UPDATE IN INFECTIOUS DISEASES: Asked to give update in all infectious diseases (!) for UCSF COVID town hall yesterday. Couldn't do talk justice in 10 minutes but here are 4 main updates in slides
#Monkeypox outbreak epidemiology.
Major #HIV update is how far behind we have fallen in terms of HIV prevention and treatment goals over past 2 years of #COVID. UNAIDS report unaids.org/en/resources/d…
Much work to do for #HIV
Major #polio update is this infection could be eradicated as only animal reservoir is other primates but we have had setbacks due to backsliding in childhood vaccination rates during #covid
Here are some clinical features of #polio to remember; dreaded symptoms are paralytic and rare but can occur among those without vaccination
And finally #measles- very sad that 157 unvaccinated children died in Zimbabwe from a large measles outbreak (all unvaccinated; we have fallen behind)
Some important medical facts about #measles and the current vaccines and symptoms
WHAT TO DO? #HIV no vaccine yet (mRNA vaccine in trials now); HIV treatment & prevention must be disseminated more equitably worldwide. Monkeypox, polio, measles all have vaccines & must address modifiable risk factors for low rates (e.g. more production Jynneos, restore trust)
"Many called, few chosen" for POLIO, looks like it has been circulating in wastewater longer than thought in NYC but one case of paralytic polio in an unvaccinated young person in Rockland means solution is vaccination; prevents disease (not all spread)
cdc.gov/mmwr/volumes/7…

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Monica Gandhi MD, MPH

Monica Gandhi MD, MPH Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @MonicaGandhi9

Aug 21
MISINFORMATION on Twitter that spreads hysteria & is inaccurate can be dangerous for public's mental health. Epidemiology of this particular monkeypox outbreak among gay men quite clear at this point; also global endemic outbreaks in West/Central Africa, need vaccine equity
To really "get" monkeypox, we have to vaccinate those at risk in this particular outbreak (gay men) but also areas in West and Central Africa where "endemic" outbreaks have been occurring for years, most often over the past decade Image
Endemic and nonendemic outbreaks treated the same- providing populations at risk immunity Image
Read 4 tweets
Aug 21
70% of hospitalizations for COVID now incidental per state recording best- Massachusetts. Not distinguishing severe disease actually due to COVID from incidental positive swabs (hospitals swab all admits) make vaccination & immunity seem less effective; media questions immunity
Immunity is not just antibodies (which will wane with time since last exposure or booster) but T and B cell immunity; this is why 2022 is so different than 2020 in terms of immunity to this now not-so-novel coronavirus. B/T cells explained here
T cell thread here; seem durable which is why US healthcare system should avoid misclassifying hospitalizations as for versus with COVID in order to reassure public of the power of the immune system
Read 5 tweets
Aug 11
LANGYA HENIPAVIRUS (LayV): A family of viruses have been classified in the genus called “henipavirus”; these are RNA viruses which occasionally cause illness in humans and cross over into humans from animals such as bats or pigs. For example, NIPAH virus who.int/news-room/fact…
and was first identified in 1999 in Malaysia after causing symptoms such as fevers, pneumonia and encephalitis (brain inflammation). Outbreaks have occurred ever since, seem to be most closely related to fruit bat exposure, and most commonly occur in Bangladesh. There is no cure
& mortality can range from 40-75%. The 2nd virus in this family is called HENDRA virus & also carried to humans by the fruit bat; known to cause severe disease in humans and horses with a high mortality rate. Now new virus in this family just identified
who.int/health-topics/…
Read 8 tweets
Jul 20
Breakthrough infection by SARS-CoV-2 Delta and Omicron variants elicited immune response comparable to mRNA booster vaccination academic.oup.com/jid/advance-ar…
Adds to other studies showing an infection after vaccination serves as a booster of the immune response (of antibodies, T and B cells) like this one from Yale and others in the thread below:
mdlinx.com/news/booster-a…
Other studies here:
T CELLS: In fact, this important paper shows that any exposure (breakthrough infection) or any booster after vaccination actually broadens and diversifies the T cell memory repertoire (e.g. expands your immune response).
nature.com/articles/s4159…
Read 6 tweets
Jul 11
EU putting out good information on monkeypox ecdc.europa.eu/en/publication…
as are @benryanwriter and @LizHighleyman. Aligns with US HHS plan to start with vaccinating men-who-have-sex-with-men & close contacts. Agree- wrote this in @TheAtlantic June 24, 2022
theatlantic.com/ideas/archive/…
UK also has good data #monkeypox. With limited US vax supply, would 1) hold for now in those who had smallpox vax (<1970 born); 3) target those w/ multiple sex partners; 4) Give 1 dose for now (like urged with limited COVID vax at start); 4) Boost supply
US apparently rejected Jynneos doses from Denmark since FDA didn't inspect but EU did & says high quality- would trust EU CDC-very good!
Beyond strategies above, here is a background on monkeypox:
Or article written for @medscape
medscape.com/viewarticle/97…
Read 4 tweets
Jul 7
BA4/BA5 SUBVARIANTS: 2-dose Pfizer vaccine 87% protective against hospitalizations with these 2 subvariants in large S. Africa study. High protection against severe disease across variants/subvariants is due to cellular immunity (B/T cells) discussed often
bloomberg.com/news/articles/…
Natural infection pre-Omicron also provides strong protection against severe disease & death (97.3%) from circulating Omicron subvariants like BA4/BA5. Despite multiple mutations across spike protein in subvariants, T cells still cover multiple epitopes
medrxiv.org/content/10.110…
T cells (prevent severe disease) line up across spike protein on multiple parts or "epitopes"; even with >32 mutations across spike protein with Omicron, still have >60 T cells from vaccine on spike. BA4/BA5 booster ready by Oct to prevent mild infections
investors.biontech.de/news-releases/…
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(