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How many measles cases in 2025? Should you go to the hospital for measles? When did COVID start? How long can long COVID last? Why are microplastics bad?
Covering the latest measles outbreak news, recent flu vaccine meeting updates, plus new studies on long COVID and the health effects of microplastics on the body with AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH. 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: Back in December, there was a research letter published in JAMA Network Open about the prevalence of long COVID. The study in that research letter found that, in 2023, over 8% of adults in the U.S. reported that they ever had long COVID, and 3.6% of people currently had it.
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, Andrea.
Garcia: Thanks, Todd. Happy to be here.
Unger: Well, let's start, as we have, in recent weeks by checking in on the measles outbreak in Texas and New Mexico. Andrea, what are the latest updates?
Garcia: Well, Todd, starting nationally, as of March 13, there were a total of 301 confirmed measles cases reported by 15 jurisdictions. So just three months into the year, we've surpassed last year's total number of measles cases. One of the most notable updates in that West Texas and New Mexico outbreak is that it's no longer confined to just Texas and New Mexico.
The Oklahoma State Department of Health has indicated that they have four probable cases of measles in the state. The agency said that the individuals were unvaccinated and reported exposure associated with that outbreak in Texas and New Mexico. The health department said the public may have been exposed to measles at five public locations. And they're urging people who have been exposed or who have symptoms to report this to the health department and then to exclude themselves from public settings.
Unger: Andrea, do public settings include doctor's offices and emergency rooms?
Garcia: Well, you should definitely call first before showing up at your doctor's office or the emergency department so that they know that you're coming in and can prepare to limit exposure to other patients.
Unger: All right. Well, what about the latest case counts in Texas and New Mexico. Where do they stand?
Garcia: Well, as of last Friday, the cases in Texas have risen to 259. That's up from 198 when we talked last week. In New Mexico, as of last Thursday, there were 33 cases, which is up from 30 the week before. However, we're starting to see more cases across the country, many of them linked to international travel.
There have been cases in LA, Philadelphia and New York, as well as cases in Maryland, Michigan and Washington state. With spring break and summer travel season about to be in full swing, we'll likely continue to see more of those cases. So if you are planning to travel to an area with an ongoing outbreak or internationally, it is important to make sure you're up to date on MMR vaccinations.
Unger: And again, that advice from Andrea, before you head to your physician's office or an emergency room, if you suspect that you have measles, make sure to phone ahead so they can take the proper precautions. Andrea, also driving headlines recently was the fact that it has been, believe it or not, five years since COVID-19 was declared a pandemic. What does this milestone mean for us?
Garcia: Well, Todd, in some ways, it's hard to believe it's been five years. We know that much has changed in that time, and the pandemic was certainly an incredibly difficult time for so many, including many of our physician members who were on the front lines treating patients. But we do now have an annual COVID vaccine, which provides strong protection against serious illness, hospitalization and death.
We have a better idea of when to expect COVID surges, which typically occur in the summer and winter. We've seen expanded use of telehealth, of at home testing. But on the other hand, that uptake of the latest COVID vaccine remains low as we discussed last week. And COVID was the 10th leading cause of death in the U.S. last year, according to the CDC.
There's also the issue of long COVID, which we're obviously still grappling with, how to effectively diagnose and treat it. This milestone is definitely, I think, one of mixed feelings as far as we've come over the past five years. We still have a ways to go, and I think it's really important that we not forget those lessons learned from the pandemic.
Unger: And just for our viewers to note, long COVID researcher doctor Akiko Iwasaki will be joining us again in the coming weeks to talk more about the current state of long COVID. In the meantime, Andrea, what do we know about how many people have had long COVID so far?
Garcia: Todd, like the milestone we just talked about, the answer to your question is somewhat complicated. Back in December, there was a research letter published in JAMA Network Open about the prevalence of long COVID. The study in that research letter found that, in 2023, over 8% of adults in the U.S. reported that they ever had long COVID, and 3.6% of people currently have it.
Among those who currently had long COVID, nearly 65% experienced symptoms that limited their activity. Other studies have found higher rates of long COVID, and part of what makes this so complicated is the wide range of symptoms that people can experience and the varying definitions of long COVID. I think, needless to say, more research is needed in this area so we can help patients who are experiencing long COVID.
Unger: We'll be sure to keep people up to date as new research becomes available. Going back a few weeks now, we reported that the FDA canceled a meeting where the strains for the next season's flu vaccines were to be determined. Andrea, tell me there must be updates since then.
Garcia: There has been, Todd, and last Thursday, the FDA made recommendations to two manufacturers on the virus strains that should be used in the flu vaccine for the 2025-26 flu season. They convened public health experts from the FDA, the CDC and the Department of Defense for this discussion. Their recommendation was made following that review of U.S. and global surveillance data.
And in that announcement, the FDA said that it did not anticipate any impact on the timing or availability of the flu vaccine and that its recommendations were similar to the previous year. I will link to the FDA announcement in this episode description so people can learn more about the specific formula that was recommended.
Unger: Andrea, another topic we covered earlier this year was the health impact of wildfires. There's a new study now talking about the impact that they can have on cancer treatment. Tell us more about that.
Garcia: Well, this study was published in the Journal of the National Cancer Institute. It found that patients recovering from lung cancer surgery in an active wildfire zone required longer hospital stays. Specifically, hospital stays for these patients were nearly two days longer on average than for those who were not exposed to a wildfire disaster. One of the reasons the researchers cited for this is that health care professionals could be reluctant to discharge patients into a hazardous environment. Without clear guidelines on what to do, clinicians look for ways to keep their vulnerable patients safe.
Unger: Well, that makes sense. But what are the implications of something like this?
Garcia: Well, there are a couple of things to consider. Obviously, these longer hospital stays could increase a patient's risk of developing a hospital-acquired infection. They also increase the overall cost on the health care system and potentially on patients themselves. Ultimately, the study's findings point to a real opportunity to update guidelines on how we're thinking about discharging patients during a wildfire or another extreme weather event or disaster.
Unger: Wildfires are increasingly something that almost every physician needs to think about in some way these days. Another issue we're starting to pay even more attention to is microplastics. A recent study showed that they might contribute to antimicrobial resistance. Andrea, tell us more about that.
Garcia: Well, Todd, this study appeared in Applied and Environmental Microbiology. Its findings add yet another concerning layer to the risk posed by microplastics, and it suggests that there's an interaction between microplastics and bacteria that influences the development of antimicrobial resistance.
To study this, the researchers exposed E. coli grown in liquid media to various types and sizes of microplastics at different concentrations. They then added in four different antibiotics commonly found in the environment and tested the sample for antibiotic susceptibility every two days. Within 10 days, they found that exposure to microplastics resulted in increased resistance to all four antibiotics. That was compared to E. coli without microplastics.
Unger: It seems pretty mysterious. Andrea, did the study offer any reason for the results that we're seeing?
Garcia: The researchers did investigate this further, and they used a specialized form of standard fluorescence microscopy to visualize the surface of the E. coli grown with microplastics. What they found was that these samples had significantly more biofilm growth than those without microplastics, and this biofilm causes cells to display increased resistance to antibiotics.
And you've previously talked with physicians about that threat of antimicrobial resistance. We know it's one of the world's most pressing health crises, and the proliferation of microplastics in the environment could certainly make that problem even worse. Like our discussion on long COVID, our understanding of the health implications of microplastics still has a long way to go. It's definitely an area we'll be paying close attention to over the coming years.
Unger: My worry list just keeps getting longer. Andrea, there's just a lot to keep track of. We appreciate you being here to keep us all up to date. 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 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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