Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week.
Once again this week, I am taking a break from COVID news. But if you are wondering, COVID cases are down by 15%, hospitalizations by 14%, and deaths by 19%. The XBB.1.5 subvariant continues as the predominant form (~90%) of COVID spreading. Yesterday I marked the third anniversary of the WHO declaring COVID a pandemic and President Trump issuing a public health emergency. Be sure to read what I am celebrating, grateful for, dreaming of, and the lessons I learned during the past three years.
This week’s Three Things Thursday focuses on an outbreak of botulism in Europe, an uptick in Shigella in kids under 5, and an update on H5N1.
Hoping these posts help to educate and empower you
to be healthy and create healthy communities.
Botulism Outbreak in Europe
On Tuesday, the European Centre for Disease Prevention reported an outbreak of botulism (67 cases to date) that is linked to a weight loss procedure.
Botulism is a rare, but serious illness that is caused by a toxin made by the Clostridium botulinum bacteria. The toxin attacks the nervous system and can result in difficulty swallowing, muscle weakness, double vision, slurred speech, difficulty breathing, vomiting, and nausea. If diagnosed in a timely manner, an individual can be treated with a botulism anti-toxin.
The European cases are all linked to an intragastric injection (shot to the belly) of the botulism neurotoxin (BoNT, aka botox). The injections were approved for use in specific procedures, but not as a weight loss treatment.
This outbreak highlights two important health lessons — first, medications and treatments should not be used “off label,” aka for purposes that they are not approved for. The phrase use only as directed should be taken to heart with every medication and medical procedure. Second, a quick fix (several shots in the belly) to a complicated problem, such as obesity, are usually too good to be true. And we should always ask questions before undergoing a new treatment or starting a new medication.
Shigella in Children Under 5
On Monday, the CDC issued a warning about an increase in Shigella, an antibiotic-resistant bacteria. The majority of individuals suffering from shigella are children less than 5 years old. The CDC’s Health Alert noted an uptick in “extensively drug-resistant” shigella, which means that it is very hard to treat.
Shigella causes bloody diarrhea, fever, and stomach pain. It is spread through fecal-oral contact (meaning poop to mouth).
This uptick in shigella cases is a friendly reminder about the importance of handwashing.
Avian Influenza Update
Since the winter of 2021-22, H5N1 (aka avian influenza) has killed nearly 60 million birds in 49 states. Avian influenza is spread through nasal secretions, salvia, and feces.
Given that the virus has jumped to several other species, including seals and skunks, public health experts are investigating whether avian influenza could jump to humans from mammals. And then whether or not the virus could spread from person to person.
Currently — there is NO EVIDENCE of person-to-person spread of H5N1.
However, a (very) small number of humans have been infected with H5N1 through close contact with infected birds or mammals.
Earlier this week, influenza experts met in South America to discuss plans for preventing, detecting, and responding to avian influenza. The focus of the meeting is to improve the capacity to detect and respond to a future avian influenza outbreak.
This is a friendly epidemiologist reminder that we are just one virus, one jump in species, one mixing of two viruses in one person away from the next pandemic.
Please support public health.
And applaud President Biden for including (proposed) increases in public health funding in the 2024 budget (source) —
$600 million, a $250 million increase from FY23 for public health infrastructure and capacity.
$340 million, a $165 million increase from FY23 for public health data modernization.
$106 million for public health workforce training and fellowship programs.
Do you have questions? other topics you’d like to see highlighted here?
And be sure to share this with a friend —