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.

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6:10pm

Tue May 15, 2012
Shots - Health Blog

U.S. Funding Of HIV/AIDS Fight Overseas Carries Other Benefits

A mother and child wait to receive treatment at the HIV clinic in Nyagasambu, Rwanda, in Feb. 2008. The clinic was built by the Washington-based Elizabeth Glaser Pediatric AIDS Foundation with a grant from the PEPFAR program.
Shashank Bengali MCT/Landov

U.S. government spending to fight HIV/AIDS in developing countries is also preventing death from other diseases, a new study finds.

Some experts worry the billions of dollars the United States spends to treat people with HIV in poor countries may crowd out prevention and treatment of other illnesses.

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3:14pm

Wed May 2, 2012
Shots - Health Blog

A Step Forward For Gene Therapy To Treat HIV

HIV particles assemble at the surface of a white blood cell called a macrophage.
PLoS Biology

Millions of people around the world are living with HIV, thanks to drug regimens that suppress the virus. Now there's a new push to eliminate HIV from patients' bodies altogether. That would be a true cure.

We're not there yet. But a report in Science Translational Medicine is an encouraging signpost that scientists may be headed in the right direction.

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8:35am

Tue May 1, 2012
Shots - Health Blog

Lighter Weights Can Still Make A Big Fitness Difference

Originally published on Tue May 1, 2012 1:30 pm

Try taking some weight off in your workout.
iStockphoto.com

Here's good news for geezers — or for merely middle-aged folks — who'd like to stay fit and independent far into their later years.

You don't have to lift heavy weights to build muscle strength. Lifting lighter weights can be just as effective if you do it right, and you're much less likely to hurt yourself, researchers say.

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4:35pm

Fri April 20, 2012
Shots - Health Blog

Couples Should Get Tested For HIV Together, WHO Says

Originally published on Mon April 23, 2012 10:05 am

What do you say we go get HIV tested together?
iStockphoto.com

The World Health Organization is telling couples around the world to get tested together to see if either is infected with HIV.

If one of them is, that partner should start treatment with anti-HIV drugs – even if it's not yet medically necessary.

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5:05pm

Thu April 19, 2012
Shots - Health Blog

Doctors Group Tells Patients To Go For Cheaper, High-Value Treatments

Originally published on Fri April 20, 2012 10:30 am

Got a backache? You can probably skip that pricey scan.
iStockphoto.com

The American College of Physicians is urging patients with newly diagnosed diabetes and back pain not to opt for the latest-and-supposedly-greatest.

It's part of a new campaign to steer patients (and their doctors) to what the College of Physicians calls "high value care," and away from expensive tests and treatments that aren't any better — and often are worse.

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7:51pm

Tue April 17, 2012
Shots - Health Blog

CDC Chief: New Vaccines In Haiti Will Save Tens Of Thousands

Originally published on Tue April 17, 2012 8:16 pm

U.S. Secretary of Health and Human Services Kathleen Sebelius (center) talks to a health worker during a visit to Eliazar Germain hospital in Port-au-Prince, Haiti, on Monday. It's Sebelius' first visit to the country.
Ramon Espinosa AP

A campaign to introduce new childhood vaccines to Haiti will save tens of thousands of lives over the next decade, Dr. Thomas Frieden told Shots at the end of a two-day tour of the beleaguered country.

"This is an enormous step forward for Haiti," says Frieden, director of the U.S. Centers for Disease Control and Prevention. "This is a big deal."

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11:28am

Tue April 17, 2012
Shots - Health Blog

Sebelius To Lend Support To Vaccination Projects In Haiti

Originally published on Tue April 17, 2012 12:34 pm

Rice farmer Alexi Rochnel shows his blank cholera vaccination card. April is the beginning of Haiti's rainy season, which will likely intensify Haiti's cholera outbreak.
John W. Poole NPR

Health and Human Services Secretary Kathleen Sebelius is in Haiti today to support two big vaccination initiatives.

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11:19am

Fri April 13, 2012
Shots - Health Blog

Port-Au-Prince: A City Of Millions, With No Sewer System

Originally published on Tue January 29, 2013 5:55 pm

A makeshift latrine hangs over the water at the edge of Cite de Dieu, a slum in Port-au-Prince, Haiti.
John W. Poole / NPR

Port-au-Prince is about the size of Chicago. But it doesn't have a sewer system. It's one of the largest cities in the world without one.

That's a big problem, but never more so than during a time of cholera.

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3:15am

Thu April 12, 2012
Shots - Health Blog

Water In The Time Of Cholera: Haiti's Most Urgent Health Problem

Originally published on Mon April 16, 2012 12:40 pm

Marlene Lucien controls the hose that fills people's plastic buckets on one busy street corner in Port-au-Prince, Haiti.
John Poole NPR

In the teeming city of Port-au-Prince, Haiti, millions of people have no reliable water supply.

Many of the underground pipes that did exist were ruptured by the 2010 earthquake. Many public water kiosks are dry.

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10:22am

Tue April 10, 2012
Shots - Health Blog

Analysis Finds Lung Cancer Screening Worthwhile For Longtime Smokers

Dr. Steven Birnbaum positions a patient inside a CT scanner at Southern New Hampshire Medical Center in Nashua, N.H., in June 2010.
Jim Cole AP

Now there's fresh evidence that CT scans to detect early lung cancer belong on the short list of effective cancer screening technologies — at least for people at high risk.

Researchers conclude that spiral CT, which makes 3-D pictures of lungs, could reduce lung cancer deaths by 35 percent at a cost of $19,000 to $26,000 per year of life saved.

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6:10pm

Thu April 5, 2012
Shots - Health Blog

New Type Of Resistant Malaria Appears On Thai-Burmese Border

A micrograph shows red blood cells infected by the malaria parasite Plasmodium falciparum.
John C. Tan AP

Malaria experts have been holding their breath and hoping it wouldn't happen. But it has.

Malaria parasites resistant to the last, best drug treatment, called artemisinin combination therapy, or ACT, are infecting people along the border of Thailand and Myanmar.

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8:45am

Wed April 4, 2012
Shots - Health Blog

Doctors Urge Their Colleagues To Quit Doing Worthless Tests

Doctors, don't order that CT scan when a less-expensive ultrasound would work just as well, the Choosing Wisely campaign advises.
Catherine Yeulet iStockphoto.com

Nine national medical groups are launching a campaign called Choosing Wisely to get U.S. doctors to back off on 45 diagnostic tests, procedures and treatments that often may do patients no good.

Many involve imaging tests such as CT scans, MRIs and X-rays. Stop doing them, the groups say, for most cases of back pain, or on patients who come into the emergency room with a headache or after a fainting spell, or just because somebody's about to undergo surgery.

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12:48pm

Tue April 3, 2012
Shots - Health Blog

Mammograms May Lead To Breast Cancer 'Over-Diagnosis,' Study Finds

The problem of breast cancer overdiagnosis with mammograms is similar to the dilemma faced by men diagnosed with prostate cancer because of a PSA test.
Damian Dovarganes AP

Norwegian scientists say as many as 1 in every 4 cases of breast cancer doesn't need to be found because it would never have caused the woman any problem.

It's a startling idea for laypeople (and many doctors) thoroughly indoctrinated with the notion that any breast cancer is medically urgent — and should be found at the earliest possible moment.

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6:50pm

Sat March 31, 2012
Shots - Health Blog

Babies Take Longer To Come Out Than They Did In Grandma's Day

Originally published on Sat March 31, 2012 6:51 pm

Fifty years ago, the typical first-time mother in the U.S. took about four hours to give birth. These days, women labor about 6 1/2 hours.
Carsten/Three Lions Getty Images

The typical first-time mother takes 6 1/2 hours to give birth these days. Her counterpart 50 years ago labored for barely four hours.

That's the striking conclusion of a new federal study that compared nearly 140,000 births from two time periods.

One big implication: Today's obstetricians may be rushing to do cesarean sections too soon because they're using an out-of-date yardstick for how long a "normal" labor should take.

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10:41am

Tue March 27, 2012
Shots - Health Blog

Bypass Surgery Edges Stents For Heart Treatment

Originally published on Tue March 27, 2012 11:09 am

iStockphoto.com

The debate over coronary bypass surgery versus stenting goes back decades.

Studies have been inconclusive, but doctors and patients have voted with their feet in favor of the less-invasive procedure — clearing clogged arteries and propping them open with tiny scaffolds called stents.

U.S. doctors do at least two stenting procedures these days for every coronary bypass operation.

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12:01am

Tue March 27, 2012
Shots - Health Blog

In Haiti, Bureaucratic Delays Stall Mass Cholera Vaccinations

Originally published on Wed May 23, 2012 10:56 am

Joseph Francis, 54, says he came to this cholera clinic in Haiti's capital, Port-au-Prince,after becoming so dehydrated he could barely walk. Cholera has killed more than 7,000 Haitians since the first outbreak of the disease in October 2010. At the start of the rainy season, cases are once again beginning to climb.
John W. Poole NPR

A hundred thousand people in Haiti are ready and waiting to get vaccinated against cholera.

The vaccine is sitting in coolers. Vaccination teams are all trained. Willing recipients are registered and entered into databases.

The impending mass vaccination project aims to show that vaccinating against cholera is feasible in Haiti. It has never been done in the midst of an ongoing cholera epidemic. So far, more than 530,000 Haitians have fallen ill with cholera, and more than 7,000 have died.

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11:15am

Mon March 26, 2012
Shots - Health Blog

Study Finds Female Condoms Are Cost-Effective For HIV Prevention

A bus in Washington, D.C., displays an advertisement for a female condom in July 2010. To encourage their use, community groups distributed more than 500,000 of the female condoms, flexible pouches that are wider than a male condom but similar in length, during instruction sessions at beauty salons, barber shops, churches and restaurants.
Drew Angerer AP

Condoms aren't just for men.

A second generation of female condoms, which was approved in 2009, is cheaper than the first version. Still, the condoms for women are a lot more expensive than those for males. And female condoms remain pretty unfamiliar to most people.

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4:14am

Mon March 19, 2012
Shots - Health Blog

Prone To Failure, Some All-Metal Hip Implants Need To Be Removed Early

Originally published on Wed March 21, 2012 5:01 pm

Young-min Kwon of Massachusetts General Hospital holds the metal-alloy ball of Susy Mansfield's faulty artificial hip joint. The yellowish tissue on top is dead muscle caused by a reaction to the metal debris produced by the defective hip implant.
Richard Knox NPR

When Susy Mansfield needed a hip replacement in 2009, her orthopedic surgeon chose a relatively new and untested kind of artificial hip made entirely of metal.

"He said, 'You're young. Metal is good for younger people. It's going to last a lot longer,' " says Mansfield, who was 57 at the time.

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12:01am

Tue March 13, 2012
Shots - Health Blog

As Cholera Season Bears Down On Haiti, Vaccination Program Stalls

Originally published on Wed March 14, 2012 2:07 pm

Thousands of doses of cholera vaccine sit in a refrigerated trailer in a United Nations compound in Saint-Marc, Haiti. Vaccination was supposed to begin last week, but bureaucratic problems have delayed the start. April is the beginning of Haiti's rainy season, which will likely intensify Haiti's cholera outbreak.
John Poole NPR

The vaccine — $417,000 worth of it — is stacked high in refrigerated containers to protect it from the Haitian heat.

Hundreds of health workers are trained and ready to give the vaccine. They're armed with programmed smartphones and tablet computers to keep track of who has been vaccinated and who needs a second dose.

And 100,000 eager Haitians, from the teeming slums of Port-au-Prince to tiny hamlets in Haiti's rice bowl, have signed up to get the vaccine.

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11:10am

Tue February 21, 2012
The Salt

How Using Antibiotics In Animal Feed Creates Superbugs

Originally published on Tue February 21, 2012 5:19 pm

Many livestock groups say there's no evidence that antibiotics in livestock feed have caused a human health problem, but researchers beg to differ.
Scott Olson/Getty Images

Researchers have nailed down something scientists, government officials and agribusiness proponents have argued about for years: whether antibiotics in livestock feed give rise to antibiotic-resistant germs that can threaten humans.

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12:01am

Thu February 16, 2012
Shots - Health Blog

Latest Drug Shortage Threatens Children With Leukemia

Originally published on Tue February 21, 2012 5:55 pm

Many hospitals are perilously close to running out of a form of methotrexate that's necessary to inject in high doses to treat certain forms of cancer.
iStockphoto.com

It's a new kind of brinksmanship for U.S. doctors: caring for patients with life-threatening diseases when the supply of critical drugs threatens to disappear.

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2:40pm

Wed February 15, 2012
Shots - Health Blog

FDA Warns About Fake Avastin In US

Packaging for fake Avastin that was just flagged by the Food and Drug Administration.
Genentech

The Food and Drug Administration says counterfeit Avastin, a costly drug cancer drug, has made its way to doctors in the United States.

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12:01am

Mon February 13, 2012
Shots - Health Blog

Health Care In Massachusetts: 'Abject Failure' Or Work In Progress?

Originally published on Tue February 14, 2012 8:28 am

Voters are hearing a lot about health care this year. Republicans want to make the 2012 elections a referendum on the health care law that President Obama signed two years ago.

That law was largely based on one that then-Gov. Mitt Romney signed into law nearly six years ago in Massachusetts.

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12:43pm

Mon January 30, 2012
Shots - Health Blog

A Bid To Replace Neglect For Tropical Diseases With Attention

Originally published on Mon January 30, 2012 2:31 pm

An artist on Rio de Janeiro's Copacabana beach puts the final touches on a sand sculpture of the assassin bug, which spreads Chagas disease. The sculpture was part of an event in 2009 commemorating the 100th anniversary of the discovery of the disease.
Vanderlei Almeida AFP/Getty Images

Tropical diseases that have long been overlooked are getting their due.

An ambitious new push to eradicate, eliminate or control 17 scourges over the next eight years was just unveiled in London. The initiative brings together some of the world's largest drugmakers, health-oriented foundations and nongovernmental organizations. Governments from the developed world and the countries most affected by the diseases are also on board.

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6:30pm

Wed January 18, 2012
Shots - Health Blog

Many Older Women May Not Need Frequent Bone Scans

discovered she has osteopenia." href="/post/many-older-women-may-not-need-frequent-bone-scans" class="noexit lightbox">
NPR journalist Gisele Grayson got her hip bone scanned a couple of years ago and discovered she has osteopenia.
NPR

The bone-thinning disease called osteoporosis is a big problem for women past menopause. It causes painful spine fractures and broken hips that plunge many women into a final downward spiral.

So it seemed to make sense to monitor older women's bones on a regular basis to see when they need to start taking drugs that prevent bone loss and fractures. Since Medicare will pay for a bone-density scan every two years, that's what many women have been getting.

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4:48pm

Fri January 13, 2012
Shots - Health Blog

India Marks A Year Free Of Polio

Originally published on Fri January 13, 2012 5:08 pm

An Indian boy receives a polio vaccination from an Indian health worker in Amritsar last year.
Narinder Nanu AFP/Getty Images

A year ago today, India saw its last recorded case of polio in an 18-month-old girl in West Bengal named Rukhsar Khatoon. She recovered without lasting paralysis.

One year without another case is an impressive milestone in the decades-long effort to wipe the poliovirus from the face of the planet. Only a few years ago, India reported more polio cases than anywhere else — as many as 100,000 cases a year.

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9:55am

Wed January 11, 2012
Shots - Health Blog

A Dozen Cases Of Tuberculosis That Resists All Drugs Found In India

An image of Mycobacterium tuberculosis bacteria captured with an electron microscope.
CDC

Tuberculosis specialists in India have diagnosed infections in a dozen patients in Mumbai that are unfazed by the three first-choice TB drugs and all nine second-line drugs.

The doctors are calling them "totally drug-resistant TB," and the infections are essentially incurable with all available medicines.

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6:50am

Fri January 6, 2012
Shots - Health Blog

Monkey Experiments Boost Hope For Human AIDS Vaccine

A rendering of a key protein the simian immunodeficiency virus uses to reproduce.
Wikimedia Commons

Researchers trudging down the long and twisted path toward an AIDS vaccine are encouraged by new studies that show an experimental vaccine protects monkeys against infection with a virus that is very similar to HIV.

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12:10pm

Wed January 4, 2012
Shots - Health Blog

In US, Hospital Round Trips More Common For Heart Attack Patients

In the U.S., hospitalized heart attack patients go home sooner than in other countries. They are more likely to return to the hospital within a month of being discharged.
iStockphoto.com

If a heart attack sends you to an American hospital, you'll probably go home after only two or three nights. That's faster than virtually anyplace else in the world.

But your chances of needing to go back into the hospital within the next month are also higher than they are for heart attack patients in 16 other countries. That's the finding from a Duke University-led study in this week's JAMA, the Journal of the American Medical Association.

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12:01am

Wed December 28, 2011
Shots - Health Blog

Antiviral Drugs Sparkle In The Race To End AIDS

Eric Goosby, United States Global AIDS coordinator, says field testing is necessary and urgent to determine if HIV testing-and-treating services are feasible.
Brendan Hoffman Getty Images

2011 has been a momentous year in the 30-year-old AIDS pandemic.

The big breakthrough was the discovery that antiviral drugs can prevent someone who's infected with HIV from passing the virus to others. It's nearly 100 percent effective. That led President Obama to declare earlier this month that the U.S. will expand HIV treatment in hard-hit countries by 50 percent.

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