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
As you may have heard, the mRNA COVID-19 vaccinations have been (rarely) associated with myocarditis (heart inflammation), especially in young men. A recent article (JAMA) looked at such cases of post-vaccination myocarditis that ended up in the hospital. When compared with heart inflammation due to other causes, the patients with vaccination-associated myocarditis were less sick and did better overall. Nonetheless, some of them required medical supervision for several months after hospital discharge.
LONG COVID:
The National Institute of Health recently studied 25 common blood tests to see if any of them could be used to diagnose Long COVID (aka PASC)....sadly, none could help make that diagnosis (Annals of Internal Medicine).
A new study (Diabetes Care) found that diabetics who were on metformin when they developed COVID-19 were less likely to develop Long COVID that those who were not on metformin.
Incidence/ Prevalence:
The summer outbreak of COVI-19 is ongoing. It's unclear how long this will last, but last year, the summer outbreak continued into the winter outbreak!
Wastewater levels of SARS-Cov-2 are moderate in California and very high in much of the rest of the country.
Treatment
A new vaccine that is administered nasally (and known by the poetic name "MPV/S-2P") is now being tested in humans, having been found to be safe in primates previously. If this vaccines proves to be as safe and effective as hoped, then we will have some great new options in preventing this nasty disease.
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.
A recent study (JAMA Network Open) looked to see if the use of the anti-viral Paxlovid for COVID-19 infections led to SARS-Cov-2 viruses that became resistant to the medication. Researchers found that while such resistance did happen, but instances were rare (thankfully!).
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:
RSV:
New data (European Journal of Allergy and Clinical Immunology) suggest that if you are infected with RSV, you are more likely to get COVID-19 and more likely to get very sick from COVID-19.
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.
As of September 13, there have been 51 cases of WNV in California in 2024.
MPOX:
The World Health Organization has just declared MPOX as an international health emergency, based on a growing outbreak in Africa, where more than 15,000 people have been infected in 2024. This declaration allows for more research funding as well as additional international public health measures and cooperation to help contain the disease.
You may recall that there was a large outbreak of MPOX 2 years ago...however, that "version" (aka "clade") of the virus was not as contagious or as aggressive as this clade. The earlier clade occurred largely in gay young men. This clade is infecting more kids and seems to also be transmitted via household contacts or via heterosexual contacts.
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. However, she did test positive for bird flu. This raises the possibility that bird flu may be spreading in new ways. At this point, the patient has been discharged from the hospital and recovered. On 9/12/24, the CDC commented that they don't know how this person contracted bird flu, but were hoping it was a "one-off" event and will continue to monitor transmission patters.
Even worse, the housemate of the Missouri person mentioned above may ALSO became ill on the same day. This again raises the possibility that avian flu is spreading from person-to-person...which is new and not good. Now, we don't know that there was person-to-person transition, so more research is being done.
FLU:
Flu season is approaching, so this is the time to come in for a flu shot: October is the best time to get vaccinated.
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.
The FDA approved, last week, a new type of nasal flu vaccination that can be used at home. Although nasal flu vaccines are not new, this is the first one that you can get at home, not at a pharmacy or doctor's office. It can be ordered by patients online. However, this novel flu vaccine will be available next flu season (2025/ 26) only, not now. Also, in the past, nasal flu vaccination have been indicated only for people less than 50 and without any underlying lung disease.
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!
At this time, there are three-times as many cases of measles this year compared to last. More precisely, there have been 188 cases in the U.S. and 93 hospitalization - mostly in kids under the age of five. Of the people who fell ill with measles, 85% were unvaccinated or didn't know if they were vaccinated. Many cases were also linked to international travel.
OTHER MEDICAL NEWS:
I know we have written in the past about all the interesting studies that are pointing to the gut microbiome (the bacteria that live in our gut normally) influencing our health in a myriad of ways. Well, along those lines, there was a recent study in Jama Network Open that found that people with damages to the lining of the intestine (think stomach or esophageal ulcers) were much more likely to develop Parkinson's Disease later in life. This finding certainly has lots of implications and may show us ways to help prevent the devastating disease of Parkinson's in the future.
There have been lots of rumors in the past decades that use of cell phones somehow leads to brain cancer. Well, a study in the journal Environment International looked at about 5,000 prior studies on this issue and found no correlation with brain cancer, even for people who spend inordinate amounts of time on their cell. Similarly, kids living near cellphone towers or TV transmitters did not have an increased risk of leukemia (a type of blood cancer) or of brain cancer. Good to know!
Another topic I have written about in the past involves the prevention of dementia. As noted in the past, alcohol excess, kidney disease, depression, and obesity all increase your risk of Alzheimer's. But an article (Frontiers in Neuroscience) found that light exposure at night (especially in people younger than 65) is actually more strongly correlated to the risk of future Alzheimer's. I like this because it is something we can easily adjust!
For decades, doctors have been using BMI (Body Mass Index, which is calculated as weight/ height^2) to assess if a patient is overweight or obese. But now we are learning that the BRI = Body Roundness Index is better at correlating a person's weight with their risk of disease. As the name implies, the BRI measures how round the body is. It looks at a person's height and waist circumference, but not their weight! People who have a high BRI had an 61% increased risk of heart disease in a six-year period.
COVID-19 levels are still high, flu season is around the corner, and we are seeing cases of RSV already. The CDC thinks this year's respiratory disease season will be similar to last year's in severity. This is not great, as we saw many more hospitalizations for respiratory infections last year compared to the years prior to the pandemic. So get the flu and new Covid shots to help keep yourself and your neighbors safe.
About Dr. Sujansky's Life in These Times
I am almost done knitting a sweater, but you'll have to wait until next newsletter for me to post a picture of that one! This is one more reason to look forward to my next missive!
Some of you may remember that we lost or 16-and-a-half-year-old puppy earlier this year. To help remember her, I went to Etsy and commissioned a painting of her...I know, it's a bit over-the-top, but it made me happy. I am posting it below: this is based on a photo we took when we were carrying her in a backpack: it was taken at a time when she was too old to participate in longer hikes and needed "a lift" at the end.
That's all I've got for this time!
