Both the springtime weather and a recent visit with family that included my granddaughter definitely put a spring in my step. Also useful for lawn mowing duties that have hit peak April duty.
A Worrisome Outbreak
Public health authorities recently called attention to an outbreak of hepatitis A associated with frozen organic strawberries sold on the west coast. That's not particularly unusual news. What really caught my attention was the fact that the strain of hepatitis A causing disease this month is identical to a strain that caused an outbreak in 2022. In essence, the cause of a past outbreak was identified, but whatever measures were taken to stop the outbreak didn't prevent the current one.
The FDA first warned of the current outbreak in February 2023, but an April 11 update (scroll to bottom of the page) identified the strain as being the same as last year's outbreak; the supplier is in Baja California. Multiple retailers had offered the products for sale, including big name stores such as Costco, Aldi, and Trader Joe's.
Currently only 7 infected individuals in 2 states have been identified, but this is always an underestimate since many people with hepatitis A never receive testing.
![](https://blogs.gwu.edu/bwiederm/files/2023/04/Screenshot-2023-04-16-at-10.43.08-AM.png)
Fauci's 10 Lessons
Dr. Fauci and his former chief of staff at NIH, Gregory K. Folkers, published a perspective article covering their top 10 lessons learned from the COVID-19 pandemic that may be useful in further pandemic planning. It's not anything particularly new or startling but nice to see gathered in one place. I was particularly struck by #1 ("Expect the unexpected.") and #10 ("Emerging infections are forever."). Given our current state of public health disarray in the US, I feel like we are sitting ducks for the next one. The tremendous culture wars surrounding personal freedoms combined with the strong resurgence of the anti-vaccination movement could greatly interfere with controlling the next epidemic or pandemic.
Infectious Period and Transmission of the Omicron Variant
The Health Security Agency in the United Kingdom published a great review of data regarding the omicron variant, covering the period from the start of the omicron wave in December 2021 through January 2023. It's a 54-page document, but fortunately you can read a nice summary of the main messages at the start.
Regarding the infectious period, most transmissions from symptomatic individuals occur during the first 5 days of symptoms. Similarly, peak viral loads occurred 2 to 5 days after symptom onset. Viral clearance mostly appeared on days 7 to 11 in the general population and slightly longer in more severely ill or immunocompromised groups (10 to 15 days).
Studies comparing viral loads and transmission rates from symptomatic versus asymptomatic people were mixed. The Agency could not make any firm conclusions from the studies comparing these 2 populations.
This review should be helpful as various groups try to decide on rational quarantine and school attendance policies for the near future.
Sitting Ducks
Although I grew up in south Texas in the 1950s and 60s and knew many hunters, I don't know a thing about duck hunting. The idiom "sitting ducks" that I used in the Fauci section above must come from a hunting analogy, but I was stymied in trying to pin down an accurate origin for the term; clearly it was in use during World War II. I did learn a bit about uropygial, or preen, glands that produce oil and help maintain duck buoyancy, can't wait to bring that up at my next group gathering.
In the meantime, get out and enjoy the springtime!