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Eric Feigl-Ding Profile picture
@DrEricDing
Aug 1, 2022 • 10 tweets • 7 min read • Read on X
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⚠️WORRISOME TRANSMISSION—We need to get sober on how & why #monkeypox is tricky to contain: thread🧵below. Many reasons outlined by DHS report:

📌MPXV is “very stable in environment”—for “days/weeks”

📌Human asymptomatic contagiousness documented *before visible rash*

🧵More—
2) 📌Furthermore, to protect against #monkeypox—doctors and nurses are recommended to wear N95 masks plus gown and gloves.

📌Decontamination protocols requires using bleach or using (harsh) quaternary ammonium reagents — which are chemicals found in pretty aggressive cleaners.
3) Routes of infection of #MPXV: (excerpted from below)
📌Intravenous
📌Oral
📌Intranasal
📌Inhalation / aerosol in primates (cough, @CDCgov, cough)
📌Intradermal
📌Cutaneous (skin)
4) Regarding #monkeypox transmission via cutaneous (skin) route… there is a recent story about a man in Spain who possibly contracted #MPXV via a handshake and 15 minutes using a scooter 🛴’s handlebars (& no sexual exposure). 👀

coronaheadsup.com/health/monkeyp…

5) while there are a few treatments and vaccines… the only vaccine of easy administration and low side effects is the Jynneos vaccine made by Bavarian Nordic. This one is in extremely short supply worldwide. The US can’t get more for months.

dhs.gov/sites/default/…
6) let this sink in— the US will not get more Jynneos #monkeypox vaccine for month - until October at the earliest, according to @ddiamond. We are facing a vaccine cliff of no more for months. washingtonpost.com/health/2022/07…
7) the Mean incubation is 7-17 days for #monkeypox, but as short as 1 day and long as 31 days. And notably, “humans can be contagious before a visible rash appears”! 👀
8) Again, kids are much more vulnerable than adults for severe #monkeypox disease. While CDC says kids <8 are at high risk, the DHS report says kids <10 years old have been more frequently affected. Let’s take care to protect kids please! 🙏

dhs.gov/sites/default/…
9) this will not end well. There are those who can see around corners, and those who cannot. Don’t be the latter. Acting late is not better than never. Act fast and furious — furious precautionary action is the only thing can save us from even worse outcomes.
10) 📌Asymptomatic Transmission of Monkeypox:

"The existence of asymptomatic #monkeypox infection indicates that the virus might be transmitted to close contacts in the absence of symptoms." 👀

➡️we are now in deep trouble.

medrxiv.org/content/10.110…

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Feb 21
Woke or biology? There are actually more than the basic “male” XY & “female” XX sexes. Why? Because biology also creates people with single X chromosomes, or extra chromosomes like XXX, XXY, XYY, or XXX+, plus many 🧬genes. 👉All I’m asking is— please be kind to others. Thanks🙏 Image
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2) “The most frequent SCAs include Turner syndrome (45,X), Klinefelter syndrome (47,XXY), Trisomy X syndrome (47,XXX), and Double Y syndrome (47,XYY).”

pmc.ncbi.nlm.nih.gov/articles/PMC10…
3) “The phenotype seen in SCAs is highly variable and may not merely be due to the direct genomic imbalance from altered sex chromosome gene dosage but also due to additive alterations in gene networks and regulatory pathways across the genome as well as individual genetic modifiers.”
Read 5 tweets
Eric Feigl-Ding Profile picture
Feb 16
I'm shocked a lot of doctors don't know about this newer flu antiviral drug called Baloxavir (XOFLUZA)... that shortens your flu illness by 33%, and reduces your viral load by day 2, versus what a placebo takes 5-6 days to achieve. Baloxavir also seems superior to TAMIFLU (oseltamivir) for smashing your viral load on 2 day, achieving what takes Tamiflu 3-4 days. CDC even lists Baloxavir on their website as one of the top 4 drugs that it tracks whether it works against new flu strains (it works)Image
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2) "Baloxavir was associated with significantly more rapid declines in infectious viral load than placebo or oseltamivir (Figure 3A and 3B)."
nejm.org/doi/full/10.10…
3) Adverse events for baloxavir were no different than placebo. in fact theres even hints that it could be lower than Tamiflu.

"Adverse events that were considered to be related to the trial regimen were more common in oseltamivir recipients (8.4%) than in baloxavir recipients (4.4%, P=0.009)"Image
Read 13 tweets
Eric Feigl-Ding Profile picture
Feb 14
⚠️WORST FLU SEASON ever since 2002-2003 when we began to track flu (red, first graph). Worst hit this year are children ages 0-4 and 5-17. ▶️We also have significantly LOWER flu vaccine uptake this year, one of the lowest flu vaccine coverages (red 3rd graph). Indisputable facts. Image
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2) I don't need to tell you that certain US states have vastly lower vaccination rates than others. See map (lighter green, less flu vaccination coverage), and which have higher (darker green)...

If you want to see details and demographics on which state has the LOWEST flu vaccine coverage rates... the data is here.
cdc.gov/fluvaxview/das…Image
3) It’s not just the flu that is going around… Gaines County, TX, where the epicenter of the measles outbreak is, has one of the lowest measles vaccination rates too.
Read 7 tweets
Eric Feigl-Ding Profile picture
Feb 11
INFLUENZA REACHES EPIDEMIC THRESHOLD in New York—Influenza A (Unknown variety) positivity soars (yellow), while hospitalizations stand higher than past 3 years. The rise of unknown subtyping Flu A has led NY to issue new alert to subtype all Flu A immediately for bird flu. Image
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2) This was the reason for the urgency in NY issuing an alert to subtype all hospitalized cases for bird flu if Flu A. See thread below 👇
3) the testing memo seems very aggressive for bird flu.
Read 7 tweets
Eric Feigl-Ding Profile picture
Feb 10
BREAKING—22 States sue to block Trump WH cuts to NIH research grants. Image
2) Attorneys general representing 22 states sued the Trump administration on Monday, asking a federal judge to temporarily block a major policy change by the National Institutes of Health that would substantially limit payments for research overhead

statnews.com/2025/02/10/nih…
3) In the lawsuit, filed in U.S. District Court for the District of MA, the AGs argued that NIH’s abrupt decision to set a 15% cap on payments for indirect costs would cause major harm to institution budgets, jeopardizing basic operations and medical research.
Read 5 tweets
Eric Feigl-Ding Profile picture
Feb 8
💣TORPEDOING MEDICAL RESEARCH—NIH indirect grant funding just got slashed by Trump to 15%. What does this mean for you? Colleges and universities won’t be able to support students, tuition will increase, especially graduate students & researchers who find cures/preventions for cancer, diabetes, heart disease, Alzheimer’s and more. This will not only raise tuition and hurt pipeline of future scientists/doctors, but COMPLETELY DECIMATE MEDICAL & PUBLIC HEALTH RESEARCH. It will also give more power to big pharma to manipulate research agendas and buy out ideas that should remain in the public domain. Ie THE RICH BIOTECH TYCOONS (eg Vivek Ramaswamy) WILL GET RICHER. The lay public will someday only see future drug/tech prices soar as biotech and big pharma control more science and make more money.

Also, Trump’s NIH posted this graphic - but it ignores that most public universities also heavily rely on indirect to subsidize tuition, and train next generation of scientists and medical doctors doing research. (Public colleges can’t compete with wealthier schools who do have endowments, and hence will fall further behind). Public colleges that do medical research will literally fall apart without this mechanism.Image
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2) People don’t seem to get 2 things:

📌Indirect funds college administration and facilities and support services. Academic advising, building operations, new labs and classrooms for students— where does that money come from? If not indirect grants, then it’ll have to come more from ⬆️student tuition.
3) Most universities don’t have billion+ endowments. Most have almost none — so when you slash NIH indirect grant funding to just 15%… it hurts small schools and public colleges the most—smaller places might even go under. Rich school survive, public schools do not.
Read 4 tweets

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