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Measles is a highly contagious virus with a primary case reproduction number (i.e., the average number of secondary cases per case patient) of 12 to 18. It is currently spreading rapidly owing to reduced measles vaccination coverage, which is due primarily to the disruption of local immunization programs by the coronavirus disease 2019 (Covid-19) pandemic and of growing vaccine hesitancy.1 Since 2024, all World Health Organization (WHO) regions have reported increased numbers of measles cases, with 395,521 laboratory-confirmed measles cases reported in 2024 and 16,147 reported during the first 2 months of 2025.2 Patients in more than half the reported cases were hospitalized, so the true number is probably much higher.3
This review covers clinical presentations and complications of measles, current recommendations, and the epidemiologic background of measles. It also addresses the current debates on immunization and the treatment of measles and presents information on the origins of the various measles vaccines and updates on measles diagnostic testing and molecular genotypes.
Importance: The US Supreme Court decision Murphy v National Collegiate Athletic Association allowed states beyond Nevada to legalize sports betting, including online wagers. How sports betting has evolved and its association with gambling harms has not been studied.
Objective: To describe how US sports betting evolved after Murphy v National Collegiate Athletic Association and offer insights into the potential health effects of sportsbooks, which are platforms for wagering on sporting events.
Exposure: Enactment of (1) Murphy v National Collegiate Athletic Association nationally and (2) the opening of retail or online sportsbooks in states.
Design, setting, and participants: In this longitudinal study, aggregate US internet search trends for gambling addiction and wagers on sports were described before and after the emergence of legalized sportsbooks.
Main outcomes and measures: Internet searches per 10 million queries that mentioned gambling and addiction, addict, anonymous, or hotline (such as gambling addiction hotline) made to Google from January 1, 2016, through June 30, 2024.
Results: The number of states with operational sportsbooks increased from 1 during 2017 to 38 during 2024. Total sports wagers increased from $4.9 billion during 2017 to $121.1 billion during 2023, with 94% of wagers during 2023 being placed online. There were 23% (95% CI, 15%-30%) more searches nationally for gambling addiction help-seeking after Murphy v National Collegiate Athletic Association. Massachusetts (47%; 95% CI, 21%-79%), New Jersey (34%; 95% CI, 21%-45%), New York (37%; 95% CI, 26%-50%), and Pennsylvania (50%; 95% CI, 35%-66%) each had more searches than expected after the opening of any sportsbooks in their state. Additional analyses suggest the opening of online, vs retail, sportsbooks corresponded with a larger increase in searches.
Conclusions and relevance: The results of this time series study suggest that access to sportsbooks, sports wagers, and potential help-seeking for gambling addiction increased substantially and highlight the need to address the health implications of sportsbooks, including recognition and treatment of gambling problems and their broader societal implications.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 2019 (COVID-19), has spread globally in a few short months. Substantial evidence now supports preliminary conclusions about transmission that can inform rational, evidence-based policies and reduce misinformation on this critical topic. This article presents a comprehensive review of the evidence on transmission of this virus. Although several experimental studies have cultured live virus from aerosols and surfaces hours after inoculation, the real-world studies that detect viral RNA in the environment report very low levels, and few have isolated viable virus. Strong evidence from case and cluster reports indicates that respiratory transmission is dominant, with proximity and ventilation being key determinants of transmission risk. In the few cases where direct contact or fomite transmission is presumed, respiratory transmission has not been completely excluded. Infectiousness peaks around a day before symptom onset and declines within a week of symptom onset, and no late linked transmissions (after a patient has had symptoms for about a week) have been documented. The virus has heterogeneous transmission dynamics: Most persons do not transmit virus, whereas some cause many secondary cases in transmission clusters called “superspreading events.” Evidence-based policies and practices should incorporate the accumulating knowledge about transmission of SARS-CoV-2 to help educate the public and slow the spread of this virus.
Spending time in natural environments can benefit health and well-being, but exposure-response relationships are under-researched. We examined associations between recreational nature contact in the last seven days and self-reported health and well-being. Participants (n = 19,806) were drawn from the Monitor of Engagement with the Natural Environment Survey (2014/15-2015/16); weighted to be nationally representative. Weekly contact was categorised using 60 min blocks. Analyses controlled for residential greenspace and other neighbourhood and individual factors. Compared to no nature contact last week, the likelihood of reporting good health or high well-being became significantly greater with contact ≥120 mins (e.g. 120-179 mins: ORs [95%CIs]: Health = 1.59 [1.31-1.92]; Well-being = 1.23 [1.08-1.40]). Positive associations peaked between 200-300 mins per week with no further gain. The pattern was consistent across key groups including older adults and those with long-term health issues. It did not matter how 120 mins of contact a week was achieved (e.g. one long vs. several shorter visits/week). Prospective longitudinal and intervention studies are a critical next step in developing possible weekly natureexposure guidelines comparable to those for physical activity.
