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Can you stay healthy when traveling? How many measles outbreaks in 2025? Which countries have measles? What is immune amnesia? What is sleep maxxing?
Discussing rising measles cases globally, avian flu in chickens, dengue fever news, immune amnesia, and how to get better sleep with the latest sleep trend in 2025 with AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH. American Medical Association CXO Todd Unger hosts.
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Speaker
- Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association
Transcript
Garcia: To put this into more context, we're at 378 confirmed measles cases reported by 18 U.S. jurisdictions. We've already surpassed what we saw in all of 2024. This is not an encouraging trend, and in the short term, it seems like it's going to get worse.
We did hear one public health official in Lubbock, Texas, say that the outbreak there is still growing. And getting through the entire outbreak could take as long as a year.
Unger: Hello and welcome to the AMA Update video and podcast. Today is our weekly look at the public health issues facing physicians and patients across the country. With the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer. Welcome back, Andrea.
Garcia: Thanks, Todd. Happy to be here.
Unger: Well, Andrea, we've got lots to cover this time, and we'll start with the bird flu. We've been keeping a close eye on the new bird flu cases for a while now. And last week, there was an outbreak in Mississippi that drove headlines. Tell us more about it.
Garcia: Well Todd, the Mississippi Board of Animal Health has reported a highly pathogenic avian flu outbreak in commercial poultry. This outbreak involves the H7N9 strain of bird flu. It's a virus type that hasn't been identified in poultry in the U.S. since 2017.
This latest outbreak began back on March 8, and it went on to affect more than 47,000 birds. State veterinarians have quarantined the affected premises, and the birds have been depopulated to prevent spread of the disease.
Unger: Andrea, obviously, it's appeared before, this different type of strain, back in 2017. Is this just coincidence that we're seeing this again and noticing it because we're looking?
Garcia: Well, Todd, that could definitely be a part of it. And this was the H7N9 strain, is different than the H5N1 strain that we have been seeing really drive the large outbreaks in commercial livestock and wild birds over the last year. The Mississippi State Department of Health hasn't confirmed any human cases, and the infected birds did not enter the food supply. And the CDC does continue to note that the public health risk associated with avian influenza remains low.
Unger: All right. Well, then that is really good news. Also, last week, we did see the CDC put out a new HAN, or Health Advisory Notice, about dengue. What's going on with that?
Garcia: Well, as the CDC noted in the health advisory, dengue activity remains high in some parts of the U.S., particularly the U.S. Virgin Islands and Puerto Rico, as well as globally. The agency is urging physicians and health departments to be vigilant for cases of dengue and to take steps to prevent and respond to them.
And as you may remember, last June, we saw the CDC issue a health advisory noting the record-breaking cases of dengue in the Americas, as well as higher than expected cases among returning U.S. travelers. Health professionals should continue to follow that guidance in the June 2024 CDC health advisory, but this new advisory does contain updated testing recommendations that clinicians should be aware of.
And we'll put the link to both of those HANs in the description of this episode. And this is especially timely because spring and summer travel definitely coincide with the peak season for dengue in many countries.
Unger: Yeah, it is bad news for spring breakers. I think as I drove down the Chicago streets, I saw about 700 families piling into Ubers on their way to the airport. And so this is probably a big concern, and there seems to be a lot going around, not just dengue. So for anybody traveling this week, what do they do to protect themselves?
Garcia: Well, Todd, dengue is spread through the bite of an infected mosquito. The best way to avoid it is to protect yourself from mosquitoes. So that means using an EPA-registered insect repellent, wearing loose-fitting, long-sleeved shirts and pants. If you are traveling to a high-risk area, you may also want to consider packing acetaminophen, which can be used to manage fever and body pain, in case you do get dengue.
Travelers who are returning from an area with risk of dengue should also then take steps to prevent mosquito bites when they return. And that's to avoid spread to mosquitoes that could then go on to infect other people. Of course, that is just one thing people traveling over spring break should be aware of.
We know that respiratory illnesses are declining. We are still seeing cases. Your risk of exposure is going to increase in those densely populated indoor areas like airports.
Unger: So besides sterilizing all the parts of the environment around me on an airplane, Andrea, is there anything that travelers can do to avoid viruses you mentioned and stay healthy throughout that travel?
Garcia: Well, Todd, in addition to being vaccinated, if you're going to be in those crowded places like airports or tourist attractions or taking public transit, consider wearing a high-quality face mask. Beyond that, one of the ways we get sick is by touching dirty surfaces and then touching our nose or mouth. So make sure you're washing your hands regularly.
This is especially important with those elevated levels of norovirus cases. And we know that using hand sanitizer can help. But be aware that that hand sanitizer alone is not going to work well against norovirus. And lastly, while you're enjoying your vacation, make sure to drink enough water, eat a well-rounded diet and get enough sleep.
Unger: We are going to have a deeper look at norovirus with Dr. Joanna Bisgrove in an upcoming episode, and one of the things she advised is make sure to wash your hands because sanitizer alone doesn't work that well against norovirus. So stay tuned for that particular program, and you'll learn all you wanted to know about norovirus.
Andrea, there are always important things to remember. Another concern that's top of mind for travelers this year is, of course, measles. The large outbreak that started in Texas is continuing to grow. What are the latest trends there?
Garcia: Well, Todd, as of Friday, those cases in Texas have risen to 309. That's up from 259 when we talked last week. In New Mexico, we're up to 42 cases, which is up from 33 the week before. And then we previously discussed that this outbreak has now also spread to Oklahoma, where there have been four cases.
And we're also continuing to see isolated cases across the U.S. due to international travel. We know that right now 57 countries are experiencing a high transmission level of measles, including Belgium, Ireland, the United Kingdom. And I think just to put this into more context, we're at 378 confirmed measles cases reported by 18 U.S. jurisdictions. We've already surpassed all of what we saw in 2024, not an encouraging trend.
And in the short term, it does seem like it's only going to get worse. We did hear a public health official in Lubbock, Texas, say that the outbreak there is still growing. And getting through the entire outbreak could take as long as a year.
Unger: Wow, that's something. So we have as many cases in the first quarter essentially of 2025 as we saw in the entire year of 2024 and a lot of work to do to get that under control. Andrea, this rise in measles has sparked a lot of conversations about longer-term consequences of measles on your health. A number of stories last week were talking about one consequence in particular called immune amnesia. Can you tell us more about what that is?
Garcia: Yeah, Todd, we're definitely seeing that more in the news, and there have been a few studies describing this theory of immune amnesia, which is when your immune system forgets how to fight off an infection that it had previously learned how to defend against. And when your immune system comes into contact with a pathogen, it usually remembers that encounter. But measles can destroy the cells that help retain those memories. So when that happens, you're no longer immune to those particular pathogens.
Unger: Andrea, how long does it take to recover from something like that?
Garcia: Well, I don't think that we know that for sure. Researchers have indicated that that could depend on the severity, and it could last anywhere from a few months to a few years. During that time, you may be more vulnerable to an infection from other diseases. So longer term, even after an outbreak ends, I think we need to be cognizant that there may be a lasting impact on a population's health.
Unger: All right. Well, thanks for breaking that down for us. And physicians out there, here is something to add to your list of things that patients might show up asking you about because they saw it on social media. It's a trend called sleepmaxxing. Andrea, what do people need to know about that?
Garcia: Well, there have been a number of stories taking a closer look at this trend. And the term sleepmaxxing is an umbrella term that was coined by social media users to describe ways to maximize the duration and the quality of your sleep. And there are a range of strategies that you'll see people talking about.
Those include taking supplements like magnesium and melatonin, mouth taping, and then even eating kiwis before bed. They also include using a white noise machine, eliminating caffeine and having a colder room temperature. So as you can see, these tips really can vary quite a bit.
Unger: Now, Andrea, I read all about these kinds of tips on social media. I see them. I'm just going to tell you right away that seeing young people interested in sleeping makes me feel less old. But I'm curious, how much of the stuff that we're reading about is science based?
Garcia: Well, as you might imagine, the amount of evidence behind these tips is just as varied as the tips themselves. So I think that being said, some of the recommendations people have shared are good sleep hygiene and do have some evidence in support. So for example, having a consistent sleep schedule or limiting daytime naps, reducing your caffeine intake in the afternoon, and then light exposure in the evening, which includes screen time, and then also sleeping in a cool environment, these are strategies that are recommended as a good place for most people to start.
Unger: Well, those make sense and hopefully easy to employ. Get off those phones, folks. Andrea, you've given us lots of good advice, as always, and I want to thank you for being here and keeping us up to date. If you're a physician and you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join.
If you're a patient, you can get involved by joining the AMA's Patient Action Network. Just look that up, and Google that. And you'll find a link to how to get involved. And as always, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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