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TWiV 1194: Clinical Update with Dr. Daniel Griffin - Summary
0:07 Introduction & Remembering Dickson Despommier: The podcast begins with hosts Vincent Racaniello and Dr. Daniel Griffin, who reminisces about colleague Dickson Despommier, referencing a New York Times article about him and his influential questions about the future.
4:58 Ebola in Uganda: There's positive news from Uganda. Eight patients treated for Sudan virus (a type of Ebola) have been discharged after two negative tests. Only one death occurred, the other eight recovered.
6:53 Polio: The WHO executive board calls for emergency measures to stop polio's global spread. There is a perfect storm brewing.
7:11 Polio, Continued: Discussion about vaccine. The preferred vaccine of choice, OPV, is mentioned to not be the right choice.
8:40 Vaccine-Derived Polio: Dr. Griffin points out that paralysis caused by vaccine-derived poliovirus is just as severe as that caused by wild poliovirus. The continued use of OPV contributes to vaccine-derived cases.
9:34 Polio Vaccination Campaign in Gaza: A third nOPV2 (novel Oral Polio Vaccine type 2) vaccination campaign is underway in Gaza, despite concerns about OPV contributing to circulating vaccine-derived poliovirus. The recommendation is that IPV should be used.
10:58 Measles Outbreak in Texas: A significant measles outbreak is occurring in rural West Texas (58 cases as of recording, possibly more), the largest in decades, and has spread to New Mexico. This highlights the dangers of low vaccination rates.
13:27 Avian Flu (H5N1) in Cats: An MMWR report details cases of highly pathogenic avian influenza (H5N1) in indoor domestic cats in Michigan, linked to dairy farms.
13:46 Avian Flu Story Breakdown: The hosts discuss the detailed case reports of infected cats, including symptoms, exposure history, and testing results. They highlight the concern of farm workers declining testing due to fear of job loss.
22:29 Avian Flu in Dairy Cattle: Avian flu (H5N1) has been detected in dairy herds in multiple states, with a new genotype (D) spillover in Arizona, raising concerns about the spread of the virus.
23:23 Avian Flu Vaccines. The US conditionally approves a vaccine from Zoetis to protect poultry.
29:29 Human Cases of H5N1. Four people in the US have been hospitalized.
29:55 Canada's Avian Flu Vaccine Purchase: Canada has secured 500,000 doses of a human vaccine against avian influenza from GSK, highlighting a proactive approach.
30:46 Respiratory Illness Update (Flu, RSV, COVID-19): Influenza A activity remains high across the US. RSV and norovirus are also high. COVID-19 is still causing a significant number of deaths (around 1,000 per week). The US numbers of deaths caused by COVID-19 remain higher than those caused by the flu.
33:01 COVID-19 Case Fatality Rate Study: A study from Austria (2020-2023) shows the case fatality rate (CFR) for COVID-19 varied significantly over time and by variant, with higher rates in unvaccinated, elderly, and nursing home residents.
38:59 Early Viral Phase COVID-19 Treatment: A Phase 1 study on an inhaled antibody treatment (IN-006) for COVID-19 shows promising safety and high nasal fluid concentrations, but efficacy is yet to be determined.
41:50 Ensitrelvir for COVID-19: A study on ensitrelvir (another antiviral, not protease inhibitor) for non-hospitalized adults with COVID-19 showed minimal impact on symptom duration.
43:41 Current COVID-19 Treatment Options: Paxlovid, remdesivir, and molnupiravir are discussed as options to reduce the risk of severe disease and hospitalization. Steroids and anticoagulation are mentioned for the inflammatory phase.
45:11 Long COVID: Concerns about long COVID (post-acute sequelae of SARS-CoV-2 infection, or PASC) remain, with links to resources provided.
45:44 Call for Support: The hosts emphasize the importance of supporting independent science communication and the "floating doctors" fundraiser.
46:34 Listener Questions: Several listener questions are addressed, covering:
Vaccination during pregnancy.
Benzalkonium chloride hand sanitizer.
Bird flu resources.
A doctor's reluctance to prescribe Paxlovid.
Immune amnesia after measles.
Frequency of COVID-19 vs. flu vaccination.
Effectiveness of Paxlovid in vaccinated individuals.
58:36 Conclusion The hosts wrap up, reminding everyone to stay safe.