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Abstract:
This episode of This Week in Virology (TWiV 1210) features Dr. Daniel Griffin's weekly clinical update alongside Vincent Racaniello. The discussion opens with a stark critique of the ongoing and proposed cuts to the US public health infrastructure, detailing significant staffing purges and budget reductions at the CDC, NIH, and FDA, and sharing a firsthand account illustrating the detrimental impact on critical surveillance and research capabilities. Concerns are raised regarding a lack of transparency in outbreak reporting, exemplified by an unpublicized E.coli outbreak. Dr. Griffin provides updates on current infectious disease trends, including domestic and international measles outbreaks, meningococcal disease linked to travel, and seasonal respiratory virus activity (flu, RSV, SARS-CoV-2), noting declining flu and RSV but potential COVID blips. A major focus is placed on long COVID in children and adolescents, presenting recent study findings that link SARS-CoV-2 infection to increased long-term risks of chronic kidney disease and various cardiovascular complications, arguing against narratives that downplay the virus's severity in younger populations. The episode concludes by addressing listener questions covering topics from animal vaccines and H5N1 risk to hantavirus precautions and the shingles vaccine's potential link to dementia prevention.
Exploring the Clinical Landscape and Threats to Public Health Infrastructure
2:04 Attack on Science and Public Health: The episode highlights significant purges and confirmed/proposed budget cuts to federal health agencies (CDC, NIH, FDA), with a disproportionate impact on Human Health and Services. Key Takeaway: These cuts severely hamper disease surveillance, research, and outbreak response capabilities.
4:55 Real-World Impact of Cuts: An email from a former CDC employee reveals the immediate negative consequences of the cuts, including staff being locked out, loss of laptop access, labs abandoned, and crucial outbreak investigations (e.g., STI lab, Hepatitis lab) being halted abruptly.
8:06 Program Eliminations: Proposed budget cuts would eliminate funding for programs focused on Lyme disease, prion diseases, chronic fatigue syndrome, and harmful algal blooms, under the guise of prioritizing "core infectious disease and surveillance," which is contradicted by cuts to infectious disease labs.
9:51 Trust in Scientists: Discussion of a study showing trust in scientists varies by political ideology, with conservatives generally trusting less than liberals. Virologists rank low on the public's trust scale among scientific professions.
15:03 Unpublicized E.coli Outbreak: An E.coli outbreak linked to Roma lettuce across 15 states, resulting in hospitalizations and one death, was not publicized by the FDA, raising concerns about transparency in outbreak reporting.
16:27 Meningococcal Disease: Reports of invasive meningococcal disease linked to individuals returning from Umrah travel to Saudi Arabia, noting that only about half of international pilgrims comply with vaccination requirements.
18:48 Measles Outbreaks: The US is experiencing significant measles outbreaks (over 700 cases in 25 jurisdictions), with Texas (561 cases) being particularly affected. CDC scientists note the response in Texas was hurt by recent funding cuts. Mexico and Canada are also reporting large outbreaks.
21:15 Flu and RSV Updates: Flu activity in the US is currently low or minimal across most of the country, though the season saw significant hospitalizations and nearly 200 pediatric deaths. RSV activity is also declining.
22:09 RSV Vaccine Recommendation Expanded: The ACIP voted to expand the recommendation for Pfizer's RSV vaccine (Brisbo) to include adults aged 50-59 who are at increased risk due to underlying conditions.
23:38 RSV Linked to Cardiovascular Events: A Danish registry study in adults aged 65+ found that incidence of heart failure hospitalization and ischemic stroke were 4 to 8 times higher in the 14 days following a positive RSV test.
26:06 COVID-19 Update: National wastewater activity and deaths remain low, but a blip was observed this week likely due to holiday gatherings, impacting older and high-risk individuals.
27:20 COVID-19 in Hospitalized Children: A study of hospitalized children with acute COVID-19 in Spain and Colombia found that while comorbidities increased risk, 64% of these hospitalized children had no underlying conditions, arguing against the notion that COVID-19 is only severe in children with health issues.
32:01 Long COVID and Kidney Function in Kids: Data from the NIH Recover initiative shows that SARS-CoV-2 infection in pediatric patients was associated with a higher risk of new onset chronic kidney disease (stage 2+ and stage 3+).
34:07 Long COVID and Cardiovascular Issues in Kids: Another Recover study using EHR data found children and adolescents with prior SARS-CoV-2 infection had a significantly increased risk of various cardiovascular outcomes (hypertension, arrhythmias, myocarditis, heart failure, cardiac arrest, etc.) compared to uninfected controls. Key Takeaway: These findings strongly challenge narratives minimizing COVID-19's long-term impact on children's health.
37:43 Call to Action: Listeners are encouraged to contact their representatives to express the importance of science and maintaining US leadership in public health, framing it as a non-partisan issue crucial for national security and well-being.
38:51 Listener Question: Animal Vaccines: Discusses the difference in duration of protection between human pertussis vaccines and canine Bordetella bronchiseptica (kennel cough) vaccines, noting less available data for canine vaccines.
40:39 Listener Question: Backyard Chickens and H5N1: Addresses concerns about the risk of raising backyard chickens regarding H5N1 transmission, concluding it's not a "horribly high-risk" activity but acknowledging the increasing difficulty in tracking outbreaks due to public health cuts.
42:41 Listener Question: Hantavirus Precaution: Confirms that wearing an N95 respirator is an appropriate precaution when cleaning areas with potential mouse droppings to avoid aerosolized hantavirus.
44:27 Listener Question: Shingles Vaccine and Dementia: Discusses the recent study linking shingles vaccination to reduced dementia risk, clarifying that the study included individuals with prior shingles and the mechanism is likely preventing the disease which contributes to dementia risk.
45:48 Listener Question: Gerald Ford's Falls: Provides context that President Gerald Ford's tendency to fall was likely related to his monovision contact lenses affecting depth perception, rather than lack of athleticism.