[Health] The Infectious Diseases Thread

[Kraken]

Covid? Remember when we were all afraid of that? Good times...NOT! So glad that's over.

[Smoove_B]

Back to COVID, right now Japan is No. 1 in number of new cases and number of new deaths. Looking at that, seem like even a country that the people are still wearing masks after the government relaxed the mask guideline still fails to reduce COVID-19 transmission. What went wrong with Japan's approach?

I'm not exactly sure what's happening with Japan. I know the BA.5 variant has been impacting different countries in different ways. It could be lower vaccination coverage in elders + lower immunity from prior infections = more deaths in comparison to the "Let 'er rip" locations like the United States where we have mixed immunity status. There's also population density and overall demographics (% of people that are 65+). It's a good question.

[Punisher]

I guarantee anti maskers are going to look at that and say "see! Masks dont help at all!"

[Smoove_B]

I don't like mysteries anymore:

Health authorities are investigating an outbreak of an unidentified illness that has sickened at least nine people at a private clinic in northern Argentina, officials say. Three of those infected have died.

The health ministry in Tucumán province reported three new cases at Luz Médica on Thursday, raising the total to nine, with symptoms that include pneumonia and fever. Three of those infected – a doctor, a nurse, and a patient – have died.

Dr. Luis Medina Ruiz, the region’s health minister, said at a briefing on Thursday that experts have so far carried out tests for more than 30 possible causes – including coronavirus, hantavirus, and multiple strains of Legionella – but all have come back negative.

The first known case is a 70-year-old woman who was admitted to Luz Médica in mid-August to undergo surgery for a gallbladder problem. She developed a lung infection on August 18, after which healthcare workers who had contact with her started falling ill.

A doctor and a nurse later died, and the patient died on Thursday morning.

EDIT: Was Legionella after all...

[Smoove_B]

Not great...

New York Gov. Kathy Hochul on Friday declared a state of emergency over polio to boost vaccination rates in the state amid further evidence that the virus is spreading in communities.

Poliovirus has now been detected in sewage samples from four counties in the New York metropolitan area as well as the city itself. The counties include Rockland, Orange, Sullivan and now Nassau.

The samples tested positive for poliovirus that can cause paralysis in humans, according to state health officials. Unvaccinated individuals who live, work, go to school or visit Orange, Rockland, Nassau, New York City and Sullivan are at the highest risk of paralytic disease, officials said.

New York began wastewater surveillance after an unvaccinated adult caught polio in Rockland County in July and suffered from paralysis, the first known infection in the U.S. in nearly a decade.

[LawBeefaroni]

At least the declaration means they recognize the problem. It allows midwives, pharmacists and other medical workers to administer the vaccine. If anyone actuality wants it.

[Smoove_B]

It does but to have the same state declare "You do you" on Wednesday for Covid-19 and then issue an emergency order for Polio (while also still scrambling to address monkeypox) is a head scratcher. We're dipping into R&P so I'll park it there.

[LawBeefaroni]

It does but to have the same state declare "You do you" on Wednesday for Covid-19 and then issue an emergency order for Polio (while also still scrambling to address monkeypox) is a head scratcher. We're dipping into R&P so I'll park it there.

Polio paralyzes kids. COVID just kills old people quietly in hospitals.

[Max Peck]

We just need to bundle everything up into one overarching emergency order for Monkey Polio-19.

[Smoove_B]

Me again, speechless:

https://twitter.com/CarolineYLChen/stat ... 6927509504

CDC announcing that the United States has been added to the WHO list of countries with circulating vaccine-derived polio.

Here is the official press release:

The United States now joins a list of about 30 other countries where cVDPVs have been identified. Circulating vaccine-derived poliovirus occurs when local immunity to poliovirus is low enough to allow prolonged transmission of the original weakened virus in the oral polio vaccine. As the virus circulates and more genetic changes occur, the virus can regain its ability to infect the central nervous system and cause paralysis. It’s important to note that cVDPVs are not caused by a child receiving the polio vaccine. Oral polio vaccine has not been used or licensed in the U.S. since 2000 but continues to be used in some countries.

[Isgrimnur]

Wired: Ebola Is Back—and Vaccines Don’t Work Against It

Ebola is a disease of multitudes. For the most common species of the virus, successful vaccines have already been developed. But for others, no vaccine exists. To the dismay of health officials in Uganda, the version of the virus found in the body at Mubende was from the Sudan species, for which there is no vaccine.

[Smoove_B]

A friendly reminder that flu season is apparently starting early in parts of the US; now is a good time to go and get vaccinated.

https://twitter.com/drswlong/status/1583499177446604801

[Max Peck]

Yeah, I already have an appointment booked at my doctor's office for a flu shot. It isn't until the first weekend in November, but that's the earliest day that they're running their flu clinics. Given the option, I decided I'd rather wait a couple of weeks and get it there than try to book a shot at the pharmacy, where most people don't bother with masks anymore, and where people who think they have COVID go for testing.

[Blackhawk]

Three of the four of us got flu shots yesterday. They wouldn't give the shot to my youngest, as apparently you can't use medicaid for flu shots at pharmacies if you're under 20. Because reasons. So we're going to have to figure out somewhere else to take him, as it would probably be December before we could get him into his GP without an priority issue.

[Smoove_B]

That is...bizarre. I'm guessing it's somehow related to the Medicaid expansion that occurred in your state - that they still carved out exceptions (like not forcing pharmacies to vaccinate for diseases that aren't mandated for school attendance).

If I knew of a local service that could help, I'd offer it. Sorry.

EDIT: NM, that's for state employees. WTF

I'd check with your county health department at this point.

[Anonymous Bosch]

Three of the four of us got flu shots yesterday. They wouldn't give the shot to my youngest, as apparently you can't use medicaid for flu shots at pharmacies if you're under 20. Because reasons. So we're going to have to figure out somewhere else to take him, as it would probably be December before we could get him into his GP without an priority issue.

FWIW, many county health departments provide free flu vaccinations during flu season. So, have a butcher's at the relevant web site for your county health department to find out if, where, and when they're available in your locale.

[Blackhawk]

Yeah, the health department is the current plan. We called today and had to leave a message, but they never called us back, and now they're closed until Monday. What we were told at Wal-Mart (paraphrased):

~Medicaid will not cover vaccines at commercial pharmacies for people under 20 (I'm guessing she meant 20 and under.)
~She can't even check to see how much it would be out-of-pocket, because running it for cash could cost him his medicaid.

I have no idea. They've made it so that nobody except a trained specialist can actually understand how it works, so I just have to take her word for it.

[Anonymous Bosch]

Yeah, the health department is the current plan. We called today and had to leave a message, but they never called us back, and now they're closed until Monday. What we were told at Wal-Mart (paraphrased):

~Medicaid will not cover vaccines at commercial pharmacies for people under 20 (I'm guessing she meant 20 and under.)
~She can't even check to see how much it would be out-of-pocket, because running it for cash could cost him his medicaid.

I have no idea. They've made it so that nobody except a trained specialist can actually understand how it works, so I just have to take her word for it.

Try contacting your Primary Care Provider to ask if you can just have a nurse practitioner administer the vaccine for your son without necessitating a prior appointment. This shouldn't cost you anything, since your PCP should be able to handle the billing through Medicaid.

[Blackhawk]

The Health Department will still be considerably faster, especially given that it's two blocks from here, while his PCP is about 35 miles away, and perpetually overbooked.

[Smoove_B]

Another push for flu shots as hospitalizations increase significantly and much earlier than usual:

"We haven't seen this level of activity this early before," said Lynnette Brammer, team lead of the domestic influenza surveillance team at the CDC. Typical flu seasons usually don't pick up steam until December.

Flu hospitalizations are rising across all age groups, especially children. The increase comes as other respiratory viruses, including RSV, or respiratory syncytial virus, are also spiking in kids. According to the Department of Health and Human Services, 76% of pediatric hospital beds nationwide are full.

"We realize the potential implications of the co-circulating viruses all at once," Brammer said. "We're taking it very seriously."

[Blackhawk]

The Health Department will still be considerably faster, especially given that it's two blocks from here, while his PCP is about 35 miles away, and perpetually overbooked.

He was able to get his shot at the health department on Wednesday, by the way.

[Max Peck]

Why Pfizer’s RSV vaccine success is a big deal, decades in the making

As an unusually large and early seasonal surge of RSV cases inundate children's hospitals around the country, pharmaceutical giant Pfizer offered a glimmer of hope Tuesday in the form of top-line, phase three clinical trial results.

The company's experimental RSV vaccine—given to pregnant trial participants—was 82 percent effective at preventing severe RSV-related lower respiratory tract illness in the first three months of an infant's life. It was 69 percent effective over the first six months, Pfizer announced.

“We are thrilled by these data as this is the first-ever investigational vaccine shown to help protect newborns against severe RSV-related respiratory illness immediately at birth,” Pfizer Chief Scientific Officer Annaliesa Anderson said in a statement.

The company said it planned to file for regulatory approval from the Food and Drug Administration by the end of the year, which may mean a vaccine could be available in time for next year's RSV season.

The announcement is promising, but there are reasons for caution, too. The company has only released top-line results in a press release, for one thing. The data will have to go through more detailed outside review. Pfizer also noted that the vaccine failed to meet the second of the trial's two primary goals, which was to reach the pre-determined statistical criteria for efficacy against non-severe RSV-related lower respiratory tract illness—though the company says some efficacy was clinically meaningful.

Still, there is reason to be excited by Tuesday's news, which follows decades of struggle by researchers trying to fight RSV. That includes a disastrous vaccine trial in the 1960s, which caused vaccinated children to develop more severe disease from an RSV infection and led to the tragic death of two infants.

[Smoove_B]

Again, get your flu vaccine if you haven't already. It's hit epidemic status:

The U.S. has “crossed the epidemic threshold” when it comes to flu, federal health officials said Friday, as they outlined plans to deploy troops and FEMA personnel, and supplies like ventilators, if needed, in response to a nationwide surge of respiratory illnesses that also includes RSV and COVID.

U.S. flu hospitalizations are higher now than they’ve been at this point in every other flu season since 2010-2011, officials with the U.S. Centers for Disease Control and Prevention said on a press call.

[Isgrimnur]

When does it become endemic?

[Daehawk]

Always got ours in Oct and I continue to do so.

[Smoove_B]

When does it become endemic?

Never. It disappears each year and re-emerges with a slightly different combination of genetic codes to spread around world all over again. Cool, right?

Would you like to know more?

[Isgrimnur]

'Twas a Covid joke.

[Smoove_B]

Wasn't sure, and I'm in education mode 90% of the time for epidemic/pandemic/syndemic.

[Kraken]

Getting mine at Tuesday's walk-in clinic at Town Hall. We had appointments set for a couple of weeks ago, but I caught the covid instead, so now Wife and I are on different vaccine schedules.

[Isgrimnur]

Wasn't sure, and I'm in education mode 90% of the time for epidemic/pandemic/syndemic.

No worries. I still love you.

[em2nought]

If felt like the guy who gave me my omicron jab was digging around for a bullet. Nice big red welt that's finally diminishing after several days. I'm just about the only person shopping in a mask now. I still don't even touch my shopping cart handle.

[Max Peck]

My current working definition for "endemic" is "Sure, it's bad, but it isn't like it's ever going to get any better. ¯\_(ツ)_/¯ YOLO!"

[Daehawk]

I got all my shots. Im just doing the shopping all normal like.

[Smoove_B]

For reference, your state is Purple - the highest level of activity. We've not seen Purple this early since 2018 or 2019. This is pretty bonkers - and that's last week's data.

[stessier]

SC represent!!

[$iljanus]

For reference, your state is Purple - the highest level of activity. We've not seen Purple this early since 2018 or 2019. This is pretty bonkers - and that's last week's data.

Glad influenza is waiting its turn while RSV is filling up all the pediatric beds in MA. But with CT in the orange zone I wonder when it will pay us a visit? Everyone in my family is current on the flu and covid vaccines so hopefully we’re either completely spared or will not be taking up a bed in the hospital.

[hitbyambulance]

got an email from Pfizer today asking if i was interested in guinea-pigging their Phase III rDNA flu vaccine. more info: https://www.fluvaccinestudy.com

(to qualify, you can't have already received this year's flu vax)

[Kraken]

Glad influenza is waiting its turn while RSV is filling up all the pediatric beds in MA. But with CT in the orange zone I wonder when it will pay us a visit?

When the weather changes. It's still summer this weekend.

[Max Peck]

I got the flu shot at my doctor's office this morning. Since I'm also up to date with my COVID booster, that should mean that I've got double advantage on all constitution checks for the winter, if I understand the 5e D&D rules correctly.

[The Meal]

Pneumococcal vaccination up to snuff? RSV vax?