In this clinical update, Dr. Daniel Griffin and Vincent Racaniello discuss several key topics in virology and public health. The episode covers the controversial return of Dr. Vinay Prasad to the FDA and the potential non-renewal of the COVID-19 vaccine authorization for young children. Updates are provided on a Legionnaires' disease outbreak in Harlem, new labeling for the Chikungunya vaccine (Ixchiq) amid global outbreaks, and the first detection of H5 avian influenza in Antarctic seabirds. Dr. Griffin reviews the latest statistics and trends for measles, influenza, RSV, and SARS-CoV-2, referencing wastewater data. The discussion also delves into updated IDSA guidelines for COVID-19 treatment, the potential for viral infections like influenza and SARS-CoV-2 to reactivate dormant cancer cells, and promising research into stellate ganglion block treatments for Long COVID.
TWiV 1244: Navigating Viral Threats and Public Health Controversies
1:55 FDA Controversy & Pediatric Vaccines: Dr. Vinay Prasad has been reinstalled at the FDA, a move that coincides with reports that the agency may not reauthorize the Pfizer COVID-19 vaccine for children aged 6 months to four years. Dr. Griffin argues there is no scientific justification for this, as hospitalization rates for this age group are comparable to those for people over 65.
6:44 Pediatric COVID-19 Mortality: A new Canadian study reinforces that children, particularly those under five, are at risk of death from COVID-19. In the study, 75% of the pediatric deaths that occurred after vaccines became available were in unvaccinated children.
9:48 Legionnaires' Outbreak Update: An ongoing Legionnaires' disease outbreak in Harlem has grown to 99 confirmed cases and four deaths as of August 14th, with 17 people currently hospitalized.
11:06 Chikungunya Vaccine and Global Outbreaks: The FDA has lifted its recommended pause on the use of the Ixchiq Chikungunya vaccine for individuals over 60 after investigating adverse event reports. This comes as the CDC has issued travel advisories for Chikungunya outbreaks in China, Bolivia, Kenya, and several other countries.
13:46 Zoster Vaccine's Cardiovascular Benefits: A new study found that the recombinant zoster (shingles) vaccine is associated with a significantly lower risk of acute myocardial infarction (28% reduction) and stroke (42% reduction) in adults over 50.
15:40 Avian Flu Reaches Antarctica: For the first time, highly pathogenic H5 avian influenza has been detected in Antarctic seabirds, specifically in Adélie penguins and Antarctic shags. Notably, the infected birds did not show any clinical signs of illness.
22:09 Respiratory Virus Statistics: Dr. Griffin discusses the latest data on respiratory viruses:
Influenza: The previous flu season saw the highest number of pediatric flu deaths (267) in a non-pandemic season since tracking began.
COVID-19: Wastewater data shows a significant increase in SARS-CoV-2 activity, particularly in western and southern U.S. states.
24:08 Updated COVID-19 Treatment Guidelines: The Infectious Diseases Society of America (IDSA) has updated its clinical practice guidelines, reinforcing its recommendation for using Pemivibart (Pemgarda) for pre-exposure prophylaxis in moderately or severely immunocompromised individuals.
25:51 Viral Infections and Cancer Reactivation: A recent study in Nature suggests that respiratory viral infections, such as influenza and SARS-CoV-2, can "awaken" dormant metastatic breast cancer cells in the lungs of mice, aligning with human observational data showing an increased risk of cancer-related mortality post-infection.
36:02 Chickenpox and Shingles Vaccine Guidance: Dr. Griffin clarifies that individuals who received the chickenpox vaccine are at very low risk for developing shingles, and there is currently no universal recommendation for them to also receive the shingles vaccine.
40:28 Long COVID Treatment Research: Dr. Griffin's institution at Columbia University is launching a randomized controlled trial to study the effectiveness of stellate ganglion block treatment, an injection aimed at reducing overactive sympathetic nervous system activity, for Long COVID symptoms like dysautonomia and brain fog.