[Health] The Infectious Diseases Thread

[Blackhawk]

I'm sure we're going to respond appropriately.

We know what to do when rodents are spreading deadly diseases.

We kill the owls.

I thought it was sparrows.

Nope. It was the bubos.

[Isgrimnur]

[Smoove_B]

This one is kinda interesting...well, it is to me:

The National Park Service and U.S. Forest Service have confirmed plague as the cause of a prairie dog die off in Badlands National Park, Buffalo Gap National Grassland, and the greater Conata-Badlands ecosystem, in South Dakota based on a test result received 5/31.

The risk to humans remains low, however, plague is concerning. The disease has not been detected in Conata Basin since 2009, when it was responsible for killing more than 80 percent of the remaining population black-footed ferrets, one of the most endangered mammals in the world.

Again, not really a human concern at this point (though there is risk, as noted), it's really more of an interest to figure out what happened in 2009 and then not again until 2024.

Spoiler: A lab wasn't involved

[Punisher]

This one is kinda interesting...well, it is to me:

The National Park Service and U.S. Forest Service have confirmed plague as the cause of a prairie dog die off in Badlands National Park, Buffalo Gap National Grassland, and the greater Conata-Badlands ecosystem, in South Dakota based on a test result received 5/31.

The risk to humans remains low, however, plague is concerning. The disease has not been detected in Conata Basin since 2009, when it was responsible for killing more than 80 percent of the remaining population black-footed ferrets, one of the most endangered mammals in the world.

Again, not really a human concern at this point (though there is risk, as noted), it's really more of an interest to figure out what happened in 2009 and then not again until 2024.

Spoiler: A lab wasn't involved

Are we sure though?
Dod anyone actually check with the coyotes, bobcats, eagles, hawks, foxes, badgers or weasels? For all we know one of them decided to step up their game. Unless...they formed a secret coalition...

[hitbyambulance]

I'm not sure we're even at a public needs to do anything yet (other than stay informed). I've been quite confused at what seems like a lackluster motivation to (1) monitor, (2) track and (3) control what's happening in these various herds at a federal level. I can't explain it, other than waving my hands in the air and saying, "politics" - namely it would potentially hurt the agricultural industry financially (domestic, foreign) if we were doing what I always thought we would be doing in this scenario.

https://www.statnews.com/2024/06/05/bir ... questions/

Widespread reluctance on the part of farmers to allow scientists — government or otherwise — onto their premises to study spread of the virus among infected cows has created a frustrating lack of understanding of the dynamics of this outbreak. U.S. Department of Agriculture incentives aimed at getting farmers to test their cows and take preventive measures to protect both animals and farmworkers do not seem to have solved the impasse, even as the outbreak has affected 82 herds in nine states.

It’s not lost on many scientists, here and abroad, that the paucity of data coming out of the U.S. is not dissimilar to the limited information flow out of China in the early days of the Covid-19 pandemic — a situation the U.S and other governments complained about loudly at the time. With the shoe on the other foot, however, there is no overt effort to make farmers cooperate.

“A lot of criticism was leveled at China for their early response to Covid-19 — some of it reasonable, a lot of it extremely ignorant. Are we currently making some of those mistakes ourselves?” wondered Kristian Andersen, an evolutionary biologist and a professor of immunology and microbiology at Scripps Research Institute in La Jolla, Calif.

[LordMortis]

This one is kinda interesting...well, it is to me:

The National Park Service and U.S. Forest Service have confirmed plague as the cause of a prairie dog die off in Badlands National Park, Buffalo Gap National Grassland, and the greater Conata-Badlands ecosystem, in South Dakota based on a test result received 5/31.

The risk to humans remains low, however, plague is concerning. The disease has not been detected in Conata Basin since 2009, when it was responsible for killing more than 80 percent of the remaining population black-footed ferrets, one of the most endangered mammals in the world.

Again, not really a human concern at this point (though there is risk, as noted), it's really more of an interest to figure out what happened in 2009 and then not again until 2024.

Spoiler: A lab wasn't involved

In the early 90s, when I road tripped the West national parks for a month, the Bubonic Plague had lots of places closed off. I wouldn't be concerned about reports now either but freedom changes my attitude on such things. I mean, I was diagnosed TB for three months before I could get insurance to cover finding out it was latent (it was) and getting it treated. While I mostly quarantined myself for those three months (masked in and out grocery shopping a couple of times) and masked in the hospital when I finally got tested and Xray'd there was no requirement for me to do so. Before, the closing off of areas and the rare bubos spread to humans would send response in to cautionary overdrive. Now, I have zero faith in that response.

Are we sure though?
Dod anyone actually check with the coyotes, bobcats, eagles, hawks, foxes, badgers or weasels? For all we know one of them decided to step up their game. Unless...they formed a secret coalition...

In the 90s, they attempted to monitor such things. Today? :shurg:

[Punisher]

Are we sure though?
Dod anyone actually check with the coyotes, bobcats, eagles, hawks, foxes, badgers or weasels? For all we know one of them decided to step up their game. Unless...they formed a secret coalition...

In the 90s, they attempted to monitor such things. Today? :shurg:

Wait. We DID monitor wildlife in case they decided to start biological warfare or form a secret coalition?
We should have never stopped!

[Zarathud]

The wildlife isn’t sending us their best. They’re full of vermin and disease, paying no attention to borders or civilization. If we’re not tracking them, we’ll never know if they’re supporting election interference. The filthy animals, they may be full of poison.

[Punisher]

Perhaps it is time to put up a wall and prevent them from illegally migrating?

[Zarathud]

Walls won’t stop Cocaine Bear.

[Blackhawk]

Cocaine bear has tunnels.

[Smoove_B]

Didn't see this coming - CDC revise recommendations for RSV vaccination:

In an unusual move, federal health officials revised their recommendations for who should receive the vaccine against the respiratory syncytial virus.

The Centers for Disease Control and Prevention recommended last year that adults age 60 or older could receive a single lifetime dose of an R.S.V. vaccine, in consultation with their health care providers.

On Wednesday, scientific advisers to the agency reframed that guideline. Based on recent safety and effectiveness data, they unanimously recommended that all Americans age 75 and older receive one dose of an R.S.V. vaccine.

But for adults 60 to 74 years of age, the panel endorsed vaccination only for those with certain serious conditions, such as chronic heart or lung disease, advanced kidney disease and diabetes with organ damage.

The advisers voted not to recommend the vaccine for other adults in this age group, although individuals may still consult with their health care providers to evaluate the risk that the infection poses to them.

Paradoxically, the new criteria may qualify more people to receive the shot, some advisers said. Not everyone at high risk — some older Black Americans, for example — has access to a health care provider who can make that determination.

[Punisher]

So what if yiu aren't 60 yet but have advanced kidney disease?
Asking for a friend..
Well not a friend exactly but I know him well..
Ok. Your got me. Asking for me.

[Smoove_B]

Sorry, we lost power last night at 11pm and it was just turned back on about an hour ago.

So what if yiu aren't 60 yet but have advanced kidney disease?

Sorry, I don't know the answer here. I'd bed your PCP can somehow get it for you if they think it is medically advisable through some type of prescription blood sugar sex magic (or whatever they call it).

[LordMortis]

I'd bed your PCP

That's certainly one way to approach things.

[Smoove_B]

I am f-ing delirious.

[LordMortis]

Was going to repsond with Prince but went this way instead

[Jeff V]

He's touring this year!

[LordMortis]

I saw him in the the last teens. He put on like 3 hour show. You'd think that would be awesome but it was hot and crowded and standing room and there just wasn't enough magic in his set to keep me for three hours. I guess I wasn't a big enough fan.

[Jeff V]

So yesterday my wife scored her hat trick -- third time testing positive for Covid. She has the same symptoms I had a week ago when I was laid up for 5 days...didn't test, but in retrospect I may have had it a second time. I think I was vaccinated more recently than her, so wasn't affected quite as bad. My son had similar symptoms, but for only about a day.

My daughter remains the only one in the house who has never had it, and has been exposed plenty of times at home and school.

[Smoove_B]

I'm sorry to hear all of that as I come back to this thread...

Finland is vaccinating farm workers against H5N1 - bird flu, but we're gonna skip it here in the United States:

“Farmworkers, veterinarians, and producers are handling large volumes of milk that can contain high levels of bird flu virus,” said Kay Russo, a livestock and poultry veterinarian in Fort Collins, Colorado. “If a vaccine seems to provide some immunity, I think it should be offered to them.”

Among a dozen virology and outbreak experts interviewed by KFF Health News, most agree with Russo. They said people who work with dairy cows should be offered vaccination for a disease that has killed roughly half of the people known to have gotten it globally over the past two decades, has killed cats in the U.S. this year, and has pandemic potential.

Counterpoints:

However, some researchers sided with the Centers for Disease Control and Prevention in recommending against vaccination for now. There’s no evidence that this year’s bird flu virus spreads between people or causes serious disease in humans. And it’s unclear how well the available vaccine would prevent either scenario.

Of note:

But the wait-and-see approach “is a gamble,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University. “By the time we see severe outcomes, it means a lot of people have been infected.”

"Let's not doing anything and wait and see how bad this gets" definitely fits with the current policy on this timeline.

I also read a really interesting article about how we (public health) should be using the lessons of Covid-19 and start working with schools *now* to try and prepare for a bird-flu pandemic as we were clearly not ready (and still aren't). Nothing is happening in my own state and I'm not aware of other states doing anything, but I'll certainly keep looking.

[Smoove_B]

This is starting to feel familiar, somehow. I can't quite place it...

Colorado health officials have given us new details about the 5 human cases of H5N1 bird flu.

• Another 16 symptomatic workers were tested yesterday
• In total: 69 symptomatic workers, 5 positive so far
• Test results still pending
• Antiviral medication given to 150 workers

[Smoove_B]

Not sure when a dedicated thread will need to be started, but I'm guessing soon:

Six people who work at a poultry farm in northeastern Colorado have tested positive for the bird flu, the Centers for Disease Control and Prevention reported July 19. This brings the known number of U.S. cases this year to 10.
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The workers were likely infected by chickens, which they had been tasked with killing in response to a bird flu outbreak at the farm. The endeavor occurred amid a heat wave, as outside temperatures soared to 104 degrees Fahrenheit.

Temperature comment is important because it's likely contributing as to why they aren't wearing masks to reduce risk. This goes back to earlier observations that maybe we should be vaccinating them (in light of that) instead of doing *absolutely nothing*.

Again:

“If a farm worker gets severely ill or dies from an H5N1 infection, it will be a stain on US public health that we didn’t do more with the tools we have,” Jennifer Nuzzo, director of the Pandemic Center at Brown University, posted on X. “You don’t send farm workers in to cull H5N1 infected birds without goggles and masks. Period. If it’s too hot to wear those protections, it’s too hot to cull. We need vaccines to be made available to farm workers. We have to stop gambling with peoples’ lives.”

A reminder:

The number of people who have gotten the virus from poultry or cattle may be higher than 10. The Centers for Disease Control and Prevention has tested only about 60 people over the past four months, and powerful diagnostic laboratories that typically detect diseases remain barred from testing for bird flu. Testing of farmworkers and animals is needed to detect the H5N1 bird flu virus, study it, and stop it before it becomes a fixture on farms.

[gilraen]

3 more cases of avian flu reported in Colorado, at a different facility.

[Smoove_B]

I saw today (need a link) that CO is going to be creating a website/dashboard to start tracking and sharing information, which is good.

Watching this all unfold is still kinda insane (which I know I keep saying, but it's true).

[Isgrimnur]

Bird flu by the dashboard light.

[Smoove_B]

In excellent news, so far there have been ZERO cases of Guinea Worm disease reported this year. There's a real good chance former President Carter will get his wish and humans will have successfully eradicated two diseases from the planet.

When The Carter Center began leading the international campaign to eradicate Guinea worm disease in 1986, there were an estimated 3.5 million cases in at least 21 countries in Africa and Asia. Today, that number has been reduced by more than 99.99%.

Absolutely astounding.

[Isgrimnur]

When Jimmy Carter wants you and your kind dead, you done fucked up.

[Isgrimnur]

Please stop eating raw shellfish - I'm begging you.

Officials have attributed his death to Vibrio vulnificus, a bacteria prevalent in warm, coastal waters, which can infect individuals when they consume raw or undercooked shellfish, notably oysters. Additionally, infection can occur through contact with an open wound.

Health officials urged people to use caution in coastal waters after a person succumbed to a rare vibriosis infection this month.

Rhode Island health officials are warning beachgoers about the risks of entering coastal waters with open wounds after a resident died of a rare bacterial infection.

The Rhode Island Department of Health said the person, who they did not identify, died sometime this month after becoming infected with vibriosis. It’s the state’s first reported case of the infection since 2017.

The infection is caused by the bacteria Vibrio vulnificus, which lives in warm seawater or brackish water. People can also develop the infection by consuming raw or undercooked seafood.

Rhode Island health officials said the infection is “very rare” but dangerous for people with underlying health issues. In severe cases, the infections can cause life-threatening sepsis. They urged people to avoid entering the ocean or brackish water if they have any open cuts, scrapes, recent surgery sites, fresh piercings, or new tattoos.

[Smoove_B]

Sorry if this is repeat news for our Colorado residents:

Six feline cases of Influenza A (HPAI H5N1) have been diagnosed in domestic cats in Colorado during 2024. One of these cases was directly associated with a known infected commercial dairy facility. Two of the six cases were indoor only cats with no direct exposures to the virus. Three of the six cases were known indoor/outdoor cats that hunted mice and/or small birds as prey and also spent time indoors with their owners. Five of the six cases have presented with similar clinical signs and disease progression: an initial complaint of lethargy and inappetence, followed by progressive respiratory signs in some and fairly consistent progressive neurologic signs in most. Several of these cases were tested for rabies preceding diagnosis with H5N1 infection due to the indistinguishable presentation once neurologic signs presented.

This is what jumped out to me:

There is high abundance of virus in Colorado at this time, predominantly being detected in domestic dairy cattle in commercial dairy herds with spillover into mammals and wild birds on and near these premises.

[Max Peck]

So birds are catching H5N1 from the cattle now, instead of the other way around? Cool!

[Isgrimnur]

CVS just texted me to come get a flu shot. I think I'll wait a bit.

[The Meal]

No, that happy news is, indeed, new to me. Good luck kitties. Good luck to us all.

[Smoove_B]

Not great:

The World Health Organization on Wednesday declared the spread of mpox in multiple African countries a public health emergency of international concern, the second such declaration in the past two years called in response to transmission of the virus.

The latest decision came on the recommendation of a panel of experts convened to advise WHO Director-General Tedros Adhanom Ghebreyesus on the issue. It also follows a similar declaration Tuesday by the Africa Centres for Disease Control and Prevention.

“It’s clear that a coordinated international response is essential to stop this outbreak and save lives,” Tedros said in announcing the declaration of the PHEIC.

What's different?

Mpox transmission in the DRC has traditionally involved small children who become infected when they trap and handle the rodents believed to carry the virus. Infected children may also infect others within their households.

Many of the cases that the DRC has reported this year — more than 14,000, with over 500 deaths — involve this type of transmission, largely in the western part of the country.

But sexual transmission of clade I viruses has now also been observed, with a locus of spread detected in the eastern portion of the DRC, near where the country borders Uganda, Rwanda, and Burundi. People seen to have been infected in this outbreak include sex workers and their clients as well as men who have sex with men.

Person-to-person transmission has led to changes in the virus, which has now been dubbed clade Ib.

[Smoove_B]

Right on time:

Sweden's public health agency has recorded what it says is the first case of a more dangerous variant of mpox outside the African continent.

The person became infected during a stay in an area of Africa where there is currently a major outbreak of mpox Clade 1, the agency said.

More info:

The mortality rate from the Clade 1 variant in Sweden will not be as high as that seen in parts of Africa, because of the high quality of healthcare in Europe.

The European Centre for Disease Prevention and Control said symptoms usually appeared 6-13 days after infection, through fevers and headaches, rashes or sores and muscle ache.

Most people experienced mild to moderate symptoms followed by a full recovery, but immuno-compromised individuals were at greater risk.

While news of the first case outside Africa may cause alarm, it was to be expected and further cases are likely to follow in other parts of the globe.

As other disease outbreaks have shown, swift international action can help stop the disease spreading further.

[gilraen]

Existing vaccines should work on this variant, though, correct? I mean, mpox is not exactly Covid, considering they were able to use decades-old smallpox vaccine formulation on it during the last outbreak. Of course, availability of the vaccine and determining the vulnerable populations to vaccinate is another story.

[Smoove_B]

Yes, my understanding is that the smallpox vaccination will work against it. It's absolutely a resource-management issue (tracking, treatment) at this point.

[Blackhawk]

Great. The jibba-jabba I'm hearing is AIDS all over again - it's a 'gay disease' that's only a threat to godless degenerates. Oh, and they're insisting on still calling it 'monkey pox' because it's got a mildly racist interpretation.

[Smoove_B]

Yeah, again, not great:

While the previous outbreak predominantly affected homosexual populations, data indicates that the new strain is also being transmitted far more broadly, perhaps initially through sexual networks and then being passed on to family members. Last month, Nachega and others published a paper in the journal Nature Medicine demonstrating how an outbreak of mpox began in the small mining town of Kamituga in eastern DRC through sex workers before being transmitted to nearby Rwanda, Uganda, and Burundi as the infected individuals returned home to visit their families.

Of note:

“The 2022 global outbreak was clade 2, and mortality was less than 1 percent,” says Jean Nachega, a Congolese infectious disease doctor and an associate professor of medicine at the University of Pittsburgh. “Now we’re talking about a strain which can have up to 10 percent mortality.”

Regarding HIV:

“It’s kind of becoming the new HIV,” says Nachega. “When I finished medical school, the HIV pandemic was taking off. We don’t want to see this become another pandemic of a sexually transmitted infection. So that’s why we need to stop this clade 1 outbreak regionally before it gets to the levels of the 2022 one, which ended up going around the globe.” On Thursday, Sweden confirmed its first case of clade 1 mpox, in a person who had been infected while traveling in Africa.

To stop mpox from spreading further, Titanji says, a massive surveillance program is needed, involving a combination of contact tracing, isolation, and testing followed by large-scale immunization campaigns. Existing vaccines can be used both to prevent people contracting the virus and to stop infected individuals from spreading it further. However, carrying out such a program poses both logistical and financial challenges.

[Smoove_B]

Can't say I can recall seeing anything like recommending a curfew before:

A small town in Massachusetts is urging residents to stay indoors in the evenings after the spread of a dangerous mosquito-spread virus reached "critical risk level."

The virus causes Eastern equine encephalitis (EEE), which kills between 30 and 50 percent of people who are stricken—who are often children under the age of 15 and the elderly. Around half who survive are left permanently disabled, and some die within a few years due to complications. There is no treatment for EEE. So far, one person in the town—an elderly resident of Oxford—has already become seriously ill with neuroinvasive EEE.

...

On August 16, the Massachusetts Department of Public Health announced the state's first case and declared a "critical risk level" in the four communities of Douglas, Oxford, Sutton, and Webster. These all cluster in Worcester county near the state's borders with Rhode Island and Connecticut.

Note:

Officials emphasized that the curfew is a recommendation, not mandatory. However, to use town properties—such as recreation fields—people will first need to file an indemnification form and provide proof of adequate insurance coverage to the town.

To date, there have been only three cases of EEE in the US this year. One in Massachusetts, one in Vermont, and the last in New Jersey. All three are neuroinvasive. The CDC says that about 30 percent of cases are fatal, while Massachusetts health officials report that about half of people who develop EEE in the state have died.

In 2019, there was a multi-state outbreak of EEE, leading to a high of 38 cases. Twelve of the cases occurred in Massachusetts, and six died.