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The caravan of Central American migrants going through Mexico to the US border isn't ending. Instead, its participants will disperse into smaller groups after reaching Mexico City.While some will stay in Mexico to try to get refugee status there, others will continue north to the US border.Organizers of the caravan estimate that some 200 or so people will proceed all the way to the US border in the coming days, although the number could be higher. Last year, about 150 went all the way to the border, they said. 523

The E. coli outbreak linked to romaine lettuce has sickened 43 people in 12 states, the US Food and Drug Administration said Monday.The FDA said that the ongoing outbreak is linked to the "end of season" harvest in some parts of California -- but the agency still says people should not eat any romaine lettuce.People have become sick in California, Connecticut, Illinois, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio and Wisconsin.An additional 22 people in Canada are also ill, so the FDA is coordinating its investigation with the Canadian health and food safety authorities, the agency said.When the outbreak was announced last week, the FDA and the Centers for Disease Control and Prevention warned consumers to stay away from all romaine lettuce, but the FDA said the investigation was focused on California and Mexico."Over the Thanksgiving holiday, the FDA continued to investigate the outbreak," according to a statement from FDA Commissioner Dr. Scott Gottlieb. "Our investigation at this point suggests that romaine lettuce associated with the outbreak comes from areas of California that grow romaine lettuce over the summer months, and that the outbreak appears to be related to 'end of season' romaine lettuce harvested from these areas. The involved areas include the Central Coast growing regions of central and northern California."Lettuce growing and harvesting in the winter months is taking place in California and Arizona's desert regions and Florida, as well as Mexico. Currently, the FDA investigation does not implicate lettuce from any of these areas.While the romaine supply undergoes a "clean break" to ensure all the contaminated lettuce is effectively gone from the market, the FDA has asked producers and distributors to provide clear labeling with the lettuce's date and origin in the future.A task force within the lettuce industry has also been established to determine better solutions for labeling long-term in order to help with tracing."Based on discussions with major producers and distributors, romaine lettuce entering the market will now be labeled with a harvest location and a harvest date," Gottlieb said. "Romaine lettuce entering the market can also be labeled as being hydroponically or greenhouse grown. If it does not have this information, you should not eat or use it."If consumers, retailers and food service facilities are unable to identify that romaine lettuce products are not affected -- which means determining that the products were grown outside the California regions that appear to be implicated in the current outbreak investigation -- we urge that these products not be purchased, or if purchased, be discarded or returned to the place of purchase."Symptoms of E. coli infection, which usually begin about three or four days after consuming the bacteria, can include watery or bloody diarrhea, fever, abdominal cramps, nausea and vomiting, according to the CDC. Most people infected by the bacteria get better within five to seven days, though this particular strain of E. coli tends to cause more severe illness.People of all ages are at risk of becoming infected with Shiga toxin-producing E. coli, according to the FDA. Children under 5, adults older than 65 and people with weakened immune systems, such as people with chronic diseases, are more likely to develop severe illness, but even healthy children and adults can become seriously ill. 3450

The deadliest shooting in Texas history could have claimed even more lives if it weren't for a local resident who confronted the gunman, and another man who helped chase down the shooter.The resident, whose name has not yet been released, ran out of his house barefoot and exchanged gunfire with the shooter before the gunman sped away in a pearl-colored Fort Explorer. The armed resident then hailed a man across the street and got in his truck, telling him to chase down the gunman."I had to catch the guy. I had to make sure he was caught and at that point the gentleman riding with me said you may have to use your truck to get him off the road and there was no hesitation. It was do everything necessary to make sure that this guy is stopped," the motorist, Johnnie Langendorff said.Hear everything Johnnie Langendorff had to say: At a news conference Sunday night, investigators offered a preliminary timeline of the attack at the First Baptist Church in Sutherland Springs and laid out the role the resident played. Langendorff spoke to CNN on Monday.The gunman entered the small church in the rural town east of San Antonio, firing with an assault weapon at the congregation attending the morning service.A local resident grabbed his own rifle and engaged the gunman, said Freeman Martin, the regional director of the Texas Department of Public Safety."The suspect dropped his rifle, which was a Ruger AR assault-type rifle and fled from the church," said Martin."What do you say to the man who stepped up when he heard the gunshots? I'd say he's a hero," Wilson County Sheriff Joe Tackitt Jr. told CNN's Chris Cuomo on Monday. "I don't think there's any question about that. Had he not done what he did, we could have lost more people."He was just driving byLangendorff said he was driving by the church on the way to his girlfriend's house when he saw gunfire between the shooter and the armed resident.Langendorff told CNN that both men had weapons drawn."There was exchange of gunfire. It lasted just a few seconds, and the shooter got in his vehicle and took off," he said.The armed resident opened Langendorff's door, said the gunman shot up the church and urged the driver to step on it."We got to chase him," the man said, according to Langendorff. He said he answered, "Let's go."They gave chase in his truck for 11 miles and called police dispatch to tell them where they were and in what direction they were headed. The chase was 10 to 12 minutes long."The vehicle was in sight and I was picking up, getting closer and closer to it. We hit about 95 (mph) ... trying to catch this guy until he eventually lost control on his own and went off into the ditch," Langendorff told CNN affiliate KSAT."The gentleman that was with me got out and rested his rifle on my hood and kept it aimed at him (the shooter), telling him to get out. There was no movement, there was none of that. I just know his brake lights were going on and off, so he might've been unconscious from the crash or something like that. I'm not sure."Langendorff felt the suspect, who crashed his vehicle near the county line, "just gave up."When police arrived about five minutes later, they approached the suspect's vehicle and found the gunman inside dead of a bullet wound. He was later identified as Devin Patrick Kelley.Asked by CNN what he was thinking at the time, Langendorff said, "Nothing. Get him." Why? "Because that's what you do, you chase a bad guy."The shooting was a horrific tragedy, Langendorff said, but he hopes the families of the victims can sleep better knowing the shooter "was taken care of."And he has no regrets about throwing himself into such a dangerous situation."I hope that everyone affected is able to rest a little better knowing that this guy, he'll never breathe again. It doesn't serve it justice completely. But he won't hurt anyone else ever."Bravery seen at another church shootingLangendorff praised the resident for his quick action and called him "very much a hero."He emerged barefooted, grabbing his gun before he grabbed his shoes."He did absolutely the right thing, which was try to take him down at the scene," he said.The shooting at the church claimed 26 lives.Investigators "are continuing in their efforts as they put all the pieces of a very complex puzzle together to try to provide their community all the answers they need and deserve," Texas Gov. Greg Abbott said.It's the deadliest mass shooting in Texas history -- and the fifth deadliest in modern US history.The Sutherland Springs resident's actions echoed another man's act of bravery during a different church shooting earlier this year in Antioch, Tennessee.As the service at the Burnette Chapel Church of Christ was ending on September 24, a gunman -- whom police identified as 25-year-old Emanuel Kidega Samson -- entered the church with a pair of pistols and started firing. An usher at the church, Robert Engle, sprang into action -- struggling with the suspect, even as he was being pistol-whipped, police said."Mr. Samson didn't expect Mr. Engle to encounter him, to struggle with him, to try to stop the shooting," said Don Aaron, the spokesman for the Metropolitan Nashville Police Department.During the altercation, the gunman accidentally shot himself in the chest with his own weapon, police said.When the gunman fell, Engle, despite his head injuries, ran to his car and came back with a pistol of his own, police said.Engle, who has a permit for a handgun, then made sure Samson stayed on the ground until officers arrived, Aaron said.  5564

The current spike in COVID-19 cases is stressing the testing system across the country.As the virus spreads at unprecedented rates, more Americans are seeking COVID-19 tests. But in recent days, companies that make the tests and the supplies needed for them are struggling to keep up with demand."Those companies were operating on an allocation basis, and that just means that basically everything they make is going out the door," said Kelly Wroblewski, the Director of Infectious Disease Programs at the Association of Public Health Laboratories. "There is no reserve, so there's an increased demand in a lab for testing. There's no more reagent to be had, so to meet that demand, that lab has to use a different manufacturer's test."Wroblewski adds that along with issues in getting supplies, officials are also short on human resources — there is only so much lab capacity and only so many trained people to conduct the tests.The American Clinical Laboratory Association says the surge in demand for testing means some labs could reach or exceed their current testing capacities soon — meaning it could take longer for patients to get PCR test results back.Wroblewski says that it can take currently take anywhere from 24 hours to a week to get PCR test results back.With antigen tests, patients can get results back in less than 30 minutes. There is currently enough of a supply for antigen tests, but not all facilities offer them.Both lab groups stress that COVID-19 testing is important, but patients should be strategic."There's been a lot of emphasis put on testing, but testing is only one piece of the puzzle," Wroblewski said. "It gives you some information, and if you're not going to do anything with that information — whether it be targeted closures. whether it be staying home and isolating — we're not going to stop the spread of disease."As far as getting more tests, it's going to take a while. Wroblewski says it could take up to six months or more to increase production capacity significantly. Labs don't expect to see a ramp-up in supplies until early 2021. 2090

The COVID-19 pandemic has hit people of color particularly hard, and one new study says that may be because of racial disparities in treating high blood pressure.According to the American Heart Association's Scientific Sessions, one-third of disparities in treatment may be the result of racial inequalities in prescribing or increasing the dosage of new medications used in treating high blood pressure.The study found that blood pressure control rates are lower in Black patients compared to other racial groups. Black patients also had more missed opportunities for treatment and missed more clinic appointments."A doctor might think a patient is less likely less able to afford medications, and because of that, they choose to not prescribe a certain medication," said Dr. Valy Fontil, an assistant professor of medicine at UCSF and one of the researchers involved in the study. "Or, they might know this person doesn't have transportation to the clinic, and so sometimes it might even be well-intentioned."Fontil says more standardized treatment protocols would help eliminate the disparities and prevent missed opportunities to get someone the medication they need."Sometimes people present, and the main thing that they're there for is not for the blood pressure," he said. "So, the clinician just sort of kind of might ignore the blood pressure. So automating these sort of standardized treatments would tell the clinician that they — even if the patient's not here for blood pressure — you have to address it in some way."Previous studies have also shown Black patients have more apprehension about why someone is giving them more medication. Fontil says one solution is having the patient be part of the treatment decision making.Fontil adds that the increasing number of virtual visits for blood pressure issues could make the racial disparities even worse. 1876