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
There is a new COVID variant, called "KP.2," that has recently become more prominent in the United States. It only made up 1% of the circulating virus one month ago, and now represents 25% of the circulating virus. It seems to be slightly more infectious than the previous variant, JN.1. However, it will take several more weeks until we see if this new variant is causing an increase in cases and may predict a summer spike. Luckily, this variant does not seem to be more dangerous than prior versions. Unfortunately, it does seem possible that our current vaccines are not quite as good at protecting us from this new variant. Nonetheless, it seems that prior vaccination will still protect us from severe COVID-19 disease.
A recent article in JAMA looked at the risk of hospitalization and death from COVID-19 versus seasonal influenza: during last season (2023-2024), there have been almost two times as many hospitalizations for COVID-19 compared to seasonal influenza. Moreover, the risk of death in hospitalized patients with COVID-19 was significantly greater than those hospitalized with seasonal influenza. So, in case you missed it, COVID-19 is significantly more dangerous than even seasonal influenza.
However, The CDC has recommended that all Americans aged 65 and older should receive an additional dose of the latest COVID vaccine this spring. This recommendations is based on past COVID-19 experience, where there is both a winter and summer surge of disease. However people aged 65 and older should wait at least four months for getting an additional COVID-19 vaccine booster.
LONG COVID:
Research is ongoing on the chemical changes that have occurred in people with Long COVID: proteins in the blood that are part of the "complement system," (which is part of the way the body's immune system works) remain abnormally elevated. It is as if the body is still working under the assumption that the virus is present and needs to be eradicated, although the infection is long gone (Science).
Incidence/ Prevalence:
The number of people seen in the emergency department for COVID-19 remains very low. In fact, it is 62% lower than it was one year ago, and 90% lower than it was four months ago.
Unfortunately, we have seen an increase of COVID incidents in doctor's offices. As hospitals no longer need to report COVID cases to the government, which makes comparisons of information data more difficult.
Treatment
A recent study published in the journal JAMA Network Open showed that the rebound rate of people suffering from mild to moderate COVID-19 who had taken Paxlovid was approximately 25%. What do we take from this data? Well, perhaps if you have a mild case of COVID-19, and are concerned that the disease will be of longer duration than desirable, you should forego Paxlovid and the possible associated rebound. Of course, if you have severe COVID-19, Paxlovid is an excellent option.
A recent study (JAMA Network Open) looked at side effects associated with the various COVID vaccines in children and adolescents. Adolescents were found to have an increased incidence of inflammation of the heart as well as a mildly increased incidence of seizures. Children aged two to five had a mildly increased incidence of seizures. Please note, however, that infection with the COVID virus itself also predisposes children and adolescents to seizures and heart inflammation and does so at a much higher rate.
A different recent article, published in the journal JAMA, looked at side effects of various COVID-19 vaccines in adults. The article found that the vaccines made by Pfizer-BioNTech and Moderna do not cause conditions such as female infertility, heart attacks, Bell's palsy, or Guillain-Barre syndrome. There was an increased risk of heart inflammation, but this side effect was considered rare. There was no association between the COVID-19 vaccination and sudden cardiac death among young people. Evidence also suggested that the vaccine produced by Johnson & Johnson may cause Guillain-Barre syndrome and blood clots. The report was sponsored by the Health Resources and Services Administration, a branch of the U.S. Department of Health and Human Services.
A study conducted in South Korea and involving 140,000 adults with a history of heart failure found that people, who had received at least two COVID-19 vaccinations, were 82% less likely to die and 47% less likely to be hospitalized for heart failure.
Also, as we have noted in the past, the diabetes medication "metformin" seems to help reduce the viral load of COVID virus, reduce the incidence of rebound disease, and reduce the risk of long COVID-19. But these studies are still in their early stages adn it is not the time for us to start prescribing metformin to non-diabetic people, to try to minimize COVID risk. But, still interesting!!
Testing
Other Infectious Diseases:
RSV:
Pfizer has announced that its RSV vaccine should be active and effective for two years at least!
West Nile Virus:
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.
So far, in 2024, 14 cases of West Nile virus has been detected in dead birds in California. This is almost five times as much as during the same in 2023.
The mosquitoes carrying the virus usually bite in the evening, night, and early morning. Recommendations to prevent infection include wearing long pants and sleeves and using appropriate insect repellent. In addition, it is important to dump out any standing water on your property, as these are breeding grounds for mosquitoes.
INFLUENZA:
The latest strain of influenza that is causing concern is the bird flu (H5N1). Other than birds, this virus has also been found in livestock. It is a pretty aggressive virus and can cause severe disease. Luckily, it seems that it is very difficult to catch the bird flu if you are a human being. Although a small number of humans have also become infected, people can catch the virus only from close contact with infected cows, not from other humans.
The H5N1 strain of influenza has been found in cow milk after pasteurization. However, this does not mean that you can get sick from drinking pasteurized cow milk, as tiny amounts of virus can be picked up with the PCR detection method. At the same time, milk from sick animals is being excluded from the commercial milk supply. In addition, the FDA does recommend that all milk be pasteurized prior to consumption. Also, the FDA has been testing retail milk samples and has not found any live H5N1 bird flu in these samples.
Sadly, we are now seeing H5N1 influenza in Antarctica. It is there infecting birds and has led to hundreds of dead penguins, among other creatures.
Many of the current influenza medications seem to work against the H5N1 strain.
The current risk of person-to-person transmission of bird flu seems to be very low at this time. Nonetheless, the rising number of mammals and birds that are being infected with the bird flu makes this possibility more likely for the future. We need to be watchful!
Measles
Adults living in the U.S. (and born after 1957) are recommended to get one measles booster. You can get the booster at a pharmacy; no doctor's prescription is required!
If you do get a measles shot at the pharmacy, please call the office or send me an email to let me know, so I can add that to your chart!
OTHER MEDICAL NEWS:
A recent study published in the Journal of the COPD Foundation found that smokers and former smokers were less likely to develop emphysema, if they consumed a plant-centered, nutritionally rich diet.
There is another study finding benefits of olive oil: This one is published in JAMA Network Open and found that people who consumed seven grams of olive oil daily (that's a little bit more than half a teaspoon) were less likely to develop a dementia-related death.
I am not a vegetarian, but now I'm thinking maybe I should be. A recent article in the Journal of Nutrition, Health and Aging showed that plant-based diets were associated with a 41% reduction of all cause mortality and a 53% reduction of heart disease mortality. That's pretty compelling!
About Dr. Sujansky's Life in These Times
Life is good in my household: my younger son just finished his junior year in college and came home for 10 days, prior to going to Maine for a 10-week internship.
We took the opportunity to watch an fun magic show in San Francisco. We also went out to an amazing restaurant to celebrate his 21st birthday (I KNOW! It seems like just yesterday that he was a toddler!). And we have been visiting Golden Gate Park- I am always amazed at how beautiful that park is! Did you know that it is actually 20% bigger than Central Park in New York?
Finally, we introduced him to the Mechanics Institute: this is a beautiful old library in San Francisco that also houses the oldest chess club in the United States. (The picture below shows the gorgeous spiral staircase of the Institute.) My husband and I have started learning chess there a few months ago. In case you are wondering: we are very much novices and really quite bad. But it is proving to be so much fun! The only thing is, that I don't like losing and I lose a lot!
