This episode of "This Week in Virology" provides a clinical update on various infectious diseases, contextualized by current events in science and public health. The discussion begins with a tribute to the legacy of primatologist Jane Goodall and a detailed explanation of the 2025 Nobel Prize in Medicine, awarded for the discovery of T-regulatory cells and their crucial role in immune tolerance.
The episode addresses significant public health concerns, including political interference in science, highlighted by an anti-vaccine law firm's involvement in selecting members for the CDC's ACIP. It covers the alarming global resurgence of measles, citing a tragic infant death in Canada and wastewater detection in New York, alongside updated case numbers. Key clinical studies are analyzed, including a meta-analysis supporting a two-dose primary influenza vaccine series for young children. On COVID-19, new research confirms the risks of maternal infection to newborns, the ineffectiveness of a second Paxlovid course for rebound, and the significant, lasting impact of Long COVID in children, with reinfection more than doubling the risk. Finally, a study links respiratory infections, including COVID-19, to an increased risk of vascular dementia in older adults.
TWIV 1260 Clinical Update: Nobel Prize for T-Regs, Measles Resurgence, and Long COVID in Kids
0:02:50 Remembering Jane Goodall: The episode begins with a quote from and tribute to the late Jane Goodall, highlighting her contributions to science, conservation, and science communication. A key takeaway is her legacy of fighting apathy.
0:05:06 Nobel Prize for T-Regulatory Cells: The 2025 Nobel Prize in Medicine was awarded to Mary E. Bruncow, Fred Ramdell, and Shimon Sakaguchi for their discovery of T-regulatory cells (T-regs). These cells are critical for preventing autoimmune diseases by suppressing self-reactive T-cells that escape the thymus.
0:11:01 Political Interference in Public Health: A report reveals that an anti-vaccine law firm is involved in vetting and selecting members for the CDC's Advisory Committee on Immunization Practices (ACIP), raising serious concerns about conflicts of interest and the integrity of public health guidance.
0:14:38 Tragic Outcomes of Measles Outbreak: A premature baby in Alberta, Canada, died from measles after the unvaccinated mother contracted the virus during pregnancy. This follows a similar death in Ontario, underscoring the severe risks of the ongoing measles outbreaks.
0:15:47 Measles Spreads in North America: Measles virus has been detected in wastewater in Oswego, New York, prompting health advisories. As of early October 2025, the US has 1,563 confirmed cases, and Canada has 5,024.
0:19:07 Two Flu Shots Recommended for Children: A meta-analysis published in JAMA Network Open confirms that for vaccine-naive children under nine, a second dose of the influenza vaccine in their first season increases vaccine effectiveness by 15 percentage points (and 28 points for children under three).
0:24:06 COVID-19 in Pregnancy Poses Risks to Newborns: A systematic review confirms that maternal COVID-19 infection is associated with significant risks for newborns, including a 2.66% incidence of vertical transmission, a 16.43% rate of NICU admission, and a 1.29% rate of neonatal death.
0:28:29 Retreatment for Paxlovid Rebound Ineffective: A randomized, placebo-controlled trial found that a second 5-day course of Paxlovid for patients experiencing a "rebound" of symptoms and viral positivity offers no significant clinical benefit.
0:31:25 Reinfection Doubles Long COVID Risk in Children: A large retrospective study from the RECOVER initiative found that a second SARS-CoV-2 infection more than doubles the risk of children and adolescents developing Long COVID (PASC), which can manifest in a wide range of debilitating symptoms.
0:36:26 Long COVID Symptoms Persist in Children: A prospective study of unvaccinated children found that Long COVID symptoms are persistent. A year after the initial infection, nearly one-third (32.5%) of children still experienced symptoms, most commonly fatigue, reduced physical activity, and headaches.
0:38:20 Respiratory Infections Linked to Vascular Dementia: A study using UK Biobank data found that COVID-19 infection increases the risk of new-onset vascular dementia in adults over 50. However, this risk was comparable to that seen after other non-COVID respiratory illnesses, suggesting a broader link.
0:45:31 Listener Rant on Vaccine Access: A listener from Georgia details the extreme political and bureaucratic hurdles required to get an annual COVID-19 vaccine, including needing a physician's prescription and facing insurance rejection, illustrating how policy decisions create significant barriers to public health.