and we're seeing virtually no dropping of coverage there."" What does it mean to keep your plan? In the view of some analysts, if the plan offered by an employer changes, it is not the same plan and this would make Axelrod wrong. Chris Conover, a critic of Obamacare and an adjunct scholar at the American Enterprise Institute, a conservative-leaning think tank, said the Affordable Care Act requires that every plan offer certain minimum benefits, such as free preventive care. It also allows children up to age 26 to stay on their parents’ plan. Those and other rules drive up premiums and lead to employers offering different plans. Conover said millions of people ""actually have had to purchase more expensive coverage even if they were perfectly happy with their old coverage."" Axelrod’s office takes a different view. We contacted them and his staff pointed us to a 2013 survey by the International Foundation of Employee Benefit Plans. Based on responses from 966 organizations, including firms both small and large, the survey found that 94 percent were definitely or very likely to continue to offer coverage. In that sense, the majority of Americans would still get insurance through their employer. Still, in the survey, about half of the companies estimated Obamacare would raise costs in the range of 1 to 4 percent. Many businesses, in the range of 30 to 40 percent overall, planned to increase the employee share of premiums, raise their deductibles and in other ways shift costs to workers. But it is important to remember that cost and risk shifting has been with the country for a long time. The Kaiser Family Foundation annual survey of employer plans reports that in the past 10 years, the average share of premiums paid by employees has gone up and the fraction of workers in high-deductible plans has risen steadily since 2006, reaching one fifth of the people in the study in 2013. Richard Zirkelbach, a spokesman for America’s Health Insurance Plans, a trade group of insurance companies, said the impact of the health care law takes place within an insurance marketplace that has been far from static. ""There have been year to year changes to policies,"" Zirkelbach said. Of all the factors that drive those changes -- rising medical costs, changes in the health of the people in the insurance pool, and government regulation -- Zirkelbach believes the Affordable Care Act rules are having the largest impact as employers look to 2014. Zirkelbach points especially to the minimum requirements for every insurance plan. The employee benefit survey reports that about three quarters of all plans meet all minimum requirements and need no further changes. Our ruling Axelrod said the vast majority of people are keeping their health care plans. That’s certainly what the 2010 health care law intended. The law was crafted largely to leave in place the health care delivery systems for people who get health insurance either through their employer (about 50 percent of people with insurance) or through the government-managed Medicare or Medicaid programs (about 30 percent). Some changes may be occurring in the employer market that would stop people from keeping the health care plans they have. But the bigger issues are in the so-called individual market, which accounts for about 6 percent of Americans who now have health care. The health care law, in essence, raises standards that will make many plans offered in the individual market obsolete. Experts told us there is no precise data to determine how many people will be forced to change health care plans, but they generally agreed the number will be small this year. The broad consensus is that, for the time being, most people will see changes in their coverage and what they pay for that coverage consistent with changes they have seen with their insurance over the past decade."
[A]:
The vast majority of people in this country are keeping their (health insurance) plan.