Category: Flu Virus

Pathologists are at the center of helping to diagnose diseases such as respiratory syncytial virus (RSV), influenza and COVID.

These diseases may be off the front pages nowbut they're very much still with us, said Donald Karcher, MD, president of the College of American Pathologists.

At this articles deadline, COVID-19 test positivity stood at 9.5%, according to the Centers for Disease Control and Prevention.

That's down a bit, but still high, said Dr. Karcher, professor of pathology at George Washington University. Hospitalizations have also declined but are still lingering at over 16,000 a week.

At a College of American Pathologists media briefing in October, Dr. Karcher joined two other pathologists to discuss test positivity in COVID-19 and other winter viruses, and how patients should approach tests and vaccines.

In a Leadership Viewpoints column, AMA President Jesse M. Ehrenfeld, MD, MPH, outlines the new prevention tools, including vaccines and monoclonal antibodies, that are available this respiratory virus season.

Expressing concerns about the potential for COVID-19 rates this winter, Dr. Karcher asked the panelists about trends in their own communities.

Leilani Valdes, MD, medical director at Regional Pathology Associates and chair of pathology and laboratory medicine at Citizens Medical Center in Victoria, Texas, saw a slight increase in COVID-19 cases over the summer.

This was a bit surprising, given some experts predictions that COVID-19 would become more seasonal, said Dr. Valdes.

We worry that we're going to see an increase once we do get into that cold and flu season again, she said. Monitoring positive COVID-19 tests gives her infection-control team an idea of how much virus is circulating in the community.

We want to be ready when it does increase for those patients to come in and be treated in our hospital, she added.

In an episode of the "PermanenteDocsChat" podcast, you can hear from physician experts on strategies to address vaccine hesitancy with patients and updates on current COVID-19 variants, flu and RSV vaccines. Listen now on Apple Podcastsor Simplecast.

At-home versus PCR

The federal government has reinstated its policy to provide four at-home COVID tests to each U.S. household at no charge.

At-home tests are a useful way for individuals to identify a current infection and take the precautions necessary to keep it from spreading, said Dr. Valdes. The patients who use them arent medical technologists or pathologists with years of training, however.

For that reason, its really important when you do these at-home tests that you really pay attention to the instructions, she urged. Users need to look at all the steps the test asks them to do to ensure an accurate result.

While they can be easy to use and provide quick answers, the at-home tests have limitations, said Diana Cardona, MD, associate professor of pathology at Duke University School of Medicine.

Polymerase chain reaction (PCR) tests, which look at the genetic material of the virus, are the most sensitive, meaning they are most likely to detect the virus if a person has it, she said.

At-home tests arent as good as detecting this material, which means someone could get a false negative result.

When to visit the doctor

For all the viruses that cause the common cold, COVID-19 or the flu, basic symptoms present with runny nose, sore throat, cough, congestion and possibly some fatigue.

As symptoms progress, the source of the illness may become clearer. Difficulty breathing or losing sense of smell or taste are signs it may be COVID as opposed to flu, RSV or a cold, said Dr. Cardona.

If you have any suspicion that maybe you actually do have COVID-19 and your home test was negative, go into a clinic and get a PCR test just to make sure, advised Dr. Cardona.

The Food and Drug Administration published a list on its website that extends expiration dates for some of the at-home test kits. If a kit is not on the list and is expired, people should either throw it away or approach the results with caution, said Dr. Cardona.

Stay updated with the AMA COVID-19 resource center for physicians.

See original here:

COVID-19, RSV, flu: When to get tested and how - American Medical Association

Research on new methods of fabrication is never-ending, and Caltech researchers have recently made another major discovery. Following Caltech's fabrication method, metallic materials as small as 150 manometers (comparable to a flu virus and certainly invisible to the naked eye) can be created with three-to-five times the sturdiness of similarly-sized materials.

So, why is 3D printing metal with this method so good? First, let's discuss the downsides of creating materials so small to begin with. At an atomic level, these nano materials actually have a "very, very messy microstructure", with issues that would lead to serious defects in larger metal objects.

But when operating at nanoscale, the rules are a little different. A "perfect," defect-free nano-pillar would inevitably collapse from contact with itself, while one full of "defects" actually enjoys a massive boost to fault tolerance. According to Wenxin Zhang, lead author of the original paper, the existence of interior "pores" allow for faults to be terminated near-immediately instead of weakening the entirety of the structure.

So, what does all this mean? Well, for one, it means physics gets really weird at a nano-scale and the further tech progresses down this road, the more often we'll be finding strange, contradictory rules like this one. But secondly and more importantly, a lot of very useful things can be created this way, including nano-scale sensors, heat exchangers, and more.

And of course, while this technically counts as 3D printing, it's very unlikely that any of the best 3D printers for consumers will be capable of creating nanoscale materials anytime soon, especially not with the specific fabrication process being used at the Caltech labs.

The process is very complicated and involves building a photosensitive mixture that includes a hydrogel polymer, hardening that mixture with a laser, infusing the substance with another solution that has nickel ions, baking it and chemically stripping oxygen atoms out of the parts, among other things. For more details, check out Zhang's paper.

See more here:

New 3D Printed Metal is as Small as a Virus and Super Strong - Tom's Hardware

Recent advances in gene editing technology could potentially be used to create disease-resistant animals. This could curtail the spread of avian influenza, commonly known as bird flu.

In a recent gene editing study, my colleagues and I showcased the potential of gene editing to protect chickens from the threat of bird flu. This disease is caused by an ever-evolving virus that gets around numerous biosecurity measures such as good hygiene, restricting bird movements, surveillance through appropriate testing, and selective elimination of infected birds.

A gene editing breakthrough would stem the huge economic losses currently suffered as a result of bird flu outbreaks. It would also be a significant step in controlling a disease that can cause serious sickness and death in humans.

Outbreaks of bird flu around the world cost billions of dollars in losses. The United States Department of Agriculture reported that up to 50 million birds died from bird flu in 2022. Recently, the South African Poultry Association said more than 7 million chickens were destroyed after outbreaks were detected in the first half of 2023.

Beyond the economic implications, bird flu outbreaks also pose a risk to human health.

Prior to the COVID-19 pandemic, bird flu was considered a possible trigger for a devastating human pandemic. This prompted international surveillance led by the World Organisation for Animal Health, the World Health Organization and the Food and Agricultural Organisation of the United Nations.

The fear is well-founded as the three flu pandemics of the 20th century including the 1918 flu pandemic that claimed tens of millions of lives originated from birds.

Vaccination is a primary method for preventing bird flu outbreaks in chickens.

However, the effectiveness of vaccines is limited because the bird flu virus rapidly evolves. This makes existing vaccines less effective over time. Also, there are multiple strains of the bird flu virus but a vaccine is effective against a specific strain only.

Its necessary to match a vaccine with the prevailing strain causing an outbreak. Using vaccines may also involve substantial costs and practical hurdles of distribution.

In contrast to vaccinations, gene editing targets a protein or proteins within chickens that are vital for all strains of bird flu, effectively stopping the virus in its tracks.

Gene editing refers to the process of making a precise change in a specific gene in an animal to introduce traits such as resistance to a particular disease, increased productivity and characteristics that enhance animal welfare.

A beneficial genetic change introduced into an animal using gene editing may already occur naturally in another animal.

For example, gene editing was used to make dairy cattle hornless by introducing into them a genetic change found in naturally hornless cattle. This is important as many dairy cattle have horns, resulting in the painful practice of dehorning calves to reduce the risk of injury to the animal and the farmer.

Its important not to confuse gene editing with genetic modification, which entails transferring a gene from one species to another. This distinction is necessary for regulatory purposes, especially as the older genetic modification technology has faced stringent regulations in many countries, hampering its development.

To produce the gene-edited chickens in our study, we used the powerful molecular scissors known as CRISPR/Cas9 to make a single gene edit. We targeted the ANP32A protein in chickens.

Compared to normal chickens hatched simultaneously, these gene-edited chickens reached maturity without any discernible adverse consequences on their health and wellbeing.

To test their resistance, we exposed the gene-edited chickens to a low dose of the bird flu virus. Remarkably, 9 out of 10 of these birds displayed complete resistance, and no transmission occurred to other chickens.

Taking a more ambitious step, we inoculated the gene-edited chickens with a high, unnatural dose of the virus 1,000 times the low dose. This time, 5 out of the 10 inoculated gene-edited chickens became infected.

We also found that the bird flu virus was capable of adapting to use the edited ANP32A protein, as well as two related proteins ANP32B and ANP32E. But we demonstrated through experiments in cells that simultaneously editing all three proteins could completely suppress the virus.

Ongoing research aims to identify the specific combination of gene edits needed to create the next generation of gene-edited chickens, providing complete and permanent protection against bird flu.

Gene editing should be regarded as an essential tool for preventing and controlling deadly animal diseases.

Supportive government regulations will be required to promote the development of gene editing aimed at enhancing animal health and welfare.

The potential for disease resistant animals to protect global food security and public health is a compelling reason to pursue this innovative path in biotechnology.

Follow this link:

Bird flu could be eradicated by editing the genes of chickens - our ... - The Conversation

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Scientists have studied the immune system to find out why flu is easier to fight off than cancer and hope it could help develop new early-stage treatments.

Studies of mice showed the immune system reacts less vigorously to cancer than to the flu virus, and can react to the same low level danger as a small cut.

Scientists at the Cancer Research UK Scotland Institute in Glasgow hope the research could lead to new treatments which boost the immune response so it fully activates and tackles cancer when it starts.

Each year, 16,300 people die from cancer in Scotland, with around 34,100 people newly diagnosed per year.

It was already understood that the body does not always recognise the major threat cancer presents, but perceives the danger posed by flu.

This could allow cancers to be caught at an early stage and tackled by a patients own immune system rather than harsh treatments which are necessary at a later stage when the cancer has grown and potentially spread to other parts of the body.

Dr Ed Roberts

Scientists examined skin cancer that had spread to the lungs how the immune system reacts to the cancer was the focus and therefore the results could be applicable to a variety of cancer types.

It is hoped the discovery, published in Science Immunology, will lead to new cancer treatments which are less harsh than existing ones.

Researchers experimented on mice, and found that while the immune system reacted vigorously to the flu virus, it did not fully activate against the cancer.

They specifically looked at cells in the immune system of mice called dendritic cells which also exist in humans.

There are two types of dendritic cells, one which exists in the cells which become tumorous and those which live in the lymph nodes, a key part of the immune system.

Once the cancer begins, the dendritic cells in the cancer move towards the lymph nodes, but once there, they do not give out the same level of danger alert to the dendritic cells in the lymph nodes as they do when the flu virus is present.

This means the immune system sees the level of threat from the cancer as the same as a minor injury, such as a small cut, and only activates in a low level way.

The next step for the research will be to further examine how the immune system communicates, how it receives signals alerting it to threats and how it understands how significant the threat is.

Further studies will also demonstrate whether the exposure of the immune system to the threat is a factor in how much, or how little, it reacts.

Lead researcher Dr Ed Roberts, of the Cancer Research UK Scotland Institute and the University of Glasgow, said: We looked at cancer which had spread to the lungs as it affects the same organs which are affected by flu for the best comparison.

We wanted to see how the immune system coped with the different threats and we saw that the alarm system didnt activate as strongly as it did for the flu.

Knowing that the emergency signals get stopped in the part of the process which the dendritic cells are responsible for, could allow new immunotherapies to be created which boost the immune system so it does attack the cancer, or activate the alert system itself.

This could allow cancers to be caught at an early stage and tackled by a patients own immune system rather than harsh treatments which are necessary at a later stage when the cancer has grown and potentially spread to other parts of the body.

Dr Catherine Elliot, director of research at Cancer Research UK, said: The immune system is a growing focus of cancer research and this exciting research could help us find ways to help our own bodies fight cancer more vigorously.

This discovery could help us tackle cancer in its early stages and prevent it developing, spreading and even starting in the first place.

Further research will be needed but immunology studies such as this could be key to how we treat cancer in the future.

Read more:

Scientists discovered why flu is easier to fight off than cancer - The Independent

Health departments offer COVID-19 and flu vaccines, free COVID self-test kits

District 4 Public Healths county health departments offer flu shots and the updated COVID-19 vaccine to provide protection against two of the three respiratory illnesses already circulating this 2023-24 season.

Visitdistrict4health.org/make-an-appointmentto schedule your visit and learn more about which COVID-19 vaccine brand your county health department currently offers for your age group. If you wish, you can schedule both vaccines for the same visit. You also may call (800) 847-4262 to make an appointment.

COVID and Influenza vaccines are covered by many insurance plans at no cost to the patient. For adults without health insurance coverage, a federal program will cover the cost of the COVID vaccine and administration fee. There is a $21.93 administration fee for the influenza vaccine for those who do not have insurance or are underinsured. Vaccines For Children (VFC)-funded COVID and influenza vaccines are available for those 6 months old to 18 years old without health insurance coverage. Unless covered by Medicaid, there is a $21.93 administration fee for those who receive the VFC-funded vaccine.

District 4 health officials also encourage eligible older adults (60 years and older) and pregnant women to talk with their primary doctor about getting the new FDA-approved RSV vaccine, which is available at select doctors offices and local pharmacies.

It is important to get your vaccines as soon as possible to protect yourself and loved ones by helping prevent the spread of the viruses, especially before the holidays.

Flu and COVID-19 Vaccines Recommended by the CDC for individuals 6 months of age and older, flu and COVID vaccines cannot completely prevent someone from getting either virus. However, CDC data show flu vaccines and updated COVID vaccines are the keyespecially for older adults and individuals with chronic health conditionsin reducing the risk of severe illness, long-term effects, hospitalization, and death.

Vaccines are particularly important for those at high risk of complications if they get sick, including adults 65 and older, children younger than 5, pregnant women, people with weakened immune systems, and people with chronic health conditions such as asthma, diabetes, and heart disease.

COVID is still a major cause of serious respiratory illnesses, with more than 267,000 deaths in the U.S. in 2022, according to Johns Hopkins University data. From January to August 2023, older adults comprised 63 percent of all COVID-related hospitalizations and nearly 90 percent of COVID deaths in 2023, according to the CDC. Most of the hospitalized patients had multiple chronic conditions, and only 24 percent had received the bivalent COVID vaccine, the most updated vaccine at that time.

Many people with long-term health conditions like type 2 diabetes, prediabetes, heart disease, high blood pressure or kidney disease dont know they have them. These conditions could put them at greater risk for severe illness if they get COVID-19, the flu or RSV (respiratory syncytial virus). Individuals also may be at a higher risk if they have a family history of diabetes or heart disease, are overweight, or smoke. A good first step toward learning your risk and taking charge of your health include visiting your doctor to get your blood pressure, blood sugar and cholesterol checked and to discuss ways to stay healthy.

When more people get vaccinated, they also help reduce the strain hospitals endured last year when patient beds were not only filled with cases of flu and COVID, but also with a higher-than-usual presence of individuals with RSV.

RSV Vaccine For the first time in U.S. history, this year the FDA approved a new RSV vaccine, which the CDC recommends for 1) adults over age 60 and 2) pregnant women between 32 to 36 weeks gestation between September and January. Individuals in these categories should talk with their primary doctor to discuss whether they should get the vaccine.

For infants, the FDA has approved an antibody therapy to help protect against this common respiratory virus if the mother did not receive the RSV vaccine during pregnancy.

COVID-19 and Flu Testing Individuals can pick up a free COVID-19 rapid self-test in the front lobby of their local District 4 health department as supplies remain available. Each health department also offers appointments for COVID-19 PCR testing and rapid testing; visitdistrict4health.org/locationsto check your local health departments page for more details on specific days and times.

Each U.S. household may place a new order atspecial.usps.com/testkitsfor four free COVID-19 rapid self-tests delivered directly to your home. You may also call (800) 232-0233 or TTY (888) 720-7489.

A PCR testing kit for COVID-19, flu A and flu B is available 24 hours a day, seven days a week, at outdoor self-service kiosks in Lamar and Henry counties:

After completing a brief registration form, the kiosks dispense a test kit that includes a nasal swab, like other at-home tests, and instructions. Once the specimen is collected, it is safely packaged back into the kit and placed in the kiosk. The specimens are picked up daily and sent to an accredited lab for PCR testing.Though not required, pre-registration for testing at the kiosks is available atregister.testandgo.com.

Additional prevention measures can help prevent the spread of flu, COVID and RSV:

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MEDIA CONTACT: Natalie Shelton 706.302.6707

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Flu and COVID Vaccines - District 4 Public Health

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Recent preclinical results indicate novel next-generation vaccine candidates developed at Cleveland Clinic protect against multiple strains of influenza and last longer than vaccines currently in use.

The vaccines are part of Cleveland Clinic's global vaccine research program, led by Ted Ross, Ph.D., Global Director of Vaccine Development at Cleveland Clinic. Published in Scientific Reports, the study credits the preclinical success of the influenza B vaccines to novel technology called Computationally Optimized Broadly Reactive Antigens (COBRAs).

Current vaccines use small, non-infectious parts of the virus or bacterium called antigens to train the immune system against infection. Keeping that immunity current can require yearly updates as the pathogen mutates, like for the flu vaccine. COBRAs are antigens designed to train the immune system's response more broadly to anticipate any changes.

"Seasonal influenza vaccines are mostly effective against pathogens with antigens matching the vaccine formulation," says study first author Michael Carlock, program manager in Dr. Ross's lab and Ph.D. student at the University of Georgia. "Viruses like to mutate constantly. If their antigens change too much, our immune system won't recognize them as the pathogen that the vaccine trained them to fight. We constantly need to update our vaccines to keep up with these new variants and mutations."

Further complicating the issue, a strain can mutate into multiple variants, and multiple strains of the same virus can break out at the same time. Vaccines made using an antigen specific to one strain or variant aren't always as effective against another.

Vaccine developers currently use a combination of statistics and public health data to predict what flu strains will be the most common that year. They use antigens from those strains to make their vaccines. However, often by the time vaccines are manufactured and distributed, strains can mutate and render the vaccines less effective, Carlock says.

"Between 2001 and 2012, the influenza B strain used to make the flu shot matched the main influenza B strain infecting the population about 50% of the time," he says, "The vaccines weren't as effective as they could have been. That's part of why some flu seasons are worse than others."

The COBRA technology, says Carlock, eliminates the guesswork from antigen selection to protect against multiple diverse strains of the virus. The technology uses public databases of sequences and bioinformatic programs to analyze hundreds of flu strains over years' worth of flu seasons. The analysis identifies conserved regions of antigens most likely to be present in many viral strains and least likely to mutate over time.

The computer models behind COBRA can be used in multiple viruses, including influenza, SARS-CoV-2, HIV, respiratory syncytial virus (RSV) and many insect-borne viruses. Carlock and Dr. Ross say the success of their influenza B vaccine candidates serves as a proof-of-concept for COBRA as a whole.

When the influenza B COBRA vaccines were tested in preclinical models, they performed even better than expected. They protected against multiple strains of influenza B and even protected against strains between the two different lineages of influenza B. There was also evidence that the COBRA vaccines are longer-lasting than current technology.

"We used old strains isolated prior to 2013 to design these vaccines, but they protected against new strains circulating in 2023," says Carlock. "The vaccines that public health officials actually made from and used against those strains ten years ago cannot protect against modern viruses. Our COBRA vaccines provide broad, long-lasting protection against many viruses over many years."

Clinical trials are planned to test the effectiveness of COBRA-based influenza vaccines against influenza in humans.

"The preclinical success of these vaccines is exciting because it shows our platform's promise in addressing public health threats effectively and proactively," Dr. Ross says. "As we continue to expand Cleveland Clinic's global vaccine research, technologies like COBRA are critical to serving the communities we reach all over the world."

More information: Michael A. Carlock et al, A computationally optimized broadly reactive hemagglutinin vaccine elicits neutralizing antibodies against influenza B viruses from both lineages, Scientific Reports (2023). DOI: 10.1038/s41598-023-43003-2

Journal information: Scientific Reports

See the original post:

Next-generation influenza B vaccines provide broad and long-lasting protection against flu viruses in preclinical tests - Medical Xpress

Frigid weather has begun creeping up as we head into the fall and winter months, so it's time to start gearing up for peak cold and flu season. While it is possible to catch a virus or a common cold at any time, the number of infections tends to spike as the calendar nears its end. The Centers for Disease Control and Prevention predicts that this coming season will have a similar hospitalization rate as last year. The number of hospitalizations is expected to remain higher than before the Covid-19 pandemic, "when severe disease was caused primarily by the influenza virus and the respiratory syncytial virus (RSV)," the CDC noted. Here are some tips for navigating the upcoming respiratory disease season.

Vaccination remains the top recommendation for preventative measures during peak respiratory illness season. Getting a jab is crucial for "those who are at higher risk of developing severe complications, including older Americans and those with medical conditions," per the CDC. This season, updated Covid-19 and flu vaccines are recommended for people six months or older. Regarding RSV, there is a vaccine for pregnant people and the elderly as well as preventative shots for newborns. The CDC noted that this fall will be the "first time in U.S. history" that a vaccine is available for all three respiratory viruses. "Higher levels of vaccination across the population will also help reduce the number of hospitalizations and risk of hospital strain," the organization added.

Perhaps the most straightforward tip for preventing the spread of respiratory germs is to routinely wash your hands. Washing your hands is most effective if you do it correctly with soap and water for at least 20 seconds. "You will keep yourself healthier by doing so, and you will also reduce the chances that you pass your germs on to others," Kristina Duda, RN, a disease and infection prevention specialist, wrote for Very Well. The CDC recommends washing your hands before and after food preparation, eating and using the restroom, changing diapers and touching animals or garbage. You should also cover your mouth and nose when sneezing or coughing. "Flu viruses spread mainly by droplets made when people with flu cough, sneeze, or talk," the CDC explained. It's also important to avoid touching your eyes, ears or mouth because that's another easy way to spread germs.

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Keeping your body in top shape with healthy habits helps to keep your immune system working at its best. As your body's primary line of defense against germs and viruses, taking care of yourself by boosting your immune system would be most beneficial. Maintaining a healthy diet, exercising, sleeping regularly, and keeping stress at bay "help ensure that your body is better able to fight off infections," Duda further advised on Very Well. Staying hydrated is also paramount, though the amount you should drink "will vary by climate, exertion and other factors," she added.

It's best to avoid any prolonged contact with anyone who might be sick, but in some cases, people could contaminate common areas before showing any symptoms. That's why it is best to clean and disinfect surfaces that people frequently touch in your home, at work or in school. It is also recommended to avoid sharing food and drinks to limit the risk of germs spreading from one person to another.

If you start feeling sick, you should stay home to tend to the symptoms. "For most people, respiratory illnesses can be treated at home," the Mayo Clinic Health System wrote. Unless you are considered 'high-risk,' you most likely don't need to seek testing or treatment from a health professional. Getting enough rest, staying hydrated and using over-the-counter meds could help soothe symptoms such as a sore throat, fatigue, cough or congestion. If you are at higher risk for severe respiratory illness, then it is best that you seek clinic-based tests or treatment. People who are immunocompromised, pregnant, age 65 or older or have other complex health issues typically have a higher risk of severe infection.

Original post:

Tips for navigating cold and flu season - The Week

November 04, 2023

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This blog post provides answers to important questions about the upcoming respiratory viral seasons.

It also offers advice for what clinicians can tell at-risk patients, including those who have undergone hematopoietic stem cell transplantation or chimeric antigen receptor T-cell therapy.

With the anticipated increase last year in all three major respiratory viruses influenza, respiratory syncytial virus (RSV) and SARS CoV-2 the term triple epidemic," sometimes called tripledemic, was coined.

Following last years tripledemic, preparations for the upcoming respiratory viral season are underway at most institutions.

According to CDCs Center for Forecasting and Outbreak Analytics, this year's hospitalizations from influenza, RSV and COVID-19 could be like last year's.

Patients undergoing HSCT or CAR T-cell therapy are more likely than the general population to experience severe sickness caused by community-acquired respiratory viruses, with increased rates of morbidity and death.

Consequently, it is vital to safeguard them using all available preventive measures to minimize potential for harm.

The main message is that our patients now have more tools than ever.

We have vaccinations accessible for all three significant respiratory viruses for the first time in our nations history.

There has been a recent increase in COVID-19 and RSV cases, with influenza shortly behind. The time to vaccinate them is now.

If eligible, all patients undergoing HSCT or CAR T-cell therapy should receive the revised COVID-19 vaccine and the flu shot.

As recommended by their transplant centers, patients aged older than 60 years should receive the RSV vaccine.

Families and caregivers of immunocompromised patients also are strongly advised to obtain the recommended vaccinations flu, COVID-19 and RSV, if eligible to protect their loved ones.

Although HSCT and CAR-T recipients are at high risk for severe illness and long-term complications from respiratory viruses, they also are less likely to respond to vaccines. These patients may require additional doses or different immunization schedules to optimize responses.

In addition to prevention, vaccination is an essential defense against severe respiratory virus infection among HSCT and CAR-T recipients.

For adult HSCT and CAR-T recipients, passive protection against the winter respiratory viruses is not currently attainable through monoclonal antibodies.

There are two RSV vaccines for this season.

For adults aged 60 years or older, the overall efficacy of both vaccines for preventing lower respiratory tract infection exceeded 80%.

HSCT/CAR-T recipients who stand to benefit from a vaccine aimed at preventing lower respiratory tract infection fall into the highest risk category; however, none of these clinical trials included HCT recipients or other immunosuppressed patients.

RSV vaccine can be considered for HSCT recipients aged older than 60 years old who are eligible for routine vaccination after HSCT. Vaccination outside this group may not be covered by insurance.

Dedicated studies of HSCT recipients are needed to evaluate RSV vaccine immunogenicity, clinical efficacy and the optimal vaccination schedule. The impact of vaccination could be more apparent preventing RSV infection among family members or health care workers who care for immunocompromised patients.

The updated COVID-19 vaccines by Pfizer/BioNTech and Moderna are designed to protect against the more recent circulating viral strains including EG.5 and BA.2.86 in addition to XBB.1.5. All immunocompromised patients should get at least one shot of either of these vaccines as directed by their transplant centers.

For the 2023-2024 flu season, the viral makeup of the vaccine is comparable to that of the preceding season. All immunocompromised individuals can get age-appropriate inactivated (IIV4s) or recombinant (RIV4) influenza vaccines under the guidance of their transplant center, preferably before HSCT or CAR-T if timing allows.

Co-administration of COVID-19 and influenza vaccine at different injection sites is safe. CDC guidance states that all three can be given simultaneously but that patients likely will experience increased reactogenicity, such as fevers, headache, swelling or pain at the injection site. Discussing the timing of administration with patients is essential to managing adverse events and the best response from the vaccine.

All three respiratory viruses exhibit indistinguishable influenza-like illness (ILI) signs and symptoms. If ILI symptoms are recorded, the patient should be checked for the diagnosis using a nucleic amplification test of the nasopharynx, especially if they are in the early post-HSCT or post-CAR T-cell therapy phase.

There is no FDA-approved at-home testing to identify the three respiratory viruses.

SARS-CoV-2 and influenza respiratory tract infections are treatable with antiviral treatments. Early directed antiviral treatment should be started to prevent the severity of the illness based on the risk for progression of infection to the lower respiratory tract; however, institutional standards vary regarding the choice of antiviral drugs.

RSV is an FDA-approved therapy for hepatitis C infection and is used off-label for treating RSV. Society treatment guidelines and additional resources are listed in the references for further guidance.

Prevention is the key.

Patients should get vaccinated if eligible and exercise caution by avoiding sick contact as much as possible.

Masking also can help reduce infection during times of heightened community transmission.

Patients should be mindful of local trends and seek medical help immediately if they develop signs and symptoms suggestive of respiratory tract infection.

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Smithville, Tenn. The DeKalb County Health Department will participate in the statewide Fight Flu 23 effort on Nov. 1, 2023, and provide free flu shots to all Tennesseans who are eligible, six-months and older.

We want to protect as many people as we can in our communities from the flu, County Director, Michael Railling, MPH, CPH said. Getting an annual flu shot is the best way to protect yourself and everyone around you.

DeKalb County Health Department will provide free flu shots on Nov. 1, 2023, at:

LOCATION: DeKalb County Health Department

ADDRESS: 254 Tiger Drive, Smithville TN 37166

HOURS: 9:00 AM 5:00 PM

An appointment is not needed to receive a free flu vaccine at the DeKalb County Health Departments Fight Flu 23 event.

Also, the flu vaccine will remain free to anyone eligible to receive it at all local health departments across the state throughout flu season.

The flu vaccine is safe and effective and can protect individuals against the most common types of flu, and the viruss worst symptoms and outcomes.

The flu virus is very contagious. Pregnant women, infants, the elderly, and people with certain medical conditions are at the highest risk of severe complications from the flu. Annually, more than 7.5 million illnesses, 400,000 hospitalizations, and 22,000 deaths could be prevented in the U.S. if more people chose to get the flu vaccine.

To prevent spreading the flu virus to others, follow precautions such as proper hygiene and handwashing, cover your coughs or sneezes with a tissue or your elbow, and stay home if you are sick.

For more information about the flu virus and Fight Flu 23, visit tn.gov/health/fightflu. For information about getting a free flu shot, contact the DeKalb County Health Department at 615-597-7599.

More here:

Dekalb County Health Department Has Free Flu Shots - Smithvillereview

OREGON (Release from ODFW) Highly Pathogenic Avian Influenza (HPAI) has been circulating in wild birds in North America since December 2021 and continues to be detected in waterfowl in Oregon. More detections are expected during this fall and winter as waterfowl migrate through Oregon or spend the winter here.

An increase in cases and mortality, especially among cackling geese, is already being seen at Staats Lake in Keizer, Fernhill Wetlands in Forest Grove and multiple wildlife refuges and locations where geese are congregating in the valley.

The current strain of the virus (H5N1) was first detected in Oregon in May 2022. Unlike previous outbreaks of HPAI in 2005 and 2014-15, this strain of the virus did not disappear by the following spring. The H5N1 strain continues to circulate in wild birds and is also infecting backyard poultry flocks. Waterfowl are the natural host of avian influenzas and increased spread is occurring during waterfowl migrations.

During fall 2022, most mortality in wild waterfowl occurred in cackling and snow geese, however the virus is also commonly detected in wild ducks that had been harvested by hunters.

Although many Low Pathogenic strains of Avian Influenza naturally occur in wild waterfowl, detections of Highly Pathogenic strains in wild birds are less frequent. Typically, HPAI does not cause large-scale mortality in wild waterfowl or other groups of wild birds but often causes severe illness and death in domestic chickens and turkeys.

However, the current H5N1 strain has caused increased mortality for wild waterfowl (especially geese), shorebirds, raptors and scavengers such as vultures. Currently, there have been 7,476 confirmed detections in 136 species of wild birds throughout the U.S. This strain has also been detected in 15 mammalian species including scavenging carnivores such as coyotes, foxes and skunks that have likely fed on infected birds.

Wildlife managers continue to monitor for the disease by testing birds found dead and sampling live birds and birds harvested by hunters for presence of the virus.

What do to if you encounter groups of sick or dead birds

ODFW asks that members of the public report groups of sick or dead wild birds to the Wildlife Health lab at 866-968-2600 or wildlife.health@odfw.oregon.gov. ODFW staff are monitoring and tracking continued mortalities. Samples may be collected in cases of large groups of dead birds or when multiple different species are involved.

Typical symptoms in wild waterfowl include cloudy eyes, head shaking, swimming in circles, and incoordination. However, HPAI can occur in dabbling duck species that show no signs of disease. These are the carrier host species that spread the virus to other birds and wetlands. Infected wild mammals may be found sick, dead or acting neurologically abnormal after consuming an infected bird and should also be reported.

ODFW veterinarians recommend that you do not handle wildlife that is sick or found dead. If it is necessary to dispose of a carcass, use a shovel or wear impermeable gloves, wash hands with soap and water and change clothing before having contact with domestic poultry or pet birds.

According to the U.S. Centers for Disease Control and Prevention, humans appear to be at low risk for infection with the current H5N1 strain. More info can be found at https://www.cdc.gov/flu/avianflu/avian-in-humans.htm

What hunters need to know

Hunters may come in contact with infected waterfowl during the hunting season and should always practice the following safe bird handling and cooking techniques, especially this season due to HPAI:

Falconers are advised to avoid hunting waterfowl and other waterbirds during the HPAI outbreak because of the risk it presents to raptors. HPAI is killing raptors that come into contact with infected avian prey or carcasses.

Danger to domestic poultry

This strain of HPAI (H5N1) is also deadly to domestic birds (chickens, turkeys, Guinea fowl). The Oregon Department of Agriculture (ODA) strongly encourages backyard poultry producers to prevent contact between their birds and wild birds. Any sick domestic birds should be reported to the State Veterinarians office at 1-800-347-7028 or AHHotline@oda.oregon.gov

ODFW is part of the State of Oregons multi-agency response to HPAI, along with the Oregon Department of Agriculture, the Oregon Health Authority and the US Department of Agricultures Animal Plant Health Inspection Service (USDA-APHIS).For information on avian influenza in domestic birds, visit ODAs website: https://www.oregon.gov/oda/programs/animalhealthfeedslivestockid/animaldiseases/pages/avianinfluenza.aspx

ODFW news releases can befound online here.

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Increase in avian flu expected during fall migration: hunters should ... - Elkhorn Media Group