Updates on New Infectious Disease Threats: What You Need to Know

Information about COVID-19 as well as other infectious diseases is constantly evolving. I am hoping to summarize some of that in these newsletters. New information will be in BOLD.

COVID-19

General Information

Finally, finally, we are seeing decreases in the number of COVID-19 cases in the Bay Area from the summer high; wastewater levels are now quite low in much of the U.S.
Novavax has been developing a vaccine that combines the flu and the COVID viruses. Unfortunately, the FDA had to put a hold on those studies, as a patient in the trial developed nerve damage. It is not clear if this nerve damage had anything to do with the Novavax vaccine.
The FDA just authorized a new test that checks for both COVID-19 and influenza. This test ("Healgen Rapid Check COVID-19/ Flu A&B Antigen Test") is intended for home use and is available over-the-counter.
A new study (Arteriosclerosis, Thrombosis, and Vascular Biology) found that infection with the COVID-19 virus can increase your risk of getting a heart attack or stroke for THREE years! Of note, this study was done in 2020, before there were vaccines or much natural immunity to the virus, so this increased risk may be different now.
On 10/23/24, the CDC added a new recommendation for vaccination for people aged 65 or have impaired immune system: such people are now urged to get a second booster of the newly formulated flu shot 6 months after the first dose.

LONG COVID:

Young adults and kids that are overweight have an increased risk of LONG COVID (JAMA Network Open).

Treatment

The FDA has granted emergency use authorization for the Novavax COVID vaccination on 8/30/2024. This vaccines is protein-based and therefore NOT a mRNA vaccine. I'm not sure that it is safer than the Moderna/ Pfizer vaccines, but I know there are some people who are wary about the mRNA vaccines. This is a good option for them.

Testing

I recommend you always have some at-home COVID tests in your household. And check yourself if you are feeling ill, especially now, when COVID rates are sky-rocketing. I do ask that anyone with cold-like symptoms check themselves for COVID prior to coming to my office.
The government has announced that they are once again offering free COVID tests, vaccines, and paxlovid treatments, given the ongoing surge of cases. They are currently available! All households can order four free COVID tests on the website "COVIDTests.gov" (or calling 1-800-232-0233) effective immediately.

Other Infectious Diseases:

TUBERCULOSIS:

I know that many of us think of tuberculosis as a disease of the Victorian era, but it has been present all along. And now, for 2023, there were more cases of tuberculosis-related death than COVID-related death world-wide! Indeed, TB was the top cause death due to infectious diseases in 2023. Last year, 8.2 million people were newly diagnosed with the infection, which is the highest number since the WHO started keeping track of this in 1995!

West Nile Virus (WNV):

West Nile virus is an infection acquired from the sting of an infected mosquito. Most people bitten by mosquitos will NOT be infected, and most people who do get infected don't feel ill. But about 20% of people will develop a mild fever and achiness. And about 1 in 150 people will get seriously ill and could die.
The incidence of WNV in California has increased by 40% in the last three weeks.

AVIAN FLU:

AKA "Highly Pathogenic Avian Influenza" or HPAI (or "A H5N1").
Bird flu has become the most recent concerning virus that could lead to an epidemic. The disease can lead to a pneumonia, neurological problems, and conjunctivitis. It has largely been found in animals such as cows, wild birds, and marine mammals, but has spread to many mammals at this point.
Unfortunately, we now have found a patient who seems to have contracted bird flu without being exposed to cows or poultry. She lives in Missouri and had underlying medical conditions and was hospitalized for other reasons.
Unfortunately, now 11 people associated with the Missouri patient have developed flu-like illnesses. Luckily, none of those people tested positive for the virus.
At this time, 31 humans in the United States have been diagnosed with bird flu...though this is likely to be an undercount. Disease in humans has been quite mild so far and often includes conjunctivitis (pink eye).
The number of dairy farms with cows infected by the bird flu is rapidly rising. As of October 29, 387 cow hers in 14 states have seen cases of bird flu. Remember, California is the largest producer of milk in our country!
Also, we have just seen our first case of a pig (this one in Oregon) being infected with bird flu. This is concerning because pigs can get infected with human as well as bird flu and then facilitate swapping of genes that makes the virus more dangerous.
Federal officials, anticipating a possible outbreak of bird flu, have doubled their stockpile of emergency bird flu vaccines. GSK, Sanofi, and CSL Ltd have contracted with the U.S. government to produce those vaccines.
The risk of bird flu in the general public remains low.

FLU:

Flu season is approaching, so this is the time to come in for a flu shot.
We have flu shots (regular and for "seniors") at our office. No appointment is needed, but try to call prior to coming in to prevent any last-minute craziness!
Please do call the office and let us know if you get a flu shot elsewhere, so we can add that to your medical record.
Health officials are expecting a "normal" flu season this year.

OTHER MEDICAL NEWS:

A recent study (JAMA Network Open) found that people who had a diet rich in flavonoids (think berries and tea) had a lower risk of dementia. This benefit was amplified in people who had depression or high blood pressure.
A study (JAMA Internal Medicine) found that having the arm in the wrong position when checking blood pressure can lead to inaccurate, elevated readings. The arm should be supported (like resting on a table) and having the middle of the cuff located at heart level.
Bad news for all of your meat-lovers out there: another study shows benefits for a vegetarian diet! This one was published in the American Journal of Preventative Cardiology and found that vegetarian and vegan diets were associated with a lower risk of heart disease, high blood pressure, and high cholesterol. Sorry!
Good news for Medicare patients: about 3.2 million Medicare recipients will have their out-of-pocket medication costs limited to $2000 in 2025 due to the Inflation Reduction Act.
I know a lot of people suffer from leg cramps at night. Certainly it helps to stretch the Achilles tendon at bedtime. Many other home remedies are touted, many without much evidence. A recent study (JAMA Internal Medicine) found that taking Vitamin K2 (180 mcg) daily could help....not sure this is ready for prime time, but could be something to try. But this is NOT a good treatment for people who are taking the blood thinner warfarin (aka coumadin).

About Dr. Sujansky's Life in These Times

With Halloween behind us and the end of daylight savings ahead of us, I think we all have to accept that fall has arrived! So I'm using this weekend to put away my summer clothing and practicing some baking for the holidays....I realize that I'm jumping the gun a bit on that one!

I went on a week-long biking trip to Portugal in early October. I had the best time! and I used an e-bike, so was finally able to keep up with my husband, who is quite into exercise! I loved biking through the little towns and stopping for coffee and the delicious "pasteis de nata." If you don't know what these fabulous Portuguese custard tarts are, I recommend you travel to Portugal yourself to try them...worth the trip!

Updates on New Infectious Disease Threats: What You Need to Know

Information about COVID-19 as well as other infectious diseases is constantly evolving. I am hoping to summarize some of that in these newsletters. New information will be in BOLD.

COVID-19

General Information

Finally, finally, we are seeing decreases in the number of COVID-19 cases in the Bay Area from the summer high; wastewater levels are now quite low in much of the U.S.

Novavax has been developing a vaccine that combines the flu and the COVID viruses. Unfortunately, the FDA had to put a hold on those studies, as a patient in the trial developed nerve damage. It is not clear if this nerve damage had anything to do with the Novavax vaccine.

The FDA just authorized a new test that checks for both COVID-19 and influenza. This test ("Healgen Rapid Check COVID-19/ Flu A&B Antigen Test") is intended for home use and is available over-the-counter.

On 10/23/24, the CDC added a new recommendation for vaccination for people aged 65 or have impaired immune system: such people are now urged to get a second booster of the newly formulated flu shot 6 months after the first dose.

LONG COVID:

**Young adults and kids that are overweight have an increased risk of LONG COVID (JAMA Network Open).**

Treatment

Testing

I recommend you always have some at-home COVID tests in your household. And check yourself if you are feeling ill, especially now, when COVID rates are sky-rocketing. I do ask that anyone with cold-like symptoms check themselves for COVID prior to coming to my office.

Other Infectious Diseases:

TUBERCULOSIS:

West Nile Virus (WNV):

The incidence of WNV in California has increased by 40% in the last three weeks.

AVIAN FLU:

AKA "Highly Pathogenic Avian Influenza" or HPAI (or "A H5N1").

Bird flu has become the most recent concerning virus that could lead to an epidemic. The disease can lead to a pneumonia, neurological problems, and conjunctivitis. It has largely been found in animals such as cows, wild birds, and marine mammals, but has spread to many mammals at this point.

Unfortunately, we now have found a patient who seems to have contracted bird flu without being exposed to cows or poultry. She lives in Missouri and had underlying medical conditions and was hospitalized for other reasons.

Unfortunately, now 11 people associated with the Missouri patient have developed flu-like illnesses. Luckily, none of those people tested positive for the virus.

At this time, 31 humans in the United States have been diagnosed with bird flu...though this is likely to be an undercount. Disease in humans has been quite mild so far and often includes conjunctivitis (pink eye).

The number of dairy farms with cows infected by the bird flu is rapidly rising. As of October 29, 387 cow hers in 14 states have seen cases of bird flu. Remember, California is the largest producer of milk in our country!

Also, we have just seen our first case of a pig (this one in Oregon) being infected with bird flu. This is concerning because pigs can get infected with human as well as bird flu and then facilitate swapping of genes that makes the virus more dangerous.

Federal officials, anticipating a possible outbreak of bird flu, have doubled their stockpile of emergency bird flu vaccines. GSK, Sanofi, and CSL Ltd have contracted with the U.S. government to produce those vaccines.

The risk of bird flu in the general public remains low.

FLU:

Flu season is approaching, so this is the time to come in for a flu shot.

We have flu shots (regular and for "seniors") at our office. No appointment is needed, but try to call prior to coming in to prevent any last-minute craziness!

Please do call the office and let us know if you get a flu shot elsewhere, so we can add that to your medical record.

Health officials are expecting a "normal" flu season this year.

OTHER MEDICAL NEWS:

A recent study (JAMA Network Open) found that people who had a diet rich in flavonoids (think berries and tea) had a lower risk of dementia. This benefit was amplified in people who had depression or high blood pressure.

A study (JAMA Internal Medicine) found that having the arm in the wrong position when checking blood pressure can lead to inaccurate, elevated readings. The arm should be supported (like resting on a table) and having the middle of the cuff located at heart level.

Good news for Medicare patients: about 3.2 million Medicare recipients will have their out-of-pocket medication costs limited to $2000 in 2025 due to the Inflation Reduction Act.

About Dr. Sujansky's Life in These Times

With Halloween behind us and the end of daylight savings ahead of us, I think we all have to accept that fall has arrived! So I'm using this weekend to put away my summer clothing and practicing some baking for the holidays....I realize that I'm jumping the gun a bit on that one!

Finally, pictured below is the sweater I have been working on for the last few months...just in time for the cooler weather.

Take care and stay warm!