Mike Russo

*correlate of protection

Also there’s no serologic correlate of mumps. IgG is more or less useless for telling whether someone is protected

Documented two doses of MMR (or VZV) trump any serologic testing for measles or varicella IgG. Commerically available tests are not sensitive enough and will be false negative in about 1/3 of vaccinated individuals.

Thursday?

Learn some new shitty thing everyday

Opinion | Let’s try something different in how we deal with polio Finding middle ground is hard. Why not just give ground instead!

some thoughts on the rush to compromise wapo.st/40h75BM

Been a long time reader of SBM but I missed this! Bookmarking to share with our learners. @andrewhaynes.bsky.social had a good discussion of this at IDWeek the other year too

Kitten

I will not abide by this feline slander

This is why clinical trials are important. Unfortunately tecovirimat did not improve resolution of clade IIb mpox compared to placebo.
There are currently no effective antivirals for the treatment of mpox and this is an urgent need. Disappointing result but at least we know.

The dramatic changes this has brought have been humbling to witness. Hope for improved access worldwide and modulators for those with rarer mutations next.

Just because it has a name, doesn’t mean we have to try to kill it.

What’s your azithromycin resistance rate these days? Pretty high up here

8/8 None of this would have been possible without strong public health agencies and the people who work there. This is another example of what we stand to lose by appointing individuals that would gut and destroy the very agencies they’d lead.

Donor-Derived Bartonella quintana Infection in Solid Organ Transplantation: An Emerging Public Health Issue With Diagnostic Challenges In 2023, multiple cases of donor-derived Bartonella quintana, a louse-borne bacterium, were acquired in Canada and the United States from deceased donors w

7/8 Subsequently, another cluster was identified in Alberta, Canada. This has all lead to wider knowledge of this issue and discussion on ways to move forward

academic.oup.com/ofid/article...

6/8 This led to rapidly identifying subclinical Bartonella quintana (probable) endocarditis in another organ recipient. Additional testing of banked donor specimens confirmed infection with B. Quintana, cinching the link.

5/8 After a report to OPTN and an email on the Emerging Infections Network, CDC and local DOH’s rapidly responded and initiated an investigation involving content experts, local OPOs, and laboratory partners as well. This was an incredible team effort and public health at its best!

Liver biopsy of a kidney transplant recipient with a Bartonella quintana infection linked to a donor who experienced homelessness, United States, 2022. A) Fibrovascular proliferation accompanied by few inflammatory cells. Magnification ×200. B) Myxoid stroma that contains clumps of granular material (arrows). Magnification ×400. C) Warthin-Starry stain highlights clumps of bacilli (arrows). Magnification ×400.

4/8 An eventual excisional liver biopsy revealed vascular-proliferative lesions. The pathologist astutely was concerned for peliosis hepatis and performed a Warthin Starry stain which was teeming with bacilli and a Bartonella PCR was positive.

A) Multiple enhancing T2 hyperintense lesions throughout the hepatic parenchyma. B) Numerous enhancing T2 hyperintense lesions affecting cervical, thoracic, and lumbar vertebrae.

3/8 Our index kidney transplant patient presented with fevers and abdominal pain and was found to have lesions in his liver, spleen, and vertebral bodies.

2/8 This is a story of transplant ID, but more so a story of public health agencies and what we stand to lose. It was one of the proudest moments of my career to be involved with so many folks who came together to decipher these cases.

<em>Bartonella quintana</em> Infection in Kidney Transplant Recipients from Donor Experiencing Homelessness, United States, 2022 <em>B. quintana</em> Infection from Kidney Donor

1/8 Our report of the first confirmed cases of transplant derived Bartonella quintana infection and the public health investigation surrounding them has been published!
#medsky
#idsky
#publichealthsky
#txid

wwwnc.cdc.gov/eid/article/...

What the hell?! Who’s next, Dr. Pepper?

“Measles, stand back and stand by,” sums all of *this* up pretty well…

If You Sanewashed RFK Jr., Or If You Sanewashed Doctors Who Did, You Own the Next 4 Years | Science-Based Medicine When RFK Jr. does to the U.S. what he did to Samoa, doctors will say they are horrified, that they love vaccines, blah blah blah. But it will be too late.

We can pray he won’t get confirmed. But if he does, doctors who’s normalized RFK Jr. own the next 4 years.

So do the doctors who normalized these cranks and charlatans.

My latest for SBM.

sciencebasedmedicine.org/ownit/

Too late

But don’t the data argue that there aren’t local (or accessible) ID specialists for many patients?

Lol

It worked!!

6. Causes brick red stools and may cause young interns to freak out overnight (my villain origin story)!

5. More expensive than say cephalexin or amoxicillin

4. Less really excreted than other beta lactams, particularly in children! Better options for UTI!