In this clinical update from "This Week in Virology" (TWiV), Dr. Daniel Griffin provides a comprehensive overview of current viral disease trends and research. He begins by highlighting the alarming surge in measles cases across the United States in 2025, which have already surpassed any year since the disease was declared eliminated. Dr. Griffin then discusses new data on H5N1 avian influenza in dairy cows, revealing a much more severe impact than previously understood, including a six-fold increased risk of death and significant economic losses. The update also covers the record-high number of pediatric deaths from seasonal influenza in the last season. Key developments in COVID-19 include early signs of a summer wave, a major meta-analysis confirming the efficacy of Paxlovid and remdesivir for early treatment, and a clinical trial showing no significant benefit to extending Paxlovid treatment beyond the standard five days. Additionally, a new study group, SPEAR, will investigate the potential of monoclonal antibodies for treating Long COVID. The episode concludes with Dr. Griffin answering listener questions on topics such as optimal vaccine timing during pregnancy, the legal battle over CDC vaccine recommendations, and scientific corrections regarding vaccine adjuvants.
Dr. Griffin's Clinical Update: Navigating Measles, H5N1 in Cows, and the Latest on COVID-19
2:24 Measles Cases Surge: As of July 2025, the U.S. has reported over 1,300 confirmed measles cases across 40 jurisdictions. This figure is higher than any other year since the disease was declared eliminated in 2000. Dr. Griffin notes the suspicious lack of reported cases in some states that are surrounded by areas with outbreaks.
9:17 The True Cost of H5N1 in Cows: Contrary to earlier, more benign reports, a new study in Nature Communications reveals the severe impact of H5N1 avian flu on dairy cows. Clinically affected cows face a six-fold increased risk of death, with about 7% of sick cows in the studied herd dying or being euthanized. The economic toll is also substantial, estimated at nearly $1,000 per affected cow.
14:31 Record Pediatric Flu Deaths: The last influenza season resulted in 260 influenza-associated pediatric deaths, the highest number reported for any non-pandemic flu season. A majority of these children were previously healthy, and over 90% were not vaccinated.
15:19 New RSV Monoclonal Antibody Guidance: The ARMADA (Advancing RSV Management And Disease Awareness) task force has issued a consensus recommendation for the use of long-acting monoclonal antibodies to prevent RSV. They are recommended for all infants under 8 months (if the mother was not vaccinated during pregnancy) and for high-risk children up to 24 months old.
17:13 Signs of a Summer COVID-19 Wave: Emergency department visits and wastewater data are showing early indications of a potential summer COVID-19 surge in the U.S. While some researchers correlate these waves with viral evolution, the hosts suggest human behavior is a more likely driver.
23:25 Confirming Early-Phase COVID Treatments: A large systematic review and meta-analysis published in the BMJ confirms that early-phase treatment with nirmatrelvir-ritonavir (Paxlovid) and remdesivir significantly reduces hospital admissions in patients with mild or moderate COVID-19.
26:23 Is Longer Paxlovid Treatment Better?: A randomized, double-blind trial published in The Lancet found no significant clinical benefit in extending Paxlovid treatment to 10 or 15 days compared to the standard 5-day course, even in immunocompromised patients.
31:33 New Research on Long COVID: A new study group named SPEAR (Spike Protein Elimination and Recovery) has been formed to formally investigate whether monoclonal antibody therapy can effectively treat Long COVID. The initiative is based on numerous anecdotal case reports suggesting that patients felt better after receiving the monoclonal antibody Pemgarda.
37:53 Expert Advice on Vaccine Timing in Pregnancy: Dr. Griffin answers a detailed listener question about the ideal timing for receiving TDAP, RSV, COVID-19, and influenza vaccines during the third trimester to maximize protection for both the mother and the baby.
43:25 Correcting the Record on Vaccine Science: In the listener mail segment, an attorney explains the potential outcomes of a lawsuit filed to reverse the recent changes to CDC vaccine recommendations for children. Other listeners provide corrections on vaccine adjuvant composition and highlight the misinterpretation of scientific literature by anti-vaccine activists.