[Health] The Infectious Diseases Thread

[Max Peck]

No and no, but my primary line of defense is clean hands and a respirator when I have to be in amongst the unwashed masses, so I'm probably fine. If my doctor thought I needed anything above and beyond the flu shot, I'd have heard about it.

[em2nought]

Pneumococcal vaccination up to snuff? RSV vax?

What's the guidance for age to get the Pneumococcal injection now, and what is RSV?

[Blackhawk]

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.

Yeah, but the DM's a dick, so every single dungeon and village you enter will be populated by NPCs with Infectious Breath. The DM figures that if he makes you roll enough, you'll get 1s eventually.

[Max Peck]

Winter is coming...

Wear masks indoors, Ontario doctors urge ahead of 'perfect storm' in pediatric system

Ontarians are being advised to keep up with vaccinations and wear masks indoors as doctors warn of a worsening respiratory illness season that's hitting children — and the pediatric health system — particularly hard.

Physicians at a news conference hosted by the Ontario Medical Association said Wednesday that influenza arrived early in the province and more than half of Canadian cases of the illness so far have been in children and teenagers.

The early arrival of the flu, a resurgence in respiratory syncytial virus, or RSV, and the continued spread of COVID-19 has made for a "triple threat" respiratory season that's sending many children to the hospital and the situation is expected to get worse in the coming months, doctors said.

"It's a little bit of a perfect storm," said Dr. Rod Lim, emergency medical director of the ER at the Children's Hospital in London, Ont.

The pediatric health-care system is under significant strain due to staffing challenges, medication supply chain issues and early circulation of viruses that typically peak in January, February and March, Lim said.

[gilraen]

Pediatric ICUs at capacity in Colorado

The current RSV season has started early and the numbers are very high, Colorado State Epidemiologist Dr. Rachel Herlihy said.

The RSV appears to be impacting children more than any other virus right now, Herlihy said.

In the last few weeks, pediatric ICU beds have been at capacity. Availability has been between 0 and 5 statewide, according to the Director of the Division of Disease Control for CDPHE, Scott Bookman.

The state is also seeing an increase in Influenza A and COVID-19 cases as well, according to Herlihy. The 7-day average positivity in Colorado is 11.99%.

"We believe that at least part of this increase in transmission of COVID-19 is being driven by new subvariants," Herlihy said.

Colorado has also seen 92 flu hospitalizations as of November 5, CDPHE reported.

Children's Hospital Associate Chief Medical Officer, Dr. Kevin Carney, said their emergency department has a daily average of patients 30% higher right now than compared to the busiest days of previous respiratory seasons.

[Daehawk]

I dont recall hearing of RSV before this year. Also in my mind theres been more new diseases spring up in the last 20 years than all my life before that. As a kid I only remember having to worry about the flu.

[Kraken]

I dont recall hearing of RSV before this year. Also in my mind theres been more new diseases spring up in the last 20 years than all my life before that. As a kid I only remember having to worry about the flu.

My little sister almost died of scarlet fever. You don't hear about that one anymore. The trifecta when I was little was chicken pox, mumps, and measles, all of which I had, and then mononucleosis when I was a teen. Measles still gets some ink but you don't hear much about the others, either. I credit Smoove for that.

[Isgrimnur]

I got chicken pox in 1996.

[Blackhawk]

I dont recall hearing of RSV before this year. Also in my mind theres been more new diseases spring up in the last 20 years than all my life before that. As a kid I only remember having to worry about the flu.

That's mostly an illusion. The changes are that we have (presumably) gotten better at identifying diseases, and that the internet lets us hear about things we never would have before.

When you (and I) were kids, the only sources of info were the newspaper and the 6 o'clock news. They didn't have the time or space to cover every minor scientific tidbit, and most of their audience would have changed the channel had they tried. Now, rather than being limited to what has the broadest appeal, we have the internet, allowing us to see what interests us, personally. It creates the illusion that there is more of that matter than there used to be.

[Daehawk]

I dont recall hearing of RSV before this year. Also in my mind theres been more new diseases spring up in the last 20 years than all my life before that. As a kid I only remember having to worry about the flu.

My little sister almost died of scarlet fever. You don't hear about that one anymore. The trifecta when I was little was chicken pox, mumps, and measles, all of which I had, and then mononucleosis when I was a teen. Measles still gets some ink but you don't hear much about the others, either. I credit Smoove for that.

My wife had scarlet fever as a child too. I mean we really only worried about the flu. Of course we knew of measles and polio and chicken pox..had that. But nothing really worrying in the 70s because there were shots for most everything and chicken pox wasn't thought of as bad just annoying. Now days you really have to worry about COVID and bird flu and SARS, and RSV and hantavirus to name a few.

[Roman]

Winter is coming...

Wear masks indoors, Ontario doctors urge ahead of 'perfect storm' in pediatric system

Ontarians are being advised to keep up with vaccinations and wear masks indoors as doctors warn of a worsening respiratory illness season that's hitting children — and the pediatric health system — particularly hard.

Physicians at a news conference hosted by the Ontario Medical Association said Wednesday that influenza arrived early in the province and more than half of Canadian cases of the illness so far have been in children and teenagers.

The early arrival of the flu, a resurgence in respiratory syncytial virus, or RSV, and the continued spread of COVID-19 has made for a "triple threat" respiratory season that's sending many children to the hospital and the situation is expected to get worse in the coming months, doctors said.

"It's a little bit of a perfect storm," said Dr. Rod Lim, emergency medical director of the ER at the Children's Hospital in London, Ont.

The pediatric health-care system is under significant strain due to staffing challenges, medication supply chain issues and early circulation of viruses that typically peak in January, February and March, Lim said.

3 members of my team came down with the flu over the last 2 weeks. All 3 have had covid already (one guy 2x) and they have all said that whatever they caught this time is way worse than Covid. They all tested negative for the vid.

I am planning on getting my flu shot today just for fun. Will get my 4th vaccine later in December - my 3rd was back in July.

[Daehawk]

Always get my flu shot in Oct and did again. Me and my wife started getting them together decades ago in Oct. I stopped getting them for 10 years nearly around like 1995 - 2005. But started back up again with her when her parents had passed and it was just us in the world. I didn't want to get sick and get her sick or make it harder on her by caring for me with the flu. So been pretty strict on them even after she died in 2019.

[Smoove_B]

Published a day early because of the holiday. This is very, very abnormal - to see this level of activity this early. Flu season doesn't end until May, so it'll be interesting to see how this progresses over the next month.

[Daehawk]

Gee look at those high numbers in the southern GOP led, GOP voters, anti vaccine backwards states. No surprise there.

[Kraken]

New England is having a record-warm November, so we haven't been forced indoors yet. That will change after the remnants of Nicole blow through this weekend. Highs will fall from the 60s and 70s to the 40s.

I got my jab last Tuesday.

[Daehawk]

Same. Its been in the 60s and 70s but come Sunday highs will be 40s and lows 28-31

[Max Peck]

From the Public Health Agency of Canada:

FluWatch report: October 30 to November 5, 2022 (week 44)

At the national level, influenza activity has crossed the seasonal threshold, indicating the start of an influenza epidemic. All surveillance indicators are increasing and most are above expected levels typical of this time of year.

[hitbyambulance]

still haven't gotten sick since the end of 2019. i have been to a number of concerts and been on a number of plane rides since then. i credit wearing N95s and respirators everywhere in public. also, not living with small children.

also of note - visited Mexico City a few weeks ago, and people there were, on the whole, waaaay more conscientious of wearing facial coverings than i see even now in Seattle (which is still one of the more conscientious places in the US).

[em2nought]

Gee look at those high numbers in the southern GOP led, GOP voters, anti vaccine backwards states. No surprise there.

My cousin is one of you non-subhuman type people, and I have to talk her into getting a flu shot so...

[Smoove_B]

Locally acquired Dengue in (checks notes) Arizona?

According to Mayo Clinic, dengue is common in tropical and subtropical areas of the world with millions of cases reported each year. It is rare in the United States, however, with an average of less than 20,000 cases per year.

Florida, Texas and Hawaii? Sure. But Arizona??

[Isgrimnur]

[gbasden]

Gee look at those high numbers in the southern GOP led, GOP voters, anti vaccine backwards states. No surprise there.

My cousin is one of you non-subhuman type people, and I have to talk her into getting a flu shot so...

Sadly, antivax stupidity is on the rise in all groups, but it's been growing like weeds in specific demographics for some reason.

[Smoove_B]

Mosquito species

I've reached out to my mosquito expert contact to see if she knows the species that was collected and was positive. Interesting times!

[Smoove_B]

Not great news for OHIO:

A growing measles outbreak in Columbus, Ohio, has sickened dozens of unvaccinated children and hospitalized nine of them, and local public health officials are seeking assistance from the US Centers for Disease Control and Prevention.

“We asked the CDC for assistance and they will be sending two epidemiologists at the end of the month to assist with our local investigation,” Kelli Newman, a spokesperson for Columbus Public Health, told CNN in an email Thursday.

The CDC confirmed Thursday that it is aware of the cases and is “deploying a small team to Ohio to assist on the ground with the investigation.”

Glad that the CDC was called in at least.

[LawBeefaroni]

Big Government messing about in local affairs.

[Smoove_B]

Definitely a little unusual for the CDC to be called in on this. I'm assuming the locals are seeing the potential for it to get much, much worse and so they want resources and expertise. This is how it's supposed to work, but yeah I'm wondering if people are going to pay a political price for bringing in big government.

[hitbyambulance]

not infectious, but another fungal-induced disease i was not aware of until now - and most commonly encountered in... Wisconsin?

blastomycosis

[Isgrimnur]

It's the cost you pay for all that cheese production.

[Max Peck]

Clearly, the reason that no government is reinstating mask mandates is because small children can't wear masks.

Why mask mandates likely wouldn't solve the crisis in children's hospitals

No province or territory has opted to make the use of masks mandatory again

Masks are an effective layer of protection in the fight against COVID-19 and have been essential throughout the pandemic, helping to prevent infection, slow transmission and make crowded indoor environments safer when used appropriately.

But while everyone is encouraged to wear a mask to protect themselves in certain situations during respiratory illness season, mandating them now is harder to justify for a wide range of reasons.

Not a single provincial and territorial chief medical officer in the country has opted to make the use of masks mandatory again, despite growing public pressure and calls from some media and front-line physicians for mask mandates to alleviate the strain on hospitals.

The top doctors in British Columbia, Ontario, Quebec, Alberta, Manitoba, Saskatchewan, Prince Edward Island and Newfoundland and Labrador have all said now is not the time to reinstate mask mandates, but continue to recommend masks to slow viral spread.

The question is, what impact would widespread mask mandates across Canada actually have on the surge in respiratory syncytial virus (RSV) in kids and the rapid return of the annual flu season currently overwhelming children's hospitals in much of the country?

[Max Peck]

New mRNA vaccine targeting all known flu strains shows early promise

A new mRNA vaccine targeting all known flu strains in a single shot is showing early promise in animal studies and is opening the door to a wide range of possibilities with the vaccine technology — including potentially preventing the next influenza pandemic. 

University of Pennsylvania researchers published their findings in the journal Science Thursday, showing the vaccine produced high levels of antibody protection in mice and ferrets against all flu strains, which could one day help pave the way for a universal flu shot.

The research rapidly lifts mRNA technology to new heights and builds off the progress made in the COVID-19 pandemic in accelerating the development of the new vaccine platform, which has already been effectively used in billions of people worldwide.

I'm guessing this won't prevent any influenza pandemics if the antivax crowd has anything to say about it.

[Isgrimnur]

EurekAlert

A new study by investigators from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, demonstrated that shingles, also known as herpes zoster, is associated with an almost 30% higher long-term risk of a major cardiovascular event such a stroke or heart attack. Their results are published in the Journal of the American Heart Association.
...
Due to timing, much of the study took place in the period before the shingles vaccines became widely available. Even after their introduction, the uptake of vaccination has been generally low. Because of these limitations, researchers were not able to evaluate whether vaccination status may influence the association of shingles and long-term risk of a major cardiovascular event.
...
Sources of Funding: This study was supported by GlaxoSmithKline Biologicals SA Supported Studies Programme Protocol 216148.

Proper Name: Zoster Vaccine Recombinant, Adjuvanted
Tradename: SHINGRIX
Manufacturer: GlaxoSmithKline Biologicals

[LawBeefaroni]

I had to go across the street for a meeting. Cars are illegally parked on the street all over in front of the ER. Asked a nurse was going on, she said "RSV and flu. Tons of it."

[MHS]

Being around children (involuntarily) at Thanksgiving led to a cold that I think is now a sinus infection/ear infection. I can't hear anything out of my right ear and it hurts. Urgent Care by us that is normally a 30 minute wait max is currently at a 3+ hour wait. Cold/flu medication aisle at Walgreens is almost completely empty. Bleh, I say.

Also, fuck small children and their stupid germs I am not doing Thanksgiving with other people again next year no matter how much I get guilt tripped.

[Anonymous Bosch]

Being around children (involuntarily) at Thanksgiving led to a cold that I think is now a sinus infection/ear infection. I can't hear anything out of my right ear and it hurts. Urgent Care by us that is normally a 30 minute wait max is currently at a 3+ hour wait. Cold/flu medication aisle at Walgreens is almost completely empty. Bleh, I say.

Also, fuck small children and their stupid germs I am not doing Thanksgiving with other people again next year no matter how much I get guilt tripped.

Alas, as Paul Newman put it, "If you're at Thanksgiving and you look around the table and can't tell who the sucker is, it's you."

[Smoove_B]

Also, fuck small children and their stupid germs I am not doing Thanksgiving with other people again next year no matter how much I get guilt tripped.

It's not a popular opinion, but I agree with it 100%. In more bad news:

The Food and Drug Administration on Wednesday ended its emergency authorization for the only remaining Covid-19 antibody therapy cleared for use, saying variants that render it ineffective are now dominant in the United States.

The news about bebtelovimab makes official what has been anticipated for several weeks, as the Omicron sublineages BQ.1 and BQ.1.1 have been growing in prevalence. Still, it comes as a blow to both providers and patients who are at risk for more severe outcomes. The rapid evolution of the SARS-CoV-2 virus had already knocked out several other monoclonal antibodies for the treatment of Covid.

...

The BQs are also undermining the effectiveness of Evusheld, a type of pre-exposure therapy that provides an extra boost of protection for people who struggle to generate a strong immune response when vaccinated. For now, Evusheld continues to have emergency use authorization from the FDA, though the agency warned last month about the emergence of variants that are not neutralized by Evusheld. 

Without bebtelovimab and Evusheld, some 7 million immunocompromised Americans will lose powerful defenses. There are other treatments available, including the oral antiviral Paxlovid, but many people — including transplant recipients — are on medications that can’t be taken at the same time as Paxlovid. 

Between this and how we're lurching into antibiotic ineffectiveness, we're really teeing up fun times for the next decade.

[Daehawk]

Had to go pick up some of my meds at the pharmacy. The building it is in used to be me and my wife's bank. Theres the outside double doors then a very small entrance room the size of a bathroom that houses the ATM still and then 2 more double doors. When i entered there was a woman using the ATM as I passed she kinda hid her face with her hoodie. While in the pharmacy she sticks her head in asking a question and apologizes for hiding her face as she is sick and thinks she has COVID.

Oh joy. No telling how long she was breathing and coughing in that tiny enclosed and really warm space before I had to pass through it twice. Well Im a goner

[Smoove_B]

Might be time to figure out what comes after purple.



Again, unprecedented. We're way ahead of when influenza should be at these kinds of levels.

[Jaymann]

I had some flu symptoms yesterday, but I got a flu shot about a month ago. Today I'm 90% better, does the shot reduce symptoms?

[Smoove_B]

Absolutely yes. Though I wouldn't necessarily expect a 24 hour turn around and really mild symptoms. Instead, I'd expect for most people it would go from "I want to die" without a vaccination to "I don't feel great and I kinda want to just sit around and do nothing for 2-3 days" for people that were vaccinated.

[Isgrimnur]

Might be time to figure out what comes after purple.

Again, unprecedented. We're way ahead of when influenza should be at these kinds of levels.

Blackwatch plaid