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    Home prices are hitting new highs again, as high rates put the squeeze on supply

    Home prices hit a record high in May, according to Black Knight.
    Even with rates still high, home prices are setting new records in some markets.
    New listings are down about 25% from a year ago, as homeowners with sub-4% mortgage rates are reluctant to sell their homes.

    A for sale sign is posted in front of a home for sale on February 20, 2023 in San Francisco, California.
    Justin Sullivan | Getty Images

    Home prices hit a record high in May, rising 0.7% nationally compared with April at a seasonally adjusted rate, according to the Black Knight Home Price Index.
    Prices, which have been rising since January, were 0.1% higher in May than a year earlier.

    The sharp jump in mortgage interest rates last year threw cold water on an overheated housing market, but it didn’t last long. Even with rates still high, home prices are now gaining again, and the gains are accelerating with each new month.
    “There is no doubt that the housing market has reignited from a home price perspective,” said Andy Walden, vice president of enterprise research at Black Knight.
    “Though the backward-looking annual growth rate dipped to 0.1%, May’s exceptionally strong +0.7% month-over-month gain would equate to an annualized growth rate of 8.9%, suggesting the annual home price growth rate would remain at or near 0% for only a short time before inflecting and trending sharply higher in coming months,” Walden added.
    Prices began dropping last summer, after the average interest rate on the 30-year fixed-rate mortgage more than doubled in just six months. They continued to fall until January, when buyer demand returned but came up against very tight supply. Buyers may have simply gotten used to higher rates.

    “Earlier this year I shared that I believed 6% mortgage rates were accepted as the new normal. I think now we’re in an environment where 7% mortgage rates are now the new normal, and people are accepting it,” Robert Reffkin, CEO of Compass Real Estate said last week on CNBC’s “Squawk on the Street.”

    By May, just over half of the nation’s 50 largest housing markets, mostly in the Midwest and Northeast, had either returned to their prior price peaks or set new highs.
    Home prices are still weaker in the West and in many of the cities deemed pandemic “boom towns,” which had an influx of remote workers finding new homes during the earlier days of Covid.
    But those prices are starting to firm up. Homes in San Jose, California, lost 10% of their value last year, but inventory is starting to fall again, and prices there are now reheating. They rose 1.4% in May, the second largest month-to-month increase of any market on a seasonally adjusted basis. San Diego, Los Angeles, San Francisco and Seattle also saw price growth in May, as well.
    The one exception is Austin, Texas, one of the biggest pandemic boom towns.
    “Inventory there continues to run above pre-pandemic levels, putting downward pressure on prices, which have fallen to -13.8% below peak, the largest gap of any market. Just eight of the top 50 markets are currently more than 5% below their 2022 peaks,” Walden said.
    In general, though, supply is declining again. New listings are down about 25% from a year ago, as homeowners with sub-4% mortgage rates are reluctant to sell their homes and potentially pay a much higher interest rate on another home. Total inventory is now about half of what it was just before the pandemic, which caused a massive housing boom.
    Sales of pre-owned homes are still much weaker than they were a year ago, but that has less to do with higher costs and more to do with less supply. The median price of a pre-owned home in May was $396,100, according to the National Association of Realtors. Redfin, a real estate brokerage, reported last week that the average home is now selling just above its list price for the first time in nearly a year.
    Bidding wars are clearly coming back, even if affordability is taking a hit. As of June 22, with 30-year rates at 6.67%, it required $2,258 per month in principal and interest to make the monthly payment on a median-priced home with 20% down and a 30-year mortgage, according to Black Knight. That is the highest such payment on record, marginally higher than the $2,234 required back in October. More

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    Schumer urges FDA to probe Prime energy drink backed by YouTube stars Logan Paul and KSI

    Senate Majority Leader Chuck Schumer says Prime energy drink has unhealthy amounts of caffeine for kids and teens.
    Schumer, D-N.Y., asked the FDA to investigate the marketing tactics for the drink as well as its high caffeine content.
    Prime says its energy drink is not made for consumers younger than 18.

    Logan Paul and KSI pose with Prime hydration bottles prior to a regular season game between the Arizona Diamondbacks and Los Angeles Dodgers on March 31, 2023, at Dodger Stadium in Los Angeles, CA. (Photo by Brandon Sloter/Icon Sportswire via Getty Images)
    Brandon Sloter | Icon Sportswire | Getty Images

    WASHINGTON — Senate Majority Leader Chuck Schumer is calling on the Food and Drug Administration to look into a sports energy drink founded by social media influencers that has become popular with kids and teens.
    Prime, founded by YouTube stars Logan Paul and KSI, quickly gained a fervent following after its 2022 launch and became an official partner of Futbol Club Barcelona this month. The brand offers a bottled hydration drink and a canned energy beverage, which is said is not intended for children.

    In a release Monday, Schumer’s office called the energy drink a “cauldron of caffeine.”
    “Many physicians have serious concern for Prime, and I write to specifically urge your agency to investigate Prime for its claims, marketing and caffeine content,” Schumer, D-N.Y., wrote in a letter to FDA Commissioner Dr. Robert Califf. Prime drinks have gone viral on social media platforms, such as TikTok, which is itself under intense regulatory scrutiny in Washington.
    The Prime energy drink contains 200 mg of caffeine per 12 ounces, compared to 34 mg in a 12-ounce can of Coca-Cola and 80 mg in an 8.4-ounce can of Red Bull, according to Schumer’s letter. Several countries, including Australia, South Africa, the United Kingdom, Canada and New Zealand have already banned Prime Energy drinks or its caffeine-free version, Prime Hydration, in some schools.
    Schumer urged Califf to start an investigation based on physicians’ warnings to parents who say the caffeine content “can have an adverse impact on the health of children” as well as targeted advertising to younger demographics. The company’s lack of sufficient warnings about its caffeine content also invites scrutiny, he wrote.
    “A simple search on social media for Prime will generate an eye-popping amount of sponsored content, which is advertising,” Schumer wrote. “This content and the claims made should be investigated, along with the ingredients and the caffeine content in the Prime energy drink.”

    A company representative told CNBC that Prime Energy “contains a comparable amount of caffeine to other top selling energy drinks, all falling within the legal limit of the countries it’s sold in,” and that it welcomes discussions with the FDA on protecting customers.
    Prime Energy “complied with all FDA guidelines before hitting the market and states clearly on packaging, as well as in marketing materials, that it is an energy drink and is not made for anyone under the age of 18,” the representative said. More

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    Medicare will pay for Alzheimer’s drug Leqembi. What patients and doctors should know

    Medicare is now covering Leqembi, the only Alzheimer’s treatment on the market that slowed cognitive decline in early stages of the disease in a clinical trial.
    Although Medicare will pick up a majority of the bill, patients could still pay more than $5,000 in out-of-pocket costs.
    Those out-of-pocket costs could prove unaffordable for many people, particularly Black and Hispanic patients who are at higher risk of Alzheimer’s disease.

    The Alzheimer’s drug Leqembi is seen in this undated handout image obtained by Reuters on January 20, 2023.
    Eisai | via Reuters

    Medicare has agreed to pay for the Alzheimer’s treatment Leqembi, a major turning point for patients who are diagnosed with the early stages of the disease.
    Leqembi is the only drug on the market right now that has demonstrated the ability to slow the progression of early stages of Alzheimer’s disease in a clinical trial. The monoclonal antibody, administered twice monthly through intravenous means, slowed cognitive decline by 27% over 18 months in the trial.

    Leqembi is made by Japanese drugmaker Eisai and its partner Biogen, which is based in Cambridge, Massachusetts.
    Medicare’s decision to cover Leqembi, which came moments after the Food and Drug Administration fully approved the drug Thursday, promises to make the treatment more accessible to patients.
    Medicare coverage is crucial for most patients to have any hope of being able to afford Leqembi. Eisai has priced Leqembi at $26,500 per year before insurance coverage, which is extraordinarily expensive for Medicare patients, who have a median income of about $30,000.
    Medicare is picking up the majority of the bill, though many patients will still face several thousand dollars in out-of-pocket costs.
    Patients with traditional Medicare will pay 20% of the bill for Leqembi, according to the federal Centers for Medicare and Medicaid Services. That means these patients could see an annual bill of more than $5,000, according to an estimate from KFF, a nonprofit group that researches health-care issues.

    People with Medicare Advantage plans also typically pay 20% for drugs such as Leqembi, up to their out-of-pocket maximum, which was about $5,000 on average for in-network services, according to KFF.
    Patients with supplemental insurance such as Medigap or Medicaid might pay less, according to KFF.
    People of modest means might not be able to afford the out-of-pocket costs for Leqembi even with Medicare coverage, said Tricia Neuman, an expert on Medicare at KFF.
    This is particularly concerning because Black and Hispanic people are at higher risk of Alzheimer’s disease but are also more likely to have lower incomes, Neuman said.
    If demand for Leqembi is high, there are also concerns that patients might face long wait times to see specialists and receive infusions.

    What are the coverage conditions?

    Medicare has imposed certain conditions that must be fulfilled for patients to become eligible to have Leqembi covered.

    Leqembi coverage requirements

    You must be enrolled in Medicare.
    You must be diagnosed with mild cognitive impairment or mild Alzheimer’s disease with evidence of amyloid plaque on the brain.
    You must have a doctor who is participating in a registry that collects information on the tests you’ve taken as part of your diagnosis, notes whether you are on blood thinners and documents whether you have had side effects from Leqembi.

    To get diagnosed with Alzheimer’s or a mild cognitive impairment, patients must undergo a cognitive evaluation and have a PET scan or spinal tap to detect the amyloid protein associated with the disease. PET scans are the most common method to detect amyloid because they are less invasive.
    Medicare currently covers a single PET scan per lifetime to detect amyloid. CMS is reconsidering this policy and plans to issue a proposed rule soon, an agency spokesperson said.
    The requirement that doctors enter information on the patient into a registry system is controversial. The Alzheimer’s Association and some members of Congress are worried the data-collection requirement creates unnecessary red tape for patients to get treated.
    The federal Centers for Medicare and Medicaid Services has set up a nationwide portal that is supposed to make it easy for doctors to enter the required information about their patients. CMS has released a video that shows doctors how to navigate the system:

    Doctors can access the free-to-use registry at this website.
    Dr. David Knopman, a neurologist who specializes in Alzheimer’s disease at the Mayo Clinic in Minnesota, said the registry is minimalist and unlikely to be burdensome to patients and physicians.

    What are the benefits and risks?

    Patients diagnosed with mild cognitive impairment or mild Alzheimer’s disease need to talk to their doctor about whether the benefits of Leqembi outweigh the risks, according to CMS.
    Although Leqembi modestly slowed cognitive decline in the clinical trial, the treatment also carries serious risks of brain swelling and bleeding. In the trial, 13% of patients who received Leqembi had swelling and 14% had bleeding.
    The swelling and bleeding were typically mild, without obvious symptoms, but these episodes can be fatal, according to the Food and Drug Administration’s independent review of the clinical trial data. When symptoms do present, they include headache, confusion, dizziness, vision changes and nausea. 
    People with two copies of a gene mutation called APOE4 are at higher risk of swelling and bleeding and patients should be tested to confirm whether they have the mutation before taking Leqembi, according to the FDA. Medicare covers testing for the APOE4 mutation, a CMS spokesperson said.
    And patients on anticoagulants also appear to have a higher risk of brain bleeding, according to the FDA.
    Three patients who received Leqembi in the trial died, although the FDA was unable to conclude whether these deaths were related to the treatment.
    Knopman said appropriately diagnosed and informed patients should be able to decide for themselves whether they want to take Leqembi after weighing the benefits of treatment against the risks of potential serious side effects. More

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    Buy Buy Baby auction is canceled, but buyers are still interested in making a bid

    Bed Bath & Beyond canceled an auction for Buy Buy Baby, but the chain could still end up being saved.
    Buyers had backed out of the auction because the chain’s value had deteriorated, but there are still parties interested in its assets.
    Dream on Me Industries, a former supplier to Buy Buy Baby, has agreed to purchase the chain’s intellectual property for $15.5 million if no better bids arise.

    “Store Closing” signs at a Buy Buy Baby store in the Brooklyn borough of New York, on Monday, Feb. 6, 2023.
    Stephanie Keith | Bloomberg | Getty Images

    Bed Bath & Beyond canceled a Friday auction for its Buy Buy Baby chain because it failed to secure a buyer willing to keep its stores running – but it’s not quite over for the baby retailer just yet, CNBC has learned.
    Bidders backed out of the auction after they determined the chain was no longer worth buying because its value had deteriorated so much, but there are parties still interested in its assets, according to two people close to the matter who weren’t authorized to discuss it publicly.

    While it would be unusual, Bed Bath & Beyond could still accept a bid for Buy Buy Baby early next week. The chain’s fate won’t be definitively determined until Tuesday, when a court hearing is scheduled to approve the sale of Buy Buy Baby’s intellectual property to Dream on Me Industries. The company, a little known New Jersey-based retailer and one of Buy Buy Baby’s former suppliers, agreed to buy its trademark and digital assets for $15.5 million if no higher bids arise.
    Once considered the crown jewel of Bed Bath & Beyond’s now-failed empire, the baby chain has been in the midst of liquidation sales at its 120 stores since its parent company filed for bankruptcy protection April 23. 
    As the auction process dragged on and Buy Buy Baby’s inventory dwindled, so did its value. Nearly three months into close out sales, there’s little left to bid on besides the brand’s intellectual property, one of the people said.
    “Most of the value was in the IP,  especially at this point in the process. One can imagine that three months ago, when they were fully functioning stores operating and running, that might not be the case,” said the person.
    For the past several weeks, Bed Bath & Beyond has repeatedly pushed back and split up the bankruptcy-run auction process for Buy Buy Baby so it could secure higher bids and find a firm that was willing to keep stores running. 

    It scheduled an auction solely for Buy Buy Baby’s intellectual property last week and announced Dream on Me as the winner. 
    Bed Bath & Beyond scheduled a separate auction for Friday in which buyers could bid on the chain as a going concern and noted Dream on Me’s bid could be superseded if they received a higher sale price. 
    However, it canceled the auction late Thursday when those bids failed to materialize, a spokesperson said in a statement. 
    Go Global Retail, a brand investment firm that’s represented by Ankura Capital Advisors, had been interested in keeping about 75% of Buy Buy Baby’s stores running and had earlier sought an additional $50 million in capital to shore up its bid, CNBC previously reported. The firm is already in the baby business and currently owns children’s apparel company Janie and Jack. It declined to comment when reached by CNBC.
    If the auction had been held, bids likely would not have been much higher than the $15.5 million Dream on Me offered for the chain’s intellectual property because the only other assets leftover were its employees, empty stores, leases and whatever inventory was left, said the source. 
    Any firm that’s willing to take over will likely have to shut the stores down for a couple of months so they can restock and get them back up and running.
    Last month, Overstock.com won the auction for Bed Bath & Beyond’s intellectual property and digital assets with a bid price of $21.5 million. It decided to change its eponymous website name to Bedbathandbeyond.com.
    It is not clear what Dream on Me plans to do with Buy Buy Baby if it ends up the ultimate victor. The company didn’t return requests for more information from CNBC. More

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    Small businesses may have a hard time finding teen workers this summer

    Outplacement firm Challenger Gray projected teens will gain 1.1 million jobs in 2023, down slightly from last year’s numbers and the lowest forecast since 2011.
    The unemployment rate for teens aged 16 to 19 crept up slightly in June, while the labor participation rate fell year on year.
    For teens who want to work this summer, pay is competitive and some jobs are offering flexibility.

    As the summer hiring market heats up, small and seasonal businesses may find they’re missing a key demographic to fill roles – teen workers.
    Outplacement firm Challenger Gray projected teens will gain 1.1 million jobs in 2023, down slightly from last year’s numbers and the lowest forecast since 2011. The group said this spring that teens are once again working at pre-pandemic levels, but cautioned many teens who are willing to take on jobs are likely already in the workforce.

    The unemployment rate for teens aged 16 to 19 crept up slightly in June to 11% from the previous month, according to Friday’s June jobs report from the Bureau of Labor Statistics. Meanwhile the labor participation rate fell year on year, to 36.3% from 42.9% in June 2022.
    That could mean fewer available workers for businesses like Grotto Pizza that rely heavily on teens, according to hiring manager Glenn Byrum.
    Across Grotto’s 20 locations in Delaware and Maryland, teens make up a little less than a third of the company’s 1,100 workers. They’re always hiring, but staffed well for this summer, he said.
    “They are a critical piece of our success,” Byrum said, adding both younger workers and J-1 visa employees help to staff seasonal locations at the beach. 
    “Teen hiring is always a process,” he said. “They seem to be much more cognizant of the flexibility in their jobs, how much they’re going to get paid, the work environment itself.”

    Byrum described what he saw as a common mentality among young workers, born out of a wealth of job opportunities during the summer.
    “If they don’t like something that employers ask them to do, even though it’s part of the job, they can easily go down the street and work somewhere else and find an alternate employment with the same wages or maybe even better,” he said. “So it just keeps us on our toes as far as making sure that we’re providing the best work environment we can.”
    Grotto often starts teen workers above minimum wage, Byrum said, and provides incentives for some to move between locations as seasonal demand fluctuates.
    Lexi Mathis, 16, was given a pay raise to work at a Grotto beach location for the summer months. She said the company is flexible with her schedule and the extra pay helps her to cover commuting costs as inflation has remained somewhat stubborn.
    “I moved down here to try and make a little bit more money tips. And that was one of the best decisions ever because it’s been a big increase and subsequently they gave me a little bit of a pay raise,” Mathis said.
    Hiring and labor availability has been an ongoing headache for small business owners in particular.
    The dynamics of worker availability and needs have shifted in the wake of the pandemic, and owners often struggle to find skilled and unskilled workers to fill positions.
    The restaurant sector is among those that has felt the sting of a lack of labor. The National Restaurant Association has said it projects restaurants will add another 500,000 jobs by the end of the year, but have seen just one job seeker for every two open jobs, enhancing competition for workers.
    Makiah Grindstaff has worked at Famous Toastery in Davidson, North Carolina, for more than two years, during both the school year and summers. The high school senior has been saving up for several goals, and said pay can reach $25 an hour depending on the role she’s filling in the restaurant and what day of the week it is.
    She and her friends take pride in having cash on hand to shop, dine and drive, Grindstaff said.
    “I started driving and gas is expensive, and I wanted to start saving for college,” she said. “And I just want to be able to have my own money.” More

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    Sales of Alzheimer’s drug Leqembi may be slow initially but could pick up in 2024

    Sales of the Alzheimer’s drug Leqembi may be slow initially due to logistical requirements but could pick up in 2024, analysts said.
    Wall Street is chewing over the Food and Drug Administration’s Thursday approval of Biogen and Eisai’s Leqembi.
    It’s the first medicine proven to slow the progression of Alzheimer’s in people at the early stages of the memory-robbing disease. 

    Jay Reinstein, who suffers from Alzheimer’s, receives an injection so he can have a PET scan at MedStar Georgetown University Hospital in Washington, DC on June 20, 2023.
    Michael Robinson Chávez | The Washington Post | Getty Images

    Sales of the Alzheimer’s drug Leqembi may be slow initially due to logistical requirements but could pick up in 2024, analysts said after the groundbreaking treatment won approval in the U.S. 
    Wall Street is chewing over the Food and Drug Administration’s Thursday approval of Leqembi – a milestone in the treatment of the disease, even though the drug isn’t a cure. 

    Leqembi, from drugmakers Eisai and Biogen, is the first medicine proven to slow the progression of Alzheimer’s in people at the early stages of the memory-robbing disease. 
    Medicare on Thursday announced it is now covering the antibody treatment for patients enrolled in the insurance program for seniors, broadening access for those who can’t afford the drug’s hefty $26,500-a-year price tag. But coverage comes with several conditions.
    Analysts believe certain Medicare requirements and new guidance on Leqembi’s prescription label could potentially weigh on sales of the drug – at least in the near term.
    “While logistic hurdles make accessibility to the drug challenging for the incoming 6-12 months, we do expect to start seeing sales ticking up starting in mid-2024,” Guggenheim analyst Yatin Suneja wrote in a note Thursday. 
    Medicare will pay for Leqembi as long as patients find health-care providers participating in a registry or a database that tracks the drug’s benefits and risks. 

    The initial process of building out a registry is one logistical hurdle that “will take time and could be somewhat burdensome early on,” Jefferies analyst Michael Yee said in a research note Thursday. 
    Yee added that the firm’s channel checks suggest doctors see the registry requirement “as a potential real-world challenge – at least in the initial phase.” But he noted that it could ease as the drug’s launch progresses. 
    Another hurdle could be related to a testing requirement on the drug’s prescribing label. 
    The FDA recommends doctors test patients for a genetic mutation known as ApoE4 before starting treatment. Those with that mutation are at greater risk of swelling and brain bleeds if they take Leqembi. About 15% of people with Alzheimer’s have ApoE4, according to the National Institute on Aging. 
    The testing requirement makes the drug “even more difficult to prescribe,” Stifel analyst Paul Matteis wrote Thursday. 
    “The strong suggestion to test, for most clinicians, is going to add another hurdle” on top of other “substantial infrastructure requirements,” he wrote. 
    That includes navigating Medicare’s registry requirement and coordinating PET scans and MRIs to screen for dangerous side effects of the drug. 
    Jefferies’ Yee also highlighted MRI monitoring – a requirement on the drug’s prescribing label – as another logistical challenge in the near term. 
    The label says patients should get multiple MRIs during the first year of treatment to check for signs of ARIA, a side effect that causes brain swelling or bleeding and can be fatal in rare cases. 
    Yee said scheduling MRI scheduling and reimbursements take time and noted that there is a fixed capacity for MRI equipment and scans. 
    The prescription label requirements won’t impact the uptake of Leqembi overall because “physicians were already planning to treat patients accordingly anyway,” SVB Securities analyst Marc Goodman wrote Thursday.
    But Goodman, like other analysts, also noted that “we continue to expect a slow ramp in 2023 and acceleration moving into 2024.” More

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    U.S. officials say risk of locally acquired malaria remains low as nationwide cases jump to seven

    U.S. public health officials say the risk of locally transmitted malaria in the country remains low as new cases in Florida and Texas raise questions. 
    The Florida Department of Health said two cases of locally acquired malaria have been reported in Sarasota County, bringing the nationwide total to seven.
    The CDC and other health experts say the new locally acquired cases shouldn’t warrant panic about widespread malaria transmission in the country.
    It’s important for the public to remain vigilant at a time when climate change and a rebound in international travel increasingly contribute to the spread of mosquito-borne diseases like malaria. 

    Barrington Sanders, a Miami-Dade Mosquito Control Inspector, sprays a pesticide to kill adult mosquitos on June 29, 2023 in Miami, Florida. 
    Joe Raedle | Getty Images

    U.S. public health officials say the risk of locally transmitted malaria in the country remains low as seven new cases in Florida and Texas raise questions. 
    The Florida Department of Health on Friday said two cases of locally acquired malaria have been reported in Sarasota County, bringing the total in the state to six.

    Last week, the Centers for Disease Control and Prevention issued a nationwide advisory over the four initial Florida cases and one in Texas to alert health-care providers, local health departments and the public about the possibility of local malaria transmission.
    Those five patients “have received treatment and are improving,” according to the CDC. “Despite these cases, the risk of locally acquired malaria remains extremely low in the United States,” the agency added.
    The seven are the first known cases of “locally acquired” malaria in the country since 2003. That means the new infections were not linked to foreign travel and appear to have been spread by U.S. mosquitoes carrying the parasite that causes the disease.
    Malaria is a serious and potentially fatal disease typically transmitted through the bite of an infective female anopheline mosquito, according to the CDC. It was once endemic in the U.S., meaning it occurred regularly and required broad public health interventions.
    The risk of the disease is higher in areas where warmer climate conditions allow those mosquitoes to survive during most of the year, the agency said.

    The U.S. records roughly 2,000 malaria cases each year, nearly all of them in people who acquired the disease abroad, not within the country. 
    Health experts say the new locally acquired cases shouldn’t warrant panic about widespread malaria transmission in the U.S.
    But they also note that it’s important for the public to remain vigilant at a time when climate change and a rebound in international travel increasingly contribute to the spread of insect-borne diseases. 
    U.S. public health authorities and health-care providers should also be prepared to ramp up their surveillance of malaria, experts added. 
    Here’s what you need to know about the locally acquired malaria cases in the U.S. – and why the risk of transmission remains low right now.

    The cause of the cases remains unclear 

    Investigations by health departments in Texas and Florida confirmed that none of the five cases were directly linked to international travel, a CDC spokesperson told CNBC.
    But it’s still unclear how mosquitoes in the U.S. came to carry malaria.
    One possible explanation has to do with the nature of the malaria species identified in both states: P. vivax, the most common form of the disease. 

    Barrington Sanders, a Miami-Dade Mosquito Control Inspector, sprays a pesticide to kill adult mosquitos on June 29, 2023 in Miami, Florida. 
    Joe Raedle | Getty Images

    P. vivax isn’t the deadliest kind of malaria, but it’s more difficult to treat than other forms, according to Daniel Parker, associate professor of population health and disease prevention with the UC Irvine program in public health.
    The P. vivax parasite can cause symptoms – which range from fever to difficulty breathing – soon after infection, like other forms of malaria. 
    But the parasite can also lie dormant in the liver for days, months or years before popping up in the bloodstream again and causing symptoms to reappear, Parker said. During that dormant period, P. vivax causes no symptoms and remains undetectable in blood tests.  
    It’s possible a Florida or Texas resident was infected with P. vivax abroad and returned to the U.S. without realizing they had malaria due to a lack of symptoms, according to Sadie Ryan, a medical geography professor at the University of Florida and director of the Florida Climate Institute.
    Local mosquitoes could have picked up malaria from an unknowing traveler after P. vivax became active in their bloodstream again, and those mosquitoes could have spread it to other people in the area.
    “It might be that one malaria case came to the U.S. from somewhere else. Then local mosquitoes here picked it up and bit people locally,” Ryan said.
    But without more details on the cases, experts say it’s difficult to offer definitive explanations. 

    U.S. is mostly equipped to contain local transmission

    Experts told CNBC that it’s possible for locally acquired malaria cases to spread to other parts of Florida, Texas or potentially other states, but the probability is low.
    That’s largely because public health authorities responded to the cases quickly and are mostly equipped to contain local malaria transmission, especially in areas known to be more suitable for mosquito-borne illnesses. 
    Ryan said health authorities did a “really good job” alerting the public and health-care providers about the cases quickly.
    The CDC and state-level warnings in Florida and Texas were also timely since they were issued ahead of the Fourth of July holiday, when more people typically expose themselves to mosquitoes outdoors, Ryan added.
    “They got the message out and said, ‘Beware this is here. Here are the things you can do to protect yourselves from it,'” she told CNBC.
    Local health authorities in Florida and Texas have also carried out aggressive “vector control” efforts in areas where the cases emerged, she added. That involves spraying insecticide from the ground or from a helicopter to kill off mosquitoes capable of carrying malaria. 

    Health officials at Sarasota County Mosquito Management Services study specimens of anopheles mosquitoes that cause malaria, in Sarasota, Florida on June 30, 2023.
    Chandan Khanna | AFP | Getty Images

    UC Irvine’s Parker also said the U.S.’s case-tracking protocols make the country more prepared to contain the spread.  
    Health-care providers are required to report all cases of laboratory-confirmed malaria to their local or state health department, making it easier to track the potential spread of the disease, according to the CDC.
    Parker added that public health authorities also investigate cases after they’re identified to better understand their origins, which is in some ways “similar to contact tracing efforts that we’re now more used to because of Covid-19.”
    “The CDC was partially born out of our malaria elimination efforts. While I would argue that we’ve neglected some of our public health infrastructure, there are systems in place…that can quickly be put into action when cases are identified,” Parker said, referring to the CDC’s inception in 1946.
    The agency played a critical role in declaring the disease’s elimination in the U.S. in 1951.
    But the U.S.’s toolkit for fighting local malaria transmission isn’t perfect. Not all areas of the country have the local public health infrastructure in place to track and combat the disease, putting them a step behind if locally acquired cases spread.

    Overall threat of malaria is still rising

    Several factors are also making the country increasingly vulnerable to malaria overall, regardless of whether they are local or imported infections. 
    Climate change is causing a shift in weather patterns that can worsen malaria conditions, according to Dr. Rajiv Chowdhury, a global health expert from Florida International University. He said global warming could lead to “higher mosquito migration and abundance” in areas of the country that were previously uninhabitable by anopheles mosquitoes.
    Existing evidence suggests warmer temperatures can increase the growth rate and transmissibility of the parasites responsible for malaria, Chowdhury added.
    He also said climate change can lead to excess rainfall and sea level rise in the U.S., creating more open spaces with standing water that serve as “effective breeding grounds” for mosquitoes.
    It’s unclear whether the new local cases in Texas and Florida are connected to rising temperatures. Ryan of the Florida Climate Institute noted those states were already warm enough for the disease to spread in the first place. 
    Chowdhury agreed: “It’s really difficult to pinpoint causation for particular cases to the broader environmental changes that have been occurring. We need a bit more research to make that connection in the U.S.”
    A CDC spokesperson told CNBC that “it is not clear that the recently reported cases are due to changes in climate,” even though shifting weather conditions do influence the distribution of diseases like malaria. 
    But the agency said a rebound in foreign travel levels this year could also increase the number of imported cases of malaria in the country. The agency last week highlighted its “concern for a potential rise” in those cases associated with increased international summer travel that could return to pre-Covid levels.
    Parker said increased international travel could potentially lead to more imported and local infections.
    “It is possible that we’ll have more imported cases and since we already have the mosquitoes locally, it’s possible that they’ll get some and there could be more local transmission,” he said.
    But he added: “I wouldn’t say I’m not too worried about it. As long as we remain vigilant.”

    There are ways to manage the risk

    Experts noted there is more work that public health authorities, health-care providers and people can do to manage the nation’s rising risk of malaria. 
    U.S. public health authorities should consider which areas of the country are becoming more suitable for malaria transmission and how those places can build or bolster the infrastructure needed to deal with the disease, according to Ryan. 
    “That’s the sort of realm in which we need to be concerned – to think about where people should be anticipating this and what they can do to build that capacity needed to manage the disease with vector control, public health messaging and other pieces of the puzzle,” she said. 

    Stephane de Sakutin | AFP | Getty Images

    Clinicians can also strengthen their surveillance of the disease by considering malaria diagnoses in any person with a fever of unknown origin, regardless of their travel history, according to the CDC.
    “It’s possible for someone to come back with malaria and for their physician to have never seen a malaria case before. So they aren’t used to dealing with the disease,” Parker said. “But public health agencies are putting out reports on local cases, so physicians should have malaria on their radar.” 
    There is no malaria vaccine available to the U.S. public yet, but travelers can prevent malaria infections during international travel using anti-malarial medicines. Those drugs appear to be underused: Only a quarter of travelers reported taking so-called malaria prophylaxis in 2018. 
    It’s easy for people to mistake malaria for a common viral infection since the disease often causes flu-like symptoms. But the CDC says the “most important step” people can take is to see a doctor if they are sick and are presently – or have recently been – in an area with malaria. 
    Getting a diagnosis early on can ensure that a malaria infection is treated before it becomes serious and life-threatening, the agency said. 
    “Right now, we should not panic,” Chowdhury said. “But we definitely need to keep an eye on malaria and take those preparatory measures.” More

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    EV sales: Hyundai overtakes GM, but Tesla’s U.S. dominance continues

    Legacy automakers continue to promise big increases in production and sales of electric vehicles, but their efforts so far have done little to change the highly watched market.
    Hyundai Motor, including Kia, overtook GM in U.S. sales of EVs but remains a far second compared with industry leader Tesla.
    Tesla, led by CEO Elon Musk, has grown its lead over the legacy automakers to roughly 300,000 all-electric vehicles, according to data from Motor Intelligence.

    A Tesla Model Y is seen on a Tesla car lot on May 31, 2023 in Austin, Texas. Tesla’s Model Y has become the world’s best selling car in the first quarter of 2023. 
    Brandon Bell | Getty Images

    DETROIT – Legacy automakers continue to promise big increases in production and sales of battery-electric vehicles, but their efforts so far have done little to change the highly watched, emerging market.
    Despite notable upticks in sales compared with a year ago, industry leader Tesla remains the top EV seller and has grown its lead over legacy automakers. It is roughly 300,000 units ahead of its closest competitors Hyundai Motor and General Motors through the first half of this year, according to Motor Intelligence. That compares with a roughly 225,000 gap in the first half of 2022.

    The auto data firm reports that Tesla, which does not release sales by region, is estimated to have sold 336,892 vehicles to retail and fleet buyers in the U.S. during the first half of the year, a 30% increase from a year earlier.
    Meanwhile, Hyundai — including the Kia brand that’s owned by the same parent company — increased its EV sales by roughly 11% during that time to 38,457 units. GM, which was second in EV sales through the second quarter, more than quadrupled electric car and truck sales to 36,322 units through June compared with a year earlier. And Volkswagen more than doubled EV sales to 26,538 units sold through June.

    Ford Motor, which was second in EV sales last year behind Tesla, rounded out the top five spots with sales of 25,709 vehicles through June, according to Motor Intelligence. Ford’s EV sales were only up 12% compared with a year earlier, as the automaker took downtime to retool some plants such as a Mexican facility that produces its electric Mustang Mach-E crossover.
    “Our EV sales continue to grow. Improved Mustang Mach-E inventory flow began to hit at the end of Q2 following the retooling of our plant earlier this year, which helped Mustang Mach-E sales climb 110% in June,” Andrew Frick, Ford vice president of sales, distribution and trucks, said Thursday in a sales release.

    Tesla sales

    Tesla’s 30% year-over-year sales growth during the first half of the year was fueled by production at a new plant in Texas coming online and ramping up. However, that hasn’t been enough to keep up with the EV market’s overall growth.

    Tesla’s market share of U.S. EV sales dropped nearly 10 percentage points from a year ago to represent 60% of electric vehicles domestically sold, according to the data from Motor Intelligence.
    Tesla’s decline in market share comes as more competitors enter the field, resulting in overall market growth. EV sales in the U.S. increased roughly 50% through June compared with the first half of 2022.
    Legacy automakers, as well as newer companies such as Rivian Automotive, have been attempting to ramp up production of all-electric vehicles but many of their outputs remain small. Aside from the top slots, only five others have between 1% and 4% U.S. market share, according to Motor Intelligence. A host of others are under 1%.
    Tesla’s global deliveries were more than 889,000 EVs during the first half of the year, including 466,140 vehicles during the second quarter. Its production is expected to continue to grow, as Tesla is aiming to produce at least 1.8 million electric vehicles in 2023.
    CEO Elon Musk has told shareholders that the Texas factory should be the highest-volume production auto plant in the U.S. once it is fully ramped up. Last year, Musk said the Texas plant was aiming to produce half a million vehicles annually by the end of 2023.

    Hyundai rises, GM disappoints

    Hyundai’s second-place position is especially notable considering that its vehicles don’t qualify for federal EV tax incentives of up to $7,500 unless they’re leased. Those incentives, which are complex, are meant to benefit EVs that are produced in North America. EVs from Hyundai are currently imported from overseas.
    The South Korea-based automaker has been leaning into that leasing loophole under the Biden administration’s Inflation Reduction Act. The Hyundai brand has increased leasing of its EVs from roughly 2% to begin this year and has now hit more than 30%, according to Hyundai Motor America CEO Randy Parker.
    “It’s not an even playing field, and we’re certainly not happy about it. But those are the deck of cards that have been dealt and we’re trying to play that deck as best as we can,” Parker said Wednesday during a call with reporters.

    Hyundai Ioniq 5 on display at the New York Auto Show, April 13, 2022.
    Scott Mlyn | CNBC

    GM’s EV sales thus far have been disappointing, especially when it comes to new models with the automaker’s “Ultium” battery technologies. The automaker has been criticized for not ramping up production of its newest EVs such as the GMC Hummer and Cadillac Lyriq quickly enough.
    The vast majority of GM’s EV sales during the first six months of the year were of its outgoing Chevrolet Bolt models, which will be discontinued later this year.
    GM CEO Mary Barra reiterated last week at the Aspen Ideas Festival that the company’s output of newer EVs has been constrained due to domestic production of its batteries that’s taking longer than expected.
    Barra has said GM plans to catch Tesla in sales by mid-decade, as the automaker rolls out more mainstream EV launches later this year such as the Chevrolet Silverado, Blazer and Equinox. It’s also launching a new electric delivery van and a $300,000-plus bespoke Cadillac EV called the Celestiq in 2023.
    The Detroit automaker has said it plans to produce 150,000 EVs this year for the U.S. market.
    — CNBC’s Phil LeBeau and Lora Kolodny contributed to this report.
    Disclosure: NBCUniversal News Group, of which CNBC is a part, is the media partner of the Aspen Ideas Festival.

    Mary Barra, GM Chair and CEO, speaks during the unveiling of the Cadillac Celestiq electric-sedan in Los Angeles, California on October 17, 2022. 
    Frederic J. Brown | AFP | Getty Images More