Health news, COVID & more, 4/13/25

The CDC reports low levels of respiratory illness overall with COVID, RSV, and flu trending downward nationally. Influenza A levels are low, but Influenza B levels are still increasing in many places including the Northeast. This week marks the first time Flu B is more prevalent than Flu A.

We are also seeing the spring uptick of Human Metapneumovirus (HMPV), a common virus that typically causes cold-like symptoms such as coughing, wheezing, a runny nose, or a sore throat. Nearly everyone has been exposed to HMPV by the age of 5.

Regional wastewater data from: https://data.wastewaterscan.org/

COVID

Through 4/5/25, SARS-CoV-2 in wastewater is MODERATE in the South, but is LOW in the rest of America per the CDC. WastewaterSCAN shows MEDIUM levels of SARS-CoV-2 in wastewater across the United States with high levels in New York state, Vermont, Massachusetts and Connecticut as well as various places in the South. WastewaterSCAN data tends to be more current, but it omits data from 12 states.

According to modeler Mike Hoerger, Virginia, Connecticut, South Carolina, and Kentucky show HIGH levels of COVID in wastewater and about 1 in 149 people in the United States is actively infectious with COVID based on CDC data from one week ago. Emergency department visits for COVID and deaths from COVID are low at this time per the CDC which is good news.

There are MEDIUM levels of SARS-CoV-2 in most inland locales in California, but the Bay Area as a whole is LOW per CDPH. CDPH reports high levels of wastewater SARS-CoV-2 in San Mateo, Santa Cruz, Yolo and to some extent Los Angeles counties this week.

Variants

The LP.8.1 variant now represents 64% of COVID cases in the United States and has pushed XEC to 15% of cases. No new worrisome variants have been seen recently which is reassuring.

Acute COVID infections, General COVID info

A new study shows that the nasal microbiome may boost the risk of getting a COVID infection by impacting ACE2/TMPRSS2 expression in the nasal cavity. "Having high densities of Staphylococcus aureus, Haemophilus influenzae, or Moraxella catarrhalis/ nonliquefaciens was linked to increased nasal ACE2/TMPRSS2 expression. In contrast, having high densities of Dolosigranulum pigrum was associated with decreased nasal ACE2/TMPRSS2 expression." The SARS-CoV-2 virus uses the ACE2/TMPRSS2 receptor to enter human cells.

The COVID virus may be using fibrinogen as a shield to hide itself from the human immune system. The N-terminal domain (NTD) of the SARS-CoV-2 spike protein “binds to fibrinogen, a key protein involved in blood clotting with stronger affinity than antibodies. This interaction not only helps the virus evade immune cells but may also contribute to the dangerous clotting issues seen in severe COVID-19 cases.”

From: https://pubs.acs.org/doi/10.1021/acsptsci.5c00122

This reminds me of a landmark paper from the Gladstone Institute and UCSF published in August 2024 showed that when fibrin binds to the SARS-CoV-2 spike protein, it forms proinflammatory clots that drive lung and brain damage. When fibrinogen is converted to fibrin, it exposes the inflammatory epitope on fibrin. This process suppresses natural killer cells in the lungs and triggers neuroinflammation and neuron loss in the brain. Mouse studies and in vitro models showed that these effects can be blocked by a monoclonal antibody targeting fibrin’s inflammatory epitope, offering a potential treatment for COVID-related thromboinflammation.

Pediatrics

In a study comparing 19 children aged 1 to 6 years old recovered from mild COVID infection to 22 age matched healthy controls, children who had mild COVID infections were found to have brain changes on MRI scans in the left parietal and left occipital lobes, as well as altered network topology and enlarged choroid plexus volume suggesting virus-induced neuroinflammation. This study raises concerns about long-term effects of even mild SARS-CoV-2 infection on brain development.

Viral persistence causing Hepatitis in children

A new study in Gut used advanced imaging and single-cell analysis to examine liver biopsies from children with acute hepatitis of unknown origin (AHUO) which was prevalent in pediatric patients in 2022. Researchers found significant CD8+ T-cell-driven immune infiltration and detected SARS-CoV-2 spike proteins in 11 out of 12 patients, despite all testing negative for active infection. These findings suggest that some cases of pediatric AHUO may represent a post-acute sequela of COVID-19, potentially triggered by persistent SARS-CoV-2 viral antigens. The study supports COVID-19 testing in unexplained hepatitis cases and suggests steroid treatment may help avoid liver transplants.

A large study of over 465,000 children and young adults under age 21 found that a second COVID infection more than doubled the risk of Long COVID symptoms including myocarditis, loss of taste/smell, and blood clots. The findings suggest that preventing reinfection, especially through vaccination, could help reduce long-term health risks in children.

Antiviral treatments

A group from China developed a versatile, high-throughput platform called the MoSMAR-chip to identify and analyze long-lived plasma cells (LLPCs) and memory B cells (MBCs) at the single-cell level. This tool overcomes current challenges in profiling LLPCs by using superhydrophobic microwell arrays to isolate cells, capture secreted antibodies, and perform transcriptomic and immune repertoire sequencing. Applied to SARS-CoV-2 vaccinated mice, MoSMAR-chip successfully identified broadly neutralizing antibodies and revealed insights into LLPC gene expression and long-term immune protection. This holds potential for future vaccine design.

Long COVID

Power to the people: Nature magazine reported that Long COVID activists and researchers were successful in fighting to get millions of dollars in NIH Long COVID research grants restored after cuts by the Trump administration. But, they are still concerned about potential future funding cuts.

A group from St. Petersburg studied 63 patients with Long COVID and found no major differences in antibody levels compared to recovered individuals, but showed that Long COVID patients had fewer transitional B cells which are known for their immune-regulating roles. They also had higher IL-5 and IL-13 cytokines suggesting Th2-driven immune imbalance. "We propose transitional B cells as a potential biomarker for identifying immune imbalance in affected [Long COVID] patients" pointing to a possible autoimmune mechanism of Long COVID.

​A multicenter prospective cohort study in the Netherlands followed 299 patients hospitalized with COVID, assessing their health outcomes over a three-year period. At the three-year mark, only 24% reported complete recovery, 66% experienced fatigue, 63% impaired fitness, and 59% memory problems. Post-exertional malaise (PEM) was present in 36% of patients, with higher prevalence among females, those with pre-existing pulmonary conditions, and individuals who had been admitted to the ICU.

A new randomized, placebo-controlled trial from Yale of 100 Long COVID patients found that a 15-day course of Paxlovid did not significantly improve physical health, mental health, cognitive function, or symptom burden compared to placebo. The trial did demonstrate the feasibility of large-scale decentralized research and high participant satisfaction. These results, consistent with the earlier STOP-PASC trial of 150 Long COVID patients at Stanford, suggest that short-course antivirals may be insufficient, and future research should explore longer treatment durations, combination therapies, or different mechanistic targets.

H5N1

Mexico has reported the first known human death from H5N1 avian flu in a 3-year-old girl. The source of infection remains unknown, and close contacts are under monitoring.

The U.S. now has over 1,000 H5N1 infected dairy herds and growing reports of mammalian infections, including eight additional cases in pet cats in California, Colorado, and Ohio.

Measles

As of Friday 4/11/25, 712 known measles cases have been reported in the United States this year, with 11% requiring hospitalization and 3 deaths. The actual number of measles cases is probably much higher. There have been more than 540 measles cases reported in Texas and two healthy, unvaccinated children age 6 and 8 have died of measles pneumonia.

Last year, measles cases in Europe reached their highest level in 25 years. Falling vaccination rates during the COVID pandemic led to more than 500,000 European children missing their first measles vaccination in 2023. Romania and Bosnia and Herzegovina, reported vaccination rates under 80%, well below the 95% needed for herd immunity.

Vaccination with the MMR vaccine is the best defense against Measles- a fully vaccinated person exposed to measles has a 97% percent chance of not contracting it.

Secretary of Health and Human Services Robert Kennedy Jr.

Despite Measles outbreaks spreading in the United States, and the fact that 2 doses of the MMR vaccine are 97% effective against the measles, this week RFK Jr. falsely told CBS News that measles vaccines “aren’t safety tested”. Mr. Kennedy went to an 8 year old child’s funeral after she died of measles pneumonia and took pictures with victims’ families which he tweeted promoting two “extraordinary healers” who treated 300 Mennonite children with measles using aerosolized budesonide and clarithromycin- neither of which are approved treatments for the measles.

When asked why the FDA did not approve the Novavax vaccine this week, RFK Jr. claimed single-antigen vaccines “have never worked” for respiratory diseases which is false. Scientists Drs. Paul Offit, Peter Marks, Stanley Plotkin and Michael Osterholm all disagree with Mr. Kennedy and are concerned. Plotkin said, “Obviously, if Kennedy is making decisions, that is going to hurt vaccine development. And more specifically, if decisions have to be made and those decisions are delayed or changed, then the public will suffer because [they] will not be made based on scientific decisions.”

This week, RFK Jr. also called for a ban on fluoride in tap water calling it a “neurotoxin” which is false. On April 1, Mr. Kennedy eliminated the CDC’s Lead Poisoning response team, so when Minnesota schools asked the CDC for help regarding lead exposure to children in their schools this week, the CDC told them that they had no one to help them. Lead exposure is neurotoxic especially in children and can irreversibly harm their brains and nervous systems, and can lead to lower IQ, decreased ability to concentrate and hearing and speech problems according to the CDC’s website.

On April 1, RFK Jr.'s administration eliminated the National Center for Environmental Health with widespread HHS layoffs. In addition to eliminating the CDC’s lead poisoning investigative team, HHS layoffs dismantled the federal capacity to respond to nuclear and radiological threats, toxic spills, cancer clusters, cruise ship outbreaks and natural disasters—leaving no team in place for future environmental health emergencies.

In addition, this week Mr. Kennedy announced that HHS will determine the cause of autism by September. RFK Jr. has been a longtime anti-vaccine advocate claiming incorrectly that vaccines cause autism based on a 1998 paper that was later retracted. Decades of research have proven over and over that vaccines do not cause autism.

Public health groups are calling for HHS Secretary Robert F. Kennedy Jr. to resign or be fired, citing deep budget cuts, anti-science rhetoric, and actions that undermine public health programs. The American Public Health Association and Treatment Action Group criticized Kennedy for weakening efforts to fight measles, HIV, hepatitis C, and TB, while a biomedical coalition warned the FDA's capacity is collapsing due to staff cuts and hiring freezes. Critics say Kennedy’s leadership threatens both public health and innovation in medicine.

The Power of Vaccines in 5 Charts

An article in Nature entitled “154 Million Lives and Counting: 5 Charts Reveal the Power of Vaccines” presented how effective vaccination has been in the last 50 years to prevent diseases and suffering. Many physicians have never seen a measles infection, or polio, or other vaccine preventable diseases because vaccines work so well. Childhood vaccines save lives as shown in the charts below.

From: https://www.nature.com/articles/d41586-025-00862-1

A new study in Nature used a large-scale simulation to model how exposure to vaccine misinformation on social media can accelerate the spread of infectious diseases like COVID-19. Vaccine misinformation could have led to a 14% increase in COVID infections- nearly 47 million extra cases in the U.S. alone. The findings highlight the profound public health risks of online misinformation and suggest urgent action is needed from both policymakers and social platforms.

Other Government news

4/10/25 FDA Announces Plan to Phase Out Animal Testing Requirement for Monoclonal Antibodies and Other Drugs https://buff.ly/60ljXyX

The FDA plans to replace animal testing for drug toxicity tests with “AI-based computational models of toxicity” and organoid toxicity testing.

4/11/25 CBS: National Oceanic and Atmospheric Administration (NOAA) could face 25% budget cut, slashing climate research, under draft proposal https://buff.ly/iraUeNa

4/5/25 Wired: DOGE Is Planning a Hackathon at the IRS. It Wants Easier Access to Taxpayer Data https://buff.ly/GGtRgTQ

3/28/25 Wired: DOGE Plans to Rebuild Social Security Administration (SSA) Code Base in Months, Risking Benefits and System Collapse https://buff.ly/0X2hx3y

4/9/25 Reuters: US to screen social media of immigrants, rights advocates raise concerns https://archive.is/fetVd

4/10/25 WSJ: Trump Administration Wants to Install Federal Oversight of Columbia University https://archive.is/s6lRc

Other news

It turns out that mitochondria, which are organelles in a cell that make energy, can actually be transferred to other cells if needed. Mitochondria move between different cells in 3 ways- through nanotubes, in extracellular bubble-shaped vesicles, or by free floating through the blood. Donating mitochondria to another cell may help to repair damaged cells, support immune function, and even aid in healing after stroke or injury.

From: https://www.nature.com/articles/d41586-025-01064-5

Researchers at Tulane University have developed a low-cost, handheld device that can diagnose tuberculosis (TB) from saliva, blood, or sputum in under an hour without lab equipment. The device showed high sensitivity (81%) and specificity (94%) in detecting TB, meeting WHO targets and outperforming more expensive tools. This innovation could significantly improve TB diagnosis in low-resource settings.

Blanche Hoschedé-Monet, Claude Monet's stepdaughter, was a gifted Impressionist painter in her own right who learned alongside him and created many remarkable works of the same outdoor subjects. Delighted by her enthusiasm for painting, Claude Monet took Blanche with him on his open air painting sessions where she helped him by carrying his canvases and easel and by rowing his boat for plein air work. A new exhibition at the Eskenazi Museum of Art in Indiana is showing Blanche Hoschedé-Monet’s impressionist works.

Photo: Art Institute of Chicago, left: Claude Monet, right: Blanche Hoschedé-Monet

Have a good week,

Ruth Ann Crystal MD