Your Health: Infectious Diseases

Joining us tonight to answer your questions and [music] talk about your health is Dr. Wilbur Chen, professor of medicine at the University of Maryland School [music] of Medicine and the Center for Vaccine Development and Global Health. Doctor, thank you for joining us. Lots to talk about, but let's let's start with the lettuce, the the produce thing, which I'd never heard of before, but now everybody has. This is um a parasite. >> Correct. So we can just review that it is actually one of the top 10 food born illnesses that occurs every year. The CDC has something called food net which is kind of you know a cute name but they have a surveillance for uh a number of different food born agents and cycllospora has been among those for many many years. So it's not completely new. It's just that it's causing this massive outbreak right now >> and apparently a couple of fatalities. Is it is it treatable? >> It is treatable. Uh it causes dehydration. It can cause weight loss, nausea, vomiting, uh abdominal pain, and diarrhea of course. Uh and then for those that are immune compromised um those people who perhaps uh can't handle the changes in the volume because of the diarrhea and the volume loss those are the people that will be having more severe infection and perhaps that's where those fatalities came from. We have some data from the uh the CDC and and this is not a small number of people. 22,000 confirmed or or suspected cases, 15 states. Um is there always a certain amount of background cases of this going around and and this year we have this concentrated outbreak? >> Yeah. Yeah. So when I reviewed the past several years, it was usually less than 5,000 total cases in a single year. So we do have many cases and thousands of cases, but it's usually less than 5,000. Now having the 22,000 that we're seeing now, that's why we're saying that it's a pretty massive outbreak from just a single uh outbreak. According to Maryland Department of Health, uh, we're up to about 150 cases, typically 100 to 200 cases a year. Is it possible that I mean, we've heard this is really bad diarrhea. >> Um, is it something that would always send somebody to the doctor? What I'm wondering is if people might have maybe not ignored it, but but um taken something over the >> treated at at home and not very severe. Yep. >> Okay. So maybe we're we're counting better this year. >> We may be counting better, at least in the context of this outbreak. I think people are probably also now holding back on purchasing lettuce or getting lettuce with their food when they go to the restaurant uh just because of the awareness of this outbreak. But for Marylanders every year, as you said, it's about 100 to 200 cases. They're usually not associated with outbreaks. A lot of them are associated with travel. So half of the ones that we're seeing right now, the 150, at least half of them are associated with travel, travelers coming back, having diarrhea, getting diagnosed, and we find out, oh, it's cycllospora. >> I'm so curious what you and your your colleagues when you talk about this at at the office. Has it changed your eating habits at all? Is there anything if you're having a salad, is there anything um you know to to do to reduce the risk? Uh my habits personally haven't changed but I have been much more aware to the people around me to encourage them to make sure that they wash their fruits and vegetables that they do not cease trying to eat fruits and vegetables because it's all still a healthy food. Uh we want to make sure that we are are washing it. We are cooking our foods. Uh making sure that that is uh we're not drinking water from untreated sources. So from lakes and streams. Um so and and washing our hands uh with soap and water when we're preing preparing our foods. Those are the basic things. Remind our viewers if you have a question about this outbreak or anything else on the infectious disease front. You can send us an email. Email address will be on the screen. Let's uh turn to vaccines. And there's a lot to to talk about there, including a new flu shot. What what is different about this one? Yeah. So, this is uh being it's building off of what Madna has done with the mRNA based COVID vaccine and they now have uh an FDA approved influenza vaccine. It is approved for older adults and older adults are the ones that have the most severe effects from influenza from year to year. So 90% of the hospitalizations due to influenza every year are among older adults, meaning 65 years of age and older. >> Is this the magic bullet that um everybody's been wishing for for a long time that we only get one more flu shot in our lifetimes? >> Don't we wish uh we we could have a a single dose and we don't have to get any more? I think that we're still looking at an annual flu shot. This is an added vaccine that will complement other influenza vaccines that are specially designed for older adults. So we have a higher dose vaccine. We have an adgivvented vaccine. An adgiant is basically a special ingredient that's added to a a vaccine that boosts the immune response. And now we have this mRNA based vaccine. >> What would you tell um older adults? they're going typically you go to the pharmacy now for your flu shot and they give you a choice. H how should people think about that? >> I would say ultimately it doesn't matter. You should just get the shot because the the worry for me is that they will turn around and not get any vaccine. So even if it's just the standard vaccine, they should go ahead and get it if it's convenient to them. Now, if they have the wherewithal to try to find a preference, I would say I don't have a preference between the highdosese and the advented vaccine. And now that we've got this mRNA based vaccine, which should be coming out this fall, we think, I don't know. Uh but then now we have three choices for these enhanced vaccines for older adults. where um health authorities struggle with flu shots sometimes is a m mismatch on the actual strain that's circulating versus the strain that they guessed would be circulating when they had to start the process. So this is going to be a faster process and if there's if there's a miss one year this this could be really helpful. >> That's right. So the manufacturer process should be much shorter. So there is the opportunity for this type of vaccine to be pivoted toward those mismatched strains. Um I don't know what that would look like because this is so new right now and the FDA would still have to regulate it. >> Um let's go back a little bit. We have a viewer question titled Salmonella. >> Yeah. Um, but the question is how does this parasite start and grow? So, I think we're back to the parasite and the and the lettuce. There's also a salmonella outbreak or there any any comparisons there? >> So, these are all foodborne agents. Often times they're from again a source that gets contaminated, a single source, whether it's a crop or a field uh that's being irrigated. And often times what happens is that it's irrigated with contaminated water. Somehow sewage got into that water system and is irrigating that field. In some developing countries, night soil is used as fertilizer and that's basically using raw human sewage uh which is very rich in uh what you want a fertilizer to have. But the bottom line is that there's contamination from sewage into the crops and those then come into our our lettuce, our jalapeno peppers and other foods. >> Do we do that here? Maybe maybe treating the sewage a little bit. >> We unless the sewage breaks down and you have a mixing of your clean water source with your sewage lines, which rarely happens. And usually we you hear about the boil water alerts. In fact, here in Baltimore, we we had a boil water alert. Uh I think it was last summer. Um so we are very conscious of making sure that our water supplies are are safe. And so when we irrigate, we're not irrigating with the with the unsafe water, we're irrigating with safe water. So it it it can rarely happen in the US, but it's because of a breakdown of a process that's supposed to be happening. Um, another viewer question uh about vaccines. This is Constance. She says, "Every year I get a flu and a COVID shot, 69 years old. When should I get these shots? And which flu shot should I get? And what about a pneumonia shot?" >> Right? So 69 years old, she should have already received her pneumonia shot hopefully upon reaching 65. But if she hasn't, then there it's always great to catch up with that. >> That's a lifesaver. It is. And for the flu and COVID, I would say get it when it comes out. It hasn't come out yet, but it'll be coming out this fall, we think. You know, again, as as the normal annual flu vaccines, >> I have about two minutes. Let's divide the time between what we were going to talk about um some some new research on COVID infections and um possible connections to other latent viruses. Well, here we have it on the screen. Reactivation of chronic viruses not associated with the vaccines could have something to do with long co. What do you make of this? >> Yes. So, it's a really terrific article that came out in Nature last week. So what it was showing was following about,00 severe COVID infections their these patients over about a year's time and what they saw was that there was uh reactivation of chronic viruses. Herpes viruses, CMV, EBV, EBV is uh not known as the monucleiosis kissing uh disease virus. These are viruses that also reactivate under stress. So we've known that for years. Shingles is another virus that reactivates under stress. So CO 19, these severe infections are a stress condition. Now we're showing that this is also a condition that can reactivate these known viruses. >> Now today's news, uh the president signing an order instructing states to revise their rules on childhood vaccines. And I imagine certain states, Maryland included, won't be super fast to adjust to that order. But your your thoughts on fears about the um the large vaccine schedule that we currently have? >> Yeah. Well, so uh the viewers are probably Marylanders mostly, but viewers that might be around around the world or the nation should feel comforted that there is a lot of data on all of these routine childhood vaccines that are licensed currently on the safety and effectiveness of them. So there's really nothing to fear about them. Each state will be deliberating uh their Congress persons uh but ultimately I hope that they land on being very favorable in promoting childhood vaccination. >> Dr. Wilbur Chen, professor of medicine at the University of Maryland School of [music] Medicine. Dr. We appreciate your time. Thank you for >> Thank you so much, Jeeoff. >> Your health segments are a co-production of Maryland Public Television [music] and the University of Maryland Medical System.