TWiV 1190: Clinical update with Dr. Daniel Griffin

Feb 8, 2025

Dr. Daniel Griffin, an infectious diseases expert, delivers a compelling clinical update. He discusses the largest tuberculosis outbreak in U.S. history and the absence of USAID in combating Ebola in Africa. The conversation also covers the complexities of avian influenza, touching on its potential airborne transmission and the effects on dairy cattle. Dr. Griffin reviews the alarming trends in RSV, influenza, and SARS-CoV-2 infections, as well as insights on long COVID, including its impact on children and potential links to Alzheimer's disease.

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ADVICE

Airborne Virus Precautions

Understand airborne viral particle transmission: It's not about distance, but shared air.
Protect yourself in poorly ventilated areas, even if distanced from an infected person.

INSIGHT

H5N1 Transmission and Severity

H5N1 transmission requires direct contact in its current, deadly form.
Mutations enabling airborne spread in ferrets also reduced the virus's severity.

INSIGHT

H5N1 Genotypes and Spillover

Two genotypes of H5N1 exist: genotype D (deadly) from ducks and genotype B (benign) found in dairy cows.
A new spillover of genotype D into dairy cattle raises concerns about its potential impact on humans.

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In his weekly clinical update, Dr. Griffin and Vincent Racaniello discuss changes in access to public health information and aid mechanisms such as the return of MMWR, the largest tuberculosis outbreak in the US ever, lack of USAID in fighting Marburg and Ebola outbreaks in Africa, discussing if avian influenza virus is airborne, how eggs are effected and the emergence of second spillover into dairy cattle, how the difference between nOPV2 and Sabin OPV2 is a minor reduction in the association of vaccine associated paralytic poliomyelitis before Dr. Griffin reviews recent statistics on RSV, influenza and SARS-CoV-2 infections, the WasterwaterScan dashboard, where to find PEMGARDA, an update of Paxlovid administration provides information for Columbia University Irving Medical Center’s long COVID treatment center, where to go for answers to your long COVID questions, how children may be affected by long COVID and if SARS-CoV-2 and other inflammatory syndromes increase the risk of Alzheimer’s disease.

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Links for this episode

The return of MMWR (CDC)
Largest tuberculosis outbreak ever in the US (Kansas Department of Health and Environment)
Marburg virus outbreak in Tanzania (Doctors without borders)
No USAID, Ebola outbreak in Uganda spreads (CBS News)
WHO accelerates efforts to Ebola response in Uganda (WHO: Uganda)
Global partners enable access to vaccine and treatment for Ebola outbreak in Uganda (WHO)
Ventilation and respiratory viruses (CDC National Institute for Occupational safety and health)
Is bird flu flying through the air…..is the virus literally airborne? (NY Times)
Is bird flu like measles (American Journal of Epidemiology)
Indoor safety guideline (Herokuapp)
Dairy herds in Nevada have influenza! (CIDRAP)
Do your eggs have H5N1? (NY Times)
New genotye D1.1 of avian flu in dairy cattle(USDA Animal and Plant Health Inspection Service)
Second spillover of avian flu into dairy cattle….does this story sound familiar? (CIDRAP)
Impact of using nOPV2 in mass vaccination campaigns? (JID)
Waste water scan for 11 pathogens (WastewaterSCan)
US respiratory virus activity (CDC Respiratory Illnesses)
Weekly surveillance report: clift notes (CDC FluView)
As flu increases so do deaths in kids (CIDRAP)
People most impacted by respiratory viruses (CDC)
Co-infection with SARS-CoV-2 and influenza A/B (BMC Infectious Diseases)
Oseltamivir reduces 30-Day mortality in older adults with Influenza (OFID)
RSV: Waste water scan for 11 pathogens (WastewaterSCan)
RSV-Network (CDC Respiratory Syncytial virus Infection)
US respiratory virus activity (CDC Respiratory Illnesses)
Waste water scan for 11 pathogens (WastewaterSCan)
COVID-19 deaths (CDC)
COVID-19 national and regional trends (CDC)
COVID-19 variant tracker (CDC)
SARS-CoV-2 genomes galore (Nextstrain)
Where to get pemgarda (Pemgarda)
EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD)
Fusion center near you….if in NY (Prime Fusions)
CDC Quarantine guidelines (CDC)
NIH COVID-19 treatment guidelines (NIH)
Drug interaction checker (University of Liverpool)
Paxlovid update (Pfizer)
Infectious Disease Society guidelines for treatment and management (ID Society)
Molnupiravir safety and efficacy (JMV)
Convalescent plasma recommendation for immunocompromised (ID Society)
What to do when sick with a respiratory virus (CDC)
When your healthcare provider is infected/exposed with SARS-CoV-2 (CDC)
Managing healthcare staffing shortages (CDC)
Steroids, dexamethasone at the right time (OFID)
Anticoagulation guidelines (hematology.org)
Daniel Griffin’s evidence based medical practices for long COVID (OFID)
Long COVID hotline (Columbia : Columbia University Irving Medical Center)
The answers: Long COVID
Long COVID Recovery Program with Zara Dureno, BA, MOT
Long COVID pevalence and associated activity limitation in US children
(JAMA Pediatrics)
Plasma proteomic evidence for increased β-amyloid pathology after SARS-CoV-2 infection (Nature Medicine)
Letters read on TWiV 1190
Dr. Griffin’s COVID treatment summary (pdf)
Timestamps by Jolene Ramsey. Thanks!

Intro music is by Ronald Jenkees

Send your questions for Dr. Griffin to daniel@microbe.tv