Justice Department attorneys stayed the legal course charted by Biden administration, though they didn’t directly weigh in on the underlying issue of access to the drug that’s part of the nation’s most common method of abortion.

Rather, the government argued the states don’t have the legal right, or standing, to sue.

“The states are free to pursue their claims in a district where venue is proper, but the states’ claims before this court must be dismissed or transferred pursuant to the venue statute’s mandatory command,” federal government attorneys wrote.

The lawsuit from Idaho, Kansas and Missouri argues that Food and Drug Administration should roll back access to mifepristone. They filed their complaint after the Supreme Court preserved access to mifepristone last year. They want the FDA to prohibit telehealth prescriptions for mifepristone, require three in-office visits and restrict the point in a pregnancy when it can be used.

The case is being considered by U.S. District Judge Matthew Kacsmaryk in Texas, a Trump nominee who once ruled in favor of halting approval for the drug.

Kacsmaryk’s original ruling came in a lawsuit filed by anti-abortion groups. It was narrowed by an appeals court before being tossed out by the Supreme Court, which found the plaintiffs lacked the legal right to sue.

The three states later moved to revive the case, arguing they did have legal standing because access to the drug undermined their abortion laws.

But the Department of Justice attorneys said the states can’t just piggyback on the earlier lawsuit as a way to keep the case in Texas.

Nothing is stopping the states from filing the lawsuit someplace else, attorney Daniel Schwei wrote, but the venue has to have some connection to the claims being made.

Besides, Schwei wrote, the states are challenging actions the FDA took in 2016, when it first loosened restrictions on mifeprostone. That’s well past the six-year time limit to sue, he said.

Abortion is banned at all stages of pregnancy in Idaho. Missouri had a strict ban, but clinics recently began offering abortions again after voters approved a new constitutional amendment for reproductive rights. Abortion is generally legal up to 22 weeks in Kansas, where voters rejected an anti-abortion ballot measure in 2022, though the state does have age restrictions.

Trump told Time magazine in December he would not restrict access to abortion medication. On the campaign trail, said abortion is an issue for the states and stressed that he appointed justices to the Supreme Court who were in the majority when striking down the national right to abortion in 2022.

Health Secretary Robert F. Kennedy Jr.’s stance on abortion seems to have shifted at times, drawing criticism from both abortion rights advocates and anti-abortion forces. During his first confirmation hearing in January, he repeatedly said, “I have always believed abortion is a tragedy,” when pressed about his views.

Mifepristone is usually used in combination with a second drug for medication abortion, which has accounted for more than three-fifths of all abortions in the U.S. since the Supreme Court’s ruling overturning Roe v. Wade.

Two cases were identified in Missouri, and one each in Florida, Illinois, South Dakota, Utah and Wisconsin, the Centers for Disease Control and Prevention said.

People got sick in February and March of this year, the CDC said. They all had the same strain of salmonella — a version that has been traced to hatcheries in the past. The investigation is continuing, health officials said.

Salmonella bacteria cause about 1.35 million infections in the United States every year, and recent outbreaks have been tied to sources such as cucumbers, eggs, unpasteurized milk, fresh basil, geckos and pet bearded dragons.

But one concern is that chickens and other backyard poultry can carry salmonella bacteria even if they look healthy and clean. A backyard poultry-associated outbreak that ended last year was tied to 470 cases spread across 48 states, including one death.

The case had been scheduled to go to trial in the next week, and was supposed to be the first to be heard in federal court in Chicago over the issue of whether Abbott’s specialized cow’s milk-based formula for preterm babies causes a life-threatening intestinal disease called necrotizing enterocolitis (NEC).

North suburban-based Abbott and formula-maker Mead Johnson are facing hundreds of lawsuits in federal court in Chicago over the issue, and Abbott is facing more than 1,400 lawsuits total in courts across the country. The case resolved Friday was a bellwether case, meaning its outcome was meant to help determine how the hundreds of other cases in federal court in Chicago proceeded, and/or how to settle those cases. The court is scheduled to hear three additional bellwether cases about the issue, with the next trial slated to begin in August.

Jose Rojas, an attorney for the plaintiff in the case that was thrown out Friday, said he was “disappointed” by the decision.

“We’re exploring all our options at the moment,” said Rojas, who is also co-lead counsel in the multidistrict litigation, meaning he’s helping to lead litigation for all the cases over the issue in federal court in Chicago. “I think it goes without saying that we’re devastated by the ruling. This is a family that is really destroyed by the death of their daughter.”

An Abbott spokesperson declined to comment Monday.

In the case, Kentucky woman Ericka Mar contended that her daughter RaiLee, who was born at 28 weeks gestation in 2014, died when she was about 2 weeks old after being fed a cow’s milk-based product made by Abbott. Mar alleges in her lawsuit that the formula was defective or unreasonably dangerous, that Abbott was negligent in selling it and that Abbott failed to warn health care providers and consumers of its dangers.

But on Friday, U.S. District Court Judge Rebecca Pallmeyer granted Abbott’s request for summary judgment and sided with the company.

In her order, Pallmeyer wrote that Mar had not been able to present evidence that Abbott could have designed the formula differently to be safer, nor that her daughter’s illness would have been prevented if Abbott had provided warnings about the higher risk of NEC in preterm babies who consume cow’s milk-based formulas.

Pallmeyer wrote that her decision in the case has “limited direct application” to the hundreds of other cases against the formula-makers in federal court in Chicago. She wrote that it’s possible plaintiffs in those other cases will be able to overcome the issues that led her to rule in favor of Abbott, depending on what evidence and testimony they provide.

In a bright spot for the other cases, Pallmeyer also decided Friday to deny Abbott’s request to exclude from those cases testimony from two expert witnesses on the link between cow’s milk-based formulas and NEC. And she denied Abbott’s motion for summary judgment in the other cases.

Wells Fargo analysts said in a note Sunday that their legal consultant “believes that it is likely that most, if not all, of the pending cases will fail on these same theories,” though it’s possible different state laws might give other plaintiffs more “breathing room,” the analysts wrote.

Rojas said he “vehemently” disagrees that the other cases against Abbott and Mead Johnson will fail.

The ruling on Friday was the latest twist in a yearslong legal battle between Abbott and families of babies who became ill after consuming the company’s specialized formula for preterm infants — a battle that has potential implications for both Abbott and families with babies born very prematurely.

Research has shown that formula feeding is associated with higher rates of NEC for premature infants, but that’s not to say that cow’s milk-based formulas cause the disease. Some premature babies who are fed only breast milk also develop NEC.

Last year, three major federal agencies — the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention and the National Institutes of Health — released a statement saying, “There is no conclusive evidence that preterm infant formula causes NEC.”

Some medical professionals are concerned about the many cases against Abbott and Mead Johnson, saying juries should not be deciding questions that scientists can’t even answer. They also worry that large verdicts against Abbott could lead the company to pull its cow’s milk-based products for preterm infants off the market, leaving some families who depend on the products in a bind.

Though neonatologists agree that mothers’ breast milk should always be the first choice of nutrition for babies born very prematurely, it’s not always available, and donated breast milk is not always an option.

Abbott Chairman and CEO Robert Ford warned in an earnings call last year, “If the regulatory process is disregarded, if the science is disregarded, it’s going to be very difficult for any company to remain on the market with these products, taking on that indefinite liability here, at least in the United States.” The specialized formulas, which are generally given in hospitals, represent a very small portion of Abbott’s overall sales.

Though Mar’s case was supposed to be the first one to go to trial in federal court, three other cases about the issue have already been heard in state courts. One of those cases resulted in a verdict of $60 million against Mead Johnson and another ended with a $495 million verdict against Abbott Laboratories — an outcome Abbott is appealing.

In the third case, Abbott initially prevailed, with a jury deciding Abbott and Mead Johnson were not liable for a boy developing NEC after he was fed the companies’ cow’s milk-based products for premature infants. But in a setback for Abbott and Mead Johnson, a St. Louis judge in March granted a motion for a new trial citing “errors and misconduct” in the original trial.

It was, as he called it, a turning point.

“That was about four years ago, when I had 2,000 plants started,” he recalled. “When they were really small they weren’t a problem. But when I had to up-plant them into 4-inch pots, we had them in every room in the house, next to every window I could find.

“My wife put her foot down and said you can’t do that anymore.”

Zeni began his tomato deep dive several years earlier when seeking a late-winter distraction after years of working at home as a graphic designer.

“It gets cold in the winter and I wouldn’t leave the house for weeks,” he said. “My wife claimed I was getting weird, and she insisted that I get a hobby.”

At the same time he was reflecting on the “tasteless atrocities that pose as tomatoes at supermarkets” during the offseason and decided to do something about it. He set up some tables and lights and planted some seeds.

There were mistakes — “overwatering, under watering, not enough heat,” Zeni said. But along with those setbacks were “small successes that gave me enough hope that I was on the right track.”

After a few seasons, he had enough plants that he would give them to any and all interested neighbors, and his tomato operation in La Grange Park kept growing larger. He began selling seedlings at “garage sales” to help fund his hobby, selling 50 to 75 plants.

“We put signage up when people just started showing up, telling me they’d heard about me from other people,” he said. “I got to 500 plants and sold them out. I’d get emails in January asking when’s the sale? That was the first indication I got that maybe this could be more than just a wintertime hobby.”

He decided to go all-in and started calling himself the Chicago Tomato Man.

“It’s spiraled to the point where this year we’ll grow around 15,000 plants,” he said in April.

He still grows at home, but the bulk of his operation is offsite, using contracters who deliver his plants to a warehouse near Western and Ogden avenues in Chicago, where they’re matched to orders and taken to pop-up markets throughout the city and suburbs.

Some of those seedlings are earmarked for other purposes as well.

“We give away lots of plants,” Zeni said. “We hear about efforts by nonprofit organizations or groups that are running gardens that use their harvest to give away produce to food banks. We totally support those efforts, so we give them plants every year.”

Last year, the Chicago Tomato Man organization gave away nearly 1,500 plants, and they’re looking to equal that this year.

Among the organizations that have worked with Zeni is Eden Greens Urban Farm, which provides healthy food as well as gardening resources for underserved communities such as Pullman, Englewood and Greater Grand Crossing.

Tomato plants also went to We Grow We Sow, Inc., an urban farm based in West Pullman that offers produce and education to people in Roseland, Morgan Park and Calumet Park.

Seedlings have even gone to the Cook County Juvenile Temporary Detention Center, for its Karma Garden project.

“This is good,” Zeni said. “We want to get these plants to any neighborhood that lacks access to food.”

And they’re not getting run-of-the-mill tomatoes. They’re getting the good ones, the heirlooms, some that have been passed down seed by seed for generations of gardeners.

Among Zeni’s seedlings are varieties such as Rutgers, developed in 1928 by the Campbell Soup Company and released to farmers in 1934 by Rutgers University.

There’s also Mortgage Lifter, a large beefsteak tomato developed, as the story goes, in the 1940s by a gardener in West Virginia who crossed varieties for six years before arriving at one so popular he was able to pay off his $6,000 mortgage by selling plants for $1 each.

There’s several varieties, such as the Sandburg yellow, attributed to Millard Murdock, a gardener based farther south in the Blue Ridge Mountains, whose retirement efforts to preserve and promote heirloom tomatoes became legendary in the seed saving community prior to his death in 2019.

Closer to home, fellow legendary seed savers Merlyn and Mary Ann Niedens, whose tomato and sunflower patches were sown in downstate Okawville, are represented by varieties such as Illini Star and Illini Gold. According to his 2009 obituary, Merlyn Niedens acquired at least some of his tomato breeding know-how in River Forest with a bachelor of science degree from Concordia Teacher’s College, now Concordia University.

One variety Zeni just started growing this year is steeped in Chicago history. The Inciardi (pronounced in-chi-ardi) paste tomato was brought over from Sicily by immigrant Enrico Inciardi, who sewed the seeds from his family’s signature tomato into the lining of his jacket because he was afraid they would be taken from him at Ellis Island, Zeni said.

Inciardi ended up settling in Downers Grove, got a job at the Western Electric Hawthorne Works in Cicero and later attended a company excursion aboard the S.S. Eastland in 1915, surviving the worst marine disaster in Chicago history after the ship overturned in the Chicago River, killing hundreds.

Through it all, he kept growing his family’s signature Sicilian tomatoes.

“Now his descendants started offering them for sale commercially,” Zeni said. “That’s a great story.”

Zeni is helping preserve another family story thanks to an encounter with an older guy he met at one of his pop-up sales at the Percolator Coffee Shop in Portage Park. He showed Zeni some seeds and said, “My father-in-law brought these over from Calabria and has been growing them ever since. He passed away and we continued to save these seeds, and I want to give them to you.”

Zeni asked the man, who came out from River Grove, what the tomatoes were called.

“I don’t know,” was the response. “It’s always just been my father-in-law’s tomato. My family has been growing them for 100 years. I’ve been growing them in my backyard.”

The man’s name was Art Zaino, “so that’s what we called them,” Zeni said. “These are big tomatoes. They’re like 16-inch softball sized tomatoes.”

While the Inciardi tomato has become somewhat more well-known among heirloom aficionados, the Art Zaino is “something that’s exclusive to us,” Zeni said. “I don’t think he gave the seeds to anyone else.”

For Zeni, heirloom tomatoes offer not only the opportunity to share the stories of fellow nightshade aficionados past and present, but also some of the places where he sells seedlings as well.

He’s already kicked off the gardening season with popup sales around the city and suburbs, including Pollyanna Brewing in Lemont, and has more coming up. There’s one from 10 a.m. to noon on May 31 at Two-Mile Coffee Bar, 9907 S. Walden Parkway, near the Metra stop in Chicago’s Beverly community; and another from 1 to 3 p.m. on May 31 at the Hyde Park Neighborhood Club, 5480 S. Kenwood Ave. in Chicago.

He’ll be at Skokie’s Sketchbook Brewing, 4901 Main St., on May 25. Other Pollyanna locations will be on June 7 in Roselle and later that day in St. Charles.

Also on the schedule is the last of four pop-ups on May 24 at First Presbyterian Church of La Grange, 150 S. Ashland Ave. A full list as well as ordering information is on his website at chicagotomatoman.com.

“These are locally owned places that let us set up, and in exchange we try to recognize and promote them, encourage people to buy a croissant and a coffee, or a four-pack or growler of beer,” Zeni said. “It’s about creating community and helping community, so we all prosper and thrive.”

But his primary goal remains to spread his love of tomatoes.

“I understand why the food industry has done what they’ve done to tomatoes,” he said. “Everyone wants to buy tomatoes in January at the grocery store, so they’ve bred them so they’re durable, they look great and they’re all the same size. But the flavor is gone and I think it’s criminal.

“A real tomato is something everyone should experience. The flavor is so wonderful. It’s so gratifying when someone picks those first few off the vine and realize the experience was worth all the time and effort put in to grow them.”

Landmarks is a column by Paul Eisenberg exploring the people, places and things that have left an indelible mark on the region. He can be reached at peisenberg@tribpub.com.

In recent months, HUD has been targeting the Obama-era Equal Access Rule that expanded protections to include sexual orientation and gender identity. Also in the bull’s-eye are fair-housing complaint investigations and federally funded homeless shelters.

“This administration wants to pretend trans people don’t exist,” said Hannah Adams, a senior staff attorney at the National Housing Law Project. “Whatever they’re doing is not in line with HUD’s supposed mission to provide a safety net for families that are struggling in this country.”

HUD said in a statement that it is upholding the landmark Fair Housing Act that guarantees equal access to housing for all Americans, as well as implementing what it called Trump’s executive order “restoring biological truth to the federal government.”

Here are key takeaways about how HUD is taking on the battle over transgender rights.

Defining LGBTQ+ rights in the Fair Housing Act

The Fair Housing Act identifies sex as one of seven protected classes for housing discrimination. But it wasn’t until the Obama administration established the Equal Access Rule in 2012 that those protections were extended to cover sexual orientation, gender identity and marital status.

In 2016, the rule was expanded to include transgender people seeking help at federally funded emergency shelters.

Four years later, a 2020 Supreme Court ruling established that a landmark civil rights law protects gay, lesbian and transgender people from discrimination in employment. Housing advocates and HUD in 2021 under the Biden administration interpreted that as broader affirmation that LGBTQ+ people were also protected in the fair housing law.

Kim Johnson, public policy manager at the National Low Income Housing Coalition, said transgender people experience homelessness at a disproportionately higher rate despite being less than 1% of the general population. The spirit of the Fair Housing Act is to protect everyone who is vulnerable to discrimination, she said, even if the text of the law does not explicitly include gender identity as a protected class.

“We really need to ensure we’re upholding what the law means, and the fact is that transgender people are some of the most marginalized people in this country,” Johnson said.

HUD drops housing discrimination cases

Since President Donald Trump appointed Scott Turner to take the helm at HUD, the Office of Fair Housing and Equal Opportunity has instructed staff to pause investigations of all gender identity discrimination cases, according to two HUD attorneys who spoke on condition of anonymity for fear of losing their jobs or benefits.

One said letters were then issued closing the cases for lack of jurisdiction.

HUD has not disclosed how many cases have been dropped. A National Fair Housing Alliance report identified at least 195 discrimination complaints involving gender identity in 2023, though HUD has not specified how many cases are still outstanding.

With changes to the Equal Access rule and other guidance still unclear, what happens now often depends on where a case is filed. In blue states with laws offering protections beyond federal law, HUD can direct tenants facing LGBTQ+ discrimination to state-run offices still taking cases, said a HUD employee who spoke on condition of anonymity to freely discuss the hot-button topic.

To Sasha Samberg-Champion, HUD deputy general counsel in the Biden administration and now special counsel for civil rights at the National Fair Housing Alliance, “There is no public policy justification for permitting discrimination in the housing market against people because they are transgender. None.”

Homeless shelters struggle to comply with Trump’s directives

Community leaders say they’re facing seemingly contradictory requirements in new HUD contracts with nonprofits that find permanent housing for the homeless and run shelters.

One section stipulates that nonprofits can’t promote “gender ideology” while at the same time another requires compliance with anti-discrimination law, according to a copy provided to the AP.

In Memphis, Tennessee, a nonprofit that provides emergency shelter for transgender people is looking to increase capacity because of the uncertainty.

Kayla Gore, executive director of My Sistah’s House, said it can do that because it doesn’t take federal funding. But other shelters are removing information from their websites about serving the LGBTQ+ community, fearful that federal funding will be stripped if they don’t, she said.

“People are confused,” Gore said. “They don’t know what to do because they want to protect their bottom line.”

Uncertain future for the Equal Access Rule

Soon after being sworn in as HUD secretary in February, Turner announced he was halting enforcement of the Equal Access Rule and quietly filed a proposal to revise the policy. HUD officials have declined to say what the proposed changes are.

In 2020, the first Trump administration unsuccessfully moved to relieve shelters of any obligation to accommodate transgender people.

With Trump back for a second term, advocates fear his administration will feel even more emboldened to go further and forbid shelters from accommodating gender identity altogether.

“Unfortunately, it’s making an already vulnerable class of people more vulnerable,” said Seran Gee, an attorney for Advocates for Trans Equality.

“Our protections can’t be a pingpong ball that changes every four years.”

More than a dozen data-gathering programs that track deaths and disease appear to have been eliminated in the tornado of layoffs and proposed budget cuts rolled out in the Trump administration’s first 100 days.

The Associated Press examined draft and final budget proposals and spoke to more than a dozen current and former federal employees to determine the scope of the cuts to programs tracking basic facts about Americans’ health.

Among those terminated at the Centers for Disease Control and Prevention were experts tracking abortions, pregnancies, job-related injuries, lead poisonings, sexual violence and youth smoking, the AP found.

“If you don’t have staff, the program is gone,” said Patrick Breysse, who used to oversee the CDC’s environmental health programs.

Federal officials have not given a public accounting of specific surveillance programs that are being eliminated.

Instead, a U.S. Department of Health and Human Services spokeswoman pointed the AP to a Trump administration budget proposal released Friday. It lacked specifics, but proposes to cut the CDC’s core budget by more than half and vows to focus CDC surveillance only on emerging and infectious diseases.

Kennedy has said some of the CDC’s other work will be moved to a yet-to-be-created agency, the Administration for a Healthy America. He also has said that the cuts are designed to get rid of waste at a department that has seen its budget grow in recent years.

“Unfortunately, this extra spending and staff has not improved our nation’s health as a country,” Kennedy wrote last month in The New York Post. “Instead, it has only created more waste, administrative bloat and duplication.”

Yet some health experts say the eliminated programs are not duplicative, and erasing them will leave Americans in the dark.

“If the U.S. is interested in making itself healthier again, how is it going to know, if it cancels the programs that helps us understand these diseases?” said Graham Mooney, a Johns Hopkins University public health historian.

The core of the nation’s health surveillance is done by the CDC’s National Center for Health Statistics. Relying on birth and death certificates, it generates information on birth rates, death trends and life expectancy. It also operates longstanding health surveys that provide basic data on obesity, asthma and other health issues.

The center has been barely touched in layoffs, and seems intact under current budget plans.

But many other efforts were targeted by the cuts, the AP found. Some examples:

Pregnancies and abortion

The Pregnancy Risk Assessment Monitoring System, which surveys women across the country, lost its entire staff — about 20 people.

It’s the most comprehensive collection of data on the health behaviors and outcomes before, during and after childbirth. Researchers have been using its data to investigate the nation’s maternal mortality problem.

Recent layoffs also wiped out the staffs collecting data on in vitro fertilizations and abortions.

Those cuts are especially surprising given that President Donald Trump said he wants to expand IVF access and that the Heritage Foundation’s Project 2025 playbook for his administration called for more abortion surveillance.

Lead poisoning

The CDC eliminated its program on lead poisoning in children, which helped local health departments — through funding and expertise — investigate lead poisoning clusters and find where risk is greatest.

Lead poisoning in kids typically stems from exposure to bits of old paint, contaminated dust or drinking water that passes through lead pipes. But the program’s staff also played an important role in the investigation of lead-tainted applesauce that affected 500 kids.

Last year, Milwaukee health officials became aware that peeling paint in aging local elementary schools was endangering kids. The city health department began working with CDC to test tens of thousands of students. That assistance stopped last month when the CDC’s lead program staff was terminated.

City officials are particularly concerned about losing expertise to help them track the long-term effects.

“We don’t know what we don’t know,” said Mike Totoraitis, the city’s health commissioner.

Environmental investigations

Also gone is the staff for the 23-year-old Environmental Public Health Tracking Program, which had information on concerns including possible cancer clusters and weather-related illnesses.

“The loss of that program is going to greatly diminish the ability to make linkages between what might be in the environment and what health might be affected by that,” Breysse said.

Transgender data

In some cases, it’s not a matter of staffers leaving, but rather the end of specific types of data collection.

Transgender status is no longer being recorded in health-tracking systems, including ones focused on violent deaths and on risky behaviors by kids.

Experts know transgender people are more likely to be victims of violence, but now “it’s going to be much more challenging to quantify the extent to which they are at higher risk,” said Thomas Simon, the recently retired senior director for scientific programs at the CDC’s Division of Violence Prevention.

Violence

The staff and funding seems to have remained intact for a CDC data collection that provides insights into homicides, suicides and accidental deaths involving weapons.

But CDC violence-prevention programs that acted on that information were halted. So, too, was work on a system that collects hospital data on nonfatal injuries from causes such as shootings, crashes and drownings.

Also going away, apparently, is the CDC’s National Intimate Partner and Sexual Violence Survey. The system is designed to pick up information that’s not found in law enforcement statistics. Health officials see that work as important, because not all sexual violence victims go to police.

Work injuries

The National Institute for Occupational Safety and Health, which tracks job-related illnesses and deaths and makes recommendations on how to prevent them, was gutted by the cuts.

Kennedy has said that 20% of the people laid off might be reinstated as the agency tries to correct mistakes.

That appeared to happen last month, when the American Federation of Government Employees said that NIOSH workers involved in a black lung disease program for coal miners had been temporarily called back.

But HHS officials did not answer questions about the reinstatement. The AFGE’s Micah Niemeier-Walsh later said the workers continued to have June termination dates and “we are concerned this is to give the appearance that the programs are still functioning, when effectively they are not.”

There’s been no talk of salvaging some other NIOSH programs, including one focused on workplace deaths in the oil and gas industries or a research project into how common hearing loss is in that industry.

Smoking and drugs

The HHS cuts eliminated the 17-member team responsible for the National Survey on Drug Use and Health, one of the main ways the government measures drug use.

Also axed were the CDC staff working on the National Youth Tobacco Survey.

There are other surveys that look at youth smoking and drug use, including the University of Michigan’s federally funded “Monitoring the Future” survey of schoolkids.

But the federal studies looked at both adults and adolescents, and provided insights into drug use by high school dropouts. The CDC also delved into specific vaping and tobacco products in the ways that other surveys don’t, and was a driver in the federal push to better regulate electronic cigarettes.

“There was overlap among the surveys, but each one had its own specific focus that the other ones didn’t cover,“ said Richard Miech, who leads the Michigan study.

Data modernization and predictions

Work to modernize data collection has been derailed. That includes an upgrade to a 22-year-old system that helps local public health departments track diseases and allows CDC to put together a national picture.

Another casualty was the Center for Forecasting and Outbreak Analytics, which tries to predict disease trends.

The center, created during the COVID-19 pandemic, was working on forecasting the current multi-state measles outbreak. That forecast hasn’t been published partly because of the layoffs, according to two CDC officials who spoke on condition of anonymity because they are not authorized to discuss it and fear retribution for speaking to the press.

Trump hasn’t always supported widespread testing of health problems.

In the spring of 2020, when COVID-19 diagnoses were exploding, the president groused that the nation’s ability to do more testing was making the U.S. look like it had a worse problem than other countries. He called testing “a double-edged sword.”

Mooney, the Johns Hopkins historian, wonders how interested the new administration is in reporting on health problems.

“You could think it’s deliberate,” he said. “If you keep people from knowing, they’re less likely to be concerned.”

The 216 pediatric deaths reported by the Centers for Disease Control and Prevention eclipse the 207 reported last year. It’s the most since the 2009-2010 H1N1 global flu pandemic.

It’s a startlingly high number, given that the flu season is still going on. The final pediatric death tally for the 2023-2024 flu season wasn’t counted until autumn.

“This number that we have now is almost certainly an undercount, and one that — when the season is declared over, and they compile all the data — it’s almost certain to go up,” said Dr. Sean O’Leary, of the American Academy of Pediatrics.

There are likely several contributors to this season’s severity, but a big one is that fewer children are getting flu shots, added O’Leary, a University of Colorado pediatric infectious diseases specialist.

The flu vaccination rate for U.S. children has plummeted from about 64% five years ago to 49% this season.

Flu vaccinations may not prevent people from coming down with symptoms, but research shows they are highly effective at preventing hospitalizations and deaths, O’Leary said.

The season has not only been hard on children. CDC officials have described it as “ highly severe,” and estimate that so far there have been at least 47 million illnesses, 610,000 hospitalizations and 26,000 deaths this season.

CDC officials have information about underlying conditions on nearly 5,200 adults who were hospitalized with flu this season, and 95% had at least one existing health problem. But among 2,000 hospitalized children with more detailed health information, only about 53% had an underlying condition — including asthma and obesity.

The CDC report did not say how many of the children who died were vaccinated. The agency did not make an expert available to talk about the flu season.

The good news is that flu indicators have been waning since February, and last week all 50 states were reporting low or minimal flu activity.

The season has seen more of a mix of flu strain circulating than in many other years, with two different Type A strains — H1N1 and H3N2 — causing a lot of infections. But CDC data released earlier this year suggested flu shots were doing a pretty good job at preventing deaths and hospitalizations.

The CDC continues to recommend that everyone ages 6 months and older get an annual flu vaccine.

Childhood vaccinations in general have been declining, driven by online misinformation and the political schism that emerged around COVID-19 vaccines. Robert F. Kennedy Jr. has also echoed some of the rhetoric of antivaccine activists since taking over as the nation’s health secretary.

But there may be other reasons fewer children got flu shots this year, O’Leary said.

Many pediatricians offices are understaffed and are not holding as many after-hours vaccination clinics as in the past. Also, more Americans are getting their vaccinations at pharmacies, but some drugstores don’t vaccinate children, he said.

”My hope is that this season will be a bit of wake up call for folks that we actually do need to vaccinate our kids against influenza,” O’Leary said.

Baxter expects to see most of the impact from increased tariffs in the second half of the year, said Joel Grade, Baxter executive vice president and chief financial officer. Baxter makes IV fluids, a number of pharmaceuticals and other hospital products.

“We are able to mitigate a portion of these impacts,” Grade said. “Currently a majority of Baxter’s products sold in the U.S. are manufactured in the U.S. and made largely from U.S.-made components. However, international procurement is part of our business operations and as such we are impacted from the U.S. and retaliatory tariffs that have been issued.”

Though only a small percentage of Baxter’s total sales are in China, “given the magnitude of the tariffs that have been enacted between the two countries, these tariffs now account for nearly half of the total impact,” he said.

President Donald Trump has proposed sweeping tariffs on a number of countries in an effort to boost jobs and manufacturing the U.S. Last month, Trump suspended most of those tariffs — but not China — for 90 days. The Trump administration has not yet imposed tariffs on pharmaceuticals, but is now investigating how imports of pharmaceuticals and pharmaceutical ingredients affects national security.

Baxter’s assumptions do not include any potential changes to tariffs on pharmaceutical products, Grade said.

Baxter is considering a number of strategies to mitigate the impact of tariffs, including carrying additional inventory, identifying alternative suppliers, alternative shipping routes and “targeted pricing actions,” Grade said. Baxter is also working with its trade association partners to advocate for possible exemptions, he said.

“Some of these actions will be able to realized more near-term to help mitigate the impact in 2025, and others will require more time to be implemented but will help offset the impact in future years,” Grade said.

Grade’s comments about tariffs came during an otherwise positive quarterly results Baxter, which saw its net income increase $126 million in the first quarter of this year, compared with an increase of $39 million in the first quarter of last year. The quarterly results were Baxter’s first since selling off its kidney care business to global investment firm Carlyle for $3.7 billion earlier this year. That business is now called Vantive and its headquarters is in the former Caterpillar building in Deerfield.

In recent weeks, a number of companies have been quantifying the impacts of tariffs. The CEO of north suburban-based Abbott Laboratories said during an earnings call last month that he expected tariffs to cost the company “a few hundred million dollars” in the second half of this fiscal year.

Highways connect his border city with the epicenter of Texas’ massive outbreak, which is up to 663 cases. They’re the same roads used by thousands of families and commercial truckers who cross into Mexico and back each day.

“Diseases know no borders,” said Ocaranza, El Paso’s top public health doctor, “so as people are mobile, they’re going to be coming and receiving medical attention in El Paso but they may be living in Juarez.” It took a couple of months, but El Paso now has the highest measles case count in the state outside of West Texas with 38. Neighboring Ciudad Juarez has 14 cases as of Monday.

Health officials confirm Cook County’s first two measles cases of the year

North America’s three biggest measles outbreaks continue to balloon, with more than 2,500 known cases; three people have died in the U.S. and one in Mexico. It started in the fall in Ontario, Canada; then took off in late January in Texas and New Mexico; and has rapidly spread in Chihuahua state, which is up to 786 cases since mid-February.

These outbreaks are in areas with a notable population of certain Mennonite Christian communities who trace their migration over generations from Canada to Mexico to Seminole, Texas. Chihuahua health officials trace their first case to an 8-year-old Mennonite child who visited family in Seminole, got sick and spread the virus at school. And Ontario officials say their outbreak started at a large gathering in New Brunswick involving Mennonite communities.

Mexican and U.S. officials also say the genetic strains of measles spreading in Canada match the other large outbreaks.

“This virus was imported, traveling country to country,” said Leticia Ruíz, director of prevention and disease control in Chihuahua.

North and South American countries have struggled to maintain the 95% measles vaccination rate needed to prevent outbreaks, said Dr. Jarbas Barbosa, director of the Pan American Health Organization. And a recent World Health Organization report said measles activity in the Americas region is up elevenfold from the same time last year and that the risk level is “high” compared to the rest of the world’s “moderate” level.

Measles cases have been confirmed in six of the region’s countries — Argentina, Belize, Brazil, Canada, the United States and Mexico — and investigating the disease’s spread is labor-intensive and pricey. The response to each measles case in the U.S. costs an estimated $30,000 to $50,000, according to Dr. David Sugerman, a U.S. Centers for Disease Control and Prevention scientist.

Measles at the U.S.-Mexico border

The cases in Ciudad Juarez have no direct connection to the Mennonite settlement in Chihuahua, said Rogelio Covarrubias, a health official in the border city. The first measles case in El Paso was in a child at Fort Bliss, Ocaranza said.

More than half of El Paso’s cases are in adults, which is unusually high, and three people have been hospitalized. The health department is holding vaccination clinics in malls and parks and says hundreds have gotten a shot. The vaccines are free — no questions asked, no matter which side of the border you live on.

Communication about measles between the two health departments is “informal” but “very good,” Ocaranza said. Covarrubias said his team was alerted last week to a case of someone who became sick in El Paso and returned home to Juarez.

“There is constant concern in Ciudad Juarez … because we have travelers that pass through from across the world,” Covarrubias said. “With a possible case of measles without taking precautions, many, many people could be infected.”

Measles at the U.S.-Canada border

Michigan health officials said the outbreak of four cases in Montcalm County are linked to Ontario.

The state’s chief medical executive, Dr. Natasha Bagdasarian, expects to see more cases. Michigan has a 95% vaccination rate for measles, mumps and rubella, but it hides weak spots — counties with 70% vaccination rates and individual schools where just 30% of kids vaccinated.

“If we think about measles as a forest fire, we’ve got these burning embers that are floating in the air right now,” Bagdasarian said. “Whether those embers result in another wildfire just depends on where they land.”

In Canada, six out of 10 provinces have reported measles cases. Alberta has the second-most with 83 as of April 12, according to government data.

Case counts in Ontario reached 1,020 as of Wednesday, mostly in the southwest part that borders Michigan. In one of the hardest-hit regions, Chatham-Kent Public Health officials announced a public exposure at a Mennonite church on Easter Sunday.

“It sometimes feels like we’re just behind, always trying to catch up to measles,” Dr. Sarah Wilson, a public health physician for Public Health Ontario. “It’s always moving somewhere.”

The Health and Human Services report questions standards for the treatment of transgender youth issued by the World Professional Association for Transgender Health and is likely to be used to bolster the government’s abrupt shift in how to care for a subset of the population that has become a political lightning rod.

This new “best practices” report is in response to an executive order Trump issued days into his second term that says the federal government must not support gender transitions for anyone under age 19.

“Our duty is to protect our nation’s children — not expose them to unproven and irreversible medical interventions,” National Institutes of Health Director Dr. Jay Bhattacharya said in a statement. “We must follow the gold standard of science, not activist agendas.”

The report sharply contradicts guidance from the American Medical Association, which has urged states not to ban gender-affirming care for minors, saying that “empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression.”

HHS said its report, however, is not clinical guidance and does not make any policy recommendations. The report is also limited to children and does not address treatment for adults.

Gender-affirming care for transgender youth under standards widely used in the U.S. includes supportive talk therapy and can — but does not always — involve puberty blockers or hormone treatment. Gender-affirming surgeries for transgender minors are rare.

“It’s very chilling to see the federal government injecting politics and ideology into medical science,” said Shannon Minter, the legal director at the National Center for Lesbian Rights. Minter said the report could create fear for families seeking care and for medical providers.

“It’s Orwellian. It is designed to confuse and disorient,” Minter added.

A judge has blocked key parts of Trump’s order, which includes denying research and educational grants for medical schools, hospitals and other institutions that provide gender-affirming care to people 18 or younger. Several hospitals around the country ceased providing care. The White House said Monday that since Trump took office, HHS has eliminated 215 grants totaling $477 million for research or education on gender-affirming treatment.

Most Republican-controlled states have also adopted bans or restrictions on gender-affirming care. A U.S. Supreme Court ruling is pending after justices heard arguments in December in a case about whether states can enforce such laws.

The Jan. 28 executive order is among several administration policies aimed at denying the existence of transgender people. Trump also has ordered the government to identify people as either male or female rather than accept a concept of gender in which people fall along a spectrum, remove transgender service members from the military, and bar transgender women and girls from sports competitions that align with their gender. This month, HHS issued guidance to protect whistleblowers who report doctors or hospitals providing gender-affirming care. Judges are blocking enforcement of several of the policies.

This latest HHS report, which Trump called for while campaigning last year, represents a reversal in federal policy. The U.S. Substance Abuse and Mental Health Services Administration, which is part of HHS, found that no research had determined that behavioral health interventions could change someone’s gender identity or sexual orientation. The 2023 update to the 2015 finding is no longer on the agency’s website.

The administration says this new report will go through a peer-review process. In the meantime, it’s not saying who contributed to it, “in order to help maintain the integrity of this process.”

The report says that medical groups have relied on medical treatment rather than behavioral therapy for transgender youth partly because of a “mischaracterization of such approaches as ‘conversion therapy,’” which about half the states have banned for minors.

The American Academy of Child & Adolescent Psychiatry has said that evidence shows conversion therapies inflict harm on young people, including elevated rates of suicidal ideation. And the American Medical Association has urged states not to ban gender-affirming care for minors, saying that “empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression.”