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A new study ranks the US counties at highest risk of a measles outbreak, with the areas surrounding Chicago, Los Angeles and Miami topping the list.The authors say places like these should be kept under close surveillance because they "could serve as the fulcrum of continuous importation of the measles virus into the USA." Their paper was published Thursday in the journal 387

A wedding was underway at a New Hampshire church when a shooting Saturday morning wounded at least two people, Pelham Police Chief Joseph Roark said.A suspect has been arrested in the shooting at the New England Pentecostal Church, Roark said. He did not identify the suspect or provide a motive, saying the incident is still under investigation.Roark confirmed two people with gunshot wounds were taken to hospitals, but their conditions were not immediately known. There were no fatalities, he said.Local and state authorities, including the New Hampshire State Police and representatives from the state Attorney General's Office, are on the scene, Roark said.Lowell General Hospital has received one patient from the incident, hospital spokesperson Angela Strunk tells CNN. There is no word on the extent of the individual's injuries, Strunk says. The hospital is not expecting any other patients from the incident.Minister was shot and killed 2 weeks agoA memorial service scheduled for early Saturday afternoon at the church was canceled after the shooting, attendee Geraldo Pagan said."We just came and we found all this police, all this chaos here, and they tell us that the activity will be canceled," Pagan told news media outside the church.The service was for Luis Garcia, 60, a minister at the New England Pentecostal Ministries for six years, who was shot and killed October 1, according to WMUR. 1422

A Northeast Ohio school district is trying to make sure students never go hungry or feel embarrassed if they can't pay for lunch.According to the School Nutrition Association, about 75 percent of school districts reported having unpaid student meal debt at the end of the 2016-2017 school year. That means sometimes kids are singled out and given an alternate lunch because they are out of money.Avoiding alternate lunches and embarrassmentJan Williams started in food service as a line worker, and the policy where she worked stated that if students couldn't pay, workers had to take away their lunches."I couldn't do that, so a lot of times I would just reach into my own pocket. I would pay for their lunch," Williams said. "Most of the other employees that I worked with would do the same." 806

After nearly a decade when US drug overdose death rates were higher in rural parts of the country, drug death rates have shifted to be higher in urban areas, according to a new analysis from the US Centers for Disease Control and Prevention's National Center for Health Statistics.Researchers found that from 1999 through 2003, drug overdose death rates were higher in urban counties than in rural counties. Then, from 2004 through 2006, overdose mortality rates in rural and urban counties were similar. In 2007 through 2015, overdose mortality rates were higher in rural counties than in urban counties. But in 2016 and 2017, urban counties once again had higher rates of drug overdose fatalities.While urban counties had higher rates of overdose deaths involving heroin, cocaine and synthetic opioids such as fentanyl in 2017, rural counties had higher rates of overdose deaths involving prescription opioids such as morphine, codeine, hydrocodone and oxycodone.The overdose death rate related to stimulants such as methamphetamine and amphetamines was 4 per 100,000 in rural counties, higher than the rate of 3.1 per 100,000 in urban counties.In 2017, There were 5.2 heroin-related overdose deaths for every 100,000 people in urban counties, whereas rural counties had a rate of 2.9 heroin-related fatalities for every 100,000 people.In urban counties, the rate of overdose deaths from synthetic opioids such as fentanyl, fentanyl analogs and tramadol was 9.3 per 100,000; and in rural counties that rate was 7 per 100,000. Death rates involving cocaine were also higher in urban counties, with a rate of 4.6 per 100,000, compared to 2.4 per 100,000 in rural counties.But, Dr. Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at Johns Hopkins, said it was important to not make too much of the distinction between rural and urban areas. "It's important not to lose the forest from the trees here," he wrote in an email to CNN. "Overall the trends and rates are much more similar than they are different between these communities."Alexander noted that the increased overdose rate in urban areas "is attributable to the greater use of heroin and illicit fentanyl in these settings.""The data demonstrate continued increases in mortality through 2017, and they underscore that the epidemic has had a profound impact in rural and urban areas alike," he added.Drug overdose deaths in the United States declined 5.1% in 2018, according to preliminary data released in July by the US Centers for Disease Control and Prevention's National Center for Health Statistics. Researchers estimate there were 68,557 drug overdose deaths in 2018, and 47,590 involved opioids. 2702

AHMEDABAD, INDIA — President Donald Trump has opened a whirlwind 36-hour visit to India by basking in the adulation of a massive, colorful crowd at a cricket stadium in the western city of Ahmedabad. Trump and Indian Prime Minister Narendra Modi lavished praised on each other during back-to-back speeches to thousands of revelers packed into the stadium in 80-degree heat. It was the biggest rally crowd of Trump's political career. Trump's visit is meant to reaffirm U.S.-India ties strained by trade disputes. But it's also providing enviable overseas imagery for a president in re-election mode. 613

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