Update on Infectious Disease Threats: What You Need to Know

Information about various infectious diseases is constantly evolving. I am hoping to summarize some of that in these newsletters. New information will be in BOLD!

GENERAL:

COVID-19

General Information

COVID cases are risking again, due to a new strain "NB.1.8.1." It is also affectionately known as "Nimbus." Hospitalizations are going up also, as we have seen in parts of Asia in particular. And it seems that this particular variant is quite contagious also, though luckily no more dangerous than previous strains.
This new variant has also gathered the moniker "razor blade throat," which does not sound good!
Covid cases are increasing. Wastewater testing has found "moderate" amounts of the virus in California, though there are "high" levels in the San Joaquin Valley. Although levels are not as high as this time last year, levels are higher than in 2023...and experts believe there is much more COVID out there than is being officially registered, as most people test positive at home and that is not "counted" in the official tallies.
The FDA has approved a new, "next generation" COVID-19 vaccine called "mNexspike" to be used in adults 65 and older (as well as younger patients with underlying health conditions). It is made with a novel technology that allows only 20% of the current dose to be given. People should have been vaccinated previously with one of the older, full-strength COVID vaccines prior to getting mNexspike. I am not aware how this new vaccine compares to the old one by way of side effects and efficacy. But both the old and the new vaccine will be available this fall.
The updated COVID-19 vaccines from 2023/ 24 were able to effectively prevent COVID-19: getting a shot led to a 24% lower risk of going to the emergency department, a 29% lower risk of being hospitalized, and a 48% lower risk of ending up in the ICU! This protection lasted up to 300 days after vaccination, though you were most protected in the first 2 months after vaccination. (JAMA Network Open).
I know a lot of us are tired of getting yet more COVID booster shots. But you should know that a yet another study (JAMA Oncology) showed that the boosters did protect against severe COVID-19 infections in people who have cancer.
A recent article in JAMA Network Open found that being hospitalized for COVID-19 is associated with more pronounced cognitive decline compared to those who were not hospitalized with the condition.
The American Heart Association is now recommending that people with Long Covid start an exercise regiment. Studies have found that exercise will help with the symptoms. But some exercise is better than others:
- start with low-duration, low-intensity exercise
- avoid "upright exercise" such as running. Instead, try a recumbent or semi-recumbent bike or rowing.

Other Infectious Diseases:

Norovirus:

Norovirus is an extremely contagious virus that causes severe diarrhea, nausea, and vomiting.
Alcohol hand sanitizer does NOT kill the norovirus....but good old-fashioned soap and water does!
Since January 1, 2025, 16 cruise ship outbreaks of gastrointestinal illnesses have been reported and at least 12 of these were due to norovirus. In all of 2024, there were 18 outbreaks (15 with norovirus).

AVIAN FLU:

AKA "Highly Pathogenic Avian Influenza" or HPAI (or " 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.
Cambodia has reported the most of the human deaths associated with H5N1: 7 people were reported infected and 5 of them died.
The USDA is considering vaccination of commercial poultry against the virus. But there are still lots of questions about whether this approach would be feasible and effective and safe. Other countries have started poultry vaccination against HPAI.

FLU:

We usually look to Australia (where it's winter now!) to help predict what our flu season will look like. Unfortunately, there is a lot of influenza Down Under right now....so we need to be prepared to have another bad season here in the fall. I hope we're wrong!

RSV:

Recent recommendations from the CDC recommend a single dose of RSV vaccine for people older than 75 in general, as well as for people older than 50 with underlying conditions.

MEASLES:

Measles is a highly contagious disease. Every person sick with measles can transmit the virus to 12-16 unvaccinated people. Just standing next to someone with measles (as in an international airport) can be enough to get you sick.
Measles was thought to have been eradicated in the U.S. in 2000. Unfortunately, vaccination rates have since fallen, leaving communities very vulnerable to the highly infectious disease. Last year, there were 285 cases of measles reported in the U.S.
Before the measles vaccine became available in 1963, 3 to 4 million people in the U.S. were infected with measles each year, 48,000 ended up in the hospital, 400-500 died.
Complications associated with measles include pneumonia, brain infections, vulnerability to future infections of multiple kinds, hearing loss, and pregnancy complications.
The death rates associated with measles is usually 2 per 1000.
Currently, the measles outbreak is growing in Texas and New Mexico, where vaccination rates were lower than recommended. At this time, there are over 1200 people who are known to be infected nationwide. 13% of people with known measles have been hospitalized. Children less than 5 with measles have a hospitalization rate of 23%. Three people (including 2 otherwise healthy children) have died. 95% of the cases were in people who were either unvaccinated or had an unknown vaccination status. 3% were fully vaccinated: this is consistent with prior studies that found that getting two doses of the measles vaccine is protective 97% of the time. In addition, it is likely that an additional hundreds (thousands?) of people are infected but were not officially diagnosed. Most cases are in children aged 5 to 17.
This is the highest number of measles cases in the U.S. since the disease was declared "eradicated" back in the year 2000! Experts are concerned that the U.S. will lose its status of a country in which measles been eliminated.
There is NO scientific evidence that measles vaccines lead to autism, cancer, or heart disease.

OTHER MEDICAL NEWS:

As mentioned in previous newsletters, the "body mass index" we physicians have been using to help diagnose people who are overweight or obese are "on the out." Studies have found that a person's percentage body fat (which we measure when you have a physical exam!) is a better predictor of future heart and other health problems. Another more accurate test in assessing someone's risk of dying is their waist circumference (Annals of Family Medicine).
A recent study (JAMA Network Open) found that it is more effective to take your blood pressure pills at night than in the morning.
A different study (Annals of Internal Medicine) looked at the vaccine experience of over 1 million people and found NO link between aluminum content in vaccines and an increased risk of 50 different medical conditions, including autoimmune disorders, allergies, and autism. Good to know!

About Dr. Sujansky's Life in These Times

I flew to the East Coast last month for my college reunion. Although the trip itself was on the short side (4 days) and I had some concerns that there would be too much travel with too little reward, I was proven wrong. I had the best time connecting with old friends and acquaintances. And isn't it almost always like that? We try to talk ourselves out of some plans of meeting with friends because we are tired or don't feel like it and then we have the best time! So I encourage all of us (myself included!) to say "yes" more when an adventure is proposed. I think it usually pays off...

I went to a lecture this week by the documentary film maker Ken Burns. Loved it! He has a new series coming out bout the American Revolution in the fall and I think it's going to be fantastic. Look for it! Also, the talk was at the Palace of Fine Arts in San Francisco and that is one of my favorite places in the City. Simply gorgeous! So, a win all around.

Other than that, I'm enjoying the warm weather, my new e-bike (contrary to popular opinion, riding an e-bike is still work :)!), and evenings on the patio.

Update on Infectious Disease Threats: What You Need to Know

Information about various infectious diseases is constantly evolving. I am hoping to summarize some of that in these newsletters. New information will be in BOLD!

GENERAL:

COVID-19

General Information

This new variant has also gathered the moniker "razor blade throat," which does not sound good!

I know a lot of us are tired of getting yet more COVID booster shots. But you should know that a yet another study (JAMA Oncology) showed that the boosters did protect against severe COVID-19 infections in people who have cancer.

**A recent article in JAMA Network Open found that being hospitalized for COVID-19 is associated with more pronounced cognitive decline compared to those who were not hospitalized with the condition.**

The American Heart Association is now recommending that people with Long Covid start an exercise regiment. Studies have found that exercise will help with the symptoms. But some exercise is better than others:

- start with low-duration, low-intensity exercise

- avoid "upright exercise" such as running. Instead, try a recumbent or semi-recumbent bike or rowing.

Other Infectious Diseases:

Norovirus:

Norovirus is an extremely contagious virus that causes severe diarrhea, nausea, and vomiting.

Alcohol hand sanitizer does NOT kill the norovirus....but good old-fashioned soap and water does!

Since January 1, 2025, 16 cruise ship outbreaks of gastrointestinal illnesses have been reported and at least 12 of these were due to norovirus. In all of 2024, there were 18 outbreaks (15 with norovirus).

AVIAN FLU:

AKA "Highly Pathogenic Avian Influenza" or HPAI (or " 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.

Cambodia has reported the most of the human deaths associated with H5N1: 7 people were reported infected and 5 of them died.

The USDA is considering vaccination of commercial poultry against the virus. But there are still lots of questions about whether this approach would be feasible and effective and safe. Other countries have started poultry vaccination against HPAI.

FLU:

We usually look to Australia (where it's winter now!) to help predict what our flu season will look like. Unfortunately, there is a lot of influenza Down Under right now....so we need to be prepared to have another bad season here in the fall. I hope we're wrong!

RSV:

Recent recommendations from the CDC recommend a single dose of RSV vaccine for people older than 75 in general, as well as for people older than 50 with underlying conditions.

MEASLES:

Measles is a highly contagious disease. Every person sick with measles can transmit the virus to 12-16 unvaccinated people. Just standing next to someone with measles (as in an international airport) can be enough to get you sick.

Measles was thought to have been eradicated in the U.S. in 2000. Unfortunately, vaccination rates have since fallen, leaving communities very vulnerable to the highly infectious disease. Last year, there were 285 cases of measles reported in the U.S.

Before the measles vaccine became available in 1963, 3 to 4 million people in the U.S. were infected with measles each year, 48,000 ended up in the hospital, 400-500 died.

Complications associated with measles include pneumonia, brain infections, vulnerability to future infections of multiple kinds, hearing loss, and pregnancy complications.

The death rates associated with measles is usually 2 per 1000.

This is the highest number of measles cases in the U.S. since the disease was declared "eradicated" back in the year 2000! Experts are concerned that the U.S. will lose its status of a country in which measles been eliminated.

There is NO scientific evidence that measles vaccines lead to autism, cancer, or heart disease.

OTHER MEDICAL NEWS:

**A recent study (JAMA Network Open) found that it is more effective to take your blood pressure pills at night than in the morning.**

A different study (Annals of Internal Medicine) looked at the vaccine experience of over 1 million people and found NO link between aluminum content in vaccines and an increased risk of 50 different medical conditions, including autoimmune disorders, allergies, and autism. Good to know!

About Dr. Sujansky's Life in These Times

Other than that, I'm enjoying the warm weather, my new e-bike (contrary to popular opinion, riding an e-bike is still work :)!), and evenings on the patio.

I hope you are doing the same (perhaps without the e-bike...).