All of Taylor Swift's minions, along with much of the world, know that today is another Super Bowl event. This time the site is New Orleans, which brings to mind the recent FDA warning about norovirus contamination of oysters from Louisiana harvest area 3. If you're like me, you had to know exactly where this is.
The Superdome is sort of like a cruise ship. I wonder what a Super Bowl norovirus outbreak would look like, but hoping I don't find out.
More Measles to Start the Year
It looks like we have 2 measles clusters already this year, 1 in Gaines County, Texas, and the other in Fulton Country, Georgia. According to news reports, both are associated with unvaccinated children who were old enough to have been vaccinated. The CDC has incomplete information as of February 6, and I note that they have decreased the frequency of measles updates to monthly as of this year. The national tally is 14 cases so far, from Alaska, Georgia, New York City, Rhode Island, and Texas.
Six of the 14 cases were hospitalized.
And, speaking of the CDC ....
MMWR is Back ... Sort Of
After an unprecedented (isn't everything unprecedented these days?) 2 week hiatus, the Morbidity and Mortality Weekly Report Volume 73 number 3 appeared on February 6. Besides the delay, it was unusual in that it contained only 2 topics, both related to wildfires: PFAS levels in first responders to the 2023 Maui wildfire and emergency department use during the LA County wildfires. Not a thing about any infectious diseases, despite the fact we are in the midst of a heavy winter respiratory virus season. Presumably this is not the new normal, and I'm hoping we soon see a return to something resembling the old weekly MMWR.
WRIS
We do have some continuation of CDC data current enough for looking at our winter respiratory infection season. FluView is cooking along, and we can see that outpatient influenza-like illness is going strong.
Influenza hospitalizations are very high, similar to the 2017-18 flu season.
Mortality data lag actual cases, but we have already tallied 57 pediatric deaths this year, and I fear we'll top last year's number of 207. This past week we saw almost exclusively influenza A viruses, about evenly divided between H3N2 and H1N1pdm09 (the pandemic 2009 strain). Both are covered by the current vaccine.
Meanwhile, RSV season is mostly over, and we're still waiting to see if covid will spike this winter. Covid wastewater levels have been and remain high.
Avian Flu
Influenza A H5N1 continues to be widespread in the animal population. Probably the biggest news the past week is that the D.1.1 genotype, so far only present in birds, has now appeared in a dairy cattle herd in Nevada. Given how long H5N1 has been present in various animal populations in the US, this doesn't seem all that surprising to me. The main import is that the longer these strains hang around, the higher the chance for mutation or reassortment into a strain with the ability to infect and spread among humans.
Here's the February 6 USDA update on recent cattle cases; if you visit the site you can change the timeline and also look at alpaca or swine cases. I'm particularly watching the swine cases because that animal has the highest risk of developing a strain with greater ability to infect humans. (Only 1 pig has been known to be infected so far, in Oregon last October.) You can go to their main avian flu website to look at other animal populations.
Just to further confuse you, the official terminology for the predominantly bird strain is "highly pathogenic avian influenza (HPAI) H5N1 clade 2.3.4.4b, genotype D1.1," as opposed to the more common cattle strain of HPAI H5N1 clade 2.3.4.4b, genotype B3.13. Now you can bore your friends with this tidbit at tonight's Super Bowl party!
Infectious Disease Troubles in Africa
Two situations in Africa are looking increasingly concerning. The Democratic Republic of Congo is trying to deal with an mpox outbreak in the midst of widespread violence and war in the country. As we know from the song, war is good for absolutely nothing, and the DRC's ability to manage the mpox outbreak, already strained, is suffering.
The other African hotspot is in Uganda, experiencing an outbreak of Suban Ebola virus disease. Fortunately WHO is facilitating a candidate vaccine trial there which could be a breakthrough in controlling this particular virus. Mortality rates in prior outbreaks were 41-100% and are improved by availability of supportive care.
In the meantime, CDC's Health Alert Network issued an advisory for the Uganda outbreak, raising the travel precautions to a level 2 (practice enhanced precautions).
Does Probability Exist?
As I was trying to interpret the various weather predictions for icy roads in my area, I came across this great piece in Nature by David Spiegelhalter, an emeritus professor of statistics at the University of Cambridge, UK. It definitely appealed to the statistics nerd in me, but I think everyone, including people without a background in science, would learn from it. I especially enjoyed the "How ignorant am I?" quiz. You don't need any special background to take it, so try it out. Next week I'll reveal my score. [Note added: apparently I used my institutional access to see this article, it's not free content for everyone. My apologies to those who can't access it, I'll give more details about the quiz next week.]
What is the probability the Super Bowl will end in a tie? The rules don't allow that, so I guess it's as close to zero as you can get with any probability in this world.
BTW, Spiegelhalter's answer to whether probability exists was, "probably not - but it is useful to act as if it does." My kind of guy.
