Days before the 2024 presidential election, future Health and Human Services Secretary Robert F. Kennedy Jr. posted a statement on X promising to end the U.S. Food and Drug Administration’s “aggressive suppression” of such alternative therapies as raw milk, ivermectin, psychedelics and, somewhat perplexingly, “sunshine.”

While the post did not explain how the FDA was limiting Americans’ access to the sun, many dermatologists were dismayed when Kennedy abruptly withdrew a proposed FDA rule that would have banned minors from using devices that mimic sunlight — indoor tanning lamps.

The rule, which was withdrawn March 16, would have also required indoor tanning facility users to sign a form acknowledging the risk of cancer, early skin aging and other health effects.

Kennedy’s action comes at a time when many adherents of his Make America Healthy Again movement have adopted regular sun exposure as a core principle of wellness, with social media influencers encouraging followers to abandon sunscreen and build up their “solar callus,” or sun tolerance, instead.

The trend has frustrated many dermatologists, who warn that the damage of frequent sunburns and tans accumulates over a lifetime, and those acquired early in life appear to play a disproportionate role in later risk of skin cancer. The Skin Cancer Foundation notes also that you cannot build up a tolerance to sun exposure and “there is no such thing as a ‘solar callus.’”

Dermatologists have long cautioned that indoor tanning lamps are no less dangerous, since they expose users to ultraviolet light at concentrations far above natural sunlight. Like sunlight, the lamps emit two different types of ultraviolet wavelengths: UVA, which are longer and penetrate more deeply into the skin, and UVB, which are shorter and more easily burn the outer layers.

Both light sources darken skin through the same biological process: UV rays change the structure and chemical profile of DNA in the skin, which then produces more melanin in order to prevent further damage.

A tanning bed session exposes users to UVB rays akin to those at noon at the equator — an intense experience, but at least one with a terrestrial equivalent, said Hunter Shain, an associate professor of dermatology at UC San Francisco. The UVA radiation in a tanning bed is roughly 15 times that found anywhere on the surface of the planet.

“They’re really blasting you with these super physiological doses of UV radiation that you couldn’t even find in a natural environment,” he said.

The World Health Organization counts UV-emitting tanning beds as a Group 1 carcinogen, alongside other known human carcinogens like tobacco cigarettes and asbestos. One study Shain co-authored found that tanning beds accelerate DNA mutations in parts of the body not typically exposed to the sun, leading to a nearly threefold increase in indoor tanners’ lifetime melanoma risk. Rates of melanoma diagnoses have increased by 46% in the last decade.

The tanning lamp rule, which was first proposed in 2015, focused on age as a specific risk factor. Tanning bed usage before the age of 35 is associated with a 75% increase in the risk of melanoma, the most serious and frequently fatal form of skin cancer.

The rule drew more than 9,000 public comments from both physicians and cancer research organizations supporting its implementation and from tanning bed industry representatives and business owners opposed.

Kennedy, who was photographed leaving a Washington tanning salon last year, was ultimately unconvinced of the need to ban minors from such establishments.

“In light of the scientific and technical concerns raised in the comments on the Proposed Rule, concerns regarding possible unintended consequences of certain proposals in the Proposed Rule, and potential alternatives proposed in comments received on the Proposed Rule, FDA is withdrawing the Proposed Rule in order to reconsider the best means for addressing the issues,” Kennedy wrote in the withdrawal letter.

Health and Human Services did not respond to questions about what scientific concerns and unintended consequences Kennedy was referring to.

Nineteen states (including California) and the District of Columbia have already banned people under 18 from indoor tanning salons. Roughly two dozen more have some kind of regulations regarding minors and indoor tanning, such as requiring parental permission or barring only younger children.

The collapse of the proposed federal ban has left many dermatologists disappointed.

“As you can see, when it’s left to the states, the implementation and the guardrails to minimize the exposure to carcinogens are not consistent. … Why are you going to default to a system that we know isn’t working correctly?” said Dr. Clara Curiel-Lewandrowski, chair of dermatology and co-director of the Skin Cancer Institute at the University of Arizona.

Minors in sun-baked Arizona are free to patronize indoor tanning establishments as long as they have a note from their parents. Curiel-Lewandrowski has treated many former sunbed enthusiasts for advanced melanoma in their 20s and 30s, she said.

“There’s a lot of regret. Regret for not knowing more, for not getting more help to understand the threat,” she said. “This is an age group that has a very hard time assessing risk. At that age, they don’t view carcinogens as a real threat.”

The U.S. is a bit of an outlier in its permissive approach to youth indoor tanning. Australia and Brazil have banned cosmetic indoor tanning entirely for people of all ages. Most western European countries ban minors from indoor tanning, as do most Canadian provinces.

“After the proposal lay dormant for more than a decade, I can’t say I was surprised to hear that the FDA withdrew it,” said Dr. Deborah S. Sarnoff, president of the Skin Cancer Foundation. “On the positive side, we made the public very aware of this issue, and this fight is far from over. We won’t be satisfied until tanning beds are banned in this country.”

A suspected outbreak of hantavirus, a rare but deadly disease that attacks the lungs, has left three people dead and several others severely ill aboard a luxury cruise ship.

Here’s what we know about the voyage and the virus that also made headlines last year after it killed Gene Hackman’s 65-year-old wife, Betsy Arakawa.

What’s going on?

Global health officials and the cruise operator, Oceanwide Expeditions, are investigating and working to contain the illnesses suspected to have been brought on by the rodent-borne illness aboard the MV Hondius — a Dutch-flagged ship, according to the World Health Organization.

On Monday, the WHO announced that the luxury ship carrying 147 passengers and crew had two laboratory-confirmed cases and five suspected cases of hantavirus. The three deaths are included in that total.

The cruise ship, which was on a 46-day journey that traveled from Antarctica with stops in Argentina, has remained off the coast of Cape Verde in the Atlantic Ocean. During a news conference, WHO officials said they’re planning to medically evacuate two individuals with suspected infections.

The vessel departed Ushuaia, Argentina, on April 1 and traveled across the Atlantic with multiple stops in remote and ecological diverse regions, according to the WHO.

“The extent of passenger contact with local wildlife during the voyage, or prior to boarding in Ushuaia, remains undetermined,” the organization said in a statement.

What we know about hantavirus

Typically, hantavirus spreads by inhaling particles contaminated with the urine, feces or saliva of wild rodents.

“What we don’t know about this current outbreak is whether someone got onto the ship and was already sick or there were rodents on the cruise,” said Dr. Gaby Frank, director of the Johns Hopkins Special Pathogens Center.

There is, however, a strain of hantavirus that can be spread from human to human, known as the Andes virus, Frank said.

In such a case, a person would first be infected by a wild rodent’s contaminated particles and then, after becoming infected themselves, pass the infection to another person.

There are 50 species of hantavirus. The virus that’s found in the Americas tends to cause a cardiopulmonary syndrome, a condition that affects the heart and the lungs, according to Frank.

There have been 890 laboratory-confirmed cases of hantavirus disease reported in the United States since surveillance began in 1993, according to the most recent data from the U.S. Centers for Disease Control and Prevention.

The data suggest that contracting hantavirus is rare, said Dr. Afif El-Hasan, member of the American Lung Assn.’s national board of directors.

“That being said, it’s probably underdiagnosed because the symptoms are a lot like the flu or other illness,” El-Hasan said. “And a lot of people may have passed away or had hantavirus, but it was never diagnosed.”

There is no vaccine or specific antiviral medicine for hantavirius.

The ICU treatment may include intubation and oxygen therapy, fluid replacement and use of medications to lower blood pressure, according to the American Lung Assn.

Know the signs of hantavirus and next steps

Early symptoms of hantavirus are similar to the flu and include fatigue, fever and muscle aches, according to the CDC. Signs of these symptoms start to show within one to eight weeks after contact with an infected rodent.

Half of those who contract the virus also experience headaches, dizziness, chills, nausea, vomiting, diarrhea and abdominal pain.

Four to 10 days after the initial phase of the illness, another round of symptoms can develop, which include coughing, shortness of breath and possible tightness in the chest as the lungs fill with fluid.

Even though contracting hantavirus in the United States continues to be a rare event, El-Hasan said, people should take these initial symptoms seriously and promptly seek medical care.

Hantavirus can be deadly. CDC officials said 38% of people who develop respiratory symptoms may die from the disease.

How to protect yourself

Hantavirus cases can occur year-round, but the peak seasons in the United States are in the spring and summer, which coincide with the reproductive seasons for deer mice.

To lessen your risk of infection, keep wild rodents out of your home, workplace, shed, cabin, car or other enclosed spaces.

Los Angeles County public health officials offer suggestions on how you can keep rodents at bay, which include:

• Sealing up holes, the width of a pencil or larger, that mice can squeeze into.
• Place snap traps to catch any rodents. The CDC cautions against using glue or live traps because they can scare the rodents, causing them to urinate, which increases your chances of exposure to any virus they may be carrying.
• Store all food items in rodent-proof containers.

If you find evidence of mice in a space that you frequent, local and state officials advise:

• Before you clean, air out the space for 30 minutes. Equip yourself with rubber or plastic gloves, an N-95 mask and a disinfectant or mixture of bleach and water.
• While cleaning, spray the contaminated areas with your disinfectant and let it soak for at least five minutes. Do not sweep or vacuum the area, the movement could stir up the infectious materials in the air. Instead, use paper towels, a sponge or a mop to clean. When you’re done, put everything, including cleaning materials, in a bag and toss it in your trash bin.