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Should I be worried about bird flu? How do humans get bird flu? What's the stomach virus going around? What happens if you drink alcohol daily?
AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, discusses alcohol’s link to cancer, the latest bird flu news, flu season trends, and the rise of norovirus. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association
Transcript
Garcia: We learned that a patient in Louisiana who had been hospitalized with severe H5N1 bird flu has now died. This was the first severe case of bird flu we've seen in this country. And we think also it's, tragically, the first human fatality here.
Unger: Hello and welcome to the AMA Update video and podcast. Today we have our weekly look at the headlines with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer. Andrea, welcome back. I hope you enjoyed your holiday. And it's good to have you back on the show.
Garcia: Happy New Year. It's great to be here.
Unger: Well, a lot's happened, not surprisingly, since we talked in mid-December. And one of the more notable headlines came from the Surgeon General himself about alcohol and its dangers. Tell us a little bit more about that.
Garcia: Well, Todd, this was really covered by all major news outlets. The New York Times, the Washington Post, CNN are really kicking off the new cycle this year. And last Friday, the U.S. Surgeon General, Dr. Vivek Murthy, issued an advisory noting that alcohol is a leading preventable cause of cancer. And that report calls for updates to the surgeon general's warning label on alcohol-containing beverages to now include cancer risk.
That current surgeon general's warning on alcoholic beverages warns of drinking while pregnant or before driving and operating other machinery. It also mentions general health risks. But there is no specific mention of cancer. And according to the surgeon general, alcohol directly contributes to 100,000 cancer cases and 20,000 related deaths each year.
Those current labels do not adequately warn of the specific risks related to consuming alcohol and cancer. So he's calling for updated messaging. That includes a heightened risk of breast cancer, colon cancer, and at least five other malignancies now linked by scientific studies to alcohol consumption.
Unger: Wow, that is big news. And I know we've certainly heard about this connection. But we've also heard different viewpoints that "moderate drinking is OK" and it may be beneficial to be to prevent heart attacks and strokes. How do we reconcile these two sides of this in relation to the cancer risk the surgeon general is now talking about?
Garcia: Well, I think there is no question that heavy alcohol consumption is harmful. And as you pointed out, there have been—there's been a perception that maybe moderate drinking is OK and it may even reduce cardiovascular disease, which we know is the leading cause of death in the United States. But growing research has linked drinking alcohol, sometimes even within the recommended limits, to various types of cancer.
And in fact, in the New York Times article, Dr. Murthy is quoted as saying many people out there assume that as long as they're drinking at the limits or below the limits of current guidelines—so one a day for women, two for men—that there is no risk to their health or well-being. But the data does not bear that out for cancer risk.
And then he goes on to explain that while most cancer deaths occur at drinking levels that exceed the current recommended dietary guidelines, the risk for cancers of the breast, the mouth and the throat may rise with consumption of as little as one drink per day, or even less. So I think the narrative around alcohol is really beginning to change.
Unger: Absolutely. And I'm curious, this movement to update the labels—what's it going to take to get something like that done? Seems like a big job.
Garcia: I think there continues to be more research linking alcohol to cancer. At this point, I think it's going to be a challenge to update that warning label. Any change in the label would have to be authorized by Congress.
And to provide some perspective, the current warning label has not changed since it was adopted in 1988, even though that link between alcohol and breast cancer specifically has been known for decades. And this is true globally, as well, not just in the U.S.
While the WHO has said there is no safe limit for alcohol consumption and we know that 47 nations require warning labels on alcoholic beverages, cancer is rarely mentioned. To date, only South Korea has a warning label about liver cancer, though manufacturers can choose alternative labels that don't mention cancer. And Ireland is slated to introduce labels that say there is a direct link between alcohol and fatal cancers in 2026. But few others have really followed suit. And I think given this, it's easy to see why many Americans are unaware of that link between alcohol and cancer.
Unger: Absolutely—unaware, confused. So this is an important moment in time to gain clarification. Where does the AMA stand on this, Andrea?
Garcia: Well, the AMA issued a press release credited to AMA President Dr. Bruce Scott applauding the surgeon general's work to make completely clear the link between alcohol consumption and increased cancer risk. As that press release says, for years, the AMA has said that alcohol consumption at any level—so not just heavy alcohol use or addictive alcohol use—is a modifiable risk factor for cancer.
And yet despite decades of compelling evidence of this connection, too many in the public remain unaware of alcohol's risk. The AMA said the advisory, coupled with a push to update the surgeon general's health warning label on alcoholic beverages, will bolster awareness, improve health and save lives.
Unger: Well, that is certainly good to know. And of course, physicians play such a critical role in educating their patients about these risks—making me feel better about being—doing Dry January this year, too.
So Andrea, let's turn to another topic that continued to make headlines over the holidays. And that is bird flu. It seems the news is getting worse. What's going on?
Garcia: Well, the most recent headline came earlier this week, when we learned that a patient in Louisiana who had been hospitalized with severe H5N1 bird flu has now died. This was the first severe case of bird flu we've seen in this country. And I think also it's, tragically, the first human fatality here.
According to media accounts, that patient was older than 65 and did have underlying medical conditions. The patient reportedly became infected with the virus after exposure to a backyard flock and wild birds. This is a different genotype of the virus than the one that's been detected in dairy cows. The CDC says there's still no sign that the virus is spreading from person to person anywhere in the country.
And Louisiana officials have not identified any other cases in the state. In a New York Times article, one virologist reminded us that it's important that people remain vigilant and they avoid contact with sick animals, sick poultry, sick dairy cattle and also avoid contact with wild birds.
Unger: Andrea, I know there's been some concern that as the virus continues to infect people—that it could mutate. Have we seen any evidence that that might be happening?
Garcia: Yeah, Todd. Actually, late last month, the CDC said its analysis of samples from that Louisiana patient showed mutations that had not been seen in samples from that infected backyard flock on the patient's property. The patient's sample showed mutations in the haemagglutinin gene—so the part of the virus that plays a key role in attaching to host cells. So this suggests that the mutation developed within the patient as their illness progressed.
One of these mutations was also present in the virus sampled from a 13-year-old Canadian girl. If you recall that case, she too was seriously ill, hospitalized, required respiratory support. Thankfully, she has since recovered.
Again, both of these patients carried a version of the virus that is circulating in wild birds. It's distinct from the one that's causing an outbreak in dairy cattle. And although these are isolated cases, some experts worry that when taken together, they point to the potential for that virus to evolve into more dangerous forms. This doesn't change the CDC's current assessment of risk. But it's certainly something that we're continuing to watch closely.
Unger: Well, thank you so much for the update on bird flu. Unfortunately, it isn't the only virus of concern right now. We've seen numbers increasing across the country for other respiratory viruses, too. Andrea, where do things stand right now?
Garcia: Well, according to reports by the Associated Press, sick season is now in full force. And CDC data suggests that influenza in particular is spreading across the U.S. In late December, 40 states reported high or very high levels of illness.
Dr. Carrie Reed, who's a spokesperson with the CDC, said the most recent CDC hospitalization data and other indicators show that flu virus is trending higher than other viruses, such as COVID or RSV. Several seasonal flu strains are driving cases. Those include H1N1 and H3N2.
Flu activity has been particularly intense in the South, the Southwest and the Western U.S. And the states reporting lesser amount of virus were mostly in the Northern Great Plains and New England. Looking at exact numbers so far this season, the CDC's estimating there have been at least 5.3 million flu illnesses, 63,000 hospitalizations and 2,700 deaths, including at least 11 children.
Unger: Wow. Andrea, how does that compare to other winter virus seasons that we've been through?
Garcia: Well, Todd, it's definitely too soon to tell if this winter will be worse than others. But health officials continue to recommend that everyone six months and older get their updated flu and COVID vaccination. They also remind people to avoid touching their eyes, their nose, their mouth and to be really vigilant with handwashing. And also, cleaning frequently touched surfaces is also always a good idea.
Unger: It's my personal motto. Don't touch anything. That's my strategy for the entire winter season. So these are all good things to know. Andrea, before we wrap up, any other viruses that we need to keep an eye on?
Garcia: Well, the one we haven't mentioned is norovirus. And as a reminder, that's a particularly nasty stomach bug. CDC's been tracking the rise of illnesses from norovirus, with 91 outbreaks reported in early December alone. So that's another virus that we continue to watch as well.
Unger: Yes, I've heard. It's making its way through many families in my social circle. And definitely be on the lookout for that. Well, Andrea, that wraps up this week's episode. As always, thanks so much for being here and sharing your perspective.
If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join. You can always find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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