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
In case you haven't noticed, we are in the middle of a summer COVID-19 outbreak. The western U.S. seems to have the highest rates in the country, no less!
Positivity rates in the Sutter system are up to 30%! At this time, almost 50% of people older than 60 who are seen in the outpatient setting for a respiratory tract infection test positive for COVID-19!
So please pay attention to any symptoms you may have of a cold and test yourself for COVID promptly. If you are negative, you may try re-testing 3 days later, just to make sure. If you do test positive, then consider yourself infectious for 5 days at least.
As the previous COVID vaccine is no longer effective in preventing disease due to mutations in the circulating viral elements, it is no longer readily available. A new, updated vaccine is expected in the fall. The Advisory Service of Immunization Practices (ACIP) of the CDC is recommending that EVERYONE aged 6 months or older get this booster.
Although we all have noticed that the vaccine's efficacy wanes after just a few months, studies have noted that the vast majority of those people who are now hospitalized with COVID-19 did not receive one of the newer vaccine boosters. This recommendation applies for all ages.
The newest COVID variant on the scene in the United States is called KP.3. It currently makes up one-third of all new cases.
A recent study published in JAMA Network Open found that use of cannabis was associated with an 80% increased risk of hospitalization due to COVID-19, and a 27% increased risk of being admitted to the intensive care unit due to the infection.
LONG COVID:
The most recent data suggests that by early 2023, 7% of the US population had suffered from Long Covid. Moreover, 6% of the vaccinated population contracted Long Covid, while 8% of the unvaccinated population suffered from the condition (JAMA).
Incidence/ Prevalence:
Local officials report a record high amount of COVID virus found in wastewater samples in the Bay Area. Similarly, medical offices and hospitals are reporting near record incidences of COVID-19. Nonetheless, due to vaccinations and prior exposure, many fewer people are being hospitalized for the disease. Death rates due to the disease have increased slightly in the last several weeks, but are still much lower than they were during the heyday of the epidemic
Treatment
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.
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:
RSV:
So now there are three different RSV vaccines, one using mRNA technology, the other two more traditional technologies.
Scientific advisors to the CDC have recently changed their recommendations for who should get this vaccination: at this time, they recommend the RSV vaccination for people who are older than 75 or are at high risk for hospitalization.
A recent study published in the journal Lancet Infectious Diseases found that the RSV virus vaccine maintained its efficacy over three seasons, even in older adults. This is great news, indicating that people don't need to be revaccinated for at least three years.
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.
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.
As of June 21, there have been five dead birds in the county of San Mateo found to be infected with the West Nile virus.
In addition, there have been 25 cases of West Nile virus in humans so far this year. These cases have been found in Arizona, Arkansas, Kansas, Maryland, Michigan, Mississippi, and Tennessee. Unfortunately, five of the human cases involved involvement of the brain and spinal cord.
The above notwithstanding, we are seeing much less West Nile Virus this year compared to last year.
DENGUE FEVER:
Another infectious disease that is transmitted through mosquitoes is dengue fever. The risk for this disease is now also increasing in the United States. In 2024, countries in North, Central, and South America have reported more than 9.7 million cases of dengue fever. This is twice as many cases as in the previous year. Puerto Rico has already declared a public health emergency due to the unusually high number of cases in the winter and spring. At this time, however, there is no evidence of a dengue outbreak in the continental United States.
It is thought that the increased number of cases is due to the effects of climate change. As a consequence, public health officials are expecting the virus to be seen more frequently in temperate regions as well, including the southernmost portions of the United States.
The virus is spread by a type of mosquito that likes warm weather and is expanding its geographic range due to climate change.
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.
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.
An increasing number of dairy cows have been found to be infected with the avian flu. As a consequence, the FDA is expanding its testing of dairy products for the virus. In addition, the FDA and the CDC are partnering with the State of Michigan to begin a study to see whether dairy workers exposed to sick animals become infected themselves. This will help us better understand the transmission dynamics of the bird flu, which only started infecting dairy cattle at the beginning of 2024.
The U.S. government has paid the vaccine maker Moderna to develop a pandemic influenza vaccine that could be used in case the bird flu becomes a danger to humans. This technology would employ the same mRNA technology that allowed development of the COVID-19 vaccine.
In addition, six people who worked with infected poultry in Colorado became infected with the virus. Luckily, these people only had mild symptoms.
We are seeing an increasing number of cattle herds infected by HPAI. Indeed, between May 14 and July 5, the number of dairy herds affected in the United States increased from 36 to 145. In addition, over 30 cats on these farms were fatally infected by this dangerous version of influenza.
Good news: antibody testing has found that asymptomatic cases to HPAI don't seem to occur; in other words: if you don't feel sick, then you are not infected!
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:
A study published in BMC Gastroenterology found that increased consumption of B vitamins (B1, B2, niacin, and B6) was associated with reduced incidence of constipation. In particular, vitamin B1 seemed to be most effective in preventing this condition.
A new study (European Urology Focus) found that drinking cranberry juice can reduce your incidence of bladder infections by 54%....the stuff really works!
About Dr. Sujansky's Life in These Times
Not much new in my life these days. My older son has a one-month break between jobs and is visiting for the month of July, which is great. We had a great picnic at the Palace of Fine Arts in San Francisco. We have also spent lots of time watching movies, playing games, and going out for dinner...I suspect he is quite sick of us already, but I don't care! I don't think we spent this much time together since the dark days of the pandemic!
Other than that, I'm trying to spend more time on my bike these days, as we are going on a biking trip to Portugal in October and I need to prepare (I suspect I will be one of the less accomplished athletes on the trip!).
No recent COVID infection for me, but trying to stay careful!
