Richard Knox

Since he joined NPR in 2000, Knox has covered a broad range of issues and events in public health, medicine, and science. His reports can be heard on NPR's Morning Edition, All Things Considered, Weekend Edition, Talk of the Nation, and newscasts.

Among other things, Knox's NPR reports have examined the impact of HIV/AIDS in Africa, North America, and the Caribbean; anthrax terrorism; smallpox and other bioterrorism preparedness issues; the rising cost of medical care; early detection of lung cancer; community caregiving; music and the brain; and the SARS epidemic.

Before joining NPR, Knox covered medicine and health for The Boston Globe. His award-winning 1995 articles on medical errors are considered landmarks in the national movement to prevent medical mistakes. Knox is a graduate of the University of Illinois and Columbia University. He has held yearlong fellowships at Stanford and Harvard Universities, and is the author of a 1993 book on Germany's health care system.

He and his wife Jean, an editor, live in Boston. They have two daughters.

Pages

12:46pm

Tue August 27, 2013
Shots - Health News

More Stroke Patients Now Get Clot-Busting Drug

Originally published on Wed August 28, 2013 12:14 pm

A brain scan followed by quick drug treatment in the right patients can stop a stroke in its tracks.
iStockphoto.com

It's been a long and often controversial road, but U.S. doctors are finally embracing a drug that can halt strokes and prevent disabling brain damage.

An analysis of more than 1 million stroke patients shows that use of the 17-year-old drug, called alteplase (brand-name Activase), nearly doubled between 2003 and 2011.

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11:18am

Fri August 23, 2013
Shots - Health News

Another Study Of Preemies Blasted Over Ethical Concerns

Originally published on Fri August 23, 2013 12:09 pm

What should parents be told before their premature infants participate in a clinical study?
iStockphoto.com

For the second time in four months, the consumer group Public Citizen is alleging that a large, federally funded study of premature infants is ethically flawed.

Both complaints raise a big issue that's certain to get more attention beyond these particular studies: What's the ethically right way to do research on the validity of the usual care that doctors provide every day.

The U.S. Department of Health and Human Services will host an unusual forum on that question next Wednesday — stimulated by the sharp questions raised by Public Citizen.

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2:03pm

Wed August 21, 2013
Shots - Health News

Ebola Treatment Works In Monkeys, Even After Symptoms Appear

Originally published on Wed August 21, 2013 8:58 pm

The Ebola virus forms threadlike structures under the microscope.
Cynthia Goldsmith CDC

Ebola, your days as one of the world's scariest diseases may be numbered.

A team of U.S. government researchers has shown that deadly Ebola hemorrhagic fever can be vanquished in monkeys by an experimental drug given up to five days after infection — even when symptoms have already developed.

An antibody cocktail aimed at Ebola's outer surface rescued three of seven macaques infected with lethal doses of the hemorrhagic virus in the U.S. Army's high-security labs at Fort Detrick, Md.

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5:27pm

Mon August 19, 2013
Shots - Health News

Lyme Disease Far More Common Than Previously Known

Originally published on Mon August 19, 2013 6:58 pm

Black-legged ticks like this can transmit the bacterium that causes Lyme disease.
CDC

The Centers for Disease Control and Prevention says 300,000 Americans are getting Lyme disease every year, and the toll is growing.

"It confirms what we've thought for a long time: This is a large problem," Dr. Paul Mead tells Shots. "The bottom line is that by defining how big the problem is we make it easier for everyone to figure out what kind of resources we have to use to address it."

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5:27pm

Wed August 14, 2013
Shots - Health News

Evidence Supports Pill To Prevent Some Prostate Cancers

Originally published on Fri August 16, 2013 8:40 am

The active ingredient in Propecia, a baldness remedy approved by the Food and Drug Administration in 1997, is showing new promise as a way to prevent some prostate cancers.
AP

Researchers say a cheap, generic pill called finasteride prevents almost 40 percent of low-grade prostate cancers without increasing the risk of dying from more aggressive tumors.

New evidence points to the drug as a potentially safer way to deal with prostate cancers that now get more intense treatment. Many prostate cancers that aren't destined to cause men serious health problems are often treated with surgery or radiation.

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3:34pm

Wed July 31, 2013
Shots - Health News

Nurse Charged With Assisting In Her Father's Death

Originally published on Wed July 31, 2013 6:22 pm

Barbara Mancini with her father, Joe Yourshaw.
Barbara Mancini via Compassion & Choices

A Philadelphia nurse has been charged with assisted suicide for allegedly providing her 93-year-old father with a lethal dose of morphine.

Authorities say Barbara Mancini, 57, told a hospice nurse and a police officer on Feb. 7 that she provided a vial of morphine to her father, Joe Yourshaw, to hasten his death.

Mancini and her attorneys acknowledge she handed the medication to her father, but maintain she never said she intended to help him end his life and was only trying to help her father ease his pain — an act they say is legally protected, even if it causes death.

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6:09pm

Mon July 29, 2013
Shots - Health News

Panel Urges Lung Cancer Screening For Millions Of Americans

Originally published on Thu August 22, 2013 2:24 pm

Some images of lung cancer are clear cut. But in many others, a nodule on the screen turns out not to be cancer at all.
iStockphoto.com

A federal task force is planning to recommend that millions of smokers and former smokers get a CT scan annually to look for early signs of lung cancer.

The 16-member US Preventive Services Task Force gives that lung cancer screening test a grade of B, which puts it on the same level as mammography for women between the ages of 50 and 74.

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3:48pm

Fri July 19, 2013
Shots - Health News

HPV Vaccination Might Help Reduce Risk Of Throat Cancers

Originally published on Tue July 23, 2013 4:29 pm

Vaccines against the HPV virus are already used to prevent cervical and anal cancer.
Harry Cabluck AP

A study of women in Costa Rica is raising hope that getting vaccinated against the human papillomavirus, or HPV, could lower the risk of throat cancers.

The research doesn't show that. It would take a much bigger and longer study to do that – if such a study could ethically be done at all.

What this study does show is that among the nearly 6,000 women in the study, those who got vaccinated against two strains of the virus had 93 percent fewer HPV throat infections four years later.

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5:05pm

Thu July 18, 2013
Shots - Health News

For A Long And Healthy Life, It Matters Where You Live

Originally published on Thu July 18, 2013 5:11 pm

It's not just living longer that matters. It's living healthier longer.
iStockphoto.com

It's not just how long you live that matters. It's healthy life expectancy – the additional years of good health you can expect once you hit 65.

And by that measure, a new analysis shows it makes a lot of difference where Americans live.

Hawaiians are lucky in more than their idyllic weather and gorgeous scenery. Seniors there can expect a little more than 16 years of healthy life after 65. Women in Hawaii can expect more than 17 years.

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3:17am

Thu July 18, 2013
Shots - Health News

Tuberculosis Outbreak Shakes Wisconsin City

Originally published on Thu July 18, 2013 7:45 am

Dale Hippensteel, manages the Sheboygan County health department.
Jeffrey Phelps For NPR

Looking crisp and official in his khaki-colored sheriff's department polo shirt, Steve Steinhardt says Sheboygan, Wis., is a pretty good place to be a director of emergency services.

"Nothing bad happens here," he says, knocking on wood. Unless, that is, you count the tuberculosis outbreak that struck the orderly Midwestern city of 50,000 this spring and summer.

"I never expected TB to be one of the bigger emergencies I'd face when I got into this field," Steinhardt says.

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9:04am

Thu June 20, 2013
Shots - Health News

Outbreak In Saudi Arabia Echoes SARS Epidemic 10 Years Ago

Saudi men walk to the King Fahad hospital in the city of Hofuf on Sunday. In eastern Saudi Arabia, where outbreaks of the MERS virus have been concentrated, people have resumed their habits of shaking hands and kissing.
Fayez Nureldine AFP/Getty Images

A detailed analysis of how the disease called Middle East Respiratory Syndrome spread through four Saudi Arabian hospitals this spring reveals disturbing similarities to the SARS pandemic that terrified the world a decade ago.

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3:46pm

Wed June 19, 2013
Shots - Health News

Vaccine Against HPV Has Cut Infections In Teenage Girls

Originally published on Wed June 19, 2013 10:18 pm

A 13-year-old girl gets an HPV vaccination from Judith Schaechter, a pediatrician at the University of Miami, in 2011.
Joe Raedle Getty Images

A vaccine against human papillomavirus — the most common sexually transmitted infection and the cause of almost all cervical cancer — is dramatically reducing the prevalence of HPV in teenage girls.

The first vaccine against HPV, Merck's Gardasil, was approved by the Food and Drug Administration in 2006. Cerverix, from GlaxoSmithKline, was approved in 2009.

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12:53pm

Thu June 13, 2013
Shots - Health News

Prevention Pill Cuts HIV Risk For Injecting Drug Users

The Centers for Disease Control and Prevention says doctors should prescribe Truvada, a once-a-day pill for HIV, to help prevent infections in IV drug users.
Jeff Chiu AP

A once-a-day pill has been proven to lower the risk of getting HIV among needle-using drug addicts, just as it does among heterosexual couples and men who have sex with men.

Among 2,400 injecting drug users in Bangkok, those assigned to take a daily dose of an antiviral drug Viread, or tenofovir generically, had half the risk of getting HIV over a four-year period as those who took a placebo pill. Among those who took tenofovir faithfully, there were 74 percent fewer infections.

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4:31pm

Mon June 10, 2013
Shots - Health News

Triple Threat: Middle East Respiratory Virus And 2 Bird Flus

Originally published on Tue June 11, 2013 8:11 am

Men outside a hospital in Dammam, Saudi Arabia, wear surgical masks as a precaution against infection with a coronavirus.
Stringer Reuters /Landov

The World Health Organization is warning health care workers everywhere to suspect a disease called Middle Eastern Respiratory Syndrome, or MERS, whenever they see a case of unexplained pneumonia.

Monday's warning comes at the end of a six-day WHO investigation in Saudi Arabia, where 40 of the 55 cases of the respiratory disease have occurred. Sixty percent of those people with known infections died.

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8:59am

Thu June 6, 2013
Shots - Health News

NIH Chief Rejects Ethics Critique Of Preemie Study

Originally published on Fri June 7, 2013 8:26 am

National Institutes of Health Director Dr. Francis Collins contested criticism that researchers running a study of premature infants didn't adequately advise parents about the risks.
Charles Dharapak AP

The chief of the National Institutes of Health is disavowing a ruling from the government office that oversees the ethics of human research.

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2:19am

Tue June 4, 2013
Shots - Health News

Obama Administration Seeks To Ease Approvals For Antibiotics

Originally published on Tue June 4, 2013 5:15 pm

These staph bacteria are resistant to vancomycin, an antibiotic that is one of the last lines of defense.
Janice Haney Carr CDC

Every day in hospitals all over America, thousands of patients die of infections that used to be curable. But the antibiotics used to treat them aren't working anymore.

It's called drug resistance, and it's largely a consequence of antibiotics overuse. The more germs are exposed to antibiotics, the faster they mutate to evade being vanquished.

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3:34am

Mon June 3, 2013
Shots - Health News

A Boston Family's Struggle With TB Reveals A Stubborn Foe

Originally published on Tue June 4, 2013 9:10 am

Michelle Williams (center) and two daughters visit the grave of her mother, Judy Williams, at Fairview Cemetery in Hyde Park, Mass., on May 11. Judy died in 2011.
Ellen Webber for NPR

Thanks to gold-standard tuberculosis treatment and prevention programs, cases of TB in the United States have declined every year for the past two decades — to the lowest level ever.

But TB's course through the Williams family in Boston shows that no nation can afford to relax its efforts to find, treat and prevent TB. It's just too sneaky and stubborn an adversary.

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2:15pm

Fri May 31, 2013
Shots - Health News

Young Women With Breast Cancer Opting For Mastectomy

Toborcia Bedgood performs a mammogram to screen for breast cancer at the Elizabeth Center for Cancer Detection in Los Angeles in 2010.
Damian Dovarganes AP

Most women diagnosed with breast cancer when they're 40 or younger are choosing mastectomy rather than more limited and breast-conserving lumpectomy plus radiation, a study of women in Massachusetts finds.

Moreover, most of those choosing mastectomy elect to have the other, noncancerous breast removed, too.

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3:52pm

Thu May 23, 2013
Shots - Health News

Researchers Find Bird Flu Is Contagious Among Ferrets

Of ferrets, men and bird flu.
iStockphoto.com

Scientists have completed the first assessments of how readily the H7N9 flu virus in China can pass among ferrets and pigs. The mammals provide the best inkling of how dangerous these bugs may become for humans.

The news is both bad and good. They've found the new bird virus is easily passed between ferrets sharing the same cage.

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1:57pm

Mon May 13, 2013
Shots - Health News

Middle East Virus Spreads Between Hospitalized Patients

Originally published on Mon May 13, 2013 2:06 pm

The new coronavirus has a crown of tentacles on its surface when viewed under the microscope.
NIAID/RML

It's been eight months since a Saudi Arabian doctor described a previously unknown virus related to SARS. And for most of that time only germ geeks paid much attention.

But in the past few days the new virus — which some would like to call MERS-CoV, for Middle East Respiratory Syndrome Coronavirus — has been making up for lost time.

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2:49am

Wed May 8, 2013
Shots - Health News

Officials Prepare For Another Flu Pandemic — Just In Case

Originally published on Thu May 9, 2013 11:43 am

Scientists in the U.S. are growing the H7N9 virus in the laboratory to help with vaccine development.
James Gathany CDC/Douglas E. Jordan

There's been a buzz of activity at the Centers for Disease Control and Prevention in Atlanta since scientists got their first samples of a new bird flu virus from China four weeks ago.

Already they've prepared "seed strains" of the virus, called H7N9, and distributed them to vaccine manufacturers so the companies can grow them up and make them into experimental flu vaccine.

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3:03am

Thu May 2, 2013
Shots - Health News

Recovery Begins For Mother, Daughter Injured In Boston

Originally published on Fri May 3, 2013 4:19 pm

Celeste Corcoran is transported to Spaulding Rehabilitation Hospital on April 28.
Ellen Webber for NPR

The number of Boston bombing victims still in the hospital dropped to 19 as of Wednesday evening. The great majority have gone home or to a rehab facility.

That's what has happened with Celeste and Sydney Corcoran, a mother-daughter pair who ended up in the same hospital room after being struck down by the first marathon bomb blast.

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3:17am

Wed May 1, 2013
Shots - Health News

Mother And Daughter Injured In Boston Bombing Face New Future

Originally published on Thu May 2, 2013 11:59 am

Celeste Corcoran and her daughter, Sydney, were injured in the Boston Marathon bombings.
Ellen Webber for NPR

Forty-seven-year-old Celeste Corcoran is propped up in her hospital bed. In a nearby window is a forest of blooming white orchids from well-wishers. On the opposite wall, a big banner proclaims "Corcoran Strong."

She's recalling how thrilled she was to be near the finish line of the Boston Marathon, waiting for her sister Carmen Accabo to run by. "I just remember standing there, wanting to be as close as I could to catch her," Corcoran says. "I really just needed to see her face."

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12:04pm

Fri April 26, 2013
Shots - Health News

Failure Of Latest HIV Vaccine Test: A 'Huge Disappointment'

Originally published on Fri April 26, 2013 1:14 pm

The green dots are HIV virus particles on a human white blood cell.
CDC

The largest current study of an AIDS vaccine, involving 2,500 people, is being stopped.

After an oversight committee took a preliminary peek at the results this past Monday, they concluded there was no way the study would show that the vaccine prevents HIV infection.

Nor would the vaccine suppress the wily virus among people who get infected despite being vaccinated.

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4:13pm

Thu April 25, 2013
Shots - Health News

Researchers Find Hormone That Grows Insulin-Producing Cells

Originally published on Thu April 25, 2013 5:04 pm

A microscopy image of a rat pancreas shows the insulin-making cells in green.
Masur Wikimedia.org

The work is only in mice so far, but it sure is intriguing.

A newly found hormone revs up production of cells that make insulin — the very kind that people with advanced diabetes lack.

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5:42am

Fri April 19, 2013
Shots - Health News

With Bird Flu, 'Right Now, Anything Is Possible'

Originally published on Fri April 19, 2013 9:27 pm

A health worker collects pigeons from a trap at People's Square in Shanghai, China, earlier this month. So far, workers have tested more than 48,000 animals for the H7N9 flu virus.
ChinaFotoPress Getty Images

An international dream team of flu experts assembled in China today.

Underscoring the urgency that public health agencies feel about the emergence of a new kind of bird flu, the team is headed by Dr. Keiji Fukuda, the World Health Organization's top influenza scientist.

Before he left Geneva, Fukuda explained the wide-open nature of the investigation in an interview with NPR.

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8:38am

Tue April 16, 2013
Shots - Health News

Boston Doctors Compare Marathon Bomb Injuries To War Wounds

Originally published on Wed April 17, 2013 11:26 am

Medical personnel work outside the medical tent in the aftermath of two explosions near the finish line of the Boston Marathon on Monday. At area hospitals, doctors say they were confronted with the kinds of injuries U.S. troops get in Iraq and Afghanistan.
Elise Amendola AP

Boston hospitals always staff up their emergency rooms on Marathon Day to care for runners with cramps, dehydration and the occasional heart attack.

But Monday, those hospitals suddenly found themselves with more than 100 traumatized patients — many of them with the kinds of injuries seen more often on a battlefield than a marathon.

Like most big-city hospitals these days, Tufts Medical Center runs regular disaster drills, featuring simulated patients smeared with fake blood.

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4:57am

Sun April 14, 2013
Shots - Health News

Scientists Race To Stay Ahead Of New Bird Flu Virus

Originally published on Mon April 15, 2013 9:01 am

Workers prepare an H7N9 virus detection kit at the Center for Disease Control in Beijing on April 3.
AFP/Getty Images

A precious package arrived at the Centers for Disease Control and Prevention last Thursday afternoon.

Inside, packed in dry ice to keep it frozen, was a vial containing millions of viruses derived from a 35-year-old Chinese housewife who died last Tuesday of respiratory and kidney failure.

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3:15pm

Wed April 10, 2013
Shots - Health News

Feds Fault Preemie Researchers For Ethical Lapses

Originally published on Thu April 11, 2013 9:04 am

How much oxygen should severely premature infants receive? A study that sought to answer the question has been criticized for not fully informing parents about the risks to their children.
iStockphoto.com

Federal officials say a large study of premature infants was ethically flawed because doctors didn't inform the babies' parents about increased risks of blindness, brain damage and death.

The study involved more than 1,300 severely premature infants at nearly two dozen medical institutions between 2004 and 2009. The infants were randomly assigned to receive two different levels of oxygen to see which was better at preventing blindness without increasing the risk of neurologic damage or death.

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6:04pm

Fri April 5, 2013
Shots - Health News

Human Cases Of Bird Flu In China Draw Scrutiny

Originally published on Mon April 8, 2013 6:09 pm

A cockerel walks on a bridge in a residential area of Beijing. The Chinese are beginning to destroy thousands of birds in an effort to stamp out the presumed source of H7N9 infection.
Wang Zhao AFP/Getty Images

Sixteen cases of a new flu around Shanghai have touched off a major effort to determine what kind of threat this new bug might be.

The victims range in age from 4 to 87 years old. Six have died. It is a tragedy for them and their families, but is it a global crisis?

To understand why so few cases are generating so much concern, the first thing to know is that no flu virus like this one — called H7N9 — has ever been known to infect humans before.

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