Dr. Klotman’s Week 258 video address this week is a public health Q&A. The highlights (answers to the questions) are:
About Measles
- Measles is extremely contagious – probably the most contagious respiratory virus
- Measles begins with coryza (cough, nasal congestion, and “pink eye”) with fever and can progress to pneumonia, and at worst, encephalitis that can cause deafness and even death
- Measles can persist in the air for a couple of hours and can settle on surfaces where it can persist
- People who contract measles are infectious four days before the rash appears and up to four days after the rash clears
- Most adults who have low or no immunity to the virus need only one dose of MMR rather than the two doses that are recommended for children. The exceptions are adults who, as a result of illness or treatment, are immunocompromised.
- The recent large measles outbreaks (2020s) have occurred in religious communities whose members travelled outside the US and contracted the virus – the first among Hassidic Jews and the most recent among Mennonites – both communities had vaccination levels far below what is necessary for herd immunity (95%+ vaccination rates)
About Flu
- California’s Flu season has already caused 900 deaths – 700 of them among folks 65+ and 15 among children
- Hummingbirds and songbirds are an unlikely source of H5N1 infection – N95 masks and gloves are reasonable personal protective equipment (PPE) if you are worried about H5N1 exposure while changing bird feeders
- The birds most likely to carry H5N1 are waterfowl, chickens, turkeys, Guinea hens, pheasants, and other birds that we eat
- Flu vaccine provides humoral (blood-based) immunity. It does not provide mucosal immunity. So, one can get a flu shot and develop humoral immunity and still contract an upper respiratory infection from influenza.
- The Flu vaccine calls forth effective immunity in 40-60% of folks who are vaccine. So, getting a Flu shot gives us some protection but it is not a guarantee.
- The wastewater data in Texas continues to show relatively low COVID levels but high Flu and RSV levels.
Other related notes:
- Historically, one out four children who contracted measles required hospitalization for severe pneumonia. Contrary to RFK, Jr’s ignorant public statements, children are not admitted to the hospital with measles for “isolation.”
- If you are worried that you may not have adequate immunity to Measles, you may be able to get a Measles IgG titer at a CVS Minute clinic, but seeing your PCP is probably the best idea.
- The last weekly report from the Texas Department of State health services showed ~27K positive Flu tests.
- In February, Flu accounted for ~11% of Texas ER visits
- This year’s Flu vaccine was not a very good match to the H3N2 Influenza A circulating this season. H3N2 seems to mutate more than H1N1; so, getting a good match is more difficult than for H1N1.
I’m still wearing my N95 mask to the store. Probably 30-50% of grocery store workers and shoppers do too. I think that those who don’t are jeopardizing their health for the sake of convenience or ideology.
As my middle school Algebra teacher was wont to say, “You pays your money and makes your choice.”