AMA Update for May 22, 2024 N/A Unger: Hello and welcome to the
AMA Update video and podcast. Today, we have our weekly
look at the headlines with the AMA's Vice President
of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's
chief experience officer. Andrea, welcome back. Garcia: Thanks, Todd. It's great to be here. Unger: We're going to start
out with headlines about Mpox. When we talked about this
a couple of weeks ago. We were seeing an outbreak
in the Democratic Republic of Congo, driven by a
deadlier version of the virus. Andrea, what's the
latest news there? Mpox outbreak 2024 DRC Garcia: Well, that outbreak in
the DRC continues to get worse. And in response on
Thursday, the CDC urged people at risk
in the U.S. to be vaccinated as soon as possible. Although no cases of
this particular subtype have been identified
outside of Africa so far, experts have said that the
escalating epidemic in the DRC does pose a global threat,
just as infections in Nigeria set off that 2022 outbreak
that struck tens of thousands of people here in
the U.S. and abroad. According to a New
York Times article, New York Times Mpox resurgence as the outbreak in
the DRC worsens, that less deadly
type of the virus that caused that 2022 outbreak
is also regaining strength. Mpox clade i and clade ii Just as a quick reminder, there
are two main types of Mpox. Mpox Clade 1 DRC Clade 1-- that's the type that
is dominant in the DRC right now, which is more deadly-- Mpox Clade 2 and then clade 2, which is
the type that caused the 2022 global outbreak. With Pride events scheduled all
over the world in the coming weeks, U.S. officials expect
that it's only a matter of time before we see a resurgence here. Unger: Andrea,
were many of those who are at high risk now
already vaccinated in 2022? Mpox vaccine shortage: Who should get Mpox vaccine? (Mpox vaccine 2nd dose) Garcia: Well, Todd, we
did contain that outbreak through behavioral
change and vaccination, but there are still many
people who are at high risk who have not been immunized or
who haven't received two doses, because as you remember,
there were supply shortages during that 2022 outbreak. Mpox vaccine efficacy: Does Mpox vaccine prevent Mpox? (monkeypox vaccine) We know that two doses of the
vaccine are better than one with an effectiveness
of up to 90%. And even when the vaccine
didn't prevent infection, it lessened the severity
and duration of the illness. Fewer than one in four
Americans who are at risk have received two doses. This is a problem because
vaccination is really the key to controlling
this long-term. CDC Mpox vaccine recommendations Given this, CDC is now
working with advocacy groups and social media influencers
to help get the message out to those in the U.S. who are
at the highest risk in hopes that they'll get vaccinated
before the virus resurges. Mpox Clade 1 CDC HAN (CDC Mpox travel warning) In December, the agency
also urged physicians to remain alert for
possible cases and travelers from the DRC, and that is going
to be especially important now. Unger: Well, speaking of
getting prepared, Andrea, what symptoms do physicians
and patients need to watch for? Garcia: Well, people with Mpox
may have fever, intense headache Mpox symptoms and back pain,
followed by a rash. Many patients also develop
painful sores, often at the site of infection. We know that people who
have weakened immune system, Mpox high risk groups including those
living with HIV, are at highest risk of becoming
severely ill and dying. Compounding the issue
is many countries have limited access to tests,
vaccines and treatment, which means a vast
majority of cases are being diagnosed
solely based on symptoms. Here in the U.S., there is
an FDA-approved test that Mpox testing detects all versions of Mpox. The challenge is it can't
distinguish between them, so a positive
result on that test would need to be followed
by a more specific test that can identify the clade. The good news so far is
that the available vaccines Mpox treatment and antiviral drugs
are expected to be effective against all
forms of the virus. Unger: All right. Thank you, Andrea. And we're going to certainly
continue to watch and track the issues around Mpox. Andrea, something else that
we've been tracking-- bird flu. That continues to
make headlines. What's the latest
news this week? H5N1 pandemic: USDA bird flu dairy cattle (avian flu in cattle) Garcia: Well, according
to the latest data, USDA is now reporting
that 51 dairy cattle herds in nine states. Nine states have
confirmed cases of H5N1. There have still been no
additional human cases detected H5N1 virus: Avian flu in humans (bird flu in humans) since that one case from
Texas was reported on April 1, H5N1 bird flu wastewater surveillance and recent wastewater
surveillance data, which the CDC posted for
the first time last week, shows no indicators of unusual
flu activity in people, including avian influenza
viruses, which is good news. While influenza testing
typically declines over CDC bird flu testing the summer, the CDC
is working on a plan for enhanced nationwide
summer monitoring to help ensure that even rare
cases of H5N1 in the community are detected. This plan includes increasing
the number of influenza virus specimens that are tested and
then subtyped in public health laboratories that
can detect H5N1, and we should be hearing more
about that plan in the coming weeks. Unger: All right. Thank you. Andrea, I know a big
concern of people out there is about the milk supply. Has there been any
additional news about that? Bird flu found in milk (avian flu raw milk) Garcia: Well, we did see the
CDC issue recommendations for physicians to
support consumption of only pasteurized
milk and dairy products made from pasteurized milk. And most of the nutritional
benefits of drinking milk are available from
pasteurized milk. Unpasteurized milk: Is raw milk safe? Physicians are being
asked to educate patients on the risks of consuming
unpasteurized milk or products made from
unpasteurized milk, particularly emphasizing that
unpasteurized milk can contain bacteria or viruses,
including the H5N1 virus. I think physicians should
also remind patients that unpasteurized or raw
milk and any products made Is raw milk dangerous? from raw milk, which can include
cheese and ice cream or yogurt, can be contaminated
with germs that can cause serious illness,
hospitalization or death. Anyone, even healthy adults, can
get sick from drinking raw milk. And it's important that
anyone who consumes raw milk and gets sick seek medical
attention immediately. Unger: Andrea, it
just makes you wonder. Is selling raw milk even legal? Garcia: Well,
federal law prevents Where to buy raw milk: Is raw milk legal? the sale of raw milk
for human consumption in its final packaged
form across state lines. But each state
makes its own laws about selling raw milk
within its borders. Just because raw milk
may be legal to obtain in a particular state
obviously does not mean that it is safe to drink. Unger: That's a
very good reminder. Andrea, earlier
this week, the CDC also issued a new health alert. Tell us more about that. Umrah latest news today: CDC HAN alert Saudi Arabia (CDC Saudi Arabia travel advisory) Garcia: Well, on Monday, the CDC
issued a health alert, or HAN, to alert physicians to cases
of meningococcal disease linked to Umrah travel to the
Kingdom of Saudi Arabia, or KSA. Umrah is an Islamic
pilgrimage to Mecca What is the difference between Hajj and Umrah? in the Kingdom of
Saudi Arabia that can be performed any
time of the year, and the Hajj is an annual
Islamic pilgrimage. This year, that's taking
place June 14 through 19. Since April of 2024,
there have been 12 cases of meningococcal
disease linked to KSA travel for Umrah, and
they've been reported to national public
health agencies. Saudi pilgrimage: Meningococcal cases globally Five of those were here in the
U.S., four in France and three were in the UK. Unger: And Andrea, I think
that can be potentially very devastating. Tell us more about that. Meningococcal mortality rate Garcia: Well,
meningococcal disease is a rare but severe
illness with a case fatality rate of 10% to 15%, even
with appropriate antibiotic treatment. Meningococcal symptoms Initial symptoms
may be nonspecific, but they can worsen rapidly
and can become life-threatening within hours. Meningococcal long term complications Survivors may experience
long-term effects, such as deafness or
amputation of extremities. Immediate antibiotic treatment
for meningococcal disease is critical. Unger: So what do physicians
need to know, in this case? Meningococcal vaccine schedule Garcia: Here in
the United States, quadrivalent meningococcal
conjugate vaccination is routinely recommended
for adolescents, and it's also
recommended for travelers to countries where
meningococcal disease is hyperendemic or epidemic. Saudi Arabia vaccine requirements 2024 (KSA travel advisory vaccinated) In addition, all Hajj
or Umrah pilgrims age one year or
older are required by KSA to receive quadrivalent
meningococcal vaccine. Physicians should be working
with their patients who are considering travel to
perform Hajj or Umrah to ensure that those aged
one year or older have received a
meningococcal conjugate vaccine within the
last five years and administered at least 10
days prior to arrival in KSA. Physicians should also
maintain increased suspicion for meningococcal
disease in anyone presenting with symptoms
after recent travel to KSA for Hajj or pilgrimage. U.S. health departments
and physicians should also preferentially
consider treating close contacts as well. Unger: Andrea,
that's great to know, and something we're going to
continue to keep an eye on. That's it for today's episode. Thanks so much for being
here and keeping us informed. Folks out there, if you found
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all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care. [UPBEAT MUSIC] N/A