Here is Dr. Klotman’s Week 269 video address. My summary is:

Measles

  • In the USA, we are up to >1000 cases
  • 717 of those cases are in Texas, of course
  • Most of the cases are in states where the MMR vaccination rate is <95%
  • Among Texans, 92 people have been hospitalized for complications of the illness
  • and, 96% of the cases have occurred among unvaccinated individuals
  • We haven’t yet reached the 2019 peak of 1274 cases, but we’ll get there; sigh.
  • Wastewater viral assays are the “canary in the coalmine” regarding measles – the two Houston cases were predicted by the detection of measles in wastewater 2 weeks earlier than the reported cases

Respiratory Virus Season

  • All the respiratory viruses in wastewater have diminished to background levels – Flu, parainfluenza, RSV, metapneumovirus, etc.
  • There are still a few cases of Flu among the 65+ year olds
  • This Flu season, we lost 226 children to Influenza
  • Overall, this Flu season was worse than most recent seasons

COVID

  • COVID is still detectable in wastewater despite relatively low levels of disease
  • The dominant COVID variant in the USA today is LP.8.1
  • COVID imported by international travelers is primarily variant B.1.1.529 – a descendant of the Omicron strain
  • The American LP.8.1 strain is a minor mutation of the strain used in our most recent COVID vaccine
  • The current COVID vaccine may well serve as an effective booster this Fall unless there is a new, recombinant, SARS-CoV-2 mutant strain

Shingles Vaccine

  • Shingles vaccination has been found to have a strong association with a decreased risk of Alzheimer’s disease and also heart disease
  • The tentative thesis for this association is that the nearly ubiquitous childhood infection of varicella (chicken pox) leaves all of us exposed to a potentially chronic inflammatory state that may be a precondition for disease of both the heart and brain

Now, for my own commentary:

The Shingles vaccine association with lower rates of Alzheimer’s and heart disease may be entirely coincidental. Hopefully, future research will reveal the relevance/importance of this association. Medicine proceeds from associations to causes only slowly. Nature gives up her secrets only unwillingly. Maybe this is not the best time to be putting our health infrastructure in the hands of an anti-vaxxer who has neither a background in the life sciences nor a clinical degree of any kind. Alas!

There has been a disturbing trend toward diagnosing colon cancer in younger adults. Colon cancer in adults <55 years old has nearly doubled in the last two decades. The current hypothesis is that this change is the result of mutations in the ubiquitous gut bacterium E. coli. The mutated strains of E. coli elaborate a toxin, colibactin, that can damage the DNA of human gut cells. If this hypothesis is correct, colon cancer, like cervical and other HPV-related cancers, may be an infectious disease.

Something similar occurred during WW II when peptic ulcer disease became common in WW-II England and later, in the rest of the world. The hypothesis then was that wartime “stress” caused excess stomach acid secretion that led to ulceration of the gut. Medicine attacked the condition with surgery that reduced stomach acid production.

It was when I was a medical student in the late 1970s that it became clear that peptic ulcer disease is the result of an intestinal infection with Helicobacter pylori, a bacterium, and could be treated with a regimen of antibiotics and stomach acid blockers. Ulcer disease went from being a surgical disease to an infectious disease.

The clinical arts and sciences have many unexpected twists and turns.

By: llcPosted on