Federal health officials and their state and local health partners are investigating reports of harmful reactions in women who received counterfeit or mishandled botulinum toxin (Botox) injections, with 19 injuries reported in nine states, the US Centers for Disease Control and Prevention (CDC) announced yesterday.
The reactions occurred following Botox injections from unlicensed and untrained people in non-healthcare settings, including homes and spas. The patients are from Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee, and Washington.
Botox contains minute amounts of botulinum toxin, which comes from the bacterium Clostridium botulinum. The toxin, which in larger amounts can cause muscle paralysis, in very small amounts is used to smooth wrinkles and treat certain muscle conditions.
Examples of the patients' reactions include vision problems, drooping eyelids, difficulty swallowing, difficulty breathing, and general weakness. Nine were hospitalized, and four were treated with botulinum antitoxin owing to concerns that botulinum could spread beyond the injection site. Five people were tested for botulism, and all were negative.
All patients were women ages 25 to 59, and all but one received the injections for cosmetic purposes.
Some women received counterfeit or unverified products, and investigators are still working to determine the sources. In a separate statement, the Food and Drug Administration (FDA) said it is working with AbbVie, the Botox manufacturer, to identify, investigate, and remove suspected counterfeit products. It added that there is no sign that the events were related to AbbVie's FDA-approved products.
The CDC urged people considering Botox injections to ensure that providers are licensed and trained and to ask if the product is approved by the FDA and obtained from a reliable source. "If in doubt, dont get the injection," the agency added.
Lawmakers are demanding answers after it was revealed the US is sending taxpayer dollars to a Chinese army lab tomake bird fluviruses more dangerous to people.
Eighteen members of Congressare demanding answers from the Department of Agriculture (USDA) about the project, which was first revealed by DailyMail.com.
It is part of a$1million collaborationbetween the USDA and theCCP-run Chinese Academy of Sciences - the institution that oversees the Wuhanlab at the center of the Covid lab-leak theory.
In a scathing letter to USDA Secretary Tom Vilsack last week, the bipartisan group said:'This research, funded by American taxpayers, could potentially generate dangerous new lab-created virus strains that threaten our national security and public health.'
The White Coat Waste Project obtained the above photo and claims it shows animal experimenters inside the USDA lab that is working with Chinese scientists on bird flu research
Tests revealed that an unknown number of cows have tested positive for bird flu Type A H5N1 in Texas, Kansas and New Mexico. Iowa is currently 'monitoring the situation' as it is also a dairy-heavy state. It comes after a goat in Minnesota tested positive last week. Bird flu has also been found in foxes, bobcats, striped skunks, raccoons and coyotes since the 2022 outbreak
The research comes as fears about bird flu rise. A farm worker in Texas caught the H5N1 strain that is racing through cattle across the US earlier this month, becoming only the second ever American to be diagnosed - and experts are bracing for more cases.
In February, it was revealed the United States government was funneling $1million to China to see if scientists could make 'highly pathogenic avian influenza' more contagious to mammals using gain-of-function research.
Government records showed the collaboration began in April 2021 and is scheduled to be funded through March 2026.The USDA previously told this website the project was applied for in 2019 and approved in 2020.
The research involves infecting ducks and geese with different strains of viruses to make them more infectious, and studying the viruses' potential to 'jump into mammalian hosts,' according to research documents obtained by the watchdog group White Coat Waste Project and shared exclusively with this website.
It is being funded through the USDA and the main collaborators on the project are USDA Southeast Poultry Research Laboratory, the Chinese Academy of Sciences and the University of Edinburghs Roslin Institute - a Wuhan lab partner.
And it has been ongoingdespite similar research being restricted in 2022 and growing concerns that dubious Chinese studies may have started the Covid pandemic.
The project is part of a $1million collaboration between the USDA and the CCP-run Chinese Academy of Sciences (pictured)
Photos inside the Chinese Academy of Sciences -the institution that oversees the Wuhan lab at the center of the Covid lab-leak theory
The bird flu project is part of a $1million collaboration between the USDA and the CCP-run lab
Just yesterday, President Joe Biden's administration announced it will work with 50 countries to identify and respond to infectious diseases, with the goal of preventing a pandemic that the US' own research could actually spark.
Last week's letter was spearheaded by Rep Nick Langworthy, a Republican from New York who serves on the House Agriculture Committee.
It states: 'We are disturbed by recent reports about the US Department of Agricultures (USDA) collaboration with the Chinese Communist Party (CCP)-linked Chinese Academy of Sciences (CAS) on bird flu research.'
The CAS is the parent organization of WIV and has previously been prohibited from receiving US government money for 'blatantly violating grant and biosafety policies, refusing to share lab notebooks and other data, and otherwise obstructing investigations into the likely role of the lab's risky coronavirus [gain of function] research in the origin of Covid-19.'
The letter continued: 'Recognizing the problematic behavior of CAS, our House and Senate colleagues have called for sanctions against CAS and its affiliates and for taxpayer funding to be cut for all research involving CAS.'
The signatories then requested written answers to seven questions inquiring about the potential of the research to increase transmissibility of bird flu viruses, details about specific experiments being performed, the biosafety levels of the experiments, what oversight the USDA is providing over CAS and if the FBI performed a safety risk assessment on the collaboration - and, if so, what those results were.
Bird flu is of particular concern right now because a farmer in Texasrecently contracted the H5N1 strain of the virus.
The patient caught the bird flu from an infected cow, which was the first time the strain had been found in cattle.
They are only the second person to contract H5N1 after someone inColoradocaught the virus in 2022.
While there is no sign of person-to-person spread a development that would signal the start of a human epidemic experts say the ease with which the strain is jumping between species raises the risk of it evolving to infect people more easily.
The Centers for Disease Control and Prevention report a 'low' public health risk.
The virus, however, is widespread in wild birds, with sporadic infections in poultry and mammals.
Experts have previously told DailyMail.com H5N1 has the potential to spark a new pandemic.
Dr Aaron Glatt, an infectious diseases expert at Mount Sinai in New York, warned: 'It is absolutely true that H5N1 has the potential to cause a pandemic.
'People who work with these animals do need to be careful.
'The more that this virus is spread, the more likely it is that it could become a strain that could mutate and start to spread from human-to-human.'
The H5N1 spreading across the world emerged in 2020 after a bird was infected with both a bird flu from domestic poultry and a virus from wild birds.
During the infection, the two viruses met in the same cell and swapped genes in a process scientifically termed re-assortment to create the new virus that now had multiple attributes that made it better at infecting bird cells.
It quickly spread globally, with the first cases identified in Europe before infections were also detected in Africa, the Middle East and Asia.
The above shows a caged chicken that the The White Coat Waste Project claims is from inside the USDA lab that is working with Chinese government scientists on bird flu research
The above shows a caged chicken that the The White Coat Waste Project claims is from inside the USDA lab that is working with Chinese government scientists on bird flu research
This month's letter is not the first written to the USDA from lawmakers.
Following February's investigation, Republican Sen Joni Ernst ofIowawrote a letter to Sec Vilsack seeking more information about the department's ongoing funding of the research.
The letter read: 'I was troubled to learn from the non-profit group White Coat Waste Project that USDA is supporting experiments involving a "highly pathogenic avian influenzavirus" that poses a "risk to both animals and humans."'
Sen Ernst said in a statement to DailyMail.com at the time: 'The health and safety of Americans are too important to just wing it, and Bidens USDA should have had more apprehension before sending any taxpayer dollars to collaborate with [China] on risky avian flu research.
'They should know by now to suspect "fowl" play when it comes to researchers who have ties to the dangerous Wuhan Lab, and simply switching from bats to birds causes concern that they are creating more pathogens of pandemic potential.
'Heres my warning: the Biden administration should be walking on eggshells until they cut off every cent going to our adversaries. We cannot allow what happened in Wuhan to happen again.'
The specific viruses the research said it will study include H5NX, H7N9 and H9N2, WCW reported.
Rep. Nicholas Langworthy (R-NY) speaks with reporters as he walks to House Republican Conference meeting at the US Capitol Building on July 18, 2023
A 2023 study described H5NX viruses as 'highly pathogenic' with the ability to cause neurological complications in humans.
The H7N9 strain first infected humans and animals in China in March 2013 and the World Health Organization said it is of concern 'because most patients have become severely ill.'
The H9N2 strain has been found in doves in China and while it has a lower pathogenicity than the other strains, it can still infect humans.
Despite the concerns, a USDA spokesperson told this website it is 'common for international researchers to conduct independent research that's connected to the same end goal' and that the research does not qualify as gain-of-function.
The confirmed presence of bird flu in American dairy cattle in a March 25 report from the U.S. Department of Agriculture (USDA) and a case in Texas where a human working with cattle was infected has put Canadian public health experts on high alert.
But, what is bird flu and what do we know about influenza in both poultry and cattle?
Bird flu, also called avian flu, refers to infection caused by the avian influenza Type A viruses. In the wild, influenza viruses generally spread among migratory waterfowls, such as ducks and geese. Within avian species, domestic poultry are highly susceptible to infection with Type A avian influenza viruses, including H5N1.
Canada itself is amid an H5N1 avian influenza virus outbreak, with over 11 million domestic poultry estimated to be affected and culled to date. In fact, a major concern for the Canadian poultry supply chain is the incurred financial loss from culling birds.
This virus is highly contagious among domestic poultry and can spread through an entire flock within a matter of days. The most common route of transmission from an infected bird to a non-vaccinated bird is via direct physical contact or contact with virus-contaminated surfaces with bodily fluids such as oral mucus and feces.
Non-avian species, like mammals, can also become infected with the H5N1 virus. In Canada, sporadic cases of mammals becoming infected with bird flu have been reported in raccoons, striped skunks, red foxes, cats and dogs.
As of March 2024, various reports from the USDA, Food and Drug Administration, and Centers for Disease Control and Prevention (CDC) confirmed the presence of H5N1 in dairy cattle across eight states, of which Idaho, Ohio and Michigan are the most northern states bordering Canada.
Although there are no known reports indicating the current bovine strain has made its way into Canada, there is no doubt that it is getting too close for comfort. As of March 27, 2024, the Canadian Food Inspection Agency has established various primary control zones in Alberta to prevent the spread of H5N1.
The emerging bovine H5N1 virus is novel to the cattle industry, a backbone of the Canadian food and agriculture industry. The close environmental relationship between humans and cattle would seem to make both species more vulnerable to influenza transmission, but that is not the case.
Interestingly, only a few cases of cattle-to-human influenza transmission have been documented. In contrast, pigs are the main mixing vessel for avian influenza A viruses, as exemplified in the 2009 H1N1 swine flu pandemic. The 2009 swine H1N1 virus was a mixing event that led to mammalian adaptation, a process that is not straightforward in any intermediate host. A natural mixing event in pigs would result from exchange of genetic material following co-infection with both an avian and human influenza virus.
However, in the current scenario, the emerging bovine H5N1 strain that has infected American dairy cattle has undergone a specific adaptation in an enzyme called polymerase. Changes to this viral enzyme are concerning, as it could allow for faster adaptation and maybe even support cattle-to-cattle transmission.
This raises numerous questions for which the answers are not yet clear. Among these, the key questions are:
The answers will support new regulations to control H5N1 spread within dairy cattle and to other farms, poultry, mammals and humans. The greater concern would be if this virus has entered the pig industry.
According to a CDC report, the H5N1 viral strain that infected a human in Texas is closely related to two candidate vaccines. It is also reassuring to know that the World Health Organization maintains a list of candidate vaccines that could be mass-produced against H5N1 influenza viruses. In fact, some countries maintain a small stockpile of vaccine doses against H5N1, should there be a need to vaccinate at-risk populations.
Until such an outbreak event occurs where vaccines against H5N1 for people might be required, the Canadian government has a list of preventive measures that people can take.
Members of the public need to keep their distance and avoid direct contact with wild birds that look sick or have died. People should also avoid touching surfaces where there are likely to be bird droppings.
As for livestock species, both the American and Canadian governments have been reluctant to approve the use of vaccines in the poultry industry. The long-standing strategy against avian influenza has been eradication, and not vaccination, by culling all infected and affected chickens. While it has been successful at preventing the virus from becoming endemic, it may not be economically sustainable with H5N1 outbreaks predicted to occur on a yearly basis.
In the wake of this unprecedented news, efforts have to be directed to study avian influenza transmission from poultry into cattle. Such proactive efforts will hopefully generate necessary data to establish a decision-making framework to safeguard our livestock industry and protect human health.
The avian influenza virus H5N1 has only turned up in two humans in the U.S., but its recent spread to dairy cattle has some experts on at least slightly elevated alert.
A tracking map updated daily by the U.S. Department of Agriculture suggests the cause of their concern: As of April 17, livestock infections were present in almost 20 domestic herds across eight states.
The mostly asymptomatic cow carriers were likely exposed via incidental brushes with the diseases primary carriersducks, geese, gulls and other wild aquatic birdsor through normal proximity to infected barnyard neighbors like chickens and turkeys.
Meanwhile trackers have noted an uptick of H5N1 in mammals like bears, coyotes, skunks and foxes, which feed on dead birds.
Regardless of the infection pathways turned up by contact tracing, at least one of the two infected persons works on a dairy farm.
For Andrew Pekosz, PhD, a molecular microbiologist and immunologist at Johns Hopkins, reasons for stepped-up watchfulness include the two human cases in light of the relative rareness of bird flu in people.
The human population is essentially completely naivehas no preexisting immunityto H5 viruses, Pekosz tells the Johns Hopkins news team. Therefore, similar to what we saw with COVID, in the worst-case scenario, if this virus enters humans and starts to spread, all of us are susceptible, and we could see massive increases in numbers of cases.
More:
H5 viruses are rather deadly in poultry. Theyre not so deadly in wild birds, but they seem to be deadly in mammals, and we dont know what theyll do in humans.
The CDC reports well more than 90 million infections in domestic poultry across 48 states as of April 17.
In Missouri, a third-generation dairy farmer who is also a nutritionist tells Iowa Public Radio that everyone he knows is well aware of the situation with avian flu in cattle.
Farm owners, farm managers are definitely keeping in touch with their veterinarians and with their other resources to understand how the situation is evolving, says the farmer, Sean Cornelius. Id say [were] not really alarmed by it but being very vigilant.
According to numerous outlets, infected cows tend to present only mild symptoms such as reduced appetite and milk production.
Meanwhile milk from cows with bird flu is safe for human consumption as long as its been pasteurized.
Commenting on the second human infection, CDCs information operation says the affected individual was exposed to dairy cattle in Texas and had eye redness as an only symptom.
The patient was told to isolate and is being treated with an antiviral drug for flu, CDC adds. More:
This infection does not change the H5N1 bird flu human health risk assessment for the U.S. general public, which CDC considers to be low. However, people with close or prolonged, unprotected exposures to infected birds or other animals (including livestock), or to environments contaminated by infected birds or other animals, are at greater risk of infection.
For CDCs recommendations on preventing, monitoring and investigating highly pathogenic avian influenza (HPAI), including H5N1 strains, click here.
(CBS DETROIT) - Michigan health experts are warning residents about the risks of consuming raw milk as the highly pathogenic avian influenza continues to affect dairy herds in the state.
The virus can spread to humans through the consumption of unpasteurized milk products.
"Anyone can get sick from drinking raw milk, but children under age 5, adults over age 65 and those with weakened immune systems are more at risk for getting sick," said Dr. Natasha Bagdasarian, chief medical executive. "Now that HPAI is infecting both cows and birds, it's important to make sure that you are consuming food that is safe, including ensuring that the milk products you eat or drink are pasteurized."
Pasteurized milk undergoes a heating process that kills germs that cause diseases, including Campylobacter, E. coli, and Salmonella.
People who consume products made using raw milk are at risk of contracting illnesses; however, milk products sold in stores and given in school lunches are all made from pasteurized milk.
In addition, health experts say milk that someone consumes from the same farm they had previously drank from may not be safe. Even though it did not cause them to get sick previously, it could have become contaminated since then.
Pasteurization inactivates bacteria and viruses, such as the avian influenza virus.
The Michigan Department of Health and Human Services is reminding residents of the risks associated with drinking raw milk due to the highly pathogenic avian influenza, also known as the bird flu, being detected in several Michigan dairy herds.
In March 2024, bird flu was detected in a dairy herd in Montcalm County. Since then, the virus has been detected in herds in Ionia, Isabella and Ottawa counties.
The Michigan Department of Agriculture and Rural Development released the following ways to prevent the spread of the bird flu:
Sara Powers is a digital producer for CBS Detroit. Sara covers local news, often focusing on crime, politics and entertainment.
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H5N1, or bird flu, has hit dairy farms but the dairy industry doesnt want us saying so.
The current, highly virulent strain of avian flu had already been ripping through chicken and turkey farms over the past two years. Since it jumped to US dairy cows for the first time last month, its infected more than 20 dairy herds across eight states, raising alarms among public health authorities about possible spread to humans and potential impacts on the food supply.
One Texas dairy worker contracted a mild case of bird flu from one of the impacted farms the second such case ever recorded in the US (though one of hundreds worldwide over the past two decades, most of them fatal).
Whatever fear-mongering you may have seen on social media, we are not on the cusp of a human bird flu pandemic; the chances of further human spread currently remain low. But that could change. As the virus jumps among new mammal species like cows, the risk that itll evolve to be able to spread between humans does increase.
But the American Association of Bovine Practitioners (AABP), an organization of beef and dairy veterinarians, declared in a statement (condemned by public health experts) last week that it doesnt believe bird flu in cows should be considered bird flu at all.
The AABP will call this disease Bovine Influenza A Virus (BIAV), the associations executive director K. Fred Gingrich II and president Michael Capel said in a statement, encouraging federal and state regulators to do the same. It is important for the public to understand the difference to maintain confidence in the safety and accessibility of beef and dairy products for consumers.
In other words, industry vets are trying to rebrand bird flu so that we keep calm and keep buying cheeseburgers. Theyre worried about selling products, bovine veterinarian James Reynolds, a professor at Western Universitys vet school, told me, calling the groups statement disease-washing.
Covering bird flu over the last two years, Ive seen a lot of wild stuff, but this may be one of the weirdest. And its more than just a terminological or political spat: It reflects an inescapable paradox about how we produce food.
Naming infectious diseases is always political.
In this case, the cattle industry appears desperate to distance itself from the bird flu news cycle and avoid the perception that its contributing to human disease risk. But animal agriculture is one of the top drivers of zoonotic diseases and growing global demand for meat, dairy, and eggs may be putting us at ever-greater risk of new outbreaks.
Understand the world with a daily explainer plus the most compelling stories of the day.
To understand why, one of the most elegant models Ive found is the infectious disease trap, a concept coined in a 2022 paper by New York University environmental scientist Matthew Hayek.
Farming animals for food requires lots of land much more land than it would take to grow an equivalent amount of plant-based foods. More than a third of the planets habitable land is devoted to animal agriculture alone, making it the worlds leading cause of deforestation as forests are cleared for farms. That in turn leads to more human and farm animal encounters with wild animals, a major source of new zoonotic diseases.
Animal agricultures land use can be shrunk through intensification densely packing animals into factory farms which limits deforestation and helps reduce meats climate footprint.
But such operations are terrible for animal welfare, and they exacerbate zoonotic disease risk in other ways, allowing viruses to rapidly tear through factory farms filled with thousands of stressed, genetically identical animals.
Thats exactly whats been happening at chicken and turkey farms across the US over the last two years and to prevent further spread, farmers have killed more than 85 million poultry birds on farms hit with bird flu since 2022, often using a grisly method that kills them via heatstroke. Our current food system is a recipe for brewing more virulent disease strains and, many experts fear, its a ticking time bomb for the next pandemic.
As long as global meat production expands, Hayeks model explains, both low-density and factory farm-style animal agriculture trap us with rising disease risk.
A lot remains unknown about how bird flu has spread so rapidly among cows on dairy farms as far apart as Michigan and New Mexico.
One plausible theory is that the disease is moving with cows being trucked across the country, just as a human disease might move with people.
In recent years, as the dairy industry has increasingly consolidated into large factory farms, long-distance transportation of cows has become very common, Reynolds explained. Young female calves are often trucked from northern states to warmer climates in the south, then shipped back north when theyre old enough to become pregnant and produce milk. Theres kind of a constant movement that really didnt exist much 20 years ago, Reynolds said.
Long-distance shipment can inflict extreme suffering on farmed animals, who are treated more like cargo than sentient beings. Its also a hallmark of intensive animal agriculture systems described in the infectious disease trap model, allowing diseases to jump to new regions.
At least 18 states have restricted cow imports from states where dairy cows have tested positive for bird flu. The dairy industry recognizes the risks, Reynolds said, and is making efforts to improve biosecurity on these cross-country journeys. Meanwhile, regulators are scrambling to track the disease and stem its spread but experts have argued those efforts dont go nearly far enough, failing to require widespread testing.
And whatever steps are being taken now to stop the spread, the infectious disease trap model shows us that if were chasing zoonotic diseases after theyve infected farm animals, were already behind.
Escaping that trap requires a much broader societal rethinking of our factory farm system.
This story appeared originally in Today, Explained, Voxs flagship daily newsletter. Sign up here for future editions.
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Since early 2022, a highly pathogenic strain of avian flu, H5N1, has been infecting wild aquatic birds and domestic poultry in the United States. More than 85 million birds in 48 states have died as a result of the virus or have been culled after exposure to infected birds.
This same strain has now spread to cows. Health officials have detected H5N1 in cattle across 16 herds in six states. And this month, the Centers for Disease Control and Prevention reported a case of bird flu in a dairy worker in Texas who likely contracted the virus from cattle.
This is an alarming situation that must be monitored closely. Livestock workers and owners of backyard flocks need to take extra precautions, and clinicians should be on the lookout for new human cases. Most Americans, though, should not be concerned about the risk of avian flu to them at this time.
Avian influenza is not new. The first description of it dates from the late 1800s. Like human flu viruses, there are multiple strains of bird flu. Some strains cause mild or no symptoms. Others are associated with mortality rates as high as 90 to 100 percent in domesticated bird species.
Many bird flu viruses originate in wild aquatic fowl and are then passed on to chickens, turkeys and other domesticated birds. While most transmission occurs among birds, some strains can cross over to infect mammals. The H5N1 strain has already been detected in more than 200 mammals in the United States.
That includes humans. In addition to the Texas dairy worker, an individual in Colorado working with poultry was diagnosed with H5N1 in 2022. The dairy workers only symptom was eye inflammation, and the poultry worker experienced fatigue. But prior cases from elsewhere in the world have resulted in pneumonia, multiple organ failure and death.
Indeed, the specter of severe illness is what makes avian flu a worrisome disease. The World Health Organization reports that 887 people globally have been infected with this strain over the past two decades. The mortality rate was 52 percent.
That is a terrifying number. Though there are approved H5N1-specific vaccines, it will take months to ramp up production. (The current seasonal flu vaccine probably does not prevent avian flu, though the CDC recommends it because it prevents people from contracting the regular flu at the same time.) There are antiviral treatments that should reduce the risk of hospitalization and death, but mortality could still be substantial if many people become infected.
Heres the reassuring part: Transmission among humans has, so far, been uncommon. Most people infected with bird flu worked closely with infected animals. Of those who contracted avian flu from other humans, most were living in the same household with a symptomatic person, resulting in close, prolonged and unprotected exposure. During the current H5N1 outbreaks, there has been no documented human-to-human transmission.
Of course, this could change. The more widespread the virus becomes among other mammalian species, the more it could acquire mutations that facilitate its spread among humans. Clinicians need to be on the lookout for people who work with animals and start experiencing symptoms. Scientists must continue tracking the spread of H5N1 in other species, and the federal government should ensure that a robust plan is in place should widespread vaccine distribution be needed.
For now, most people do not need to change their daily lives. Specifically, they do not need to stop drinking milk or eating chicken. Pasteurizing milk and cooking poultry kills pathogens, including the avian influenza viruses.
Those who have frequent contact with birds should take additional precautions. Bird flu is spread through direct contact with secretions from the animals mouth or nose, or through its feces. The virus can also be inhaled as well as transmitted from someone touching a contaminated surface and then their mouth, nose or eyes.
The CDC recommends that poultry workers, individuals who rehabilitate birds in sanctuaries and people with backyard flocks use eye protection and a well-fitting face mask if they have to handle sick birds. They should avoid touching their mouth, nose or eyes after contact with possibly contaminated objects. Hand-washing is a must, and workers should change clothes after handling birds. Hobbyists, meanwhile, should observe wild birds at a distance and especially stay away from birds that look sick or have died.
Finally, its worth remembering that avian flu is one of more than 200 diseases that are spread between animals and humans. Zoonotic diseases have been increasing with warming climates, urbanization and the destruction of natural habitats, which have all accelerated contact between humans and wild animals. Protecting humans from these diseases requires not only better surveillance and expedited vaccine research, but also environmental measures that safeguard biodiversity.
This article has been reviewed according to ScienceX's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:
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Protecting men who have sex with men against gonorrhea with the 4CMenB meningococcal B vaccine is cost-effective; Imperial College London study finds
Gonorrhea is a sexually transmitted disease which is caused by infection with the Neisseria gonorrhoeae bacterium. Previous studies showed that the 4CMenB meningococcal vaccine (also called Bexsero) partially protects against gonorrhea.
This mathematical modeling study by Imperial College London, published in The Journal of Infectious Diseases, combines data on disease transmission and economics to evaluate the cost-effectiveness of vaccinating men who have sex with men (MSM) with 4CMenB to protect against future gonorrhea infection.
To be cost-effective, vaccination has to be offered to those who are particularly at risk of gonorrhea. Offering vaccination to patients diagnosed with gonorrhea to reduce their risk of getting another infection can prevent 57,000 cases over 10 years and is cost-effective.
Expanding the eligible group to include not only those with current infection but also uninfected individuals attending sexual health clinics who report more than five sexual partners per year is even more cost-effective. This approach could prevent 140,000 gonorrhea cases over 10 years.
This study also examined the importance of variation in the population regarding how people feel about vaccination because this affects how many people ultimately get protected. In an "optimistic" scenario, the number of gonorrhea cases prevented is 30%-60% more than in a "pessimistic" scenario.
The authors demonstrate that a vaccination program using 4CMenB does not need to achieve a minimum level of uptake to be cost-effective, although promoting vaccine uptake can increase the impact and value of the program.
The UK's Joint Committee on Vaccination and Immunisation (JCVI) has advised using the 4CMenB vaccine to protect men who have sex with men against gonorrhea, and the UK government is currently considering this advice.
Prof Peter White, MRC Centre for Global Infectious Disease Analysis, Imperial College London, said, "We have examined for the first time how variation in the way people feel about vaccination in the community of men who have sex with men would affect the impact and cost-effectiveness of using 4CMenB to protect against gonorrhea and it amounts to tens of thousands of cases and millions of pounds over a decade."
"Currently, we don't have information, so we recommend community engagement activities and studies to understand the range of views so that we can make vaccination as effective as possible."
Dariya Nikitin, MRC Centre for Global Infectious Disease Analysis, Imperial College London, said, "We have a gonorrhea epidemic at present, and offering the 4CMenB vaccine to at-risk men who have sex with men could greatly reduce the number of cases. Vaccination would be cost-saving because reduced costs of managing gonorrhea cases outweigh the costs of the vaccination program."
More information: Peter J. White et al, Cost-effectiveness of 4CMenB vaccination against gonorrhea: importance of dosing schedule, vaccine sentiment, targeting strategy, and duration of protection, The Journal of Infectious Diseases (2024). DOI: 10.1093/infdis/jiae123
Journal information: Journal of Infectious Diseases
A rising number of measles cases in the U.S. this year is raising concerns over a comeback of a disease that was declared eliminated in this country 24 years ago.
A measles report from the Centers for Disease Control and Prevention last week concluded that the spike in cases means more public health efforts are needed to increase routine vaccination coverage.
This year there have been 121 infections reported in 17 states, according to the Centers for Disease Control and Prevention. That is well above the total of 58 cases documented for the country for all of 2023.
Among the national cases this year were three in Georgia, all of them in unvaccinated people. The latest was confirmed Thursday in a person traveling with an international group of students. Earlier this year, state health officials confirmed two cases of measles in a metro Atlanta family after one of the family members had traveled internationally.
Before this year, the last measles cases in Georgia were reported in 2020.
While the numbers might seem low, measles is a serious illness that can lead to severe complications.
The airborne virus is also highly contagious. If one person has it, up to 90% of the people close to that person who are not immune will also become infected, according to the CDC.
Falling vaccination rates and a rise in cases globally are raising questions for older adults who got a measles vaccine a long time ago, or maybe they arent sure if they ever got vaccinated as a child.
Heres what you need to know about the measles vaccine and what to do if you are unsure about your vaccination status.
People born before 1957 are nearly always immune. The measles vaccine was made available in 1963, but in the decade before that virtually every child got measles by 15, making them immune. The CDC considers people born before 1957 to be protected from measles.
But for those born later, it may not be so simple. Measles vaccines first became available in 1963. Laws requiring a measles vaccine before attending school rolled out slowly and over the years so not all children were automatically vaccinated. Initially, there were two vaccines: a live attenuated version (which is a live form of the virus weakened in medical labs), or a killed vaccine (which contains the dead virus), which was not considered effective and is no longer used.
So some people who received the vaccine between 1963 and 1967 may have gotten a dose of the killed vaccine and they should consider getting an updated vaccine, according to Dr. Jayne Morgan, executive director of health and community education for Piedmont Healthcare.
The CDC said for those born after 1957, one dose of live vaccine is considered adequate unless a person is at high risk of exposure. Those at higher risk such as those working in health care, who are attending college, or who travel internationally should consider having two doses.
If you got the standard two doses of the measles vaccine after 1967, you should be protected against measles for life.
What if I dont know if Im immune?
For those unsure if theyve either had measles or took the vaccine as a child, the CDC said theres no harm in taking another, now known as the measles, mumps and rubella (MMR) vaccine. While healthcare providers can do a blood test to determine immunity, that step is generally not recommended.
Jodie Guest, professor and vice chair of the department of epidemiology at Emory Universitys Rollins School of Public Health, also says if you are not sure of your immunity, go ahead and get vaccinated. Go ahead and get the vaccine and do not worry about getting tested, Guest said.
Should younger adults also consider a measles vaccine?
Measles is a dangerous virus, so anyone of any age unsure of their vaccination status should get one. Guest said more than half of the people sickened with measles this year in the U.S. have required hospitalization, and close to a third of them were adults at least 20 years of age.
We have likely forgotten how dangerous measles is as vaccination rates have been high and kept us safe, said Guest. With vaccination rates falling, we are seeing a rise in a vaccine preventable illness that causes death and long-term, severe complications.
Severe complications from measles include pneumonia and encephalitis (swelling of the brain). Nearly one to three of every 1,000 children who become infected with measles will die from respiratory and neurologic complications, according to the CDC.
How effective is the MMR vaccine?
The measles vaccine is very effective, according to the CDC. Two doses of an MMR vaccine are about 97% effective at preventing measles if exposed to the virus. One dose is about 93% effective.
Very few people about three out of 100 who get two doses of measles vaccine will still get measles if exposed to the virus, according to the CDC.
Experts arent sure why. It could be that their immune systems didnt respond as well as they should have to the vaccine. But the good news is, fully vaccinated people who get measles seem more likely to have a milder illness.
Whooping cough outbreaks in Europe, Asia and parts of the U.S. should be a reminder to get vaccinated, experts say.
Since January, cases of whooping cough have risen sharply in the U.K. and Europe, the largest surge since 2012.
China logged more than 15,000 cases in January of this year, a 15-fold increase over the same time period last year. This month there have been small clusters of reported cases among high school students in the San Francisco Bay Area and several isolated cases in Hawaii. From October through earlier this year, New York City went through an outbreak, with more than 200 cases of mostly young children.
Whooping cough, or Bordetella pertussis the bacteria that causes the illness is a very contagious respiratory illness spread through small respiratory droplets. Due to widespread vaccination, whooping cough is largely under control in the U.S., but breakthrough cases, which are usually mild, do happen in people who are vaccinated.
Some U.S. health departments have informed us of local outbreaks, which we expect to see every year, Jasmine Reed, a Centers for Disease Control and Prevention spokesperson, told NBC News. So we are not seeing anything unusual.
Cases of whooping cough in the U.S. in 2024 are still lower than normal pre-pandemic levels. The U.S. usually logs around 20,000 cases of whooping cough every year. There were nearly 50,000 cases during a 2012 outbreak, CDC data shows.
Annual cases dropped steeply during the first two years of the pandemic, to 6,100 in 2020 and just 2,100 in 2021. Masking and physical distancing disrupted the normal cycles of many respiratory illnesses, including common colds, RSV and flu.
Where the pandemic may have interrupted the normal cycle of pertussis is people were not getting vaccinated on schedule because families werent seeing their physicians as frequently as we would like, said Dr. Thomas Murray, a professor of pediatric infectious disease at the Yale School of Medicine.
Whooping cough causes cough seizures, a series of coughs that make it hard for a person to take a breath.
When it finally stops, you take a breath in and it sounds like a whoop, said Dr. William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine.
In adults and kids, whooping cough can look very much like a cold, prompting a runny nose and cough. But in young babies, an infection can be much more serious.
Pertussis inflames young babies bronchial tubes, or airways, making it difficult to breathe. The most common complication of an infection is pneumonia, which can be fatal. According to the CDC, there were 307 reported deaths from pertussis from 2000 to 2017. Nearly 85% were infants younger than 2 months.
The disease is typically called whooping cough, but the very young babies dont necessarily cough, they stop breathing, Murray said, adding that the first thing parents should be aware of is anyone who is sick trying to come visit their newborn. For babies themselves, any fever over 100.4 degrees is something their pediatrician needs to know about.
If a babys lips are turning blue or they appear not to be breathing how they normally would, that is something to be worried about, especially if they have been around someone who is sick, Murray said.
The CDC recommends babies start their DTaP vaccine series which can prevent diphtheria, tetanus and pertussis starting at 2 months old. The series includes four more shots, at 4 and 6 months, 15 to 18 months, and 4 to 6 years old.
The concern is that during the Covid period, a lot of kids were withheld from regular vaccination, Schaffner said. Now practitioners are trying to catch up.
DTaP, which is formulated to elicit an immune response in babies, who have a less-developed immune system than kids, is about 98% effective at preventing pertussis in the first year following a five-dose series, according to the CDC.
The Tdap vaccine is recommended for kids 11 and older as well as adults who may need a booster. DTaP cannot be given to kids older than 7, but the Tdap booster can be given even to people who never had their initial DTaP series, the CDC advises.
Its important for all adults to have received a dose of Tdap. Following that, they should get either a Td or Tdap vaccine every 10 years, Reed, of the CDC, said, noting that vaccination wanes over time.
Adult vaccination protects kids from whooping cough, and lessens the disease if the vaccinated person does get sick. However, our compliance with that is less than optimal, which provides an opportunity for older people to get whooping cough, Schaffner said.
While whooping cough can be dangerous for older adults, the primary concern is an adult passing the bacteria to an unvaccinated newborn baby.
Anyone who comes to see the new baby should have had a recent inoculation with Tdap vaccine, to provide a cocoon of protection around that baby, Schaffner said.
The CDC advises women to get a booster with every pregnancy. The American College of Obstetricians and Gynecologists recommends pregnant mothers get vaccinated with Tdap during their third trimester, which the CDC says prevents around 78% of pertussis cases and 90% of pertussis hospitalizations in babies younger than 2 months.
In 2019, researchers at the CDC found the bacteria that causes pertussis bacterium Bordetella pertussis has changed over time, which could make the current vaccines less protective than they once were.
Its not clear what effect, if any, those changes have on vaccine effectiveness, Reed said.
Schaffner said the vaccines do still offer significant protection and are currently the best method for protection.
Its not like the flu. It mutates very slowly and these strains are sufficiently related to each other, so the vaccine still works, he said.
The influenza virus mutates rapidly, as does coronavirus, which is why vaccines for those illnesses need to be updated every year. DTaP and Tdap vaccines are not reformulated.
The current outbreaks arent cause for alarm, but parents of new babies should be aware of the best ways to protect their newborns.
It wont turn into a pandemic because we have a highly vaccinated population, Schaffner said. However, lets make sure that pregnant people get vaccinated, that babies are vaccinated on schedule, and the rest of us take the Tdap vaccine every 10 years.
Kaitlin Sullivan
Kaitlin Sullivan is a contributor for NBCNews.com who has worked with NBC News Investigations.She reports on health, science and the environment andis a graduate of theCraig Newmark Graduate School of Journalism at City University of New York.
