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"Here's an update on the latest developments in public health: Avian flu and measles outbreaks, the end of the respiratory season, and mpox (monkeypox) brewing on the horizon.
Avian flu: risk remains lowSince the last YLE update, there have been a few important (and optimistic) insights into the current avian flu outbreak:
Lab results came in from a Texas farmer. CDC collected samples and posted results in a highly technical document. (Results were surprisingly fast, which is a nice change of pace.) Here is the plain language translation:
One mutation—PB2 E67K—was found in the virus that infected the farmer. A mutation in this spot indicates that the virus mutated to jump to mammals. This was expected.
There were no other surprising mutations, including no mutations that indicated an increased ability to spread human-to-human.
Antivirals and the H5N1 vaccines we have in a small emergency stockpile will still work. It’s unclear to what extent the seasonal flu shot will provide cross-protection.
Another state with infected cows. It’s time to add Ohio to the list, bringing the total to 15 dairy herds across six states. We will likely see more.
The virus is replicating in the udder. USDA tested cow’s milk, noses, and blood and found the most replicating virus in the udder. This means it’s likely spreading via milking machines, which would be easier to control than in the air. Also, the virus samples across cows look very similar, meaning this outbreak likely happened during one spillover event (from a dead bird).
Chickens are being infected. Two avian flu outbreaks in chickens have now been reported in Texas and Michigan. The largest producer of fresh eggs said it had temporarily halted production and is killing 1.6 million hens and 337,000 baby chickens. Avian flu has also been detected among cats at the farms.
Clinicians are on alert. The CDC warned physicians to be on the lookout for avian flu patients. I don’t know how necessary this is, given that the probability of this happening is small and isolated.
Economy vs. public health debate bubbling up. The wide geographical distribution of avian flu in such a short time period is concerning. It would be incredibly helpful to understand, at the very least, how this is spreading by testing livestock. However, the age-old battle between the economy (concerns about losing livestock exports) and public health (testing livestock) is igniting. I would strongly argue that a healthy economy depends on controlling avian flu.
Measles: Still heating up
March was a big month for measles. We are up to 119 cases, more than double last year’s total.
CDC has finally started providing data on the severity of these cases:
95% of cases are among unvaccinated or under-vaccinated (only 1 MMR vaccine) people. This tells us that the vaccines are working.
58% of cases are hospitalized. This is high, as typically 1 in 5 cases are hospitalized. This may be inflated due to mandatory isolation, which can be done at a hospital.
The majority of cases and hospitalizations are among those under 5 years old.
Communities can be categorized into three “groups” of risk, as displayed below. While most (70%) of communities have high immunity, 29% are susceptible to small and medium outbreaks. This means we will likely see more small outbreaks this year. The risk of a huge outbreak remains low, but it’s certainly possible.
Respiratory season: (nearly) over
The number of people going to the doctor for cough or fever is declining quickly. We are almost at the epidemic-level threshold, which means the respiratory season is nearly over. This means I will no longer be masking. This season lasted about five months—on par with pre-pandemic years.
This also means that Covid-19 is nosediving, as seen in the wastewater below. It will likely be back this summer, as this has been the pattern for the past three years. Enjoy the lull for now."
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