What happens when a prominent public figure who thinks he knows everything about everything finds himself in a position to control an important public institution? It's another brave new world we'll need to endure as best we can.
Of course I'm speaking about the Broccoli family ceding creative control of the iconic James Bond franchise to Amazon/MGM, i.e. Jeff Bezos. I shudder at the possibilities of another billionaire-induced stream of havoc.
Er, no. What I'm really referring to is the postponement of this week's meeting of CDC's Advisory Council on Immunization Practices. I had detailed last week that it was scheduled for February 26-28 as one of the three planned meetings this year; the dates are selected well in advance and had been planned through 2027. Not any more, apparently.
These meetings, with the entire public invited to view in real time, were among the most transparent of all healthcare meetings in our country. I'm not sure what public comment accommodations were needed; comments had been requested via the Federal Register as per standard practice, and the draft agenda already included the usual times for live public comments prior to all votes. The concern is that RFK, Jr., will overhaul committee membership to install new members to carry out his anti-science doctrine. The website promises that the ACIP workgroups will still present their findings, but I'm concerned the votes could look much different by the time that happens.
Coupled with potential new rules for FDA and research funding, we could end up with no progress in vaccine development and increasing vaccine hesitancy in the general public. At worst, we may lose access to currently available safe and effective vaccines. The ACIP could cease to be a reliable partner for our nation's health. Private organizations, including the American Academy of Family Physicians, the American Academy of Pediatrics, and the American College of Physicians, among others, may need to step forward to fill the vacuum of discussion and recommendations.
As I step down from my soap box, Ambrose Bierce reminds me, "Speak when you are angry and you will make the best speech you will ever regret.”
Good News Department
After my Debbie Downer impersonation above (did you watch SNL's 50th Anniversary show?), I'm thankful I saw more positives than negatives this past week.
MMWR is Back in Form
The February 20th issue looked a lot more like a typical edition. It had 4 topics and didn't appear to be skimping/censoring information. Of course the biggest news from an infectious diseases standpoint is the report of 2 exclusively indoor pet cats from 2 separate households in Michigan who died from avian flu. Owners of both cats were workers on dairy farms. The cats never had direct exposure to the farms.
The investigation was somewhat limited by incomplete testing. The most logical conclusion is that these 2 episodes represent passage of the virus from humans to cats.
Polio Vaccination Resumes in Gaza
WHO reports another round of polio vaccination is ongoing now in the Gaza strip after wastewater monitoring recently showed a poliovirus spike. Almost 600,000 children under 10 years of age have been identified to receive vaccination through February 26.
Low Dose Yellow Fever Vaccine Produces Similar Seroconversion Rates
At first glance, this might not seem that important to those outside of the yellow fever world. However, yellow fever vaccine is in short supply at a time when this hemorrhagic fever virus is surging in many parts of the world, including the Americas. Investigators published a non-inferiority randomized, double-blind controlled trial of standard dose (13,803 IU) compared to lower doses of 1000, 500, or 250 U administered to adults in Uganda and Kenya.
Using a lower vaccine dose vastly increases the number of people residing in high-risk countries who can be vaccinated. Note that in addition to 29 African countries, 13 countries in Central and South America have some risk of yellow fever transmission.
Listeria Outbreak Linked to Frozen Shakes
Mostly these nutritional supplements are used in long-term care facilities. I haven't noticed any of these products in my local grocery stores. Last Friday FDA reported on the outbreak that first came to light in November 2024 and covers 21 states across the country. Thirty-eight individuals have been infected, resulting in 37 hospitalizations and 11 deaths. The high morbidity and mortality probably relate to the high-risk populations residing in these facilities. If you visit one a nursing home it's worth a mention to the staff to make sure they are aware.
Measles
I'm afraid that reports of vaccine-preventable diseases will increase in the current regulatory and cultural climate. Friday's update from Texas Health and Human Services now lists the total number at a whopping 90 cases, and if news reports are to be believed this is significantly under-reported due to high rates of home schooled children affected. Added to this are 9 cases just across the border in New Mexico, though news reports state there is no known contact to infected individuals in Texas. That seems to be a very unlikely coincidence.
Last week I mentioned that I thought the CDC needed to update their measles tracking page more frequently than monthly, and they listened to me! Now we have updates every Friday.
We haven't broken any records yet, here's hoping Texas officials get this under control soon.
WRIS
It's nice to see the influenza-like illness curve head down this past week, but it could bounce up again like it's done before.
Hospitalizations for confirmed influenza infections also trended down.
Mortality is the highest we've seen since the pandemic. The numbers below include 86 pediatric deaths.
On a national level, covid and RSV aren't doing much, though even low levels result in significant disease.
Bernarr Macfadden
Yeah, I never heard of him either, but opinion columnist Jessica Grose at the NY Times brought him to my attention as a precursor/dopelganger for RFK, Jr. Unfortunately Macfadden's Wikipedia article has too many poorly documented statements to recommend, but what I can verify is that he was a weight-lifter who liked to be photographed showing his muscles (and most of his body) and founded various health movements. A charismatic individual, his influence was prominent from the early 1900s through World War II. He had no medical background. He championed raw milk and denounced white bread and pharmaceutical agents including vaccines. His "movement" reportedly had prominent adherents including Franklin Roosevelt and Rudolph Valentino. Eerily familiar.
As a distraction, I found myself wondering how Jeff Bezos would tilt his newfound power to influence the future of James Bond. I know just the person to play the next villain.
