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Opinion: Abortion foes lost Round One on mifepristone. Here's how their fight continues

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Opinion: Abortion foes lost Round One on mifepristone. Here's how their fight continues

The Supreme Court’s mifepristone decision on June 13 put a stop to one challenge to the drug used in more than half of all abortions in the United States. But antiabortion groups are already preparing their next line of attack.

New groups of plaintiffs might try to establish that they have standing where the doctors in the Food and Drug Administration vs. Alliance for Hippocratic Medicine failed. But if Donald Trump wins the 2024 election, such lawsuits might be far less important to abortion foes: Conservatives already have detailed plans in place to use the executive branch to impose national limits on abortion.

The plaintiffs in FDA vs. Alliance made two sets of claims. First, they challenged the overall authority of the agency to approve and subsequently lift restrictions on mifepristone. The plaintiffs also argued that the FDA didn’t have the power to allow patients to receive the pills in the mail because the federal Comstock Act, a 19th century obscenity law, includes a ban on mailing and receiving abortion-related items.

In holding that the Alliance plaintiffs didn’t have standing to sue, the Supreme Court didn’t say a word about the merits of either of those claims. So it’s no surprise that other plaintiffs might try to bring them again before the justices. The leading contenders are the states of Kansas, Missouri and Idaho, which had sought to intervene in the case, a request turned away by the Supreme Court.

The states’ attorneys general have suggested that they will continue the litigation, with a new argument on standing. A preview of that claim came in the states’ petition to intervene: They argued that because their citizens could get mifepristone from doctors out of state, the states’ own interests were affected. Medicaid recipients who suffered mifepristone complications were imposing costs on state medical systems, they added, and the availability of mifepristone was making it difficult to make and enforce abortion bans.

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There may be problems with the states’ case for standing too. Patients might experience complications if they take mifepristone, which might impose costs on the states. That doesn’t sound so different from the weak hypotheticals on which the Alliance plaintiffs relied. And what about Missouri and Idaho’s supposed sovereign interest in enforcing their abortion bans when other states allow it? The answer the court gave the Alliance doctors would seem to apply: “A plaintiff’s desire to make a drug less available for others does not establish standing to sue.”

Kansas’ case for standing is even more puzzling. Abortion is legal in Kansas until 22 weeks, albeit with restrictions. Barely more than a month after Roe was overturned, Kansans expressly voted against amending their state constitution to say there was no right to abortion. How will the state make the case that it is harmed by the approval of mifepristone when its own voters chose to preserve abortion access?

Whatever the fate of the case the Alliance doctors started, abortion foes and conservatives understand that the war against mifepristone and medication abortion can’t just depend on litigation. For example, Louisiana recently passed a law categorizing mifepristone and misoprostol, another drug used in medication abortion, as controlled substances, making it easier for the state to surveil patients, doctors and pharmacies and to punish anyone in possession of the drugs without a prescription. Idaho passed a so-called trafficking law that criminalizes those who help minors travel out of state or obtain abortion pills without parental consent.

But even these kinds of strategies may be far less important if Donald Trump wins a second term. The Heritage Foundation and a coalition of more than 100 conservative groups have laid out a detailed plan — known as Project 2025 — for a second Trump administration. The plan begins with a call for the FDA to “reverse its approval of chemical abortion drugs,” including mifepristone, or at a minimum, to eliminate the telehealth option for the drug.

Thousands of abortions can take place each month in states that ban the procedure because the telehealth option allows patients to get a prescription and get the pills by mail. With a Trump appointee as secretary of Health and Human Services, and one heading the FDA , the government might approach mifepristone differently without the pressure of a lawsuit. Some legal scholars argue that structural features of the federal Food and Drug Act could even allow the HHS secretary alone to override scientists at the FDA.

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Then there is the ancient Comstock Act — moribund but still on the books. Gene Hamilton, a prominent figure in the first Trump administration, argues in the Project 2025 plan that the Department of Justice could simply dust off the 151-year-old law and start criminally prosecuting the mailing or receipt of mifepristone. If the Supreme Court buys this interpretation of the Comstock Act, despite its flaws, such an executive action would get around the thorny questions about standing raised in Alliance.

The Supreme Court deflected the Alliance case against mifepristone. We may well see it reappear in some form on the court’s docket next year. But whatever shape Alliance 2.0 takes, in the fight over a national abortion ban, it’s unlikely to be the main event.

Mary Ziegler is a law professor at UC Davis and the author of “Roe: The History of a National Obsession.”

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L.A. County reports first West Nile virus death this year

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L.A. County reports first West Nile virus death this year

A San Fernando Valley resident is the first person in L.A. County to die this year from West Nile virus, a mosquito-transmitted illness that can cause lethal inflammation in the brain.

The L.A. County Department of Public Health reported on Thursday that the patient died from neurological illness caused by severe West Nile. So far in 2024, there have been 14 confirmed cases of the virus in the county and 63 in the state, according to state and county public health departments.

“To the family and friends grieving the loss of a loved one due to West Nile virus, we extend our heartfelt condolences,” said Muntu Davis, L.A. County health officer. “This tragic loss highlights the serious health risks posed by mosquito-borne diseases, such as West Nile virus, dengue, and others.”

West Nile virus is the most common mosquito-borne disease that harms residents in L.A. County. The disease lives in infected birds and is transmitted to humans via mosquito bites.

Davis recommended Angelenos take simple steps to protect themselves from mosquito bites. This includes using insect repellent, getting rid of items that hold standing water around the home — such as flowerpots and bird baths — and using screens on doors and windows to keep mosquitoes out.

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Most people who are infected will not experience any symptoms, but 1 in 5 will suffer a fever with symptoms including:

  • headache
  • body ache
  • joint pain
  • vomiting
  • diarrhea
  • rash

About 1 in 150 people will experience more severe symptoms such as high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness and paralysis, according to the World Health Organization. The Department of Public Health recommends anyone with severe symptoms call their doctor immediately.

In serious cases, the virus can cause inflammation of the brain or spinal cord, leading to permanent neurological damage or death. People older than 50 and those with health problems are at greater risk of complications, according to the Public Health Department.

The disease was first found in Africa before being discovered in the U.S. in 1999 and California in 2003. Since then the state has reported more than 300 deaths and 7,500 cases.

This year, there have also been deaths reported in Santa Clara County, Contra Costa County and Fresno County. Orange County reported its first case of West Nile in August, but so far there have been no deaths.

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Virus that can cause paralysis in children is on the rise in California: A few safeguards

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Virus that can cause paralysis in children is on the rise in California: A few safeguards

A respiratory virus that in rare cases can cause polio-like paralysis in children is on the rise in California and across the nation, according to wastewater analyses.

Enterovirus D68 was detected in 207 out of 268 samples taken from wastewater sites across the nation in the last 10 days, says the nonprofit WastewaterSCAN.

In the same time period, EV-D68 was detected at a medium level at 17 wastewater sites in California, including facilities in Los Angeles, San Diego, San Francisco, Sacramento and San Jose. Because humans shed viruses in waste, wastewater sampling is used to measure the prevalence of infection in a community.

Most people who contract EV-D68 will experience slight respiratory symptoms or none at all, according to the Centers for Disease Control and Prevention. Nevertheless, its spread is troubling because the virus can lead to a rare and debilitating neurological condition called acute flaccid myelitis, or AFM.

AFM attacks motor neurons in the spinal cord’s gray matter, which controls movement. This causes muscles and reflexes to weaken and, in severe cases, can lead to paralysis and death, according to the CDC.

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Around 90% of cases occur in children, and there is no known treatment.

Dr. Robert Kim-Farley, an epidemiologist and infectious diseases expert with the UCLA Fielding School of Public Health, told The Times that the best way to avoid contracting EV-D68 is to practice common respiratory hygiene.

“This is covering your coughs and sneezes, it’s washing hands,” he said, “If you’ve been around someone who’s coughing and sneezing … make sure that you haven’t touched contaminated surfaces that they’ve been touching or shared cups or utensils.”

This year, the CDC has confirmed 13 cases of AFM, including one in California, as of Sept. 3.

The largest known outbreak of the illness took place in 2018, when 238 cases were confirmed across the country. Cases also spiked in 2014 and 2016.

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Most cases of EV-D68 will be mild and feel like a common cold. However, children with asthma are at higher risk of experiencing more severe symptoms, according to the CDC.

Here are some common symptoms of EV-D68:

  • Runny nose
  • Sneezing
  • Cough
  • Body aches
  • Wheezing and difficulty breathing

If the virus progresses to cause AFM, symptoms include:

  • Arm or leg weakness
  • Difficulty swallowing or slurred speech
  • Difficulty moving the eyes and drooping in the eyelids and face

Kim-Farley recommends people seek medical care if they develop any evidence of paralysis or weakness in the limbs or muscles after having had a respiratory or fever-inducing illness one to two weeks prior.

The paralysis caused by AFM is very similar to that caused by polio — which, like EV-D68, is also an enterovirus.

Polio was eradicated in the Unites States in 1979, thanks to a widespread vaccination campaign, according to the CDC. Unfortunately, there is no vaccine for EV-D68.

“Even though [EV-D68] is not vaccine-preventable, it’s always a good opportunity to realize there are other diseases that cause paralysis, like polio, that are vaccine-preventable” and against which children can be inoculated, Kim-Farley said.

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He also recommended getting the latest COVID-19 vaccine.

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Brett Favre, testifying at welfare fraud hearing, reveals he has Parkinson's

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Brett Favre, testifying at welfare fraud hearing, reveals he has Parkinson's

Testifying Tuesday before the House Ways and Means Committee, Hall of Fame quarterback Brett Favre said in a prepared statement that he was recently diagnosed with Parkinson’s disease.

Favre, 54, was testifying about welfare abuses in Mississippi and allegations that he and others used Temporary Assistance for Needy Families state funds for personal and corporate gains. Favre, who earned about $140 million during a 20-year NFL career that ended in 2010, said in his statement that he was unaware he was receiving welfare funds and was misled by public officials.

A Mississippi state audit found that $5 million in TANF funds paid for the construction of a volleyball arena at the University of Southern Mississippi — Favre’s alma mater — and that $1.7 million was paid to Prevacus, a company developing concussion medication. Favre’s daughter was a volleyball player at Southern Mississippi at the time and Favre is an investor in Prevacus, whose founder, Jacob VanLandingham, pleaded guilty to wire fraud in July.

Favre, who has not been charged criminally, repaid $1.1 million in TANF money for speeches he never gave. The Mississippi Department of Human Services filed a civil lawsuit against him and other defendants, citing text messages between Favre and officials as evidence of his involvement in embezzling funds.

Favre, a Green Bay Packers legend, played in more than 300 NFL games and has long advocated research into concussions and resulting brain trauma. Asked on the “Today” show in 2018 how many concussions he suffered, Favre replied that he was diagnosed with “three or four” but believed the true number was far higher.

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“When you have ringing of the ears, seeing stars, that’s a concussion,” Favre said on the show. “And if that is a concussion, I’ve had hundreds, maybe thousands, throughout my career, which is frightening.”

A 2020 study published in the journal Family Medicine and Community Health determined that “regardless of age, sex, socioeconomic status and residence, having suffered a single concussion in one’s lifetime increased the likelihood of later being diagnosed with Parkinson’s disease by 57%.”

“Sadly, I also lost an investment in a company that I believed was developing a breakthrough concussion drug I thought would help others, and I’m sure you’ll understand why it’s too late for me because I’ve recently been diagnosed with Parkinson’s,” Favre told the House committee Tuesday.

Favre was portrayed in court filings in the embezzlement case as a willing participant in the scheme that allegedly diverted millions of dollars meant for the poorest people in the nation’s poorest state.

Court documents and text messages outlined his alleged involvement in diverting TANF money. Favre and then-Mississippi Gov. Phil Bryant discussed via text using $5 million to help build the volleyball arena at Southern Mississippi.

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Favre also exchanged text messages with Nancy New, executive director of the education center responsible for allocating millions in government funds.

“If you were to pay me, is there any way the media can find out where it came from and how much?” Favre reportedly asked her in 2017.

New, who later pleaded guilty to 13 felony counts of fraud, bribery and racketeering for her role in the theft of TANF funds, replied: “We never have that information publicized.”

Journalist Anna Wolfe of Mississippi Today revealed the payouts in a Pulitzer Prize-winning series of articles starting in April 2022.

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