4th death in Legionnaire’s outbreak tied to NC state fair

iStock(FLETCHER, N.C.) — Four people have died from a Legionnaire’s outbreak tied to a hot tub display at a North Carolina state fair, according to state health officials.

In addition to the deaths, North Carolina’s Department of Health and Human Services reported 133 cases of Legionnaire’s and eight cases of Pontiac fever among people who attended the North Carolina Mountain State Fair in September. Ninety-four people were hospitalized as a result of the outbreak.

Legionnaire’s is usually caused by inhaling air contaminated with the bacteria Legionella, which can grow in moist environments like cooling towers, swimming pools and plumbing systems.

It’s considered to be a severe form of pneumonia, with symptoms including headache, muscle ache, fever and coughing that can produce mucus and blood, according to the Mayo Clinic. The disease is not contagious and cannot spread from person to person.

Legionella can also cause Pontiac fever, which is milder than Legionnaire’s and typically clears up within a few days.

Health departments reported roughly 7,500 cases of Legionnaire’s disease in the United States in 2017, according to the Centers for Disease Control and Prevention, although that number is likely low since many cases go undiagnosed.

In August, one woman was killed and dozens were sickened in a Legionnaire’s outbreak linked to a water cooling tower and decorative fountain in an Atlanta hotel.

Hot tubs that are not regularly cleaned and disinfected can become breeding grounds for Legionella, according to the CDC.

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Baby who weighed less than 1 pound at birth heads home after 150 days

Ebonie Bender (PHOENIX) — Four-month-old Kallie Bender’s life has been full of firsts.

There was her first bottle. Her first bath in a “big girl” tub. The first time she could fit into newborn clothes.

Those might seem like typical milestones for any newborn, but for this baby, born at just 25 weeks gestation and weighing less than 1 pound, it’s nothing short of a miracle.

And Monday is the sweetest first of all: baby Kallie is headed home for the first time.

She was born on May 24, 2019, 15 weeks early and one of the smallest babies ever born at Dignity Health St. Joseph’s Hospital & Medical Center, the Phoenix, Ariz. hospital told Good Morning America.

Her mom, Ebonie Bender, was admitted to the hospital when she found out Kallie was measuring small during an ultrasound appointment. There was also a lack of fluid around the baby, caused by a condition called absent end diastolic flow, the hospital said.

In addition to being a micro-preemie, Kallie also survived a successful heart procedure for a patent ductus arteriosus (PDA), a common heart defect among babies born as early as she.

“She’s a feisty girl,” Bender told GMA.

Kallie’s mom was “scared” at the time of her birth,” she said. “It was so much fear of the unknown.”

For several weeks after her birth, Kallie relied on a machine to help her breathe. She was intubated and needed to learn to eat.

Dr. Vinit Manuel, medical director of the nursery intensive care unit (NICU) at Dignity Health St. Joseph’s Hospital and Medical Center, told GMA that the hospital’s NIDCAP — Newborn Individualized Developmental Care and Assessment Plan — is a teaching program for other NICUs in Arizona.

It “looks at each baby as an individual,” he said. From the delivery room to pharmacists to the nurses to the occupational and physical therapists, he said, the team works together to meet each baby’s needs.

However, Manuel said, “No technology can replace the womb.”

For that reason, he said, “the involvement of the family in the care of these babies is crucial.”

The Benders, who have have three sons in addition to baby Kallie, were “very involved from day one. They were by her bedside, reading to her. It’s not possible to quantify, but research shows it’s very important for the baby’s development.”

For the nurses dedicated to her care, seeing Kallie go home is a joy.

“We’re thrilled that after nearly five months Kallie is going home with he family,” said Becky Cole, one of Kallie’s primary nurses. “We’ve loved being able to watch her grow and are excited for her to celebrate many milestones in the future with her parents and brothers.”

Today, Kallie weighs over 7 pounds and is thriving.

“It’s bittersweet to leave,” her mom told GMA. “But she’s an amazing little fighter and I can’t wait to see the personality she brings to our family.”

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Study finds two-thirds of moms aren’t following steps to prevent infant deaths

monkeybusinessimages/iStock(NEW YORK) — Most new parents have, at one point or another, heard about safe sleep practices to help reduce the chance of sudden infant death syndrome (SIDS).

But a new study, published in the journal Pediatrics, finds that up to two-thirds of moms aren’t following these steps to prevent infant deaths.

ABC News’ Chief Medical Correspondent Jennifer Ashton appears on Good Morning America Monday to discuss the study and ways to protect against SIDS:

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Celebrity nanny offers tips to help parents tackle temper tantrums

mofles/iStock(NEW YORK) — From the “Terrible Twos” to “Threenagers,” parents of toddlers are all too familiar with tantrums.

But what if there were ways to help stop them before they start?

Watch the video below to hear tips from celebrity nanny Connie Simpson on how to prevent kids from throwing tantrums and how to stop them once they start:

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A quarter of US health care spending is waste, report says

iStock(NEW YORK) — The Department of Health and Human Services and the Centers for Medicare and Medicaid Services reported that U.S. health care spending hit $3.5 trillion in 2017, a 3.9% increase from 2016.

But those increases in spending don’t necessarily translate to better care, because there is a tremendous amount of waste, and a majority of the spending may be tied up in trying to make healthcare more affordable to the patients, according to a new study published in the Journal of the American Medical Association.

The study, by Dr. Natasha Perekh from the University of Pittsburgh School of Medicine and representatives of Humana Health Care, estimates that the annual costs of waste in the health care system ranges from $760 billion to $935 billion.

They claim waste accounts for a quarter of all health care spending.

This waste comes from unnecessary hospital visits, fraud, hospital-related complications, poor outpatient treatment, brand-name medications, and overly aggressive care, to name a few things, the study says.

The highest burden of waste came from administrative costs. Researchers speculated that, ironically, these costs might be resulting from insurance companies’ attempts to lower waste. Does such high waste mean our health care system broken? Can we fix it? And most of all, have our attempts at fixing it made things worse?

Administrative complexities wasted $265 billion annually, the report said. Administrative complexities refer to behind-the-scenes administrative tasks, such as billing, completed by physicians and insurance companies. Government agencies and insurance companies mandate many of these tasks.

“In payers’ [insurance companies, Medicare, Medicaid] attempts to lower costs with measures like requiring prior authorizations for certain medications or procedures, there has actually been an increase in costs on the providers’ [physicians, nurse practitioners] side,” Dr. William Shrank, Chief Medical Officer at Humana and lead author of the study, told ABC News.

Thus there has been a mismatch between insurance companies and health care providers on what will actually decrease costs. This discrepancy has increased waste.

The second-highest category of waste was the high prices of medications, lab tests, imaging, and office visits, which led to $240 billion in waste. Study authors commented that prices are much higher than they need to be due to a lack of transparency and competitive markets in US health care. To this, Shrank states, “No single policy change will address this. We need a thoughtful policy approach to allow the market to function competitively.”

While the results may seem dismal, the study offers an optimistic outlook. In addition to the loss of money, researchers found potential opportunities for saving.

Interventions to decrease hospital-acquired infections and ensure that people have outpatient treatment set up before they leave the hospital already occur. They can be further optimized to reduce waste. Integration of behavioral and physical health, disease prevention initiatives, and expansion of hospice access can also help. The study estimated $191 to $282 billion in potential savings.

Shrank is hopeful about the state of the health care system. “Considering that we have so many good things in our health care system, if we take a more active role to eliminate waste, address affordability, and improve care, we don’t need to fundamentally disrupt the health care system,” he said.

Dr. Saumya Bhutani is a resident in psychiatry in New York working with the ABC News Medical Unit.

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27-year-old New York City mom dies after going into hospital to have cyst removed

peterspiro/iStock(NEW YORK) — A young New York City mother died at a local hospital after going in for what was meant to be a simple procedure, according to her family and their attorney.

Rosemary Abreu, 27, went to Lincoln Hospital, in the Bronx, to have a cyst in her left thigh removed on Sept. 21, attorney Sanford Rubenstein told ABC News on Saturday.

However, the procedure at some point went awry, and Abreu went into cardiac arrest, according to Rubenstein, who noted that he believes she went into cardiac arrest on the operating table.

Abreu was pronounced dead the next day.

She’s survived by her mother and her two daughters, a 2-year-old and a 9-year-old.

Her family is now seeking $50 million in damages from the Bronx hospital and New York City Health + Hospital.

“This is tragic and unacceptable,” Rubenstein said. “A single mother of two young girls should not die under these circumstances. … She went in for a simple procedure which was to remove a cyst in the left thigh.”

Rubenstein said Abreu was in perfectly good health otherwise. He believes the hospital either administered too much anesthesia or the administration of the anesthesia was improperly monitored.

Abreu’s mother, Dorah Restituyo, was overcome with emotion Friday at a press conference.

“They killed my daughter. They killed her. I don’t know why. I don’t know what happened to my daughter,” Restituyo said.

New York City Health + Hospital did not immediately respond to requests for comment from ABC News.

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A healthy diet might help college-age adults manage depression

iStock/Thinkstock(NEW YORK) — A new study has found that a 3-week dietary intervention, including cutting down on processed foods, could decrease symptoms of depression in younger adults.

The research suggests that for younger adults – including busy college students – changes in diet can be helpful in managing depression during a critical period of development, while offering myriad other health benefits. The study was published by researchers at Macquarie University in Sydney, Australia, in the journal PLoS One.

“The literature now strongly suggests that poor diet quality is associated with an increased risk of depression,” the study said. “Diet is therefore a modifiable risk factor for depression, which would be a good target for early intervention.”

While past research has focused on observing people’s diets and their moods, this study used randomized controlled trials where people are put into groups and one group receives an intervention.

The design allowed researchers to link changes to the controlled intervention. However, since the controlled group received significant attention, that factor might have also contributed to an alleviation of depression.

Still, the young adults’ ability to stick to the diet shows us that it wasn’t just additional support that led to benefits.

Some 17.3 million adults suffered from depression in 2017, and the age group with the most cases of depression were adults between 18 to 25, according to the National Institutes of Mental Health.

The study recruited adults with depression with an average age of 19. Half of the adults received dietary guidance from a registered dietician via an instructional video and were told to eat a modified Mediterranean-style diet with increased servings of vegetables, fruits, wholegrain cereals, protein, unsweetened dairy, fish, nuts and seeds, olive oil, and spices. They were instructed to decrease their consumption of refined carbohydrates, sugar, fatty or processed meats and soft drinks.

The group received sample meal plans and recipes, a small hamper of food items and were reimbursed up to $60 for grocery costs. During the three weeks of the study, they received two phone calls to check in and see how their diets were going.

The other half of the adults with depression received nothing and maintained their usual diet.

Three weeks later, researchers evaluated the depression of all subjects. They also checked that the group on the diet stuck to it by asking all the young adults about their eating patterns. Researchers kept them honest by using a special device that measures the levels of chemicals originating from fruits and vegetables in the skin.

The group that received dietary guidance had a healthier diet and reported feeling less depressed. When researchers checked in with some of them three months later, the benefits were still present in some of them.

Michelle Milgrim, a registered dietician and the manager of employee wellness at Northwell Health in New York, noted that a good diet can be helpful through a couple of potential mechanisms.

“Serotonin helps us control our mood. Anti-inflammatory diets – made up of high antioxidant foods like vegetables, beans, nuts and fruit as well as few refined sugars – protect the brain from oxidative damage,” she said.

Dr. Timothy Kreider, assistant professor of psychiatry at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, who specializes in treating adults in this age group, said that diet may complement treatment with therapy and medication.

“Indirectly, a healthful diet makes you feel more energetic. More energy will increase your social and physical activity, and being more active is a key step in recovering from depression,” he said.

“Do we know what specific diet will treat depression? No, I don’t think we have solid evidence for that yet, but I’d love to see some,” Kreider said.

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On 1st National Period Day, youth group shines spotlight on ‘tampon tax’

Chistina Garcia(NEW YORK) — “Menstrual hygiene is a right, not a privilege.”

That’s the message that youth activists hope to take nationwide for the first National Period Day, Oct. 19, as they campaign to end the tax on menstrual hygiene products.

Rallies are taking place on Saturday across all 50 states, where women are gathering in hopes of shifting a culture of silence around periods and demanding policy changes that will help inch toward an economy of gender equity.

What is the tampon tax?

Right now, 35 states still have the “tampon tax,” a catchy nickname for the sales tax imposed on tampons and other menstrual products, since they are considered non-essential goods. Though there is no specific tax for those products, products like pads, liners and cups are all subject to taxes as non-essential items in many states. Viagra, Rogaine, lip balms and candy, meanwhile, are considered basic necessities and are exempt from sales tax in some of these same states.

Critics of the tax have said this is an injustice that needs to be corrected.

Take 21-year-old activist Nadya Okamoto, who has been vocal in the movement to push legislators to eliminate the tampon tax.

“Menstrual hygiene is a right, not a luxury, and the tampon tax tells us that it’s essentially a luxury,” Okamoto told “GMA.” “That assumption is one of our biggest barriers in front of us, so we need to take that down so we can continue to fight for menstrual equity.”

At just 16, Okamoto founded Period, a non-profit organization. It’s now the largest youth-run NGO in women’s health.

In 2014, Okamoto’s family experienced legal homelessness after her mother left her job. Okamoto’s commute to school went from 20 minutes to more than two hours. On her journey through downtown Portland, she said she would often pass by homeless shelters where she made conversation with some of the women she met. It was there where she learned about period poverty, the lack of access to menstrual hygiene resources.

Ever since then, she “became obsessed with periods,” she said.

As she researched the topic more and learned about issues people face regarding menstruation, the tampon tax stuck out to her.

“Advocating against the tampon tax and once and for all getting our government to actually recognize menstrual products as a necessity is really important,” Okamoto told “Good Morning America.”

From there, she added, they can work on solving other problems, from providing “freely accessible period products in schools, shelters and prison,” to getting benefit programs to cover feminine hygiene products that many don’t currently cover.

For example, federal assistant programs like the Special Supplemental Nutrition Program for Women, Infants and Children, aka WIC, don’t include access to menstrual hygiene products.

A common hurdle in this legal fight, Okamoto said, is that “often cisgender male legislators” either don’t understand the issue or are hesitant to talk about periods in a public setting.

“So a big part of this fight is just getting the culture ready to talk about periods,” she explained. “So legislators can come out and speak freely about it without having to think they’re the ones who have to do all the heavy lifting on destigmatizing menstruation.”

Momentum to repeal the tampon tax

In recent years there has been momentum to repeal the tax. States like Connecticut, Maryland, Massachusetts and New Jersey passed laws to eliminate the tax. In this past year, progress has been made in Rhode Island where the tax was eliminated in their budget effective in June of this year, and in California where a budget bill is passed in which period products were exempt from a tax for two years.

Democratic California Assemblymember Cristina Garcia said she’s pushing Gov. Gavin Newsom to permanently extend a tax exemption on menstrual products.

When she first came up with the proposal she said people dismissed it and made fun of her. “People would say, ‘Oh, it’s going to be a bloody fight,’ and they started calling me the tampon lady,” Garcia told “GMA.”

Opponents have said the main problem is the loss in revenue.

Katherine Loughead, a policy analyst at the Tax Foundation, a think tank based in Washington, told “GMA” that abolishing the tampon tax may force governments to apply higher sales tax rates to other items.

In large states like California and Texas, taxes on menstrual products alone can generate more than $20 million annually. To make up the difference, lawmakers have suggested raising taxes on alcohol and tobacco. But no change has been made.

The danger of creating so many exemptions is that “ultimately it leads to a slippery slope, where do we draw the line? There’s a lot of things that are a necessity to other people,” Loughead said.

However, Garcia argues if people were able to keep the taxed money, they could spend it on other taxed products, thus adding to the state’s tax revenue.

“But more importantly, my uterus should not be used in balancing the budget,” she said.

As it turns out, this issue is not unique to the U.S.

Half of the European Union countries still impose a value-added tax, or VAT, rate on menstrual hygiene products although some have reduced that rate. Other countries, including Australia, India and Canada, have abolished the policy.

At the end of the day, Garcia said, this fight is about much more than tax revenue or the affordability of period products — it’s about the larger conversation of equality under our system and how we as a society value a woman’s body.

Copyright © 2019, ABC Audio. All rights reserved.

Boston hospital’s mock safe-injection site: ‘This is a medical procedure’

Massachusetts General Hospital(BOSTON) — Friday marked the final day of a mock safe-injection site in Boston designed to familiarize the public with what a potential facility might look like.

“We want to demystify safe-injection sites and give the public a sense that this is a medical procedure, like anything else,” Dr. Mark Eisenberg, a primary care physician and assistant professor of medicine at Massachusetts General Hospital, who oversaw the event, told ABC News.

Safe injection sites, where drug users can inject in hygienic facilities, under supervision, are currently illegal in the United States.

After a ruling by a federal judge in Philadelphia earlier this month, which found that a nonprofit with plans to open a site in the city did not violate federal law, has renewed interest in the idea.

Eisenberg thinks the Philadelphia ruling might have piqued the public’s interest in the Boston-based demonstration, which was far better attended than similar events in years past.

The demonstration was set up in a health center in the Charlestown neighborhood of Boston and featured a table equipped with a mirror, water and sterile equipment. The three-day event drew dozens of curious attendees, including members of the community, legislative aids and representatives from a local district attorney’s office.

In addition to Philadelphia, cities like Seattle, Denver, San Francisco and New York all have nascent plans to open their own sites. In Massachusetts, there’s an ongoing battle between the mayor of Somerville, who supports a supervised injection site in his city and Gov. Charlie Baker, who staunchly opposed them.

While offering a place for people to use drugs might seem counterintuitive, public health experts have said that the sites reduce the spread of infectious disease and connect drugs to the health care system.

The issue is personal for Eisenberg, who’s had dozens of patients die of drug overdoses during his years working as a primary care physician. The reality is that people use drugs, he explained, and the goal is to is to give people the option to avoid using under unsafe conditions, such as in a bedroom or alleyway.

It’s not enabling drug use, Eisenberg added: “We are enabling people to stay alive.”

Copyright © 2019, ABC Audio. All rights reserved.

Congresswoman called ‘period lady’ wants all women to have access to period products

Office of Congresswoman Grace Meng(NEW YORK) — A New York congresswoman known as the “period lady” for her work on ending period poverty has proven critical in enacting changes so that girls in schools and women in prisons and homeless shelters can have free access to pads and tampons.

Rep. Grace Meng is still fighting for more, trying to create a world where menstruation is not stigmatized and period products are not seen as luxury items but necessities that should be accessible and, in many cases, free.

“I think almost everyone can relate or remember a situation where you were in a public space and you got your period and you didn’t know what to do because either you didn’t have money or you or you weren’t near a drugstore,” Meng, a Democrat who represents Queens, New York, told ABC News’ Good Morning America. “These are not luxury products that we choose to use for ourselves and they should be just as available as toilet paper is and paper towels in a bathroom.”

Meng’s activism on the issue all started with a letter from a high school girl who lived in her congressional district and wrote to her concerned that women in homeless shelters did not have access to tampons and pads.

“When I first started studying up on this issue I sort of just assumed, OK, this affects people in underdeveloped countries and how can we help girls who have to skip school,” said Meng. “Then the more I learned about it, I realized that it’s happening to people right here in our country and right here in [New York City].”

“I realized there really was a sort of injustice about how girls and boys are being treated, especially in the lens of menstrual equity and just the basic human right of being able to access these products that affect a majority of our population,” she said.

Women make up more than half of the population in the United States, according to the Census Bureau. They are also more likely than men to live in poverty, and they spend an average of 2,535 days in their lifetime, or almost seven years, on their periods, according to UNICEF.

A survey released this year of low-income women in St. Louis, Missouri, found nearly two-thirds couldn’t afford menstrual hygiene products in the past year, and more than one in five said they had the same problem every month. The women said they instead had to use cloth, rags, tissues, toilet paper and sometimes diapers or paper towels, according to the report published in Obstetrics & Gynecology.

It is those stories that Meng said she hears too often and which motivate her to make menstruation equity a priority in Congress.

“In this great country, there should not be anyone who is not able to access these products for a human bodily function that they have no control over,” she said. “Access to these products should not depend on your income level or your status in life.”

From a high school student’s letter to changing federal prisons

Meng, a mother of two sons, learned after receiving the letter from her high-school-age constituent that federal grants provided to homeless shelters in New York City prohibited the shelters from purchasing and distributing menstrual products.

She wrote a letter to the Obama administration asking for help, and soon after the Federal Emergency Management Association (FEMA) announced it would allow homeless shelters to use federal grant money to buy the products.

Up next, Meng took on the federal prison system after she heard stories of women in prison having to ration out their menstrual supplies with their cellmates or having to use limited funds in their commissary accounts to buy tampons and pads.

Meng again wrote a letter to the Obama administration asking for menstrual products to be free in federal prisons, but it was close to the 2016 election and the end of President Obama’s second term.

When President Donald Trump was elected in 2016, Meng said she was “concerned” about the future of her request, but the Trump administration expressed its support.

Free menstrual products for inmates at federal prisons was included in the bipartisan First Step Act that Trump signed into law last December.

“Obviously people in both parties menstruate and know people who get their periods,” said Meng of the bipartisan support she sees on the issue. “Quite frankly, I find that a lot of people just haven’t thought about this issue and once they hear and learn about this issue are willing to support and help alleviate these situations.”

Meng is now pressing governors to increase access to menstrual products in state and local prisons and questioning the Trump administration on their protocols for making sure female migrants at the border have access to menstrual products and showers.

She is also pushing to require that federal buildings, including the building where her office sits in the U.S. Capitol, have free supplies. It was only this year that House members became allowed to use their budget to purchase menstrual products for their offices.

Meng’s “Menstrual Equity for All” bill also proposes changes like requiring corporations of 100 employees or more to provide free menstrual products to employees. Her “Menstrual Products Right to Know” bill would make tampons and pads just like most other products where manufacturers are required to list out their ingredients.

Both of those bills are still pending in the House, while legislation she worked on in the last Congress that would allow people to use health savings accounts to buy menstrual products passed the House but was never taken up in the Senate.

“[One] big hurdle that we are still trying to overcome is that this, in most cases, is not a life or death issue,” said Meng. “So especially in this unpredictable political climate [it] might not necessarily be the first priority issue that is on the minds of people but we definitely want to make it a priority.”

“I don’t mind being called ‘the period lady’”

Poor menstrual hygiene does pose health risks for women, including reproductive issues and urinary tract infections.

The taboo around menstruation and the lack of access to menstrual products also hurts women economically because it costs them money for products and may keep them from jobs and school, advocates say. It also sets women back mentally and in a society where something that happens to them naturally is demeaned or even not discussed.

“Most of us have been conditioned for all of our lives to not talk about menstruation,” said Jennifer Weiss-Wolf, a lawyer and author of Periods Gone Public. “And the things that keep us potentially from succeeding are often the things that happen to be what we don’t talk about in polite society.”

“All the ways our bodies work just the way they’re supposed to we don’t talk about because we haven’t truly valued women and girls,” said Weiss-Wolf, who took up the issue of menstrual equity after teen girls in her community posted on Facebook seeking tampon donations for a food pantry.

Weiss-Wolf, also the co-founder of Period Equity, a law and policy organization fighting for menstrual equity, said the needle has moved in talking publicly about menstrual equity with celebrities including Sophia Bush, Gina Rodriguez and Meghan, the Duchess of Sussex, taking on the issue.

A documentary short on menstruation even won an Oscar this year.

Weiss-Wolf credits Meng with elevating the discussion in a “really productive and responsible and meaningful way.” The two have worked together on issues like eliminating the so-called “tampon tax” that still exists in more than 30 states in the U.S.

“Congresswoman Meng really does stand out,” she said. “She’s’ been extraordinarily creative in thinking about what federal levers can be pulled.”

Meng, who took office in 2013, said she doesn’t mind being called the “period lady” by her colleagues or the public, saying, “If it helps me be able to talk about the issue and educate people around me, then I don’t mind being called that.”

She noted that growing up in a middle-class household, she never knew about the issues of period poverty or menstrual equity, but she did learn from a young age the stigma of having a period.

“I don’t want to, as I [did when I] grew up, feel like I have to hide my product up my sleeve as I’m walking through the halls of school or the office toward the bathroom,” Meng said. “This is a natural part of being a human being and I don’t want people to be ashamed of it.”

“What’s been so inspiring is that anywhere I go, I will run into people, mostly women, who come up to me and these are women of all different ethnic backgrounds or come from different professions or are students or grandmothers,” she said. “They tell me how much they appreciate our work on this subject and a lot of them tell me they never thought about this issue before and how it impacts so many people in this country.”

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