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
The latest COVID variant rising in dominance in the United States is called "KP.2." It now makes up 25% of the COVID cases in the U.S. and is now the dominant variant.
Current Research is showing that a very large percentage of people hospitalized for COVID-19 had only been vaccinated with the primary vaccine series, but had not received any updated shots.
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).
A recent study in the journal Nature found that people vaccinated against COVID-19 were less likely to develop Long COVID compared to unvaccinated patients.
The National Academies of Sciences, Engineering and Medicine recently came out with a 265 page report that confirmed the seriousness and persistence of Long COVID. This nongovernmental institution typically advises federal agencies on science and medicine. They found that, according to 2022 data, almost 18 million adults and 1 million children in the United States have had Long COVID at some point. In addition, about 9 million adults and 360,000 children have the condition currently.
Incidence/ Prevalence:
Unfortunately, the incidence of COVID-19 appears to be increasing again. This is based on positivity rates that have been reported by labs as well as wastewater testing. Unfortunately, since the beginning of May, hospitals are no longer required to report COVID hospitalizations. As a consequence, we do not have reliable information about how many people are being hospitalized for COVID-19.
Treatment
A recent study published in the New England Journal of Medicine found that the most recent COVID vaccines continue to be effective in preventing COVID-19, but this efficacy decreases after several months. Initially, the three available vaccines were 67% effective in preventing hospitalizations four weeks later. Unfortunately, after 10 weeks, the vaccines were only 57% effective in preventing hospitalization.
The Food and Drug Administration has granted emergency use authorization to a new medication called "PEMIVIBART," Also known as "Pemgarda" to protect people who are significantly immunocompromised and at risk of contracting COVID-19. At this time, the medication is only available for people who have a very weakened immune system. It is the only medication available at this time to help protect people prior to exposure. Pemgarda is a intravenous infusion that needs to be given every three months, as needed. Side effects include fatigue, nausea, headaches, and allergic reactions.
Moderna is currently developing a new vaccine that protects against influenza as well as COVID-19. Early trials show that the combination of the mRNA technology used to develop the COVID vaccine as well as flu vaccine actually produced more antibodies against influenza than the currently marketed traditional flu vaccine. It is hoped that this vaccine will be available in the U.S. markets in the fall of 2025.
Testing
Other Infectious Diseases:
RSV:
Pfizer has announced that its RSV vaccine should be active and effective for two years at least!
The FDA has recently approved a new vaccine for RSV. This one is made by Moderna using mRNA technology, similar to prior technologies used to produce COVID vaccinations. This vaccine is indicated for adults older than 60. It was found to be 79% effective in preventing at least two symptoms of RSV, such as a cough and fever.
So now there are three different RSV vaccines, one using mRNA technology, the other two more traditional technologies.
In the past, the RSV vaccination was recommended for adults older than 60. However, the FDA recently approved the vaccine for adults aged 50 and older. At this time, however, the CDC still needs to sign off on this recommendation for the younger patient group. This will hopefully happen in late June.
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.
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.
Unfortunately, we are seeing lots more mosquitoes around than in past years. A recent study from Las Vegas found a record-breaking number of mosquitos there. In addition, about 169/ 24,000 of the "mosquito pools" tested positive for West Nile Virus.
INFLUENZA:
Although the seasonal influenza activity is low nationally, rates are significantly elevated within the Sutter system compared to this time of year in previous years.
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. There has even been a report of two cats that died after consuming unpasteurized cow's milk.
At this time three humans have been infected with avian influenza. All of these have been dairy workers (one in Texas and two in Michigan). All of them have had mild symptoms only it is thought that they were infected by close contact with the cows and the milk. Unpasteurized milk has been found to carry the virus in it and can cause disease. It does not seem that pasteurized milk, which we consume, leads to disease. Also, no human-to-human spread of the virus has been noted so far.
At this time, the United States and Europe are working on producing H5N1 bird flu vaccines. These would be used to protect poultry and dairy workers, veterinarians, and lab technicians. Finland is planning to vaccinating such high-risk workers.
The World Health Organization head recently stated that the avian flu currently poses very little risk to public health. He noted that the virus has not shown any signs of spreading easily among humans.
Many of the current influenza medications seem to work against the H5N1 strain.
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:
There was a interesting and somewhat confusing article published in the British Medical Journal recently. It was based on an observational study, the type of study that tends to be of lower quality than the placebo-controlled trials. It looked at patients who took fish oil and how it affected their health. Those patients without known heart disease were found to have an increased incidence of the heart irregularity (called "atrial fibrillation") and an increased incidence of stroke, if they took fish oil. However, at the same time, those people with known heart disease had fewer heart attacks and strokes if they took fish oil. In the past, higher quality trials have shown that consumption of fish oil did indeed increase the incidence of atrial fibrillation. However, it also consistently reduced the risk of heart attacks and strokes. I understand that this is all very confusing and I am sure we have not heard the last word on this.
Now this is great news: have you ever noticed how inhalers are incredibly expensive? There is a new out-of-pocket price cap for inhalers from AstraZeneca, Boehringer Ingelheim, and Glaxo SmithKline. These pharmaceutical companies have committed to capping the out-of-pocket cost for inhalers at $35 per inhaler peer month. It is hoped that these price will become effective by January 1.
About Dr. Sujansky's Life in These Times
Happy Summer! Yesterday was the longest day of the year and I, for one, love the extra hours of daylight. So take out your wine and cheese and have a picnic in the evening this week!
My husband and I spent last weekend in Pacific Grove, by Monterey. It is so beautiful there! I highly recommend it for anyone seeking to get away from the heat of the Bay Area. We took a tandem bike ride, a long hike, and ate well! I have attached a picture below.
Otherwise, not much to report....my older son is coming home in July for a month, so I am figuring out some fund things to cook for him and things to do with him (I'm thinking a picnic at the Palace of Fine Arts in SF is a must).
Take good care - all of you! And stay well hydrated. This summer could get hot!
