Outbreaks of norovirus, also known as the stomach flu, are on the rise across the United States, particularly in the Northeast and West, experts reported.
Data from the U.S. Centers for Disease Control and Prevention show positive tests for noroviruses on the rise throughout the nation for the week ending Saturday, Feb. 10.
The number of positive tests are highest in the Northeast and West regions of the U.S.
Noroviruses, also known as the stomach flu, can cause diarrhea, cramps and vomiting.
It is incredibly contagious, Dr. Alfred Sacchetti from Virtua Our Lady of Lourdes Hospital in New Jersey told WPVI. Just one particle of the norovirus that you ingest will get you sick.
Heres what to know about noroviruses:
Noroviruses are the most common cause of acute stomach and intestinal infections in the United States, reports the National Foundation for Infectious Diseases. Its also sometimes called stomach flu, viral gastroenteritis or the winter vomiting bug. The U.S. reports 19 million to 21 million cases a year. Humans are the only hosts of the virus.
The virus was formerly known as the Norwalk virus, because the first known outbreak took place at an elementary school in Norwalk, Ohio, according to norovirus.com. Scientists identified the virus in 1972 from stool samples stored after the outbreak. It was officially renamed norovirus by the International Committee on Taxonomy of Viruses.
Extremely. The U.S. Centers for Disease Control and Prevention caution that noroviruses can be transmitted by infected people, contaminated food or water, or just by touching contaminated surfaces.
Noroviruses kill an average of 900 people a year in the United States, mostly those 65 and older, the agency said. More than 100,000 people are hospitalized each year on average, and the virus results in 465,000 emergency room visits annually.
People sick with a norovirus are most contagious during the illness and for a few days afterward, and the virus can remain in stools for up to two weeks after the illness. The virus can survive temperature extremes, too.
Also, catching a norovirus doesnt help you fight it off if youre exposed to it later, in part because there are many different types of noroviruses catching one doesnt protect you from others.
Cruise ships, nursing homes, day care centers and schools are common breeding grounds for norovirus anywhere large numbers of people are packed in close quarters, basically, the CDC reports. Outbreaks on cruise ships frequently make the news and there are countless travel websites dedicated to tracking cruise lines with the worst track records for the illness.
Diarrhea, cramps and vomiting usually start within 12 to 48 hours of exposure to the virus, according to the Mayo Clinic. Norovirus symptoms normally last one to three days, and most people recover without treatment. But infants, older adults and people with chronic illnesses may require medical attention for dehydration.
Since its a virus and not a bacteria, antibiotics arent any help, and there are no antiviral drugs for noroviruses.
The Mayo Clinic advises that people with norovirus take special care to replace fluids lost by vomiting or diarrhea to prevent dehydration. Drinks like Pedialyte are good for young children, while sports drinks and broths are suggested for adults. Sugary drinks, like sodas and fruit juices, can make diarrhea worse, while alcohol or caffeinated drinks can speed dehydration.
Most people recover in one or two days, but some cases can last up to a week, the Minnesota Department of Health said.
Most patients have no long-term effects but dehydration can be a concern in the very young, the elderly, or people with weakened immune systems, the agency said.
Good hygiene is key to avoiding noroviruses, WebMD.com suggested. Wash your hands frequently with soap and water, particularly after using the bathroom and before preparing food. Alcohol-based cleaners are not as effective. The site also advises carefully throwing away contaminated items, such as dirty diapers.
Wash raw fruits and vegetables, and cook oysters and other shellfish. Clean and disinfect surfaces with a mixture of detergent and chlorine bleach after someones sick, WebMD says. And if you catch a norovirus, dont prepare food for at least two to three days after you feel better.
Raw oysters linked to norovirus outbreak in California. Heres what to know
Cruise lines are battling norovirus outbreaks, affecting hundreds of passengers and crew
The arrival of a devastating strain of avian influenza, which has killed millions of animalsglobally, to the Antarctic mainland makes Australia the last continent free of the virus.
The highly-contagious strain of bird flu, known as H5N1, was confirmed over the weekend in two brown skua, which are large seabirds that prey on fish, small mammals and other birds like penguin chicks.
Scientists from Spanish National Research Council tested the two dead birds, which were collected by Argentine researchers in early February.
The birds were found near Argentina's Primavera Base, which is on the western side of Antarctica, close to South America.
While avian influenza had previously been detected on islands between South America and Antarctica, this is the first confirmed detection on the mainland.
Scientists expected the flu to reach Antarctica's mainland this year or next, and are concerned it could lead to the deaths of thousands of the frozen land's unique animal species.
Here's five quick things to know about the virus and its likelihood of getting to Australia.
Different types of bird flu have been around as long as we've had birds.
Sometimes the viruses are not all that deadly and do not spread far.
But there are also strains of high-pathogenicity avian influenza, which can do a lot more damage.
In 1996 a strain of the flu, known as H5N1, was first detected in a goose in Guangdong, China.
This virus was able to kill domestic chicken flocks within a matter of days.
The strain was a precursor to the current outbreak known as H5N1 clade 2.3.4.4b,which started in Europe in 2020 when gene-swapping of the virus between wild and domestic birds created an even deadlier version.
That strain made its way to the shores of North America in 2021 thanks to trans-Atlantic migration pathways for shorebirds.
Since then some 81 million domestic birds have been killed or euthanised because of the virus.
The number of wild birds around the world that have succumbed to the disease is unknown, but it is believed to be in the millions.
H5N1 spread quickly around the rest of the world and rapidly made its way down the South America coastline to the subantarctic region at South Georgia and the Falkland Islands.
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So far Oceania, including Australia and New Zealand, has remained free of the virus.
The outbreak has been called a panzootic, which is like an animal version of a pandemic with a worldwide spread of an infectious disease.
About 600,000 wild birds died in South America between October, 2022, when the virus was first detected on the continent, up to November last year.
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The hardest hit species were cormorants and Peruvian boobies with a combined 504,000 deaths.
The virus has also killed different species of mammals around the world.
In South America, at least 50,000 mammals have died, most of these were sea lions.
At the other end of the world, the virus has affected mammals in the Arctic region andwas recently found in a dead polar bear.
Since 2020 there have been 26 cases of the virus in humans who have been infected by birds in Asia, Europe and the Americas.
Most recently there were four cases of the virus in people detected in Cambodia.
The detection of bird flu in the skuas potentially signals a serious event that could wipe out whole colonies of Antarctica's unique wildlife.
Australian Antarctic Division seabird ecologist Dr Louise Emerson recently visited the southern continent and subantarctic islands before the detection of avian flu at Primavera Base.
She said the concern about the virus being in Antarctica was because so many species from penguins to seals aggregated in large colonies.
"Which provides opportunity for the virus to spread between individuals," Dr Emerson said.
A recent study found about 70 per cent of elephant seal pups born at a high-density breeding site in Argentinalast year died from bird flu.
Dr Emerson said there were a lot of unknowns about what the virus would do in Antarctica and she hoped the harsh weather conditions would hinder the spread of the virus.
She also hoped the spread to East Antarctica, where Australia's research bases are, was slowed by the distance from West Antarctica.
"There's a lot we just don't know at the moment," Dr Emerson said.
"We don't know how the virus will cope with dry and cold Antarctic conditions... we don't know how close birds need to be to spread."
But University of Melbourne microbiologist Dr Michelle Wille believes the virus will cope well in Antarctic conditions.
Dr Wille is part of the Scientific Committee on Antarctic Research's wildlife health network and helps keep a database of avian influenza cases in the region.
"We know that [other]low pathogenic avian viruses are present in Antarctica," she said.
"If those viruses can survive fine, I'd suspect this one will do just fine."
Spread of avian influenza from Antarctica is one of three possible scenarios of how the virus could get to Australia suggested by the international expert group OFFLU, which provides animal influenza advice to the World Health Organization.
The transmission of the disease from Antarctica is seen as the least likely way for the virus to spread to Australia, althoughthere is a great deal of uncertainty because of a lack of tracking data.
OFFLU considered two possibilities for a spread from Antarctica.
First, a long-distance flying seabird, like the northern petrel or albatross, could make its way from a subantarctic island near South America to New Zealand.
An albatross could make the trip in just under six days and still be infectious when they arrive.
The second possibility could happen once the virus reached East Antarctica.
OFFLU suggested it could be possible for short-tailed shearwaters, which breed in South Australia, Victoria and Tasmania, to be exposed to the virus from other animals while foraging in the polar region for food.
Dr Wille said the spread of the virus from Antarctica to Australia was plausible, but not as likely as the spread byshorebirds making annual migrationssouth using theEast Asian-Australasian flyway.
Millions of birds use the flyway travelling from breeding grounds in places like Siberia and Alaska through Asia before arriving in Australia from about September.
The other most likely scenario would be the spread of the virus from waterfowl in the Papuan region.
If the virus reached Australia it could bring mass death for birds and other species.
Not only would poultry and egg industries be under pressure, but so too would wildlife with the potential for species like black swans to be wiped out.
Dr Wille and Deakin University ecology chair Marcel Klaassen have been testing migratory shorebirds that arrive in Australia each year.
Their latest season of testing which finished in December took them all over the country from west to east.
"All the migratory birds from the north have arrived now in Australia," Professor Klaassen said.
"None of those that we looked at had any signs of an infection or a past infection."
Testing of wild birds will continue next migration season and there is also ongoing testing of suspicious bird deaths in the different states and territories.
ADepartment of Agriculture, Fisheries and Forestry spokeswoman said Australia had a nationally-agreed response plan and cost-sharing arrangements if there did end up being an outbreak in the country.
"The department also participates in emergency management exercises to prepare for emergency animal disease outbreaks," she said.
A bird flu incursion was part of an animal health laboratory preparedness exercise last year by the federal government.
Dr Wille said Australia had been strengthening its systems wherever it could in preparation for the virus.
But the country was still very much in a wait-and-see situation.
Anyone who comes across dead birds or marine mammals is asked to contact the Emergency Animal Disease Hotline.
Ducks at lake Louise might have Avian Flu. Photo by Clint Parker.
Weaverville The North Carolina Wildlife Resources Commission District Biologist recently announced the detection of Avian Influenza (Flu) in two ducks found deceased at Lake Louise in Weaverville, triggering worries among both the local populace and officials. This development, communicated through a town press release, has heightened awareness and concern regarding the potential implications of the diseases presence in the local wildlife population. The confirmation of Avian Flu in these waterfowl has underscored the importance of vigilance and preventive measures to mitigate any possible spread of the virus, reflecting the seriousness with which local authorities are approaching the situation.
Last month, the Tribune reported that residents were concerned with the number of deceased ducks at the lake. Weaverville Town Manager Selena Coffey told the Tribune last month it was more than likely people feeding the ducks, which is against the town ordinance, but that dead duck had been sent off for testing. The ducks, found on January 26 and subsequently sent for testing, tested positive for the avian flu virus, prompting District Biologist Justin McVey to issue a cautionary advisory.
McVey highlighted the important distinction that, despite Avian Flus presence in infected waterfowl and water sources, it does not pose an immediate threat to human health. However, he voiced a strong caution regarding the significant danger it presents to domestic poultry populations, encompassing not only commercial operations but also backyard flocks and various other waterfowl species. He pointed out the particularly alarming aspect of the diseaseits potential to be fatal for poultry that contract it. This underlines the critical need for vigilance and proactive measures to prevent the spread of the Avian Flu within these vulnerable bird populations, ensuring the safety and wellbeing of the poultry industry at large.
The discovery of Avian Influenza in waterfowl, while alarming, aligns with expectations within the scientific and agricultural communities. McVey elucidated that its not uncommon for infected birds to show no outward symptoms of the illness, effectively making them silent carriers of the virus. These carriers have the potential to spread the disease to new locations. This transmission occurs through the excretion of fecal matter or oral discharges, especially during their migration periods. Such a mode of dissemination underscores the challenges in tracking and controlling the spread of Avian Influenza, as these asymptomatic carriers can introduce the virus to previously unaffected areas and populations, posing a significant risk to both wild and domestic bird species.
For those seeking additional information and guidance on Avian Influenza, the USDA APHIS website offers comprehensive resources and guidance at the QR code below.
In light of these developments, the public is strongly advised against handling wild birds suspected of carrying Avian Influenza. Instead, individuals encountering sick waterfowl or domestic poultry are urged to promptly report their observations to the North Carolina Wildlife Helpline at (866) 318-2401, available Monday through Friday from 8 am to 5 pm, or via email at HWI@ncwildlife.org.
Any instances of sick or dying captive birds should also be reported to local veterinarians, the North Carolina Department of Agriculture & Consumer Science (NCDA&CS) Veterinary Division at (919) 707-3250, or the North Carolina Veterinary Diagnostic Laboratory System at (919) 733-3986. Such proactive measures are essential in containing the spread of Avian Influenza and safeguarding both wildlife and domestic poultry populations from its adverse effects.
As the temperature is changing, it's time to arm yourself with the ultimate defence against those notorious flu bugs. Here we will know vitamins and nutrients that can help you stay strong and healthy even when the flu virus is making its rounds. From Vitamin C to omega-3 fatty acids, we'll uncover the secrets to staying flu-free with the power of nutrition. Say goodbye to sick days and hello to a healthier you! Let's jump right in and discover how to boost your immunity naturally. Vitamin CKnown for its immune-boosting properties, Vitamin C is your first line of defence against the flu. Found abundantly in citrus fruits like oranges, lemons, and grapefruits, as well as in leafy greens like spinach and kale, Vitamin C works wonders in strengthening your immune system. Its powerful antioxidant properties help to neutralise harmful free radicals in the body, reducing the risk of falling prey to the flu virus. So, stock up on those oranges and keep your immune system fighting fit! Vitamin DVitamin D also plays a crucial role in supporting the immune system. Often dubbed as the "sunshine vitamin" because our bodies produce it in response to sunlight, Vitamin D deficiency is common, especially during the darker winter months when sun exposure is limited. It suggested that adequate levels of Vitamin D can help reduce the risk and severity of respiratory infections, including the flu. So, soak up some sunshine whenever you can or consider adding Vitamin D-rich foods like fatty fish, eggs, and fortified dairy products to your diet. Zinc This mighty mineral plays a vital role in various immune functions, including supporting the production of immune cells and regulating inflammation. Zinc deficiency has been linked to an increased susceptibility to infections, making it essential to ensure you're getting enough of this powerhouse nutrient. Foods like chickpeas and pumpkin seeds are excellent sources of zinc and can help bolster your defences against the flu virus. So, don't overlook zinc it might just be the key to staying flu-free this season!
Quercetin Ever heard of quercetin? If not, it's time to get acquainted with this potent flavonoid with impressive antiviral properties! Found in various fruits, vegetables, and herbs, quercetin has been shown to inhibit the replication of viruses, including the influenza virus. This makes it a valuable ally in the fight against flu-related illnesses. Foods like apples, onions, broccoli are rich sources of quercetin and can help bolster your immune defences naturally.
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KOLKATA: Doctors across the city are getting numerous cases of viral infection of the stomach or a stomach flu. Even though most of the affected have not needed hospitalization, the infection has restricted their activities, with many losing working hours. Health experts said hand hygiene and eating healthy are the principal prevention measures for stomach flu. Termed viral gastroenteritis, it is an infection in the intestine which causes symptoms like watery stool, stomach cramps and vomiting, which are sometimes accompanied by fever. Experts said a person can catch this infection after consuming contaminated food or water, and an infected person can pass it on. We are getting acute cases of vomiting, diarrhoea and abdomen cramps. While post-infection weakness is common, none that I came across has required hospital care, said internal medicine specialist Rahul Jain of Belle Vue Clinic. While this infection is self-limiting and settles within a few days, it could be severe in infants and older adults who are not immune competent. Some doctors are getting patients who have gastrointestinal symptoms along with respiratory infection symptoms. Joydeep Ghosh, consultant, internal medicine, Fortis Anandapur, said, Ive been encountering patients with viral infections, primarily linked to respiratory issues rather than isolated stomach infections. These individuals exhibit a combination of respiratory and gastrointestinal symptoms, including cough, fever, diarrhoea and nausea. Though often called stomach flu, the infection is not caused by the influenza virus. The inflammation in the stomach and the intestine can be caused by other viruses, including rotavirus, adenovirus and norovirus.
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The H5N1 virus continues its global spread, having recently been found for the first time ever in mainland Antarctica.
Avian flu reached the wider Antarctic region in October last year when it was reported on sub-Antarctic islands. Since 2021, highly pathogenic avian influenza (HPAI) has gone gangbusters and made its way to almost every continent, but has not yet been detected in New Zealand, Australia or the Pacific Islands.
The SMC asked experts to comment.
Associate Professor Michelle LaRue, School of Earth and Environment, University of Canterbury, comments:
Researchers predicted the arrival of highly-pathogenic avian influenza (HPAI) this summer season in Antarctica, it was just a matter of when. So, seeing this news is not a surprise, though no less devastating to hear. Since we know HPAI can kill both birds and marine mammals, it is possible we may see catastrophic mortality events and devastation of Antarctic wildlife.
Conflict of interest statement: Not really a conflict, but of interest is that I am also the Chief Officer of the Expert Group on Birds and Marine Mammals within the Scientific Committee on Antarctic Research.
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Dr Mary van Andel, Chief Veterinary Officer, Ministry for Primary Industries, comments:
The recent cases confirmed were from dead skuas found near the Argentine Antarctic base Primavera, in San Martin Land on the Antarctic Peninsula. Given how the disease has been moving southwards over the past year, this detection is not unexpected and does not significantly change the risk of HPAI arriving in New Zealand. HPAI has been spreading in the sub-Antarctic South Atlantic since October 2023, with suspected cases found on islands near the Antarctic Peninsula in recent weeks.
We are actively monitoring disease spread, particularly towards the Ross Sea region. We have many systems in place to prevent HPAI entering New Zealand on those pathways that can be managed, and to ensure early detection if it does arrive. International experience has shown that a One Health approach to the current strain of HPAI is essential. We are working closely with the Department of Conservation and the Ministry of Health to jointly prepare for any detection of HPAI in New Zealand.
No conflict of interest.
Bruce McKinlay, Technical Advisor Ecology, Department of Conservation, comments:
DOC and Biosecurity New Zealand are working together to continually monitor the situation here and overseas, and coordinate readiness, response, and communications.
We dont know exactly what impact HPAI would have on native species but its more likely to affect colony nesting birds such as red and black-billed gulls, gannets, terns and other seabirds or animals interacting with these birds, during times of close contact. Transmission of the virus through secretions and faeces is likely to occur at this time. Also potentially at risk are non-breeding aggregations of waterbirds that congregate on wetlands or high tide roosts.
DOC is developing plans to mitigate risks to threatened species should HPAI arrive in New Zealand including actions to enhance detection, reduce spread and protect threatened species.
For a few species, vaccination might be an effective tool during outbreaks to protect a captive breeding population to prevent species extinction. It is not possible to vaccinate all our endangered birds, but we can focus on those species in captivity where the full two doses of vaccine can be given.
We are currently undertaking a vaccination safety and efficacy trial for avian influenza for five critically endangered native species: kak/black stilt, takah, kkp, tturuatu/shore plover and red-crowned kkriki (as a surrogate species for kkriki karaka/orange-fronted kkriki).
Once the trial is completed, we will have good evidence about how well the vaccine works and how much protection it might provide to these manu/birds. Vaccination would be used when bird flu has arrived to ensure the protection is recent and strong.
Conflict of interest: None. Bruce notes that he is President of Birds NZ.
Professor Jemma Geoghegan, Virologist, University of Otago, comments:
The discovery of birds infected with highly pathogenic avian influenza virus now on mainland Antarctica is alarming, but not all that surprising given how geographically widespread this virus has become globally. This finding demonstrates the ability of H5N1 to spread over long distances and highlights its potential to spread even further: up to New Zealand. Close monitoring of the virus is needed to detect it as it spreads into other species, as it has done so in other regions. Surveillance in New Zealands sub-Antarctic islands is now crucial for its early detection.
No conflict of interest.
Nigel French, Distinguished Professor of Infectious Disease Epidemiology and Public Health, Massey University, comments:
The virus is continuing to expand both its host range and geographical range. While this is some cause for concern, currently the risk is still very low due to the relative isolation of Aotearoa and the absence of certain risk factors, such as the presence of migratory waterfowl. Ongoing monitoring of the global situation, combined with surveillance for early detection and preventive measures (such as vaccination of endangered wildlife where possible), will all help to mitigate the threat to our at-risk populations.
No conflict of interest.
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The main covid-19 vaccines seem to have a net positive effect on our heart health
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Many covid-19 vaccines appear to reduce the risk of heart attacks, strokes and other blood clot conditions for at least six months, according to a study of the health of about 46 million people amid the coronavirus pandemic. This is despite them causing rare side effects that affect the heart and blood clotting system.
The net benefit to heart conditions most probably happens because the vaccines protect against severe covid-19, which itself can cause heart attacks,
The watchdog also saw a signal for the heart problems myocarditis and pericarditis in February 2021, but did not include the conditions in safety updates until June 2021, MPs said.
In effect, the MHRA licences medical products as safe knowing it lacks the processes to properly monitor adverse events, the APPG wrote.
In the case of Covid-19 vaccines, given the comparatively novel technology and record manufacturing speed, could the MHRA have even properly scrutinised the licensing data or known the short term safety?
Historically trust and confidence in vaccines and vaccine safety has been high in the UK, but it seems that the experience of the Covid-19 vaccines has undermined this and by association trust in the regulator and the pharmaceutical industry.
Now more than ever a wide-reaching and in-depth review is needed.
The group also warned that the MHRA Yellow Card reporting system which encourages patients and doctors to flag-up medicine side effects grossly underestimates complexities, and in some instances picks up just one in 180 cases of harm.
An analysis by Stockport NHS Foundation Trust found that in the North West of England, 1,058 people had been admitted to hospital with stomach bleeds caused by anticoagulant medication over five years, yet just six Yellow Card reports were made during the period.
Side effects from drugs account for one in every 16 hospital admissions in Britain, and cost the NHS more than 2 billion each year.
But trials are often too small to pick up adverse reactions, particularly when they are driven by rare genetic mutations, meaning it is vital to continue monitoring drugs in the community.
The MHRA recently said it would investigate why blood thinners were causing dangerous side effects in between two and five per cent of patients.
The APPG said it was also concerned that MHRA regulation of medicine was funded by the pharmaceutical industry and said the body had shifted from focusing on scrutiny to trying to help drugs get approved.
Dame June Raine, the chief executive of the MHRA, who announced she would be stepping down last week, has previously said the agency was transitioning from watchdog to the enabler, a phrase which MPs said warranted its own investigation.
Graham Stringer MP, co-chair of the APPG on pandemic response and recovery, said:
The MHRA oversees a failing system that is slow to act, causing harm to patients and beset with conflicts of interest.
We cannot allow it to continue. Thats why we have written to the health select committee calling for an urgent investigation into the MHRA.
The APPG said that concerns raised directly with the MHRA had been met with an habitually dismissive and evasive response.
Dame June said: We have made significant steps to put patients at the heart of all our work.
These include incorporating patient views and lived experience into our safety reviews; involving patients in the early stages of planning medicines development and building a new responsive reporting system for patients to tell us about any adverse incidents. We have also led on legislative changes to strengthen surveillance for medical devices and medicines, meaning patient safety is embedded firmly into law.
Our progress so far in making changes based on meaningful patient involvement gives us a solid base to build upon as we continue on this important journey.
We are committed to enabling innovation that brings transformative medical products safely to patients.
The culture of public health and medicine rests on open discussions in which different points of view are considered for the betterment of patient care and health. This process depends on psychological safety so individuals feel free and safe to speak and openly disagree. These factors collectively create a just culture, which improves systems and organizations and is being widely implemented in healthcare nationwide.
However, in the face of politicized anti-science and anti-expert sentiment and attacks, we need to ask if just culture is being restricted in public health. Following a series of legislative policy changes in Florida affecting academic institutions, health care, and public health, we see a regression in the open dialog of medical and public health experts about infectious disease control practices related to COVID-19 and now measles.
On January 3, 2024, in marked opposition to the CDC, FDA, and medical and public health experts, State Surgeon General Dr. Joseph Ladapo recommended that everyone avoid COVID-19 mRNA vaccines over concerns that they contain DNA. This notion starkly contrasts ample scientific data showing that these vaccines do not alter a persons genes, even if they contain minuscule amounts of DNA related to vaccine production. This announcement came on the heels of an earlier announcement on September 13, 2023, recommending that individuals younger than 65 not receive the updated COVID-19 vaccine, even though 25% of COVID-19 deaths have occurred in those younger than 65. Previously, he recommended that young adult men avoid the vaccine because of concerns about myocarditis. However, this risk of myocarditis is very rare, and the risk of myocarditis following COVID-19 is far greater than after vaccination.
Following these announcements, there was broad national criticism of these Florida-only policies. In contrast, the response by the Florida medical and public health community to these controversial recommendations, either in support or opposition, was modest. This tepid response contrasts the first years of the pandemic, when Florida medical organizations, medical schools, and public health experts often commented publicly about the state's COVID-19 mitigation and vaccination policies.
Currently, there is ameasles outbreakin a South Florida elementary school. Dr. Ladapo, not the county health officer, has stated that children at high risk for getting measles can attend school while potentially being contagious,leaving the decision to the parents. Although we are early in this outbreak, we are observing a similar situation where there is considerablenationaloutcry against his recommendation, while the response from the Floridamedical communityislimitedto afew practitioners.
Measles is a very contagious virus, 5 to 10 times more contagious than COVID-19, as it travels long distances and lingers in the air for hours. If an unvaccinated individual is exposed, there is a very high chance that the person will get the virus, which can result in encephalitis, pneumonia, and hearing loss.
Reflecting anti-vaccine and anti-science activity that has become part of the political agenda, rates of measles vaccination among young children have fallen below critical levels in many parts of the US. Not surprisingly, there has been a recent rise in measles cases in the US. The medical community overwhelmingly supports childhood vaccinations but is drowned out by policies that weaken vaccination requirements and misinformation that erodes confidence in vaccines.
Measles outbreaks can be controlled through early post-exposure vaccination measures and quarantining unvaccinated and exposed individuals for 21 days, spanning the incubation period. This recommendation is based on the fact that individuals with measles can be contagious for several days before they show symptoms. Even though more than 90% of the population may be vaccinated against measles in some parts of the U.S., those who are unvaccinated or medically compromised are at high risk if exposed, irrespective of community vaccination rates.
Having a child out of school for three weeks is a long time. Yet, coming out of the pandemic, we have widely available tools to facilitate remote learning, which the school has implemented. When parents do not feel comfortable that an outbreak can be controlled, it is natural for them to keep their children out of school. It was reported that almost 20% of the student body was absent several days after this outbreak, even in this school, which had previously reported high vaccination rates. Was it considered that emphasizing standard measles control policies are being followed, rather than allowing children with potential measles to go to school, could boost attendance?
We need to ask what has happened over the past year to discourage the airing of views contrary to state policies. Is there self-censorship or external censorship? Was there opposition to these recent recommendations by Dr. Ladapo from inside the Florida Department of Health? The answer may lie in reviewing recent legislative and state actions that may give medical experts and those at academic institutions pause in speaking out.
First, a law was passed allowing faculty tenure to be revoked at state universities, meaning faculty with secure positions can now be fired. Florida University faculty members have stated that this policy limits the freedom of experts to speak openly over fears of retribution.
Second, the Medical Freedom bills signed into law in Florida on May 11, 2023, now allow physicians to make public, unsubstantiated, and false claims without consequence. Medicine has regulated itself to keep the public safe. Without these guardrails, inaccurate information can increase without the proper checks of hospital credentialing boards and medical societies. Does this new law make physicians powerless to challenge false and potentially harmful medical information?
Third, the state regulateshospital fundingandMedicaidpatient care reimbursement rates. University, medical school, and hospital leadership administrators may thus be concerned when faculty members speak publicly and run afoul of political leaders.
Fourth, we see the state dictating what can and cannot be taught at K-12 schools and public universities, something unheard for college and universities in the past. Recently, the Florida Board of Governors banned sociology from the core curriculum of the university system. Considering that the most popular majors at the University of Florida, for example, are psychology and biological sciences, for which sociology is foundational, one needs to ask if the state policy is in the students best interest.
Fifth, healthcare providers are now being drawn into culture wars. Medical organizations are also being investigated for health-related issues at the state and national levels.
We now see what happens when policies threaten the perceived ability of medical experts, university experts, medical societies, and public health employees to speak openly. Public discussion about crucial public health state policies fades.
Florida once took its place among the states with the highest COVID-19 vaccination rates for those older than 65 in the US and was among those with the lowest COVID-19 death rates per capita, ranking 29th in the spring of 2021. In contrast, Florida currently has one of the lowest booster COVID-19 vaccination rates in the U.S. and ranks 8th in COVID-19 deaths per capita. Now, Florida has a serious measles outbreak and is not following standard measures of infection control by allowing potentially contagious children to return to school.
Consideringthe high vaccination rateof 97% at the outbreak site, this outbreak will be contained. But what will happen when measles lands in a school or community with lower vaccination rates and standard public health measures need to be followed?
Do we really want to limit discussions about infectious disease control policies? We have learned the clear advantages of a culture that considers different viewpoints in medicine and public health.
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